Cuomo, Biden to Promote Family Leave; Massachusetts AG Suggests High Drug Prices May Violate Law

Governor Cuomo and Vice President Joseph Biden will be holding an event in the state on Friday to promote paid family leave and other economic priorities.  Supporters of paid family leave have been informed of the event.    Our coalition members are hoping Governor Cuomo agrees to a more robust proposal for paid leave which will include 2/3 of the wages of workers up to twelve weeks.  Cuomo’s proposal starts at 35% of workers wages and rises only to 50% after a phase-in of four years.  The coalition will hold a press conference during a lobby day in Albany on Tuesday to push for its plan.

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Massachusetts Attorney General Maura Healy is the first state attorney general to raise the issue of “unfair trade practices” of drug companies for their exorbitant prices.  She sent a letter to Gilead sciences, makers of Sovaldi and Harvoni, two drugs to treat hepatitis C and costing $84,000- $94,000 for the course of treatment.    Healy says she is investigating to see whether the pricing breaks state laws.  She urges the company to adjust its pricing to make the drugs more accessible.  The company is requesting a meeting with Healy.  The mere threat of legal action may cause problems for companies which see their stocks dive when government officials attack their pricing or suggest some action may be taken.   Also, Healy’s public stance may quickly lead to other state AGs beginning their own investigations, including New York’s Eric Schneiderman.

 

 

Health Providers Want More Money to Raise Minimum Wage; Schneiderman Announces $47 Milion Settlement For Medicaid Fraud Using Social Adult Day Care Centers

You can read all blog posts at http://www.generationsofnewyork.com

News Briefs

At Monday’s state budget hearing on health and Medicaid, many provider organizations discussed how Governor Cuomo did not include any targeted funds to help them raise the pay of their workers to reach the $15 minimum wage he has proposed.   Hospitals and home care agencies said it will cost them millions phased in over several years and they would like to get funds to pay for the increase which is an unplanned expense.

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Donald Trump says he would be willing to let Medicare negotiate drug prices.  That position goes against the Republican orthodoxy on the Medicare drug benefit.

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Some hospitals are reporting that because of data breaches with health insurance companies like Anthem, some patients are not willing to provide personal information and sometimes refuse to allow health records to be shared with other providers.   This is hurting efforts to make health information more accessible to provide more coordinated care.  The providers are forced to spend more time explaining why it is important to share the data so that other providers in the same health network have the patient’s medical record and information.

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New York Attorney General Eric Schneiderman announced a $47 million settlement with CenterLight Health Care, a Medicaid managed long term care plan for services it did not provide to 1200 Medicaid recipients.  Centerlight enrolled them in its Medicaid managed care plan after referrals from social adult day care centers they started.   Centerlight got over $3000 per month, per member in the Medicaid managed care plan even though the individuals in question were not eligible for the services.

Schneiderman said “We won’t tolerate companies that seek to exploit the system for profit.  My office will continue to be vigilant in protecting Medicaid against fraud.”

When some of these companies running Medicaid managed care plans saw the funded attached to them, they set up social adult day care centers to attracts seniors and others and then referred them to their plans and said that as participants in the day care centers they were part of the managed care plan.  The settlement said “CenterLight used the day care centers to provide community-based MLTCP personal care services that did not qualify as personal care services under CenterLight’s Select plan.”

In October 2014, Schneiderman announced a similar $37 million settlement with VNS Choice, Visiting Nurse Service of New York.

These abuses led to legislation to better regulate social adult day care centers through the State Office for the Aging so that companies could not just pop up such a center and deem that it was providing reimbursable services.

 

 

 

 

 

 

 

Comparison of Assembly and Cuomo Positions on Paid Family Leave

You can read all blogposts at http://www.generationsofnewyork.com

Assembly Speaker Carl Heastie says that paid family leave will again be a priority for the Democratic majority in the State Assembly.  That chamber passed a bill sponsored by Assemblywoman Cathy Nolan that had the support of the coalition for family leave. Heastie said he is glad Governor Cuomo has put the issue forward as one of his priorities but that he still prefers the Assembly version.  The Senate is open to considering the bill though some are saying it is a further hindrance to businesses in the state.  However, the entire program is employee paid though the Assembly version would also increase disability benefits for which businesses share in the cost.

Advocates for paid family leave also are very happy that the Governor has included the family leave proposal in his budget though it comes up short of what the coalition wanted with a program that people can actually use.  Discussions are continuing with the Governor’s office.  Key areas of concern are differences in the amount of “replacement wages.”  The Governor’s proposal would only cover one third of wages phasing up to one half.  The coalition wants to cover two thirds of the wages.  See the details below on this item and other differences in the proposals.  The coalition will have a lobby day in Albany on next Tuesday, February 2nd.  For more information go to http://www.timetocareny.org

Length of leave time – up to 12 weeks in both the Assembly/coalition bill and the Governor’s proposal

Purpose of leave – bond with a new child, care for a seriously ill family member; address issues arising from a family member’s military service – same for both proposals

What family members can a workers take leave to care for?  – child, spouse, domestic partner, parent, grandchild, grandparent, sibling or parent of spouse or partner – same for both proposals

Employer rules – All employers regardless of number of employees must offer the benefit and are required to hold the worker’s job for up to 12 weeks

Wage replacement rate – Assembly/coalition proposal : 2/3 of the worker’s average weekly wage ; Governor’s proposal:  35% of average weekly wage in 2018, 40% in 2019; 45% in 2020 and 50% in 2021

Benefit Cap – Year 1:  35% of statewide average weekly wage (currently $1266); Year 2:  40%, Year 3: 45%, Year 4: 50% – both proposals are the same except the Governor’s specifies that Year 1 is 2018

 Funding – 100% employee paid in Assembly/coalition bill and Governor’s proposal

Maximum employee pay – Year 1: Assembly/coalition proposal:  maximum of 45 cents/week; Year 2 set by Department of Financial Services in consultation with an advisory council; Governor’s proposal :  set by Department of Financial Services

Temporary Disability Insurance benefits – Assembly/coalition bill would raise to the same level as paid family leave benefits;  Governor’s proposal  no increase in disability benefits

 

 

 

 

 

 

 

 

100 Year Olds Up 44% Since 2000

The number of Americans reaching the age of 100 rose to 72,197 in 2014, up from 50,281 in 2000 according to an article in Thursday’s New York Times citing federal health officials.   More than 80% are women.      Death rates for people living to 100 are 39.3 per 100 for whites, 28.6 per 100 for blacks and only 22.3 per 100 for Hispanics.  Death rates dropped overall among centenarian men by 20% and by 14% for women 100 or older.

As people are living to 100, the death rate from Alzheimers disease among them increased 119% from 2000 stop 2014.  Deaths of centenarians from influenza and pneumonia dropped 48% since the turn of the century and 31% for stroke and 24% for heart disease though it remains the leading cause of death for centenarians.

Persons who don’t have a genetic and personal history of heart disease and cancer and stay in good physical shape are living well into their 90s and beyond.  Good nutrition and health habits have to begin early in life and be maintained or strengthened in middle age.  Better drugs and health care also play a big part.

Here is a link to calculate your lifespan
http://media.nmfn.com/tnetwork/lifespan/#0

Unfortunately, the good news about centenarians comes as recent reports are showing an increase in the death rate of almost epidemic proportions for middle aged whites from opioid and drug abuse and related suicides.  The New York Times ran a map earlier in the week showing the dramatic increase in deaths across the country.  The maps got redder and redder each year in the 2000s showing death rates increasing.  While New York State fares much better than many other states, some areas of the state are seeing larger increases.

Upcoming Budget Hearing, Advocacy Calendar

You can read all of our blog posts at http://www.generationsofnewyork.com

Monday, January 25

The Assembly Ways and Means Committee and the Senate Finance Committee will hold their annual budget hearing on health care, Medicaid and aging issues on Monday, January 25 at 9:30 at Hearing Room B in the Legislative Office Building (LOB) in Albany.  The Health Commissioner is usually the first speaker at this hearing.

Monday, Tuesday, February 1-2

The annual conference sponsored by Live-On on aging issues and long term care supports will be held in Meeting Room 5 on the Concourse Level of the Empire State Plaza.   The first day will focus on presentations and the second day will be for legislative visits.  New York State Office for the Aging Director Corinda Crossdale will be among the speakers at this event. You can register at http://www.liveon-ny.org

Wednesday, February 3

The annual budget briefing by the Fiscal Policy Institute, presenting a progressive vision for the state budget on income inequality, minimum wage, shared opportunity agenda.  The briefing will also analyze the Governor’s budget on tax and spending issues and provide materials with its analysis. The event will start at 8:30 in the Albany Room on the Concourse level of the Empire State Plaza.  A second briefing will be held in New York City in mid-February.  Go to http://www.fiscalpolicy.org to register and for more information.

Justice Center Director Jeff Wise Passes Away

I was sorry to hear of the sudden passing this week of Jeff Wise, the first Executive Director of the Justice Center, the new agency Governor Cuomo created to monitor and investigate complaints about the quality of care for the disabled in state facilities.  Jeff had worked for many years as an advocate in nonprofit organizations and I worked with him on issues related to the aging disabled population when I was Director of the New York State Office for the Aging .     – Mike Burgess

 

 

Roundup on Cuomo Budget: Drug Costs, Minimum Wage, Family Leave

More details are coming out about Governor Cuomo’s budget this week in several areas:

Drug Pricing – A media report by Politico New York this morning discusses how the Governor is looking to force drug prices lower by requiring transparency and reporting on the costs of producing drugs and beginning to look at how to control costs.  Cuomo’s plan requires the Commissioner of Health to develop a list of prescription drugs “for which there is a significant public interest in  ensuring rational pricing by drug manufacturers.  The proposal also requires drug companies to report what they charge other customers including pharmacies and wholesalers.  Consumers, insurers and the health care providers say that prices for new drugs and increases for older ones are unsustainable for the health care system.

Minimum Wage increase for Home care and non profit workers with state contracts – Even though the Governor is proposing to raise the minimum wage to $15/hour for state workers and SUNY employees he is not proposing any funding to cover the costs of raising the minimum wages for employees of not for profits with state contracts in health and human services.  Of course, the minimum wage is phased in to $15.00/hour over several years and the impact this year will be incremental.   Home care agencies and nonprofits in the human services sector are concerned about how they will absorb the added the costs over several years.

Family Leave – The Governor’s budget proposal on family leave was greeted positively by the coalition supporting a family leave program.   The Governor’s proposal is not as robust as the plan the coalition supports that would include a benefit or “replacement wage” of up to 2/3 of the employee’s weekly wage up to a cap of half of the statewide weekly wage.    The Governor’s plan will provide a replacement of only a third of wages, phasing up to 50% of the employee’s wages.

Safe Staffing – The Assembly Health Committee is taking up the Safe Staffing for Quality Care Act  (A8580)  on Thursday morning to require safe staffing ratios, an issue that is a top priority of the nurses union and many health, senior and consumer advocacy organizations.  They say that the lack of staffing ratios leads to threats to patient safety when enough staff are not available, forcing some nurses to be responsible for a larger number of patients.

Cuomo Proposes Employee Paid Family Leave Program

(to read all of my blog posts, go to http://www.generationsofneweyork.com)

Governor Andrew Cuomo used a touching reflection about his father’s last days to introduce his proposal for a family leave program in his budget and State of the State Address yesterday.  The Governor recounted how he regrets not spending more time with his father in his last days before he died on January 1, 2015 .  The Governor said he wished he had taken more time off to be with his father and then said many people don’t have that chance and that the relationships are important in life.

The Governor’s decision to include family leave comes after a strong campaign led by a coalition of public interest, health care, child and senior advocates and labor unions.  The coalition had recently met with the Governor’s staff to ask him to include the proposal in his budget and champion it.

Though the Governor’s proposal is still being analyzed by the coalition, it differs somewhat from the proposal that the coalition supports and was passed by the Assembly in the spring. That bill ran the program through the state’s Temporary Disability Insurance program and included employee and employer contributions.  The Governor noted his proposal is “employee funded.”   Apparently, the Governor’s office did not want to give the business sector a reason to oppose it.  The program would be run through the workers compensation system.  Also the Department of Financial Services would determine the mandatory amount to be paid in by employees each year through a payroll deduction.    Senator Jeff Klein was reported in the media as saying the cost would be about $35 per worker per year.   That would be about $1.35 per bi-weekly paycheck.

The State Senate has expressed interest in family leave but was really concerned about the impact on businesses and had not endorsed the Assembly bill.  They should be more supportive of the Governor’s proposal and might be more willing to embrace to show their support for workers as they resist his effort to raise the minimum wage to $15/hour.

Assembly Speaker Carl Heastie said that family leave would be a top priority of the Assembly again.

 

 

 

 

 

 

Advocates, Opponents to Square Off Over Assisted Suicide

Advocates for “aid in dying” or doctor assisted suicide hold a lobby day in Albany today to support legislation that would make New York the fifth state to support provisions that would allow doctors to prescribe pills for persons to take their own lives.  California Governor Jerry Brown signed into law a similar bill this fall.

Opponents are planning to speak to the press in Albany today to oppose the bill saying that hospice care is what people need and that the bill proposed has many issues that need to be addressed including disposal of drugs not used and mental health counseling.  A wide coalition of people opposing the bill include major disability organizations, hospice advocates, many doctors as well as religious organizations.

JJ Hansen, who worked for Governors Spitzer and Paterson and who was diagnosed with brain cancer and given four months to live will be speaking against the bill.  His cancer is in remission twenty months later and he says that many times in the midst of the pain if a pill was available he might have been tempted to use it.  Now, he is fighting the bill and saying we should be offering people hope.

I will also be down at the Capitol working against this bill which would put great pressure on many older people who often feel like a burden when they are seriously ill and regret losing their independence.  Many are depressed and to me, what they really want and need is love and caring, not a pill.   Hospice is a better alternative to provide comfort from pain and social and spiritual support to people in their last days.  This bill “normalizes” suicide at a time when the suicide rate for  younger people not facing terminal illness is going up (because of substance and drug abuse) and communities across the state are stepping  up  suicide prevention efforts.

In New Jersey the state Assembly has passed a bill for assisted suicide but the State Senate could not muster the votes for it as several Democrats refused to support it.  This type of bill has done well in the polls until all the arguments against it are raised.  A referendum in Massachusetts in 2012 began with the proposal having over 70% support in polls but was defeated at the ballot box by a 51% -49% margin.

Care Transitions Coaching Needed to Prevent Hospital Re-Admissions and Improve Quality of Care

A model care transitions program at Lee Memorial Health System in Florida shows how necessary it is to develop a patient-centered approach to care transitions that addresses housing and community services issues in order to prevent hospital re-admissions and improve the delivery of care.  A review of the program’s success  notes that prior to implementing the care transitions coaching, 60% of patients were discharged from the hospital system cited without any type of post-acute services.    The care transitions project discovered “that some patients were not safe at home or quickly became depressed and lonely.”   
They found “filthy nebulizers, lack of transportation to and from primary care physician visits, ineffective caregiving by a loved one, shut off electricity and even hunger.”   
Also, “several patients did not know their diagnosis and had no idea what their diagnosis meant for their health.  They had no understanding of whether their condition was acute or chronic and believed that the hospital had cured them.” 
Using care transitions and coaching, they were able to reduce discrepancies in medical discharge orders from 92% to zero, re-admission rates have decreased and discharge planners have improved assessments to  address the problems cited above including some of the community services which were lacking.   A home visit is performed within 48 hours of discharge and psycho-social evaluations are done to identify needs before patients are sent home. 
The program and results make it quite clear that there has been a great disconnect between the health care system and the patient’s understanding of their health care and their needs following a hospital discharge.  It is clear that if re-admissions are to reduced, then health systems have to put in place extensive post-hospital care plans which educate and involve patients and caregivers and also make referrals to appropriate home and community based services.   Patient navigators and coaches can plan a key role in making the care transition work.

 

Cuomo Considering Including Paid Family Leave in Agenda

Governor Andrew Cuomo who has been embracing many progressive economic positions in recent months is considering whether to include a proposal for paid family leave in his agenda.   He is set to announce his proposals in his annual State of the State address which will be combined with his budget presentation on January 13.

The Governor is mounting a major campaign for the $15 minimum in his proposals.  In recent days he has said that he will unilaterally raise that wage for state employees and those at the SUNY system.  The legislation he is proposing would raise  the wage to $15 for all workers in New York State.  There has been speculation he will offer some tax incentives for businesses as part of the push since there is significant opposition brewing in upstate New York with some small businesses saying a minimum wage of $15/hour  will result in layoffs.

There has been some thinking that the Governor might not push for the minimum wage and paid family leave at the same time but he met with advocates for the proposal last week.  He has officially launched the “Mario Cuomo Campaign for Economic Justice” on the state website and the $15 minimum wage is the centerpiece.  Whether there will be other planks in the campaign such as paid family leave is unclear.  However, there is growing momentum for the paid family leave proposal.  AARP is making the passage of the issue one of its priorities in 2016 as we noted last month.

Last week, New York City Mayor Bill deBlasio announced he will extend paid family leave to employees who have newborns.   His proposal does not go as far as the state bill to have paid family leave for all employees attending to a newborn or seriously ill family member.  Cuomo, who has been in sharp conflict with deBlasio on a number of issues, may see an opportunity to go well beyond deBlasio’s proposal which received significant media attention.

Cuomo marked the first anniversary of his father’s death on January 1st and he seems intent on linking his father’s name to an issue like the minimum wage which he says helps the most vulnerable members of society that his father championed.