NYC Health Department Notes on the
Governor's Executive Budget
School-Based Health Centers
DOHMH requests a permanent carve-out for school-based health centers (SBHCs) to allow them to
bill Medicaid directly. SBHCs currently have a one-year carve-out of Medicaid Managed Care until
July 2017.
+ SBHCs provide comprehensive primary medical care, dental care, and mental health services at no
out-of-pocket cost to all students, regardless of insurance status. This has increased access to.
health care for minority youth, improved school attendance and performance, reduced Emergency
Room visits, prevented unnecessaty hospitalizations, and lowered total annual Medicaid expenditures.
+ There are currently 145 SBHCs serving over 345 schools in New York City. The City is investing $80
million in capital funds for new SBHCs.
Without a permanent carve-out:
+ Inadequate managed care capitation rates will result in funding shortfalls and leave many SBHC
costs uncovered.
+ Medicaid Managed Care billing will reduce revenue to SBHCs due to administrative challenges
involving credentialing, contracting, billing and claims processing, resulting in the closure of
some SBHCs.
+ DOHMH would be required to provide nurses to sites without an SBHC at a substantial cost (as high
as $15 million) to the City and State.
Essential Plan Premium
DOHMH requests that health insurance premiums for low-income New Yorkers remain at their
current rates.
+ A premium could lead to people cycling on and off health insurance (“churning”) due to affordability
issues, which could cause disruptions in access to care, especially given the current uncertainty
over the Affordable Care Act.
+ Low-income New Yorkers (individuals between 138% and 150% of the federal poverty level) have
historically had health insurance with no premiums in New York State (NYS), even before the
Affordable Care Act.
+ According to the NYS 2016 Open Enrollment Report, 12% (ust over 45,000) of the 379,559 Essential
Plan enrollees had incomes between 138% and 150% of the federal poverty level.
HealthArticle 6 Cut
Article 6 provides partial reimbursement for city tax levy
(CTL) funding to support local public health activities and
services in six core service areas: Community Health
‘Assessment, Family Health, Communicable Disease Control,
Chronic Disease Prevention, Environmental Health,
Emergency Preparedness and Response.
‘The proposed cut would reduce reimbursement by 7%
(from 36% to 29%) for New York City only. This translates
10 less revenue to support essential public
health programs.
If State aid is reduced, the NYC Health Department wil
Reduce the number of asthma counseling
‘staff, which can result in an increase
of emergency department visits,
hospitalizations and even fatalities of
children East Harlem, Central Harlem
‘and South Bronx.
Close one of eight STD clinies, resulting
int east 6,000 sexually transmitted
a infections not getting treated, and at least
30 people living with HIV not getting
diagnosed and treated.
Reduce the number of flu vaccinations
‘administered in our City’s only immunization
clinic, resulting in increased fiuiliness
‘among populations that rely on DOHMH
clinics, such as recent immigrants.
Eliminate testing for Zika virus, resulting
in delayed or missed diagnoses.
Diminish drinking water safety, and
recreational water and building water supply
oversight, including cooling tower
enforcement to prevent diseases like
Legionellosis.
Reduce the number of TB public
health advisors, and conduct fewer
and less-intensive investigations
Into the contacts of active TB cases.
This could result in missed
noses and future TB outbreaks.
‘This NYC-specific cut is based on the assumption that,
Unlike other counties, NYC can directly access other forms
of public health funding, including from the CDC. However,
federal funds are not fungible and may decrease under the
new Administration (e.g., a repeal of the Affordable Care Act
will rescind the Prevention and Public Health Fund, which is
of the CDC's budget).
need to:
Reduce the number of disease detectives
who assist with communicable disease
surveillance and public health
‘emergency response,
Eliminate the Connecting Adolescents.
‘to Comprehensive Healthcare (CATCH)
program, which provides reproductive
health services and education to nearly
‘50% of high school students.
Eliminate operating funds for School-Based
Health Centers, which provide primary care
such as physical examinations, reproductive
health services, screening, education and
referrals.
Distribute nearly 600,000 fewer clean
syringes to drug users, increasing the risk
of new HIV infections.
Distribute 760 fewer naloxone kits to
people at risk for overdose. Assuming a
10% fatality rate, about 19 lives lost may
be lost to overdose,
Reduce funding for tobacco control media
‘campaigns. From 2006 - 2013, DOHMH's
anti-smoking campaigns have generated
‘over 600,000 calls for help quitting
‘smoking. This translates into over 60,000
future smoking-related deaths prevented,