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Health, Department of

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Agency Web Site: https://www.health.ny.gov/Link to External Website

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 operates the Medicaid Program. Each of these business units contains multiple 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 2021 Executive Budget recommends $88.5 billion for DOH, including $76.7 billion for Medicaid, including $5.3 billion for the Essential Plan, and $6.5 billion for remaining health program spending. This reflects a decrease of $71.7 billion from the FY 2020 Enacted Budget due to the discontinuation of two-year appropriations for Medicaid.

The Budget recommends a workforce of 5,637 full time equivalent employees (FTEs) for the Department. This is an increase of 22 FTEs from the FY 2020 Budget. The increase of 22 FTEs is driven by support for the ninth year of the phased State takeover of local administration of the Medicaid program (+75), additional staff for the purposes of testing and regulating industrial hemp and CBD products (+20), and a shift from local support to state operations of the Family Planning program (+10). These increases are offset by FTE reductions from main office attrition (-67) and movement of 16 FTEs to the Office of Cannabis Management for the medical cannabis program (-16).

Major budget initiatives include:

The 2020 MRT must report back before the April 1 deadline to enact a Budget with a plan to deliver $2.5 billion in recurring savings. The Governor is directing the members of MRT II to develop a plan that doesn’t rely on local governments as a funding sources and has minimal impact on beneficiaries. Instead, MRT II must once again find solutions through industry efficiencies and/or by relying on new resources provided by the industry itself.

Local governments administer and monitor programs and determine eligibility and they must also find efficiencies and savings, as well as and rooting out waste, fraud and abuse in our system. Because the State takeover of 100% of the growth in local Medicaid costs was intended to assist counties and staying within the two percent property tax cap, the Budget ensures that counties that adhere to the two percent property tax growth cap continue to receive full benefit of the State takeover of Medicaid spending growth while penalizing those that don't by limiting the State’s financing of growth in Local Medicaid expenditures to 3 percent annually. Additionally, the Commissioner and the Director of the Division of the Budget are empowered to access any data necessary to manage the Medicaid program.

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).

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

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, nearly 420,000 New York children receive health coverage through CHP. Families with incomes below 160 percent of the Federal Poverty Level (FPL) 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.

Federal funding for the Children's Health Insurance Program (CHIP) has been reauthorized through FFY 2027

The Budget includes savings associated with claiming enhanced Federal funding through a health services initiative for non- Medicaid programs that support children.

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 335,000 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.

The Affordable Care Act (ACA) provides a phase-out of the Medicare Part D coverage gap (ended January 2020). The closure of the coverage gap will result in Medicare Part D picking up a larger share of program costs that were previously covered in EPIC.

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 over 770,000 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-eligible enrollees 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.

In FY 2018, the President took unilateral Executive action to withhold Cost Sharing Reduction (CSR) payments, threatening low-cost health insurance coverage for income eligible recipients when purchasing a Qualified Health Plan or Essential Plan coverage through the New York State of Health, New York's official health plan marketplace. Despite the Federal withholding of CSR payments, which amount to 25 percent of the Federal funding for the Essential Plan, the Executive Budget supported this program. However, recent actions by the Trump Administration in response to litigation brought by the State will allow the State to recoup some of the withheld EP funding through changes to the reimbursement methodology. The Executive Budget continues to reflect support for the EP program.

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 50 fully and partially capitated 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)

In 2013, in accordance with the Federal Affordable Care Act, the Governor issued Executive Order #42 to establish a New York Health Benefit Exchange. The Exchange – NY State of Health – 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, 55 percent less expensive than those available in 2013, prior to the creation of the marketplace. Since its inception in 2014, the NY State of Health has enrolled more than 4.8 million New Yorkers in affordable health coverage. The number of uninsured New Yorkers has declined by over one million. Between 2013 and 2018 the rate of uninsured in the State has declined to 5.6 percent among the non-elderly population according to the Centers for Disease Control and Prevention. The Executive Budget includes $519 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:

ALL FUNDS
APPROPRIATIONS
(dollars)
Category Available
FY 2020
Appropriations
Recommended
FY 2021
Change From
FY 2020
Reappropriations
Recommended
FY 2021
State Operations 3,605,713,400 2,506,470,000 (1,099,243,400) 3,784,346,438
Aid To Localities 156,439,208,171 85,795,089,100 (70,644,119,071) 163,118,716,000
Capital Projects 202,904,000 206,170,000 3,266,000 3,513,225,000
Total 160,247,825,571 88,507,729,100 (71,740,096,471) 170,416,287,438

ALL FUND TYPES
PROJECTED LEVELS OF EMPLOYMENT BY PROGRAM
FILLED ANNUAL SALARIED POSITIONS
Program FY 2020
Estimated FTEs
03/31/20
FY 2021
Estimated FTEs
03/31/21
FTE Change
Administration
General Fund 1,094 1,070 (24)
Special Revenue Funds - Federal 24 24 0
Special Revenue Funds - Other 116 112 (4)
Capital Projects Funds - Other 26 26 0
Child Health Insurance
Special Revenue Funds - Other 23 23 0
Center for Community Health
Special Revenue Funds - Federal 381 381 0
Special Revenue Funds - Other 79 75 (4)
Center for Environmental Health
Special Revenue Funds - Federal 96 91 (5)
Special Revenue Funds - Other 30 37 7
Capital Projects Funds - Federal 51 51 0
Capital Projects Funds - Other 50 50 0
Elderly Pharmaceutical Insurance Coverage
Special Revenue Funds - Other 13 13 0
Essential Plan
General Fund 6 6 0
Institutional Management
Special Revenue Funds - Other 1,472 1,472 0
Capital Projects Funds - Other 51 51 0
Medical Assistance Administration
General Fund 776 809 33
Special Revenue Funds - Federal 696 738 42
Special Revenue Funds - Other 10 10 0
Medical Cannabis
Special Revenue Funds - Other 32 0 (32)
New York State of Health
Special Revenue Funds - Other 80 80 0
Office of Health Insurance Programs
Special Revenue Funds - Federal 41 41 0
Office of Primary Care and Health Systems Management
General Fund 0 26 26
Special Revenue Funds - Federal 85 85 0
Special Revenue Funds - Other 197 186 (11)
Wadsworth Center for Laboratories and Research
Special Revenue Funds - Federal 47 47 0
Special Revenue Funds - Other 139 133 (6)
Total 5,615 5,637 22

STATE OPERATIONS
ALL FUNDS FINANCIAL REQUIREMENTS BY FUND TYPE
APPROPRIATIONS
(dollars)
Fund Type Available
FY 2020
Recommended
FY 2021
Change
General Fund 784,759,400 475,555,000 (309,204,400)
Special Revenue Funds - Federal 2,413,864,000 1,626,246,000 (787,618,000)
Special Revenue Funds - Other 407,090,000 404,669,000 (2,421,000)
Total 3,605,713,400 2,506,470,000 (1,099,243,400)
Adjustments:
Transfer(s) To
Prevention of Domestic Violence, Office for the
General Fund 36,000
Appropriated FY 2020 3,605,749,400

STATE OPERATIONS
ALL FUNDS FINANCIAL REQUIREMENTS BY PROGRAM
APPROPRIATIONS
(dollars)
Program Available
FY 2020
Recommended
FY 2021
Change
AIDS Institute
Special Revenue Funds - Federal 600,000 600,000 0
Administration
General Fund 160,055,400 160,191,000 135,600
Special Revenue Funds - Federal 11,054,000 11,188,000 134,000
Special Revenue Funds - Other 19,904,000 28,243,000 8,339,000
Center for Community Health
Special Revenue Funds - Federal 169,747,000 170,517,000 770,000
Special Revenue Funds - Other 5,050,000 5,030,000 (20,000)
Center for Environmental Health
Special Revenue Funds - Federal 18,413,000 18,488,000 75,000
Special Revenue Funds - Other 8,141,000 8,385,000 244,000
Child Health Insurance
Special Revenue Funds - Federal 138,500,000 138,500,000 0
Special Revenue Funds - Other 13,297,000 17,061,000 3,764,000
Elderly Pharmaceutical Insurance Coverage
Special Revenue Funds - Other 13,250,000 13,250,000 0
Essential Plan
General Fund 84,225,000 78,089,000 (6,136,000)
Health Care Reform Act Program
Special Revenue Funds - Other 8,470,000 7,370,000 (1,100,000)
Institutional Management
Special Revenue Funds - Other 166,448,000 166,448,000 0
Medical Assistance Administration
General Fund 540,479,000 237,275,000 (303,204,000)
Special Revenue Funds - Federal 1,415,093,000 626,496,000 (788,597,000)
Special Revenue Funds - Other 3,081,000 1,541,000 (1,540,000)
Medical Cannabis
Special Revenue Funds - Other 9,778,000 0 (9,778,000)
New York State of Health
Special Revenue Funds - Other 53,398,000 49,033,000 (4,365,000)
Office of Health Insurance Programs
Special Revenue Funds - Federal 625,491,000 625,491,000 0
Special Revenue Funds - Other 6,517,000 6,517,000 0
Office of Primary Care and Health Systems Management
Special Revenue Funds - Federal 21,353,000 21,353,000 0
Special Revenue Funds - Other 37,228,000 35,993,000 (1,235,000)
Wadsworth Center for Laboratories and Research
Special Revenue Funds - Federal 13,613,000 13,613,000 0
Special Revenue Funds - Other 62,528,000 65,798,000 3,270,000
Total 3,605,713,400 2,506,470,000 (1,099,243,400)

STATE OPERATIONS - GENERAL FUND
SUMMARY OF PERSONAL SERVICE APPROPRIATIONS AND CHANGES
FY 2021 RECOMMENDED
(dollars)
Program Total Personal Service Regular
(Annual Salaried)
Amount Change Amount Change
Administration 113,762,000 1,858,000 111,540,000 1,858,000
Essential Plan 4,692,000 111,000 4,674,000 108,000
Medical Assistance Administration 38,093,000 (63,706,000) 37,783,000 (63,396,000)
Total 156,547,000 (61,737,000) 153,997,000 (61,430,000)
STATE OPERATIONS - GENERAL FUND
SUMMARY OF PERSONAL SERVICE APPROPRIATIONS AND CHANGES
FY 2021 RECOMMENDED CONTINUED
(dollars)
Program Temporary Service
(Nonannual Salaried)
Holiday/Overtime Pay
Amount Change Amount Change
Administration 329,000 0 1,893,000 0
Essential Plan 0 0 18,000 3,000
Medical Assistance Administration 65,000 (65,000) 245,000 (245,000)
Total 394,000 (65,000) 2,156,000 (242,000)

STATE OPERATIONS - GENERAL FUND
SUMMARY OF NONPERSONAL SERVICE AND MAINTENANCE UNDISTRIBUTED
APPROPRIATIONS AND CHANGES
FY 2021 RECOMMENDED
(dollars)
Program Total Supplies and Materials
Amount Change Amount Change
Administration 46,429,000 (1,722,400) 6,555,000 2,000
Essential Plan 73,397,000 (6,247,000) 9,000 0
Medical Assistance Administration 199,182,000 (239,498,000) 524,000 (524,000)
Total 319,008,000 (247,467,400) 7,088,000 (522,000)
STATE OPERATIONS - GENERAL FUND
SUMMARY OF NONPERSONAL SERVICE AND MAINTENANCE UNDISTRIBUTED
APPROPRIATIONS AND CHANGES
FY 2021 RECOMMENDED CONTINUED
(dollars)
Program Travel Contractual Services
Amount Change Amount Change
Administration 1,944,000 75,000 35,820,000 (1,814,400)
Essential Plan 20,000 0 73,361,000 (6,247,000)
Medical Assistance Administration 300,000 (300,000) 197,258,000 (237,574,000)
Total 2,264,000 (225,000) 306,439,000 (245,635,400)
STATE OPERATIONS - GENERAL FUND
SUMMARY OF NONPERSONAL SERVICE AND MAINTENANCE UNDISTRIBUTED
APPROPRIATIONS AND CHANGES
FY 2021 RECOMMENDED CONTINUED
(dollars)
Program Equipment
Amount Change
Administration 2,110,000 15,000
Essential Plan 7,000 0
Medical Assistance Administration 1,100,000 (1,100,000)
Total 3,217,000 (1,085,000)

STATE OPERATIONS - OTHER THAN GENERAL FUND
SUMMARY OF APPROPRIATIONS AND CHANGES
FY 2021 RECOMMENDED
(dollars)
Program Total Personal Service
Amount Change Amount Change
AIDS Institute 600,000 0 0 0
Administration 39,431,000 8,473,000 15,236,000 500,000
Center for Community Health 175,547,000 750,000 62,789,000 175,000
Center for Environmental Health 26,873,000 319,000 12,865,000 0
Child Health Insurance 155,561,000 3,764,000 49,016,000 186,000
Elderly Pharmaceutical Insurance Coverage 13,250,000 0 2,275,000 0
Health Care Reform Act Program 7,370,000 (1,100,000) 0 0
Institutional Management 166,448,000 0 104,917,000 0
Medical Assistance Administration 628,037,000 (790,137,000) 32,595,000 (83,005,000)
Medical Cannabis 0 (9,778,000) 0 (3,670,000)
New York State of Health 49,033,000 (4,365,000) 5,470,000 (193,000)
Office of Health Insurance Programs 632,008,000 0 74,028,000 0
Office of Primary Care and Health Systems Management 57,346,000 (1,235,000) 21,423,000 (652,000)
Wadsworth Center for Laboratories and Research 79,411,000 3,270,000 15,711,000 1,045,000
Total 2,030,915,000 (790,039,000) 396,325,000 (85,614,000)
STATE OPERATIONS - OTHER THAN GENERAL FUND
SUMMARY OF APPROPRIATIONS AND CHANGES
FY 2021 RECOMMENDED CONTINUED
(dollars)
Program Nonpersonal Service
Amount Change
AIDS Institute 600,000 0
Administration 24,195,000 7,973,000
Center for Community Health 112,758,000 575,000
Center for Environmental Health 14,008,000 319,000
Child Health Insurance 106,545,000 3,578,000
Elderly Pharmaceutical Insurance Coverage 10,975,000 0
Health Care Reform Act Program 7,370,000 (1,100,000)
Institutional Management 61,531,000 0
Medical Assistance Administration 595,442,000 (707,132,000)
Medical Cannabis 0 (6,108,000)
New York State of Health 43,563,000 (4,172,000)
Office of Health Insurance Programs 557,980,000 0
Office of Primary Care and Health Systems Management 35,923,000 (583,000)
Wadsworth Center for Laboratories and Research 63,700,000 2,225,000
Total 1,634,590,000 (704,425,000)

AID TO LOCALITIES
ALL FUNDS FINANCIAL REQUIREMENTS BY FUND TYPE
APPROPRIATIONS
(dollars)
Fund Type Available
FY 2020
Recommended
FY 2021
Change
General Fund 44,843,704,171 26,292,119,100 (18,551,585,071)
Special Revenue Funds - Federal 99,326,660,000 52,586,634,000 (46,740,026,000)
Special Revenue Funds - Other 12,268,844,000 6,916,336,000 (5,352,508,000)
Total 156,439,208,171 85,795,089,100 (70,644,119,071)

AID TO LOCALITIES
ALL FUNDS FINANCIAL REQUIREMENTS BY PROGRAM
APPROPRIATIONS
(dollars)
Program Available
FY 2020
Recommended
FY 2021
Change
AIDS Institute
General Fund 104,380,700 103,255,700 (1,125,000)
Special Revenue Funds - Federal 600,000 600,000 0
Administration
General Fund 266,000 266,000 0
Center for Community Health
General Fund 601,224,471 574,537,400 (26,687,071)
Special Revenue Funds - Federal 904,117,000 904,117,000 0
Special Revenue Funds - Other 5,665,000 5,665,000 0
Center for Environmental Health
General Fund 6,512,000 6,512,000 0
Special Revenue Funds - Federal 3,687,000 5,187,000 1,500,000
Special Revenue Funds - Other 9,560,000 9,560,000 0
Child Health Insurance
Special Revenue Funds - Federal 1,750,000,000 1,664,098,000 (85,902,000)
Special Revenue Funds - Other 482,087,000 658,149,000 176,062,000
Elderly Pharmaceutical Insurance Coverage
Special Revenue Funds - Other 121,357,000 104,413,000 (16,944,000)
Essential Plan
General Fund 386,218,000 386,218,000 0
Special Revenue Funds - Federal 4,884,774,000 4,884,774,000 0
Health Care Reform Act Program
Special Revenue Funds - Other 416,502,000 290,631,000 (125,871,000)
Medical Assistance
General Fund 42,344,845,000 24,502,017,000 (17,842,828,000)
Special Revenue Funds - Federal 90,017,500,000 44,082,526,000 (45,934,974,000)
Special Revenue Funds - Other 11,207,103,000 5,821,348,000 (5,385,755,000)
Medical Assistance Administration
General Fund 1,387,500,000 713,750,000 (673,750,000)
Special Revenue Funds - Federal 1,441,300,000 720,650,000 (720,650,000)
Office of Health Insurance Programs
General Fund 3,228,000 1,490,000 (1,738,000)
Special Revenue Funds - Federal 320,000,000 320,000,000 0
Special Revenue Funds - Other 2,930,000 2,930,000 0
Office of Primary Care and Health Systems Management
General Fund 9,370,000 4,073,000 (5,297,000)
Special Revenue Funds - Federal 1,000,000 1,000,000 0
Special Revenue Funds - Other 12,560,000 12,560,000 0
Wadsworth Center for Laboratories and Research
General Fund 160,000 0 (160,000)
Special Revenue Funds - Federal 3,682,000 3,682,000 0
Special Revenue Funds - Other 11,080,000 11,080,000 0
Total 156,439,208,171 85,795,089,100 (70,644,119,071)

CAPITAL PROJECTS
ALL FUNDS FINANCIAL REQUIREMENTS BY PROGRAM
APPROPRIATIONS
(dollars)
Comprehensive Construction Program Available
FY 2020
Recommended
FY 2021
Change Reappropriations
FY 2021
All Payers Claims Database
Capital Projects Fund 10,000,000 10,000,000 0 0
Capital Restructuring Program for Health Care and Related Facilities
Capital Projects Fund - Authority Bonds 0 0 0 992,538,000
Facilities Maintenance and Operations
Capital Projects Fund 9,000,000 12,266,000 3,266,000 0
Health Care Facility Transformation Program
Capital Projects Fund - Authority Bonds 0 0 0 2,135,219,000
IT Initiatives Program
Health Care IT Capital 10,000,000 10,000,000 0 8,136,000
Laboratories and Research
Capital Projects Fund 8,000,000 8,000,000 0 33,140,000
Capital Projects Fund - Authority Bonds 0 0 0 372,000
Maintenance and Improvements of Existing Institutions
Capital Projects Fund 58,904,000 58,904,000 0 38,879,000
Statewide Health Information Network For New York
Capital Projects Fund 30,000,000 30,000,000 0 0
Water Resources
Federal Capital Projects Fund 77,000,000 77,000,000 0 304,941,000
Total 202,904,000 206,170,000 3,266,000 3,513,225,000

Note: Most recent estimates as of 01/29/2020

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