Hochul's health care proposals: Worker bonuses, increased Medicaid rates and millions for Roswell Park

Gov. Kathy Hochul's administration on Tuesday unveiled details of its $10 billion multi-year plan to bolster the state's health care industry, including $1.2 billion for worker retention bonuses, increased Medicaid reimbursement rates and millions of dollars for Roswell Park Comprehensive Cancer Center to boost cancer screenings in underserved communities.

"One hard lesson we learned about what happens when there's a lack of investment is how our health care system crumbled under the stress of the pandemic," Hochul said. "That's why we're making up for lost time and positioning the state to be on better footing going forward with the largest investment in health care in state history."

The budget presentation followed Hochul's health care spending promises made during her State of the State address on Jan. 5.

While some details became clearer with the release of a fiscal year 2023 executive budget briefing book, health care stakeholders and lawmakers were just starting to digest thousands of pages of budget documents that were released late Tuesday.

Many health care officials were happy with what they heard Tuesday, but not everyone was celebrating.

The home care industry, the fastest-growing segment of health care, felt left out, claiming Hochul's budget missed an opportunity to raise wages for home care workers. New York Caring Majority co-director Ilana Berger urged the State Legislature to include the Fair Pay for Home Care bill in the final budget it will negotiate with Hochul.

George Gresham, president of 1199SEIU United Healthcare Workers East, called Hochul's proposed health care spending "significant," but indicated more needed to be done.

"They are not yet enough to support a real recovery for our vital safety net institutions or for the home care workers that care for the most vulnerable," Gresham said.

Health care worker bonuses

Some clarity was provided on the proposed $1.2 billion in state funding for health care and mental hygiene worker retention bonuses.

For instance, the bonus program would be for workers earning up to $100,000 annually, aimed at recruiting and retaining front-line health care employees. 

The bonuses would be tailored in varying amounts based on hours worked and time of service. Up to $3,000 in bonuses would go to full-time workers who remain in their positions for one year. Those working fewer hours would be eligible for a pro-rated bonus.

"It’s both retention and also a desire to create an incentive for more people to enter the field because we're seeing a lot of shortages," state Budget Director Robert F. Mujica Jr. said.

Catholic Health System President and CEO Mark Sullivan sees the one-time bonuses as a good thing to retain staff that is nearing the start of their third year battling Covid-19.

Sullivan provided written testimony about the issues within health care to the several state Assembly committees in mid-November, shortly after Catholic Health and the Communications Workers of America reached a new labor contract following a more than month-long strike at Mercy Hospital that centered on staffing and wages.

"We have already implemented market wages, and this will help with that, but it will also bolster and recognize those hard workers at the bedside, as well as all those other people within the services of providing care," Sullivan said Tuesday.

Medicaid reimbursement rates

Health care facilities, especially nursing homes, have long complained that the state's Medicaid reimbursement rates need to increase, saying more than a decade of stagnant financial support has made it difficult to cover rising costs.

"There's a lot of investments that we're making in the Medicaid space and in the health care space overall," Mujica said. 

To allow providers to invest in better wages and compete for workers, Hochul is proposing a multi-year investment of $3.7 billion by reversing the 1.5% Medicaid cut to health care providers in the fiscal year 2021 budget and also increasing Medicaid rates across the board by 1% after years of flat reimbursement.

"We are grateful for the governor’s support for New York's not-for-profit and public hospitals, continuing care providers and the communities they serve," said Bea Grause, president of the Healthcare Association of New York State, which represents nonprofit and public hospitals as well as other health care facilities.

Roswell Park

Across New York, only about 6% of those eligible for lung cancer screening actually get screened, said Candace S. Johnson, president and CEO of Roswell Park Comprehensive Cancer Center. 

Lung cancer, she said, also disproportionately affects people of color.

Initiatives included in Hochul's executive budget aim to put a dent in that dynamic, especially in the midst of a pandemic that has caused a sharp decline in cancer screenings.

The budget will provide a one-time investment of $4 million to Roswell Park for the procurement of lung cancer screening mobile vans and medical technology. Those units will then be deployed in "racially diverse neighborhoods and communities for early detection of lung cancer," the budget book states.

"You have no idea how excited we are about this," Johnson said. "This is exactly what Roswell Park is about. We talked to the governor about this. Gov. Hochul is a visionary in giving us these funds, because this is going to save lives in Western New York."

The proposed budget also plans $4 million in additional ongoing operational support for Roswell Park, allowing the institution to expand and enhance cancer screening operations among underrepresented populations. 

The budget also would increase capital support for Roswell Park by $2 million to establish a home base for its community outreach and engagement team. 

That will involve putting those educational activities in a location in the Fruit Belt. There, Johnson said, Roswell Park is going to renovate a home, where community outreach and engagement meetings and gatherings can be held.