• NYSPHA 2022 State Budgetary, Legislative and Policy Priorities 

  Interim Draft March 7, 2022

  1.  NYSPHA 2022 Legislative Priorities

  New York State PREPARE Act:

  Legislative Priority #1: NYSPHA supports the public health reinvestment and emergency pandemic adaptability, readiness, and efficiency (PREPARE) act.  The PREPARE Act is designed to increase the infrastructural state funding supporting local health departments’ provision of the core public health services needed to provide a base level of protection to the communities they serve. Unfortunately, over the past five years in New York State, the number of LHD staff delivering Article 6 core services has declined. According to data from the New York State Department of Health, the number of FTEs working on Article 6 services declined by 7% between 2015 and 2020. During this period, the population of the state increased by 3%. This reduction in staff has made it harder for the state’s local health departments to address the public health challenges facing their communities, including responding to the COVID-19 pandemic. While the largest reduction in staff was experienced by the New York City Department of Health and Mental Hygiene, other LHDs also experienced a decline.  State reinvestment in the funding for local health departments will help retain and sustain a responsive, skilled public health workforce necessary not only to undertake a wide variety of evidence-based public health program but also to take prompt and effective action in future public health emergencies.

  Provisions of the PREPARE Act

• Increase Article 6 base grant for full service LHDs (37) to $750,000 or $1.50 per capita. Total increase over current base grant= $15.19 million PASSED IN THE ENACTED BUDGET. 
• Increase Article 6 base grant for partial service LHDs (21) to $577,500. Total increase over current base grant=$1.62 million PASSED IN THE ENACTED BUDGET. 
• Restore NYC to 36% reimbursement beyond the base grant under Article 6 state aid. Total cost NYC restoration=$60 million annually
• Permit fringe benefits as an eligible expense under article 6 state aid and reimburse fringe at 36% in all counties. Total estimated cost of fringe reimbursement at 36%=$56 million PASSED IN THE ENACTED BUDGET UP 50%.
• Provide state reimbursement of 50% for pathology and toxicology services provided by county medical examiners. Total estimated cost=$53.4 million (based on 2018 budgets)
• Fully fund the implementation of the 2019 Elevated Blood Lead Level Mandate. Total estimated cost=$30.3 million.

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• Tobacco Prevention and Control:  While we continue to battle the COVID-19 pandemic, public health is at the forefront of every New Yorker’s mind. With the World Health Organization stating smokers are likely more vulnerable to severe and potentially life-threatening cases of COVID-19, it is imperative that New York’s enacted budget and legislation take aggressive action to prevent tobacco initiation and enable users to quit.

  Legislative Priority #2: NYSPHA supports A3499/S84 (Bichotte Hermelyn/ Hoylman) (Status: in committee), an act to amend the public health law in relation to prohibiting the retail sale of flavored tobacco products and accessories.  (Bans menthol-flavored cigarettes and all flavors of other tobacco products).

  Legislative Priority #3: NYSPHA supports additional funding for the NYSDOH Tobacco Control Program in the State Budget.  Although the state receives $2.63 billion annually ($1.63 billion in tobacco excise taxes and $737.7 million in Master Settlement Agreement funds), it only spends $39 million (1.6%) on the Tobacco Control Program.  This funding level is a 54% decrease from the Program’s peak funding level of $85 million in the 1990s.  NYSPHA supports an increase in the state budget to $52 million as a down payment towards the CDC-recommended funding level for New York State of $203 million. Click <here> for the link to the NYSPHA Memorandum of Support.

  Legislative Priority #4: NYSPHA supports increasing the tax on tobacco products by the equivalent of $1 per pack of cigarettes. Raising the cigarette tax is one of the most effective tobacco prevention and control strategies, but the tax has remained static for the last ten years. A tax increase would generate needed revenue. More importantly, youth have been shown to be very sensitive to tobacco price increases. It is estimated that a $1 per pack tax increase would result in 22,200 youth under age 18 not becoming adult smokers, decreasing future healthcare expenditures due to smoking. Currently, $9.7 billions is spent annually on tobacco related healthcare costs in New York State. Therefore, increasing the price of cigarettes not only raises critical revenue – it decreases the prevalence of tobacco use, particularly among youth and young adults. To further increase public health benefits, increase cost savings, and generate revenue, New York State should also raise the tax on all other tobacco products including e-cigarettes and cigars to provide tax parity with cigarettes. This will also prevent tobacco users from jumping between products whenever one product's price increases. Click <here> for the link to the NYSPHA Memorandum of Support.

  Legislative Priority #5: NYSPHA supports A8199/S5788 (Glick/Stavisky) (Status: in committee), an act to amend the public health law in relation to requiring smoke-free college campuses (outdoors) in New York. 

  Legislative Priority #6: NYSPHA supports and will work to advance A3648/S601 (Rosenthal/Addabo) (Status: in committee), an act to amend the public health law in relation to the definition of an indoor area; and to repeal certain provisions of such law relating thereto. (Closes a loop holes in the state’s Clean Indoor Air Law).

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• Immunizations:
  

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• Legislative Priority#7: NYSPHA supports and will work to advance A279/S75 (Gottfried/Hoylman) (Status: In committee), an act to amend the public health law in relation to mandating reporting of adult vaccinations to the NYS state and city immunization registries (NYSIIS and CIR)

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• Legislative Priority #8:  NYSPHA supports A8378 (Dinowitz) (Status: No Senate “same as”.  In Assembly Committee).  The bill requires that all children attending school, daycare and after-school activities be immunized against SARS-CoV-2 in accordance with FDA approval of the appropriate vaccines consistent with CDC recommendations for use.

  Legislative Priority #9:  NYSPHA supports A7829 (Dinowitz) (Status: No Senate “same as”.  In Assembly Committee).  The bill requires that that all students attending colleges or universities be immunized against SARS-CoV-2 in accordance with FDA approval of the appropriate vaccines consistent with CDC recommendations for use.

  Prevent Gun Violence:

  Legislative Priority #10: NYSPHA supports measures to reduce gun violence listed in the Statement of Policy and Governor Hochul’s State-of-the-State and Executive Budget proposals:

• ·      Invest in public safety and fund state and local policing gun safety efforts.
• ·      Create the Interstate Gun Tracing Consortium
• ·      Invest in community-based prevention and response efforts that have been proven to curb gun violence. This major investment will expand hospital-based gun violence specialists to all 22 of New York State's trauma centers, expand the State's network of SNUG street outreach to Niagara Falls, Utica, and Schenectady, provide skills-based job-readiness and work placement training for at-risk youth involved in the State's violence interruption work, and launch a first-in-the-nation program to recruit and retain outreach workers.

Health Insurance:

Legislative Priority #11:  NYSPHA supports A880/S1572 (Gottfried/Rivera) (Status: In committee), an act that provides eligibility for services under the basic health program for individuals whose immigration status renders him or her ineligible for federal financial participation and who meet additional requirements. PASSED IN THE ENACTED BUDGET FOR PERSONS AGE 65 YEARS AND OLDER AND PREGNANT WOMEN FOR ONE YEAR POSTPARTUM.

Health and Public Health Workforce:

Legislative Priority #12: NYSPHA supports programs that encourage, recruit, train, incentivize and support the rural health and human services workforce and assure that they apply to staff working in local County Health Departments. Health Workforce programs that fund student loan repayment include approving the Nurses Across New York program proposed in the Executive Budget. [proposed] and additional funding for the existing Doctor’s Across New York, Diversity in Medicine, Rural Residency, Primary Care Service Corps, J-1 Visa Waiver, Take a Tour, and Health Workforce Retraining Initiative programs.

Legislative Priority #13.  NYSPHA supports the Clinician Preceptor Tax Credit A285/S4229 (Gunther/Stavisky) (Status: in committee): An act to amend the tax law, in relation to establishing a personal income tax credit to preceptor clinicians who provide preceptor instruction.  Click <here> to read a commentary about the bill.

Legislative Priority #14.  NYSPHA supports  S359/A3145 (Persaud/Epstein) that requires the provision of care to persons requiring twenty-four hours of care take the form of non-sequential split shifts of twelve hours each.  Click <here> to read the NYSPHA Memorandum of Support.

Cancer Prevention and Control:

Legislative Priority #15.  NYSPHA supports the Colorectal Cancer Screening Cost Sharing Removal Act A2085/S906 (Dinowitz/Sanders). This legislation would require insurance plans to cover colorectal cancer screening beginning at age 45 and eliminate all patient cost-sharing for a follow-up colonoscopy. Click <here> to read the link to the NYSPHA Memorandum of Support.

Legislative Priority #16.  NYSPHA supports increasing funding for the New York State Cancer Services Program (CSP) to $21.8 million in Fiscal Year 2022-2023. This modest increase in funding would help the Cancer Services Program serve their existing patients and expand outreach to those in need.  The CSP provides uninsured and under insured New Yorkers with access to breast, cervical, and colorectal cancer screenings. Each year the CSP provides approximately 29,300 Breast cancer screening services, 7,600 Cervical cancer screening services, and 4,200 Colorectal cancer screening services.

Mental Health:

Legislative Priority #17.  NYSPHA supports increased funding for staff at Local Governmental Unit (LGU) mental health agencies to support and maintain the essential services they provide their county residents. The LGUs have stepped up during the pandemic to ensure their county residents were able to access essential mental health services. Specifically, a full-time mental health and suicide prevention coordinator is critical to support the suicide prevention coalitions within each New York county.

Legislative Priority #18.  NYSPHA supports providing additional resources to rural Local Governmental Units (LGU) Mental Health Agencies to address the disproportionate risk of opioid overdose and suicide and limited resource availability. LGUs struggle significantly due to lack of funding because the state allocates funding based on population size rather than need. In addition, serving individuals with significant needs and within multiple service systems, they struggle to meet service quotas because these patients require more time to achieve positive outcomes. The state should consider revising its funding allocation and quota requirements to take into account needs within resource-limited rural areas.

Legislative Priority #19.  NYSPHA supports state funding for medical examiner and coroners’ offices to develop and implement a suicide fatality review system piloted in four New York counties between 2019 and 2022. The goal of this system is to use timely and accurate data to inform suicide prevention efforts at the local level so that counties can make best use of limited resources and achieve the best outcomes for residents. State funding is needed to continue to support the four counties after the grant ends and to fund the remaining counties so that they can implement a similar process.

Legislative Priority #20. NYSPHA supports investment in prevention and early intervention for opioid overdose and suicide risk. For opioid overdose, this includes the implementation of Screening, Brief Intervention, and Referral to Treatment (SBIRT) for alcohol and other drug use in schools and primary care settings so that risk is identified across a continuum, and brief intervention is provided to reduce risk before consequences become more severe. For suicide, this includes making Question, Persuade, Refer (QPR) training readily available free-of-charge across the state, providing universal screening and brief intervention for depression and suicide risk in primary care settings, and ensuring county and organizational leadership have the information and tools they need to develop and implement a comprehensive approach to suicide prevention.

Legislative Priority #21. NYSPHA supports funding for schools to address the mental health needs of students following their return to in-person schooling in the wake of the COVID-19 pandemic. Bills in the U.S. Senate support funding for schools to provide mental health services to students. Bills in the New York State Assembly support a psychologist and social worker in each school (A5019), universal screening for mental health issues (A6636), and mental health parity for student insured through CHIP (A343). NYSPHA strongly supports these bills. In addition, NYSPHA strongly supports funding to schools to implement depression and suicide risk screening and intervention and the evidence-based Sources of Strength program to build trust between students and adults, promote help-seeking, create a positive school climate, and prevent suicide.

Legislative Priority #22. NYSPHA urges the state to invest in more guidance to schools on its mental health laws around mental health education in schools and training for school staff. First, mental health is as important as physical health, so mental health education should be provided at the same level as standard health classes, not only one class. Second, schools should be provided guidance on specific evidence-based mental health and suicide prevention trainings including Youth Mental Health First Aid; Question, Persuade, Refer (QPR); Applied Suicide Intervention Skills Training (ASIST); Suicide Safety Training for School Staff (SST); and Helping Students At-Risk for Suicide (HSAR).

Rural Health:

Legislative Priority #23.  NYSPHA supports restoration of funding to the level of $16.2 million for the 32 Rural Health Networks and 44 Rural Hospitals. The funding to these programs has significantly eroded in the past several years by 42%. The dramatic decline in support for these programs has negatively impacted the health of rural communities across NYS.

Nutrition:

Legislative Priority #24.  NYSPHA supports the recommendations of the NYC Food Policy Alliance as follows: $13 million to support Farm to School, $14.1 million to support NYSOPHA-supported home delivered meals for seniors, increase funding to the Hunger Prevention and Nutrition Assistance Program to $54 million, $85 million to fund the Nourish New York program, and the recommendations of the Black Farmers United NYS to advance racial equity in the farming sector.

Legislative Priority #25.  NYSPHA supports S2532A/A8860A (Reyes/Rivera) that requires warning icons for chain restaurant menu items containing more than the recommended daily limit for sodium. New York City has already enacted this requirement in local legislation.

Legislative Priority #26.  NYSPHA supports S4602/A6857A (Reyes/Rivera) sugary beverage excise tax to provide an economic incentive for consumers to purchase drinks with less sugar to evade the higher tax.

Legislative Priority #27: NYSPHA supports and will work to advance A5682/S4644 Gottfried/Biaggi) (Status: in committee), an act to amend the public health law in relation to healthy food service guidelines.  Link to NYSPHA Memorandum of Support.

Parole reform:

Legislative Priority #28: NYSPHA supports and will work to advance A3475/S15 (De La Rosa/Holylman), an act to amend the executive law to make people in prison aged 55 or older who have served at least 15 years eligible for individualized parole consideration (Elder Parole).  Link to NYSPHA Memorandum of Support.

Legislative Priority #29: NYSPHA supports and will work to advance A4231/S1415 (Weprin/Rivera), an act to amend the executive law in relation to providing more meaningful parole reviews for incarcerated people who are already parole eligible by changing the standard of parole to center release determinations not on the original crime but on the person’s rehabilitation while incarcerated and their current risk of violating the law (Fair and Timely Parole Act).  Link to NYSPHA Memorandum of Support. 

End of Life Care:

Legislative Priority #30.  NYSPHA supports A1542/S1487 (Rosenthal/Serrano).  The bill would, among other things, provide on a driver's license application a space for health care proxy information and space on driver's licenses for health care proxy information.  Click <here> to read the Memorandum of Support. 

Legislative Priority #31.  NYSPHA supports A1303/S8279 (Rosenthal/May).  The bill would require only one witness, with an exception for those in certain facilities, to sign the health care proxy. Currently, no witnesses are required for the signing of a Medical Orders for Life Sustaining Treatment (MOLST) form.  Click <here> to read the Memorandum of Support. 

Legislative Priority #32.  NYSPHA supports A210/S8280 (Rosenthal/May).  which would require pre-admission notification, except in case of emergency, of policies authorizing the refusal to follow directives in health care proxies that are contrary to a hospital's operating procedures. Click <here> to read the Memorandum of Support. 

2.  NYSPHA supports the following NYSACHO 2022 Legislative Priorities

NYSACHO Legislative Priority: NYSACHO supports and will work with bill sponsors to amend/enhance A6961/S4249 (Dinowitz/Skoufis) (Status: in committee), which would require that any child attending an overnight, summer day, travelling summer day or children’s non-regulated camp be up to date on their vaccinations; excluding those with a compromising medical condition.

NYSACHO Legislative Priority: NYSACHO supports A7408-A/ S7501 (Gottfried/Hinchey) to amend public health law related to rabies post-exposure prophylaxis (PEP) third-party reimbursement to require health providers to accept payments by the county health authority for human post exposure treatment at a rate set by the commissioner of health; provided that such reimbursement shall be no less than the Medicaid rate.

3.  NYSPHA 2021 Policy priorities

Policy Priority #1: Implement the recommendations of the NYSPHA Policy Statement entitled Racism is a Public Health Crisis.

Policy Priority #2: Monitor implementation of the state Public Health Corps initiative to assure full integration with existing public health programs

Policy Priority #3: Monitor implementation of Adult-use cannabis.  Reinforce with Governor/DOH and new cannabis authority the need for public health funding and measures to study and mitigate the impact.

Policy Priority #4:  Support the recommendations of the report Tobacco Control Enforcement for Racial Equity: Decriminalizing Commercial Tobacco Addressing Systemic Racism in the Enforcement of Commercial Tobacco Control. Oct 2020, co-authored by PAC member Sean Haley.  Available at: https://sph.cuny.edu/wp-content/uploads/2020/10/Tobacco-Control-Enforcement-for-Racial-Equity_FINAL_20201007.pdf

Policy Priority #5.  Develop pain management recommendations and policies for nursing home and long-term care facilities in New York State.