Cuomo: February is the last chance
By Mary Frost
Brooklyn Daily Eagle
Governor Andrew Cuomo and Mayor Bill de Blasio, at a Monday news conference in Albany, presented a united front in their plea to the federal government to act immediately on New York State’s $10 billion Medicaid Waiver request, of which $1 billion would go towards transforming teetering Brooklyn hospitals.
“Help delayed is help denied,” Governor Cuomo warned. “If we don’t get help, hospitals will collapse.”
Mayor de Blasio told representatives from Brooklyn gathered in the Red Room that the $1 billion would have “a seismic impact for the long term.”
“We’ve been living hand to mouth, and in the court system,” de Blasio said, referring to the year-long battles waged by supporters of Long Island College Hospital (LICH) in Cobble Hill and Interfaith Medical Center in Bedford-Stuyvesant. Brookdale University Hospital, in eastern Brooklyn, is also on the brink. De Blasio, when Public Advocate, was arrested during the fight to save the LICH from closure by the state.
Getting those federal dollars in time to save LICH and Interfaith is crucial, he said. Both Mayor de Blasio and Gov. Cuomo called on the U.S. Department of Health and Human Services (HHS) to “give us the waiver” sooner rather than later.
The state needs approval by February, Gov. Cuomo said. “February is the last period I can do a modification to the budget. If we get the waiver, then I will do a budget modification.”
In his Executive Budget address last week, Governor Cuomo blamed the federal government’s foot-dragging for exacerbating Brooklyn’s hospital crisis. The waiver application was first filed 18 months ago, and was revised more than a month ago after months of back and forth conversations with HHS.
Last week the state received a letter from HHS Secretary Kathleen Sebelius summarizing the changes but saying that more needed to be done.
According to an AP report, Sebelius said in the letter that they've begun drafting "a potential agreement" based on New York's revisions, but there are "outstanding issues." She proposed additional staff meetings this week "to expedite this process."
“We’ve been doing short-term planning for 18 months,” Gov. Cuomo said on Monday. “While other states were given approval in just a few months, New York is still waiting and hospitals in Brooklyn will close if we wait any longer. We need HHS funding to transform the system.”
He added, “Reality doesn’t have to fit the government process, the government process has to fit reality.”
Gov. Cuomo maintained that Brooklyn has “excess” hospital beds and not enough primary care. De Blasio, however, said that the emergency rooms at LICH and Interfaith are the “first point of access to health care” for a quarter of a million people.
The Medicaid waiver was “meant explicitly for this type of situation,” he said. “I have spoken to Kathleen Sebelius. It’s truly the time for action. I am convinced we can secure local health care . . . emergency room capacity, primary and urgent care, along with mental health capacity at Interfaith.”
De Blasio also pointed out that New York City has lost 12 hospitals over the last 12 years. “The same mistakes have played out over and over again. There has not been a clear strategy. This time, we are working together.”
Both Mayor de Blasio and Governor Cuomo highlighted their long-term relationship, with “20 years of working together.”
“We use the word friend often in politics and sometimes casually,” Cuomo said. “But the mayor truly is a friend in every sense of the word. We go way back.”
Despite suing several state agencies for their attempts to shut the Brooklyn hospitals, on Monday de Blasio thanked the state for “stepping in” while awaiting the federal government to move on its request for the waiver funds. “I know it hasn’t been easy, Governor, and I know it hasn't been cheap, but you did something powerful by helping us have the opportunity to bridge to long-term solutions.”
New York State Medicaid Director Jason Helgerson said that the Governor’s budget opened the door to investment by private equity in the health care system.
A three-pronged approach would include “state borrowing, private equity, and the waiver together,” he told reporters. While this would still not allow a “for-profit administration,” it would allow some private investment,” he said.
The Governor’s Medicaid Redesign Team identified savings of $34 billion in New York’s Medicaid system while adding half a million people to the program. If approved, the waiver funds is meant to allow the state to reinvest its portion of these savings, $10 billion, toward improvements in the state’s healthcare delivery system.
Assemblyman Joseph Lentol, Dean of the Brooklyn Delegation of the New York State Legislature said in a statement, "I am pleased to join with Governor Cuomo and Mayor Bill De Blasio in unified support for saving Brooklyn's hospitals. The health system of Brooklyn cannot be allowed to collapse. We must work to restore Brooklyn's hospitals and health care system back to its own fiscal fitness and move it forward so that Brooklyn boasts a creative and vital health care system for its residents."
Updated at 5:45 p.m. with clarification about the timing of a letter from HHS Secretary Kathleen Sebelius.