NYAPRS Note: The legislature will be working on a number of late session bills during their last week in Albany. These include important harm reduction measures such as making fentanyl test strips more available and allowing for the operation of overdose prevention centers. A 2021 report from the Institute for Clinical and Economic Review found these centers prevented and reduced overdose deaths in the community while lowering total health costs by reducing emergency room visits and hospitalizations. These centers offer another way to offer services for many who need support in the community, with the two centers in New York City saving “nearly 1,000 people” according to state Senator Gustavo Rivera. See below for more information on the bill Sen. Rivera has sponsored as well as other health related bills being considered over the next week.
Harm Reduction, Mental Health, Workforce Woes: Here Are The Health Care Bills That Are Still On The Table
By Jacqueline Neber and Amanda D’Ambrosio | Crain’s Health Pulse | May 31, 2023
Health care advocates and New York’s lawmakers are pushing to pass several health care-related bills prior to the state’s legislative session ending June 8. Much of the legislation revolves around combatting issues of growing concern across the state, including substance use, mental health care and expanded health insurance coverage.
Substance Use Disorder
New York has seen an unprecedented increase in overdose deaths in the past few years, many of which have been tied to the presence of fentanyl. To that end, last week, the Senate health committee passed the Safer Consumption Services Act (S399A), a bill that would allow providers to operate overdose prevention centers in New York state. Many support these centers, which are supervised sites where people can use drugs, as a critical harm reduction tool. But state officials have rejected funding them, including with opioid settlement funds.
The two overdose prevention centers that are in operation in New York City have a proven track record of providing help to New Yorkers with substance use disorders, said Sen. Gustavo Rivera, who sponsored the bill. The centers, located in East Harlem and Washington Heights, have saved nearly 1,000 people from succumbing to an overdose, Rivera added.
Rivera, who represents parts of the Bronx, said that the bill is one pathway to support the establishment of overdose prevention centers in New York, but it is not the only way. The governor could issue an executive order to achieve this goal, he added.
Since the most recent overdose data was released, substance use treatment advocates such as members of the Drug Policy Alliance and Coalition of Medication-Assisted Treatment Providers and Advocates have urged the state to invest in overdose prevention centers, which are currently only operating in the city and are privately funded.
Meanwhile, Sen. Pete Harckham and Assemblyman John McDonald introduced a bill in April which aims to make fentanyl and xylazine test kits more accessible by allowing licensed pharmacists to prescribe them to any New Yorker.
According to the state’s 2021 data, fentanyl was present in 80% of overdose deaths that year and is growing in the drug supply. Testing kits are currently distributed by treatment providers whose locations can be few and far between, according to Harckham.
The senator, who used to chair the state’s Committee on Alcoholism and Substance Use, said his motivation behind pushing for the bill comes from speaking to members of New York’s substance use recovery community and “filling in the gaps” in care across the state. “Matthew’s Law,” as the bill is called, is in committee.
Mental Health
Mental health has been at the forefront of Gov. Kathy Hochul’s, Mayor Eric Adams’ and legislators’ minds for many months. The governor committed $1 billion of the fiscal 2024 state budget to increasing access to care, while the mayor’s plans have garnered controversy and focused on expanding treatment and supportive housing plans for the city.
On the legislators’ side, Harckham is focused on getting clarification on a “green light bill” for mental health crisis mobile response teams in Westchester County. The bill, which the governor vetoed at the end of 2022, defines mobile crisis response services as those which provide immediate and short-term emergency responses to New Yorkers in distress to prevent critical incidents. Additionally, the bill would allow staff to use a green light on any vehicle they own to signal that other drivers must pull over to let units pass on the way to emergencies. Hochul vetoed the bill by saying that only the state Office of Mental Health can authorize green lights, a snag Harckham said he is looking to clarify.
Senate bill S7079, meanwhile, would establish a “first responder peer support program for first responders” and is currently in committee, sponsored by Harckham and Chris Burdick on the Assembly side. Advocates have long said that peer support is a lynchpin in successful mental health responses. According to Harckham, the bill is based on the PFC Dwyer Veterans’ Support Program, an “incredibly successful program” that offers veterans in the city and around the state peer-to-peer support through recreational, health and wellness, and athletic programs.
Health Care Workforce
Assemblywoman Amy Paulin, chair of the health committee, said that her biggest priority is addressing shortages in the health care workforce. State executive orders that relaxed certain rules during the pandemic will expire on June 8.
“We had a lot of flexibility under the executive orders that we will no longer have,” said Paulin, who represents parts of Westchester County. “We have a lot of hospitals that will be even more in dire straits.”
One of the bills that could relieve the health care staffing shortage would temporarily authorize doctors and nurses with out-of-state licenses to practice medicine in New York. The bill, A6697, which is sponsored by Assemblymember Patricia Fahy, would relate to clinicians who have applied for licensure in New York and not those who have temporary contracts.
Paulin is also pushing a bill that would authorize out-of-state clinicians to provide time-limited follow-up care to patients in New York via telehealth, as well as a law that would allow physicians to issue a standing order to expand the types of procedures a registered nurse can perform to address health care staffing gaps.
Coverage for All
As the legislative session comes to a close, lawmakers are making a final push to pass Coverage for All, a bill that would require the state to include undocumented immigrants who have a household income up to 250% of the federal poverty level in the state’s basic insurance plan.
The bill would require the state to submit a 1332 waiver to the federal government to amend eligibility for the Essential Plan , low-cost health insurance for people who aren’t eligible for Medicaid. Hochul has submitted a letter to the federal government asking for guidance on how to implement this change but has yet to make a formal request to expand eligibility.
Undocumented immigrants are prohibited from participating in many federal health care insurance programs and can only access coverage via emergency Medicaid. This bars the community from seeking care until it is absolutely necessary—and fuels inefficient state spending on health costs for this community, lawmakers and advocates say.
Currently, the state pays about $544 million on emergency Medicaid coverage, said Assemblymember Jessica González-Rojas, who has sponsored the bill. If passed, Coverage for All could leverage federal funds to provide insurance to the undocumented population and save money, she added.
The governor could submit a request to the federal government without the passage of Coverage for All; this legislation would require her to do so.
There are many other bills that will go up for a vote before the end of session, including a law that will create a pilot program for medical debt reform and another that would change rules around the audit process for Medicaid providers. Additionally, legislators and advocates have rallied around a bill called Reinvest in NY, which would tax out-of-state profits made by New York health insurers and reinvest them in financially struggling hospitals.
The Senate rules committee will be meeting essentially every day until June 8 “cranking out bills,” Harckham said. The rules committee can still pass bills that have not yet exited the Senate and Assembly committees during this time. Hochul has until the end of the year to approve or veto bills.