Home Community pharmacy budget Starved of funding by pending Cuomo exclusion, safety net providers consider layoffs – troyrecord

Starved of funding by pending Cuomo exclusion, safety net providers consider layoffs – troyrecord


By Perry Junjulas

Albany’s failure to repeal a pre-pandemic cash grab has left community health and social services centers like mine in a precarious financial vacuum, threatening both jobs and the care we provide to residents. New York’s most vulnerable, the majority of whom are black and brown communities.

The exclusion from Medicaid drug benefits proposed by former Governor Andrew Cuomo, which diverts money from safety net providers to state coffers, will not take effect until April 2023. But the reality is that providers like mine operate under very strict conditions. margins and desperately need predictability.

This 30-year-old federal drug pricing program, known as 340B, allows safety net providers to buy drugs at discounted prices and use the savings to fund services for our clients who don’t are not covered by Medicaid, such as food, housing assistance, transportation, mental health counseling, medical care, and medication adherence assistance.

In April 2021, implementation of the exclusion was delayed by the Legislative Assembly until 2023 after an outcry from lawyers. We hoped that the exclusion plan would be permanently repealed after Governor Hochul took office and pledged to bolster the state’s pandemic-ravaged health care system.

But the governor and legislative leaders missed the opportunity to permanently end exclusion in the 2022-23 state budget. They can still act before the end of the session next month by passing and signing the proposed repeal law. Failure to do so will undoubtedly hurt the 2.3 million New Yorkers who rely on our services, 71% of whom are people of color and 89% low-income.

Excluding Cuomo will prevent safety net clinics from accessing more than $250 million in funding. Those of us with calendar year budgets will soon begin working on the year budget. Without knowing if we can rely on this essential funding stream, we will be forced to consider program cuts and staff cuts at all levels to make ends meet.

The Damien Center alone would lose 20% of our annual budget. Overall, it is estimated that nearly 80% of health centers would lay off or lay off staff, and at least 32 community clinics would be forced to close entirely, according to a survey by the Community Health Care Association of New York.

In the fall of 2020, the Damien Center faced the same dilemma as we prepared our 2021 budget. The proposed exclusion weighed heavily, with no repeal in sight. In December, we reduced our staff by 20%, eliminating eight of 40 positions, and imposed service cuts to all programs.

The ban was extended months later, but the damage was already done. For the first time in 34 years, the Damien Center was forced to conduct a mid-year review of its budget. But we could not, in good conscience, fully restore all cut jobs and services because a delay in implementation is not a total repeal. We were still in limbo.

The whole process was extremely disruptive for staff and customers. And we will have to repeat this painful exercise unless the governor and the legislature act now.

The state maintains that the carve-out will generate significant savings. But based on New York’s Medicaid funding, the state would be required to transfer more than 70% of the funding from the dismantling of the safety net system to the federal government, diverting resources away from communities in need. It does not mean anything.

The world has turned upside down since this ill-conceived plan was put forward. The budget deficit disappeared, thanks in large part to an unprecedented influx of federal pandemic aid. And the need for our services has only increased due to the COVID crisis and worsening economic conditions amplifying health inequities.

Governor Hochul and state legislators are playing a game of chicken with our community health centers, making a decision as we plan our budgets. They must stop torturing safety net facilities with indecisiveness and immediately repeal Cuomo’s exclusion so that we can continue to keep vulnerable New Yorkers safe and healthy.

— Perry Junjulas is executive director of the Albany Damien Center, a non-profit HIV/AIDS service organization and a person living with AIDS.