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POLITICO New York Health Care: De Blasio's public health record examined -- Cuomo carves out school-based health centers -- Cuomo vetoes SSI increase and enhanced safety net bill

By Dan Goldberg | 12/20/2017 09:59 AM EDT

PROGRAMMING NOTE: POLITICO New York Health Care will not publish from Dec. 25-Jan. 1. Our next POLITICO New York Health Care newsletter will publish on Tuesday, Jan. 2. Please continue to follow New York health care issues here.

A HEALTH CHECK FOR DE BLASIO — Mayor Bill de Blasio doesn't talk much about health care. His signature achievements — the ones he points to when discussing his legacy, the ones he ran on during his campaign for reelection — are in education and affordable housing. That has invited comparisons to his predecessor, Mayor Michael Bloomberg, who was much more vocal about the importance of public health and pushed a set of policies — not always successfully — that put New York City at the vanguard of the nation. As de Blasio readies for a second term, he faces little public criticism over how he has handled public health. But the lack of animating ideas that advocates grew used to under Bloomberg has invited concern the mayor may not be as aggressive as he could in the public health arena.

... The mayor's defenders say that to see the totality of his public health achievements, you have to broaden the lens to include policies that don't typically fall under the rubric of health. De Blasio's signature pre-K program may prove to do more for public health than anything else the administration achieves. Housing is among the most important predictors of health and the mayor has an ambitious affordable housing plan. The problem with the broad public health lens argument is that the mayor's defenders cling to it only when it works in their favor. If Vision Zero is a public health success because safer streets make it easier for people to walks, then the mayor's opposition to congestion pricing, which Bloomberg supported and linked to reducing asthma rates, should be viewed as a public health failing. So should his punting on supervised injection facilities, which could help reduce opioid-related deaths. So, too, his politically expedient, short-lived deal with certain Orthodox Jews who practice metzitzah b'peh, a controversial practice during which the mohel suctions blood from the open wound, which has been linked to neonatal herpes. Read my whole story here.

SESSION IS COMING — There's less than two weeks to go before lawmakers return to Albany for the start of the 2018 legislative session. We want to hear your top priorities, budget asks and nonstarters, and how this all plays out with the 2018 election in the background. Reach out to Nick at nniedzwiadek@politico.com or call him at 518-703-6135.

MAKE SURE YOU FOLLOW Dan on Twitter @DanCGoldberg and Nick @NickNiedz. And for all New Jersey health news, check out @katiedjennings.

WE'D LOVE TO HEAR FROM YOU: This roundup is for you, so please tell us how we can make it even better. Send tips, news, ideas, calendar items, releases, promotions, job postings, birthdays, congratulations, criticisms and corrections to dgoldberg@politico.com.

BILL TRACKER — Gov. Andrew Cuomo vetoed legislation that would have increased the Supplemental Security Income rate by $4 per resident, per day for the next five years — a total of $20 per day by 2022. Operators of adult homes had been hoping that Cuomo would approve the first rate increase since 2007 and the second increase since 1992. In his veto message , Cuomo said this was one of a series of bills that would add hundreds of millions of dollars in "unbudgeted costs" and that increased payment rates should be negotiated during the budget sessions. The current rate is $41 per day, per resident, paid for by both the state and federal government. The federal portion has increased incrementally over the years, but the state's contribution has remained the same for a decade. Read more here.

... School-based health centers will be carved out of Medicaid managed care until 2021 under an agreement reached between the state Legislature and Cuomo. On Monday, Cuomo vetoed a bill that would have permanently carved the state's 250 school-based health centers out of the Medicaid managed care model. In his veto message , the governor said the legislation set a "bad precedent" and does not align with his administration's long-term strategy, but he recognized that these programs need more time to implement care coordination strategies.

... Cuomo vetoed legislation that would have created a new definition for safety net hospitals and required the administration to provide a higher Medicaid rate to those newly designated hospitals. This is the second consecutive year the governor has vetoed the legislation, saying that it would have increased Medicaid funding without specifying how the state would pay for this new obligation or how much it would cost.

...The governor vetoed three pieces of legislation that would have required the state Department of Health to conduct asthma studies in Manhattan, Brooklyn and the Bronx. Cuomo vetoed similar legislation last year that related only to the Bronx.

... Cuomo also vetoed a bill that would have required the Office of Children and Family Services to study staffing levels at OCFS facilities. In his veto message, Cuomo pointed out that the current model exceeds national standards and that the legislation provides no funding source to pay for the study.

... The governor also vetoed a bill that would have ended the competitive solicitation process for assisted living program beds and, in its place, created a new certificate of need process. Cuomo, in his veto message, said that would expand ALP slots beyond existing budget allocations.

... Under legislation signed Monday by Cuomo, New Yorkers with Crohn's disease, ulcerative colitis or any other inflammatory bowel disease, or diseases that requires immediate access to a toilet can now go into any business that has a bathroom and use it even if it is typically only available to employees.

... Cuomo also signed a bill that codifies existing state programs for people with developmental disabilities.

NOW WE KNOW — A rude waiter can be enough to make the meal less tasty for some people, according to researcher Jaehoon Lee of Southern Illinois University.

TRUMP HALTS MEDICAID FUNDS FOR DELIVERY SYSTEM REFORM — The Trump administration released new guidance that could make it a little harder for New York to renew its Delivery System Reform Incentive Payment program, the cornerstone of the Cuomo administration's efforts to reform Medicaid. More here.

CHIP CLOCK — It's been 81 days since Congress let the Children's Health Insurance Program lapse.

... Connecticut became the latest state to say it will begin notifying families that CHIP coverage will stop at the end of January, unless Congress steps up to renew federal funding.

CHIP ON THE AGENDA — Senate GOP leaders are planning to load up this week's must-pass spending bill with contentious provisions ranging from Obamacare subsidies to surveillance powers, the No. 2 Republican said Tuesday. Read more from our D.C. colleagues here.

UNABLE TO FLUSH — Patients on the first floor of Niagara Falls Memorial Medical Center have been able to use the showers or toilets because of a water main break, according to the Buffalo News. Read more here.

KALEIDA MAKES MOVE — The Buffalo News reports: "Kaleida Health will become the active parent of Eastern Niagara Hospital in Lockport next year, once state and federal regulators approve the deal."

IN CASE YOU MISSED IT — The New York Times had a story Friday about the challenges of being an obstetrician in the Bronx. It can hinder your career. "The difficulties of being an expectant mother in the Bronx are well known: A 2016 report found that the borough consistently had the city's highest rates of life-threatening complications during childbirth, with those dangers arising there in 296 of every 10,000 deliveries between 2008 and 2012, compared to 230 citywide. Less frequently discussed are the effects on obstetricians practicing in the Bronx. High-risk pregnancies are by definition more taxing for physicians. And the heightened likelihood of something going wrong may in turn increase the likelihood of a malpractice lawsuit."

PHARMA REPORT:

FOLLOW THE MONEY — Kaiser Health News reports the pharmaceutical industry spent millions to squelch talk about high drug prices.

GENE THERAPY — The Associated Press reports: "U.S. health officials on Tuesday approved the nation's first gene therapy for an inherited disease, a treatment that improves the sight of patients with a rare form of blindness."

CRACKDOWN — The Washington Post reports: "The Food and Drug Administration on Monday proposed a tougher enforcement policy toward homeopathic drugs, saying it would target products posing the greatest safety risks, including those containing potentially harmful ingredients or being marketed for cancer, heart disease and opioid and alcohol addictions."

WHAT WE'RE READING:

THE STEALTH REPEAL OF OBAMACARE — Obamacare survived the first year of President Donald Trump, but it's badly damaged. The sweeping Republican tax bill on the verge of final passage, H.R. 1 (115) , would repeal the individual mandate in 2019, potentially taking millions of people out of the health insurance market. On top of that, the Trump administration has killed some subsidies, halved the insurance enrollment period, gutted the Obamacare marketing campaign, and rolled out a regulatory red carpet for skimpy new health plans that will change the insurance landscape in ways that are harmful to former President Barack Obama's signature health care law. None of these individually represent a death blow. But in aggregate, the past year adds up to a slow, stealthy erosion of the law. Read more from POLITICO's health editor Joanne Kenen here.

PULSE CHECK: Ady Barkan, activist and ALS patient. On POLITICO's podcast, Barkan discussed his work, his illness and the importance of advocacy. Listen here.

WHAT WORKS — Poor, chronically ill patients often find themselves with nowhere to go for refuge except hospital emergency rooms. These "frequent fliers," as they are known to emergency nurses, include many whose medical emergencies could have been prevented with regular care, housing or a decent diet. In POLITICO Magazine's latest "What Works" edition, eHealth editor Arthur Allen looks at how Parkland Memorial Hospital is addressing the issue by building a safety net that attempts to tackle the health issues plaguing the city's most vulnerable citizens before they find their way into the emergency room. Find out how here.

RISKY RESEARCH RESUMES — The federal government lifted it's three-year moratorium on funding research involving intentionally altering genes to make viruses more dangerous and/or contagious, according to STAT. Read more here.

DIABETES FUNDING IN JEOPARDY — Sam Stein in the Daily Beast reports: "For months now, a program dedicated to funding critical breakthroughs in diabetes research has been on hold, set off to the side amid Congress' obsessive focus on repealing and replacing Obamacare. Now, as a fix is on the horizon, advocates fear that legislative gridlock may get in the way again."

HEALTH POLICY VET TAKES HERITAGE HELM — The conservative Heritage Foundation announced that board member Kay Coles James, a health policy official in the George W. Bush administration, will serve as its sixth president beginning Jan. 1.

TODAY'S TIP — Comes from Northwell Health's Dr. Michael Birnbaum: "Depression and other mood disorders are not a question of willpower. Like any disease, it requires intervention and treatment." Five things you should know.

STUDY THIS:

WHO'S SMOKES? — Researchers from Columbia University's Mailman School of Public Health and CUNY, writing in the journal Addiction, found that smoking increased significantly among people who uses illicit substances.

INSURANCE HELPS — Axios reports: "Having health insurance makes health care easier to pay for, and the number of people who struggle to pay their health care bills has fallen since the ACA's coverage expansion took effect, according to updated data released yesterday by the Centers for Disease Control and Prevention."

POOR EMERGENCY PREPAREDNESS — The U.S. isn't investing adequately in health preparedness capabilities and instead relies on inefficient federal emergency funding packages every time a disaster strikes, according to a critical report from the Trust for America's Health.

MISSED A ROUNDUP? Get caught up here.

To view online:
https://www.politico.com/states/new-york/newsletters/politico-new-york-health-care/2017/12/20/de-blasios-public-health-record-examined-019499

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