GNS: New York Applies For Federal Waiver to 'Transform' Health Care

NYAPRS Note: New York State has submitted its application to the federalgovernment for approval to reinvest $10 billion in anticipated savings from Medicaid redesign and reforms. Among the items that NYAPRS members and friends advocated for during state webinars, regional forums and meetings that were highlighted in the proposal include:

* Peer support pilots and, possibly, health home outreach and education efforts

* $750 million to pay for an estimated 15,000 new supportive housing beds over the next 5 years, along with the services to support SH residents

* Workforce retraining with a special emphasis on advancing cultural competence

* A $23 million ombuds program designed to protect consumer rights within managed care plans

* Primary care co-location within behavioral health programs and supportive housing.

For details, go to aiver_amendment_request.pdf.

New York Applies For Federal Waiver to 'Transform' Health Care

By Jessica Bakeman Gannett News Service August 6, 2012

New York today submitted an application to the federal government <> asking to reinvest into the state's health care infrastructure $10 billion of savings created by Gov. Andrew Cuomo's Medicaid Redesign Team.

Phase one of the team's recommendations are estimated to save a total of $34 billion in Medicaid funds - about half to the state and half to to the federal government. The waiver application, touted by a slew of health-care industry stakeholders at a Capitol news conference on Monday, asks for $10 billion of the estimated $17.1 billion federal savings over five years to be reinvested into New York's industry.

Cuomo assembled the Medicaid Redesign Team in January 2011 to identify potential cost savings in the state's Medicaid program - the largest and most expensive in the nation.

State Health Commissioner Nirav Shah demonstrated no doubt that the federal government would provide the waiver.

"It will be approved, because all of New York state will be behind it," he said at the conference. "And it makes sense."

Calling the waiver "revenue-neutral," he explained approving the application would not cost the federal government any more money. It will, in fact, cost less money, as the feds will still realize a savings of $7.1 billion.

Shah and Deputy Secretary for Health James Introne explained that the $10 billion would account for start-up costs necessary to update and modernize both the physical and organizational infrastructure of health care in New York. That investment will generate further cost savings, they said, assuring that the state would not be left with a multi-billion dollar commitment when the would-be five-year waiver runs out.

An example is a $750 million investment in supportive housing, included as one component in the 127-page waiver application. Providing housing and centrally located health services to the most vulnerable individuals will save money by preventing and shortening hospitalizations, officials said.

These individuals include patients being treated for substance abuse, psychiatric disorders, behavioral or developmental disabilities or chronic illnesses like HIV/AIDS. About 1 million New Yorkers fall into the "high-cost, high-needs" category, said Harvey Rosenthal, executive director of the New York Association of Psychiatric Rehabilitation Services.

Ted Houghton, executive director of the Supportive Housing Network of NY, said at the conference that 20 percent of Medicaid members account for 80 percent of spending.

"For these people, housing is health care," Houghton said. With housing support, "people that we really gave up on in previous generations are becoming success stories."

Also touting both the waiver and the work of the Medicaid Redesign Team, Paloma Hernandez, president and CEO of the Bronx-based Urban Health Plan, Inc., said all stakeholders' opinions were considered while developing the overhaul plan.

"When you try to improve a system," she said at the conference, "you need to take what you do and not add to it but really transform it. And I think that's what's being proposed here." waiver-to-transform-health-care/