Health, Department of

Agency Web Site: http://www.health.ny.gov/

Mission

The mission of the Department of Health (DOH) is to ensure high quality health services are available to all New Yorkers. The Department is also the principal State agency that administers the Medicaid Program, the New York State of Health (NYSOH) Exchange, and other public health and health insurance programs.

The Department operates health care facilities including Helen Hayes Hospital, four veteran’s nursing homes, and the Wadsworth Centers for Laboratories and Research. In addition, DOH conducts oversight of health professionals and all other health care facilities to ensure that high quality, cost effective, health care alternatives are provided throughout the State.

Organization and Staffing

DOH is headed by a Commissioner, who is appointed by the Governor subject to Senate confirmation. The agency is organized into four major business units: the Office of Public Health; the Office of Primary Care and Health Systems Management; Institutional Management; and the Office of Health Insurance Programs which houses Medicaid. Each of these business units contains multiple centers, divisions, and bureaus that work together to carry out DOH’s mission.

The workforce is spread out across the state, encompassing employees of the central office in Albany, four regional offices (located in Syracuse, New York City, Long Island, and Buffalo), the Wadsworth Center Public Health Laboratories, Helen Hayes Hospital (located in Haverstraw) as well as employees of the New York State Veterans’ Homes (located in Oxford, Queens, Batavia, and Montrose).

Budget Highlights

The FY 2018 Executive Budget recommends $148 billion for DOH, including $137 billion for Medicaid (represents two year appropriation authority), including $4.2 billion for the Essential Plan, and $6.8 billion for remaining health program spending. This reflects an increase of $10.7 billion from the FY 2017 Budget primarily reflecting the continuation of two-year appropriations for Medicaid, Medicaid program changes under the Affordable Care Act, the continued implementation of the Essential Plan, as well as anticipated funding under Federal waiver amendments.

The Budget recommends a workforce of 5,082 full time equivalent employees (FTEs) for the Department. This is an increase of 163 FTEs from the FY 2017 Budget, which is intended to provide staff to support the sixth year of the phased State takeover of local administration of the Medicaid program.

Major Budget initiatives include:

• Continuing Medicaid Redesign Team (MRT) reforms. A fiscally-neutral package of new MRT initiatives is proposed to make critical investments in health care delivery and support health care transformation. This package provides continued support to essential community providers. Investments are balanced by improvements in benefits design, greater pharmaceuticals controls to protect consumers from the health and economic consequences of the rapidly rising cost of prescription drugs, efficiencies within the Medicaid transportation benefit and compliance with the Federal spousal support law.
• Supporting $3.3 billion in capital investments to make infrastructure improvements and provide additional tools to stabilize health care providers to further advance transformation goals. This includes $500 million in new bonded and hard dollar funding to support capital projects and debt relief for health care institutions. A minimum of $50 million in funding will be reserved for Montefiore Medical Center and $30 million will be made available to community based providers.
• Consolidating 39 public health programs into four pools, achieving $24.6 million in savings.
• Reducing General Public Health Work reimbursement to New York City, saving $11 million.
• Saving $3.9 million in the Early Intervention program through a series of reforms that increase reimbursement from third-party insurers.
• Expanding public water testing to require every covered public water system in the State to test drinking water for the presence of emerging contaminants once every three years, require the testing of private wells for emerging contaminants for new wells, require testing prior to the sale of any residential property, and require testing of leased residential property once every five years. Testing results will be reported to DOH.
• Providing $150 million to support a life sciences laboratory public health initiative which will develop life science research, innovation and infrastructure through a joint effort between Empire State Development and the Department of Health.
• Providing $40 million to continue operational support for the State Health Information Network of New York (SHIN-NY) and continue to develop the All Payer Claims Database (APD).
• Establishing a stakeholder engagement process to make recommendations toward a fundamental restructuring of the statutes, policies and regulations that govern the licensure and oversight of health care facilities, home health care and community based services.

For more information on this agency's budget recommendations located in the Executive Budget Briefing Book, click on the following link:

Briefing Book – Health Care (PDF)

Program Highlights

Child Health Plus (CHP)

CHP provides comprehensive health coverage for children up to age 19 with family incomes above Medicaid eligibility levels. Like Medicaid, CHP is administered by states with guidance from the Centers for Medicare and Medicaid Services (CMS) and is jointly funded by the Federal government and states. Currently, approximately 300,000 New York children receive health coverage through CHP. Families with incomes below 160 percent of the Federal Poverty Level (FPL) can receive free coverage for their children while families with incomes over that threshold pay on a sliding scale from about $9-$60/month per child. Enrollees in CHP receive primary, preventive, specialty and inpatient care.

Elderly Pharmaceutical Insurance Coverage (EPIC)

The EPIC program provides drug coverage to income-eligible seniors aged 65 and older to supplement out-of-pocket Medicare Part D costs. This program serves approximately 300,000 seniors annually and is financed entirely with State funds, which are offset by revenues from fees paid by EPIC members and rebates from drug manufacturers for generic drugs.

Essential Plan (EP)

The EP provides health coverage for individuals with family incomes between 138 and 200 percent of the Federal Poverty Level (FPL) and for individuals from 0-200 percent FPL who are lawfully present in the United States but do not qualify for Medicaid due to their immigration status. The EP currently has enrollment of approximately 620,000 individuals statewide. The State receives Federal funding through the Essential Plan Trust Fund equal to 95 percent of what would have been provided to EP eligibles had they enrolled in the second lowest cost Silver Plan through the NYSOH. The EP offers a comprehensive package of benefits which include primary, preventive, specialty and inpatient care.

Medicaid

Medicaid is a means-tested program that finances health care services for over 6 million low-income individuals and long-term care services for the elderly and disabled, primarily through payments to over 80,000 health care providers and more than 90 managed care plans. The Medicaid program is financed jointly by the State, the Federal government, and local governments. Eligible services include inpatient hospital care, outpatient hospital services, clinics, nursing homes, managed care, prescription drugs, home care and services provided in a variety of community-based settings (including mental health, substance abuse treatment, developmental disabilities services, school-based services and foster care services).

New York State of Health (NYSOH)

NYSOH serves as a centralized marketplace to shop for, compare, and enroll in a health plan. The health plans offered through NY State of Health are, on average, 50 percent less expensive than those available in 2013, prior to the creation of the marketplace. To date, over 3.4 million New Yorkers have enrolled in coverage through the marketplace. The Executive Budget includes $553 million in total funding for the operation of the NY State of Health.

Public Health

DOH promotes and protects the health of people and the communities where they live, learn, work, and play. These efforts work to prevent people from getting sick or injured, and promote wellness. DOH staff are responsible for a wide range of public health issues including tracking disease outbreaks, educating the public about the health risks caused by alcohol and tobacco, and developing school nutrition programs. Major programs include:

• General Public Health Work (GPHW). The GPHW program, authorized under Article 6 of Public Health Law, provides reimbursement to counties and NYC for six mandated core public health services (Family Health, Communicable Disease Control, Chronic Disease Prevention, Community Health Assessment, Emergency Preparedness, and Environmental Health) by providing base grants and covering 36 percent of the remaining net costs.
• Early Intervention (EI). The EI program provides a comprehensive array of therapeutic and support services to children under the age of three with confirmed disabilities (e.g., autism, cerebral palsy) or developmental delays. The program serves approximately 68,000 children annually and is jointly financed by Federal, State and local governments.

Note: Most recent estimates as of 1/17/2017