News
from STATE SENATOR
Liz Krueger
New York State Senate, 26th
District
COMMUNITY BULLETIN – January 2004
Message from Liz . . .
One of the major issues the legislature is likely to be dealing with this year is Medicaid reform. There is substantial pressure to change the way the state administers Medicaid. Local governments complain that New York State is unique in requiring counties to contribute half of the state’s cost for Medicaid, without allowing them any mechanism for managing that cost. Governor Pataki highlighted the need for reform in his State of the State address earlier this week. Finally, in December, the State Senate Majority issued a report outlining potential ways of reducing the costs of Medicaid. While the reform discussion has been suspiciously short on details, some key themes are emerging, which I explore below. In attempting to alleviate the burdens on counties, we must not decimate the level of health care we provide to Medicaid recipients.
The first step that should be taken in reforming Medicaid is to remove the requirement that localities contribute to the cost. There are two key reasons this reform is necessary. First, since New York State determines the level of coverage that must be provided under Medicaid, it is reasonable to expect that they should bear the costs of those decisions, rather than passing them on to counties as “unfunded mandates.” Second, the State is in fact more capable of bearing these costs, because it has more options for generating revenue. With the exception of New York City and a few other localities, most counties in New York State can only raise revenue through property taxes, which are both inflexible and regressive. Counties rightly complain that rising health care costs are forcing them to cut other vital services, because they cannot raise property taxes enough to keep pace with the increased costs.
Once this reform is made, the State will be in the position to accept responsibility for developing mechanisms for containing costs without eliminating vital services. This will be a very difficult balance to maintain, no doubt requiring a reevaluation of the state tax system to develop a more progressive revenue generating model.
As these discussions go forward some of the proposed changes to Medicaid that are likely to receive significant attention are:
· New restrictions on the transfer of assets by seniors in need of long term health care. It is critical that any such restrictions not undermine the ability of seniors to access basic services. Furthermore, the ability of the spouses of these seniors to retain enough money to support themselves must also be protected.
· Development of community based support services for severely disabled individuals as an alternative to nursing homes. This could be extremely beneficial to the disabled, as long as the pressure to reduce costs does not result in inadequate community based services, as unfortunately happened with the deinstitutionalization of the mentally ill in the 1960s and 1970s.
· Expanding requirements for participation in Medicaid managed care. This could severely limit the access of Medicaid recipients to reproductive health services in some upstate counties where the only HMO does not provide such services on religious grounds.
· Development of drug formularies. This could result in significant cost savings, but must be developed carefully to avoid unnecessarily limiting access to drugs, or physicians’ waivers for reasons of medical necessity.
· Transferring severely disabled children from Medicaid to Child Health Plus. This could deprive these children of access to home health care services, which are not covered under Child Health Plus.
· Improving coordination of health care services. It may be possible to both improve service and reduce costs by utilizing a case-management model for Medicaid.
Health care consumers, advocates, and elected officials will have to work hard this year to make certain that reform takes place in a context that protects access to needed services. I will be actively participating in debates over these issues, and welcome your input regarding Medicaid reform.
The longer-term solution to both the challenges of serving low-income, high-need New Yorkers and covering people who currently have no coverage at all is to develop a statewide single-payer plan bringing both groups under the same umbrella. If those who use emergency rooms as their primary care system were to receive regular preventive checkups-- and all health care "back office" costs were collapsed into one system-- we could deliver more actual health care at lower cost. Such plans can contain costs, which is why the Canadians spend 50% less than we do on administering their health care system.
Community
Spotlight
Calling
for the Revocation of the Liquor License for the Cheetah Club:
I recently wrote to the New York State Liquor
Authority (SLA), which was holding a disciplinary hearing regarding the Cheetah
Club, located at 12 West 21st Street. The Cheetah Club has a long history of lawless behavior, and has
received 232 summonses for illegal behavior since January 1, 2002. I indicated to the SLA that this record of
violations merits revocation of their liquor license under the 1995 Rowdy Bar
Law. The location of the Cheetah Club
in a heavily residential area has only exacerbated the myriad of problems that
it has caused. Cheetah Club is also located in the “moratorium area” designated
by Community Board 5, which has called on the SLA to deny any additional
licenses for this area due to the proliferation of clubs. I will continue to work to resolve the
problems caused by Cheetah and other clubs in this neighborhood.
Opposing Unreasonable Rent Increases
for Rent-Controlled Tenants:
Earlier this week I
submitted testimony to the Division of Housing and Community Renewal (DHCR)
opposing the proposed Standard Adjustment Factor (SAF) of 17.24% for rent
controlled tenants. If approved this
SAF would result in almost all rent-controlled tenants receiving rent increases
of 7.5% for each of the next two years. According to the
2002 Housing and Vacancy Survey, rent controlled tenants maintain the lowest
average income of any group of renters in the city, earning a median household
income of only $20,120 in 2001. Rent
controlled tenants have a median age of 68 and on average already pay a greater
percentage of their incomes for housing than any other group of residents. It is clear to me that the system by which
rents are determined for rent-controlled units is hopelessly out of date. The
MBR system was designed in 1970 for a rental market in which there were over
one million rent controlled apartments, vacancy decontrol did not exist, New
York City controlled all of its own rent regulation laws, inflation was high
and the market value of most properties was comparably low. It is essential that DHCR act to protect
rent-controlled tenants from unreasonable rent increases. I will also be working with my legislative
colleagues to better protect rent-controlled tenants.
Opposing Partisan Cuts to Advantage
After-School Funding:
Last month, I held a
press conference with educators, parents, and children to challenge the
elimination of state funding for eleven after-school programs in New York
City. These programs, funded through
the Advantage After-School program of the State Office of Children and Family
Services, were cut along with 31 other programs in the state. The Senate Majority responded to these cuts
by restoring funding to some programs, based primarily on their location in
Republican districts. Funding
streams in the New York City Metropolitan area have been renewed for thirteen
programs in Republican districts and for only one program in Democratic
districts. Research shows that children
who spend large amounts of time after school without supervision are more
likely to end up getting into trouble and working people face the crisis of
having to choose between being good employees or good parents – an untenable
situation. It is extremely unfortunate
that funding for such basic services is apparently being determined on the
basis of partisanship, rather than need.
Heat and Hot Water Complaint
Information:
By law, apartment, co-op and condo
building owners or managers must provide adequate heat between October 1 and
May 31. During this period, between 6:00 a.m. and 10:00 p.m., if the outside
temperature is below 55 degrees Fahrenheit, owners must heat apartments to at
least 68 degrees Fahrenheit. Between 10:00 p.m. and 6:00 a.m., if the outside
temperature is below 40 degrees Fahrenheit, owners must heat apartments to at
least 55 degrees Fahrenheit. Owners must also provide hot water at a minimum
constant temperature of 120 degrees Fahrenheit all year round. Tenants whose building owners fail to
provide adequate heat or hot water should first try to speak with the owner or
building manager about the problem. If an owner is unavailable or does not
correct the problem, tenants should then call the City's Citizen Service Center
at 311, open 24 hours per day, seven days per week, to lodge a complaint.
The New York State College Savings
Program:
New
York's 529 College Savings Program Direct Plan provides a flexible,
convenient, and low-cost way to save for college. The Program features a wide
range of investment choices, tax-free withdrawals when used for qualified
higher education expenses, and contributions that are tax-deductible (up to
certain limits) for New York State residents.
You can save for a child, grandchild, friend — or even yourself. For more information on the College Savings
Program, visit their website at www.nysaves.org,
or call 1-877-NYSAVES (1-877-697-2837).
The recent discovery
of Mad Cow Disease in a cow in Washington State has highlighted the importance
of ensuring the safety of our food supply.
The fact that the infected cow was allowed to enter our food supply is a
clear indication that there is something seriously wrong with our farming
practices. I have been working to deal
with this issue by calling for a ban on the slaughter of animals too sick to
walk, known as “downed animals.” This
session, I am reintroducing the “Downed Animal” Protection bill, which
was last considered in the 1999 session.
The legislation is aimed at promoting the humane treatment of downed
animals. Animals too sick to stand
(often a direct result of inhumane farming practices) have commonly been
slaughtered and sold for human consumption in the United States.
Downed animals
should not be sent to the slaughterhouse for consumption, but rather to a
veterinarian for treatment. Even before
the December 23, 2003 announcement that Mad Cow Disease was found in a downed
cow, the United States Department of Agriculture (USDA) was aware that mad cow
disease often manifests itself by rendering animals unable to walk, and that
infected animals could pass USDA inspections and enter the food supply. Downed animals are afflicted with a myriad
of ailments besides mad cow disease. USDA records obtained show that USDA
explicitly approved the consumption of meat from downed animals afflicted with
hepatitis, gangrene, pneumonia, malignant lymphoma, and other ailments. Downer
animals are also more likely to harbor bacterial contamination than walking
animals.
I am pleased that in
the wake of this case, the USDA has finally changed its policy and prohibited
the slaughter of downed animals by USDA inspected slaughterhouses. That said, it is essential that this ban be
enacted into legislation, so that it is not simply overturned at some later
point when the immediate fear of mad cow disease subsides. Furthermore, the Downed Animal Protection
Bill would expand the prohibition to slaughter by farms or in transit. Similar legislation was introduced in July,
2003 at the federal level (S.1298 in the U.S. Senate and H.R. 2519 in the U.S.
House of Representatives known as the “Downed Animal Protection Act”) and
narrowly missed being passed by a vote of 202 to 199. Several states and cities have been successful in passing downed
animal legislation, including California, Colorado, Illinois and
Cincinnati.
While the USDA has
adopted a number of additional measures in response to the mad cow disease
case, they have resisted taking the step that experts agree is most important –
implementing a large scale program to test cattle for bovine spongiform
encephalopathy (BSE), the cause of mad cow disease. Last year, the U.S tested 20,000 cattle for BSE, out of 35 million
slaughtered for human consumption.
Other countries test a far larger percentage of their cattle – in fact,
Japan tests every cow slaughtered to ensure its food supply remains safe.
It is essential that
our food policy be focused on protecting the safety of the consumer and the
health of the animals being sold for human consumption. Unfortunately, current federal policy places
the profits of agribusiness above health and safety concerns.
__________________________________________________________________________________________
District Office: 211
East 43rd Street, Suite 1300, New York NY 10017 (212) 490-9535 Fax:
(212) 490-2151
Albany
Office: Room 302,
Legislative Office Bldg., Albany NY 12247 (518) 455-2297 Fax: (518) 426-6874
On the Web at
http://www.lizkrueger.com