S8307C

The New York State Senate passed the Health and Mental Hygiene budget bill (S8307C) on a 40-20 vote Friday evening, capping a contentious debate over healthcare spending priorities that revealed deep divisions within the chamber over the state's approach to Medicaid, nursing homes, and vulnerable populations. The bill, made available to the public only six hours before floor debate, includes $285 million in Medicaid rate increases for nursing homes—far short of the $510 million they requested—and implements a controversial transition to a single statewide fiscal intermediary for the Consumer Directed Personal Assistance Program serving 250,000 to 300,000 New Yorkers with disabilities and chronic illnesses. Senate Health Committee Chair Sen. Jose Rivera characterized the budget as "harm reduction," acknowledging widespread dissatisfaction with the compromise reached after 18 days of negotiations. "This is the best that we could get," Rivera said repeatedly during the debate, defending provisions that even supporters admitted fell short of their goals. Opposition centered on several key issues: the CDPAP transition to a single vendor without Comptroller oversight or state procurement law requirements; inadequate funding for nursing homes facing closures; insufficient wage increases for direct service workers (1.7 percent versus the requested $4,000 enhancement); and the complete omission of opioid crisis provisions, including xylazine scheduling language that was in the Governor's original proposal. Sen. Helming raised particular concerns about the CDPAP changes, noting that Massachusetts and Pennsylvania's similar single-broker models led to caregivers going weeks without pay. "There's just a parade of flags, red and yellow and white," Rivera acknowledged, but said the state had to accept the Governor's insistence on the single intermediary model. Sen. Stec criticized the nursing home funding as inadequate, noting that Medicaid rebasing has not occurred since 2007 and that the Vital Access Provider program was cut from $100 million to $25 million, likely leading to more facility closures. Sen. Rhoads raised urgent concerns about Nassau University Medical Center, the only safety-net hospital in Nassau County serving 1.4 million people, which received no explicit funding despite facing potential closure by late May or early June due to years of state disinvestment. The bill did include some provisions supporters highlighted: expansion of doula care and maternal health services, continuous health insurance coverage for children ages zero to six, cost-of-living adjustments for mental health workers, and $300 million in capital funding and $100 million in operational support for SUNY Downstate, which was saved from closure through community advocacy. Five more budget bills remain to be passed, with three already in print. The Senate recessed for party conferences after the vote.