1 1 BEFORE THE NEW YORK STATE SENATE FINANCE AND ASSEMBLY WAYS AND MEANS COMMITTEES 2 ----------------------------------------------------- 3 JOINT LEGISLATIVE HEARING 4 In the Matter of the 2016-2017 EXECUTIVE BUDGET 5 ON HEALTH AND MEDICAID 6 ----------------------------------------------------- 7 Hearing Room B 8 Legislative Office Building Albany, New York 9 January 25, 2016 10 9:35 a.m. 11 12 PRESIDING: 13 Senator Catharine M. Young Chair, Senate Finance Committee 14 Assemblyman Herman D. Farrell, Jr. 15 Chair, Assembly Ways & Means Committee 16 PRESENT: 17 Senator Liz Krueger Senate Finance Committee (RM) 18 Assemblyman Robert Oaks 19 Assembly Ways & Means Committee (RM) 20 Senator Kemp Hannon Chair, Senate Committee on Health 21 Assemblyman Richard N. Gottfried 22 Chair, Assembly Health Committee 23 Senator David J. Valesky Co-Chair, Senate Committee on Health 24 2 1 2016-2017 Executive Budget Health and Medicaid 2 1-25-16 3 PRESENT: (Continued) 4 Senator James L. Seward Chair, Senate Committee on Insurance 5 Assemblyman Kevin A. Cahill 6 Chair, Assembly Committee on Insurance 7 Senator Diane Savino 8 Assemblyman Michael J. Cusick 9 Senator Kathleen A. Marchione 10 Assemblyman Kevin A. Cahill 11 Senator Gustavo Rivera 12 Assemblywoman Jo Anne Simon 13 Assemblyman Félix W. Ortiz 14 Assemblyman Andrew P. Raia 15 Senator Roxanne Persaud 16 Assemblyman Andrew Goodell 17 Assemblyman Jeffrion L. Aubry 18 Assemblyman Phil Steck 19 Assemblyman Andrew Garbarino 20 Assemblyman John McDonald 21 Senator Martin J. Golden 22 Assemblywoman Aileen M. Gunther 23 Assemblyman Edward P. Ra 24 Assemblywoman Nicole Malliotakis 3 1 2016-2017 Executive Budget Health and Medicaid 2 1-25-16 3 PRESENT: (Continued) 4 Assemblyman Thomas J. Abinanti 5 Senator John DeFrancisco 6 Assemblywoman Shelley Mayer 7 Assemblyman David Weprin 8 Senator Phil M. Boyle 9 Assemblyman Raymond Walter 10 Senator Susan Serino 11 Senator Velmanette Montgomery 12 Assemblywoman Latrice Walker 13 14 15 16 LIST OF SPEAKERS 17 STATEMENT QUESTIONS 18 Howard Zucker, M.D., J.D. Commissioner 19 NYS Department of Health -and- 20 Jason Helgerson NYS Medicaid Director 10 17 21 Dennis Rosen 22 Medicaid Inspector General NYS Office of the Medicaid 23 Inspector General 252 261 24 4 1 2016-2017 Executive Budget Health and Medicaid 2 1-25-16 3 LIST OF SPEAKERS, Continued 4 STATEMENT QUESTIONS 5 Dennis P. Whalen President 6 Healthcare Association of NYS 284 292 of NYS (HANYS) 7 Kenneth Raske 8 President Greater New York Hospital 9 Association (GNYHA) 310 319 10 Laura Haight Vice President of Public Policy 11 Bader Reynolds Board Member 12 NYS Association of Health Care Providers 320 331 13 Elizabeth Dears, Esq. 14 Senior VP/Chief Leg. Counsel Medical Society of the 15 State of New York 338 16 Stephen B. Hanse, Esq. Vice President & Counsel, 17 Governmental Affairs Deanna Stephenson 18 Director, Managed programs NYS Health Facilities Assn., 19 NYS Center for Assisted Living 344 356 20 Ami J. Schnauber VP, Advocacy & Public Policy 21 LeadingAge New York 359 22 Beverly Grossman Senior Policy Director 23 Community Health Care Association of NYS 369 376 24 5 1 2016-2017 Executive Budget Health and Medicaid 2 1-25-16 3 LIST OF SPEAKERS, Continued 4 STATEMENT QUESTIONS 5 Steven Sanders Executive Director 6 Agencies for Children's Therapy Services 378 386 7 Joanne Cunningham 8 President Home Care Association of NYS 401 410 9 Paul Macielak 10 President & CEO NY Health Plan Association 411 11 James Lytle 12 Counsel NYS Coalition of Managed Long 13 Term Care and PACE Plans 421 14 Julie Hart Director, Government Relations 15 American Cancer Society Cancer Action Network 427 435 16 Ted Okon 17 Executive Director Community Oncology Alliance 18 -and- Maryann Roefaro 19 CEO Hematology-Oncology Assn. 20 of Central New York 436 450 21 James Kane Treasurer 22 Empire State Association of Assisted Living 453 23 24 6 1 2016-2017 Executive Budget Health and Medicaid 2 1-25-16 3 LIST OF SPEAKERS, Continued 4 STATEMENT QUESTIONS 5 Roger Paganelli President 6 Kathy Febraio Executive Director 7 Pharmacists Society of the State of New York 464 470 8 Michael Duteau 9 President Chain Pharmacy Association 10 of New York State 471 11 Susan Zimet Executive Director 12 Hunger Action Network of NYS 476 486 13 Dr. Bryan Ludwig Albany District President 14 New York Chiropractic Council 490 15 Renée Nogales NY Business Development Manager 16 Nurse-Family Partnership 495 17 Kim Atkins Board Chairman 18 Family Planning Advocates of NYS 499 19 Frank Kruppa Vice President 20 Linda Wagner Executive Director 21 NYS Association of County Health Officials 505 22 Kathleen Callan 23 Assistant Director NYS Area Health Education 24 Center System 508 7 1 2016-2017 Executive Budget Health and Medicaid 2 1-25-16 3 LIST OF SPEAKERS, Continued 4 STATEMENT QUESTIONS 5 Leslie Grubler Founding Director 6 United NY Early Intervention Providers and Parents as 7 Partners (UNYEIP) 512 518 8 Dan Lowenstein Senior Director, Public Affairs 9 Primary Care Development Corp. 519 523 10 Bryan O'Malley Executive Director 11 Consumer Directed Personal Assistance Association of NYS 526 533 12 Amy Lowenstein 13 Senior Attorney Empire Justice Center 535 546 14 Bridget Walsh 15 Senior Policy Analyst, Health and Public Health 16 Schuyler Center for Analysis and Advocacy 549 17 Lara Cassel 18 Coordinator Medicaid Matters New York 555 19 Bob Cohen 20 Policy Director, Citizen Action of New York 21 Health Care for All New York 564 22 Henry Garrido Executive Director 23 District Council 37, AFSCME 569 24 8 1 CHAIRMAN FARRELL: Good morning. 2 Today we begin the second in a series of 3 hearings conducted by the joint fiscal 4 committees of the Legislature regarding the 5 Governor's proposed budget for fiscal year 6 2016-2017. The hearings are conducted 7 pursuant to Article 7, Section 3 of the 8 Constitution and Article 2, Sections 31 and 9 32A of the Legislative Law. 10 Today the Assembly Ways and Means 11 Committee and the Senate Finance Committee 12 will hear testimony concerning the budget 13 proposal for health and Medicaid. 14 I will now introduce the members from 15 the Assembly, and Senator Young, chair of the 16 Senate Finance Committee, will introduce 17 members from the Senate. 18 We have been joined by Assemblyman 19 Richard Gottfried, chair of the Health 20 Committee; Assemblyman Michael Cusick, 21 Assemblyman McDonald, Assemblyman Steck, and 22 Assemblyman Oaks, who will give us -- 23 ASSEMBLYMAN OAKS: Yes, we've also 24 been joined by Assemblyman Raia, Assemblyman 9 1 Garbarino, Assemblyman Goodell, and 2 Assemblywoman Malliotakis. 3 CHAIRMAN FARRELL: Senator? 4 CHAIRWOMAN YOUNG: Thank you very 5 much. 6 And good morning to my colleagues here 7 at this Health Committee hearing. And also 8 to the people who are in the audience, we 9 welcome you. As you know, this is one of the 10 most important areas of the State Budget and 11 also it's the most extensive area, in many 12 ways, of the State Budget. And it impacts so 13 many lives across our entire state. And so 14 we expect to have very good discussions this 15 morning, and probably into the afternoon -- 16 hopefully not into the evening, though. But 17 you never know. 18 I'd like to welcome my colleagues 19 Senator Kemp Hannon, Senator Jim Seward, 20 Senator Kathy Marchione, Senator David 21 Valesky, Senator Diane Savino, and Senator 22 Marty Golden. 23 And I'd like to turn it over to my 24 colleague Senator Liz Krueger. 10 1 SENATOR KRUEGER: Thank you very much. 2 I'd like to welcome our Ranking 3 Senator Gustavo Rivera, and our newest 4 Senator, Roxanne Persaud. 5 CHAIRMAN FARRELL: Before introducing 6 the first witness, I would like to remind all 7 of the witnesses testifying today to keep 8 your statement within your allotted time 9 limit so that everyone can be afforded the 10 opportunity to speak. If we do it well, 11 we'll be out of here by 6:30. 12 (Laughter.) 13 CHAIRMAN FARRELL: That's something we 14 don't have to meet, that point. 15 We're joined today, we begin with 16 Dr. Howard Zucker, commissioner of the 17 New York State Department of Health. 18 Good morning. 19 COMMISSIONER ZUCKER: Good morning. 20 Good morning, Chairpersons Young, 21 Farrell, Hannon and Gottfried, and 22 distinguished members of the State Senate and 23 Assembly. I am pleased to be here today to 24 discuss Governor Andrew Cuomo's 2016-2017 11 1 Executive Budget as it relates to the goals 2 of the Department of Health. 3 There is a great deal of good news to 4 share with you this morning. The commitment 5 Governor Cuomo has made to protect and 6 improve public health is significant. 7 I'd like to begin by discussing the 8 accomplishments of the State Medicaid 9 Redesign Team, which has had extraordinary 10 success in overhauling the largest and most 11 expensive Medicaid program in the nation. 12 When Governor Cuomo established the 13 MRT, our program cost twice the national 14 average per recipient, yet it was 15 consistently ranked below other states on 16 several measures of care quality. Even 17 worse, it was growing at an unsustainable 18 rate of 4.3 percent annually. Today, 19 Medicaid spending per recipient has dropped 20 to its lowest level in 13 years, and the rate 21 of spending growth has slowed to just 22 1.4 percent annually. At the same time, we 23 have increased enrollment to 6.3 million 24 people and improved the quality of care in 12 1 communities across the state.