WEDNESDAY, JUNE 5, 2019 11:49 A.M.
ACTING SPEAKER PICHARDO: THE HOUSE WILL
COME TO ORDER.
IN THE ABSENCE OF CLERGY, LET US PAUSE FOR A MOMENT OF
SILENCE.
(WHEREUPON, A MOMENT OF SILENCE WAS OBSERVED.)
VISITORS ARE INVITED TO JOIN THE MEMBERS IN THE PLEDGE
OF ALLEGIANCE.
(WHEREUPON, ACTING SPEAKER PICHARDO LED VISITORS
AND MEMBERS IN THE PLEDGE OF ALLEGIANCE.)
ACTING SPEAKER PICHARDO: A QUORUM BEING
PRESENT, THE CLERK WILL READ THE JOURNAL OF TUESDAY, JUNE 4TH.
MRS. PEOPLES-STOKES.
MRS. PEOPLES-STOKES: MR. SPEAKER, I MOVE TO
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NYS ASSEMBLY JUNE 5, 2019
DISPENSE WITH THE FURTHER READING OF THE JOURNAL OF TUESDAY, JUNE THE
4TH AND THAT THE SAME STAND APPROVED.
ACTING SPEAKER PICHARDO: WITHOUT
OBJECTION, SO ORDERED.
MRS. PEOPLES-STOKES.
MRS. PEOPLES-STOKES: THANK YOU, MR.
SPEAKER. I'D LIKE TO OFFER FOR OUR COLLEAGUES, STAFF AND GUESTS THAT ARE
IN THE CHAMBERS [SIC] A QUOTE THIS MORNING FORM CARLOS SANTANA.
MANY OF YOU MAY REMEMBER HIM AND HIS MUSICAL STYLE. BUT HIS QUOTE
TODAY IS, "THE MOST VALUABLE POSSESSION YOU CAN OWN IS AN OPEN HEART.
THE MOST POWERFUL WEAPON YOU CAN BE IS AN INSTRUMENT OF PEACE."
AGAIN, MR. SPEAKER, THAT'S CARLOS SANTANA.
ON MEMBERS' DESKS THERE IS A MAIN CALENDAR. WE'RE
GOING TO CONTINUE ON THAT MAIN CALENDAR AS WELL AS A DEBATE LIST. AFTER
ANY INTRODUCTIONS AND HOUSEKEEPING, WE WILL TAKE UP RESOLUTIONS WHICH
ARE ON PAGE 3. AND THEN WE'RE GOING TO CONTINUE WITH NEW BILLS THAT
ARE ON THE MAIN CALENDAR, BEGINNING WITH CALENDAR NO. 539 WHICH IS
ON PAGE 37. WE'LL ALSO BE TAKING UP BILLS ON DEBATE AS WELL. THERE ARE
ALSO GOING TO BE COMMITTEES. WE ARE ALREADY ENGAGED IN BANKING. WE
ARE GOING TO HAVE TO CALL ALCOHOLISM, ENERGY, TRANSPORTATION, CODES,
AND WAYS AND MEANS. THE RULES COMMITTEE WILL MEET TODAY AS WELL,
AND THE COMMITTEE IS GOING TO PRODUCE AN A-CALENDAR WHICH WE'RE
GOING TO TAKE UP TODAY, MR. SPEAKER. AT SOME POINT THE MINORITY IS
GOING TO BE IN NEED OF A CONFERENCE. WE'LL LOOK TO MR. GOODELL TO LET
US KNOW WHEN THAT HAPPENS. AND FOR OUR MAJORITY MEMBERS, THERE
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NYS ASSEMBLY JUNE 5, 2019
WILL BE A NEED FOR A DEMOCRATIC CONFERENCE AT THE CONCLUSION OF
TODAY'S SESSION. AS ALWAYS, MR. SPEAKER, I WILL CONSULT WITH THE OTHER
FOLKS TO SEE WHEN THEY NEED TO HAVE THEIR CONFERENCE.
THAT'S THE GENERAL OUTLINE, MR. SPEAKER. IF THERE ARE
INTRODUCTIONS AND HOUSEKEEPING, NOW WOULD BE THE APPROPRIATE TIME.
ACTING SPEAKER AUBRY: MS. WALSH FOR THE
PURPOSES OF AN INTRODUCTION.
MS. WALSH: THANK YOU, MR. SPEAKER. WE ARE SO
PLEASED TO BE JOINED TODAY BY THE CHARLTON HEIGHTS ODYSSEY OF THE
MIND TEAM. MEMBERS STELLA KIBLER, EMME FISCHER, ARDEN HEINER,
LUCY CAPO, CAROLINE WELSH, GABI TATRO; THEIR COACHES KODI KIBLER
AND SARA WELSH; THEIR PRINCIPAL, DAN [SIC] SINNENBERG -- TIM
SINNENBERG, I'M SO SORRY -- AND SEVERAL OF THEIR PARENTS, INCLUDING
PAULA FISCHER, JARED HEINER, MELISSA CAPO, MICHAEL COLLIGAN AND DAN
TATRO. ON MARCH 23RD, THE CHARLTON HEIGHTS ODYSSEY OF THE MIND ALL-
GIRL TEAM, WHICH IS MADE UP OF THE SIX FOURTH-GRADERS FROM THE BURNT
HILLS-BALLSTON LAKE SCHOOL DISTRICT THAT WE HAVE HERE TODAY, WON THE
STATE CHAMPIONSHIP AND ADVANCED TO THE WORLD FINALS. AT THE END OF
MAY, THE GIRLS WON THIRD PLACE AT THE WORLD FINALS, WHICH WAS HELD IN
MICHIGAN. THEY PLACED FIRST IN THE PERFORMANCE PORTION OF THE
COMPETITION. THEY COMPETED AGAINST 72 OTHER TEAMS FROM ALL OVER THE
UNITED STATES, AS WELL AS CHINA, POLAND, JAPAN, KOREA, CANADA,
SWITZERLAND AND MEXICO. DURING THE COMPETITION, THE GIRLS WERE
REQUIRED TO REPLICATE LEONARDO DA VINCI WORKS. THE MONA LISA WAS
QUILTED BY ONE OF THE GIRLS, USING HUNDREDS OF ONE-INCH FABRIC SQUARES
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NYS ASSEMBLY JUNE 5, 2019
AND THE PAINTING "LADY WITH ERMINE" WAS MADE COMPLETELY OUT OF
BEANS AND BARLEY. THEIR PERFORMANCE BROUGHT GREAT RECOGNITION TO
THEIR CREATIVITY AND TALENTS, AND ULTIMATELY EARNED THEM A TOP
PLACEMENT.
FOR THOSE OF YOU WHO DON'T KNOW, ODYSSEY OF THE
MIND AS IN AN INTERNATIONAL CREATIVE PROBLEM-SOLVING COMPETITION.
STUDENTS LEARN CRITICAL THINKING AND PROBLEM-SOLVING SKILLS, AS WELL AS
THE VALUE OF TEAMWORK BY WORKING TOGETHER THROUGHOUT THE SCHOOL YEAR
TO SOLVE A LONG-TERM PROBLEM. THOUSANDS OF TEAMS THROUGHOUT THE
UNITED STATES AND 25 COUNTRIES PARTICIPATE IN THE PROGRAM.
I AM SO PROUD, I WANT TO CONGRATULATE THESE EXTREMELY
INTELLIGENT AND DRIVEN YOUNG LADIES ON THEIR STATE CHAMPIONSHIP AND
THIRD PLACE WORLD FINISH. I HOPE YOU ARE AS PROUD OF YOURSELVES AS WE
ARE OF YOU. WE ARE SO LUCKY TO HAVE YOU REPRESENTING THE BURNT
HILLS-BALLSTON LAKE CENTRAL SCHOOL DISTRICT. AND AS NINE- AND
TEN-YEAR-OLDS, I CANNOT WAIT TO SEE WHAT YOU WILL DO NEXT.
SO, ON BEHALF OF MYSELF AND, MR. SPEAKER, IF YOU
COULD PLEASE EXTEND THE CORDIALITIES OF THE HOUSE AND A WARM WELCOME
TO THESE YOUNG LADIES.
ACTING SPEAKER AUBRY: CERTAINLY. ON BEHALF
OF MS. WALSH, THE SPEAKER AND ALL THE MEMBERS, WE WELCOME YOU HERE
TO THE NEW YORK STATE ASSEMBLY. WE EXTEND TO YOU THE PRIVILEGES OF
THE FLOOR. ALSO, TO YOUR PRINCIPAL AND YOUR PARENTS WHO HAVE COME.
WE CELEBRATE WITH YOU THE VICTORIES THAT YOU'VE HAD AS CHAMPIONS IN
NEW YORK STATE AND THIRD PLACE IN THE WORLD. NOT BAD WORK FOR
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NYS ASSEMBLY JUNE 5, 2019
TEN-YEAR-OLDS. CONGRATULATIONS. CONTINUE THAT GREAT WORK, AND WE
HOPE THIS WILL BE SOMETHING THAT WILL GUIDE YOU ONTO A HUGE, BRIGHT
FUTURE. THANK YOU SO VERY MUCH. YOU ARE ALWAYS WELCOME HERE.
(APPLAUSE)
MRS. PEOPLES-STOKES.
MRS. PEOPLES-STOKES: MR. SPEAKER, IF WE CAN
NOW GO TO PAGE 3, RESOLUTIONS. WE'RE GOING TO START AT ASSEMBLY NO.
493.
ACTING SPEAKER AUBRY: THE CLERK WILL READ.
THE CLERK: ASSEMBLY RESOLUTION NO. 493, MR.
CUSICK.
LEGISLATIVE RESOLUTION MEMORIALIZING GOVERNOR
ANDREW M. CUOMO TO PROCLAIM JUNE 5TH, 2019, AS GLOBAL RUNNING
DAY IN THE STATE OF NEW YORK.
ACTING SPEAKER AUBRY: MR. CUSICK ON THE
RESOLUTION.
MR. CUSICK: THANK YOU, THANK YOU, MR. SPEAKER.
I RISE TO EXPLAIN THE RESOLUTION TODAY. TODAY IS GLOBAL RUNNING DAY.
IT IS ALWAYS THE FIRST WEDNESDAY OF JUNE EVERY YEAR. HERE IN THE
CAPITOL, WE INSTITUTED BACK IN 2013 A -- BACK THEN IT WAS NATIONAL
RUNNING DAY, NOW IT'S GLOBAL RUNNING DAY. BUT BACK IN 2013 WE
INSTITUTED A FUN RUN HERE AT THE CAPITOL. AND THIS RESOLUTION
COMMEMORATES GLOBAL RUNNING DAY AND IT ENCOURAGES PEOPLE TO LIVE A
HEALTHY LIFESTYLE AND TO TAKE UP RUNNING IF YOU'RE NOT A RUNNER, OR TO
CONTINUE RUNNING AS A HEALTHY WAY OF KEEPING FIT. TONIGHT, MR.
5
NYS ASSEMBLY JUNE 5, 2019
SPEAKER, TO COMMEMORATE GLOBAL RUNNING DAY WE ARE SPONSORING A
FUN RUN THAT STARTS AT THE EMPIRE PLAZA. ANY OF MY COLLEAGUES WHO
ARE INTERESTED, YOU'RE MORE THAN WELCOME TO JOIN US FOR A NICE RUN
STARTING AT 6:30 TONIGHT. IT WILL END -- IT'S A THREE-MILE RUN. THERE ARE
HALF-MILE AND MILE INCREMENTS THAT YOU CAN RUN ALSO, IF YOU'D LIKE. AND
THEN AFTERWARDS WE WOULD -- WE WILL GATHER AT A LOCAL ESTABLISHMENT
AFTER THE RUN.
SO, MR. SPEAKER, AGAIN, I WANT TO THANK MY COLLEAGUES
FOR VOTING FOR THIS RESOLUTION AND -- FOR GLOBAL RUNNING DAY, AND HOPE
THAT MANY COLLEAGUES WILL JOIN US TONIGHT IN RUNNING. THANK YOU, MR.
SPEAKER.
ACTING SPEAKER AUBRY: ON THE RESOLUTION, ALL
THOSE IN FAVOR SIGNIFY BY SAYING AYE; OPPOSED, NO. THE RESOLUTION IS
ADOPTED.
THE CLERK: ASSEMBLY RESOLUTION NO. 494, MS.
SOLAGES.
LEGISLATIVE RESOLUTION MEMORIALIZING GOVERNOR
ANDREW M. CUOMO TO PROCLAIM JUNE 8TH, 2019, AS BELMONT STAKES
DAY IN THE STATE OF NEW YORK, AND COMMENDING THE NEW YORK RACING
ASSOCIATION UPON THE OCCASION OF THE 151ST RUNNING OF THE BELMONT
STAKES.
ACTING SPEAKER AUBRY: ON THE RESOLUTION, ALL
THOSE IN FAVOR SIGNIFY BY SAYING AYE; OPPOSED, NO. THE RESOLUTION IS
ADOPTED.
THE CLERK: ASSEMBLY RESOLUTION NO. 495, MS.
6
NYS ASSEMBLY JUNE 5, 2019
MALLIOTAKIS.
LEGISLATIVE RESOLUTION MEMORIALIZING GOVERNOR
ANDREW M. CUOMO TO PROCLAIM SATURDAY, SEPTEMBER 21ST, 2019, AS
PUPPY MILL AWARENESS DAY IN THE STATE OF NEW YORK.
ACTING SPEAKER AUBRY: ON THE RESOLUTION, ALL
THOSE IN FAVOR SIGNIFY BY SAYING AYE; OPPOSED, NO. THE RESOLUTION IS
ADOPTED.
THE CLERK: ASSEMBLY RESOLUTION NO. 496, MR.
MAGNARELLI.
LEGISLATIVE RESOLUTION MEMORIALIZING GOVERNOR
ANDREW M. CUOMO TO PROCLAIM SEPTEMBER 23-29, 2019, AS DIAPER
NEED AWARENESS WEEK IN THE STATE OF NEW YORK.
ACTING SPEAKER AUBRY: ON THE RESOLUTION, ALL
THOSE IN FAVOR SIGNIFY BY SAYING AYE; OPPOSED, NO. THE RESOLUTION IS
ADOPTED.
THE CLERK: ASSEMBLY RESOLUTION NO. 497, MRS.
GUNTHER.
LEGISLATIVE RESOLUTION MEMORIALIZING GOVERNOR
ANDREW M. CUOMO TO PROCLAIM WEDNESDAY, SEPTEMBER 25TH, 2019, AS
WOMEN'S HEALTH AND FITNESS DAY IN THE STATE OF NEW YORK
ACTING SPEAKER AUBRY: ON THE RESOLUTION, ALL
THOSE IN FAVOR SIGNIFY BY SAYING AYE; OPPOSED, NO. THE RESOLUTION IS
ADOPTED.
THE CLERK: ASSEMBLY RESOLUTION NO. 498, MS.
MALLIOTAKIS.
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NYS ASSEMBLY JUNE 5, 2019
LEGISLATIVE RESOLUTION MEMORIALIZING GOVERNOR
ANDREW M. CUOMO TO DECLARE SEPTEMBER 2019, AS CHRONIC PAIN
AWARENESS MONTH.
ACTING SPEAKER AUBRY: ON THE RESOLUTION, ALL
THOSE IN FAVOR SIGNIFY BY SAYING AYE; OPPOSED, NO. THE RESOLUTION IS
ADOPTED.
MRS. PEOPLES-STOKES.
MRS. PEOPLES-STOKES: WE'RE GOING TO GO TO
CONSENT NOW, MR. SPEAKER, ON PAGE 37 [SIC], GOING TO CALENDAR NO.
539 BY MR. STERN.
ACTING SPEAKER AUBRY: PAGE 36, CALENDAR
NO. 539, THE CLERK WILL READ.
THE CLERK: ASSEMBLY NO. A07097, CALENDAR NO.
539, STERN. AN ACT TO AMEND THE INSURANCE LAW, IN RELATION TO
STANDARDS FOR PROMPT INVESTIGATION AND SETTLEMENT OF CLAIMS ARISING
FROM STATES OF EMERGENCY.
ACTING SPEAKER AUBRY: THE BILL IS LAID ASIDE.
THE CLERK: ASSEMBLY NO. A07103, CALENDAR NO.
540, CRUZ, D'URSO, COLTON, BLAKE, RIVERA, ORTIZ, DESTEFANO, TAYLOR,
JAFFEE, DICKENS, BARRON, DINOWITZ, M.G. MILLER, SAYEGH, GOTTFRIED.
AN ACT IN RELATION TO THE EXAMINATION OF AN INCARCERATED INDIVIDUAL'S
RE-ENTRY PLANNING; AND PROVIDING FOR THE REPEAL OF SUCH PROVISIONS
UPON EXPIRATION THEREOF.
ACTING SPEAKER AUBRY: ON A MOTION BY MS.
CRUZ, THE SENATE BILL IS BEFORE THE HOUSE. THE SENATE BILL IS ADVANCED.
8
NYS ASSEMBLY JUNE 5, 2019
READ THE LAST SECTION.
THE CLERK: THIS ACT SHALL TAKE EFFECT IMMEDIATELY.
ACTING SPEAKER AUBRY: THE CLERK WILL
RECORD THE VOTE.
THE BILL IS LAID ASIDE.
THE CLERK: ASSEMBLY NO. A07128, CALENDAR NO.
541, PAULIN. AN ACT TO AMEND THE CRIMINAL PROCEDURE LAW, IN RELATION
TO TREATMENT PROGRAMS AND TREATMENT COURT DURING INTERIM PROBATION
SUPERVISION.
ACTING SPEAKER AUBRY: READ THE LAST SECTION.
THE CLERK: THIS ACT SHALL TAKE EFFECT ON THE 60TH
DAY.
ACTING SPEAKER AUBRY: THE CLERK WILL
RECORD THE VOTE.
(THE CLERK RECORDED THE VOTE.)
FIRST VOTE OF THE DAY, MEMBERS. PLEASE, IF YOU ARE IN
YOUR SEAT, VOTE NOW. IF YOU ARE IN THE SOUND OF OUR VOICE, PLEASE COME
INTO THE CHAMBER AND VOTE.
ARE THERE ANY OTHER VOTES? ANNOUNCE THE RESULTS.
(THE CLERK ANNOUNCED THE RESULTS.)
THE BILL IS PASSED.
MRS. PEOPLES-STOKES.
MRS. PEOPLES-STOKES: MR. SPEAKER, BEFORE WE
CONTINUE ON OUR CONSENT, IF WE COULD GO BACK TO CALENDAR NO. 540 BY
MS. CRUZ.
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NYS ASSEMBLY JUNE 5, 2019
ACTING SPEAKER AUBRY: THE CLERK WILL READ.
THE CLERK: ASSEMBLY NO. A07103, CALENDAR NO.
540, CRUZ, D'URSO, COLTON, BLAKE, RIVERA, ORTIZ, DESTEFANO, TAYLOR,
JAFFEE, DICKENS, BARRON, DINOWITZ, M.G. MILLER, SAYEGH, GOTTFRIED.
AN ACT IN RELATION TO THE EXAMINATION OF AN INCARCERATED INDIVIDUAL'S
RE-ENTRY PLANNING; AND PROVIDING FOR THE REPEAL OF SUCH PROVISIONS
UPON EXPIRATION THEREOF.
ACTING SPEAKER AUBRY: READ THE LAST SECTION
-- OH.
ON A MOTION BY MS. CRUZ, THE SENATE BILL IS BEFORE THE
HOUSE. THE SENATE BILL IS ADVANCED.
READ THE LAST SECTION.
THE CLERK: THIS ACT SHALL TAKE EFFECT IMMEDIATELY.
ACTING SPEAKER AUBRY: THE CLERK WILL
RECORD THE VOTE.
(THE CLERK RECORDED THE VOTE.)
MS. CRUZ TO EXPLAIN HER VOTE.
MS. CRUZ: THANK YOU, MR. SPEAKER. OUR CRIMINAL
JUSTICE SYSTEM OFTEN DOESN'T PROVIDE ENOUGH OPPORTUNITIES TO ENSURE
THAT FOLKS EXITING THAT SYSTEM ARE NOW GOING BE REENTERING IN TWO,
THREE, FOUR MONTHS. AND SO THIS PARTICULAR BILL ENSURES THAT SOCIAL
SERVICES ARE BEING PROVIDED TO THESE MEMBERS OF OUR COMMUNITY SO
THAT THEY CAN CONTINUE TO BE PROACTIVE MEMBERS OF OUR COMMUNITY AND
THAT WE ARE GIVING THEM A FULL CHANCE. AND ONE OF THE THINGS THAT OFTEN
HAPPENS AND THAT WE HEAR IS THAT THEY'RE PROHIBITED FROM, SAY, LIVING IN
10
NYS ASSEMBLY JUNE 5, 2019
PUBLIC HOUSING. BUT THAT'S THE ONLY HOUSING THEY KNOW. THEY MIGHT BE
GOING BACK TO THEIR PRIOR HOME, TO THEIR PARENTS' HOME. SO IF WE ARE
NOT ANALYZING THE LIMITATIONS OF THEIR EXIT PLAN, HOW DO WE MAKE SURE
THAT THESE FOLKS DON'T CONTINUE TO COMMIT CRIMES AND CONTINUE TO ENTER
THE SYSTEM. IT IS OUR DUTY AS LEGISLATORS TO PROVIDE THEM WITH THOSE
TOOLS TO MAKE SURE THAT THEY HAVE ALL THE CHANCES AVAILABLE TO THEM.
SO I AM PROUD TO VOTE IN THE AFFIRMATIVE, AND I THANK
YOU, MR. SPEAKER.
ACTING SPEAKER AUBRY: MS. CRUZ IN THE
AFFIRMATIVE.
ARE THERE ANY OTHER VOTES? ANNOUNCE THE RESULTS.
(THE CLERK ANNOUNCED THE RESULTS.)
THE BILL IS PASSED.
ENERGY COMMITTEE, PLEASE GO TO THE SPEAKER'S
CONFERENCE ROOM IMMEDIATELY. ENERGY COMMITTEE, SPEAKER'S
CONFERENCE ROOM.
THE CLERK WILL READ.
THE CLERK: ASSEMBLY NO. A07131, CALENDAR NO.
542, PEOPLES-STOKES. AN ACT TO AMEND THE ALCOHOLIC BEVERAGE
CONTROL LAW, IN RELATION TO A LICENSE TO SELL LIQUOR AT RETAIL FOR
CONSUMPTION ON CERTAIN PREMISES.
ACTING SPEAKER AUBRY: READ THE LAST SECTION.
THE CLERK: THIS ACT SHALL TAKE EFFECT IMMEDIATELY.
ACTING SPEAKER AUBRY: THE CLERK WILL
RECORD THE VOTE.
11
NYS ASSEMBLY JUNE 5, 2019
(THE CLERK RECORDED THE VOTE.)
ARE THERE ANY OTHER VOTES? ANNOUNCE THE RESULTS.
(THE CLERK ANNOUNCED THE RESULTS.)
THE BILL IS PASSED.
THE CLERK: ASSEMBLY NO. A07190, CALENDAR NO.
543, ZEBROWSKI, COLTON, WRIGHT, DAVILA, COOK. AN ACT TO AMEND THE
TAX LAW AND ADMINISTRATIVE CODE OF THE NEW YORK, IN RELATION TO REAL
PROPERTY TRANSFER TAX RETURNS OF LIMITED LIABILITY COMPANIES.
ACTING SPEAKER AUBRY: THE BILL IS LAID ASIDE.
THE CLERK: ASSEMBLY NO. A07228, CALENDAR NO.
544, BARCLAY. AN ACT RELATING TO LEGALIZING, VALIDATING AND RATIFYING
AND CONFIRMING A TRANSPORTATION CONTRACT OF THE FULTON CITY SCHOOL
DISTRICT.
ACTING SPEAKER AUBRY: READ THE LAST SECTION.
THE CLERK: THIS ACT SHALL TAKE EFFECT IMMEDIATELY.
ACTING SPEAKER AUBRY: THE CLERK WILL
RECORD THE VOTE.
(THE CLERK RECORDED THE VOTE.)
ARE THERE ANY OTHER VOTES? ANNOUNCE THE RESULTS.
(THE CLERK ANNOUNCED THE RESULTS.)
THE BILL IS PASSED.
THE CLERK: ASSEMBLY NO. A07282, CALENDAR NO.
545, ZEBROWSKI. AN ACT TO AMEND THE PUBLIC SERVICE LAW, IN RELATION
TO AUTHORIZING THE PUBLIC SERVICE COMMISSION TO REQUIRE WATER-WORKS
CORPORATIONS TO PROVIDE CERTAIN RESIDENTS WITH NON-BILLING-RELATED
12
NYS ASSEMBLY JUNE 5, 2019
INFORMATION.
ACTING SPEAKER AUBRY: THE BILL IS LAID ASIDE.
THE CLERK: ASSEMBLY NO. A07310-A, CALENDAR
NO. 546, JAFFEE. AN ACT TO AMEND THE REAL PROPERTY TAX LAW, IN
RELATION TO LIMITING THE SHIFT BETWEEN CLASSES OF TAXABLE PROPERTY IN THE
TOWN OF ORANGETOWN, COUNTY OF ROCKLAND.
ACTING SPEAKER AUBRY: READ THE LAST SECTION.
THE CLERK: THIS ACT SHALL TAKE EFFECT IMMEDIATELY.
ACTING SPEAKER AUBRY: THE CLERK WILL
RECORD THE VOTE.
(THE CLERK RECORDED THE VOTE.)
ARE THERE ANY OTHER VOTES? ANNOUNCE THE RESULTS.
(THE CLERK ANNOUNCED THE RESULTS.)
THE BILL IS PASSED.
MRS. PEOPLES-STOKES.
MRS. PEOPLES-STOKES: THANK YOU, MR.
SPEAKER. IF YOU COULD PLEASE CALL THE COMMITTEE ON ALCOHOLISM TO THE
SPEAKER'S CONFERENCE ROOM.
ACTING SPEAKER AUBRY: COMMITTEE ON
ALCOHOLISM, SPEAKER'S CONFERENCE ROOM, PLEASE. THANK YOU.
THE CLERK WILL READ.
THE CLERK: ASSEMBLY NO. A07326, CALENDAR NO.
547, MCDONALD. AN ACT IN RELATION TO PERMITTING MOUNT MORIAH
BAPTIST CHURCH TO FILE AN APPLICATION FOR A REAL PROPERTY TAX EXEMPTION.
ACTING SPEAKER AUBRY: ON A MOTION BY MR.
13
NYS ASSEMBLY JUNE 5, 2019
MCDONALD, THE SENATE BILL IS BEFORE THE HOUSE. THE SENATE BILL IS
ADVANCED.
READ THE LAST SECTION.
THE CLERK: THIS ACT SHALL TAKE EFFECT IMMEDIATELY.
ACTING SPEAKER AUBRY: THE CLERK WILL
RECORD THE VOTE.
(THE CLERK RECORDED THE VOTE.)
ARE THERE ANY OTHER VOTES? ANNOUNCE THE RESULTS.
(THE CLERK ANNOUNCED THE RESULTS.)
THE BILL IS PASSED.
THE CLERK: ASSEMBLY NO. A07327, CALENDAR NO.
548, MCDONALD. AN ACT -- AN ACT IN RELATION TO PERMITTING THE
NORTHEASTERN ASSOCIATION OF THE BLIND AT ALBANY, INC. TO FILE AN
APPLICATION FOR A REAL PROPERTY TAX EXEMPTION.
ACTING SPEAKER AUBRY: ON A MOTION BY MR.
MCDONALD, THE SENATE BILL IS BEFORE THE HOUSE. THE SENATE BILL IS
ADVANCED.
READ THE LAST SECTION.
THE CLERK: THIS ACT SHALL TAKE EFFECT IMMEDIATELY.
ACTING SPEAKER AUBRY: THE CLERK WILL
RECORD THE VOTE.
(THE CLERK RECORDED THE VOTE.)
ARE THERE ANY OTHER VOTES? ANNOUNCE THE RESULTS.
(THE CLERK ANNOUNCED THE RESULTS.)
THE BILL IS PASSED.
14
NYS ASSEMBLY JUNE 5, 2019
MRS. PEOPLES-STOKES.
MRS. PEOPLES-STOKES: THANK YOU, MR.
SPEAKER. IF YOU COULD PLEASE CALL ON MR. CROUCH FOR AN ANNOUNCEMENT.
ACTING SPEAKER AUBRY: MR. CROUCH FOR THE
PURPOSES OF AN ANNOUNCEMENT.
MR. CROUCH: THANK YOU, MR. SPEAKER. THERE WILL
BE AN IMMEDIATE REPUBLICAN CONFERENCE IN THE PARLOR.
ACTING SPEAKER AUBRY: IMMEDIATE
REPUBLICAN CONFERENCE IN THE PARLOR.
MRS. PEOPLES-STOKES.
MRS. PEOPLES-STOKES: MR. SPEAKER, IF WE
COULD STAND AT EASE FOR 20 MINUTES OR SO WHILE THE REPUBLICANS ARE IN
THEIR CONFERENCE.
ACTING SPEAKER AUBRY: THE ASSEMBLY WILL
STAND AT EASE.
(WHEREUPON, THE HOUSE STOOD AT EASE.)
*****
ACTING SPEAKER AUBRY: THE HOUSE WILL COME
TO ORDER.
MRS. PEOPLES-STOKES.
MRS. PEOPLES-STOKES: IF YOU -- MR. SPEAKER,
WOULD YOU PLEASE ASK THE CODES COMMITTEE TO MEET MEMBER LENTOL IN
THE SPEAKER'S CONFERENCE ROOM IMMEDIATELY?
15
NYS ASSEMBLY JUNE 5, 2019
ACTING SPEAKER AUBRY: CODES COMMITTEE,
SPEAKER'S CONFERENCE. MR. LENTOL IS ON HIS WAY. SEE IF YOU CAN'T BEAT
HIM THERE.
MRS. PEOPLES-STOKES.
MRS. PEOPLES-STOKES: MR. SPEAKER, I NOW
WOULD LIKE TO INTERRUPT OUR BRIEFLY-OPENED RECONVENED SESSION TO
INTRODUCE SOME GUESTS ON BEHALF OF MEMBER QUART. THESE ARE STUDENTS
FROM ROOSEVELT SCHOLARS FROM HUNTER COLLEGE. THEY'RE HERE JOINING
MR. QUART AND TAKING AN OPPORTUNITY TO TOUR IN AND AROUND ALBANY.
THESE ARE STUDENTS WITH PASSION FOR CIVIL ENGAGEMENT AND PUBLIC
AFFAIRS. ROOSEVELT ASPIRES TO BE A FORCE OF CONSTRUCTIVE CHANGE. THEY
SEEK TO IMPACT THROUGH THEIR DIRECT SERVICE SOCIAL ENTREPRENEURSHIP AND
LEADERSHIP THAT FOSTERS STRONG COMMUNITIES AND SENSIBLE POLICIES.
MR. SPEAKER, IF YOU WOULD PLEASE WELCOME THESE FINE
24 FRESHMAN STUDENTS AND WELCOME THEM TO OUR CHAMBERS [SIC] TODAY.
ACTING SPEAKER AUBRY: CERTAINLY. ON BEHALF
OF ASSEMBLYMAN QUART, THE SPEAKER AND ALL THE MEMBERS, WE WELCOME
YOU HERE TO THE NEW YORK STATE ASSEMBLY, EXTEND TO YOU THE
PRIVILEGES OF THE FLOOR, CONGRATULATE YOU ON THE EXCELLENCE OF YOUR
ACADEMIC WORK, AND HOPE THAT THIS PARTICULAR TRIP WILL GIVE YOU INSIGHTS
INTO STATE GOVERNMENT THAT WILL BE HELPFUL TO YOU IN YOUR FUTURE.
THANK YOU SO VERY MUCH FOR COMING.
(APPLAUSE)
MR. GOODELL FOR AN INTRODUCTION.
MR. GOODELL: THANK YOU VERY MUCH, MR.
16
NYS ASSEMBLY JUNE 5, 2019
SPEAKER. ON BEHALF OF LEADER BRIAN KOLB, ASSEMBLYMAN WILL BARCLAY
AND ASSEMBLYMAN COLIN SCHMITT, IT'S MY PLEASURE TO INTRODUCE A -- A
FORMER MEMBER OF THE ASSEMBLY WHO WENT ON TO BECOME THE
SUPERINTENDENT OF THE DEPARTMENT OF FINANCIAL SERVICES. MANY OF YOU
KNOW OF HIS GREAT WORK BOTH AS AN ASSEMBLYMAN AND A
SUPERINTENDENT, AND THAT'S HOWARD MILLS. AND HE IS HERE WITH HIS
WIFE, ERIN. ALSO ACCOMPANYING MR. MILLS AND HIS WIFE ARE A NUMBER
OF GUESTS WHO ARE UP HERE EXPRESSING CONCERNS AND PROVIDING HELPFUL
INFORMATION ON ISSUES INVOLVING KIDS AND VAPING. HE HAS BEEN VERY
ACTIVE IN THIS FIELD AND, OF COURSE, AS YOU KNOW, HAS A LONG AND
DISTINGUISHED CAREER, ALONG WITH THE GUESTS THAT HE BRINGS WITH HIM, IN
HELPING US MAKE THOUGHTFUL AND INTELLIGENT DECISIONS ON THE FLOOR OF
THE LEGISLATURE.
IF YOU WOULD WELCOME MR. MILLS, HIS WIFE AND ALL OF
HIS GUESTS, I WOULD CERTAINLY APPRECIATE IT.
ACTING SPEAKER AUBRY: CERTAINLY. ON BEHALF
OF MR. KOLB AND MR. SCHMITT AND MR. BARCLAY, THE SPEAKER AND ALL THE
MEMBERS, WE WELCOME YOU BACK, HOWARD, TO THE NEW YORK STATE
ASSEMBLY AND YOUR FAMILY, YOU ARE FAMILY AND, THEREFORE -- AND A
FORMER MEMBER -- ALWAYS PROVIDED THE -- THE PRIVILEGES OF THE FLOOR.
HAPPY TO SEE YOU, HOPE THAT YOU HAVE ENJOYED YOUR DIVERSE CAREER
SINCE YOU LEFT US. AND TO THOSE GUESTS THAT YOU HAVE COME HERE WHO
HAVE PUBLIC INTERESTS IN PROTECTING THE REST OF THE YOUTH OF THIS
COMMUNITY, THANK YOU SO VERY MUCH FOR THE WORK THAT YOU DO. PLEASE
KNOW THAT YOU ARE ALSO ALWAYS WELCOME HERE. THANK YOU.
17
NYS ASSEMBLY JUNE 5, 2019
(APPLAUSE)
MRS. PEOPLES-STOKES.
MRS. PEOPLES-STOKES: MR. SPEAKER, WE HAVE
SOME OTHER FINE SCHOLARS IN OUR CHAMBERS [SIC]. THEY HAPPEN TO BE
FOURTH- GRADERS FROM MARCY ELEMENTARY IN OUR COLLEAGUE MS.
BUTTENSCHON'S DISTRICT. IF YOU WOULD WELCOME THESE YOUNG SCHOLARS TO
OUR CHAMBERS [SIC].
ACTING SPEAKER AUBRY: CERTAINLY. ON BEHALF
OF MS. BUTTENSCHON, THE SPEAKER AND ALL THE MEMBERS, WE WELCOME
THESE EXTRAORDINARY FOURTH-GRADERS HERE TO THE NEW YORK STATE
ASSEMBLY, EXTEND TO YOU THE PRIVILEGES OF THE FLOOR, HOPE THAT YOU HAVE
ENJOYED YOUR TRIP HERE TO ALBANY. KNOW THAT YOU ARE IN THE PEOPLE'S
HOUSE AND YOU ARE ALWAYS WELCOME HERE. WE HOPE TO SEE YOU FOR
MANY YEARS UNTIL MAYBE ONE OF YOU TAKES ONE OF THESE SEATS. THANK
YOU SO VERY MUCH. HOPE THAT YOU'LL BE BACK. THANK YOU.
(APPLAUSE)
MRS. PEOPLES-STOKES.
MRS. PEOPLES-STOKES: MR. SPEAKER, IF WE
COULD NOW CONTINUE OUR WORK ON CONSENT ON PAGE 38, WE'RE GOING TO
GO TO CALENDAR NO. 549.
ACTING SPEAKER AUBRY: PAGE 38, CALENDAR
NO. 549, THE CLERK WILL READ.
THE CLERK: ASSEMBLY NO. A07372, CALENDAR NO.
549, PAULIN, OTIS. AN ACT TO AMEND THE PUBLIC SERVICE LAW, IN RELATION
TO TRANSFERS OF CABLE SYSTEMS.
18
NYS ASSEMBLY JUNE 5, 2019
ACTING SPEAKER AUBRY: READ THE LAST SECTION.
THE CLERK: THIS ACT SHALL TAKE EFFECT IMMEDIATELY.
ACTING SPEAKER AUBRY: THE CLERK WILL
RECORD THE VOTE.
(THE CLERK RECORDED THE VOTE.)
ARE THERE ANY OTHER VOTES? ANNOUNCE THE RESULTS.
(THE CLERK ANNOUNCED THE RESULTS.)
THE BILL IS PASSED.
THE CLERK: ASSEMBLY NO. A07373, CALENDAR NO.
550, GLICK, STIRPE, FAHY. AN ACT TO AMEND THE EDUCATION LAW IN
RELATION TO REQUIREMENTS FOR THE NEW YORK STATE SCIENCE, TECHNOLOGY,
ENGINEERING AND MATHEMATICS INCENTIVE PROGRAM.
ACTING SPEAKER AUBRY: THE BILL IS LAID ASIDE.
THE CLERK: ASSEMBLY NO. A07459, CALENDAR NO.
551, STECK, RAIA, RAYNOR, MOSLEY. AN ACT TO AMEND THE GENERAL
BUSINESS LAW, IN RELATION TO MERCANTILE ESTABLISHMENTS AND THE DEFENSE
OF LAWFUL DETENTION.
ACTING SPEAKER AUBRY: ON A MOTION BY MR.
STECK, THE SENATE BILL IS BEFORE THE HOUSE. THE SENATE BILL IS
ADVANCED.
THE BILL IS LAID ASIDE.
THE CLERK: ASSEMBLY NO. A07462, CALENDAR NO.
552, EPSTEIN. AN ACT TO AMEND THE ALCOHOLIC BEVERAGE LAW, IN
RELATION TO MAKING THE PROVISIONS GOVERNING THE VARIOUS ON-PREMISES
LIQUOR LICENSES CONSISTENT WITH RESPECT TO PUBLIC INTEREST FACTORS THAT
19
NYS ASSEMBLY JUNE 5, 2019
MAY BE CONSIDERED BY THE STATE LIQUOR AUTHORITY WHEN EVALUATING THE
MERITS OF A LICENSE APPLICATION.
ACTING SPEAKER AUBRY: THE BILL IS LAID ASIDE.
THE CLERK: ASSEMBLY NO. A07499, CALENDAR NO.
553, B. MILLER. AN ACT AUTHORIZING THE SCHENEVUS CENTRAL DISTRICT --
SCHOOL DISTRICT TO APPLY FOR [SIC] THE COMMISSIONER OF EDUCATION TO
RECEIVE AN IMPORTANT -- AN APPORTIONMENT TO BE USED FOR SERVICES AND
EXPENSES OF SUCH SCHOOL DISTRICT AND TO SUPPORT ITS EDUCATIONAL
PROGRAMS AND ANY LIABILITY IN CARRYING OUT THE FUNCTIONS AND
RESPONSIBILITIES OF SUCH DISTRICT.
ACTING SPEAKER AUBRY: ON A MOTION BY MR.
BRIAN MILLER, THE SENATE BILL IS BEFORE THE HOUSE. THE SENATE BILL IS
ADVANCED.
READ THE LAST SECTION.
THE CLERK: THIS ACT SHALL TAKE EFFECT IMMEDIATELY.
ACTING SPEAKER AUBRY: THE CLERK WILL
RECORD THE VOTE.
(THE CLERK RECORDED THE VOTE.)
ARE THERE ANY OTHER VOTES? ANNOUNCE THE RESULTS.
(THE CLERK ANNOUNCED THE RESULTS.)
THE BILL IS PASSED.
THE CLERK: ASSEMBLY NO. A07504, CALENDAR NO.
554, EICHENSTEIN, BRONSON, REYES, TAYLOR, D. ROSENTHAL, WRIGHT,
ABBATE, JOYNER, WALLACE, DENDEKKER, CRUZ, BRAUNSTEIN, DICKENS,
BARNWELL. AN ACT TO AMEND THE ELDER LAW, IN RELATION TO REPORTING
20
NYS ASSEMBLY JUNE 5, 2019
UNMET NEED FOR PROGRAMS AND SERVICES FOR THE AGING.
ACTING SPEAKER AUBRY: READ THE LAST SECTION.
THE CLERK: THIS ACT SHALL TAKE EFFECT IMMEDIATELY.
ACTING SPEAKER AUBRY: THE CLERK WILL
RECORD THE VOTE.
(THE CLERK RECORDED THE VOTE.)
ARE THERE ANY OTHER VOTES? ANNOUNCE THE RESULTS.
(THE CLERK ANNOUNCED THE RESULTS.)
THE BILL IS PASSED.
AND SIR, IT IS YOUR FIRST. YOU ARE AT THE ZENITH.
(APPLAUSE)
THE CLERK WILL READ.
THE CLERK: ASSEMBLY NO. A07523, CALENDAR NO.
555, DINOWITZ. AN ACT TO AMEND THE SURROGATES'S COURT PROCEDURE
ACT, IN RELATION TO THE COMPUTATION AND ALLOCATION OF THE COMMISSIONS
OF TRUSTEES OF CHARITABLE TRUSTS; AND REPEALING CERTAIN PROVISIONS OF SUCH
LAW RELATING THERETO.[
ACTING SPEAKER AUBRY: THE BILL IS LAID ASIDE.
THE CLERK: ASSEMBLY NO. A07528, CALENDAR NO.
556, GANTT, DINOWITZ, WRIGHT, WEPRIN. AN ACT TO AMEND THE FAMILY
COURT ACT, IN RELATION TO USE OF RESTRAINTS OF CHILDREN APPEARING BEFORE
THE FAMILY COURT.
ACTING SPEAKER AUBRY: THE BILL IS LAID ASIDE.
THE CLERK: ASSEMBLY NO. A07529-A, CALENDAR
NO. 557, WALLACE, DINOWITZ. AN ACT TO AMEND THE FAMILY COURT ACT
21
NYS ASSEMBLY JUNE 5, 2019
AND THE DOMESTIC RELATIONS LAW, IN RELATION TO ORDERS FOR TEMPORARY
SPOUSAL SUPPORT IN CONJUNCTION WITH TEMPORARY AND FINAL ORDERS OF
PROTECTION IN FAMILY COURT AND CALCULATION OF THE SPOUSAL MAINTENANCE
"CAP."
ACTING SPEAKER AUBRY: THE BILL IS LAID ASIDE.
THE CLERK: ASSEMBLY NO. A07557, CALENDAR NO.
558, D'URSO, ENGLEBRIGHT, SAYEGH, SEAWRIGHT. AN ACT TO AMEND
CHAPTER 58 OF THE LAWS OF 2013 AMENDING THE ENVIRONMENTAL
CONSERVATION LAW AND THE STATE FINANCE LAW RELATING TO THE "CLEANER,
GREENER NY ACT OF 2013", IN RELATION TO THE EFFECTIVENESS THEREOF.
ACTING SPEAKER AUBRY: READ THE LAST SECTION.
THE CLERK: THIS ACT SHALL TAKE EFFECT IMMEDIATELY.
ACTING SPEAKER AUBRY: THE CLERK WILL
RECORD THE VOTE.
(THE CLERK RECORDED THE VOTE.)
ARE THERE ANY OTHER VOTES? ANNOUNCE THE RESULTS.
(THE CLERK ANNOUNCED THE RESULTS.)
THE BILL IS PASSED.
THE CLERK: ASSEMBLY NO. A07598, CALENDAR NO.
559, SEAWRIGHT, DINOWITZ. AN ACT TO AMEND CIVIL PRACTICE LAW AND
RULES, IN RELATION TO THE FAILURE TO PROVIDE NOTICE OF A DEFAULT JUDGMENT.
ACTING SPEAKER AUBRY: THE BILL IS LAID ASIDE.
THE CLERK: ASSEMBLY NO. A07600, CALENDAR NO.
560, ABINANTI, DINOWITZ. AN ACT TO AMEND THE CIVIL PRACTICE LAW AND
RULES, IN RELATION TO THE PERMITTED SUBMISSIONS IN A DEFAULT JUDGMENT.
22
NYS ASSEMBLY JUNE 5, 2019
ACTING SPEAKER AUBRY: READ THE LAST SECTION.
THE CLERK: THIS ACT SHALL TAKE EFFECT IMMEDIATELY.
ACTING SPEAKER AUBRY: THE CLERK WILL
RECORD THE VOTE.
(THE CLERK RECORDED THE VOTE.)
ARE THERE ANY OTHER VOTES? ANNOUNCE THE RESULTS.
(THE CLERK ANNOUNCED THE RESULTS.)
THE BILL IS PASSED.
MRS. PEOPLES-STOKES.
MRS. PEOPLES-STOKES: MR. SPEAKER, IF WE CAN
NOW GO TO OUR DEBATE LIST, WE'RE GOING TO TAKE UP MR. DINOWITZ'S
CALENDAR NO. 158, AND THEN WE'RE GOING TO GO RIGHT TO MS. HUNTER ON
CALENDAR NO. 391.
ACTING SPEAKER AUBRY: THE CLERK WILL READ.
THE CLERK: ASSEMBLY NO. A04745-A, CALENDAR
NO. 158, DINOWITZ. AN ACT TO AMEND CHAPTER 455 OF THE LAWS OF 1997
AMENDING THE NEW YORK CITY CIVIL COURT ACT AND THE CIVIL PRACTICE
LAW AND RULES RELATING TO AUTHORIZING NEW YORK CITY MARSHALS TO
EXERCISE THE SAME FUNCTIONS, POWERS AND DUTIES AS SHERIFFS WITH RESPECT
TO THE EXECUTION OF MONEY JUDGMENTS, IN RELATION TO EXTENDING THE
EFFECTIVENESS OF SUCH CHAPTER.
ACTING SPEAKER AUBRY: READ THE LAST SECTION.
THE CLERK: THIS ACT SHALL TAKE EFFECT IMMEDIATELY
ACTING SPEAKER AUBRY: THE CLERK WILL
RECORD THE VOTE.
23
NYS ASSEMBLY JUNE 5, 2019
(THE CLERK RECORDED THE VOTE.)
ARE THERE ANY OTHER VOTES? ANNOUNCE THE RESULTS.
(THE CLERK ANNOUNCED THE RESULTS.)
THE BILL IS PASSED.
MRS. PEOPLES-STOKES.
MRS. PEOPLES-STOKES: MR. SPEAKER, IF YOU
COULD PLEASE CALL THE RULES COMMITTEE TO THE SPEAKER'S CONFERENCE
ROOM FOR A MEETING IMMEDIATELY.
ACTING SPEAKER AUBRY: RULES COMMITTEE,
SPEAKER'S CONFERENCE ROOM IMMEDIATELY, PLEASE.
THE CLERK WILL READ.
THE CLERK: ASSEMBLY NO. A02455-A, CALENDAR
NO. 391, HUNTER, COOK, HEVESI, GOTTFRIED, HYNDMAN, BLAKE, ROMEO,
BRONSON, BARRON, REYES. AN ACT TO AMEND THE SOCIAL SERVICES LAW, IN
RELATION TO CONCILIATION AND NON-COMPLIANCE WITH PUBLIC ASSISTANCE
EMPLOYMENT; AND TO REPEAL CERTAIN PROVISION OF SUCH LAW RELATING
THERETO.
ACTING SPEAKER AUBRY: ON A MOTION BY MS.
HUNTER, THE SENATE BILL IS BEFORE THE HOUSE. THE SENATE BILL IS
ADVANCED.
AN EXPLANATION IS REQUESTED, MS. HUNTER.
MS. HUNTER: THANK YOU, MR. SPEAKER. THIS BILL
WOULD EXPAND THE CONCILIATION PROCESS TO THE REST OF THE STATE REQUIRING
LOCAL SOCIAL SERVICES DISTRICTS TO CONFIRM THAT THE RECIPIENT IS NOT
EXEMPT FROM THE MANDATORY WORK REQUIREMENT, AND THAT THE RECIPIENT
24
NYS ASSEMBLY JUNE 5, 2019
HAS APPROPRIATE CHILDCARE, TRANSPORTATION AND DISABILITY
ACCOMMODATIONS PRIOR TO IMPOSING A SANCTION ON A RECIPIENT FOR FAILURE
TO COMPLY WITH WORK RULES. THE LANGUAGE WOULD END DURATIONAL
SANCTIONS ONCE THE RECIPIENT IS WILLING TO COMPLY.
ACTING SPEAKER AUBRY: MR. GOODELL.
MR. GOODELL: THANK YOU, MR. SPEAKER. WOULD
THE SPONSOR YIELD?
ACTING SPEAKER AUBRY: WILL YOU YIELD, MS.
HUNTER?
MS. HUNTER: YES.
ACTING SPEAKER AUBRY: THE SPONSOR YIELDS.
MR. GOODELL: THANK YOU, MS. HUNTER. SO,
BEFORE WE TALK ABOUT WHAT THIS BILL CHANGES, CAN WE TALK A LITTLE BIT
ABOUT WHAT THE CURRENT LAW IS?
MS. HUNTER: THE CURRENT LAW IS WHEN SOMEONE IS
SANCTIONED, THERE'S A CONCILIATION PROCESS: THEY SEND A NOTICE TO THE
RECIPIENT REGARDING THE FAILURE TO COMPLY. THERE ARE SEVERAL DIFFERENT
STEPS AFTER THAT. IF THEY REFUSE TO COMPLY, THERE'S ONE THING; IF THEY DO
COMPLY, IT'S ANOTHER. THEY HAVE TEN DAYS IN ORDER TO GET BACK TO THE
CURRENT SOCIAL SERVICES. THEY HAVE A SEVEN-DAY NOTIFICATION AND TEN
DAYS FOR THE RECIPIENT TO RESPOND, AND THEN AFTER ALL OF THIS PROCESS,
THERE IS ANOTHER 30 DAYS. SO, IN TOTAL, THEY HAVE 50 DAYS FROM THE
BEGINNING OF A -- A CONCILIATION PROCESS THROUGH TO THE END, IF, IN FACT, A
SANCTION HAS OCCURRED.
MR. GOODELL: AND THAT'S UNDER CURRENT LAW.
25
NYS ASSEMBLY JUNE 5, 2019
MS. HUNTER: CORRECT.
MR. GOODELL: AND SO, IF A [SIC] ABLE-BODIED
WELFARE RECIPIENT IS ASSIGNED TO A TRAINING PROGRAM, FOR EXAMPLE, AND
LET'S SAY THE TRAINING PROGRAM STARTS, FOR THE SAKE OF ARGUMENT, ON A
MONDAY, AND THEY DON'T SHOW UP ON MONDAY. UNDER CURRENT LAW, THE
DEPARTMENT OF SOCIAL SERVICES SENDS THEM A NOTICE, A TEN-DAY NOTICE
SAYING, WHY DIDN'T YOU SHOW UP FOR THIS TRAINING? IT STARTED ON
MONDAY. RIGHT?
MS. HUNTER: CORRECT.
MR. GOODELL: AND IF THEY GET A RESPONSE BACK,
MAYBE THEY CAN GET THEM INTO THE NEXT TRAINING PROGRAM. OF COURSE,
THE TRAINING PROGRAM IS NOW MOVING ON. SO, AFTER THAT FIRST TEN-DAY
NOTICE, IF THEY DON'T HEAR ANYTHING THEN THEY SEND A SECOND TEN-DAY
NOTICE UNDER CURRENT LAW. RIGHT?
MS. HUNTER: CORRECT.
MR. GOODELL: AND THE SECOND TEN-DAYS NOTICE
SAID, YOU DIDN'T SHOW UP AT THE TRAINING SESSION, YOU HAVEN'T
RESPONDED AT ALL TO OUR FIRST NOTICE, SO, IF WE DON'T HEAR FROM YOU IN THE
NEXT TEN DAYS, WE'RE GOING TO SANCTION YOU. WE'RE GOING TO CUT BACK ON
YOUR BENEFITS. CORRECT?
MS. HUNTER: WELL, AFTER -- AFTER THE CONCILIATION IS
EXTENDED, THEY MAKE A DETERMINATION WITHIN 14 DAYS. AND THEN THE
RECIPIENT HAS 30 DAYS AFTER THAT.
MR. GOODELL: AND SO, AFTER YOU HAVE THE FIRST
TEN-DAY NOTICE, YOU HAVE A SECOND TEN-DAY NOTICE OF AN INTENT TO CUT
26
NYS ASSEMBLY JUNE 5, 2019
BENEFITS UNDER CURRENT LAW. IF THE RECIPIENT DISAGREES, THE RECIPIENT CAN
REQUEST A FAIR HEARING. I KNOW MOST OF OUR UPSTATE COUNTIES ARE
RUNNING THREE OR FOUR MONTHS BEFORE THEY EVEN SCHEDULE A FAIR HEARING.
SO, IF YOU DON'T SHOW UP FOR A JOB TRAINING OR WORK EXPERIENCE OR A
TRAINING PROGRAM, UNDER THE CURRENT LAW, YOU CAN LIKELY COLLECT BENEFITS
FOR ANYWHERE FROM THREE TO FIVE MONTHS BEFORE THERE'S A FINAL
DETERMINATION AND SANCTIONS ACTUALLY WOULD KICK IN, RIGHT?
MS. HUNTER: YES.
MR. GOODELL: AND THEN, OF COURSE, ONCE THE
SANCTIONS KICK IN, YOU CAN IMMEDIATELY SAY, NEVER MIND, I'D LIKE TO GO
TO THAT TRAINING, AND THEY'LL LIFT THE SANCTIONS?
MS. HUNTER: ONLY IF IT'S YOUR FIRST SANCTION AND
YOU'RE -- IF YOU'RE ON TANF, NOT SAFETYNET.
MR. GOODELL: OKAY. SO, THE CURRENT PROCESS IS...
I MEAN, REMARKABLY SLOW AND CUMBERSOME, IT SEEMS, IF WE'RE SERIOUS.
BECAUSE IF -- IF YOU'RE IN THE REAL WORLD, AND WHEN I SAY THE REAL WORLD,
I MEAN THE WORKING WORLD, AND YOU DIDN'T SHOW UP ON MONDAY, MOST
EMPLOYERS WILL HAVE IT RESOLVED BY TUESDAY, RIGHT? I MEAN, MOST
EMPLOYERS WILL PICK UP THE PHONE AND CALL YOU AND SAY, YOU DIDN'T
SHOW UP FOR WORK TODAY, ON MONDAY. WHERE ARE YOU? WHAT'S GOING
ON? ARE YOU OKAY? ARE YOU SICK? WHAT'S GOING ON? BUT THAT'S NOT
THE WAY THE STATE OF NEW YORK WORKS. THE STATE OF NEW YORK SENDS
YOU A LETTER TWO WEEKS LATER AND SAYS, HOW COME YOU DIDN'T SHOW UP TO
WORK ON MONDAY?
MS. HUNTER: ACTUALLY --
27
NYS ASSEMBLY JUNE 5, 2019
MR. GOODELL: SHOULDN'T WE BE TRYING TO STRUCTURE
THE --
MS. HUNTER: -- THIS PROCESS -- THIS CHANGE,
ACTUALLY, MR. GOODELL, WOULD ACTUALLY CHANGE THAT PROCESS. BECAUSE
AFTER THE -- THE PERSON DOES NOT SHOW UP TO THE WORK TRAINING, TO THE --
TO THE POSITION, IT'S INCUMBENT UPON THE SOCIAL SERVICES DEPARTMENT TO
FIND OUT IF IT IS A DISABILITY ACCOMMODATION ISSUE, CHILDCARE,
TRANSPORTATION ISSUE, SO THEY CAN WORK TO -- TO RECTIFY THE ISSUE SO THE
PEOPLE COULD GET BACK INTO THE PROGRAM AS QUICKLY AS POSSIBLE.
MR. GOODELL: WELL, I -- I -- I DISAGREE WITH YOUR
ASSESSMENT OF WHAT THIS BILL DOES. BUT LET'S GET BACK TO THAT IN A
MINUTE. SO, I'M JUST SAYING, IN THE -- IN THE WORKING WORLD, WHERE WE
HOPE EVENTUALLY EVERYONE ENDS UP SO THAT THEY CAN MAXIMIZE THEIR
POTENTIAL AND BECOME SELF-SUFFICIENT -- IN THE WORKING WORLD WE
RESOLVE A FAILURE TO SHOW UP WITHIN A DAY OR TWO, BECAUSE THE EMPLOYER
PICKS UP THE PHONE -- AND BY THE WAY, HERE ON THE FLOOR OF THE
ASSEMBLY, IF YOU DON'T SHOW UP AT A COMMITTEE MEETING, WE TYPICALLY
TEXT YOU WITHIN A FEW MINUTES. WE DON'T SEND YOU THE -- A LETTER AND --
AND GIVE YOU SEVEN TO TEN DAYS TO SAY WHY YOU DIDN'T SHOW UP. WHY
AREN'T WE FOLLOWING THAT PROCEDURE THAT APPLIES EVERYWHERE ELSE IN THE
PRIVATE SECTOR, AND EVEN IN GOVERNMENT, WHEN IT COMES UP TO AN
INDIVIDUAL WHO'S ON THIS WELFARE WORK PROGRAM WHO DOESN'T SHOW UP
FOR WORK OR TRAINING?
MS. HUNTER: WELL, I WOULD SUBMIT TO YOU, MR.
GOODELL, THAT EVERY COMPANY ACTUALLY HAS THEIR OWN POLICY ON
28
NYS ASSEMBLY JUNE 5, 2019
ABSENTEEISM. THE -- WE'RE TALKING SPECIFICALLY ABOUT THIS BILL. AND
WHAT THIS BILL WOULD DO WOULD ACTUALLY HELP PEOPLE TO GET BACK TO
WORK, BY TRYING TO IDENTIFY WHAT THE ISSUE IS IN ORDER TO GET THEM BACK
TO -- TO THE JOB TRAINING, THE WORK THAT THEY... NEED TO BE IN IN ORDER TO
THE -- BE ABLE TO PROVIDE FOR THEIR FAMILIES.
MR. GOODELL: AND WE'LL COME TO THAT IN JUST A
SECOND. AND, INDEED, IF -- IF I THOUGHT THAT WERE THE CASE, I'D BE A
COSPONSOR. BUT, UNFORTUNATELY, I'M NOT, SO WE'LL COME BACK TO THAT IN A
MINUTE. SO, UNDER THE CURRENT LAW, OR EVEN UNDER THIS LAW, IF
SOMEONE'S ASSIGNED TO A JOB TRAINING PROGRAM THAT HELPS THEM GET THE
SKILLS SO THEY CAN MAKE MONEY AND BE SELF-SUFFICIENT, THAT TRAINING
PROGRAM DOESN'T WAIT FOR THE TEN-DAY NOTICE, OR THE FOLLOW-UP TEN-DAY
NOTICE, OR THE THREE OR FOUR MONTH DELAY IN HEARING, RIGHT? THAT
TRAINING PROGRAM -- THAT TRAIN HAS LEFT THE STATION. RIGHT? ON MONDAY.
MS. HUNTER: THEY CAN CONTINUE TO PARTICIPAT --
PARTICIPATE IN THAT TRAINING PROGRAM IF THEY LIKE.
MR. GOODELL: OH, SO, THEY CAN JUST JOIN IN AFTER
MISSING THE FIRST --
MS. HUNTER: THEY JUST WOULDN'T RECEIVE --
MR. GOODELL: -- THREE OR FOUR MONTHS?
MS. HUNTER: -- THEIR BENEFITS. BUT THEY CAN START
BACK INTO THE TRAINING PROGRAM.
MR. GOODELL: OKAY. SO, NOW THAT WE UNDERSTAND
HOW INCREDIBLY SLOW AND CUMBERSOME THE CURRENT PROCESS IS, AND HOW
IT HAS NO CONNECTION WITH THE REAL WORLD, LET'S TALK ABOUT WHAT THESE
29
NYS ASSEMBLY JUNE 5, 2019
CHANGES ARE, BECAUSE, AFTER ALL, THAT'S WHY WE'RE HERE AND --
MS. HUNTER: CORRECT.
MR. GOODELL: -- I APPRECIATE YOU TAKING MY
COMMENTS AND QUESTIONS. SO, IN THE CURRENT LAW, THEY SEND A -- A
TEN-DAY NOTICE AND THEY SAY, WHY DIDN'T YOU SHOW UP FOR WORK ON
MONDAY? AND UNDER THIS LAW, BEFORE THEY EVEN SEND THAT NOTICE, WE
ASK NOW THE DEPARTMENT OF SOCIAL SERVICES TO DO SOME SORT OF
INVESTIGATION TO DETERMINE WHETHER OR NOT THE WELFARE RECIPIENT HAD
CHILDCARE AVAILABLE, OR TRANSPORTATION AVAILABLE, RIGHT? OR IF THERE WAS
SOME OTHER EXCUSE, EVEN BEFORE WE START THE PROCESS. IS THAT CORRECT?
THAT'S WHAT THIS BILL DOES?
MS. HUNTER: CORRECT. AND BECAUSE THOSE ARE --
THOSE THREE ISSUES ARE THE MAIN REASONS WHY PEOPLE HAVE BEEN UNABLE
TO GET TO THEIR WORK OR JOB TRAINING PROGRAM. THAT'S WHY WE WANT
SOCIAL SERVICES TO DO THIS AT THE BEGINNING, SO THAT WE CAN KEEP PEOPLE
IN THE PROGRAM AND KEEP PEOPLE WORKING --
MR. GOODELL: NOW, OF COURSE --
MS. HUNTER: TO SHORTEN THE PROCESS.
MR. GOODELL: OF COURSE, IN THE --IN THE WORKING
WORLD, BOTH PRIVATE AND PUBLIC, IT'S NOT THE RESPONSIBILITY TO CALL UP THE
EMPLOYEE AND SAY, UMM, WHAT CHILDCARE ARRANGEMENTS DO YOU HAVE
FOR MONDAY'S WORK? YOU KNOW, YOU'RE SUPPOSED TO BE HERE ON
MONDAY. WE EXPECT THE EMPLOYEE TO BE PRIMARILY RESPONSIBILE FOR
ARRANGING THEIR OWN CHILDCARE AND THEIR OWN TRANSPORTATION, RIGHT? IN
THE -- IN THE PRIVATE SECTOR, IT'S THE EMPLOYEE'S RESPONSIBILITY TO MAKE
30
NYS ASSEMBLY JUNE 5, 2019
THOSE ARRANGEMENTS, NOT THE EMPLOYER, RIGHT?
MS. HUNTER: WELL, THEY ARE STILL RESPONSIBLE TO
TAKE CARE OF CHILDCARE ARRANGEMENTS AND TRANSPORTATION. AND JUST LIKE,
AS YOU REFERRED TO THE WORKING WORLD, WHICH THESE PEOPLE ARE IN THE
WORKING WORLD, THEY ARE WORKING, THAT -- YOU KNOW, AS A MATTER OF FACT,
THEY ARE RESPONSIBLE TO MAKE SURE THAT THEY HAVE TRANSPORTATION AND
CHILDCARE. AND JUST AS, YOU -- YOU KNOW, STATE, IN THE WORKING WORLD, IF
SOMEONE IN AN OUTSIDE EMPLOYER, THEY HAVE A CHILDCARE ISSUE OR THEY
HAVE TRANSPORTATION ISSUE, THEY COULD CALL THEIR EMPLOYER AND SAY, I
CAN'T BE [SIC] COME BECAUSE OF... THIS VALID REASON, USUALLY, WITHOUT
PENALTY OF BEING FIRED OR SANCTIONED BECAUSE THEY COULDN'T GET TO WORK.
AND WE WANT TO BE ABLE TO MAKE SURE THAT THOSE RECEIVING THIS KIND OF
ASSISTANCE ARE AFFORDED THE SAME TYPE OF SERVICE.
MR. GOODELL: I ABSOLUTELY AGREE WITH YOUR
ANALYSIS, AND -- AND I APPRECIATE THAT. AND I'VE BEEN BOTH AN EMPLOYEE
AND AN EMPLOYER. AND THERE HAVE BEEN TIMES AS AN EMPLOYER WHERE
I'VE RECEIVED A CALL FROM ONE OF MY EMPLOYEES SAYING, I'M GOING TO BE
LATE BECAUSE MY CAR BROKE DOWN, OR, YOU KNOW, I CAN'T GET THE
CHILDCARE, OR MY BABYSITTER IS SICK. OR WHATEVER, RIGHT? DOES THIS BILL
REQUIRE THE WELFARE RECIPIENT TO MAKE A PHONE CALL TO SOCIAL SERVICES
AND ADVISE THEM, LIKE WE EXPECT FROM EVERY OTHER EMPLOYEE IN THE
STATE OF NEW YORK?
MS. HUNTER: THIS IS A COMPUTERIZED SANCTION, SO
THERE'S NO WAY TO STOP THAT FROM -- FROM HAPPENING, FOR THE PERSON TO
BE ABLE TO -- TO MAKE THAT PHONE CALL.
31
NYS ASSEMBLY JUNE 5, 2019
MR. GOODELL: BUT THIS BILL DOESN'T REQUIRE THE
WELFARE RECIPIENT TO NOTIFY SOCIAL SERVICES THAT THEY HAVE A
TRANSPORTATION PROBLEM OR CHILDCARE PROBLEM. IS THAT CORRECT?
MS. HUNTER: IN CURRENT REGULATIONS, THEY ARE
TECHNICALLY SUPPOSED TO BE CALLING IN NOTIFICATION SAYING THEY'RE NOT
ABLE TO MAKE IT.
MR. GOODELL: BUT THIS BILL DOESN'T REQUIRE THAT.
CORRECT?
MS. HUNTER: IT'S ALREADY IN CURRENT REGULATION,
WE'RE NOT CHANGING THAT.
MR. GOODELL: BUT THIS BILL DOES CHANGE THE
PROCESS. BECAUSE UNDER CURRENT LAW, IT'S THE RESPONSIBILITY OF THE
WELFARE RECIPIENT TO COME UP WITH THE EXPLANATION. THIS REVERSES THE
BURDEN OF PROOF FROM THE WELFARE RECIPIENT TO THE SOCIAL SERVICES
DEPARTMENT. SO, THIS IS GOING IN THE EXACT OPPOSITE DIRECTION IN THE
WAY WE TREAT NORMAL EMPLOYEES, ISN'T IT?
MS. HUNTER: I DISAGREE. YOU KNOW, OBVIOUSLY --
MR. GOODELL: I MEAN, IF WE WANTED TO TRACK WHAT
WE DO WITH NORMAL EMPLOYEES, THIS BILL WOULD SAY, IF THE WELFARE
RECIPIENT LACKS TRANSPORTATION OR DAYCARE OR ACCOMMODATIONS, THE
RECIPIENT SHOULD CONTACT THE SOCIAL SERVICES DEPARTMENT AS QUICKLY AS
POSSIBLE SO THEY CAN HELP ADDRESS THAT SITUATION. BUT THIS, INSTEAD,
GOES THE OPPOSITE DIRECTION. THIS, INSTEAD SAYS, AND I QUOTE, THE -- "IF
THE PARTICIPANT HAS FAILED OR REFUSED TO COMPLY AND THE DISTRICT HAS
DETERMINED THAT THEY DON'T HAVE CHILDCARE OR TRANSPORTATION OR OTHER
32
NYS ASSEMBLY JUNE 5, 2019
ACCOMMODATIONS..." AND ONLY AFTER THE DISTRICT HAS DETERMINED THAT CAN
THE DISTRICT THEN EVEN SEND OUT THE TEN-DAY NOTICE UNDER THIS NEW LAW,
RIGHT?
MS. HUNTER: THEY COULD HAVE DETERMINED THAT
BASED ON THE INDIVIDUAL ALREADY SELF-REPORTING THAT THEY DIDN'T OR DID
HAVE THOSE SERVICES AVAILABLE.
MR. GOODELL: I SEE.
MS. HUNTER: AND AGAIN, AS YOU WERE STATING, THE
-- THE RECIPIENT IS ALREADY RESPONSIBLE, AND CONTINUES TO BE RESPONSIBLE,
TO MAKE THAT PHONE CALL. AND THIS COMPUTERIZED GENERATION ESSENTIALLY
HAPPENS AND, HOPEFULLY, PROMPTS BEFORE, SO THAT THE SOCIAL SERVICE
AGENCY MAKES THAT CALL BEFORE THE NOTIFICATION GOES OUT TO THE RECIPIENT.
MR. GOODELL: MS. HUNTER, THANK YOU VERY MUCH
FOR YOUR COMMENTS. I APPRECIATE YOUR COMMENTS.
ON THE BILL, SIR.
ACTING SPEAKER BLAKE: ON THE BILL.
MR. GOODELL: I THINK EVERYONE IN -- IN THIS ROOM
SHARES THE SAME OBJECTIVE: THAT WE WANT TO HELP WELFARE RECIPIENTS
BECOME SUCCESSFUL, BECOME GAINFULLY EMPLOYED, LEAVE THE TAX ROLLS,
ENJOY ALL THE BENEFITS OF LIVING IN ONE OF THE WEALTHIEST STATES AND THE
COUNTRIES IN THE WORLD. THAT, I THINK, WE ALL SHARE. AND THEN I THINK
MOST OF US RECOGNIZE THAT ONE OF THE BEST WAYS FOR AN INDIVIDUAL --
WHETHER IT'S OUR OWN KIDS, SOMETIMES AS TEENAGERS OR FRIENDS OR
NEIGHBORS WHO AREN'T WORKING -- ONE OF THE BEST WAYS FOR SOMEONE
WHO'S UNEMPLOYED TO GET INTO THE EMPLOYMENT FIELD IS TO GET WORK
33
NYS ASSEMBLY JUNE 5, 2019
EXPERIENCE AND TRAINING. AND RECOGNIZING THAT, OUR CURRENT LAW
REQUIRES THAT ABLE-BODIED WELFARE RECIPIENTS PARTICIPATE IN WORK
EXPERIENCE AND JOB TRAINING SO THAT WE CAN HELP THEM GET ON THEIR FEET
AGAIN AND MOVE FORWARD WITH LIFE. BUT WHAT WE DON'T DO WITH OUR
WORK AND JOB TRAINING PROGRAMS IS IN ANY WAY EXPECT ANY PERSONAL
RESPONSIBILITY OR ACCOUNTABILITY, NOR DO WE REALLY EXPECT THEM TO
BEHAVE IN A WAY THAT'S CONSISTENT WITH WHAT THE -- ANY OTHER EMPLOYER
IN THE STATE OF NEW YORK WOULD EXPECT. AND WHAT IS THAT BASIC
CONSISTENCY? THE BASIC CONSISTENCY IS THAT THEY SHOW UP ON MONDAY,
IF THEY'RE ASSIGNED TO START ON MONDAY FOR A JOB TRAINING PROGRAM OR
WORK EXPERIENCE, THAT THEY SHOW UP. AND IF THEY DON'T SHOW UP
BECAUSE THEY CAN'T, THAT THEY PROMPTLY CONTACT US AND SAY, I CAN'T
BECAUSE I HAVE A TRANSPORTATION ISSUE, OR A DAYCARE ISSUE OR SOME
OTHER ACCOMMODATION, SO THAT WE, AS THE STATE, CAN HELP THEM ADDRESS
THOSE ISSUES AND MAKE SURE THAT THEY CAN CONTINUE ON WITH JOB TRAINING
AND THEIR WORK EXPERIENCE AND MAXIMIZE THEIR POTENTIAL.
OUR CURRENT SYSTEM IS SO EXTRAORDINARILY CUMBERSOME.
IT IS NO -- NO SURPRISE AT ALL THAT IT IS VIRTUALLY WORTHLESS IN TERMS OF
HELPING PEOPLE GET INTO THE JOB TRAINING PROGRAM. BECAUSE IF THEY MISS
ON MONDAY, WE SEND THEM A LETTER GIVING THEM TEN DAYS TO EXPLAIN WHY
THEY WEREN'T THERE ON MONDAY. AND DO YOU KNOW WHAT'S HAPPENED IN
THE MEANTIME? THAT EMPLOYER HAS MOVED ON. THAT JOB TRAINING
PROGRAM HAS MOVED ON. THOSE OPPORTUNITIES ARE NO LONGER THERE. AND
THIS BILL TAKES AN ALREADY INEFFECTIVE, INEFFICIENT AND CUMBERSOME
SYSTEM AND MAKES IT EVEN WORSE. BECAUSE THIS PROGRAM NOW CHANGES
34
NYS ASSEMBLY JUNE 5, 2019
THE BURDEN OF ESTABLISHING IF SOMEONE DOESN'T HAVE CHILDCARE OR
TRANSPORTATION NOT ON THE INDIVIDUAL WHO KNOWS THEIR EXACT
CIRCUMSTANCES AND THEIR PERSONAL SITUATION, IT CHANGES IT FROM HAVING
THE INDIVIDUAL EXPLAIN, TO HAVING THE DEPARTMENT OF SOCIAL SERVICES,
OUR COUNTY EMPLOYEES AND CITY EMPLOYEES, HAVING TO SOMEHOW VERIFY
OR FIGURE OUT THAT THE INDIVIDUALS [SIC] DOESN'T HAVE CHILDCARE; THAT
THERE'S NOBODY IN THE INDIVIDUAL'S FAMILY THAT CAN HELP THEM; THAT
THERE'S NO INFORMAL OR FORMAL DAYCARE AVAILABLE. AND ONLY AFTER OUR
BELEAGUERED LOCAL OFFICIALS AND EMPLOYEES DO THAT CALCULATION CAN THEY
EVEN RESPOND --
ACTING SPEAKER BLAKE: THANK YOU --
MR. GOODELL: SIR, IS THERE ANYONE BEHIND ME?
ACTING SPEAKER BLAKE: THERE IS A LIST, MR.
GOODELL.
MR. GOODELL: FOR THESE REASONS, I HAVE CONCERNS
AND I LOOK FORWARD TO COMMENTS FROM MY COLLEAGUES.
ACTING SPEAKER BLAKE: WE -- WE THANK YOU,
MR. GOODELL.
MR. HEVESI.
MR. HEVESI: THANK YOU, MR. SPEAKER. I RISE TO
CONGRATULATE THE SPONSOR. THIS IS A GREAT BILL. AND FROM THE
EXPLANATION FROM MY COLLEAGUE, I DON'T UNDERSTAND IF WE'RE READING THE
SAME BILL. HERE'S THE POINT OF THIS EXERCISE: RIGHT NOW, IF YOU'RE ON
PUBLIC ASSISTANCE AND YOU MISS APPOINTMENTS, FOR WHATEVER REASON, NO
TRANSPORTATION AND NO CHILDCARE, YOU GET BOOTED OFF; A DURATIONAL
35
NYS ASSEMBLY JUNE 5, 2019
SANCTION THAT WE KICK YOU OFF OF PUBLIC ASSISTANCE FOR A CERTAIN AMOUNT
OF TIME, WHICH HURTS YOU AND YOUR FAMILY. BUT GUESS WHO ELSE THAT
HURTS? IT'S HURTS THE COUNTIES. BECAUSE IT COSTS YOU MORE MONEY.
EVERY TIME YOU BOOT SOMEBODY OFF OF PUBLIC ASSISTANCE FOR A CERTAIN
PERIOD OF TIME, THE EXPONENTIALLY MORE LIKELY THAT THOSE PEOPLE ARE
GOING TO WIND UP IN A HOMELESS SHELTER, COSTING YOUR COUNTIES MORE
MONEY. THIS IS HELPFUL TO YOU. SO, WHEN WE HAVE A NEW REQUIREMENT
TO HAVE THE DSS MINIMALLY CHECK IN TO SAY, HEY, BEFORE WE HURT YOU
AND OURSELVES, AND COST OUR TAXPAYERS MORE MONEY, WHY DON'T WE SEE
IF THERE WAS A REASON WHY WE -- YOU MISSED YOUR APPOINTMENT? YOU
COULDN'T GET TO THE DOCTOR'S APPOINTMENT, MAYBE THERE WAS NO
TRANSPORTATION. THIS IS A BARE MINIMUM OF DUE DILIGENCE THAT IS
REQUIRED TO HELP THE FAMILIES TO GET THE SERVICES THAT THEY NEEDED, AND
TO HELP YOUR TAXPAYERS NOT BE ON THE HOOK FOR MORE EXPENSIVE SERVICES.
I WILL ALSO TELL YOU, THIS IS CURRENTLY THE LAW IN NEW
YORK CITY. IT'S BEEN WORKING WONDERFULLY FOR THE LAST THREE YEARS.
ORIGINALLY, THE INTENT WAS TO DO THE WHOLE STATE TOGETHER. POLITICALLY,
WE COULDN'T GET IT DONE. NEW YORK CITY PASSED WITH MY CHAIR --
FORMER CHAIRMAN KEITH WRIGHT PASSED THIS. IT'S THE LAW IN NEW YORK
CITY. TODAY, MS. HUNTER IS GOING TO MAKE IT PART OF THE LAW IN NEW
YORK STATE, WHICH IS FANTASTIC.
ONE LAST THING I WANT TO OPINE ON. AND IT WILL BE
INTERESTING TO SEE HOW OUR GOVERNOR REACTS. BECAUSE WHEN THE ORIGINAL
BILL PASSED FOR NEW YORK CITY TO DO THIS EXACT SAME THING, THE
GOVERNOR WAS EFFUSIVE, THIS IS GREAT, NO MORE DURATIONAL SANCTIONS,
36
NYS ASSEMBLY JUNE 5, 2019
NO MORE HURTING PEOPLE. WELL, I WANT TO SEE HIM PUT HIS MONEY IN --
WHERE HIS MOUTH IS AND MAKE SURE THAT HE SIGNS THIS WHEN THIS COMES
BEFORE HIS DESK. THIS IS A GREAT BILL.
THANK YOU, MS. HUNTER, FOR ALL YOUR WORK ON IT.
ACTING SPEAKER BLAKE: THANK YOU, MR.
HEVESI.
MRS. PEOPLES-STOKES.
MRS. PEOPLES-STOKES: APOLOGIES, MR. SPEAKER,
FOR INTERRUPTING THE PROCEEDINGS OF -- OF THE DEBATE TO CALL THE WAYS
AND MEANS COMMITTEE TO THE SPEAKER'S CONFERENCE ROOM
IMMEDIATELY.
ACTING SPEAKER BLAKE: WAYS AND MEANS TO
THE SPEAKER'S CONFERENCE ROOM IMMEDIATELY.
AND NOW, MR. BARRON.
MR. BARRON: THANK YOU, MR. SPEAKER. IT -- IT
NEVER CEASES TO AMAZE ME, THE CONDESCENDING, DISRESPECTFUL MANNER IN
WHICH THEY TALK ABOUT PEOPLE RECEIVING SOCIAL SERVICES. HOW DARE YOU
SAY THAT IN THE REAL WORK WORLD, LIKE THEIRS IS FAKE. THAT'S INSULTING AND
RACIST AND I BELIEVE THAT THEY SAY THESE THINGS --
MR. GOODELL: MR. SPEAKER, POINT OF ORDER --
MR. BARRON: NO, I'M NOT INTERRUPTED --
ACTING SPEAKER BLAKE: MR. GOODELL, WHY DO
YOU RISE?
MR. GOODELL: AS YOU KNOW, WE HAVE VERY CLEAR
RULES --
37
NYS ASSEMBLY JUNE 5, 2019
MR. BARRON: NO, HE CAN'T TALK. YOU'VE GOT TO ASK
HIM --
MR. GOODELL: -- IN OUR ASSEMBLY THAT --
MR. BARRON: I DON'T ACCEPT HIS INTERRUPTION.
ACTING SPEAKER BLAKE: MR. -- MR. GOODELL,
WHY DO YOU RISE?
MRS. PEOPLES-STOKES: HE IS ALLOWED TO RISE.
MR. BARRON: BUT HE CAN'T --
ACTING SPEAKER BLAKE: THANK YOU --
MR. BARRON: -- START TALKING WITHOUT ME ACCEPTING
HIS INTERRUPTION.
UNIDENTIFIED SPEAKER: HE'S MAKING A POINT OF
ORDER.
ACTING SPEAKER BLAKE: ALL RIGHT. MR. -- MR.
GOODELL, IS IT A POINT OF ORDER?
MR. GOODELL: YES, IT IS, SIR.
MR. BARRON: OH, COME ON, NOW. YOU GAVE HIM
THE IDEA?
MR. GOODELL: MR. BLAKE, AS -- MR. SPEAKER, AS
YOU KNOW, UNDER RULE V, SECTION 6 (B) --
MR. BARRON: THAT'S NOT RIGHT.
MR. GOODELL: FIRST OF ALL, A MEMBER WHO IS
CALLED TO ORDER IS REQUIRED TO IMMEDIATELY STOP UNTIL WE HAVE THIS
DISCUSSION.
MR. BARRON: I DIDN'T CALL HIM A RACIST. WHAT HE
38
NYS ASSEMBLY JUNE 5, 2019
SAID WAS A [SIC] RACIST. WELL, I'M STANDING UP, TOO --
MR. GOODELL: MR. SPEAKER --
MR. BARRON: -- TO INTERRUPT THAT.
MR. GOODELL: AGAIN, A POINT OF ORDER. IT'S THE
POLICY OF THIS --
MR. BARRON: HE CAN'T DO THAT.
MR. GOODELL: -- LEGISLATURE TO PROHIBIT ARGUMENTS
AD HOMINEM THAT QUESTION IN ANY WAY THE CHARACTER, MOTIVE, ATTRIBUTE
OF ANY CANDID -- OF ANY OF OUR MEMBERS, DIRECTLY OR INDIRECTLY. AND SO,
WHILE I CERTAINLY WELCOME ALL DISCUSSION, HOWEVER ROBUST, ON THE VALUE
OF THIS BILL OR THE WEAKNESSES OF THIS BILL, OUR DISCUSSION, AS YOU KNOW,
UNDER OUR RULES, FOCUSES ON THE MERITS OF THE BILL, AND DOES NOT AND
SHOULD NOT INVOLVE THE CHARACTERIZATION OF ANY MEMBER OR THEIR
COMMENTS. I WOULD ASK THAT YOU GENTLY REMIND THE MEMBER OF OUR RULE
AND ASK THAT HE CONFINE HIS COMMENTS TO WHAT HE LIKES ABOUT THE BILL,
OR DOESN'T LIKE ABOUT THE BILL.
ACTING SPEAKER BLAKE: THANK YOU, MR.
GOODELL. WE -- WE UNDERSTAND AND WE HEAR. MEMBERS ARE REMINDED
TO CONFINE THEIR COMMENTS TO THE MERITS OF THE BILL.
MRS. PEOPLES-STOKES.
MRS. PEOPLES-STOKES: MR. SPEAKER, I -- WITH
ALL DUE RESPECT TO MY COLLEAGUE, I -- I DO THINK THAT MR. BARRON WAS
SPEAKING ON THE MERITS OF THE BILL --
MR. BARRON: EXACTLY.
MRS. PEOPLES-STOKES: SOMETIMES YOU HAVE TO
39
NYS ASSEMBLY JUNE 5, 2019
CREATE THIS KIND OF LEGISLATION TO COMBAT THE ATTEMPTS OF OTHERS THAT ARE
INSTITUTING RACIST POLICY. SO, IT WASN'T DIRECTED AT A PERSON OR A
MEMBER, IT IS ABOUT THE CONTENT OF THE BILL AND ITS VALUE IN REMOVING
SOME OF THE DIALOGUE THAT COMES OUT OF POLICY THAT IS ADMINISTERED IN A
WAY THAT IS NOT FAIR TO ALL PEOPLE OF ALL RACES.
AND SO, I WOULD ALSO REMIND MY COLLEAGUE, MR.
BARRON, THAT UM... IN ORDER FOR US TO REALLY HAVE GOOD COMMUNICATIONS
IN OUR CHAMBERS [SIC], OPPORTUNITIES TO REMIND PEOPLE OF THINGS THAT
PERHAPS THEY DON'T WANT TO BE REMINDED OF DOESN'T BODE FOR GOOD
CONVERSATION. AND SO, I -- I THINK IF WE CAN, YOU KNOW, REALLY JUST KEEP
OUR -- EVEN-KEELED. THIS IS GOOD LEGISLATION THAT MS. HUNTER HAS PUT
FORWARD. IF IT CLEARLY CAN WORK IN NEW YORK CITY, IT CAN WORK IN NEW
YORK STATE. AND SO, I HOPE AT THE END OF THIS CONVERSATION, WE ALL ARE
VOTING YES FOR THIS REALLY GOOD PIECE OF LEGISLATION THAT WILL PROMOTE
NOT JUST GOOD SPIRIT, BUT OFFER GOOD POLICIES FOR THE CITIZENS THAT WE ALL
REPRESENT ACROSS THE STATE OF NEW YORK.
ACTING SPEAKER BLAKE: AB -- ABSOLUTELY,
MEMBER PEOPLES-STOKES. AND -- AND THE POINT IS DEFINITELY NOTED.
MR. KOLB, WHY DO YOU RISE?
MR. KOLB: WHY DO I RISE IS BECAUSE I'M TIRED --
SICK AND TIRED --
ACTING SPEAKER BLAKE: CAN EVERYONE PLEASE
TAKE THEIR SEATS.
MR. KOLB: -- OF THE TYPE OF LANGUAGE THAT IS USED
ON THIS BILL AND ANY OTHER BILL ACCUSING ANY MEMBER OF BEING RACIST --
40
NYS ASSEMBLY JUNE 5, 2019
ACTING SPEAKER BLAKE: MR. -- MR. KOLB --
MR. KOLB: -- OR USE OF --
ACTING SPEAKER BLAKE: MR. KOLB --
MR. KOLB: NO, I'M GOING TO FINISH --
ACTING SPEAKER BLAKE: MR. KOLB --
MR. KOLB: -- MY COMMENT. HE GOT --
ACTING SPEAKER BLAKE: MR. KOLB, WE -- WE --
MR. KOLB, I -- I WOULD EXPECT AS WE ALL AS COLLEAGUES THAT WE CAN SPEAK
IN A COURTEOUS MANNER. SO, AGAIN I ASK, WHY DO YOU RISE?
MR. KOLB: I'M RISING TO DISAGREE WITH THE
CHARACTERIZATION MADE BY THE OTHER MEMBER ON THIS PARTICULAR BILL.
ACTING SPEAKER BLAKE: UNDERSTOOD. MR.
KOLB, THE -- THE MEMBER NEVER SPOKE OF THE OTHER MEMBER, AND SO,
THEREFORE, YOUR POINT IS ACKNOWLEDGED AND I THINK WE CAN GO BACK TO
MR. BARRON. BUT WE DO HEAR YOUR POINT, MR. KOLB.
MR. KOLB: WE'RE GOING TO HAVE A PROBLEM.
MR. BARRON: ARE YOU THREATENING?
MR. KOLB: WE HAVE HAD THIS DISCUSSION AND WE'RE
GOING TO HAVE --
ACTING SPEAKER BLAKE: MR. -- MR. KOLB, THE
-- THE POINT HAS BEEN MADE AND MR. BARRON IS STILL THE ONE --
MR. KOLB: I'M NOT GOING TO HAVE ANY MEMBER OF
THIS HOUSE MISCHARACTERIZING AND MOTIVATIONS OF OUR MEMBERS ON THE
DEBATE OF A LEGISLATIVE BILL. IT'S UNCALLED FOR, UNNECESSARY AND --
ACTING SPEAKER BLAKE: MR. -- MR. KOLB --
41
NYS ASSEMBLY JUNE 5, 2019
(APPLAUSE)
MR. BARRON: IF HE'S NOT GOING TO RESPECT THE
PROCESS --
ACTING SPEAKER BLAKE: MR. BARRON --
MR. BARRON: -- NEITHER AM I.
ACTING SPEAKER BLAKE: MR. BARRON --
MR. BARRON: I WILL CONTINUE MY REMARKS, I WILL
CONTINUE MY REMARKS. WHEN PEOPLE SPEAK OF US ON SOCIAL SERVICES,
SOME OF THE IDEAS ARE RACIST. I DON'T KNOW WHAT THE INDIVIDUAL IS, SOME
OF THE IDEAS COME FROM A RACIST --
ACTING SPEAKER BLAKE: MR. -- MR. GOODELL --
MR. GOODELL: AGAIN --
ACTING SPEAKER BLAKE: -- WHY DO YOU --
MR. GOODELL: -- MR. SPEAKER, A POINT OF ORDER.
THERE HAS BEEN ABSOLUTELY NO DISCUSSION UP TO THIS POINT OF ANYTHING
INVOLVING RACISM --
MR. BARRON: YES, IT HAS --
MR. GOODELL: AND MY--
MR. BARRON: YES, IT HAS --
MR. GOODELL: MR. SPEAKER, LET ME COMPLETE MY--
MR. BARRON: YES, IT HAS -- YOU JUST KEEP
INTERRUPTING --
MR. GOODELL: -- POINT OF ORDER. IN MY DISTRICT --
ACTING SPEAKER BLAKE: MR. -- MR. GOODELL. I
WOULD JUST ASK, AS I THINK OTHERS WOULD AS WELL, WE SHOULD LET MR.
42
NYS ASSEMBLY JUNE 5, 2019
BARRON COMPLETE --
MR. BARRON: LET ME FINISH.
ACTING SPEAKER BLAKE: -- HIS COMMENTS. HE
HAS NOT DIRECTED HIS COMMENTS TO ANY INDIVIDUAL MEMBER --
MR. BARRON: WHY DON'T YOU LET ME FINISH. I
WASN'T EVEN TALKING --
MR. GOODELL: MR. SPEAKER, POINT OF ORDER --
MR. BARRON: LET ME FINISH --
ACTING SPEAKER BLAKE: THE POINT -- MR.
GOODELL, RESPECTFULLY, THE POINT OF ORDER WAS RAISED INITIALLY. WE
SHOULD LET MR. BARRON COMPLETE HIS COMMENTS --
MR. BARRON: LET ME FINISH MY STATEMENT.
ACTING SPEAKER BLAKE: -- AND THEN WE CAN GO
FROM THERE.
MR. BARRON: WHEN I HEAR COMMENTS --
MR. GOODELL: MR. SPEAKER --
MR. BARRON: -- WHEN I HEAR COMMENTS COMING
FROM ANYBODY ON THIS FLOOR --
MR. GOODELL: MR. SPEAKER.
ACTING SPEAKER BLAKE: MR. GOODELL --
MR. BARRON: -- WHETHER THEY --
ACTING SPEAKER BLAKE: -- YOUR POINT HAS BEEN
HEARD. WE SHOULD LET MR. BARRON COMPLETE HIS COMMENTS.
MR. BARRON: WHEN I HEAR COMMENTS COMING --
ACTING SPEAKER BLAKE: PLEASE, MR. BARRON,
43
NYS ASSEMBLY JUNE 5, 2019
GO AHEAD.
MR. BARRON: WHEN I HEAR COMMENTS COMING
FROM THIS FLOOR --
MR. GOODELL: POINT OF ORDER -- I ASK THAT --
MRS. PEOPLES-STOKES: MR. GOODELL.
MR. BARRON: -- I THINK --
MRS. PEOPLES-STOKES: MR. GOODELL --
ACTING SPEAKER BLAKE: MR. GOODELL. MR.
GOODELL.
MRS. PEOPLES-STOKES: -- MR. BARRON DOESN'T
HAVE TO YIELD.
ACTING SPEAKER BLAKE: THANK YOU.
MR. BARRON: EXACTLY.
MR. GOODELL: MR. SPEAKER --
MRS. PEOPLES-STOKES: PLEASE.
MR. BARRON: SO WHEN I HEAR COMMENTS COMING
FROM THIS FLOOR --
MRS. PEOPLES-STOKES: WE WON'T GET THROUGH
THIS IF YOU DON'T STOP INTERRUPTING --
MR. GOODELL: MR. SPEAKER --
MR. BARRON: WHEN I -- WHEN I HEAR COMMENTS
COMING --
ACTING SPEAKER BLAKE: MR. --
MR. BARRON: I HAVE THE FLOOR --
ACTING SPEAKER BLAKE: MR. GOODELL --
44
NYS ASSEMBLY JUNE 5, 2019
MR. BARRON: -- I HAVE THE FLOOR. I HAVE THE TIME.
AND I'M GOING TO KEEP TALKING.
ACTING SPEAKER BLAKE: -- MR. BARRON HAS THE
FLOOR. HE HAS CHOSEN NOT TO YIELD.
MR. BARRON: I HAVE THE FLOOR --
ACTING SPEAKER BLAKE: WE HEAR YOU ON YOUR
POINT.
MR. BARRON: -- I DON'T YIELD TO MR. GOODELL. I
HAVE THE FLOOR.
MR. KOLB: MR. SPEAKER --
MR. BARRON: I HAVE THE FLOOR. I HAVE THE FLOOR.
ACTING SPEAKER BLAKE: MR. BARRON, PLEASE
CONTINUE.
MR. BARRON: THANK YOU. WHEN I HEAR IDEAS THAT I
BELIEVE ARE CODED RACIST --
ACTING SPEAKER BLAKE: MR. RA, WHY DO YOU
RISE?
MR. GOODELL: MR. SPEAKER, I APPEAL TO THE --
MR. RA: MR. SPEAKER, A POINT OF ORDER --
ACTING SPEAKER BLAKE: MR. RA.
MR. RA: -- APPEAL TO THE CHAIR THAT THE MEMBER WAS
NOT OUT OF ORDER.
ACTING SPEAKER BLAKE: HE -- THE MEMBER IS
NOT OUT OF ORDER BECAUSE HE NEVER SPOKE DIRECTLY OF AN INDIVIDUAL
MEMBER --
45
NYS ASSEMBLY JUNE 5, 2019
MR. RA: AND --
ACTING SPEAKER BLAKE: -- AND THEREFORE, WE
SHOULD LET MR. BARRON COMPLETE HIS COMMENTS.
MR. RA: AND WE HAVE A PROCESS UNDER THE RULES TO
APPEAL THE --
MRS. PEOPLES-STOKES: MR. SPEAKER. MR.
SPEAKER, CAN WE --
MR. RA: -- RULING OF THE CHAIR.
MRS. PEOPLES-STOKES: CAN I CALL EVERYBODY'S
ATTENTION TO THE FACT THAT OUR RULES ASK US TO ASK THE SPEAKER --
ACTING SPEAKER BLAKE: MRS. PEOPLES-STOKES.
MRS. PEOPLES-STOKES: -- MR. SPEAKER FOR A
DETERMINATION. HE HAS MADE THAT DETERMINATION. IT'S BEEN MADE. IT'S
BEEN DECIDED. CAN WE PLEASE MOVE ON? MR. BARRON STILL HAS THE FLOOR,
I WANT TO SAY, FOR ANOTHER 12 MINUTES --
ACTING SPEAKER BLAKE: THAT IS CORRECT.
MRS. PEOPLES-STOKES: AND I DO HOPE, MR.
BARRON, THAT IF YOU COULD POSSIBLY NOT CAUSE MR. GOODELL OR MR. RA OR
MR. KOLB TO WANT TO STAND UP --
MR. BARRON: MY MISSION IN LIFE, THERE'S NOTHING I
COULD SAY --
MRS. PEOPLES-STOKES: -- ON ANY OF THESE TOPICS
AGAIN, COULD YOU PLEASE REMOVE THAT WORD --
MR. BARRON: THERE'S NOTHING I COULD SAY TO NOT
UPSET THEM. AND SO, I NO LONGER TRY --
46
NYS ASSEMBLY JUNE 5, 2019
ACTING SPEAKER BLAKE: MR. BARRON, WHY
DON'T YOU PLEASE CONTINUE YOUR COMMENTS AND THEN WE'LL GO FROM THERE
--
MR. BARRON: AND IT'S NOT ABOUT HIM --
MRS. PEOPLES-STOKES: I KNOW IT WASN'T ABOUT
HIM.
MR. BARRON: -- IT'S ABOUT ME NOT ALLOWING CODED
RACIST IDEAS TO PROCEED WITHOUT ADDRESSING THEM. AND WHEN YOU SPEAK
OF US IN SOME WORK WORLD THAT IS NOT THE REAL WORLD, THEN YOU'RE TALKING
SOMETHING VERY NEGATIVE ABOUT PEOPLE WHO DON'T WANT TO BE ON SOCIAL
SERVICES. THIS BILL STOPS THEM FROM PUNISHING THEM FOR MISSING A TIME
AT WORK. WE WOULD LOVE TO HAVE AN OPPORTUNITY TO BE IN THE WORKPLACE
AND NOT HAVE TO BE ON WELFARE AT ALL. BUT WE LIVE UNDER A RACIST --
ACTING SPEAKER BLAKE: MS. -- MR. GOODELL.
MR. BARRON: -- WE LIVE UNDER --
MR. GOODELL: MR. SPEAKER --
MR. BARRON: YOU CAN'T LET HIM KEEP INTERRUPTING.
MR. GOODELL: -- IN ACCORDANCE WITH RULE I,
SECTION 1 (C) (2) OF THE RULES OF THE ASSEMBLY, I HEREBY APPEAL YOUR
RULING -- YOUR RULING, AND REQUEST THE FLOOR TO SPEAK ON THE APPEAL.
ACTING SPEAKER BLAKE: MS. GOODELL -- MR.
GOODELL DOES HAVE THAT RIGHT.
MR. BARRON: YOU CAN'T DENY THAT REQUEST AND LET
ME FINISH? I MEAN, THIS GUY, HE CAN'T KEEP INTERRUPTING ME AND THEN
SAY THIS IS THE RULES --
47
NYS ASSEMBLY JUNE 5, 2019
ACTING SPEAKER BLAKE: MR. BARRON --
MR. BARRON: IF HE AIN'T GOING TO PLAY BY THE RULES,
I'M NOT. YOU CAN'T HAVE HIM INTERRUPTING EVERY TIME TALKING ABOUT
SOMETHING HE'S READ OUT OF SOME RULES. THIS IS INTERRUPTING ME. I
WOULD HAVE BEEN FINISHED BY NOW.
ACTING SPEAKER BLAKE: MS. -- MR. BARRON,
THE POINT HAS BEEN HEARD. THE POINT THAT WAS RAISED WAS CAN HE APPEAL
ON THE RULE, AND THAT HE CAN. THE SAME WAY WHEN WE STOPPED HIM
INITIALLY, WHEN HE WAS TRYING TO MAKE HIS INITIAL COMMENT WE SAID THAT
THEY WERE INCORRECT BECAUSE YOU DID NOT SPEAK DIRECTLY TO HIM, SO WE'RE
JUST ACKNOWLEDGING THAT THE POINT IS APPROPRIATE TO BE MADE AND YOU
STILL HAVE YOUR TIME. WE'RE JUST ACKNOWLEDGING THE POINT AS BEING
MADE.
MR. GOODELL.
MR. GOODELL: THANK YOU VERY MUCH, MR.
SPEAKER. AS YOU KNOW, PURSUANT TO RULE I, SECTION 1 (C) (2) OF THE
RULES OF THE ASSEMBLY, ANY RULING BY THE CHAIR CAN BE APPEALED.
EVERY MEMBER HAS UP TO 15 MINUTES TO DISCUSS THEIR VIEWS FOR OR
AGAINST THE RULING OF THE CHAIR. AND I APPRECIATE THAT WE ARE NOW
GOING BACK ON THE RULES AND THAT I HAVE 15 MINUTES TO EXPLAIN WHY I'M
APPEALING THE RULING OF THE CHAIR.
UP UNTIL THIS POINT IN THE DEBATE WE WERE TALKING
ABOUT A CONCILIATION PROCESS INVOLVING THE DEPARTMENT OF SOCIAL
SERVICES, AND WHETHER THAT PROCESS SHOULD BE MADE MORE DIFFICULT ON
OUR COUNTY EMPLOYEES AND CITY EMPLOYEES, WHETHER IT SHOULD BE MADE
48
NYS ASSEMBLY JUNE 5, 2019
SLOWER, OR WHETHER OR NOT WE SHOULD LOOK AT TRYING TO IMPROVE THE
PROCESS AND HELP PEOPLE MOVE FORWARD WITH THEIR LIVES AND GETTING INTO
PRIVATE-SECTOR EMPLOYMENT. AND THAT PROCESS INVOLVES HELPING PEOPLE
ATTEND WORK EXPERIENCES ON TIME, TO TAKE RESPONSIBILITY FOR KEEPING
THEIR EMPLOYER ADVISED, TO ATTEND TRAINING ON TIME, AND TAKE PERSONAL
RESPONSIBILITY TO THE MAXIMUM EXTENT POSSIBLE TO MOVE THEIR LIFE
FORWARD. NONE OF THAT DISCUSSION, MR. SPEAKER AND MY COLLEAGUES,
NONE OF THAT DISCUSSION WAS RACIST. IN MY COUNTY, IT'S TWO PERCENT
BLACK, SEVEN PERCENT HISPANIC AND THE REST IS WHITE. AND IN SOME OF
MY NEIGHBORING COUNTIES, IT'S ALMOST 98 PERCENT WHITE. IT HAS NOTHING
TO DO WITH WHETHER YOU'RE WHITE, BLACK, BROWN, WHETHER YOU'RE
HISPANIC, WHETHER YOU'RE ENGLISH, WHETHER YOU'RE RUSSIAN. IT DOESN'T
HAVE ANYTHING WHATSOEVER TO DO WITH THAT. IT HAS NOTHING, ABSOLUTELY
NOTHING TO DO WITH RACISM. SO, WHEN A MEMBER OF THIS ASSEMBLY
STANDS UP AND TALKS ABOUT THE MERITS OF A BILL, A BILL THAT AFFECTS, IN MY
COUNTY, ALMOST EXCLUSIVELY WHITE, ANGLO-SAXON AMERICANS, TO STAND
UP AND ACCUSE THAT MEMBER'S COMMENTS OF BEING RACIST AND TRY TO HIDE
BEHIND THE FACT THAT YOU DIDN'T NAME THAT MEMBER BECAUSE, AS THOUGH
WE DIDN'T KNOW HE'S THE ONLY MEMBER THAT SPOKE ON IT, LIKE THAT'S SOME
SORT OF SMOKESCREEN THAT WE CAN HIDE BEHIND, LEADS ALL OF US IN THIS
CHAMBER DOWN A RAT HOLE. INSTEAD OF FOCUSING ON THE MERITS OF A BILL
AND TALKING ABOUT WHETHER IT'S GOOD OR BAD OR WHETHER IT HELPS OUR
RESIDENTS OR NOT, WHETHER -- INSTEAD OF FOCUSING ON WHETHER IT MOVES
THE STATE OF NEW YORK FORWARD, WE SLIDE DOWN THAT ROLE OF CALLING
NAMES AND COMMENTS, DEROGATORY TERMS, AND RACISM IS ONE OF THEM.
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NYS ASSEMBLY JUNE 5, 2019
AND NO ONE'S COMMENTS ON THIS FLOOR SHOULD BE ACCUSED OF BEING RACIST
OR SEXIST OR ANY OTHER DEROGATORY TERM WHEN THE FOCUS OF THAT
DISCUSSION IS ON THE MERITS OF THE BILL. AND WE ALL SHOULD FEEL FREE TO
STAND UP AND -- AND SPEAK OUR CONVICTIONS ABOUT A BILL. WHETHER IT'S
GOOD OR BAD, WHETHER IT HELPS OUR SOCIETY MOVE FORWARD OR NOT, WITHOUT
HAVING OUR COMMENTS CHARACTERIZED INCORRECTLY AS BEING RACIST OR ANY
OTHER MISCHARACTERIZATION.
NOW, WE WORKED -- WE HAVE WORKED EXTRAORDINARILY
HARD ON THE MINORITY SIDE - AND I HOPE ALL OF YOU APPRECIATE IT - WE
HAVE WORKED EXTRAORDINARILY HARD TO AVOID CALLING PEOPLE NAMES, TO
AVOID ATTACKING PEOPLE. OH, SURE, IT WOULD BE EASY FOR US TO STAND UP
AND SAY, THAT IS A DUMB COMMENT. OR, IS THAT MEMBER STUPID, OR
WHAT? AND BY THE WAY, I'VE BEEN HERE ON THE FLOOR OF THE ASSEMBLY
WHEN WE WENT DOWN THAT ROAD. MOST OF YOU HAVE SEEN THAT BEFORE.
WE'VE HAD DEBATES WHERE THE DEBATE WAS ATTACKED, NOT THE MERITS OF
THE BILL, BUT THE DEBATER, HIS COMPETENCE, HIS INTELLIGENCE, HIS
UNDERSTANDING. AND BELIEVE ME, AS THE ASSISTANT FLOOR -- AS A FLOOR
LEADER, ASSISTANT PRO TEM, THERE ARE PLENTY OF TIMES ON ALL OF YOUR
BILLS WHERE OUR MEMBERS MAY HAVE RESEARCHED IT BETTER THAN YOU HAVE,
AND WE CAN WORK COOPERATIVELY AND PROFESSIONALLY, FOCUSED ON WHAT'S
GOING ON, OR WE CAN MAKE IT REALLY NASTY AND REAL PERSONAL, AND WE
HAVE WORKED REALLY HARD NOT TO GO THAT ROUTE.
SO, WHEN I APPEAL THIS DECISION, THE QUESTION BEFORE
THE HOUSE FOR ALL OF YOU, RECOGNIZING THAT ALL OF US ARE GOING TO BE
ASKING ALL OF YOU A WHOLE BUNCH OF QUESTIONS OVER THE NEXT FEW WEEKS,
50
NYS ASSEMBLY JUNE 5, 2019
WHAT TONE DO YOU WANT ON THE FLOOR OF THIS ASSEMBLY? DO YOU WANT IT
RESPECTFUL? DO YOU WANT IT PROFESSIONAL? DO YOU WANT TO FOCUS ON THE
BILL AND THE MERITS OF THE BILL? OR DO YOU WANT TO GO A DIFFERENT ROUTE?
WHERE WE'RE SUGGESTING THAT IF YOU DON'T AGREE WITH US YOU'RE RACIST, OR
A FLAMING LIBERAL, OR A RADICAL CONSERVATIVE, OR ANY OTHER DEROGATORY
NAME YOU CAN THINK OF. WE ALL HAVE THAT LIST BECAUSE WE ALL HAVE BEEN
CALLED THOSE NAMES ONE TIME OR ANOTHER BY OUR OPPONENTS OR PEOPLE
THAT ARE NOT WELL-CONSTRAINED OR PROFESSIONAL.
SO, THE CHOICE MY FRIEND, TODAY, IS IT -- IS IT ACCEPTABLE
ON THE FLOOR OF THIS ASSEMBLY FOR A DISCUSSION THAT HAS NOTHING TO DO
WITH RACE, TO BE ACCUSED OF RACISM? I'M PERSONALLY OFFENDED, AND EACH
OF YOU SHOULD BE AS WELL. AND, THEREFORE, I BELIEVE, THE MEMBER'S
COMMENTS THAT SUGGESTS THAT ANY DISCUSSION ABOUT IMPROVING THE WAY
WE DEAL WITH PEOPLE TO HELP THEM LEAVE POVERTY IS IN ANY WAY
MOTIVATED BY RACISM, LET ME TELL YOU THIS: MY COMMENTS ABOUT HOW WE
CAN IMPROVE HELPING PEOPLE GET OUT OF POVERTY IS BECAUSE I WANT TO
HELP PEOPLE GET OUT OF POVERTY. I WANT THEM TO MAXIMIZE THEIR
BENEFITS. I WANT THEM TO MOVE FORWARD IN LIFE. THAT'S MY FOCUS. IT'S
NOT RACISM. IT'S NOT SEXISM. IT'S NONE OF THOSE OTHER ISMS. I'M FOCUSED
SOLELY ON WHAT WE CAN DO, THE BEST WAY WE CAN WORK TOGETHER AS
REPUBLICANS, AS DEMOCRATS, AS LIBERALS AND CONSERVATIVES, TO HELP THE
PEOPLE IN POVERTY IMPROVE THEIR LIVES. THAT'S MY FOCUS. I HOPE THAT'S
YOUR FOCUS. AND I HOPE NOBODY IN THIS ROOM THINKS THAT DOING THE BEST
WE CAN DO TO HELP PEOPLE WHO ARE IN POVERTY IMPROVE THEIR LIVES IS
RACISM.
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NYS ASSEMBLY JUNE 5, 2019
THANK YOU, SIR.
ACTING SPEAKER BLAKE: THANK YOU.
(APPLAUSE)
THANK YOU, MR. GOODELL. ON THE...
(APPLAUSE)
(ACTING SPEAKER GAVELING)
THE POINT'S BEEN HEARD.
ON THE APPEAL, MRS. PEOPLES-STOKES.
MRS. PEOPLES-STOKES: LET ME MOTIVATE YOU TO
HEAR WHAT MR. GOODELL HAD TO SAY, REMIND YOU OF WHAT MR. BARRON HAD
TO SAY, THAT WAS IN NO WAY POINTING FINGERS AT ANYBODY, BUT, THE
SCENARIO THAT WE LIVE IN TODAY'S SOCIETY IN AMERICA, WHERE THE VAST
MAJORITY OF PEOPLE -- BE THEY IN THESE CHAMBERS [SIC], OR BE THEY
OUTSIDE IN ANY OF OUR COMMUNITIES, INCLUDING THE ONE I LIVE IN -- HAVE
THIS TERRIBLE PERCEPTION THAT MOST OF THE PEOPLE WHO RECEIVE SOCIAL
SERVICES BENEFITS IN THIS STATE LOOK LIKE ME. WELL, THEY DON'T. THAT'S
THE FIRST THING WE NEED TO REMOVE FROM OUR THOUGHT PROCESS. THE
SECOND THING IS, IS MR. BARRON CLEARLY -- I MEAN, I HEARD HIM. I DID NOT
HEAR HIM DIRECT A NEGATIVE COMMENT AT ANYBODY. AND I -- I THINK IF --
ONCE YOU HEAR WHAT MR. GOODELL HAD TO SAY, HEAR WHAT MR. BARRON HAD
TO SAY, AND MAKE YOUR RULING ON THIS -- ON THIS APPEAL THAT HE'S OFFERED,
THAT WE SHOULD MOVE ON. BECAUSE THE BILL BEFORE US IS A LOT MORE
IMPORTANT THAN THE DIALOGUE WE'RE HAVING HERE NOW. NOW, THERE'S NO
QUESTION THAT ONE THING THAT WE LACK IN AMERICA IS A REAL WILLINGNESS TO
TALK ABOUT RACE.
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NYS ASSEMBLY JUNE 5, 2019
(APPLAUSE)
WE REALLY DON'T -- DON'T EVEN WANT TO HEAR IT.
(APPLAUSE)
THAT'S THE PROBLEM. BUT THIS IS NOT THE TIME TO DO THAT,
MR. SPEAKER. RIGHT NOW BEFORE US THERE'S A VERY IMPORTANT PIECE OF
LEGISLATION THAT MEET -- NEEDS TO BE MOVED FORWARD. I WOULD IMPLORE
MR. BARRON, MR. GOODELL, MR. KOLB AND EVERYBODY IN THIS CHAMBERS
[SIC] RIGHT NOW, TO LET US MOVE FORWARD. I WILL BE HAPPY TO LEAD THAT
DISCUSSION THAT WE NEED TO HAVE ON RACE. THERE IS NOT A POLICY AREA
THAT WE WORK ON IN THE STATE OF NEW YORK THAT DOESN'T HAVE SOME
RACIAL IMPLICATIONS.
(APPLAUSE)
DON'T ACT LIKE IT DOESN'T.
(APPLAUSE)
BUT THIS IS NOT THE TIME TO WORK ON THAT, MR. SPEAKER.
THE TIME RIGHT NOW FOR US IS TO REJECT MR. GOODELL'S APPEAL, MOVE
FORWARD WITH THIS LEGISLATION AND THE MANY OTHER PIECES OF FINE WORK
THAT WE HAVE BEFORE US TODAY.
ACTING SPEAKER BLAKE: THANK YOU, MEMBER
PEOPLES-STOKES.
MR. RA ON THE APPEAL.
MR. RA: THANK YOU, MR. SPEAKER. YOU KNOW, I FIRST
CAME UP HERE ABOUT NINE YEARS AGO NOW, AND LIKE ALL OF YOU, I CAME UP
HERE TO REPRESENT THE PEOPLE IN MY DISTRICT. I THINK WE ALL CAME HERE FOR
THE RIGHT REASONS, TO REPRESENT OUR COMMUNITIES. AND WHETHER WE
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NYS ASSEMBLY JUNE 5, 2019
COME FROM LONG ISLAND OR NEW YORK CITY OR THE NORTH COUNTRY OR THE
CAPITAL REGION OR ALL THE WAY IN WESTERN NEW YORK, WHAT WE DO ON
THE FLOOR EACH AND EVERY DAY, WHAT WE DO IN OUR COMMITTEE MEETINGS,
WHAT WE DO IN ALL OUR CAPACITIES AS -- AS ELECTED MEMBERS OF THIS BODY,
IS DONE WITH THE BEST INTERESTS OF THOSE INDIVIDUALS IN MIND. AND WE
MAY DISAGREE ON ISSUES. AND I'VE SEEN DAYS IN HERE WHERE WE'VE HAD
VERY SPIRITED DEBATES ON REALLY CONTROVERSIAL ISSUES, BUT EVERYBODY
WALKED OUT OF THE CHAMBER, NO GRUDGES BEING HELD, EVERYBODY HAVING
HAD THEIR VOICE HEARD. AND WE GET IT ON OUR SIDE OF THE AISLE. WE --
WE KNOW HOW THE VOTE'S GOING TO GO AT THE END OF THE DAY. BUT, WE
HAVE JUST AS MUCH OF A RIGHT TO REPRESENT OUR CONSTITUENTS AS ANYBODY
ON THE OTHER SIDE OF THE AISLE. WE HAVE JUST AS MUCH A RIGHT TO RAISE OUR
POINTS. AND WE HAVE JUST AS MUCH A RIGHT TO RAISE THEM IN A WAY THAT
NOBODY SHOULD QUESTION WHAT OUR MOTIVATION IS IN DOING SO; OTHER THAN
TO REPRESENT THE PEOPLE WHO ELECTED US AND SENT US HERE TO SIT IN THIS
HOUSE AND VOTE IN ACCORDANCE WITH WHAT'S BEST FOR THEM AND WHAT'S
BEST FOR OUR COMMUNITIES. AND WE'RE SEEING FAR TOO MUCH OF THIS THIS
YEAR AND -- AND LATELY. I KNOW WE LIVE IN POLARIZING TIMES. BUT, TO
CAUSE DEBATES ON -- ON ISSUES -- YOU KNOW, MY -- MY COLLEAGUE, I THINK,
HAS THE SAME END GOAL. HE WANTS TO HELP INDIVIDUALS THAT ARE IN
POVERTY. HE HAS A DIFFERENT IDEA OF HOW WE CAN BEST GET THERE. THAT
DOESN'T MEAN HE DISLIKES PEOPLE THAT ARE IN POVERTY. IT DOESN'T MEAN
THAT HE'S MISCHARACTERIZING ANYBODY, OR -- OR -- OR THAT HE'S MAKING ANY
RACIST ALLEGATIONS. IT MEANS HE'S DECIDED THAT FROM A PUBLIC POLICY
STANDPOINT -- AN ISSUE THAT I KNOW HE HAS STUDIED EXTENSIVELY BECAUSE
54
NYS ASSEMBLY JUNE 5, 2019
I'VE HAD A MILLION CONVERSATIONS WITH HIM ABOUT THESE ISSUES -- HE HAS A
DIFFERENT WAY THAT HE WANTS TO -- WANTS TO GET TO THE END RESULT.
SO, I -- I THINK WE HAVE JUST OVER TWO WEEKS LEFT.
WE'RE SCHEDULED TO FINISH TWO WEEKS FROM TODAY. WE'RE GOING TO HAVE
A LOT OF DEBATES BETWEEN NOW AND THEN, THERE ARE A LOT OF ISSUES THAT ARE
GOING TO COME UP. AND IF THIS IS WHAT WE WANT OUR HOUSE TO DEVOLVE
INTO, IT'S GOING TO BE A VERY LONG TWO WEEKS. SO, I THINK THAT IF WE -- AS
WE PUT THIS QUESTION BEFORE THE HOUSE AS TO WHETHER THE MEMBER WAS
OUT OF ORDER, AND -- AND PERHAPS, IF IT'S APPROPRIATE, WE COULD READ BACK
WHAT THE COMMENTS WERE SO THAT PEOPLE CAN BE AWARE OF WHAT THE
COMMENTS WERE, AND -- AND VOTE ACCORDINGLY. BUT I THINK THAT WE NEED
TO KEEP IN MIND THAT WE COME HERE TO REPRESENT OUR CONSTITUENTS. AND
IF WE FEEL OUR CONSTITUENTS AREN'T GOING TO BENEFIT FROM A PIECE OF
LEGISLATION BEFORE THIS HOUSE, OR ARE GOING TO BE HURT FROM A PIECE OF
LEGISLATION BEFORE THIS HOUSE, WE HAVE A RIGHT TO RAISE THOSE POINTS.
AND IT DOESN'T MEAN THAT WE DON'T LIKE YOUR CONSTITUENTS, OR -- OR
PEOPLE IN YOUR DISTRICT THAT -- THAT YOU REPRESENT, BUT -- BUT WE -- WE
HAVE A DIFFERENT VIEWPOINT THAN YOU. SO, I THINK THE CIVILITY IN THIS
HOUSE IS SOMETHING THAT WE CAN BE PROUD OF WHEN WE'RE DOING IT RIGHT,
WHEN WE'RE HAVING THOSE SPIRITED POLICY DEBATES, THAT WE'RE TALKING
ABOUT THE ISSUES. WE'RE TALKING ABOUT WHY THIS BILL IS GOOD, WHY THIS
BILL IS BAD. WHY -- WHY... YOU KNOW, ONE GROUP OR ANOTHER GROUP IS
GOING TO BENEFIT OR -- OR NOT BENEFIT FROM IT. BUT IF IT BECOMES LOOKING
AT AND -- AND ATTACKING OTHER MEMBERS' MOTIVATIONS, WE'RE GOING TO
HAVE A REALLY TOUGH TIME HAVING CIVIL DEBATES IN THIS HOUSE.
55
NYS ASSEMBLY JUNE 5, 2019
THANK YOU, MR. SPEAKER.
ACTING SPEAKER BLAKE: THANK YOU, MR. RA.
MS. MELISSA MILLER ON THE APPEAL.
MS. M. MILLER: I JUST WANT TO SAY THAT THIS IS THE
SECOND TIME THIS SESSION THAT I HAVE BEEN DRIVEN TO TEARS WHILE SITTING
IN THIS CHAMBER OVER THIS TONE. AND THIS IS NOT WHAT I WAS ELECTED TO
DO. I WAS ELECTED TO REPRESENT MY CONSTITUENTS TO MY BEST POSSIBLE
ABILITY, AND THAT'S WHAT WE'RE ALL HERE TO DO. AND WE ALL HAVE THE SAME
RIGHT TO DO IT. WE HAVE TO RESPECT EACH OTHER. WE ARE -- WE ARE ALL OUR
STATE'S REPRESENTATIVES. IF WE CAN'T SET THE TONE AND RESPECTFULLY SET THIS
TONE -- PEOPLE WATCH US. THESE SESSIONS ARE VIEWED BY PEOPLE. AND
THIS IS THE TONE, THIS IS WHAT WE'RE SHOWING PEOPLE? SHAME ON US. WE
CAN DIFFER, WE CAN HAVE A DIFFERENCE OF OPINION AND STILL BE RESPECTFUL
TO EACH OTHER. AND I THINK THAT'S WHAT WE NEED TO PAY MORE ATTENTION
TO. IT'S OKAY TO DISAGREE. WE'RE GOING TO DISAGREE. BUT WE NEED TO
FIGURE OUT HOW TO DISAGREE AND STILL RESPECT EACH OTHER, BECAUSE THAT'S
WHAT DEMOCRACY IS. AND I THINK WE NEED TO MOVE FORWARD WITH THAT IN
MIND. WE ALL HAVE A RIGHT TO REPRESENT OUR CONSTITUENTS THE WAY WE
FEEL WE NEED TO. BUT WE NEED TO RESPECT EACH OTHER. THANK YOU.
(PAUSE)
ACTING SPEAKER AUBRY: THERE IS AN APPEAL TO
THE RULING OF THE CHAIR, AND THE QUESTION BEFORE THE HOUSE IS SHALL THE
DECISION OF THE CHAIR STAND AS THE JUDGMENT OF THE HOUSE. THOSE
VOTING YES VOTE TO SUSTAIN THE RULING OF THE CHAIR. THOSE VOTING NO
VOTE TO OVERRIDE THE DECISION OF THE CHAIR.
56
NYS ASSEMBLY JUNE 5, 2019
THE CLERK WILL RECORD THE VOTE.
(THE CLERK RECORDED THE VOTE.)
THE CLERK WILL ANNOUNCE THE RESULTS.
(THE CLERK ANNOUNCED THE RESULTS.)
THE RULING OF THE CHAIR IS SUSTAINED. READ THE LAST --
THE BILL IS BEFORE THE HOUSE.
READ THE LAST SECTION.
THE CLERK: THIS ACT SHALL TAKE EFFECT APRIL 1ST.
ACTING SPEAKER AUBRY: THE CLERK WILL
RECORD THE VOTE.
(THE CLERK RECORDED THE VOTE.)
MS. HUNTER TO EXPLAIN HER VOTE.
MS. HUNTER: THANK YOU, MR. SPEAKER, TO EXPLAIN
MY VOTE. I WOULD LIKE TO ASK ALL MY COLLEAGUES TO VOTE IN SUPPORT OF
THIS BILL. THERE'S BEEN PROVEN STATISTICS TO SHOW THAT THE COST OF
TURNOVER IS ONE OF THE HIGHEST OPERATIONAL COSTS FOR EMPLOYERS IN THE
COUNTRY. PEOPLE WHO ARE OUT OF WORK AND WHO ARE LET GO FROM WORK
ARE USUALLY -- IT'S THE MOST COSTLY TO TURN THOSE FOLKS AROUND. WE WANT
TO MAKE SURE THAT WE ARE ABLE TO KEEP PEOPLE IN THE WORKFORCE SO THAT
THEY CAN CONTINUE TO CONTRIBUTE. THIS BILL WILL BE ABLE TO DO THAT. WE
WILL BE ABLE TO SHORTEN THE PROCESS IN ORDER TO ALLEVIATE SANCTIONS. AND
AGAIN, I ASK ALL OF MY COLLEAGUES TO VOTE IN SUPPORT OF THIS BILL.
THANK YOU, MR. SPEAKER.
ACTING SPEAKER AUBRY: MR. BARRON TO
EXPLAIN HIS VOTE.
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NYS ASSEMBLY JUNE 5, 2019
MR. BARRON: FIRST LET ME SAY, MR. CHAIR, I STAND
BY EVERY WORD I UTTERED. I STAND BY THAT. WE NEED TO HAVE THAT
CONVERSATION ON RACE BECAUSE EVERYBODY'S BUTTON GETS PUSHED THE
MINUTE YOU MENTION IT. WE NEED TO HAVE A CONVERSATION ON THAT
BECAUSE WHEN IT REARS ITS UGLY HEAD, I'M GOING TO RAISE IT.
ON THE BILL.
I THINK THAT THE BILL IS VERY SIMPLE, FAIR. WHY SHOULD
PEOPLE HAVE TO HAVE THEIR FUNDS REDUCED BECAUSE THEY MISS AN
APPOINTMENT? THAT'S A VERY SERIOUS ISSUE. AND WHEN SOME PEOPLE
CAN'T UNDERSTAND THAT, THEN I SEARCH FOR OTHER REASONS WHY YOU DON'T
UNDERSTAND SOMETHING SO SIMPLE, SOMETHING SO SIMPLE. DO YOU THINK
PEOPLE WANT TO BE ON WELFARE? TRADE PLACES, YOU THINK WE HAVING IT SO
GOOD. PEOPLE DON'T WANT TO BE ON WELFARE. SO IF, IN FACT, THEY MISS AN
APPOINTMENT, WHY WOULDN'T YOU WANT TO REENGAGE AND FIND OUT? AND
THEN IF YOU REALLY WANT TO GET US OFF WELFARE, WHEN WE PUT FORTH THESE
OTHER BILLS THAT GET US OFF WELFARE, SUPPORT THEM. SUPPORT THEM AND WE
WILL BE OFF WELFARE. WE LIVE IN A VERY RACIST, CAPITALISTIC SOCIETY. I'M
GOING TO RAISE IT EVERY CHANCE I GET AND EVERY TIME IT REARS ITS UGLY
HEAD.
THIS IS A GOOD BILL. I COMMEND THE SPONSOR OF THIS
BILL. AND WE SHOULDN'T HAVE TO GO THROUGH ALL OF THIS KIND OF
INTERROGATION ON A BILL THAT IS SO SIMPLE AND A BILL THAT HELPS THOSE WHO
ARE MOST VULNERABLE AND THE MOST NEED TO BE HELPED. WHEN YOU CAN'T
HELP THEM LIKE THAT AND WHEN YOU COME UP WITH ALL OF THIS OTHER STUFF, I
GET SUSPICIOUS AND I RAISE MY CONCERNS. AND I WILL CONTINUE TO DO THAT
58
NYS ASSEMBLY JUNE 5, 2019
AS LONG AS I'M IN THIS ASSEMBLY.
I VOTE AYE.
ACTING SPEAKER AUBRY: MRS. ARROYO TO
EXPLAIN HER VOTE.
MRS. ARROYO: THANK YOU, MR. SPEAKER. I
COMMEND THE -- THE PERSON THAT PUT THIS BILL IN THE FLOOR. AND THE
SPEAKER FOR THE OPPORTUNITY TO GIVING US THE OPPORTUNITY TO HELP THOSE
IN NEED. I HAVE TO TELL YOU SOMETHING PERSONAL FROM MY LIFE. I WAS IN
WELFARE FOR NINE MONTHS WITH MY SEVEN KIDS WHEN I HAD TO QUIT MY JOB
BECAUSE I DIDN'T HAVE NOBODY TO TAKE CARE OF THEM WHEN I WAS
WORKING. I NEVER -- AND I NEVER DREAMED TO BE ON WELFARE BECAUSE I
HAD CHILDREN. I TAKE THE OPPORTUNITY TO EDUCATE MYSELF AND TO PREPARE
MYSELF IN THIS SOCIETY THAT HAVE BEEN DESCRIBED HERE. THANK YOU VERY
MUCH. AND I WENT THROUGH OBTAINING AN EDUCATION IN ORDER TO MAKE
ENOUGH MONEY TO SUPPORT MY CHILDREN AND TO MAKE THEM PROUD OF
WHAT WE ARE IN THIS SOCIETY AS A PUERTO RICAN AND A U.S. CITIZEN.
PROBABLY BEFORE THAT MANY OTHER PEOPLE HERE IN THIS ROOM. I'M PROUD
OF THE WORK THAT WAS DONE FOR ME WITH THE SOCIAL WORKERS THAT GAVE ME
THE OPPORTUNITY TO GO TO SCHOOL AND PREPARE MYSELF. AND TODAY I AM
HERE, AND MY CHILDREN ARE PROFESSIONALS. AND WE ARE MAKING
PROFESSIONALS OF MY GRANDCHILDREN BECAUSE THAT IS THE STIGMA THAT MANY
PEOPLE HAVE. BUT WE ARE HERE TO MAKE OURSELVES BETTER AND TO BE PART
OF A SOCIETY THAT, IN PART, DOESN'T LIKE US. I DON'T WANT NOBODY TO LIKE
ME BECAUSE LOVE -- GOD LOVE ME AND I LOVE GOD.
ACTING SPEAKER AUBRY: MRS. ARROYO, HOW DO
59
NYS ASSEMBLY JUNE 5, 2019
YOU VOTE?
MRS. ARROYO: I VOTE IN THE AFFIRMATIVE.
ACTING SPEAKER AUBRY: THANK YOU, MY DEAR.
MRS. ARROYO IN THE AFFIRMATIVE.
ARE THERE ANY OTHER VOTES? ANNOUNCE THE RESULTS.
(THE CLERK ANNOUNCED THE RESULTS.)
THE BILL IS PASSED.
MRS. PEOPLES-STOKES.
MRS. PEOPLES-STOKES: MR. SPEAKER, COULD YOU
CALL ON MR. CROUCH FOR AN ANNOUNCEMENT?
ACTING SPEAKER AUBRY: MR. CROUCH FOR THE
PURPOSES OF AN ANNOUNCEMENT.
MR. CROUCH: THANK YOU, MR. SPEAKER. THERE WILL
BE AN IMMEDIATE MEMBERS-ONLY REPUBLICAN CONFERENCE IN THE PARLOR.
ACTING SPEAKER AUBRY: IMMEDIATE
MEMBERS-ONLY REPUBLICAN CONFERENCE IN THE PARLOR.
MRS. PEOPLES-STOKES.
MRS. PEOPLES-STOKES: MR. SPEAKER, CAN YOU
CALL ON MR. OTIS FOR AN ANNOUNCEMENT?
ACTING SPEAKER AUBRY: MR. OTIS.
MR. OTIS: THERE WILL BE AN IMMEDIATE CONFERENCE
OF THE DEMOCRATIC CONFERENCE IN THE SPEAKER'S CONFERENCE ROOM.
ACTING SPEAKER AUBRY: IMMEDIATE
DEMOCRATIC CONFERENCE, SPEAKER'S CONFERENCE ROOM.
MRS. PEOPLES-STOKES.
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NYS ASSEMBLY JUNE 5, 2019
MRS. PEOPLES-STOKES: MR. SPEAKER, IF WE
COULD GO INTO RECESS FOR A FEW MOMENTS, PLEASE.
ACTING SPEAKER AUBRY: THE HOUSE WILL STAND
IN RECESS.
(WHEREUPON, THE HOUSE STOOD IN RECESS.)
*******
ACTING SPEAKER AUBRY: THE HOUSE WILL COME
BACK TO ORDER.
MRS. PEOPLES-STOKES.
MRS. PEOPLES-STOKES: MR. SPEAKER, WE'RE
GOING TO CONTINUE ON OUR DEBATE LIST WITH CALENDAR NO. 414 BY MRS.
GALEF.
ACTING SPEAKER AUBRY: THE CLERK WILL READ,
PAGE 28, CALENDAR NO. 414.
THE CLERK: ASSEMBLY NO. A05147, CALENDAR NO.
414, GALEF, THIELE, MOSLEY, GOTTFRIED, DE LA ROSA, JEAN-PIERRE,
L. ROSENTHAL, GLICK. AN ACT TO AMEND THE PUBLIC HEALTH LAW, IN
RELATION TO THE MANUFACTURE AND SALE OF SEASONAL AND DECORATIVE
LIGHTING PRODUCTS CONTAINING LEAD.
ACTING SPEAKER AUBRY: MR. GOODELL.
MR. GOODELL: AN EXPLANATION.
ACTING SPEAKER AUBRY: AN EXPLANATION IS
REQUESTED, MRS. GALEF.
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NYS ASSEMBLY JUNE 5, 2019
MRS. GALEF: THANK YOU VERY MUCH. WHAT THIS BILL
DOES IS JUST REQUIRE THAT ALL DECORATIVE HOLIDAY LIGHTS AND LIGHTING -- AND
IT SEEMS LIKE WE ARE DEVELOPING MORE WITH ALL OF OUR HOLIDAYS. IN FACT,
HALLOWEEN, I THINK THERE'S PROBABLY MORE LIGHTS THAN -- THAN CHRISTMAS
AT THIS POINT. BUT THE LIGHTING PRODUCTS THAT ARE MANUFACTURED OR
DISTRIBUTED INTO NEW YORK THAT WOULD CARRY A WARNING LABEL THAT JUST
SAYS, WARNING: HANDLING THE COATED ELECTRICAL WIRE OF THIS PRODUCT
MAY EXPOSE YOU TO LEAD. WASH YOUR HANDS THOROUGHLY AFTER USE. AND
THE PURPOSE OF THE BILL IS TO PROTECT CONSUMERS, AND PARTICULARLY
CHILDREN, FROM EXPOSURE TO LEAD THROUGH THE CONTACT WITH THE LEAD-
COATED WIRES OF DECORATIVE LIGHTING. CALIFORNIA HAS DONE A SIMILAR KIND
OF -- OF LEGISLATION, AND, YOU KNOW, WE HAVE PASSED, I THINK IT WAS
MAYBE A COUPLE OF WEEKS AGO, LEGISLATION PROTECTING OURSELVES AGAINST
LEAD IN JEWELRY, AND WE'VE ALSO DONE THAT WITH TABLEWARE. WE'VE DONE
IT WITH TOYS AND FURNITURE, AND CERTAINLY WITH PAINT. I THINK WE ALL ARE
SO MUCH AWARE THAT PARTICULARLY YOUNG CHILDREN CAN BE SO IMPACTED BY
LEAD IN THEIR BLOODSTREAM. AND THESE WIRES, WHEN CHILDREN TOUCH IT, THE
DUST FROM THE WIRE CAN IMPACT THEM, AND IF YOU DON'T WASH YOUR HANDS
IT CAN GO RIGHT INTO YOUR MOUTH. AND THIS IS JUST -- JUST TO PUT A
WARNING ON --ON OUR DECORATIVE WIRING.
ACTING SPEAKER AUBRY: MR. MIKULIN.
MR. MIKULIN: THANK YOU. WILL THE SPONSOR YIELD?
MRS. GALEF: CERTAINLY.
ACTING SPEAKER AUBRY: WILL YOU YIELD?
MRS. GALEF: YES.
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NYS ASSEMBLY JUNE 5, 2019
ACTING SPEAKER AUBRY: MRS. GALEF -- MRS.
GALEF YIELDS, SIR.
MR. MIKULIN: JUST A FEW QUICK QUESTIONS. NOW, IS
THERE ANY EVIDENCE THAT HAZARDOUS SUBSTANCES ARE IN HOLIDAY
DECORATIONS, OR DOES IT POSE A SIGNIFICANT THREAT TO PUBLIC SAFETY?
MRS. GALEF: WELL, IT'S IN -- WHAT -- WHAT HAPPENS
IS THE POLYVINYL CHLORIDE -- LEAD IS USED AS A STABILIZER AND A FIRE
RETARDANT IN THE POLYVINYL CHLORIDE, WHICH IS COATED ON THE WIRES AND
THE BULBS AND THE SOCKETS AND THE HOLIDAY LIGHTS. THERE HAVE BEEN
STUDIES -- IT MAKES IT VERY FLEXIBLE. YOU KNOW, WE'VE ALL PUT LIGHTS ON
SOMETHING, IT MAKES IT VERY FLEXIBLE. BUT WHEN IT'S EXPOSED TO SUNLIGHT
AND LIGHT, THAT'S WHEN YOU START TO GET THE DECAY. THERE HAVE BEEN
STUDIES. THERE WAS ONE RECENTLY -- WELL, IT WASN'T AS RECENT AS I'D LIKE --
BUT 2008 WITH THE CORNELL UNIVERSITY WHERE THEY DID LEAD SWIPE TESTS
ON SOME NEWLY-PURCHASED AND OLDER CHRISTMAS LIGHTS. AND THEY FOUND
THAT ACTUALLY THE AMOUNTS OF LEAD ON THE SURFACE WAS IN EXCESS OF THE
US EPA CLEARANCE LEVEL FOR LEAD ON WINDOWSILLS. SO IT WAS REALLY
WORSE THAN ON WINDOWSILLS. AND THEN THERE WAS ANOTHER REPORT DONE IN
2010 BY THE ECOLOGY CENTER, A US ENVIRONMENTAL GROUP, THAT TESTED 68
SETS OF CHRISTMAS LIGHTS AND FOUND THAT MORE THAN HALF OF THEM
CONTAINED MORE THAN THE 210 FEDERAL REGULATIONS ALLOWED FOR CHILDREN'S
PRODUCTS, AND SOME OF THEM EVEN CONTAINED 30 TIMES THESE LIMITS. I
THINK IT'S SOMETHING THAT WE REALLY HADN'T FOCUSED ON. YOU KNOW, OVER
THE TIME, I'VE HAD CHILDREN, I'VE DECORATED TREES. I HAVEN'T DECORATED FOR
HALLOWEEN. BUT, YOU KNOW, I DON'T THINK WE THINK ABOUT THAT. BUT
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NYS ASSEMBLY JUNE 5, 2019
WHEN WE HAVE LEAD IN ALL OF THESE THINGS THAT WE PUT ON TREES AND
PEOPLE HANDLE AND CHILDREN HANDLE -- I -- I REMEMBER THE WONDERFUL
TIMES I'VE HAD MY GRANDCHILDREN OVER TO DECORATE THE TREE, AND WHAT A
BAD THING I PROBABLY DID BECAUSE I DIDN'T THINK ABOUT THE WASHING OF
THE HANDS, ET CETERA. I DIDN'T KNOW ABOUT THIS UNTIL I STARTED TO GET INTO
THE LEGISLATION, AND THEN I WAS AWARE OF IT. AND ALL WE'RE DOING IS
SAYING PUT A WARNING, YOU KNOW, ON YOUR -- ON YOUR PACKAGING AND ON
YOUR -- ON YOUR STRING OF LIGHTS THAT YOU NEED TO WASH YOUR HANDS AFTER
YOU DEAL WITH THIS.
MR. MIKULIN: OKAY. NOW, WOULDN'T THE FEDERAL
HAZARDOUS AND SUBSTANCES ACT OF FEDERAL LAW, 15 U.S.C. SECTION
1261, WOULDN'T THAT HANDLE THAT WITH LABELS ON CERTAIN LEAD PRODUCTS
AND HAZARDOUS PRODUCTS?
MRS. GALEF: I'M NOT SURE I QUITE HEARD THAT, BUT WE
HAVE THE ABILITY HERE THROUGH OUR CONSUMER AFFAIRS COMMITTEE AND
THROUGH THE ASSEMBLY AND THE SENATE TO ADOPT LEGISLATION TO REQUIRE
THIS LABELING. WE DO THIS ON --ON MANY DIFFERENT KINDS OF ITEMS. AND
AS I SAID, CALIFORNIA HAS DONE IT AS A STATE. SO, OBVIOUSLY, WE COULD GO
FORWARD TO THAT. I THINK THEY DID IT BACK IN -- I DON'T KNOW WHAT YEAR IT
WAS, BUT IT WAS A LONG TIME AGO. IT -- IT WAS CALIFORNIA'S PROPOSITION
65, WHENEVER THAT WAS.
MR. MIKULIN: YEAH, BUT WOULDN'T -- WOULDN'T THE
FEDERAL GOVERNMENT, IF THERE, YOU KNOW, WAS A RISK OF LEAD REQUIRE AS A
PRECAUTION THE LABEL ON THE -- THE DECORATION? SO, YOU KNOW, IF THE
FEDERAL GOVERNMENT'S NOT DOING THIS, WHY ARE WE?
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MRS. GALEF: WE DO A LOT OF THINGS THAT THE FEDERAL
GOVERNMENT DOESN'T DO. BECAUSE WE ACTUALLY PROBABLY WANT TO PROTECT
-- I DON'T KNOW, THE FEDERAL GOVERNMENT WANTS TO PROTECT US, BUT I
GUESS WE WANT TO PROTECT OURSELVES EVEN MORE. WHEN WE KNOW THERE'S
A PROBLEM, THAT WE WANT TO GO FORWARD AND -- AND DEAL WITH THAT. I'M
TRYING -- YOU KNOW, WE -- WE HAD PROBABLY DONE -- WHEN WE PASSED -- I
DON'T KNOW HOW YOU ALL VOTED FOR THAT -- BUT THE LEGISLATION ON JEWELRY
-- I CAN'T REMEMBER WHO HAD THE BILL OVER THERE. YOU KNOW, WE -- WE
ARE DOING SOMETHING THAT THE FEDERAL GOVERNMENT WASN'T DOING. YOU
KNOW, WE -- WE DO THAT ALL THE TIME. WE HAVE REGULATIONS, YOU KNOW,
WITHIN OUR HOUSING AND -- AND IN EDUCATION. I MEAN, WE -- WE -- THAT'S
OUR ROLE. THAT'S OUR ROLE TO RESPOND TO PROBLEMS AND TO PROTECT THE
PEOPLE OF OUR STATE.
MR. MIKULIN: HOW ABOUT THE SALE OF HOMEMADE
HOLIDAY CRAFTS?
MRS. GALEF: WELL, HOMEMADE HOLIDAY CRAFTS
WOULDN'T COME UNDER THIS BECAUSE THEY'RE HOMEMADE. IT'S -- IT'S WITH
CERTIFICATIONS -- IT REALLY SAYS IN THE BILL THAT"... A PERSON, FIRM,
CORPORATION OR ASSOCIATION THAT" -- THAT -- WELL, THAT IS ACTUALLY FOR THE
CIVIL PENALTY. RIGHT. OKAY. AND THE LIGHTING PRODUCTS, THE RULE IS THE
FACTORY ASSEMBLED WITH A PUSH-IN -- IT -- IT TALKS ABOUT THE -- THE FACTORY
BEING -- ASSEMBLING THIS AND SO ON, AND THE -- AND -- DID I MISS
ANYTHING IN THIS ONE? IT'S -- IT'S ALL MAN -- IT'S ALL MANUFACTURED. IT'S NOT
MANUFACTURED AT HOME.
MR. MIKULIN: OKAY. SO IF A PERSON MAKES THEIR
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OWN HOMEMADE HOLIDAY DECORATIONS AND SELLS THEM --
MRS. GALEF: IT DOESN'T -- DOESN'T MATTER.
MR. MIKULIN: -- THEY --
MRS. GALEF: WELL, WE WOULD HOPE THAT --
MR. MIKULIN: -- THEY WOULDN'T HAVE ANY CIVIL
VIOLATION WITH THIS LAW?
MRS. GALEF: NO. NO. I WOULD HOPE THAT THEY
WOULD NOW KNOW THAT THEY -- THEY SHOULDN'T, YOU KNOW, HAVE THIS KIND
OF WIRING AS -- AS THEY'RE DEALING WITH THEIR -- THEIR HOME PRODUCTS.
BUT, NO.
MR. MIKULIN: THANK YOU VERY MUCH.
ACTING SPEAKER AUBRY: READ THE LAST SECTION.
THE CLERK: THIS ACT SHALL TAKE EFFECT ON THE 90TH
DAY.
ACTING SPEAKER AUBRY: THE CLERK WILL
RECORD THE VOTE.
(THE CLERK RECORDED THE VOTE.)
ARE THERE ANY OTHER VOTES? ANNOUNCE THE RESULTS.
(THE CLERK ANNOUNCED THE RESULTS.)
THE BILL IS PASSED.
MRS. PEOPLES-STOKES.
MRS. PEOPLES-STOKES: MR. SPEAKER, IF WE CAN
ADVANCE THE A-CALENDAR, PLEASE.
ACTING SPEAKER AUBRY: ON A MOTION BY MRS.
PEOPLES-STOKES, THE A-CALENDAR IS ADVANCED.
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MRS. PEOPLES-STOKES.
MRS. PEOPLES-STOKES: THANK YOU, MR.
SPEAKER. WE WILL BEGIN ON PAGE 3 ON THE A-CALENDAR WITH RULES
REPORT NO. 65 BY MR. CAHILL.
ACTING SPEAKER AUBRY: THE CLERK WILL READ.
THE CLERK: ASSEMBLY NO. A00264-B, RULES
REPORT NO. 65, CAHILL, COLTON, ARROYO, JEAN-PIERRE, TAYLOR,
MCDONOUGH, JACOBSON, STECK. AN ACT TO AMEND THE FINANCIAL SERVICES
LAW, IN RELATION TO ESTABLISHING PROTECTIONS FROM EXCESS HOSPITAL
CHARGES.
ACTING SPEAKER AUBRY: AN EXPLANATION IS
REQUESTED, MR. CAHILL.
SHH. LADIES AND GENTLEMEN, WE ARE ON DEBATE.
MR. CAHILL: THANK YOU, MR. SPEAKER. THIS BILL
WOULD SUBJECT HOSPITAL CHARGES FOR EMERGENCY SERVICES THAT FOLLOW TO
THE -- TO THE INDEPENDENT DISPUTE RESOLUTION PROCESS ESTABLISHED TO
PROTEST -- PROTECT AGAINST EXCESSIVE EMERGENCY CHARGES. IT IS A PROCESS
THAT EXISTS FOR MOST OTHER MEDICAL COSTS, AND WE'RE NOW EXPANDING IT TO
INCLUDE EMERGENCY CHARGES AND THE CHARGES THAT FOLLOW.
ACTING SPEAKER AUBRY: MR. RA.
MR. RA: THANK YOU, MR. SPEAKER. WILL THE SPONSOR
YIELD?
ACTING SPEAKER AUBRY: WILL YOU YIELD, MR.
CAHILL?
MR. CAHILL: YES, OF COURSE.
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ACTING SPEAKER AUBRY: THE SPONSOR YIELDS.
MR. RA: THANK YOU. FIRST OFF, I KNOW WE HAVE
VOTED ON A VERY SIMILAR BILL IN THE PAST. CAN YOU JUST GO THROUGH WHAT
IS CHANGED FROM THE BILL WE PASSED LAST YEAR?
MR. CAHILL: WE HAD VOTED ON A VERY SIMILAR BILL,
MR. SPEAKER, MR. RA. THE -- THE BILL THAT WE VOTED ON IN THE PAST WAS
FAIRLY IDENTICAL IN TERMS OF THE SUBSTANCE, WITH ONE EXCEPTION: WE'VE
MADE IT MORE NARROW TO TAKE OUT THE SAFETY NET HOSPITALS, THE HOSPITALS
THAT PROVIDE CARE TO PEOPLE USING THE MEDICAID PLAN TO THE TUNE OF 60
PERCENT OF THEIR REVENUE OR MORE. AND WE VOTED ON IT FOUR TIMES SO
FAR, UNANIMOUSLY.
MR. RA: SO THE -- THAT -- THAT PIECE, IN TERMS OF THE
60 PERCENT, WHERE -- WHERE'S THAT NUMBER COMING FROM? IS THAT -- IS
THAT REFLECTED ANYWHERE ELSE IN THE LAW? WHY -- WHY 60 PERCENT
MEDICAID AS -- AS THE EXEMPTION?
MR. CAHILL: IT'S -- IT'S OUR BELIEF THAT AT THAT
PARTICULAR THRESHOLD, THAT'S A POINT AT WHICH THE HOSPITAL NEEDS TO RELY
UPON THE COMMERCIAL INSURERS TO MAKE SURE THEY CAN STAY AFLOAT. IT IS
NOT A SPECIFIC NUMBER. AND CERTAINLY, SOME WOULD ARGUE WE SHOULD'VE
GONE TO 51 PERCENT, OTHERS WOULD ARGUE WE SHOULD'VE GONE TO 75
PERCENT. I THINK 60 IS A GOOD HAPPY MEDIUM.
MR. RA: OKAY. NOW, JUST IN TERMS OF THE, YOU
KNOW, THE SUBSTANCE OF -- OF WHAT THIS BILL DOES. CURRENTLY, THE PATIENT
IS, YOU KNOW, IS PROTECTED BY -- BY OUR CURRENT LAW. THIS DEALS WITH,
BASICALLY, BETWEEN THE INSURANCE COMPANY AND THE HOSPITAL, CORRECT?
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MR. CAHILL: WELL, DIRECTLY, THAT IS THE CASE.
BECAUSE WE'VE DONE A -- A NUMBER OF THINGS TO PROTECT -- PROTECT
CONSUMERS FROM SURPRISE BILLING. WE'VE PUT PROTECTIONS IN PLACE THAT
WOULD PROHIBIT THE CHARGES BEING INCURRED BY THE CONSUMER IN EXCESS
OF ANYTHING THEY WOULD'VE PAID UNDER THEIR PLAN, EVEN IF THEY'RE USING
AN OUT-OF-NETWORK PROVIDER. BUT LET'S NOT FOR A MOMENT THINK THAT THIS
CURRENT SET OF CIRCUMSTANCES PROTECTS CONSUMERS. THERE ARE A NUMBER
OF REASONS WHY THE CURRENT CIRCUMSTANCE DOES NOT. AND PRIMARILY IS
WHAT COULD BE THE DRAMATIC IMPACT ON THE COST OF HEALTHCARE, WHICH
THEN REFLECTS ITSELF AS THE COST OF HEALTH INSURANCE, WHICH IS OFTENTIMES
PAID IN AN INCREASING PERCENTAGE BY THE CONSUMER.
MR. RA: SO NOW, WHEN A PATIENT GOES INTO AN
EMERGENCY FACILITY AT A -- AT A HOSPITAL AND IT'S OUT-OF-NETWORK, WHAT --
WHAT CURRENTLY HAPPENS WHEN THEY ARE, YOU KNOW, PUT INTO THE
EMERGENCY ROOM AND, YOU KNOW, GIVE OVER AN INSURANCE CARD FOR -- FOR
A -- AN INSURANCE COMPANY THAT IS NOT PART OF THE NETWORK OF THAT
HOSPITAL?
MR. CAHILL: LET ME TELL YOU WHAT USUALLY HAPPENS.
AND BY "USUALLY" I MEAN ALMOST ALL OF THE TIME. WHAT HAPPENS IS THAT
A PERSON GOES INTO A HOSPITAL THAT DOESN'T HAPPEN TO BE A NETWORK
WITHIN -- AND THEY PRESENT THEIR INSURANCE CARD, AND THAT HOSPITAL SENDS
A BILL TO THE INSURANCE COMPANY THAT REFLECTS WHAT ARE THEIR USUAL AND
CUSTOMARY CHARGES, AND THE INSURANCE COMPANY PAYS IT. THAT'S WHAT
USUALLY HAPPENS. WHAT COULD HAPPEN AND WHAT HAS HAPPENED IS THAT
INSURANCE COMPANIES HAVE RECEIVED BILLS FROM HOSPITAL PROVIDERS AFTER
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THE CONTRACT HAS EXPIRED, WHEN THE CONTRACT IS IN NEGOTIATION, OR WHEN
NO CONTRACT EXISTS, WHERE THE CHARGES ARE NO LONGER WHAT THEY USED TO
BE. THEY'RE NOT WHAT THEY WERE WHEN THEY HAD A CONTRACT. THEY'RE NOT
WHAT THEY WERE CHARGING OTHER PEOPLE. BUT THEY HAVE BEEN INFLATED TO
THE POINT OF BEING SO HIGH THAT THEY CAN'T EVEN BE PAID. AND WHAT
HAPPENS THEN? THEN THE HOSPITALS USE THOSE INFLATED BILLS TO FORCE A
DIFFERENT KIND OF NEGOTIATION FOR THE NEW CONTRACT AS OPPOSED TO HAVING
A LEVEL PLAYING FIELD. WHAT THIS BILL WILL DO IS MAKE SURE THAT WHEN WE
HAVE THOSE KIND OF DISPUTES BETWEEN THESE PARTIES, THAT -- AND ONLY IN
THOSE INSTANCES WHERE WE HAVE THOSE KIND OF DISPUTES -- THAT THERE'S A
PLACE WHERE THOSE DISPUTES CAN BE RESOLVED BY A NEUTRAL THIRD-PARTY.
MR. RA: OKAY. NOW, THE -- THE NEUTRAL THIRD-PARTY
THAT -- THAT WILL BE THE ARBITER OF THIS INDEPENDENT DISPUTE PROCESS, WHO
SELECTS THAT INDIVIDUAL?
MR. CAHILL: THE NEUTRAL THIRD-PARTY IS AN
INDEPENDENT DISPUTE RESOLUTION REPRESENTATIVE THAT IS APPOINTED BY THE
DEPARTMENT OF FINANCIAL SERVICES.
MR. RA: OKAY. AND UNDER THIS BILL -- SO YOU SAY
CURRENTLY, YOU KNOW, THEY -- THEY GO -- THEY SEND A BILL AND THEY'LL -- THE
HEALTH PLAN WILL, YOU KNOW, GIVE THE HOSPITAL OR PAY THE HOSPITAL
WHATEVER IS THEIR USUAL AND CUSTOMARY AMOUNT. BUT UNDER THIS BILL,
THEN, THE HEALTH PLAN IS GOING TO BASICALLY DETERMINE WHAT THEY'RE GOING
TO PAY, CORRECT? AND THEN IF THERE'S A DISPUTE IN THAT AMOUNT IT GOES TO
THIS PROCESS?
MR. CAHILL: THE HEALTH PLAN WILL DETERMINE WHAT
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THEY ARE GOING TO PAY IN THE SAME MANNER THAT THE HOSPITAL WILL
DETERMINE WHAT THEY ARE GOING TO CHARGE. IF THEY CANNOT COME TO AN
AGREEMENT ON THEIR OWN, THEY HAVE TO SUBMIT IT TO AN INDEPENDENT
DISPUTE RESOLUTION PROCESS. IF IT GETS SUBMITTED TO AN INDEPENDENT
DISPUTE RESOLUTION PROCESS, THAT INDIVIDUAL WHO IS CHARGED WITH
DETERMINING THE APPROPRIATE CHARGE LOOKS AT BOTH SIDES, AND THEN USES
SOMETHING THAT -- THAT WE CALL "BASEBALL ARBITRATION" - THAT'S THE ACTUAL
TERM OF ART FOR IT - WHERE ONE OF THOSE SIDES IS CHOSEN. SO, IF THE
INSURANCE PLAN HAS DECIDED TO LOWBALL THE HOSPITAL BY -- BY A RATE THAT IS
NOT WHAT THEY WERE PAYING THEIR NETWORK PROVIDERS, BY A RATE THAT IS NOT
WHAT THEY WOULD PAY FOR A HOSPITAL THAT HAS THE LEVEL OF ACUITY OF
PATIENTS THAT THEY WOULD PAY FOR THE COMPLEXITY OF THE CASE, AND THE
HOSPITAL SUBMITS A REASONABLE CHARGE, THE REASONABLE CHARGE WILL BE
AWARDED BY THE -- BY THE INDEPENDENT BODY. IF THE OPPOSITE IS TRUE, IF
THE INSURANCE COMPANY SUBMITS A CHARGE, SUBMITS AN OFFER TO PAY THAT
IS VERY REASONABLE CONSISTENT WITH WHAT THEY'VE PAID BEFORE AND THE
HOSPITAL HAS ALL OF A SUDDEN STARTED CHARGING 150 PERCENT OR 200
PERCENT OF WHAT THEY USED TO CHARGE, WELL, THEN GUESS WHAT'S GOING TO
HAPPEN? THE HOSPITAL IS NOT GOING TO WIN AND THE AWARD IS GOING TO GO
TO WHAT THE INSURANCE COMPANY SAID IT WOULD PAY. THIS FORM OF AWARD,
WHICH I WAS A LITTLE SKEPTICAL ABOUT AT FIRST, HAS PROVEN TO PUSH BOTH
SIDES TO THE APPROPRIATE CENTER. THEY BOTH END UP OFFERING WHEN THEY
GO INTO AN IDR PROCESS THE REASONABLE AND APPROPRIATE AMOUNT BECAUSE
THEY WANT TO WIN THAT RESOLUTION.
MR. RA: SURE. AND AS A BASEBALL FAN, I -- I'M
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NYS ASSEMBLY JUNE 5, 2019
FAMILIAR WITH -- WITH THAT. THAT'S HOW --
MR. CAHILL: I -- I HAD TO QUIT -- I STOPPED WATCHING
BASEBALL WHEN JOE NAMATH RETIRED, SO...
(LAUGHTER)
MR. RA: UNFORTUNATELY, AS A LONG-SUFFERING METS
FAN, I CAN'T WALK AWAY THAT EASILY. SOMETIMES I WISH I COULD. BUT ONE
OF THE CONCERNS THAT'S BEEN RAISED BY, YOU KNOW, OPPONENTS OF THIS
PIECE OF LEGISLATION IS THAT THIS WILL THROW KIND OF OUT OF BALANCE THE --
THE BARGAINING POSITIONS OF THOSE TWO PARTIES, THE HOSPITALS VERSUS THE
-- THE INSURANCE PLANS. RIGHT NOW, YOU KNOW, YOU'LL HAVE A
NEGOTIATION, PERHAPS, TO BE INCLUDED IN A CERTAIN PLAN, AND THEN YOU
HAVE, YOU KNOW, THIS PROCESS WHICH WILL TAKE PLACE IF SOMEBODY'S
OUT-OF-NETWORK. THE -- THE CONCERN THAT'S BEEN EXPRESSED IS THAT IF
SOMETHING LIKE THIS IS -- IS PUT IN PLACE, THERE WILL BE LESS OF AN
INCENTIVE FOR THE HEALTH PLANS TO BASICALLY, YOU KNOW, PUT MORE
HOSPITALS INTO THEIR NETWORK, AND ALSO THAT THE BARGAINING POWER OF
THOSE HOSPITALS WILL BE REDUCED BECAUSE THE HEALTH -- THE HEALTH
INSURANCE POLICIES WILL KNOW THAT THEY HAVE THIS PROCESS TO FALL BACK
ON.
MR. CAHILL: WELL, MR. SPEAKER, MR. RA, THAT --
THAT ANTICIPATES THAT WHAT THE INSURANCE COMPANY INTENDS TO DO IS TO
LOWBALL THE PAYMENTS. WHY ELSE WOULD THEY DO IT IF THEY COULDN'T SAVE
MONEY? THEY'RE NOT GOING TO GO KICK HOSPITALS OUT OF THE NETWORK SO
THAT THEY CAN'T HAVE OTHER THINGS LIKE QUALITY ASSURANCE, LIKE -- LIKE
AFFILIATIONS WITH OTHER PARTS OF THEIR NETWORK UNLESS THEY WERE GOING TO
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DO IT TO SAVE MONEY. IF THEY LOW BALL, WHEN THEY GET TO THE IDR
PROCESS THEY'RE GOING TO LOSE. SO THERE IS REALLY NO INCENTIVE FOR THAT TO
HAPPEN. WHAT THIS REALLY DOES IS IT PREVENTS THE DISRUPTION OF THE
NORMAL DELIVERY OF HEALTHCARE IN A COMMUNITY, QUITE FRANKLY, WHEN A
CONTRACT IS COMING TO AN END. INSTEAD OF THAT CONTRACT COMING TO AN END
ABRUPTLY, INSTEAD OF THAT CONTRACT COMING TO AN END AFTER A MODEST
COOLING-OFF PERIOD, WHAT HAPPENS IS THAT THE -- THE CONSUMER CAN
CONTINUE TO USE THAT FACILITY. THAT FACILITY CAN CONTINUE TO PROVIDE
QUALITY HEALTHCARE. THE INSURANCE PLAN CAN CONTINUE TO OFFER TO PAY THE
PLAN, AND AN INDEPENDENT THIRD-PARTY WILL DETERMINE WHAT'S RIGHT UNTIL
THE TWO PARTIES CAN GET BACK INTO THAT KUMBAYA THAT THEY HAD BEFORE
AND ENTER THEIR CONTRACT.
MR. RA: OKAY. AND THAT -- NOW ONE OF, YOU KNOW,
THE -- THE OTHER THINGS THAT HAS BEEN RAISED IS, YOU KNOW -- AS WE KNOW
WHEN WE DO MANY OF THESE LAWS, THERE ARE -- THERE ARE -- BECAUSE OF
MAYBE THE COMPLEXITY OF -- OF, YOU KNOW, HEALTH INSURANCE AND THE
WAY CERTAIN ENTITIES ARE -- ARE INSURED THAT, YOU KNOW, WE HAVE MANY
MUNICIPALITIES, SCHOOL DISTRICTS, THINGS OF THAT NATURE, THAT ARE
SELF-INSURED.
MR. CAHILL: YES.
MR. RA: WOULD -- WOULD THIS DO ANYTHING TO PROTECT
PEOPLE THAT ARE COVERED BY THAT TYPE OF PLAN?
MR. CAHILL: OH, ABSOLUTELY. THAT'S WHERE IT HAS
SOME OF THE GREATEST IMPACTS ALL TOGETHER. AND THANK YOU FOR ASKING
THE QUESTION. WHEN YOU HAVE A SELF-INSURED PLAN, FOR ALL INTENTS AND
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NYS ASSEMBLY JUNE 5, 2019
PURPOSES, THE SPONSOR OF THE PLAN IS USUALLY THE EMPLOYER - OR PERHAPS
EVEN THE EMPLOYEE, AS ISN'T OFTEN THE CASE - AND THOSE FOLKS ARE
RESPONSIBILE FOR THE FIRST NICKLE AND THE LAST DIME OF WHATEVER IS PAID.
AND IF THE CHARGES GO UP, THE COST OF THAT PLAN GOES UP FOR THAT
MUNICIPALITY. AND IF THE COST OF THAT PLAN GOES UP FOR THAT
MUNICIPALITY, THE NEXT THING THAT RISES IS YOUR REAL PROPERTY TAX CAP.
AND THEY COME AND THEY ASK TO PIERCE IT BECAUSE THEIR INSURANCE COSTS
WENT OUT -- WENT THROUGH THE ROOF. OR, A BENEVOLENT PLAN HAS AN
INSURANCE PLAN AND THEY HAVE TO PAY THOSE CHARGES. THEY'RE NOT AT THE
TABLE. WHO'S AT THE TABLE IS THE INSURANCE COMPANY THAT'S ADMINISTERING
THE PLAN FOR THEM. SO, WHERE THE INSURANCE COMPANY IS THE ONE THAT
HAS THE CONTRACT WITH THE HOSPITAL, THE SELF-INSURED PLAN OFTENTIMES USES
THAT INSURANCE COMPANY TO ADMINISTER THEIR PLAN. SO IT HAS A DIRECT,
EVEN PERHAPS A GREATER DOLLAR IMPACT ON THOSE PLANS EACH AND EVERY
DAY.
MR. RA: OKAY. AND JUST TO GO BACK TO -- TO ONE
OTHER THING THAT I BELIEVE IS NEW TO THE BILL THIS YEAR, IS THIS -- YOU
KNOW, THAT IT'S NOT JUST THE INITIAL EMERGENCY, YOU KNOW, TREATMENT, BUT
IT'S ANY INPATIENT SERVICES THAT HAPPEN AS A RESULT AND IN THE AFTERMATH
OF THAT EMERGENCY VISIT?
MR. CAHILL: YES. WHAT -- WHAT THE BILL -- WHAT
THE BILL WAS CORRECTED TO DO WAS TO ADDRESS THE PROBLEM THAT EXISTED.
THE PROBLEM THAT EXISTED WAS CERTAINLY THAT IF YOU WALK INTO AN
EMERGENCY ROOM OR GET WHEELED INTO AN EMERGENCY ROOM - WHICH IS
MAYBE MORE LIKELY IN SOME CIRCUMSTANCES - THAT CHARGE IS ONE PART OF
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NYS ASSEMBLY JUNE 5, 2019
THE EQUATION. BUT THE AFTERCARE THAT FOLLOWS FROM THAT EMERGENCY AND
THE ADMISSION THAT FOLLOWS FROM THAT EMERGENCY IS OFTEN TO THE HOSPITAL
OR THE HOSPITAL SYSTEM THAT HAS ADMITTED YOU -- THAT -- THAT HAS SEEN YOU
FOR THE EMERGENCY. SO THE ISSUE ABOUT THE BILLING OFTENTIMES IS -- IS
MORE CONCERNED WITH WHAT HAPPENS AFTER THE EMERGENCY ROOM VISIT,
BUT ASSOCIATED WITH THAT EMERGENCY ROOM VISIT. SO, YES, THAT WAS A
CORRECTION THAT WAS MADE, AND -- AND I APOLOGIZE, COLLEAGUES, FOR NOT
HAVING DONE SO SOONER.
MR. RA: OKAY. THANK YOU VERY MUCH.
MR. SPEAKER, ON THE BILL.
ACTING SPEAKER AUBRY: ON THE BILL, SIR.
MR. RA: SO, YOU KNOW, I KNOW MANY OF US WHO
HAVE BEEN HERE IN THE PAST HAVE VOTED ON THIS BILL, AND -- AND PERHAPS,
YOU KNOW, THERE HAVE BEEN SOME CHANGES; SOME OF THEM MAY BE GOOD,
SOME OF THEM MAY BE, YOU KNOW, TROUBLING FOR DIFFERENT INSTITUTIONS.
BUT -- BUT I DO THINK THAT WE NEED TO BE AWARE AS WE -- WE VOTE ON THIS
-- YOU KNOW, WE'VE HAD MANY HEALTHCARE INSTITUTIONS, MANY OF OUR
HOSPITALS IN OUR STATE THAT HAVE HAD THEIR -- THEIR DIFFICULTIES. YOU
KNOW, WE HAVE THIS NUMBER OF 60 PERCENT MEDICAID THAT IS -- THAT IS
EXEMPT FROM IT. BUT REGARDLESS OF WHAT YOUR, YOU KNOW, RATE IS IN ANY
GIVEN, YOU KNOW, COUNTY OR ANY PLACE WHERE -- WHERE A CERTAIN HOSPITAL
IS LOCATED, YOU KNOW, THOSE ARE PATIENTS THAT, YOU KNOW, NEED SERVICES.
THEY MAY BE, YOU KNOW, MEDICALLY FRAIL, THEY NEED EXTENSIVE SERVICES.
AND -- AND CERTAINLY, YOU KNOW, THAT'S AN EXPENSIVE THING FOR THE
HOSPITALS TO TAKE CARE OF. WHEN WE HAVE A SITUATION WHERE, YOU KNOW
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NYS ASSEMBLY JUNE 5, 2019
-- AND IT COULD HAVE BEEN ANY NUMBER, AS THE SPONSOR INDICATED.
MAYBE, YOU KNOW, THIS IS MAYBE A HAPPY MEDIUM. MAYBE IT COULD BE
HIGHER, IT COULD BE LOWER ON WHAT -- WHAT WE USE AS THE CUTOFF. BUT --
BUT THERE IS THE POTENTIAL THAT CERTAIN INSTITUTIONS THAT SERVICE REALLY
VULNERABLE POPULATIONS COULD -- COULD BE HURT BY THIS TYPE OF PIECE OF
LEGISLATION BECAUSE OF THE -- THE CHANGE IN -- IN THE, YOU KNOW,
BARGAINING POWER THAT THE HOSPITALS ARE GOING TO HAVE WITH THESE PLANS
AND THE REDUCTION OF THE INCENTIVE FOR THOSE PLANS TO INCLUDE HOSPITALS
IN THEIR -- IN THEIR NETWORKS.
SO, I'M GOING TO BE VOTING IN THE NEGATIVE ON THIS
PIECE OF LEGISLATION. I DO THINK THERE ARE MEASURES THAT WE CAN TAKE TO
HELP CONTINUE TO, YOU KNOW, PROTECT PEOPLE FROM OUT-OF-NETWORK
CHARGES. CERTAINLY, WE HAVE A GREAT PRO-CONSUMER STATUTE TO PROTECT
THE INDIVIDUAL CONSUMER, AND -- AND -- AND THIS IS REALLY ABOUT THE
RELATIONSHIP BETWEEN THOSE -- THOSE HEALTH INSURERS AND THE HOSPITALS.
AND I THINK THERE ARE OTHER THINGS WE CAN DO WITHOUT DOING SOMETHING
THAT COULD PUT THAT RELATIONSHIP OUT OF BALANCE. THANK YOU.
ACTING SPEAKER AUBRY: THANK YOU, SIR.
MR. BUCHWALD.
MR. BUCHWALD: THANK YOU, MR. SPEAKER. AND I
-- I'M -- ON THE BILL.
ACTING SPEAKER AUBRY: ON THE BILL, SIR.
MR. BUCHWALD: I -- I'M SORRY TO BE RISING TODAY
FOR A FEW REASONS: FIRST, BECAUSE I HAVE A NUMBER OF GOOD FRIENDS IN
SUPPORT OF THIS LEGISLATION, BOTH INSIDE THIS HOUSE AND OUTSIDE. AND
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NYS ASSEMBLY JUNE 5, 2019
I'M ALSO SORRY BECAUSE I THINK THERE WAS ANOTHER WAY TO GET TO THIS
POINT THAT WOULD NOT HAVE HAD AS DIRECT AN IMPACT ON THE REGION OF THE
STATE THAT I REPRESENT. BUT NONETHELESS, BECAUSE WE ARE WHERE WE ARE,
MR. SPEAKER. I PLANNED TO SPEAK FOR 30 MINUTES TODAY IN TWO 15-
MINUTE CHUNKS, AS ARE PERMITTED UNDER OUR RULES. SO LET ME TAKE A
MOMENT, IF I CAN, MR. SPEAKER, TO EXPLAIN FROM MY PERSPECTIVE WHAT
THIS BILL DOES, AND THEN PROVIDE A LITTLE BIT OF THE LOCAL IMPACT ON MY
DISTRICT AND MY COUNTY AND THE LOWER HUDSON REGION.
THIS BILL IS NOT ABOUT PATIENTS AND CUSTOMERS OF
HOSPITALS. THIS DOESN'T DO WHAT THE PRIOR LEGISLATION DID ON SURPRISE
BILLING WHERE FOLKS WHO WERE GETTING BILLS FROM -- FROM MEDICAL
PROVIDERS WERE BEING FORCED TO DEAL WITH THOSE BILLS AND WE HAD TO PASS
A SURPRISE BILLING LEGISLATION IN ORDER TO MAKE THAT AN ISSUE THAT WOULD
BE WORKED OUT BETWEEN THE MEDICAL PROVIDER AND THE INSURANCE
COMPANY. THIS BILL ISN'T ABOUT THAT. THIS BILL IS ONLY ABOUT THE
RELATIONSHIP OF INSURANCE COMPANIES TO HOSPITALS. AND ALTHOUGH THAT'S
A - A PERFECTLY FINE TOPIC, IT IS VERY DIFFERENT THAN PROTECTING THE PEOPLE
OF NEW YORK IN THE SAME WAY THE PRIOR LEGISLATION DID. AND IN
PARTICULAR, I FIND IT INAPPROPRIATE FOR US TO GET IN THE MIDDLE OF THE
RELATIONSHIP BETWEEN INSURANCE COMPANIES AND HOSPITALS WHEN SOME OF
THOSE HOSPITALS AND INSURANCE COMPANIES RIGHT NOW ARE IN THE MIDDLE
OF NEGOTIATIONS. WE ALL, IN GOVERNMENT, DEAL WITH NEGOTIATIONS
BETWEEN VARIOUS PARTIES. USUALLY IT IS OUR APPROACH NOT TO GET INVOLVED
IN THE MIDDLE AND INTERRUPT THOSE NEGOTIATIONS. ONE OF THOSE
NEGOTIATIONS IS OCCURRING RIGHT NOW BETWEEN WESTCHESTER MEDICAL
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CENTER AND BLUE CROSS BLUE SHIELD, WHICH HAPPENS TO PROVIDE OUR
INSURANCE HERE IN THE STATE LEGISLATURE. SO I KNOW NOT JUST BEING A
WESTCHESTER RESIDENT, BUT BECAUSE I'M DIRECTLY AFFECTED ALSO HAVE
KNOWLEDGE OF THAT. BUT THIS IS A BROADER ISSUE THAN JUST ABOUT
WESTCHESTER MEDICAL CENTER. THIS IS ABOUT WHETHER INSURANCE
COMPANIES WILL HAVE ANY INCENTIVE TO HAVE HOSPITALS BE IN-NETWORK.
RIGHT NOW UNDER EXISTING NEW YORK STATE LAW, EMERGENCY SERVICES
THEMSELVES ARE PROVIDED TO CUSTOMERS AT THE IN-NETWORK REDUCED RATE.
IF YOU WERE BROUGHT BY AN AMBULANCE TO A HOSPITAL THAT HAPPENS NOT TO
BE IN YOUR INSURANCE COMPANY'S NETWORK, YOU, AS A CUSTOMER, DON'T
DEAL WITH THAT, AND THE -- EFFECTIVELY, THE IN-NETWORK RATE APPLIES. THIS
BILL DEALS WITH THE SECOND CATEGORY OF TYPES OF CHARGES THAT A HOSPITAL
HAVE [SIC], WHICH IS AFTER YOU'VE RECEIVED EMERGENCY CARE AND ARE
ADMITTED TO THE HOSPITAL, WHAT THOSE CHARGES ARE. AND THEN THERE'S A
THIRD CATEGORY THAT CHARGE -- THAT HOSPITALS CHARGE FOR, WHICH IS FOR
ELECTIVE SURGERIES. ELECTIVE SURGERIES ARE THE ONES THAT PREDOMINANTLY
PROVIDE THE VAST MAJORITY OF REVENUE TO HOSPITALS. THAT'S THE NATURE OF
-- OF THEM. AND ONLY IF THOSE ELECTIVE SURGERIES ARE SUFFICIENTLY
PERFORMED CAN THE HOSPITAL FUND THE EMERGENCY CARE AND THE ANCILLARY
CARE TO EMERGENCIES. THAT, FRANKLY, IS NOT NEARLY AS LUCRATIVE. THIS BILL
DEALS -- AS I SAID, WITH THE SECOND CATEGORY, THOSE ADMISSIONS
POST-EMERGENCY CARE. RIGHT NOW, NEW YORK STATE LAW, FOR BETTER OR
WORSE, SAYS, CUSTOMERS, YOU DON'T HAVE TO DEAL WITH THAT. THE
INSURANCE COMPANY WILL SIMPLY HAVE TO ACCEPT THE OUT-OF-NETWORK
CHARGE OF THE HOSPITAL IF THE HOSPITAL IS OUT-OF-NETWORK. AND OF COURSE
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YOU MIGHT SAY, WELL, THAT'S NOT FAIR. WHY SHOULD THE INSURANCE
COMPANY HAVE TO PAY THAT? OBVIOUSLY, THE INSURANCE COMPANIES DON'T
FEEL THAT'S FAIR. BUT, THAT SYSTEM IS WHAT SETS UP THE INCENTIVE FOR
INSURANCE COMPANIES TO BRING THE HOSPITAL IN-NETWORK AND TO NEGOTIATE
A RATE THAT IS FAR LESS THAN THE LIST PRICE THAT A HOSPITAL CHARGES. THAT
CATEGORY IS, IN FACT, THE REASON WHY HOSPITALS ARE BROUGHT IN-NETWORK.
IT'S NOT THE THIRD CATEGORY, THE ELECTIVE SURGERIES, THAT ARE THE REASON TO
BRING IN -- THE HOSPITAL IN-NETWORK. AN INSURANCE COMPANY REALLY ONLY
NEEDS ONE HOSPITAL IN EVERY REGION TO BE IN-NETWORK FOR THOSE ELECTIVE
SURGERIES. THEY CAN SAY TO THEIR COVERED CONSUMERS, SORRY, THAT
ELECTIVE SURGERY YOU'RE NOT GOING TO BE ABLE TO DO AT THIS HOSPITAL
BECAUSE IT'S OUT-OF-NETWORK. YOU CAN -- YOU HAVE TO GO TO THE ONE
THAT'S IN-NETWORK. BUT WITH REGARDS TO THE ANCILLARY TO EMERGENCY CARE
SERVICES, BECAUSE, OF COURSE, PEOPLE DON'T HAVE THE NECESSARY CONTROL
OVER WHAT HOSPITAL THEY'RE BROUGHT TO FOR AN EMERGENCY, IT'S IMPORTANT
FROM A MARKETING AND OTHER PERSPECTIVE FOR THE HOSPITAL TO HAVE THAT
IN-NETWORK. AND IT IS ONLY THE FACT THAT AN OUT-OF-NETWORK HOSPITAL
COULD CHARGE THOSE HIGHER -- HIGHER RATES THAT FORCES THE DIALOGUE
BETWEEN INSURANCE COMPANIES AND HOSPITALS. WHAT THIS BILL DOES IS IT --
INSTEAD OF HAVING THE HOSPITAL BE ABLE TO CHARGE ITS HIGHER RATE, IT SAYS
WE'RE GOING TO GO TO AN -- THE ARBITRATOR RATE. AND OF COURSE, THE
ARBITRATOR RATE IS LOWER. AND VIS-À-VIS THE INSURANCE COMPANY, THAT'S,
OF COURSE, GREAT. VIS-À-VIS THE EMPLOYERS AND SOME FRIENDS IN LABOR
WHO NEGOTIATE WITH THE INSURANCE COMPANY FOR THEIR PRICES, THERE'S A
HOPE THAT THERE WILL BE PASSED-ON LOWER PRICES. BUT FROM -- REMEMBER,
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FROM THE PATIENT PERSPECTIVE, THEY'RE NOT COVER -- THEY'RE NOT PAYING THIS
CHARGE ANYWAY; AT LEAST FOR THE BASIS OF RECEIVING IT. IF THE HOSPITAL IS
NOT ENGAGED WITH THE INSURANCE COMPANY IN THE NEGOTIATIONS TO MAKE IT
IN-NETWORK AND THE INSURANCE COMPANY DOES NOT HAVE THE INCENTIVE TO
HAVE THAT NEGOTIATION, THEY WILL SIMPLY BE ABLE TO LEAVE A WHOLE HOST OF
HOSPITALS OUT-OF-NETWORK, MEANING DIVERTING THOSE ELECTIVE SURGERIES TO
OTHER HOSPITALS. MEANING THAT HOSPITALS THAT RELY ON THOSE ELECTIVE
SURGERIES TO FUND THEIR OTHER OPERATIONS WILL SIMPLY NOT BE ABLE TO
MAINTAIN ANY SEMBLANCE OF PROFITABILITY. AND THAT IS CRUCIALLY
IMPORTANT FOR THOSE OF US WHO RECOGNIZE THAT THERE ARE HOSPITALS ACROSS
THE STATE THAT PROVIDE ESSENTIAL CARE, INCLUDING ESSENTIAL EMERGENCY
CARE, AND IF THEY'RE NOT ABLE TO HAVE AN ECONOMIC MODEL THAT WORKS,
THOSE COMMUNITY SERVICES ARE GOING TO BE LOST. IN WESTCHESTER
COUNTY, IF INSURANCE COMPANIES ARE ABLE TO PUT WESTCHESTER COUNTY
MEDICAL CENTER OUT-OF-NETWORK AND PEOPLE DIVERT THEIR ELECTIVE
SURGERIES TO OTHER HOSPITALS AROUND WESTCHESTER, WESTCHESTER MEDICAL
CENTER, A HERETOFORE HISTORICALLY STRUGGLING HOSPITAL NETWORK THAT FOR
YEARS REQUIRED BAILOUTS AND PUBLIC FUNDS BECAUSE OF A FORMER PUBLIC
HOSPITAL, NOW A PUBLIC BENEFIT CORPORATION, BUT HAS FINALLY, AFTER SO
MANY YEARS, GOT INTO FINANCIAL STABILITY, WILL ONCE AGAIN REVERT TO BEING
RELIANT ON TAXPAYER DOLLARS. AND FUNDAMENTALLY, WE CANNOT, ONCE
AGAIN, ESTABLISH THAT WESTCHESTER MEDICAL CENTER - THE TRAUMA CENTER
FOR THE ENTIRE LOWER HUDSON VALLEY, THE BURN CENTER FOR EVERYWHERE
IN NEW YORK STATE FROM WESTCHESTER ON NORTH TO CANADA - FOR THE
CRUCIAL SERVICES THAT IT PROVIDES AS THE SOCIAL SAFETY NET HOSPITAL IN THE
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AREA THAT SO MANY OTHER HEALTHCARE PROVIDERS, INCLUDING HOSPITALS, RELY
ON TO PROVIDE THE BASE-LEVEL OF SUPPORT FOR EVERYTHING FROM TRAUMA
EMERGENCY SERVICES TO INPATIENT PSYCHIATRIC FACILITIES. IF WESTCHESTER
MEDICAL CENTER'S FINANCIAL STABILITY IS THREATENED, IT THREATENS THE ENTIRE
HEALTHCARE SYSTEM OF WESTCHESTER COUNTY AND THE LOWER HUDSON
REGION. AND, ULTIMATELY, IT WOULD BE IRRESPONSIBLE FOR ME, AS A
REPRESENTATIVE FROM WESTCHESTER, TO ALLOW LEGISLATION TO MOVE FORWARD
THAT HAVE THAT IMPACT. AND YOU MIGHT ASK, WELL, SINCE THIS LEGISLATION
IN A DIFFERENT FORM IT COULD COME UP PREVIOUSLY, YOU KNOW, WHY DID I
AND SO MANY OTHER COLLEAGUES VOTE FOR IT, IT'S BECAUSE THE LEGISLATION
WAS DIFFERENT AT THE TIME. IT APPLIED ACROSS THE ENTIRE STATE. IT DID NOT
HAVE AN EXEMPTION FOR HOSPITALS THAT PROVIDE OVER 60 PERCENT OF
INPATIENT EMERGENCY SERVICES FROM -- INPATIENT SERVICES FOR MEDICAID
AND MEDICARE SERVICES. THIS LINE WAS ALL HOSPITALS WERE IN IT TOGETHER.
NOW WE ARE DRAWING A LINE, AND INSTEAD OF RELYING ON THE SOCIAL SAFETY
NET HOSPITAL LINE - WHICH WE OFTEN RELY ON, THAT WOULD HAVE INCLUDED
WESTCHESTER MEDICAL CENTER -- WE ARE DRAWING A LINE THAT,
CONVENIENTLY FOR SOME AND INCONVENIENTLY FOR OTHERS, EXCLUDES
WESTCHESTER MEDICAL CENTER. THAT IS JUST SIMPLY NOT RIGHT. IT'S ONE
THING FOR US TO SET POLICY ON THE OVERALL HEALTHCARE INDUSTRY, BUT TO HAVE
THERE BE WINNERS AND LOSERS AND HAVE THE LOWER HUDSON VALLEY BE A
DEFINITIVE LOSER IS NOT SOMETHING THAT MY CONSTITUENTS SENT ME HERE TO
STAND FOR.
SO INSTEAD, I STAND AGAINST THIS LEGISLATION. I
OBVIOUSLY URGE COLLEAGUES TO LOOK CAREFULLY AT WHAT THIS MEANS FOR THE
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HOSPITALS IN THEIR OWN DISTRICTS, TO UNDERSTAND THAT EVEN IF THEIR HOSPITAL
ISN'T THE FIRST TO SUFFER FINANCIALLY FROM THE LEGISLATION. IF THEY'RE NOT IN
THE EXEMPT CATEGORY, THEY ARE AT RISK. AND EVEN IF THEY ARE IN THE
EXEMPT CATEGORY, IF EVER THEIR -- THEIR PATIENT MIX DROPS BELOW THE 60
PERCENT THRESHOLD, THEN THAT HOSPITAL, TOO, WILL BE AT RISK. AND WE HAVE
VERY IMPORTANT THINGS TO DEBATE AND DISCUSS AND TO UNDERSTAND WITH --
WITH REGARDS TO OUR HEALTHCARE INDUSTRY AND CERTAINLY THE WAY INSURANCE
IS PROVIDED IN NEW YORK STATE, I, FRANKLY, FIND A NUMBER OF THE
ARGUMENTS OF THE INSURANCE COMPANIES AND THEIR CUSTOMERS ARE MAKING
ABOUT HOW -- OR IF WE JUST ARE ABLE TO KNOCK A BUNCH OF PLACES
OUT-OF-NETWORK THAT LOWERS THE COSTS, IT WILL BE A MORE EFFICIENT SYSTEM.
WELL, FRANKLY, THOSE VERY SAME INSURANCE COMPANIES WILL -- WILL BE
FIGHTING TOOTH AND NAIL IF EVER THIS HOUSE CONSIDERS A SINGLE-PAYER
SYSTEM THAT WOULD, IN FACT, BE MUCH MORE EFFICIENT, AT LEAST WITH
REGARDS TO THE ABILITY TO -- TO DETERMINE PAYMENTS TO HOSPITALS AND OTHER
MEDICAL PROVIDERS.
I -- I UNDER -- UNDERSTANDABLY -- I UNDERSTAND THE
MOTIVATIONS OF, YOU KNOW, THE FOLKS WHO WILL BE THE WINNERS UNDER THIS
LEGISLATION, BUT I DO NOT BELIEVE THAT WE CAN PIT ONE MEDICAL INSTITUTION
VERSUS OTHERS. NOT JUST ONE. I THINK OF A HUNDRED HOSPITALS ACROSS THE
STATE THAT WOULD BE COVERED BY THIS, AND THAT FUNDAMENTALLY MANY OF
THEM, SHORTLY AFTER THIS BILL BECAME LAW -- IF IT BECOMES LAW, AND I HOPE
IT DOESN'T -- MANY OF THEM WOULD FIND THEMSELVES OUT-OF-NETWORK. AND
THE IDEA THAT WE WOULD GO BACK TO OUR CONSTITUENTS AND SAY, THE REASON
YOU COULDN'T GET ACCESS TO IN-NETWORK COVERAGE AT YOUR AREA HOSPITAL IS
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BECAUSE OF SOMETHING WE DID ESSENTIALLY IS NOT THE MESSAGE WE SHOULD
BE SENDING TO OUR CONSTITUENTS.
SO I WOULD CONCLUDE, MR. SPEAKER, BUT I CANNOT.
UNTIL THAT BUZZER GOES OFF, I WILL BE STANDING HERE AND I WILL BE
CONVEYING HOW UNFORTUNATE IT IS THAT DESPITE THE EFFORTS OF MANY OF US,
AND PARTICULARLY THE WESTCHESTER DELEGATION, TO SIMPLY SAY IN THE
MIDDLE OF NEGOTIATIONS WITH WESTCHESTER MEDICAL CENTER, PLEASE,
WESTCHESTER MEDICAL CENTER IS A SAFETY NET HOSPITAL. IT IS -- UNDERMINE
-- UNDERLIES THE ENTIRE HEALTHCARE STRUCTURE OF AT LEAST WESTCHESTER
COUNTY AND BEYOND. PLEASE EXCLUDE WESTCHESTER MEDICAL CENTER. NO
OPTION TO DO THAT. INSTEAD, WHAT DO WE HAVE? A BILL THAT BEFORE TODAY
WAS JUST SIMPLY IN THE CODES COMMITTEE. TODAY, PUT ON -- WELL, LAST --
YESTERDAY PUT ON THE CODES COMMITTEE AGENDA FOR TODAY. THE CODES
COMMITTEE VOTED. IT DIDN'T EVEN GO THROUGH WAYS AND MEANS, EVEN
THOUGH IT HAS A FISCAL IMPACT. IT WENT STRAIGHT TO RULES -- STRAIGHT FROM
RULES TO THE FLOOR FOR A VOTE. THIS BILL IS BEING RUSHED. IT IS BEING
RUSHED BECAUSE IF ENOUGH NEW YORKERS FIND OUT WHAT IMPACT IT WILL
HAVE ON THEIR AREA HOSPITALS, IT IS QUITE POSSIBLE THAT THE SUPPOSED
BENEFITS OF THIS LEGISLATION WILL BE SHOWN TO HAVE -- BE MATCHED WITH
VERY SIGNIFICANT COSTS.
AND THAT IS THE BUZZER, MR. SPEAKER. I WILL BE BACK
FOR A SECOND ROUND.
ACTING SPEAKER AUBRY: AS PROMISED, YOU'VE
ELAPSED THE FIRST TIME.
MR. MONTESANO.
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MR. MONTESANO: THANK YOU, MR. SPEAKER. WILL
THE SPONSOR YIELD, PLEASE?
ACTING SPEAKER AUBRY: MR. CAHILL, WILL YOU
YIELD?
MR. CAHILL: YES.
ACTING SPEAKER AUBRY: MR. CAHILL YIELDS.
MR. MONTESANO: MR. CAHILL, JUST A FOLLOW-UP
QUESTION.
MR. CAHILL: SURE.
MR. MONTESANO: WITH REGARD TO THE, I THINK THE
IDRS THEY CALL THEM, THE INDEPENDENT RESOLUTION PEOPLE, THE LIST -- THE
INVOLVEMENT FROM THE DEPARTMENT OF FINANCIAL SERVICES, DO THEY PUT
OUT A LIST AND THEN THE PARTIES, THE HOSPITALS AND THE INSURER CHOOSE
FROM THAT LIST, OR DOES DFS ACTUALLY APPOINT ONE OF THE COMPANIES?
MR. CAHILL: I AM BEING ADVISED BY COUNSEL THAT
THE PROCESS BY WHICH THE INDEPENDENT DISPUTE RESOLUTION REPRESENTATIVE
IS APPOINTED IS THAT IT IS APPOINTED BY THE DEPARTMENT OF FINANCIAL
SERVICES. A SPECIFIC INDIVIDUAL IS APPOINTED FROM A LIST THAT THEY HAVE.
MR. MONTESANO: OKAY. AND THE COST FOR THAT
INDIVIDUAL, IS THAT SHARED BY BOTH PARTIES?
MR. CAHILL: THAT'S ANOTHER INTERESTING PART,
BECAUSE, YOU KNOW, WE'RE USING THIS PROCESS ACROSS THE BOARD. WE'RE
USING THIS FOR A LOT OF HEALTHCARE IN NEW YORK STATE. AND THE WAY IT
WORKS, BECAUSE WE DON'T WANT TO ENCOURAGE PEOPLE TO HAVE DISPUTES, IS
THAT THE LOSER OF THE RESOLUTION - BECAUSE REMEMBER, THERE'S A WINNER
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NYS ASSEMBLY JUNE 5, 2019
AND A LOSER, WE'RE NOT GOING SPLITTING THE BABY - THE LOSER HAS TO PAY THE
COST UNLESS THERE IS SOME SETTLEMENT AGREEMENT TO THE CONTRARY.
MR. MONTESANO: THANK YOU VERY MUCH. THANK
YOU, MR. SPEAKER.
ACTING SPEAKER AUBRY: THANK YOU, SIR.
MR. SAYEGH.
MR. SAYEGH: THANK YOU, MR. SPEAKER.
ON THE -- ON THE BILL BEFORE US.
ACTING SPEAKER AUBRY: ON THE BILL, SIR.
MR. SAYEGH: I STAND BEFORE YOU TO -- TO REALLY
FOCUS ON HOW IMPORTANT THIS BILL IS AND THE IMPACT IT WOULD HAVE ON
HOSPITALS ACROSS THE STATE, AND MORE IMPORTANT, AS MY COLLEAGUE MR.
BUCHWALD EXPLAINED ELOQUENTLY, ON ESPECIALLY A HOSPITAL THAT IS IN MY
DISTRICT. MY DISTRICT IN THE CITY OF YONKERS, A HIGH URBAN AREA, IS PART
OF WESTCHESTER COUNTY, PART OF THE LOWER HUDSON VALLEY REGION. AND
WESTCHESTER COUNTY MEDICAL CENTER IS A KNOWN TRAUMA CENTER WHERE
ALL THE LOCAL HOSPITALS, WHETHER IN WESTCHESTER COUNTY, IN ROCKLAND
AND SULLIVAN AND DUTCHESS AND PUTNAM COUNTIES, WHENEVER THERE'S
TRAUMA CASES DEALING POTENTIALLY WITH SERIOUS MATTERS - ANEURYSMS AND
HEART CONDITIONS AND AUTO ACCIDENTS AND OTHER TRAUMA-RELATED TYPE OF
INCIDENTS - ARE OFTEN REFERRED TO WESTCHESTER MEDICAL CENTER. AND
WESTCHESTER MEDICAL CENTER HAS HAD A HISTORY OF FINANCIAL WOES IN THE
PAST, AND HAVE MADE SERIOUS ATTEMPTS TO TRY TO SETTLE DOWN THEIR FISCAL
WOES AND REALLY DEVELOP SOME SENSE OF STABILITY, WHICH IS NECESSARY FOR
THE ENTIRE REGION THAT WE'RE TALKING ABOUT. I'M A LITTLE CONCERNED OF
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NYS ASSEMBLY JUNE 5, 2019
HOW THIS BILL WAS EXPEDITED IN SUCH A FASHION TO AVOID THE PARTIES THAT
ARE INVOLVED - NAMELY, THE INSURANCE COMPANY AND THE HOSPITAL - TO TRY
TO NEGOTIATE THIS MATTER. I THINK WHEN THE DELEGATION MEMBERS,
ESPECIALLY FROM WESTCHESTER COUNTY, MET WITH THE PARTIES NOT TOO LONG
AGO, THE UNDERSTANDING WAS THAT THEY WERE ENCOURAGED TO SIT ON THE
TABLE AND TRY TO COME UP WITH WHAT WAS REASONABLE FOR BOTH SIDES.
WE'RE NOT IN A PHILOSOPHY OR IN A SITUATION WHERE THERE MUST BE LOSERS
AND WINNERS. WHEN YOU DEAL WITH HEALTHCARE, IT'S CRUCIAL TO MAKE SURE
THAT WE'RE ABLE TO PROVIDE THOSE INSTITUTIONS WITH THE RIGHT TO NEGOTIATE
AND THE RIGHT TO MAKE SURE THAT THEY'RE COMPENSATED FOR SERVICES
PROVIDED. MY CONCERN IS BY RUSHING A VOTE ON THIS BILL, WE HAVE CLOSED
THE DOOR TO NEGOTIATIONS. WE HAVE PUT WESTCHESTER MEDICAL CENTER
AND MANY HOSPITALS ACROSS THE STATE POTENTIALLY IN -- IN A BANKRUPTCY
SITUATION, WHICH IS A LOSE-LOSE FOR MANY PATIENTS IN OUR AREAS AND
THROUGHOUT THE STATE OF NEW YORK.
SO, I URGE MY COLLEAGUES, THIS IS NOT THE RIGHT TIME TO
PASS A BILL LIKE THIS. LET'S GIVE NEGOTIATIONS AN OPPORTUNITY. LET'S TELL
THE PARTIES, SIT ON THE TABLE AND RESOLVE THIS, SO THAT AT THE END OF THE
DAY, THE INSURANCE COMPANY, PATIENTS ARE PROTECTED AND THE HOSPITAL IS
PROTECTED. AND WHATEVER ISSUES THAT RELATE TO LABOR, THEY WILL BE
ADDRESSED, ALSO. SO, I URGE MY COLLEAGUES TO REALLY, AT THIS TIME MORE
THAN EVER, TO VOTE THIS DOWN. THANK YOU.
ACTING SPEAKER AUBRY: THANK YOU, SIR.
MRS. GALEF.
MRS. GALEF: YES. I'VE REALLY NEVER DONE THIS
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BEFORE, LIKE THIS. SO I'M GOING TO SAY I'M A LITTLE NERVOUS ABOUT THIS.
WHAT DID I LEARN AT THE CODES COMMITTEE MEETING TODAY? WELL, FIRST I
LEARNED THAT IT WAS ON THE AGENDA, THIS BILL WAS ON THE AGENDA. AND
WITHIN, I THINK, 20 MINUTES IT WENT TO THE RULES COMMITTEE, AND THEN IT
DIDN'T GO TO WAYS AND MEANS EVEN THOSE THERE'S THIS HUGE ECONOMIC
IMPACT ON THIS. AND THEN IT'S HERE ON THE FLOOR FOR US TO DEBATE WHEN
WE'RE SUPPOSED HAVE A WOMEN'S DINNER ANYWAY. OKAY. SO THAT'S WHAT
I LEARNED TODAY. I ALSO LEARNED TODAY THAT THIS IS THE ONLY STATE THAT
WOULD HAVE A POLICY LIKE THIS. THERE'S NEVER BEEN AN EXPERIENCE LIKE
THIS ANYWHERE ELSE. MAYBE THE INSURANCE COMPANIES ARE DOING THIS SO
THAT THEY CAN USE NEW YORK STATE AS AN EXAMPLE. I DON'T KNOW. I HOPE
NOT. WHAT ELSE? IN THE CODES COMMITTEE SOMEBODY ASKED THE
QUESTION - I HAVE TO SAY THAT MY COLLEAGUE SITTING IN FRONT OF ME WHO
ASKED QUESTIONS LATER WAS ABSOLUTELY TERRIFIC - BUT ASKING SOME
QUESTIONS ABOUT WHAT IS AN EXTENS -- EXCESSIVE CHARGE. WELL, I DIDN'T
HEAR A CLARIFICATION. WHAT IS AN EXCESSIVE CHARGE? WHO'S GOING TO
DETERMINE THE EXCESSIVE CHARGE? ANOTHER THING, WHAT HOSPITALS ARE
GOING TO BE IMPACTED? IN THE CODES COMMITTEE, I DID NOT HEAR AN
ANSWER TO THAT. I HAVE A LIST THAT I'VE SEEN, BUT I DIDN'T HEAR AN ANSWER
FROM THE CODES COMMITTEE. COMPARABLES. WHAT KIND OF COMPARABLES
ARE WE GOING TO USE FOR A BURN CENTER OR A TRAUMA CENTER, ET CETERA? I
DIDN'T REALLY FEEL THAT I GOT AN ANSWER TO THAT. THE BURN CENTER IS THE
ONLY ONE IN THE AREA, I THINK, FROM DOWN HERE. WE KEPT THE BURN
CENTER GOING AT THE MEDICAL CENTER BECAUSE IT'S SO EXPENSIVE AND
NOBODY ELSE WANTED TO DEAL WITH IT, SO WE HAD IT THERE. I DON'T KNOW
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NYS ASSEMBLY JUNE 5, 2019
ABOUT THE COMPARABLES. AND REMEMBER, WE'RE DEALING IN A COUNTY THAT
IS A LITTLE BIT MORE EXPENSIVE THAN THE UPSTATE COUNTIES. I WISH IT
WASN'T, BUT IT IS. WHY -- WE ASKED THE QUESTION OF WHY 60 PERCENT, AND
THE STAFF, I BELIEVE, HAD NO ANSWER TO 60 PERCENT. I KNOW THE SPONSOR
OF THE BILL HAS SAID SOMETHING ABOUT WELL, IT COULD'VE BEEN 51 PERCENT,
IT COULD'VE BEEN WHATEVER. WELL, THERE'S NO DATA TO SAY IT SHOULD BE 60
PERCENT, SO WHY DID WE CHOOSE 60 PERCENT? THEY TALKED ABOUT A SAFETY
NET HOSPITAL, AND I DON'T KNOW EXACTLY WHAT THAT DEFINITION IS AND THAT
PROBABLY GOT INTO THE 60 PERCENT. I DON'T KNOW. THEN THERE WAS A
QUESTION ABOUT WHY IS MONTEFIORE EXCUSED FROM THIS. WHY, I DON'T
REALLY KNOW. I GUESS THEY'RE AT 63 PERCENT SO THAT THEY ARE. BUT WHAT IS
THE REAL DIFFERENCE BETWEEN THE HOSPITALS? THEN I HEARD THAT ALBANY
HAS 59 PERCENT. SO THE HOSPITAL HERE IN ALBANY, IF WE GET TAKEN THERE
WITH AN EMERGENCY, WILL BE COVERED. BUT WE WON'T BE COVERED IF WE
STAY AT THE ALBANY HOSPITAL BECAUSE THEY'RE GOING -- IT'LL BE
OUT-OF-NETWORK. DID THEY -- THEY LOOK -- DID THE CODES COMMITTEE
LOOK AT THE IMPACT ON HOSPITALS? WE DIDN'T GET AN ANSWER THAT THEY
LOOKED AT ANY IMPACT ON THE HOSPITAL BECAUSE NOBODY KNOWS WHAT
IMPACT IS ON HOSPITALS. HAVE THERE BEEN ANY HEARINGS ON THIS SO THAT
PEOPLE CAN COME IN? I DON'T THINK SO. IT WAS SO CLEAR FROM THE CODES
COMMITTEE TODAY THAT THERE'S BEEN NO RESEARCH OR DATA ON THIS ISSUE.
LET ME JUST TALK ABOUT THE WESTCHESTER MEDICAL
CENTER. I WAS A WESTCHESTER COUNTY LEGISLATOR STARTING IN 1980.
BEFORE THAT, MY HUSBAND WAS A COUNTY LEGISLATOR IN 1975. AND THAT
HOSPITAL WAS A POOR PERSON'S HOSPITAL. IT WASN'T EVEN A MEDICAL CENTER.
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IT WAS THE WESTCHESTER HOSPITAL. IT WAS FOR ONLY POOR PEOPLE. AND
THEY MADE THE DECISION IN ABOUT 7 -- 1978 THAT THIS HOSPITAL WAS GOING
TO TAKE CARE OF ALL PATIENTS IN THE REGION AND BE A HOSPITAL THAT HAD
REALLY, REALLY TOP-NOTCH CARE. IT WAS GOING TO BE A TERTIARY CARE FACILITY.
AND AT THAT TIME, ALL THE OTHER HOSPITALS AROUND THE AREA WERE ALL UPSET
BECAUSE THEY'D HAD A POOR PERSON'S HOSPITAL AND THEY SENT ALL THEIR POOR
PEOPLE TO THE HOSPITAL. AND ALL OF A SUDDEN, NOW THERE'S GOING TO BE A
HOSPITAL THAT IS FOR EVERYBODY AND THEY'RE GOING TO TAKE PATIENTS AWAY
FROM ALL OF THE OTHER HOSPITALS. THEY WERE SO UPSET. I REMEMBER ALL OF
THOSE HOSPITAL ADMINISTRATORS IN MY HOUSE. I WAS A DEVOTED WIFE. I
GAVE THEM TEA AND COFFEE AND COOKIES, AND MY HUSBAND NEGOTIATED
WITH THEM. NOW WE'VE TURNED THE TABLES, RIGHT? ANYWAY, IT JUST -- I
MEAN, IT WAS INCREDIBLE. THEY WERE SO UPSET WITH THE COMPETITION. SO
WHAT WE SAID WAS WHEN I GOT ON THE COUNTY BOARD, WE'RE GOING TO BE
SURE IT'S TERTIARY. WE'RE GOING TO TAKE THOSE BURN PATIENTS, WE'RE GOING
TO TAKE THE ORGAN DONATIONS. WE'RE GOING TO TAKE THE HEART TRANSPLANTS.
AND THEY WERE ONE OF THE HOSPITALS THAT STARTED THE FIRST HEART
TRANSPLANT. AMY AND I SAW THIS WEEKEND TWINS THAT HAD BEEN SEPARATED
AT THE HOSPITAL. YOU DON'T DO THAT IN EVERY HOSPITAL. THAT IS EXPENSIVE.
AND IF YOU -- NEONATAL FACILITY, WHERE THOSE LITTLE BABIES THAT LIVE WHEN
THEY'RE LIKE TWO POUNDS, THEY GO TO THE MEDICAL CENTER. THAT'S
EXPENSIVE. AND YOU'RE GOING TO SAY IN THIS BILL THAT THEY CAN COME IN
FOR THE EMERGENCY, I GUESS FOR THE DELIVERY, I DON'T KNOW, AND THEN
WHEN THE BABY IS GOING TO STAY THERE THAT THEY'RE NOT GOING TO BE
COVERED, THEY'RE GOING TO BE -- THEY'RE GOING TO BE OUT-OF-NETWORK?
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YOU KNOW THE COST OF ALL THAT AND THE HOSPITAL'S COST FOR THOSE? AND
WE'RE NOT DEALING WITH THAT ISSUE? IT JUST DOESN'T MAKE SENSE TO ME. I
TEND TO THINK THAT IF THIS BILL WENT THROUGH, THAT THE WESTCHESTER
MEDICAL CENTER WOULD THINK ABOUT THE BURN CENTER AND MAYBE ALL THE
FIREFIGHTERS WHO END UP AT OUR MEDICAL CENTER AND OTHER PEOPLE THAT
ARE IN CAR ACCIDENTS THAT END UP AT THE MEDICAL CENTER, THAT WE'RE NOT
GOING TO HAVE A BURN CENTER THERE BECAUSE ALBANY DROPPED IT. DO --
ARE OTHER PEOPLE GOING TO DROP IT? WE CAN DROP IT. IT'S REALLY, REALLY,
REALLY EXPENSIVE, AND PEOPLE ARE THERE FOR A LONG TIME. AND THIS IS ALL
ABOUT THE INSURANCE COMPANY. THE INSURANCE COMPANY JUST WANTS TO
MAKE MORE MONEY ON ALL THIS STUFF. I ALSO THINK BECAUSE IT'S A PUBLIC
BENEFIT HOSPITAL NOW, IT'S GOING THROUGH - AND I'M TALKING ABOUT THE
MEDICAL CENTER, BUT IF THIS -- ANY HOSPITAL IN YOUR DISTRICT CAN BE PART OF
ALL THIS. BECAUSE YOU COULD BE 60 PERCENT TODAY AND 59 PERCENT NEXT
YEAR, AND YOU COULD BE OUT OF THE SYSTEM. YOU CAN HAVE THE SAME
PROBLEMS THAT WE'RE GOING TO HAVE. THE PUBLIC EMPLOYEES, BECAUSE WE
PUT TOGETHER PUBLIC BENEFIT CORPORATION -- WHICH WE VOTED ON HERE IN
THE 1990'S SOMETIME TO MAKE IT A PUBLIC BENEFIT CORPORATION, AND SO
DURING THAT PERIOD OF TIME WESTCHESTER COUNTY TAXPAYERS WERE PUTTING
A LOT OF MONEY INTO THE DISTRICT. AND EVEN THOUGH IT WAS A REGIONAL
HOSPITAL, THE OTHER REGIONS WERE NOT PUTTING MONEY IN, AND WE WERE
REALLY FUNDING THAT HOSPITAL. AND NOW AT THIS POINT, WE MADE SURE THAT
OUR EMPLOYEES - REMEMBER, THEY ALL STARTED OUT AS COUNTY EMPLOYEES -
WE MADE SURE THAT THEY WERE ALL IN THE UNIONS. THE NURSES, ALL THE
WORKERS THERE ARE IN THE UNIONS. THEY'RE PUBLIC EMPLOYEES. PUBLIC
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EMPLOYEES COST MORE THAN THE PRIVATE EMPLOYEES AT YOUR PRIVATE
HOSPITALS. SO, YES. IT'S GOING TO COST MORE TO BE ABLE TO HAVE THE
MEDICAL CENTER CONTINUE, AND IT'S MORE FOR REIMBURSEMENT. I TEND TO
THINK IF WE PASS THIS BILL, OUR COUNTY IS GOING TO HAVE TO PUT MORE
MONEY INTO IT. BUT I TEND TO THINK THAT WE ARE GOING TO, AT THE MEDICAL
CENTER, GRAB PATIENTS THAT ARE NOT TERTIARY CARE PATIENTS BECAUSE WE'RE
GOING TO HAVE TO START TO BE ABLE TO PUT MORE PEOPLE IN THERE BECAUSE
MANY OF THE -- BECAUSE THE WAY THE SYSTEM WORKS, YOU GO TO THE
EMERGENCY ROOM AND THEN AFTERWARDS - AND YOU GET COVERED - AND THEN
AFTERWARDS, WITH YOUR AFTERCARE, YOU ARE GOING TO END UP WITH YOUR
AFTERCARE MAYBE AT ANOTHER HOSPITAL. IT'S -- FIRST OF ALL, IT'S NOT REALLY
GOOD TO MOVE PEOPLE AROUND WHEN THEY'RE SICK, BUT WE MAY BE HAVING
TO DO THAT. AND IF YOU'RE GOING TO LOSE PEOPLE OUT OF BEDS, WHAT YOU'RE
GOING TO DO IS YOU'RE GOING TO PUT MORE PEOPLE IN THE BEDS THAT MAYBE
AREN'T TERTIARY. THEN WE HAVE A RIPPLE EFFECT ON ALL OF OUR OTHER
HOSPITALS, AND THEY'RE GOING TO HAVE A PROBLEM.
YOU KNOW, DID THIS ALL START, THIS BILL -- WHICH DID
CHANGE, IT'S NOT THE SAME BILL THAT WE HAVE VOTED ON IN THE PAST. IT IS A
DIFFERENT BILL. DID THIS ALL START BECAUSE THE WESTCHESTER MEDICAL
CENTER CAME IN TO RESCUE SOME HOSPITALS IN THE HUDSON REGION A LITTLE
BIT NORTH? THEY RESCUED THOSE HOSPITALS BECAUSE THOSE HOSPITALS WERE
FAILING, AND THEY CAME IN. ARE WE UPSET BECAUSE WESTCHESTER CAME IN
TO HELP PULL TOGETHER SOME OF THOSE REGIONAL HOSPITALS? MAYBE THAT'S
THE ESSENCE OF WHY THIS BILL IS BEFORE US. I DO NOT KNOW. BUT I WOULD
SUGGEST THAT THE RUSH ON THIS BILL, THIS IS NOT LIKE ANYTHING WE'VE EVER
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DONE BEFORE. RUSH, RUSH, RUSH. EXCEPT MAYBE ON THE LAST NIGHT OF
SESSION. I MEAN, I CAN'T IMAGINE WHY WE ARE DOING THIS AT 5: OF 6:00
LET ME TALK A LITTLE BIT ABOUT NEGOTIATIONS. THIS BILL, IN
MY MIND, IS TRYING TO TAKE AWAY NEGOTIATIONS FOR WHAT IS -- WHAT ARE
GOING ON RIGHT NOW. I DON'T KNOW WHETHER YOUR HOSPITALS THAT YOU'RE
NEGOTIATING -- WELL, WE'RE ALWAYS -- THEY'RE ALWAYS NEGOTIATING WITH
HEALTHCARE PROVIDERS. BUT THE MEDICAL CENTER IS NEGOTIATING WITH THE
EMPIRE PLAN -- FOR THE EMPIRE PLAN, AND THEY'VE BEEN IN NEGOTIATIONS.
AND MY UNDERSTANDING IS LAST FRIDAY IN NEGOTIATIONS, THE MEDICAL
CENTER ACCEPTED THE RATES THAT EMPIRE HAD OFFERED FOR THE -- FOR THE
HOSPITALS OTHER THAN THE MEDICAL CENTER. SO ALL THE OTHER HOSPITALS
THEY'RE A PART OF THE MEDICAL CENTER, THEY ACCEPTED THE RATES, AND THAT
EMPIRE WALKED AWAY FROM THAT. THEY ALSO ASKED -- THE MEDICAL CENTER
ASKED FOR TWO WEEKS TO CONTINUE TO NEGOTIATE, AND EMPIRE SAID NO.
AND EMPIRE SAID, LET'S GET BACK UP TO THE ASSEMBLY AND LET'S GET THEM
TO VOTE ON THIS. THAT'S WHAT GOING ON. I'VE JUST NEVER SEEN IT SO BLATANT
IN MY -- IN MY TIME HERE OF WHAT IS GOING ON HERE. AND THE FACT THAT
THERE'S NO DATA, NO FACTS. WE DON'T KNOW WHAT HOSPITALS ARE IMPACTED.
YOU -- YOU OUGHT TO QUESTION THAT. IS YOUR HOSPITAL ON THE LIST? DO
YOU KNOW WHAT'S GOING ON WITH YOUR HOSPITAL? AND WHAT HAPPENS IF
YOUR HOSPITAL CHANGES FROM 6 -- 60 PERCENT TO 50 PERCENT? ARE YOU
GOING TO BE IN THIS BOAT, TOO? AND ARE YOUR SERVICES GOING TO START TO
FAIL? I -- I'M -- I'M -- I TOLD YOU, I STARTED OUT WITH THIS MEDICAL CENTER
IN 1975, PUSHING EVERY WAY, WHETHER IT'S LEGISLATION UP HERE OR AT THE
COUNTY. I DON'T WANT IT TO FAIL. I DON'T WANT IT TO FALL APART. IT IS
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PROVIDING FANTASTIC SERVICE TO PEOPLE. AND, YES, THEY'RE DOING TERTIARY
CARE. IT IS MORE EXPENSIVE THAN OUR REGULAR PRIMARY CARE. BUT WE'RE
GOING TO START PUTTING ALL THOSE PRIMARY CARE PEOPLE IN TO TRY TO GET THE
REVENUES AND TO FILL THE BEDS. THAT'S WHAT WILL HAPPEN. AND WE'RE
GOING TO TOPPLE THIS WHOLE SYSTEM DOWN. I THINK IT'S JUST A BAD IDEA. IF
YOU WANT TO EXEMPT THE MEDICAL CENTER, I WOULD LOVE TO DO THAT. BUT I
DON'T REALLY THINK IT'S FAIR, BECAUSE YOUR HOSPITAL CAN BE IN IT NEXT YEAR.
AND IF WE EXEMPT ONE, WE SHOULD -- WE SHOULD JUST GET RID OF THIS
WHOLE POLICY. I DON'T KNOW WHERE THE 60 PERCENT CAME FROM. YOU
COULD PUT IT DOWN AT 2 PERCENT. NOBODY KNOW, BECAUSE NOBODY CARES.
THANK YOU.
ACTING SPEAKER AUBRY: MR. WALCZYK.
MR. WALCZYK: THANK YOU, MR. SPEAKER. WOULD
THE SPONSOR YIELD?
ACTING SPEAKER AUBRY: WILL YOU YIELD, SIR?
MR. CAHILL: YES, SIR.
ACTING SPEAKER AUBRY: THE SPONSOR YIELDS.
MR. WALCZYK: I APPRECIATE THAT. WHO EXACTLY
DETERMINES WHAT AN EXCESSIVE CHARGE IS? IS THERE A SPECIFIC INDIVIDUAL
THAT WOULD DO THAT?
MR. CAHILL: THANK YOU FOR THE QUESTION. THERE
ARE SOME STANDARDS WRITTEN INTO THE LEGISLATION. THERE ARE ALSO SOME
STANDARDS WRITTEN INTO THE LEGISLATION TO WHICH IT REFERS, SEPARATE AND
APART FROM WHAT IS WRITTEN IN THE BILL IN FRONT OF YOU. BUT THE EXCESS
CHARGES ARE BASED UPON A NUMBER OF DIFFERENT CRITERIA, INCLUDING WHAT
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WAS BEING CHARGED BEFORE THE CONTRACT ENDED, WHAT IS BEING CHARGED TO
OTHER PEOPLE. THE ACUITY OF THE PATIENT BEFORE THAT -- THAT IS BEING
TREATED AND THAT IS BEING -- THAT THE CHARGES ARE BASED UPON. AND A
NUMBER OF OTHER VERY SPECIFIC FACTORS. THE IDEA IS THAT -- THAT WE ARE
SENDING THIS TO A NEUTRAL THIRD-PARTY TO MAKE A DETERMINATION. THAT
NEUTRAL THIRD-PARTY IS THE PARTY THAT WILL ULTIMATELY DETERMINE WHETHER IT
IS AN EXCESSIVE CHARGE. BOTH SIDES WILL MAKE ARGUMENTS THAT IT IS OR IS
NOT, BUT THE THIRD-PARTY WILL MAKE THAT DETERMINATION BASED UPON THE
EVIDENCE BEFORE THEM AND THE STANDARDS THAT ARE PUT IN -- THAT ARE -- THAT
ARE -- THAT THEY ARE REQUIRED TO ADHERE TO.
MR. WALCZYK: MAYBE IT WAS IN YOUR ANSWER AND I
MISSED IT, BUT HOW EXACTLY DO WE FIND THAT NEUTRAL THIRD-PARTY? WHO
APPOINTS THEM?
MR. CAHILL: I -- I ANSWERED THAT BEFORE TO ANOTHER
INDIVIDUAL WHO ASKED. IT IS APPOINTED BY THE DEPARTMENT OF FINANCIAL
SERVICES.
MR. WALCZYK: OKAY. WHO DETERMINES WHAT AN
EXORBITANT FEE WOULD BE?
MR. CAHILL: AGAIN, IT'S THE -- IT'S THE CRITERIA THAT
ARE INDICATED IN THE -- IN THE BILL AND IN THE LAW, IN THE EXISTING LAW
TODAY THAT WE USE WHERE -- BY THE WAY, THE HISTORY OF THIS BILL IN NEW
YORK STATE IS WHERE WE CAN -- WHERE WE CAN GET A REFERENCE POINT IS
WHERE PHYSICIANS HAVE BEEN SUBJECT TO THE BILL, AND THE RESULTS HAVE
VIRTUALLY BEEN EVENLY DIVIDED BY THE INDEPENDENT DISPUTE RESOLUTION
REPRESENTATIVE BETWEEN THE INSURANCE COMPANY AND THE PROVIDER. SO,
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THE DETERMINATION IS MADE BASED UPON THE CRITERIA IN THE STATUTE, AND
BASED UPON THE EVIDENCE BEFORE THE INDEPENDENT THIRD-PARTY.
MR. WALCZYK: WELL, I'M GLAD THAT THE SPONSOR
BROUGHT UP THE HISTORY OF THIS BILL BECAUSE IT CERTAINLY PREDATES ME, AND
I UNDERSTAND THAT IT HAS SOME HISTORY HERE. BUT THERE HAVE BEEN
CHANGES TO THE BILL. WHERE EXACTLY DID THIS ORIGINATE FROM? WHERE DID
THE IDEA OF THIS BILL COME FROM?
MR. CAHILL: THANK YOU FOR THE QUESTION. THE --
THE BILL ORIGINATED FROM A COUPLE OF DIFFERENT PLACES. BUT PRIMARILY, IT
-- IT ORIGINATED BECAUSE WE, AS A LEGISLATIVE BODY, WERE CONCERNED WITH
THE RUNAWAY COST OF HEALTHCARE AND THE INCREASING BURDEN THAT IS BEING
PLACED -- THAT'S BEING PLACED ON INDIVIDUALS FOR SURPRISE BILLING. THERE
WAS A NUMBER OF DIFFERENT STUDIES THAT TOOK PLACE. BUT ULTIMATELY, WE
PASSED LEGISLATION THAT WOULD PREVENT SURPRISE BILLING, AND WE
EMPANELED A COMMISSION, A WORK GROUP, IF YOU WILL. AND THAT WORK
GROUP MET, AND IN 19 -- AND IN 2017 OFFERED A SERIES OF
RECOMMENDATIONS, ONE OF WHICH WAS TO DO EXACTLY THIS BILL. SO, THE
ORIGIN WAS TO PROTECT CONSUMERS, NUMBER ONE; TO REIN IN HEALTHCARE
COSTS, NUMBER TWO; AND TO ALLOW A -- A WORK GROUP TO STUDY THE ISSUE
MORE IN DEPTH AND COME BACK WITH RECOMMENDATIONS. AND TO THE
POINT THAT SOME COLLEAGUES HAVE MADE ABOUT THIS BEING RUSHED, IT IS
ANYTHING BUT RUSHED. THIS IS THE FOURTH TIME THE CONCEPTS THAT UNDERLIE
THIS BILL HAVE BEEN BEFORE THIS BODY. THE FOURTH TIME. THE BILL WAS
INTRODUCED ON JANUARY 9TH. IT WASN'T INTRODUCED TODAY. IT WAS
INTRODUCED ON JANUARY 9TH. IT WASN'T CONSIDERED BY THE CODES
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COMMITTEE FOR THE FIRST TIME THIS AFTERNOON. IT WAS CONSIDERED BY THE
CODES COMMITTEE AND WENT ON AN AGENDA FOR THE CODES COMMITTEE
LAST WEEK. THE CODES COMMITTEE POSTPONED CONSIDERATION OUT OF
CONSIDER -- TO -- TO ALLOW PARTIES TO CONTINUE TO DISCUSS, AND THE CODES
COMMITTEE CONSIDERED IT TODAY. IT IS NOT ALL UNUSUAL, MADAM SPEAKER,
MY COLLEAGUES, FOR A -- A COMMITTEE TO PASS A BILL, FOR IT TO GO TO RULES
AND THEN TO WIND UP ON THE FLOOR WITH JUST A -- IN -- IN DUE COURSE.
THERE'S NOTHING RUSHED ABOUT THIS. THIS IS PART OF A LONGSTANDING
PROCESS THAT WE HAVE UNDERTAKEN AS LEADERS IN THIS COUNTRY TO REIN IN
THE COST OF HEALTHCARE. I WOULD ALSO POINT OUT, IF MY COLLEAGUE WOULD
ALLOW ME, THAT WE ARE NOT ALONE. THAT WE ARE BEING COPIED BY OTHER
STATES -- THE STATE OF CALIFORNIA, THE STATE OF WASHINGTON, THE STATE OF
COLORADO, THE STATE OF TEXAS EITHER HAVE OR ARE CONSIDERING DOING THESE
THINGS EITHER BY STATUTE OR BY REGULATION. THE COST -- THE RUNAWAY COST
OF HEALTHCARE IS OF GREAT CONCERN TO THE PEOPLE OF NEW YORK STATE, BUT
GUESS WHAT? IT'S OF GREAT CONCERN TO PEOPLE ACROSS THIS COUNTRY. AND
THIS IS ONE OF THE MANY TOOLS WE'RE TRYING TO BRING TO THE FLOOR TO ARREST
SOME OF THOSE COSTS UNDER CONTROL. BUT ALSO TO MAKE SURE WE DO IT IN A
FAIR AND IMPARTIAL WAY. WE DIDN'T JUST STOP PAYING HOSPITALS. WE
DIDN'T JUST SAY, OH, INSURANCE COMPANIES, WHATEVER YOU WANT TO
CHARGE, YOU CAN CHARGE. WE SAID LET'S ALLOW A THIRD-PARTY TO
DETERMINE, BASED UPON THE CRITERIA IN THE STATUTE. BASED UPON THE
EVIDENCE BEFORE THEM WHETHER A CHARGE IS EXORBITANT, WHETHER IT IS AN
EXCESSIVE -- OR WHETHER AN INSURANCE COMPANY IS TRYING TO TAKE
ADVANTAGE OF THAT PROVIDER BY LOWBALLING THE PAYMENTS.
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MR. WALCZYK: I APPRECIATE THE SPONSOR'S ANSWER
TO MY QUESTION OF WHERE DID THIS IDEA COME FROM, AND I -- I THINK THE
ANSWER WAS IT WAS GENERALLY FROM THIS LEGISLATIVE BODY. YOU ALSO WENT
INTO A -- A GOOD AMOUNT OF HISTORY THAT HAS BROUGHT A COUPLE MORE
QUESTIONS TO ME TO THE FOREFRONT. IN 2017, I WAS JUST A WATERTOWN CITY
COUNCILMAN SERVED BY THE GREAT SAMARITAN MEDICAL CENTER AT THE TIME.
WHILE YOU WERE WORKING ON THIS WITH A WORK GROUP, WOULD YOU
ENLIGHTEN ME AS TO WHO WAS ON THAT WORK GROUP AND HOW THAT FORMED?
MR. CAHILL: WELL, I WASN'T ON THE WORK GROUP. I
BELIEVE THE WORK -- WORK GROUP WAS APPOINTED CONSISTENT WITH WHAT
THE ORIGINAL SURPRISE BILLING LAWS PROVIDED, AND I DON'T HAVE THAT
INFORMATION IN FRONT OF ME. BUT IT DID INCLUDE A VARIETY OF
REPRESENTATIVES AND STAKEHOLDERS FROM -- FROM DIFFERENT WALKS OF LIFE.
AND I -- IF YOU WANT TO WAIT ONE MINUTE I'LL ASK THE EXPERTS HERE AND I'LL
GIVE YOU THE PRECISE ANSWER.
MR. WALCZYK: I'D APPRECIATE IT.
(PAUSE)
MR. CAHILL: WE'LL -- WE'LL GET BACK TO YOU WITH
THAT INFORMATION. BUT REST ASSURED, I WASN'T ON THERE.
MR. WALCZYK: YEAH. AND OBVIOUSLY, IT COMING
BEFORE MY TIME, I'M ALWAYS CURIOUS ABOUT WHERE THE IDEAS FOR THESE
BILLS COME FROM, WHAT THE MOTIVATION IS BEHIND THEM AND WHEN THEY --
WHEN THEY SHOW UP. YOU ALSO BROUGHT UP A -- A DEFENSE ON PROCESS. I
WASN'T -- WASN'T PREPARED TO BRING UP PROCESS, BUT SINCE YOU BROUGHT IT
UP -- AND I HAVE NOTICED THAT SINCE THIS BILL WAS BROUGHT TO THE FOREFRONT
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-- YOU KNOW, AND BEING A FRESHMAN IN THE LEGISLATURE, THERE'S A LOT OF
BILLS THAT ARE NEW TO ME. SO I'M OF -- OFF -- OFTEN FOUND MYSELF
SCRAMBLING TO GET INPUT FROM THOSE INDIVIDUALS IN MY DISTRICT WHO
WOULD BE IMPACTED. AND I'VE BEEN SCRAMBLING, YOU KNOW, IN THE LAST
COUPLE OF HOURS TO GET INPUT FROM MY HOSPITAL CEOS. BUT MAYBE THIS
WORK GROUP IN 2017 OR YOU, THROUGH THIS LONG PROCESS THAT YOU'VE
DESCRIBED, HAVE HEARD FROM MASSENA MEMORIAL HOSPITAL AND YOU COULD
ENLIGHTEN ME AS TO WHAT THEIR POSITION ON THIS BILL WOULD BE.
MR. CAHILL: I HAVE NOT HEARD FROM MASSENA
MEMORIAL HOSPITAL. I WOULD POINT OUT THAT -- THAT THE -- THAT THE BILL
HAS BEEN INTRODUCED NOW FOR OVER FIVE MONTHS. OR MAYBE IT IS EXACTLY
FIVE MONTHS OR GETTING THERE VERY SOON. THIS IS THE THIRD YEAR THAT
WE'VE CONSIDERED THIS BILL. HOSPITALS ARE CERTAINLY AWARE OF IT. REST
ASSURED, THEY ARE AWARE OF IT. WE'VE HEARD FROM THE HOSPITAL
ASSOCIATIONS THAT REPRESENT THE HOSPITALS IN NEW YORK STATE ON THIS BILL
EXTENSIVELY. THEY HAVE LOBBIED AND -- AND VISITED INDIVIDUAL MEMBERS.
SO THERE'S NO SURPRISE TO THEM THAT THIS LEGISLATION IS MOVING FORWARD.
AND, QUITE FRANKLY, THE -- THE ARGUMENTS THAT WE'VE HEARD TODAY ARE NOT
NEW ARGUMENTS. SOME OF THEM ARE NOT BASED ON FACT, BUT THEY ARE NOT
NEW ARGUMENTS THAT HAVE BEEN HEARD AND CONSIDERED NOW BY MULTIPLE
COMMITTEES IN THIS LEGISLATURE MULTIPLE TIMES, AND BY THIS ENTIRE BODY
MULTIPLE TIMES.
MR. WALCZYK: WELL -- WELL, I'M DISAPPOINTED TO
HEAR THAT YOU HAVEN'T HEARD FROM THE GREAT MASSENA MEMORIAL
HOSPITAL. I WAS WONDERING IF -- IF YOU HAD HEARD FROM CLAXTON
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HEPBURN HOSPITAL IN OGDENSBURG AS TO WHAT THE IMPACT WOULD BE, OR IF
THE WORKING GROUP IN 2017, IN ALL OF THEIR DUE DILIGENCE IN THE LONG
PROCESS OF THIS LEGISLATION, HAS HEARD FROM THAT HOSPITAL AT ALL, FROM
CLAXTON HEPBURN.
MR. CAHILL: WELL -- EXCUSE ME FOR INTERRUPTING.
BUT THE -- GENERALLY SPEAKING, THOSE HOSPITALS, I THINK, WOULD BE HEARD
FROM THROUGH THE ASSOCIATIONS OF WHICH THEY ARE A MEMBER. AND WE
HAVE HEARD FROM THE ASSOCIATIONS OF WHICH THEY ARE A MEMBER, AND THEY
ARE OPPOSED TO THIS BILL. THEY HAVE REGISTERED IN AGAINST THIS BILL. NOT
IN -- IN A PARTICULAR STRIDENT WAY, IN MY VIEW. THEY RAISED SOME ISSUES
WITH IT. THEY SAID THAT IT WOULD TAKE AWAY AN ADVANTAGE THAT THEY
WOULD HAVE. THEY SAID THAT IT WOULD MAKE A PLAYING FIELD THAT WASN'T
AS LEVEL THE WAY THEY WANTED IT TO GO. BUT THE FACT OF THE MATTER IS,
THEY HAVE REGIS -- I DON'T KNOW ABOUT YOUR SPECIFIC HOSPITALS, BUT WE
HAVE HEARD FROM HOSPITAL ASSOCIATIONS WHO HAVE INDICATED THEIR
OPPOSITION. HOWEVER, I WOULD ALSO POINT OUT THAT WE HEARD FROM A LOT
OF PEOPLE WHO SUPPORT THIS. I COULD -- I COULD GO DOWN THE LONG, LONG
LIST OF PEOPLE WHO HAVE INDICATED THEY SUPPORT IT. MOST RECENTLY,
DISTRICT COUNCIL 37, THE CONSUMERS UNION, SEIU, BJ32 -- 32BJ.
HERE'S AN INTERESTING PAIRING THAT WE HAVEN'T SEEN IN A WHILE: THE
BUSINESS COUNCIL AND THE TRIAL LAWYERS. HOW OFTEN DO YOU SEE THEM
ON THE SAME MEMOS? UNITED FEDERATION OF TEACHERS, THE NATIONAL
FEDERATION OF INDEPENDENT BUSINESSES AND THE NEW YORK STATE UNITED
TEACHERS, THE CIVIL SERVICE EMPLOYEES ASSOCIATION, AN ORGANIZATION
KNOWN AS HEALTHCARE FOR ALL OF NEW YORK [SIC], THE MUNICIPAL LABOR
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COMMITTEE, AND SEVERAL OTHER ORGANIZATIONS HAVE INDICATED THEIR
SUPPORT. THERE'S NO QUESTION. EVERY TIME WE TAKE UP A PIECE OF
LEGISLATION THERE ARE BODIES IN SUPPORT AND THERE ARE BODIES IN
OPPOSITION. IN THIS INSTANCE, IF WE'RE GOING TO PUT THEM ON THE SCALE,
FORGETTING THE WEIGHT OF THE EVIDENCE, THE WEIGHT OF THE WITNESSES,
CERTAINLY INDICATES THAT THERE'S MUCH BROADER SUPPORT THAN THERE IS
OPPOSITION FOR THIS BILL.
MR. WALCZYK: I -- I APPRECIATE THAT AND
UNDERSTAND THAT THERE ARE, ON ANY ISSUE, YOU KNOW, TWO VOICES AND --
AND OFTEN OPPOSING VOICES THAT WE'LL HEAR IN THIS CHAMBER. AND IF THE
SPONSOR WOULD CONTINUE TO YIELD, I WONDER IF YOU'VE HEARD FROM THE --
THE GREAT SAMARITAN MEDICAL CENTER IN WATERTOWN, NEW YORK, WHETHER
THEY HAD THE OPPORTUNITY TO REVIEW THE AMENDMENTS OF THIS BILL AND
WHETHER THEY WOULD SUPPORT OR OPPOSE IT.
MR. CAHILL: I -- I WOULD POINT OUT, MR. SPEAKER
AND MY COLLEAGUES, THAT -- THAT THESE HOSPITALS THAT YOU'VE MENTIONED,
THAT HAVE BEEN MENTIONED HERE TODAY, ARE -- ARE REPRESENTED BY AN
INCREDIBLY EFFECTIVE ORGANIZATION. ONE THAT IS HEARD FROM ON -- ON A
NUMBER OF DIFFERENT ISSUES AND HAVE BEEN HEARD FROM ON THIS. IT IS MY
ASSUMPTION THAT THAT ASSOCIATION DID WHAT THEY DO WELL, AND THAT IS TO
COMMUNICATE BOTH WAYS; BACK TO THE HOSPITAL AND THEN BACK TO US,
WHAT THE -- WHAT THE CONSENSUS WAS OF THEIR MEMBERSHIP.
MR. WALCZYK: SO YOU -- YOU HAVE HAVEN'T HEARD
SPECIFICALLY FROM SAMARITAN MEDICAL CENTER ON THE -- ON THE
AMENDMENTS OF THIS BILL, THEN?
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MR. CAHILL: I HAVE NOT, BUT GUESS WHAT? YOU'VE
GIVEN US ENOUGH TIME FOR ME TO TELL YOU WHO'S ON THE WORK GROUP. SO,
THE WORK GROUP CONSISTED OF PHYSICIANS, CONSUMER GROUPS, BUSINESSES
AND OTHER PROVIDERS. HOSPITALS WERE NOT ON THE WORK GROUP, PER SE, BUT
THEY DID WEIGH IN.
MR. WALCZYK: OKAY. SO THIS -- THIS 2017 WORK
GROUP DIDN'T HAVE ANY HOSPITAL REPRESENTATION ON IT?
MR. CAHILL: THE WORK GROUP, TO THE BEST OF MY
KNOWLEDGE - AND AGAIN, I'M DOING THIS SORT OF SEAT-OF-THE-PANTS HERE -
DID NOT HAVE AN OFFICIAL REPRESENTATION FROM THE HOSPITALS, BUT THE
HOSPITALS WERE HEARD FROM AT THE WORK GROUP, AS WERE A NUMBER OF
OTHER PARTIES.
MR. WALCZYK: AND I'M -- I'M UNDERSTANDING --
TELL ME IF I'M WRONG -- YOU WEREN'T ON THE WORK GROUP EITHER?
MR. CAHILL: NO. I WAS CERTAINLY NOT ON THE WORK
GROUP.
MR. WALCZYK: WELL, THAT'S A -- THAT'S A BOLD
MOVE, CARRYING A PIECE OF LEGISLATION LIKE THIS. I -- I CERTAINLY WOULDN'T
WANT TO CARRY A BILL FORWARD IF I HADN'T BEEN -- YOU KNOW, HAVE A GOOD
KNOWLEDGE OF WHERE IT CAME FROM OR BEEN A PART OF THE CONVERSATIONS
WITH THE IMPACT THAT IT -- IT WOULD HAVE. BUT MAYBE IF YOU'VE -- IF
YOU'VE HAD ENOUGH TIME TO RESEARCH WITH SOME OF THE STAFF ON THE SIDE,
THEY COULD ENLIGHTEN BOTH YOU AND I AS TO WHETHER RIVER HOSPITAL IN
ALEXANDRIA BAY, NEW YORK WOULD BE IMPACTED BY THIS LEGISLATION.
WHETHER THEY'VE SEEN THE RECENT AMENDMENTS TO IT AND WHAT THE IMPACT
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WOULD BE ON RIVER HOSPITAL IN ALEXANDRIA BAY, RIGHT IN THE FRONT YARD
OF AMERICA.
MR. CAHILL: SURE. MR. SPEAKER, I CANNOT ADDRESS
HOW ONE INDIVIDUAL HOSPITAL WOULD BE IMPACTED BY THIS BILL AT ANY
POINT IN TIME. WHAT WE HAVE DONE IN THE BILL, HOWEVER, IS TO TAKE THOSE
HOSPITALS THAT ARE MOST IN THE PUBLIC SERVICE, MOST RELIANT UPON
GOVERNMENT DOLLARS - THAT IS OUR HOSPITALS THAT ARE SERVING 60 PERCENT OR
MORE MEDICAID - AND WE HAVE EXCLUDED THEM. SO IF ONE OF THOSE
HOSPITALS FITS INTO THAT CHARACTERIZATION, THEY WOULD BE EXCLUDED FROM
THIS PROCESS. AND LET ME ALSO POINT OUT, IF THAT HOSPITAL DOES NOT OFFER A
CHARGE THAT IS DIFFERENT FROM THE CHARGES THAT THEY OFFERED BEFORE, THEY
ALSO WOULD NOT BECOME PART OF THIS PROCESS. IF THAT HOSPITAL CONTINUED
- WHETHER THEY WERE IN A NETWORK OR NOT - BUT TO CHARGE WHAT WERE THE
USUAL AND CUSTOMARY CHARGES, THEY WOULD NOT BE IN THIS PROCESS. THOSE
CHARGES WOULD HAVE TO BE PAID. THAT'S WHAT THE BILL SAYS. IN TERMS OF
SPONSORING SOMETHING FOR WHICH I WAS NOT A MEMBER OF THE WORK
GROUP, I THINK WE ALMOST ALWAYS DO THAT HERE. RARE IS THE TIME THAT WE
GET THE BENEFIT OF SERVING ON THE GROUPS THAT WE APPOINT TO DO SOME OF
THE DETAILED WORK. AND I WOULD POINT OUT TO MY COLLEAGUE, MR.
SPEAKER, THAT THIS LEGISLATION, ALTHOUGH CARRIED IN THIS HOUSE BY ME
HERE TODAY, HAS BEEN CARRIED BY MY COLLEAGUE, SENATOR SEWARD, IN THE
SENATE IN THE TIMES IN THE PAST, IS CURRENTLY BEING SPONSORED BY SENATOR
BRESLIN IN THAT HOUSE. AND IN NATIONAL ORGANIZATIONS, WE HAVE HAD
STRONG BIPARTISAN NEW YORK STATE SUPPORT FOR LEGISLATION AND MODEL
LEGISLATION EXACTLY LIKE THIS.
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NYS ASSEMBLY JUNE 5, 2019
ACTING SPEAKER AUBRY: YOUR TIME IS EXPIRED.
MR. WALCZYK: IS THERE ANY ONE ELSE?
ACTING SPEAKER AUBRY: OH, BOY.
(LAUGHTER)
MS. PAULIN.
MS. PAULIN: THANK YOU. I THINK THIS -- YOU KNOW,
IT'S END OF SESSION. LOTS OF THINGS HAPPEN END OF SESSION, AS WE'VE
LEARNED TODAY. AND ONE OF THE THINGS THAT I HAVE SEEN BEFORE, HAVING
BEEN HERE FOR AS LONG AS I HAVE, THAT SOME OF YOU MIGHT NOT HAVE, IS
WHEN A GROUP OF MAJORITY MEMBERS GET UP UNITED AND BELIEVE THAT
SOMETHING IS HURTING THEIR COMMUNITY, YOU -- I THINK -- I THINK I'VE
SEEN IT ONLY, ACTUALLY WHEN I THINK ABOUT IT, ONCE. AND THAT DEBATE WAS
JUST LIKE THIS ONE, EXCEPT IT WAS THE MIDDLE OF THE NIGHT. YOU KNOW,
THOSE OF US WHO REMEMBER THAT. AND IT WAS SPEEDED THROUGH JUST LIKE
THIS ONE, AND SOME OF US LISTENED AND DECIDED THAT IT WAS MORE
IMPORTANT THAN THE INTEREST GROUPS THAT WERE DISCUSSED, THAT ARE
SUPPORTING IT, TO SUPPORT THEIR COLLEAGUE BECAUSE THEY UNDERSTOOD THAT IT
COULD HAPPEN TO THEM. AND LET ME TELL YOU, MY COLLEAGUES, IT IS
HAPPENING TO US IN WESTCHESTER COUNTY. LET ME TELL YOU ABOUT THE
MEDICAL CENTER. THE MEDICAL CENTER IS OUR ONLY TERTIARY CARE FACILITY.
THE MEDICAL CENTER IS A PUBLIC HOSPITAL THAT TAKES OUR POOREST OF THE
POOR. OUR MEDICAL CENTER IS THE PLACE THAT WHEN I WAS UP HERE AND MY
DAUGHTER WAS HIT BY A CAR AND THE LOCAL HOSPITAL COULDN'T ACCOMMODATE
HER INJURIES, THAT TOOK HER AND MADE HER WHOLE. THAT IS THE MEDICAL
CENTER. IT IS PERSONAL. WE BELIEVE IN THIS BODY THAT HEALTHCARE IS OUR
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NYS ASSEMBLY JUNE 5, 2019
RIGHT. LOOK AT THE BILLS WE PASS. AND LOOK AT THE BILLS WE'RE PUTTING IN
JEOPARDY. IF OUR HEALTHCARE FACILITIES DO NOT GET THE RATES THAT THEY NEED
TO SUCCEED -- AND I CAN TELL YOU, OUR MEDICAL CENTER IS NOT GOING TO
SUCCEED IF THE RATES AREN'T UP TO WHAT THEY NEED TO BE AND THIS BILL GOES
THROUGH. SO OUR MEDICAL CENTER, WE WON'T HAVE A TERTIARY CARE FACILITY.
AT LEAST WE WILL NOT HAVE ONE THAT HAS A BURN CENTER AND HAS A
CHILDREN'S HOSPITAL. WE WILL NOT HAVE A MEDICAL CENTER THAT COULD HAVE
ACCOMMODATED MY DAUGHTER. WE WILL NOT HAVE A MEDICAL CENTER THAT
WHEN WE PASS SAFE STAFFING, THAT THEY CAN DO. WHY? BECAUSE THEY WILL
NOT HAVE THE RATES TO PAY THE WORKERS.
SO, WE ARE GOING TO PASS LOTS OF BILLS. WE'RE GOING TO
PASS BILLS TO GIVE MORE RESOURCES TO WORKERS. WELL, YOU KNOW WHAT?
IF THEY DON'T EXIST, THEY WILL NOT GET PAID. SO WHEN WE WANT OUR NURSES
TO GET PAID MORE, WHEN WE WANT MORE NURSES, OUR MEDICAL CENTER IS
GOING TO GO UNDER. AND THEN THINK ABOUT IT. THINK ABOUT IT FROM YOUR
PERSPECTIVE. THINK ABOUT IT FROM YOUR HOSPITAL. IF YOU HAVE A PUBLIC
HOSPITAL, THIS -- THIS BILL IS GOING TO DESTROY THAT, TOO. BUT YOU KNOW
WHAT? THERE ISN'T MANY PUBLIC HOSPITALS ON THAT LIST. THERE'S ONLY TWO,
AND ONE OF THEM IS OURS. AND I AM TELLING YOU THAT THE WESTCHESTER
DELEGATION NEEDS YOUR SUPPORT IN THIS CHAMBER, BECAUSE IF IT HAPPENS
TO YOU, YOU'D WANT OURS. IT'S SO UPSETTING FOR US THAT THIS IS GOING TO
COMPLETELY DESTROY OUR HEALTHCARE. IT IS OUR HOSPITAL OF LAST RESORT. IT'S
THE PLACE WE GO WHEN WE ARE HURT. I KNOW I'M SUPPOSED TO TALK 15
MINUTES, THIS IS HARD.
YOU KNOW, LET ME TELL YOU ABOUT THE INTEREST GROUP.
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YOU KNOW, WE HEARD ABOUT THE LONG LIST OF INTEREST GROUPS THAT -- THAT
ARE --
ACTING SPEAKER AUBRY: MR. BUCHWALD, WHY
DO YOU RISE?
MR. BUCHWALD: WOULD -- WOULD THE GENTLELADY
YIELD FOR A QUESTION?
MS. PAULIN: YES, THANK YOU.
(LAUGHTER)
ACTING SPEAKER AUBRY: MS. PAULIN YIELDS,
MR. BUCHWALD.
MR. BUCHWALD: THANK YOU, MR. SPEAKER. MY
APPRECIATION TO THE LADY. COULD SHE GO IN -- COULD YOU ENLIGHTEN US AS
TO THE HISTORY OF WESTCHESTER MEDICAL CENTER AND WHY IT IS THAT
WESTCHESTER MEDICAL CENTER MIGHT HAVE HIGHER COSTS THAN OTHER AREA
HOSPITALS? AND FOR WHICH, THEREFORE, AN INDEPENDENT ARBITER
COMPARING COSTS ACROSS THE NEARBY HOSPITALS MIGHT PRODUCE A RESULT
THAT IS, IN FACT, BELOW WHAT WESTCHESTER MEDICAL CENTER NEEDS TO BE A
VIABLE INSTITUTION.
MS. PAULIN: THANK YOU. YES. AND, IN FACT, THAT
REMINDS ME THAT -- WELL, LET'S -- LET'S TALK ABOUT THE, YOU KNOW, THE
HISTORY, RIGHT? SO, THE HISTORY IS THAT A LONG TIME AGO - AS MY COLLEAGUE
TO THE SIDE OF ME MENTIONED, A LONG TIME AGO WE WERE -- THE HOSPITAL
WAS A CHARITY HOSPITAL, AND IT -- IT WAS UNSUCCESSFUL AND FALLING UNDER.
AND IT WAS VISIONARY THAT THE ELECTED OFFICIALS AT THE COUNTY AND STATE
LEVEL 30 YEARS AGO DECIDED THAT WE WANTED TO HAVE A MODEL HOSPITAL.
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AND THAT MODEL HOSPITAL DOESN'T JUST SERVE WESTCHESTER COUNTY, BY THE
WAY. IT'S THE ENTIRE HUDSON VALLEY. AND IT'S THE ONLY TERTIARY HOSPITAL
UP UNTIL THE ALBANY MEDICAL CENTER RIGHT HERE. SO THAT WHOLE
CATCHMENT AREA IS SERVED BY THE MEDICAL CENTER. THEY DECIDED THEY
WANTED TO HAVE A GREAT HOSPITAL. AND SO WITH COUNTY SUPPORT, WE GOT
THERE. AND IT WAS AT GREAT COUNTY EXPENSE. A LOT OF TAXPAYER MONEY
WENT INTO MAKING THAT A FINE HOSPITAL. AND NOW -- AND NOW WE ARE
FINALLY -- WE HAD -- WE LEARNED -- WE -- YOU KNOW, WE ARE FINALLY
SOLVENT WITHOUT TAXPAYER EXPENSE. AND WE'RE GOING TO GO BACK ON
TAXPAYER EXPENSE. BUT MAYBE NOT, BECAUSE OUR TAXPAYERS CANNOT
AFFORD IT. CERTAINLY NOT WITH THE 2 PERCENT CAP, TO BE ABLE TO -- TO GIVE
THEM THE RESOURCES THAT THEY HAD BEEN GIVING THEM, WHICH WAS $30-
AND $40- AND $50- AND $60 MILLION A YEAR. WE ARE DOWN TO ZERO. WE
ARE DOWN TO A SELF-SUSTAINING HOSPITAL. AND LET ME TELL YOU, THE INTEREST
GROUPS. THE INTEREST GROUP THAT WE RECEIVED A MEMO FROM WAS 1199.
WHY? BECAUSE THEY ARE THE WORKERS AT THE HOSPITAL, TO YOUR POINT. TO
YOUR POINT, WHEN WE FORMED THE MEDICAL CENTER AND WE WENT FORWARD
AND WE MADE THEM A PUBLIC BENEFIT CORPORATION, WE MADE SURE THAT THE
WORKERS GOT THE -- THE -- THE -- THAT THEY WERE UNIONIZED. SOMETHING
THAT OUR HOUSE CHERISHES. WE MADE SURE THAT THEY RECEIVED MINIMAL
PAY SO THAT BECAUSE OF THAT -- THOSE CONTRACTUAL OBLIGATIONS THAT WE, AT
THE STATE, PUT ON THE MEDICAL CENTER, BECAUSE WE DECIDED -- WE KNEW
THAT WE WANTED TO PROTECT THOSE WORKERS, IT -- IT COSTS MORE. AND WHEN
IT COSTS MORE, THEY NEED HIGHER RATES. AND IF THEY DON'T GET THE HIGHER
RATES, 1199, THESE WORKERS, THE NURSES, THEY'RE GOING UNDER. THEY'RE
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LOSING THEIR JOBS. THAT IS SOMETHING THAT WE NEED TO PROTECT. IT IS -- IT
IS JUST A -- A VERY UPSETTING SITUATION FOR US IN THIS DELEGATION. YOU'RE
GOING TO HEAR EACH OF US TALK ABOUT IT. AND I APOLOGIZE, BECAUSE I
KNOW THAT WE WANT TO BE SOMEWHERE ELSE TONIGHT. BUT THIS IS SO
IMPORTANT TO US. YOU CANNOT BELIEVE HOW IMPORTANT THIS PARTICULAR
INSTITUTION IS TO THIS COMMUNITY AND TO THIS DELEGATION. SO, YOU KNOW
WHAT? I CAN'T USE MY 15 MINUTES UNLESS, DAVID, YOU HAVE ANOTHER
QUESTION.
MR. BUCHWALD: WELL, ACTUALLY -- IF I -- IF I COULD,
COULD I ASK, MR. SPEAKER, IS IT THE RIGHT OF ANY MEMBER RIGHT NOW TO
MOVE TO ADJOURN UNTIL 10:00 A.M. TOMORROW?
ACTING SPEAKER AUBRY: LEARNED COUNSEL IS
GOING TO ADVISE ME ON THIS ONE.
MRS. PEOPLES-STOKES, AS WE --
MRS. PEOPLES-STOKES: MR. SPEAKER, THANK YOU
FOR REMINDING OUR COLLEAGUE WHERE WE ARE AT THIS POINT. WE'RE IN THE
MIDDLE OF DEBATE. IF HE WANTS TO CONTINUE IT, HE COULD DO THAT. BUT HE'S
NOT GOING TO BE IN A POSITION TO DETERMINE WHAT WE HAVE ON THE FLOOR.
MR. BUCHWALD: MR. SPEAKER, IF I COULD, I DID NOT
MAKE THE MOTION, I SIMPLY INQUIRED --
ACTING SPEAKER AUBRY: I DID --
MR. BUCHWALD: -- WHETHER IT WAS THE RIGHT OF
ANY MEMBER --
ACTING SPEAKER AUBRY: I DID UNDERSTAND YOUR
QUESTION.
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MR. BUCHWALD: OKAY. I'M JUST CLARIFYING.
THANK YOU, MR. SPEAKER.
ACTING SPEAKER AUBRY: THE MOTION WOULD BE
IN ORDER.
MR. BUCHWALD: THANK YOU, MR. SPEAKER. BUT TO
ASK MY COLLEAGUE --
ACTING SPEAKER AUBRY: YOU CANNOT,
HOWEVER, BECAUSE YOU DON'T HAVE THE FLOOR.
MR. BUCHWALD: I -- I UNDERSTAND THAT. THANK
YOU, MR. SPEAKER. I -- I WOULD JUST -- TO CONTINUE MY LINE OF
QUESTIONING WITH MY SECOND QUESTION. IS IT, IN FACT, THE CASE THAT
WESTCHESTER MEDICAL CENTER IS BY NO MEANS UNIQUE IN BEING IMPACTED
BY THIS PIECE OF LEGISLATION?
MS. PAULIN: WE ARE NOT UNIQUE IN BEING IMPACTED
BY THIS LEGISLATION. HOWEVER, BECAUSE WE'RE A PUBLIC HOSPITAL, WE ARE
IN A DIFFERENT SITUATION THAN THE PRIVATE HOSPITALS. BUT WE ARE NOT
UNIQUE. AND I WILL JUST POINT OUT THAT IF ANYBODY IS WORRIED ABOUT THE
FINANCIAL STRAIGHTS OF THEIR HOSPITAL AND THEY ARE ONE OF THE HUNDRED THAT
ARE INCLUDED, THEN THEY ARE IN JEOPARDY, TOO. AND SINCE WHEN DO WE
PUT THE INSURANCE COMPANY'S ABILITY TO MAKE MONEY -- BECAUSE WE HAVE
NO GUARANTEE. LET ME JUST MAKE THAT POINT. WE HAVE NO GUARANTEE.
THERE'S NOTHING IN THIS BILL THAT SAYS ANY SAVINGS IS GOING TO GO --
ACTING SPEAKER AUBRY: MS. PAULIN, FOR ONE
MINUTE. JUST ONE MINUTE.
(BANGING GAVEL)
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LADIES AND GENTLEMEN, WE HAVE SOME COMPLAINT FROM
MEMBERS WHO ARE TRYING TO LISTEN TO THE DEBATE THAT THE CONVERSATIONS
THAT ARE GOING ON OUR DROWNING OUT THEIR ABILITY TO LISTEN. SO, I SUGGEST
IF YOU'RE A MEMBER AND YOU HAVE SOMETHING TO SAY TO ANOTHER MEMBER,
ASK THEM TO LEAVE THE CHAMBER WITH YOU AS OPPOSED TO HAVING THE
CONVERSATION WHERE YOU STAND. AND I ALSO SUGGEST THAT MEMBERS TAKE
THEIR SEATS AND DON'T WAIT ME OUT.
I'M SORRY, MS. PAULIN. PLEASE PROCEED.
MS. PAULIN: SO, IN THE LEGISLATION, YOU KNOW,
WE'VE BEEN PROMISED A REDUCTION OF INSURANCE COSTS. THERE'S NOTHING
IN THE LEGISLATION TO GUARANTEE THAT. THERE'S NOTHING IN THE LEGISLATION
THAT SAYS WHERE THAT MONEY GOES. SO IT'S POSSIBLE, BECAUSE THESE ARE A
LOT OF PRIVATE INSURANCE -- THIS ISN'T ALSO LIMITED TO JUST ONE INSURANCE
COMPANY, IT'S ALL THE INSURANCE COMPANIES. SO ALL OF THE INSURANCE
COMPANIES ARE NOW GOING TO GET A BENEFIT. THEY'RE ALL GOING TO GET
MONEY, EXTRA MONEY OFF THE BACKS OF OUR INSTITUTIONS THAT PAY OUR
NURSES AND PAY OUR DOCTORS. AND SO WHEN OUR DOCTORS FLEE AND OUR
NURSES FLEE BECAUSE THEY DON'T HAVE MONEY, THE INSURANCE COMPANIES
WILL HAVE IT. OKAY, SO YOU SAY WHERE IS THE INSURANCE MONEY GOING TO
GO? WELL, IT DOESN'T SAY IT IN THE BILL. IT DOESN'T SAY IT'S GOING TO GO
BACK INTO HEALTHCARE. IT DOESN'T SAY IT'S GOING TO GO BACK INTO THE
CONSUMER'S POCKET IN ANY WAY. THERE'S NO GUARANTEE IT DOES THAT. SO --
SO HERE YOU HAVE A PROMISE OR AN EXPECTATION THAT SOMEHOW IT'S GOING
TO LOWER HEALTHCARE COSTS. WELL, I CAN TELL YOU, IT'S NOT GOING TO LOWER
HEALTHCARE COSTS. IT'S GOING TO DESTROY HEALTHCARE. AND IT'S STARTING FIRST
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NYS ASSEMBLY JUNE 5, 2019
IN OUR COUNTY. SO -- SO -- BUT IF YOU HAVE A HOSPITAL ON THAT LIST, I
WOULD WORRY. AND I WOULD LOOK BEFORE I TOOK THIS VOTE, BECAUSE LET
ME TELL YOU, WHEN YOUR HOSPITAL GOES DOWN IN A FEW YEARS BECAUSE OF
THE NEGOTIATIONS, IT'S GOING TO BE BECAUSE OF THIS AND IT'S GOING TO COME
BACK TO, DID YOU VOTE FOR THAT BILL? BECAUSE THIS HOSPITAL IS NOW IN
JEOPARDY. DID YOU VOTE FOR THAT BILL? BECAUSE NOW WE CAN'T PAY OUR
NURSES. DID YOU VOTE FOR THAT BILL? BECAUSE WE'RE CLOSING OUR
CHILDREN'S CENTER. DID YOU VOTE FOR THAT BILL? BECAUSE WE CAN'T HAVE
A BURN CENTER. DID YOU VOTE FOR THAT BILL? BECAUSE NOW WE CAN'T DO --
WE CAN'T ADDRESS HEART FAILURE. DID YOU VOTE FOR THAT BILL? BECAUSE
YOU KNOW WHAT? WE DON'T HAVE THE TECHNOLOGY, THE NEW TECHNOLOGY
ANYMORE. YOU KNOW, THAT'S WHAT IT'S GOING TO COME DOWN TO, BECAUSE
THIS BILL TAKES MONEY OUT OF HEALTHCARE. IT DOES NOT PUT MONEY INTO
HEALTHCARE.
MR. BUCHWALD: IF THE LADY WOULD CONTINUE TO
YIELD. IS THERE ANYTHING IN THIS BILL THAT DIRECTS THE ARBITER SETTING PRICES
TO TAKE INTO ACCOUNT WHAT SERVICES THE HOSPITAL PROVIDES OTHER THAN THE
ONE THAT'S PARTICULARLY AT ISSUE IN THE -- IN THE PRICING DISPUTE? IN OTHER
WORDS, IF A HOSPITAL PROVIDES SIGNIFICANT BUT BELOW 60 PERCENT
MEDICAID AND UNINSURED COVERAGE, THE -- OR SERVICES -- IF THE HOSPITAL
ALSO PROVIDES THESE UNIQUE BUT HIGH-COST, LOW-PROFIT ENDEAVORS, IS THERE
ANYTHING WHICH THE ARBITER IS SUPPOSED TO TAKE THAT INTO ACCOUNT UNDER
THIS BILL?
MS. PAULIN: NO. AND SO, IN FACT, WE -- IT DOESN'T
SAY, AND WE DON'T KNOW WHAT THAT PROCESS IS GOING TO BE LIKE. IT
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DOESN'T -- IT'S NOT DEFINED. IT'S BRAND-NEW. WE DON'T REALLY KNOW IF THE
PEOPLE CHOSEN AND THE PEOPLE THAT ARE GOING TO BE IMPLEMENTING IT ARE
GOING TO HAVE ANY EMPATHY TOWARD THE FACT THAT THE MEDICAL CENTER HAS
THESE EXTRA SERVICES OR THAT ANY HOSPITAL HAS EXTRA SERVICES. WE REALLY
DON'T KNOW WHAT THE PROCESS IS GOING TO BE. SO, YOU KNOW, WE CANNOT
FEEL CONFIDENT THAT GOING FORWARD, THAT OUR INSTITUTIONS THAT ARE
PROVIDING THESE EXTRA SERVICES ARE GOING TO BE PROTECTED IN -- IN ANY
WAY. AND, YOU KNOW, I WOULD JUST WONDER -- YOU KNOW, BECAUSE THE
BILL HAS CHANGED SO DRAMATICALLY, YOU KNOW, FROM LAST YEAR WHEN IT WAS
JUST EMERGENCY SERVICES AND NOT OTHER SERVICES, AND WHEN THERE WEREN'T
AN ARBITRARY CAP OF 60 PERCENT MEDICAID SET. YOU KNOW, SINCE THOSE
WERE SUCH DRAMATIC CHANGES, WERE THOSE CHANGES THAT THE WORK GROUP
IN 2017, WHICH MIGHT HAVE RECOMMENDED THE LEGISLATION FROM 2018 --
DID THAT WORK GROUP SUGGEST THAT? YOU KNOW, OR WERE THESE ADDED --
YOU KNOW, I WOULD ARGUE LIKELY ADDED IN ORDER TO ELIMINATE SOME
HOSPITALS FROM THAT LIST. THAT MIGHT BE A POLITICAL PROBLEM FOR PASSING
THIS BILL. SO, YOU KNOW -- SO WE ARE NOW -- WE NOW HAVE 100 HOSPITALS
IN JEOPARDY. LUCKILY, WE HAVE A NUMBER THAT ARE NOT. BUT ONE YEAR
MAYBE YOUR HOSPITAL IS GOING TO GET INCLUDED, AND THEN MAYBE NOT THE
NEXT YEAR. SO YOU DON'T KNOW WHEN YOU'RE GOING TO BE IN JEOPARDY FOR
-- FOR THESE KINDS OF DRACONIAN METHODS TO PUT THE ONUS OR TO GET IN THE
MIDDLE OF THE NEGOTIATIONS, WHICH WE HAVE NEVER, NEVER DONE. WE
HAVE NEVER DECIDED THAT WE ARE GOING TO PASS A BILL IN THE MIDDLE OF
NEGOTIATIONS -- MOUNT SINAI, NYU, THE MEDICAL CENTER. THEY'RE ALL --
ACTING SPEAKER AUBRY: MS. --
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NYS ASSEMBLY JUNE 5, 2019
MS. PAULIN: -- IN THE MIDDLE OF THEIR NEGOTIATION --
ACTING SPEAKER AUBRY: MS. PAULIN --
MS. PAULIN: -- AND WE'RE DOING A BILL TO JEOPARDIZE
THAT.
ACTING SPEAKER AUBRY: YOU HAVE
SUCCESSFULLY DONE YOUR 15 MINUTES.
MS. PAULIN: THANK YOU VERY MUCH.
ACTING SPEAKER AUBRY: YOU'RE WELCOME.
(LAUGHTER)
MR. ABINANTI.
MR. ABINANTI: THANK YOU, MR. SPEAKER. TO MY
COLLEAGUES FIRST --
ACTING SPEAKER AUBRY: SIR, I PRESUME THIS IS
ON THE BILL?
MR. ABINANTI: YES, ON THE BILL, SIR.
ACTING SPEAKER AUBRY: THANK YOU.
MR. ABINANTI: YOU'RE HEARING FROM THE
WESTCHESTER DELEGATION, BUT THIS IS NOT JUST ABOUT WESTCHESTER. THE
BILL GOT OUR ATTENTION BECAUSE OF THE DIRECT IMPACT ON WESTCHESTER'S
MEDICAL CENTER. AND BECAUSE THE ADVOCATE FOR EMPIRE, EMPIRE
INSURANCE COMPANY, ADMITTED TO US IN A CONVERSATION THAT HIS
INSURANCE COMPANY WAS TARGETING THE WESTCHESTER COUNTY MEDICAL
CENTER. BUT AS YOU KNOW, I SPEND A LOT OF TIME READING LEGISLATION AND
ANALYZING LEGISLATION, MUCH TO THE CHAGRIN OF MANY PEOPLE IN THIS -- IN
THIS LEGISLATURE. BUT I WANT TO ASSURE YOU, THIS IS NOT A GOOD BILL. THIS
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IS NOT JUST ABOUT THE WESTCHESTER MEDICAL CENTER. THIS IS A BAD BILL.
THIS BILL WOULD BE BETTER NAMED "THE INSURANCE COMPANY PROFIT
ENHANCEMENT ACT." THE INSURANCE COMPANY PROFIT ENHANCEMENT ACT.
THE PREMISE OF THIS BILL IS THAT THE BEST WAY TO REDUCE THE HIGH
INSURANCE RATES IS TO TURN OVER HEALTHCARE TO THE INSURANCE COMPANIES.
THIS BILL IS GOING TO ALLOW INSURANCE COMPANIES TO SET PRICES. SOME OF
US MIGHT THINK IT'S A GOOD IDEA TO HAVE PRICE CONTROLS. I'VE HEARD
NOBODY EVER SUGGEST THAT WE LET THE INSURANCE COMPANIES SET THE PRICE
CONTROLS. THAT'S WHAT THIS BILL DOES. IT'S A VERY SIMPLE BILL. IT INSURE --
INSERTS HOSPITALS NEXT TO PHYSICIANS IN A BILL THAT WE PASSED A WHILE AGO.
AND SOME PEOPLE ARE TRYING TO SAY WE CAN TREAT HOSPITALS THE WAY WE
TREAT PHYSICIANS. I RESPECTFULLY SUGGEST THAT ANYBODY THAT KNOWS
ANYTHING ABOUT HEALTHCARE KNOWS THERE'S A BIG DIFFERENCE BETWEEN
PHYSICIANS AND HOSPITALS; THE WAY THEY'RE FINANCED, THE WAY THEY
FUNCTION, THEIR OBLIGATIONS. PUBLIC HOSPITALS HAVE TO TAKE ANYBODY THAT
WALKS IN THE DOOR. PHYSICIANS DON'T HAVE TO DO THAT. THAT PUTS THEM IN
A VERY DIFFICULT SITUATION, ESPECIALLY IF THEY TAKE A LOT OF MEDICAID
PATIENTS OR THEY'RE IN A SITUATION WHERE THEY'RE AVAILABLE TO MEDICAID
PATIENTS.
BUT I WANT TO TALK A LITTLE BIT ABOUT WHAT THIS BILL DOES
AND DOESN'T DO, SO THAT THOSE OF YOU WHO WANT TO VOTE NO WILL
UNDERSTAND THAT THIS IS NOT JUST SEVEN OF US ASKING YOU TO VOTE NO. THAT
THIS IS A BAD BILL. IT'S BAD POLICY, AND IT'S BADLY DRAFTED. WHAT IT DOES IS
IT ALLOWS INSURANCE COMPANIES TO REJECT OUT-OF-NETWORK HOSPITAL BILLS
FOR INPATIENT SERVICES WHICH FOLLOW AN EMERGENCY ROOM VISIT. AND IT
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NYS ASSEMBLY JUNE 5, 2019
REQUIRE -- IT ALLOWS THE INSURANCE COMPANY TO REQUIRE THAT THE BILL BE
SUBMITTED TO AN INDEPENDENT DISPUTE RESOLUTION ENTITY. NOW, YOU
MIGHT BE IN FAVOR OF THE BASEBALL MODEL, BUT THINK ABOUT HOW THAT
APPLIES TO A HOSPITAL. THIS WAS, I BELIEVE, MOTIVATED BY EMPIRE. BUT
HOW MANY HEALTH INSURANCE COMPANIES ARE THERE IN THE -- IN THE STATE?
SO IF ONE HOSPITAL FINDS THAT EVERY ONE OF THE INSURANCE COMPANIES
DECIDES NOT TO LET THEM INTO NETWORK BECAUSE THEY MAY BE AN EXPENSIVE
HOSPITAL OR BECAUSE THEY'RE FOLLOWING THE DICTATES OF THEIR NATIONAL
PARENT THAT HAS ANNOUNCED PUBLICLY THAT THEY ARE NOW GOING TO TRIM
DOWN THEIR NETWORKS. SO THEY MAY DECIDE THIS HOSPITAL'S TOO
EXPENSIVE, WE'RE GOING TO USE THE LESS EXPENSIVE HOSPITAL. AND UNDER
THIS BILL WE CAN CHALLENGE EVERY BILL THAT WE DON'T LIKE FOR SOMEBODY
WHO IS ADMITTED AFTER AN EMERGENCY. THE BILL THAT WE HAVE PASSED YEAR
AFTER YEAR AFTER YEAR APPLIED ONLY TO EMERGENCY SERVICES. NOT TO THE
SERVICES AFTER THE EMERGENCY. NOT TO THE ADMISSION AFTER THE
EMERGENCY. THAT'S A VERY BIG DIFFERENCE. AND FOR AN EMERGENCY-TYPE
HOSPITAL, THAT'S A VERY EXPENSIVE DIFF -- DIFFERENCE. SO, THIS IS NOT THE
SAME BILL THAT WE PASSED YEAR AFTER YEAR AFTER YEAR, SO DON'T BE MISLED.
THE HOSPITALS WANT YOU TO THINK THAT IT IS. BUT THIS IS A GIMMICK FOR THE
-- FOR THE INSURANCE COMPANIES TO DECIDE NOT TO PUT HOSPITALS IN A
NETWORK AND THEN GET THE NETWORK RATE. BECAUSE THEY'RE GOING TO GO TO
THE IDR, THE INDEPENDENT REVIEW, AND THEY'RE GOING TO SAY CUSTOMARY
FOR THIS HOS -- FOR THIS IS WHAT WAS OUR RATE IN-NETWORK, OR WHAT THE GUY
DOWN THE STREET CHARGES. AND THAT MAY NOT BE APPROPRIATE. SO THIS IS A
BILL THAT'S DESIGNED TO HELP THE INSURANCE COMPANIES, EITHER BECAUSE
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NYS ASSEMBLY JUNE 5, 2019
THEY DON'T WANT TO PUT A HOSPITAL IN-NETWORK AND THEY WANT THE NETWORK
RATE, OR IN THEIR NEGOTIATIONS. THEY CAN THREATEN THE HOSPITAL, YOU'D
BETTER GIVE US A BETTER DEAL OR WE'RE GOING TO END UP WITH A DEAL. AND
YOU'RE NOT GOING TO GET ANYTHING BECAUSE WE'RE GOING TO BE ABLE TO USE
THIS -- THIS BILL, THIS LEGISLATION, TO HARASS YOU. SO THIS IS NOT A PATIENT
PROTECTION BILL. THIS IS AN INSURANCE COMPANY PROTECTION BILL. IT'S AN
ENHANCEMENT OF THEIR -- OF THEIR INSURANCES AND THEIR PROFITS.
BY THE WAY, IT'S INTERESTING TO NOTE, AS I SAID BEFORE,
THAT THIS IS A PRICE FIXING -- THIS ALLOWS THE INSURANCE COMPANIES, IN
EFFECT, TO FIX PRICES. AND LET ME ASK YOU, HOW MANY PEOPLE IN YOUR
DISTRICT THINK THAT INSURANCE COMPANIES ARE KNOWN AS CONSUMER-
FRIENDLY? AREN'T WE CONSTANTLY COMPLAINING THAT INSURANCE COMPANIES
ARE REJECTING CLAIMS OF OUR -- OF OUR CONSTITUENTS? EVERY TIME YOU TURN
AROUND, YOU'RE GETTING ONE OF THOSE COMPLICATED THINGS IN THE MAIL
SAYING, WE'RE NOT PAYING THIS, WE'RE NOT PAYING THAT. WE'RE NOT PAYING
THIS, WE'RE NOT PAYING THAT. THEY DON'T TELL YOU WHY. YOU HAVE TO TRY
TO FIGURE IT OUT BY MATCHING UP BILLS. BUT THAT'S WHAT INSURANCE
COMPANIES DO. DO WE THINK THEY'RE GOING TO BE ANY DIFFERENT WITH THE
HOSPITALS IF WE TURN THEM LOSE? DO WE THINK THAT THEY'RE GOING TO BE
GENTLER WITH A HOSPITAL THAT -- THAT NOW HAS SOMEBODY RUSHED IN IN AN
AMBULANCE, EMERGENCY SURGERY, AND THEN HAS TO STAY IN THAT HOSPITAL FOR
TEN DAYS? DO YOU THINK THEY'RE GOING TO PAY THAT BILL WILLINGLY IF THEY
HAVE A WAY AROUND IT?
YOU KNOW, THERE WAS A REFERENCE, BY THE WAY, TO THE
SPONSOR OF THIS BILL TO A WORK GROUP. I'M NOT FAMILIAR WITH THAT WORK
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NYS ASSEMBLY JUNE 5, 2019
GROUP, BUT THIS IS A NEW BILL. I DIDN'T HEAR ANY ASSURANCE THAT THE WORK
GROUP ACTUALLY CONSIDERED THIS BILL, OR WAS THE WORK GROUP TALKING
ABOUT LAST YEAR'S BILL, WHICH WE PASSED UNANIMOUSLY. AND BY THE WAY,
YES, THE SENATE HAS HAD THIS BILL AND WE'VE PASSED IT FOUR TIMES. BUT
CURIOUSLY, THE SENATE NEVER PASSED THE BILL. NOW, THOSE OF US WHO'VE
BEEN AROUND FOR A WHILE UNDERSTAND THAT THE, LET'S SAY, THE SENATE WAS A
LITTLE BIT FRIENDLIER TO INSURANCE COMPANIES THAN WE'VE BEEN IN THE PAST,
AND YET IT NEVER PASSED THE SENATE. BECAUSE THE SPONSORS IN THE SENATE
REALIZED THAT IF THERE'S GOING TO BE A BATTLE BETWEEN THE INSURANCE
COMPANIES AND THE HOSPITALS, THEY WERE GOING TO GO WITH THE HOSPITALS.
AND I RESPECTFULLY SUGGEST, SO SHOULD WE. THIS IS GIVING LEVERAGE TO
THE INSURANCE COMPANIES THAT THEY DON'T DESERVE, OVER EVERY HOSPITAL IN
EVERY ONE OF OUR DISTRICTS. YOU MAY NOT BE HEARING FROM THEM NOW
BECAUSE THEY MAY NOT REALIZE WHAT'S HAPPENING HERE. AND MOST OF
THEM HAVE CONTRACTS WITH INSURANCE COMPANIES, SO THEY'RE IN THE
NETWORK. BUT IF THEY CAN TAKE ON A BIG MEDICAL CENTER LIKE WESTCHESTER
MEDICAL CENTER AND GET THE SUPPORT OF THE NEW YORK STATE ASSEMBLY
IN THAT EFFORT, WHAT CHANCE DOES MASSENA HOSPITAL HAVE, OR WHAT
CHANCE DOES ANY OF THE OTHER HOSPITALS IN THE STATE HAVE; THE SMALL,
LOCAL HOSPITALS, WHEN THE INSURANCE COMPANY COMES IN AND SAYS, SCREW
YOU. WE'RE NOT CUTTING A DEAL WITH YOU UNLESS YOU GIVE US EXACTLY WHAT
WE WANT.
YOU KNOW, I FIND IT INTERESTING THAT THIS IS BEING
PROMOTED AS SOME KIND OF A CONSUMER BENEFIT. IF IT'S SUCH A GREAT
CONSUMER BENEFIT, WHY ARE WE NOT APPLYING IT TO ALL OF THE HOSPITALS?
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NYS ASSEMBLY JUNE 5, 2019
WHY SHOULD THIS BILL NOT APPLY TO EVERY HOSPITAL? WHY ARE WE SAYING
ONLY -- ONLY 100 OF THE HOSPITALS AND NOT A 140? WHY HAVE WE CARVED
OUT 40 HOSPITALS? WELL, THE SPONSOR EARLIER, I BELIEVE, SAID SOMETHING
ABOUT WELL, SOMEBODY MADE A DETERMINATION THAT THOSE HOSPITALS
NEEDED THE INSURANCE COMPANY MONEY SO THAT THEY COULD SURVIVE AND
PAY FOR MEDICAID, MEDICAID PATIENTS. WELL, WHO DID THE ANALYSIS OF
EACH INDIVIDUAL HOSPITAL TO DETERMINE THAT THAT 60 PERCENT NUMBER WAS
THE MAGIC NUMBER? AND LET'S TALK ABOUT SOME FAIRNESS HERE. ARE WE
BEING FAIR TO ALBANY MEDICAL CENTER WHEN THEY LAST YEAR WERE 59
PERCENT MEDICAID AND THEY DIDN'T MAKE THE 60 PERCENT CUTOFF? NOW
THEY HANDLED 11,000 MEDICAID CASES. 11,000. AND YET, WE HAVE
HOSPITALS ON THIS LIST WHO ARE EXEMPTED BECAUSE THEY'RE OVER THE 60
PERCENT, HANDLED FAR FEWER MEDICAID CASES. NOW I'M NOT TALKING ABOUT
WESTCHESTER COUNTY MEDICAL CENTER, I'M TALKING ABOUT ALBANY COUNTY
[SIC] MEDICAL CENTER. AND I'VE GOT A LIST HERE IF YOU WANT TO SEE WHERE
YOUR HOSPITAL RANKS. MANY, MANY HOSPITALS THAT ARE NOT EXCLUDED HAVE
HANDLED MORE MEDICAID PATIENTS THAN THE HOSPITALS WHO ARE EXCLUDED.
SO WHERE'S THE FAIRNESS IN THIS? AND WHO SAYS THAT IN A PARTICULAR
REGION, THE MONEY THAT THE HOSPITAL IS GETTING FROM THE INSURANCE
COMPANIES AND THE OTHER SOURCES IS SUFFICIENT OR ISN'T SUFFICIENT TO PAY
FOR MEDICAID? LET ME TAKE THE HOSPITAL I KNOW, WHICH IS THE
WESTCHESTER COUNTY MEDICAL CENTER. THEY'VE HANDLED SOME 10,000
CASES LAST YEAR OF MEDICAID PATIENTS. BUT EVERY ONE OF THEM WAS A HIGH
ACUITY. WESTCHESTER COUNTY MEDICAL CENTER HAS THE HIGHEST ACUITY RATE
IN THE COUNTRY. SO THEY ARE AN EXPENSIVE HOSPITAL IN AN EXPENSIVE
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NYS ASSEMBLY JUNE 5, 2019
COUNTY. AND THE MEDICAID PATIENTS WHO GO THERE DON'T GO THERE
BECAUSE THEY HAVE A COLD. THEY GO THERE BECAUSE THEY HAVE A SERIOUS
PROBLEM. IF YOU HAVE A REGULAR PREGNANCY, YOU GO TO WHITE PLAINS
HOSPITAL, NOT THE MEDICAL CENTER. BUT IF YOU WALK INTO THE WHITE
PLAINS HOSPITAL AND WHITE PLAINS LOOKS AT YOU AND SAYS, YOU KNOW
WHAT? THIS IS GOING TO BE A TROUBLED PREGNANCY. YOU'RE GOING TO HAVE
A REAL PROBLEM, THEY PUT THEM IN AN AMBULANCE AND SEND THEM TO THE
MEDICAL CENTER. AND SO, THE MEDICAL CENTER MAY NOT HAVE MORE THAN
60 PERCENT OF ITS ADMISSIONS AS MEDICAID, BUT IT CERTAINLY HAS A LARGE
NUMBER OF PEOPLE ON MEDICAID WHO DESERVE TO GET QUALITY TREATMENT.
VERY HIGH-LEVEL TREATMENT. AND THAT'S WHAT THIS MEDICAL CENTER DOES.
AND I BET YOU, YOU CAN LOOK AROUND AT EVERY ONE OF YOUR DISTRICTS AND
YOU WILL HAVE THE EXACT SAME CIRCUMSTANCE. YOU WILL HAVE SOME
MEDICAL CENTER THAT'S THE BEST ONE AROUND, AND THAT'S WHERE SOMEBODY
WHOSE GOT A HIGH LEVEL OF PROBLEMS NEEDS TO GO. AND WE DON'T NEED
THEM REJECTED OR PUSHED WAY BECAUSE THAT HOSPITAL CAN'T AFFORD IT
BECAUSE THEY'RE NOT GETTING ENOUGH FROM THE PRIVATE SECTOR TO COVER THE
MEDICAID PATIENTS.
THERE ARE A LOT OF IMPLICATIONS TO THIS BILL WHICH WE
HAVEN'T DISCUSSED. BUT LOOK AT THIS LIST AND TELL ME ABOUT THE FAIRNESS OF
THIS. TO SAY THAT A HOSPITAL THAT MEETS THIS ARBITRARY 60 PERCENT AND HAS
61 PERCENT OR 63 PERCENT SHOULD BE LET OUT OF THIS, BUT A HOSPITAL THAT
MAKES 59 PERCENT DOES NOT. AS REFERENCED BEFORE, THE ALBANY MEDICAL
CENTER JUST CLOSED DOWN ITS BURN CENTER. NOW I HAVE A -- A PERSONAL
EXPERIENCE WITH THE MEDICAL CENTER BECAUSE I WAS THE WESTCHESTER
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COUNTY LEGISLATOR THAT PASSED THE LEGISLATION THAT SPUN IT OFF FROM
BEING A COUNTY HOSPITAL. BUT WE HAD CERTAIN GOALS IN MIND WHEN WE
SPUN IT OFF. SOME PEOPLE SAID, YOU KNOW IT SHOULD BE A PRIVATE
HOSPITAL. OTHERS SAID, NO, IT SHOULD BE A NOT-FOR-PROFIT. WE
DEMOCRATS ON THE BOARD OF LEGISLATORS SAID, NO, IT'S GOING TO BE A
PUBLIC HOSPITAL. HOW DO WE FREE IT FROM THE -- FROM THE CONFINES OF THE
POLITICS OF GOVERNMENT AND AT THE SAME TIME KEEP IT PUBLIC? AND WE
MADE IT A PUBLIC BENEFIT CORPORATION. AND WE INSISTED THAT IT STAY
UNDER CIVIL SERVICE. SO THE MEDICAL CENTER IN WHITE PLAIN -- IN
WESTCHESTER COUNTY, THE WESTCHESTER MEDICAL CENTER, IS A CIVIL
SERVICE HOSPITAL. THEY CAN'T CHANGE A JOB TITLE WITHOUT GOING TO CIVIL
SERVICE. THEY HAVE PUBLIC PENSIONS WHICH THEY HAVE TO FUND EVERY
YEAR. AND THEY HAVE CSEA AND THEY HAVE THE NYSNA. I FIND IT VERY
INTERESTING TO SEE THE DIFFERENCE BETWEEN THE STATEWIDE UNIONS AND THE
LOCAL UNIONS. YOU TAKE A LOOK AT WHERE THE STATEWIDE UNIONS ARE, BUT
THE CSEA LOCAL PEOPLE WHO WE'VE WORKED WITH TO PRESERVE THEIR JOBS
OVER AND OVER AGAIN, ARE BEGGING US TO TURN THIS BILL DOWN. BECAUSE
THEY UNDERSTAND THE PRESSURE ON THE MEDICAL CENTER WILL MEAN THAT THE
MEDICAL CENTER COULD NO LONGER SUPPORT PUBLIC SALARIES. THAT'S WHAT
WE'RE DOING HERE.
YOU KNOW, I FIND IT INTERESTING AS I LOOK AT THIS BILL,
THERE ARE LOTS OF OTHER QUESTIONS WHICH I'LL COME BACK TO ON MY SECOND
ROUND. BUT THERE ARE SERIOUS QUESTIONS WITH THIS BILL ABOUT WHAT'S IN
THE BILL AND WHAT ISN'T IN THIS BILL. THERE'S NO DEFINITION OF EXCESS COST.
THERE'S NO DEFINITION OF INDEPENDENT DISPUTE ENTITY AND HOW IT'S
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SUPPOSED TO WORK. IT WAS SET UP FOR THE DOCTORS. WELL, SOMEBODY
BELIEVES THAT THAT'S GOING TO WORK FOR HOSPITALS. AND -- AND -- AND
THERE'S NOTHING IN THE BILL THAT REQUIRES THAT ANY SAVINGS AT ALL, ANY
SAVINGS, IF THERE ARE ANY, ACTUALLY GO TO THE CONSUMERS. THIS IS THE
SAME THING WE HEAR FROM INSURANCE COMPANIES ALL OF THE TIME. PUT US
IN CHARGE AND WE'LL SAVE MONEY. WHILE THEY'RE TRYING TO SAVE MONEY
ON THE BACKS OF EVERY HOSPITAL IN THIS STATE. THEY'VE JUST STARTED WITH
WESTCHESTER MEDICAL CENTER AND NYU AND PRESBYTERIAN AND
NORTHWELL. THEY'RE THE ONES THAT THEY'RE STARTING WITH -- -
ACTING SPEAKER AUBRY: MR. --
MR. ABINANTI: -- AND THEY'RE AIMING FOR EVERY
OTHER ONE.
ACTING SPEAKER AUBRY: MR. ABINANTI, YOU
ARE --
MR. ABINANTI: THANK YOU, MR. SPEAKER.
ACTING SPEAKER AUBRY: -- READY FOR YOUR
SECOND WHEN WE GET AROUND TO YOU.
MR. BYRNE.
MR. BYRNE: YES, THANK YOU, MR. SPEAKER.
ON THE BILL.
ACTING SPEAKER AUBRY: ON THE BILL, SIR.
MR. BYRNE: THANKS. I'D LIKE TO ADD THAT I HAVE
GREAT RESPECT FOR THE SPONSOR OF THIS BILL AND WHAT THEY'RE TRYING TO
ACCOMPLISH. BUT I'M COMPELLED TO JOIN MY MANY COLLEAGUES FROM
WESTCHESTER COUNTY ACROSS THE AISLE AND OPPOSE THIS PROPOSAL. AS
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SOMEONE FROM PUTNAM COUNTY BUT THAT REPRESENTS A SLICE OF NORTHERN
WESTCHESTER, I CAN TELL YOU THE REGIONAL EFFECTS AND SERVICE THAT THE
WESTCHESTER MEDICAL CENTER PROVIDES IS GREAT. IT GOES WELL BEYOND
WESTCHESTER AND INTO PUTNAM COUNTY AND THE HUDSON VALLEY. IT IS ONE
OF THE MAIN TRAUMA CENTERS THAT PEOPLE IN MY DISTRICT USE, SHOULD THEY
HAVE TO GO THROUGH THAT TRAGEDY OF HAVING A HORRIFIC AUTOMOBILE
ACCIDENT OR SOME OTHER SEVERE TRAUMA. CURRENTLY, HOSPITALS HAVE AN
INCENTIVE TO BE INCLUDED IN AN INSURANCE NETWORK SO THAT INSURERS
ENROLLEE -- ENROLLEES CAN ACCESS HOSPITAL SERVICES, INCLUDING ELECTIVE
SERVICES. THIS PROPOSAL WOULD ELIMINATE OR GREATLY REDUCE THAT
INCENTIVE.
I ALSO FIND IT PROBLEMATIC THAT MANY HOSPITALS ARE
EXCLUDED FROM THIS PROPOSAL. AND I AGREE WITH MANY OF MY COLLEAGUES'
REMARKS REGARDING THE TRANSPARENCY, AND WHILE I UNDERSTAND THIS BILL
WAS INTRODUCED EARLIER IN THE YEAR, IT MOST CERTAINLY WAS RUSHED THROUGH
TODAY, THROUGH TWO COMMITTEES AND ON TO THE FLOOR. WE HAVE A -- A
POLICY WITH OTHER PROPOSALS WHEN THEY'RE CONTROVERSIAL. SOMETIMES WE
DO HAVE PUBLIC HEARINGS. AND I THINK THERE'S AN OPPORTUNITY THAT IF IT
DOES NOT BECOME LAW, PERHAPS WE HAVE PUBLIC HEARINGS ON A PROPOSAL
LIKE THIS TO INCLUDE ALL THE STAKEHOLDERS SO THE HOSPITALS WILL HAVE THEIR
REPRESENTATIVES TO -- TO MAKE SURE THAT THEY EXPRESS THEIR OPINIONS TO ALL
OF OUR COLLEAGUES.
AGAIN, I OPPOSE THIS PROPOSAL. I WILL BE VOTING NO.
THANK YOU, MR. SPEAKER.
ACTING SPEAKER ORTIZ: MR. OTIS TO EXPLAIN HIS
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VOTE.
MR. OTIS: I'M GOING TO BE OPPOSING THIS BILL, AND I
THINK THAT WHEN WE'RE DEALING WITH HEALTHCARE AND INSURANCE AND
HEALTHCARE INSTITUTIONS, WE HAVE A RESPONSIBILITY TO DO THINGS CAREFULLY.
AND I THINK IT'S APPARENT FROM THE COMMENTS THAT YOU'VE HEARD SO FAR
THIS EVENING THAT THIS BILL NEEDS MORE WORK. WESTCHESTER MEDICAL
CENTER, AS HAS BEEN STATED EARLIER, IS, IN A SENSE, OUR PUBLIC HOSPITAL IN
WESTCHESTER. IT PROVIDES A LOT OF EXPENSIVE SERVICES, PROVIDES SERVICES
TO THE NEEDY, AND HAS HAD SOME TOUGH YEARS UNTIL TODAY WHERE THEY'RE --
HAVE GOTTEN TO A PLACE OF SOME FINANCIAL STABILITY. WHAT WE'RE
CONCERNED ABOUT IS THE RISK THAT THIS PUTS TO FUTURE FINANCIAL STABILITY.
AROUND THE STATE WE HAVE LOST MANY HOSPITALS. AND THE HOSPITAL AND
HEALTHCARE BUSINESS IS A TOUGHER BUSINESS THAN IT USED TO BE, AND SO
SOME OF THOSE REDUCTIONS WERE INEVITABLE. BUT YOU HAVE TO ASK
YOURSELF THE QUESTION, THROUGHOUT THE STATE DO WE HAVE MEDICAL
FACILITIES, DO WE HAVE HOSPITALS IN THE PLACES THAT WE NEED THEM? DO
WE HAVE TERTIARY CARE FACILITIES WITH EXPERT SURGEONS, EXPERT PEOPLE
WHO DEAL WITH EMERGENCIES IN PROXIMITY TO WHERE PEOPLE CAN GET TO
THEM IN TIME TO SAVE A LIFE.
SO, I'M OPPOSING THIS BILL. MY SUGGESTION WOULD BE
THAT WE SPEND SOME MORE TIME NOT ON THE FLOOR - YOU CAN HAVE SOME
APPLAUSE FOR THAT - NOT ON THE FLOOR, BUT BACK IN -- IN MEETING ROOMS
AND FIGURE OUT A BETTER WAY TO ADDRESS THESE ISSUES AND TO COME UP WITH
SOMETHING THAT PROVIDES COST CONTAINMENT FOR OUT-OF-NETWORK COSTS,
BUT ALSO IN A WAY THAT IS RATIONAL AND IS NOT HARMFUL TO SOME OF OUR
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HEALTHCARE INSTITUTIONS.
I'LL BE VOTING NO.
ACTING SPEAKER ORTIZ: MR. WALCZYK FOR THE
SECOND.
MR. WALCZYK: THANK YOU, MR. SPEAKER. IF THE
SPONSOR WOULD YIELD.
ACTING SPEAKER ORTIZ: WILL THE SPONSOR
YIELD?
MR. CAHILL: YES.
ACTING SPEAKER ORTIZ: YES, MR. WALCZYK.
MR. WALCZYK: I APPRECIATE THE TIME AND
ACCOMMODATION AND PATIENCE AS WE TRY TO GET ADDITIONAL INPUT, AND I
GET A GOOD FEEL FOR THE STATEWIDE IMPACT OF THIS BILL AND, CERTAINLY,
OBVIOUSLY, MY DISTRICT AT THE FOREFRONT. I -- I WONDERED IF, YOU KNOW,
EITHER IN 2015 WHEN THIS BILL FIRST CAME UP AND 2017 WHEN THE WORKING
GROUP THAT IGNORED HOSPITALS - AT LEAST THEY WEREN'T A PART OF THE
WORKING GROUP - IF WE HAD HEARD FROM HOSPITALS IN 2017 THAT WOULD
INCLUDE CANTON-POTSDAM HOSPITAL. ARE YOU FAMILIAR WITH THE POSITION
THAT CANTON-POTSDAM WOULD HAVE ON THIS BILL, ON THE AMENDMENTS OF
THE BILL THAT WERE DONE RECENTLY? HAVE THEY BEEN A PART OF THE
CONVERSATION, OR YOU, MR. SPONSOR, ARE -- ARE YOU FAMILIAR WITH THE
IMPACT THAT THIS WOULD HAVE ON THEM?
MR. CAHILL: MR. SPEAKER, AS I HAVE INDICATED
BEFORE WHEN MY COLLEAGUE HAS ASKED ABOUT A SPECIFIC HOSPITAL, I WILL
REPEAT THAT SAME ANSWER. THE HOSPITAL TO WHICH HE REFERS MOST LIKELY
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BELONGS TO ONE OF THE HOSPITAL ORGANIZATIONS THAT HAVE REGISTERED IN IN
OPPOSITION OF THIS BILL. THAT -- IT IS CERTAINLY TRUE AND UNDISPUTED THAT
THE TWO MAJOR HOSPITAL ASSOCIATIONS OF NEW YORK STATE WHICH
COMMUNICATE REGULARLY WITH THE HOSPITALS ALL ACROSS NEW YORK STATE
HAVE REGISTERED IN OPPOSITION TO THIS BILL. IT IS ALSO TRUE THAT PUBLIC
EMPLOYEE REPRESENTATIVES FROM THE CSEA, THE MUNICIPAL UNIONS
REPRESENTING OVER 1.1 MILLION MEMBERS, 97 DIFFERENT MUNICIPAL UNIONS,
THE TRIAL LAWYERS AND A NUMBER OF OTHER ENTITIES WHO ARE NOT INSURANCE
COMPANIES AND NOT HOSPITALS HAVE ALSO INDICATED THAT THEY STRONGLY
SUPPORT THIS LEGISLATION AND HAVE URGED US REPEATEDLY - NOT JUST THIS
YEAR, NOT JUST TODAY, BUT OVER THE COURSE OF THE PAST FIVE MONTHS, OVER
THE COURSE OF THE PAST THREE YEARS - TO PASS THIS BILL THAT OUR COLLEAGUES,
MANY OF WHOM ARE STANDING HERE TODAY AND ARGUING AGAINST THIS BILL,
HAVE VOTED FOR FOUR TIMES.
MR. WALCZYK: I -- I APPRECIATE YOUR RESPONSE,
AND WHILE I'M NOT PRIVY TO EXACTLY WHO REPRESENTS THESE HOSPITALS, I
WONDERED IF -- IF YOU WERE FAMILIAR WITH THE HOSPITALS IN -- IN KINGSTON,
WHICH INCLUDE THE -- THE MARY'S AVENUE CAMPUS, THE BROADWAY
CAMPUS, AND ALSO IN MARGARETVILLE, FOR THE HEALTHALLIANCE OF THE
HUDSON VALLEY. HAVE -- HAVE THEY BEEN A PART OF THE CONVERSATION?
WHAT WOULD THE IMPACT BE ON THOSE FACILITIES?
MR. CAHILL: WELL, I WILL -- AND MR. SPEAKER, I WILL
ANSWER THAT DIRECTLY. THE HOSPITALS THAT ARE IN MY COMMUNITY - THAT IS,
THE KINGSTON -- FORMER KINGSTON HOSPITAL, OR NOW THE BROADWAY
CAMPUS; AND THE FORMER BENEDICTINE HOSPITAL, NOW THE MARY'S AVENUE
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CAMPUS OF WESTCHESTER MEDICAL CENTER - HAVE NOT SPECIFICALLY TALKED
TO ME ABOUT THIS BILL. HOWEVER, IT'S IMPORTANT TO NOTE THAT I'VE HAD
EXTENSIVE CONVERSATIONS WITH REPRESENTATIVES AND EMPLOYEES OF
WESTCHESTER MEDICAL CENTER ABOUT THIS LEGISLATION AND I'VE HEARD THEIR
CONCERNS. AND I'VE INCORPORATED SOME OF THEIR CONCERNS INTO THE
LEGISLATION OR AT LEAST CONSIDERED IT AS WE MOVED FORWARD. SUFFICE IT TO
SAY, WE DON'T AGREE. WE DON'T AGREE THAT -- THAT THERE'S ANYTHING -- MY
VIEW IS THAT THERE'S NOTHING WRONG WITH TELLING PEOPLE WHO DISAGREE TO
COME UP WITH A MEANS OF FINDING AGREEMENT. THERE'S NOTHING WRONG
WITH HAVING A THIRD-PARTY DETERMINE WHETHER A -- WHETHER A FEE BEING
CHARGED IS EXORBITANT OR WHETHER AN INSURANCE COMPANY IS TRYING TO
TAKE UNFAIR ADVANTAGE OF A HOSPITAL, BE THEY A RURAL HOSPITAL OR AN
UPSTATE HOSPITAL OR A SUBURBAN HOSPITAL OR EVEN AN URBAN HOSPITAL.
THAT IS EXACTLY WHAT THIS BILL DOES. WHAT THIS BILL DOES NOT DO, AS HAS
BEEN PORTRAYED MANY TIMES, IS LINE OUT SPECIFIC HOSPITALS THAT ARE
COVERED AND NOT COVERED. WHAT DOES IT DO? IT SETS CRITERIA FOR WHAT
CIRCUMSTANCES ARE COVERED. AND IF YOU ARE NOT OUT OF CONTRACT OR NOT
CONCLUDING YOUR CONTRACT, IT DOESN'T COVER YOU. IF YOU PROVIDE
HEALTHCARE TO 60 PERCENT OR MORE OF YOUR PATIENTS WHO ARE DISCHARGED
THROUGH MEDICAID, IT DOES NOT COVER YOU. IF YOU ARE CHARGING RATES THAT
ARE APPROPRIATE, NOT BASED UPON WHAT OTHER HOSPITALS CHARGE, BUT WHAT
YOUR HOSPITAL CHARGES FOR OTHER PATIENTS OR FOR THAT PATIENT WHEN THEY
ARE COVERED BY A HEALTH PLAN, OR WHEN THEY ARE NOT COVERED BY A HEALTH
PLAN. THEN YOU MIGHT BE COVERED. IF NONE OF THOSE CIRCUMSTANCES
EXIST, THEN THIS BILL MIGHT HAVE SOME IMPACT ON YOU. BUT I WOULD
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SUGGEST TO YOU THAT WILL NOT NECESSARILY BE A NEGATIVE IMPACT. IT COULD
HAVE A VERY POSITIVE IMPACT, BECAUSE IF THE RATES THAT YOUR HOSPITAL
WANTS TO CHARGE ARE REASONABLE, NOT IN THE VIEW OF THE INSURANCE
COMPANY, BUT IN THE VIEW OF AN INDEPENDENT DISPUTE RESOLUTION
REPRESENTATIVE APPOINTED BY A DULY-APPOINTED STATE AGENCY, THE
DEPARTMENT OF FINANCIAL SERVICES, THEN YOUR HOSPITAL WILL GET THOSE
CHARGES. THAT'S WHAT THIS PROCESS DOES. IT ACTUALLY GIVES A TOOL. AND,
QUITE FRANKLY, WHILE THIS YEAR, AT THIS EXACT MOMENT, CLEARLY THIS
MOMENT, THE -- THERE ARE HOSPITALS THAT OPPOSE THIS, I WOULD SUBMIT TO
YOU THAT IN A FEW YEARS OR IN DIFFERENT CIRCUMSTANCES, THOSE VERY SAME
HOSPITALS MAY COME HERE AND LOBBY FOR THIS KIND OF LEGISLATION. WHEN
THE DEPARTMENT OF FINANCIAL SERVICES TELLS THE INSURANCE COMPANIES TO
NARROW THEIR NETWORK AND THE TABLE HAS TURNED. WHEN THE INSURANCE
COMPANIES DECIDE THAT THERE'S MORE COMPETITION THAN -- THAN WARRANTS
THE RATES THAT THEY'RE PAYING, AND THE HOSPITAL WANTS TO CONTINUE IN THE
PROCESS, THEN THEY CAN TAKE ADVANTAGE OF THE INDEPENDENT DISPUTE
RESOLUTION PROCESS. HERE'S THE THING: IT HAS BEEN PORTRAYED TODAY BY
PEOPLE WHO HAVE KNOWN ABOUT THIS LEGISLATION FOR THREE YEARS THAT
SOMEHOW OR ANOTHER THIS IS INSURANCE COMPANY LEGISLATION. I SUBMIT TO
YOU, AND MANY OF YOU HAVE HAD VISITS FROM A LOT OF PEOPLE WHO ARE NOT
INSURANCE COMPANY REPRESENTATIVES WHO SUPPORT THIS LEGISLATION
BECAUSE IT BRINGS ABOUT A PROCESS OF FAIRNESS THAT CAN RESULT IN NOT JUST
APPROPRIATE LEVELS OF CARE, CONTINUATION OF CARE THAT WON'T BE
INTERRUPTED BECAUSE CONTRACTS END, BUT ALSO WILL MAKE SURE THAT THE
CHARGES THAT ARE BEING OFFERED AND THE CHARGES THAT ARE BEING PAID ARE
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REASONABLE ACCORDING TO A NEUTRAL THIRD-PARTY, AND CRITERIA THAT IS CLEARLY
LINED OUT IN THE LAST PAGE OF THE BILL, WHICH, YOU KNOW, I KNOW MY
COLLEAGUES HAVE QUESTIONS ABOUT IT. NONE OF THE WESTCHESTER
COLLEAGUES HAVE ADVANCED THOSE QUESTIONS TO ME IN THIS DEBATE. NONE
OF THE WESTCHESTER COLLEAGUES HAVE CHOSEN TO LOOK AT THE LEGISLATION TO
SEE IF THE ANSWERS EXIST THERE. INDEED, THEY DO. INSTEAD, THERE'S BEEN A
-- A CHOICE, AND I -- I SPECIFICALLY DO NOT REFER TO MY COLLEAGUE WHO IS
STANDING HERE TODAY BEFORE ME AT THIS MOMENT -- BUT SPECIFICALLY AS
STATED BY SOME OF THOSE COLLEAGUES SIMPLY TO FILIBUSTER BECAUSE THEY
DISAGREE. AND -- AND WITH ALL DUE RESPECT TO MY COLLEAGUE WHO ASKED
ME TO YIELD, I DON'T APPLY THAT TO YOU BECAUSE YOU HAVE SPECIFICALLY
ASKED ME SUBSTANTIATIVE QUESTIONS, AND I WOULD URGE MY COLLEAGUES
FROM THE OTHER PARTS OF THE STATE TO DO THE SAME.
MR. WALCZYK: WELL, THANK YOU BOTH FOR THE
ANSWER AND THE SENTIMENT. I APPRECIATE IT. AND THROUGH YOU, MR.
SPEAKER, IF THE SPONSOR WOULD CONTINUE TO YIELD?
MR. CAHILL: YES, SIR.
ACTING SPEAKER ORTIZ: YES, HE WILL.
MR. WALCZYK: THANK YOU. WITH A PARADIGM SHIFT
IN THE RELATIONSHIP BETWEEN COMMUNITY HOSPITALS AND INSURANCE
COMPANIES, ARE YOU CONCERNED AT ALL THAT INSURANCE COMPANIES WILL BE
SETTING THEIR OWN RATES AS A RESULT OF THIS LEGISLATION?
MR. CAHILL: TO THE CONTRARY. I BELIEVE THIS
LEGISLATION PROTECTS COMMUNITY HOSPITALS FROM HAVING INSURANCE
COMPANIES SET THEIR RATES, BECAUSE WE'VE INTERJECTED INTO THE WHOLE
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PROCESS AN INDEPENDENT THIRD-PARTY WHO WILL NOW MAKE A
DETERMINATION AS TO WHETHER THOSE RATES ARE REASONABLE OR NOT. IF A
HOSPITAL BELIEVES THAT THEY -- AND -- AND -- AND LET'S ALSO NOT FORGET THIS
LITTLE -- LITTLE DETAIL THAT HASN'T BEEN MENTIONED HERE TODAY: HEALTH
INSURANCE COMPANIES, BY REGULATION, BY SUPERVISION OF THE DEPARTMENT
OF FINANCIAL SERVICES, AND IN SOME INSTANCES THE DEPARTMENT OF HEALTH
AS WELL, ARE REQUIRED TO HAVE WHAT IS CALLED "AN ADEQUATE NETWORK."
THAT IS, THEY CAN'T GO AROUND WILLY-NILLY DISMISSING CONTRACTS AND GOING
BACK TO THE DEPARTMENT OF HEALTH AND SAYING, OH, IT'S OKAY. WE'RE
GOING TO DO EVERYTHING OUT-OF-NETWORK. NO. THE REQUIREMENT THAT THE
DEPARTMENT OF FINANCIAL SERVICES PLACES ON THESE INSURANCE COMPANIES
IS THAT THEY DEVELOP A NETWORK. THEY NEED A NETWORK. AND EVEN IF
THEY DIDN'T WANT ONE, THE LAW REQUIRES THEM TO HAVE ONE. WHAT THIS BILL
WILL DO IS MAKE SURE THAT WHEN THE CONTRACT ENDS OR WHEN A NEW ONE IS
BEING NEGOTIATED, THERE'S NOT A GAP FOR THE PEOPLE WHO WE REPRESENT, AS
THERE WAS IN MY COMMUNITY FOR YOU WANT TO KNOW HOW LONG?
EIGHTEEN MONTHS. LONGER, 18 MONTHS. THAT'S HOW LONG PEOPLE THAT I
REPRESENT WERE NOT ABLE TO GO TO THEIR COMMUNITY HOSPITAL BECAUSE OF A
- DON'T SAY THAT WORD - A CONTEST BETWEEN AN INSURANCE COMPANY AND A
-- AND A HOSPITAL CONGLOMERATE. YOU KNOW WHO WAS LEFT OUT IN THE
COLD? THE PEOPLE I REPRESENT. YOU KNOW WHO ENDED UP PAYING THE
BILL? THE COUNTY AND -- AND THE MUNICIPALITIES WHO SELF-INSURE AND
WHO NOW HAVE TO PAY SIGNIFICANTLY HIGHER RATES. AND BY THE WAY, WE
TALK ABOUT THIS COMING TO YOUR TOWN. IT WILL COME TO YOUR TOWN.
BECAUSE WE'RE IN THE PROCESS OF MASSIVE HOSPITAL CONSOLIDATION. AND
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THAT'S THE PARADIGM SHIFT, NOT THE RELATIONSHIP OF TWO HOSPITALS BECAUSE
WE'VE INTERJECTED AN INDEPENDENT DISPUTE RESOLUTION PROCESS. IT'S THE
FACT THAT HOSPITALS ARE BEING GOBBLED UP LIKE - FOR THOSE OF YOU WHO ARE
MY AGE AND OLDER - LIKE PAC-MAN ON A VIDEO GAME.
MR. WALCZYK: THANK YOU, MR. SPONSOR. THE --
THE AMENDMENTS TO THIS BILL WERE -- WERE ISSUED RELATIVELY RECENTLY.
CAN YOU -- CAN YOU EXPLAIN WHY THERE WAS A HURRY-UP ON THE
AMENDMENTS TO THIS BILL?
MR. CAHILL: MR. SPEAKER, THROUGH YOU, I -- I DON'T
BELIEVE THERE WAS A HURRY-UP. WE MODIFY LEGISLATION ALL THE TIME. AND
IN THIS INSTANCE, ADDITIONAL CONSIDERATION WAS GIVEN TO THOSE HOSPITALS
THAT ARE PRIMARILY MEDICAID HOSPITALS - THAT IS, GREATER THAN HALF, 60
PERCENT MEDICAID HOSPITALS - AND WE FELT THERE ARE ENOUGH SUFFICIENT
CONTROLS ON THOSE HOSPITALS ALREADY THAT IT WOULD NOT BE NECESSARY TO --
TO INCLUDE THEM IN THIS LEGISLATION. WE ALSO FELT AS A MATTER OF PUBLIC
POLICY THAT WE WISHED TO EXCLUDE THEM. BUT IT WASN'T A HURRY-UP, IT
WAS JUST AS WE WENT ALONG. AND BY THE WAY, ONCE IT BECOMES LAW, AS
THE INDEPENDENT DISPUTE PROCESS ALREADY IS LAW, SOMEBODY IN THIS ROOM
MAY DECIDE TO PUT IN A BILL TO MODIFY THAT, AND THAT WOULD BE FINE, TOO.
AND IF WE CAN GET ON THE FLOOR AND HAVE A DEBATE AND MAYBE EVEN HAVE
ANOTHER - FOR THE FIRST TIME IN MY EXPERIENCE HERE - A FILIBUSTER DEBATE,
MAYBE WE'LL FIND OUT THAT SOMEBODY ELSE WANTS TO CHANGE THE LAW THAT I
AM OFFERING HERE TODAY.
MR. WALCZYK: UNDERSTOOD. WOULD THERE BE --
WOULD THERE BE, YOU KNOW, ANY LEVEL OF AMENDMENTS TO THIS BILL THAT
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WOULD CAUSE YOU TO GO BACK TO A -- A WORKING GROUP LIKE YOU HAD IN
2017? WHAT WOULD TRIGGER THE NEED FOR GREATER PUBLIC INPUT? AND I
KNOW THAT -- I KNOW THAT YOU'VE CONTINUALLY WORKED ON THIS TO PROGRESS
IT THROUGH THE PROCESS. IT'S ALREADY BEEN AN A-PRINT AND NOW A B-PRINT
IN THIS LEGISLATIVE SESSION. WHAT SORT OF TRIGGERS FOR YOU, AS A
POLICYMAKER, GIVE ENOUGH PAUSE TO HOLD YOUR BILL ON THE ASSEMBLY
FLOOR AND SAY, HEY, WAIT A MINUTE. WE PROBABLY NEED TO HEAR FROM THE
PUBLIC AND THE HOSPITALS, THE COMMUNITY HOSPITALS THAT THESE MEMBERS
REPRESENT IN THIS CHAMBER? THIS IS TIME TO -- TO TAKE A PAUSE AND --
AND HEAR FROM THOSE WHO WOULD BE IMPACTED. WHAT WOULD DO THAT FOR
YOU?
MR. CAHILL: MR. SPEAKER, THAT IS EXACTLY WHAT
HAPPENED HERE. WHEN THE INDE -- INDEPENDENT DISPUTE RESOLUTION
PROCESS WAS INTRODUCED INTO LAW, THERE DID NOT APPEAR TO BE A NEED TO
INCLUDE CHARGES FOR EMERGENCIES AND THOSE CHARGES THAT FOLLOWED
EMERGENCIES. BECAUSE IT APPEARED THAT THERE WAS A STASIS, THAT THERE
WAS A BALANCE THAT WAS TAKING PLACE. WHAT OCCURRED OVER THE PAST
SEVERAL YEARS IS -- IS IT BECAME CLEAR THAT THERE WAS NOT A BALANCE. SO,
IF WE FOUND IN THE FUTURE THAT THERE WAS AN IMBALANCE, WHETHER IT WAS
THAT IT DID NOT CONTAIN THOSE COSTS AS WE ANTICIPATED IT WOULD; IT DID NOT
ALLOW FOR CONTINUITY OF CARE, AS IS THE PRIMARY OBJECTIVE OF THIS
LEGISLATION; OR THAT HOSPITALS WERE BEING TREATED UNFAIRLY IN THE PROCESS,
I ABSOLUTELY WOULD BE BACK HERE. YOU MENTIONED THE TWO HOSPITALS IN
MY COMMUNITY, AND THE ONE HOSPITAL, MARGARETVILLE, ON THE PERIPHERAL
OF MY COMMUNITY. I HAVE STOOD ON THIS FLOOR A NUMBER OF TIMES AND
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DEFENDED THOSE HOSPITALS. I HAVE ADVOCATED FOR THOSE HOSPITALS IN THE
BUDGET AND SECURED PRETTY NEAR $200 MILLION TO KEEP THEM AFLOAT
THROUGH THEIR TOUGH TIMES. AND I CONTINUE TO ADVOCATE FOR MONEY,
INCLUDING $100 MILLION-PLUS THAT I ADVOCATED FOR FOR WESTCHESTER
MEDICAL CENTER, THE VERY HOSPITAL WE'RE TALKING ABOUT HERE TODAY, SO
THAT THEY COULD CONTINUE TO PROVIDE QUALITY CARE THROUGHOUT THE HUDSON
VALLEY, INCLUDING IN THEIR HOME COUNTY. SO, YES. THERE'S A LOT OF
THINGS THAT COULD HAPPEN THAT WOULD CAUSE ME AND OTHERS IN THIS ROOM
TO REVISIT THIS, AND THAT'S EXACTLY WHY WE ARE HERE, TO BE ABLE TO HAVE
THAT SORT OF DYNAMIC APPROACH TO THE CHANGING NATURE OF THE ISSUES
BEFORE US, INCLUDING HEALTHCARE.
MR. WALCZYK: THANK YOU. AND THROUGH YOU,
MR. SPEAKER, IF THE SPONSOR WOULD CONTINUE TO YIELD?
MR. CAHILL: ABSOLUTELY.
ACTING SPEAKER AUBRY: THE SPONSOR
CONTINUES TO YIELD.
MR. WALCZYK: AND JUST REMIND ME, BECAUSE I'M
NOT SURE THAT I HEARD YOU CORRECTLY EARLIER. BUT YOU SAID YOU HADN'T
SPECIFICALLY HEARD FROM THE HOSPITALS IN YOUR DISTRICT TO INCLUDE THE --
THE MARY'S AVENUE, THE BROADWAY AND THEN THE HOSPITAL THAT'S ON THE
PERIPHERY OF YOUR DISTRICT, MARGARETVILLE, ABOUT THIS LEGISLATION
SPECIFICALLY?
MR. CAHILL: I BELIEVE THAT THERE WAS A MEETING
HELD - FORGIVE MY MEMORY - I THINK IT WAS EARLIER THIS YEAR, BUT IT MIGHT
HAVE BEEN LAST YEAR - WITH REPRESENTATIVES OF THE WESTCHESTER MEDICAL
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CENTER. AND UNDER THE AFFILIATION AGREEMENT THAT EXISTS BETWEEN THESE
HOSPITALS RIGHT NOW, IT IS THE WESTCHESTER MEDICAL CENTER THAT SERVES AS
THE MANAGEMENT OF MY LOCAL HOSPITALS. AND -- AND I WILL BE HONEST
WITH YOU; IT WAS A VERY CORDIAL AND OPEN MEETING WHERE BOTH SIDES
DISCUSSED THEIR POINT OF VIEW. AND I HAVE BEEN IN REGULAR
COMMUNICATION AND HAVE HAD MY DOOR OPEN TO PEOPLE WHO REPRESENT
MY COMMUNITY HOSPITALS. I COUNT AS THE PEOPLE I SEE IN THE GROCERY
STORE, SOMETIMES WHEN I LEAVE THIS BUILDING AT NIGHT, MEMBERS OF THE
BOARDS OF THOSE HOSPITALS, AND -- AND THEY ARE AWARE OF THE LEGISLATION.
THEY HAVEN'T REGISTERED ONE WAY OR ANOTHER WITH ME SPECIFICALLY ON
THIS. BUT YES, I'VE HEARD FROM THEM THROUGH THEIR REPRESENTATIVES AT
WESTCHESTER MEDICAL CENTER.
ACTING SPEAKER AUBRY: SIR, YOUR TIME HAS
EXPIRED.
MR. WALCZYK: IT'S BEEN A PLEASURE.
ACTING SPEAKER AUBRY: IT'S BEEN A PLEASURE
LISTENING TO YOU.
MS. REYES.
MS. REYES: THANK YOU, MR. SPEAKER.
ON THE BILL.
ACTING SPEAKER AUBRY: ON THE BILL.
MS. REYES: I'VE BEEN SITTING HERE LISTENING VERY
INTENTLY TO MY COLLEAGUES ON THIS DEBATE, AND EVERYBODY'S BEEN TALKING
ABOUT HOSPITALS. BUT NOT A SINGLE PERSON HAS MENTIONED A PATIENT AND
THE ASTRONOMICAL COSTS THAT PATIENTS IN OUR DISTRICTS THAT EACH AND EVERY
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ONE OF US REPRESENTS ARE STRADDLED WITH WHEN IT COMES TO HOSPITAL BILLS.
BECAUSE IN AN EMERGENT SITUATION, NOBODY HAS THE OPTION TO DECIDE
WHETHER THEIR DOCTOR OR THEIR MEDICAL PROVIDER IS IN- OR OUT-OF-NETWORK.
SO I THINK THAT WE'RE MISSING THE BROADER PICTURE HERE, AND IT'S THAT THIS
BILL REALLY ADDRESSES THE -- THE -- THE COSTS THAT SO MANY FAMILIES HAVE TO
DEAL WITH. AND LET'S BE FRANK. THIS WILL BANKRUPT MANY, MANY FAMILIES
AND MANY PATIENTS. AND THOSE OF YOU THAT HAVE EXPERIENCED THAT, THAT
HAVE EXPERIENCED INSTANCES WHERE YOU HAVE TO GO INTO THE EMERGENCY
ROOM, YOU KNOW WHAT THAT MEANS. SO, I'M NO LAWYER, BUT I AM A NURSE.
AND I READ THROUGH THE LANGUAGE OF THIS BILL, AND I HAVE NOT SEEN A
SINGLE MENTION OF ANY HOSPITAL. SO I DON'T KNOW WHERE PEOPLE ARE
GETTING THIS FROM. BUT I HAVE -- I DID UNDERSTAND THAT THERE IS A 60
PERCENT CARVE-OUT FOR THOSE THAT TAKE CARE OF PREDOMINANTLY THE
INDIGENT CARE POOL, WHICH IS OUR MEDICAID PATIENTS, THOSE THAT ARE
MEDICARE AND MEDICAID RECIPIENTS, THOSE THAT ARE UNDERINSURED, WHICH
MEANS THAT A LOT OF -- A LOT OF THE HOSPITALS THAT SERVE OVERWHELMINGLY A
POOR POPULATION WILL NOT BE AFFECTED BY THIS PIECE OF LEGISLATION. BUT IT
ALSO TALKS ABOUT CREATING A DISPUTE RESOLUTION. SO, IF YOU ARE A PATIENT
THAT HAS INSURANCE AND YOU FIND YOURSELF IN AN EMERGENT SITUATION IN AN
EMERGENCY ROOM, AND YOU ARE OUT-OF-NETWORK WITH THE MEDICAL
PROVIDER, THEN YOU HAVE THE ABILITY TO ENTER A DISPUTE RESOLUTION WHERE
THEN THOSE CHARGES WILL BE ABLE TO BE NEGOTIATED WITH THE INSURANCE
COMPANIES AT AN IN-NETWORK RATE. AND IF WE LOOK AT THE SALARIES OF
MANY OF THESE CEOS, THEY GO UP TO THE MILLIONS AND MILLIONS OF
DOLLARS. SO I DON'T FORESEE THERE BEING A HUGE FISCAL IMPACT ON MANY OF
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THESE HOSPITALS. IF THE -- THE PAYMENT, THE REIMBURSEMENT THAT THEY WILL
RECEIVE UNDER A DISPUTE RESOLUTION WOULD BE AN IN-NETWORK RATE --
ACTING SPEAKER AUBRY: MR. BUCHWALD, WHY
DO YOU RISE?
MR. BUCHWALD: WOULD THE LADY YIELD FOR A
QUESTION?
MS. REYES: NO. NO.
ACTING SPEAKER AUBRY: THE LADY SAID SHE
WILL NOT YIELD.
MS. REYES: SO I DON'T FORESEE THAT THESE MEDICAL
INSTITUTIONS WOULD LOSE AN ASTRONOMICAL AMOUNT OF MONEY IF WHAT THE
DISPUTE RESOLUTION -- OR WHAT THIS LANGUAGE ON THIS BILL TALKS ABOUT IS
THEM RECEIVING AN IN-NETWORK RATE THAT THEY HAD PREVIOUSLY BARGAINED
FOR OR NEGOTIATED IN THE FIRST PLACE. IT JUST MEANS THAT THOSE INDIVIDUALS
THAT FIND THEMSELVES IN AN EMERGENT SITUATION WHERE THEY CANNOT PAY OR
THEY DON'T HAVE THE OPTION TO CHOOSE AN IN-NETWORK PROVIDER, THEY WILL
NOT FIND THEMSELVES WITH THIS ASTRONOMICAL BILL.
BUT I WANT TO SAY SOMETHING ABOUT WESTCHESTER
MEDICAL CENTER. AND I -- I DO UNDERSTAND THAT MANY YEARS AGO THEY
FOUND THEMSELVES IN A BANKRUPT SITUATION, AND THE HOSPITAL THAT WENT
FORWARD -- THAT SET FORWARD A PLAN TO BAIL THEM OUT OF THAT WAS
MONTEFIORE MEDICAL CENTER, WHICH IS THE LARGEST EMPLOYER IN THE
BRONX, BUT ALSO TAKES CARE OF ONE OF THE LARGEST INDIGENT CARE POOLS IN
THE BRONX AS WELL. AND WE HAVE A POPULATION -- BRONX COUNTY IS THE
-- RANKS 52ND IN HEALTHCARE OUTCOMES IN ALL OF NEW YORK STATE, AND WE
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FOUND ONE OF OUR MEDICAL CENTERS TRYING TO BAIL OUT ALSO WESTCHESTER
MEDICAL CENTER.
SO I THINK WE NEED TO LOOK AT THIS FROM THE LENS OF THE
PATIENTS AND OF THOSE INDIVIDUALS THAT WE REPRESENT, BECAUSE THE
HOSPITALS DID NOT VOTE ME IN HERE AND THEY DID NOT SEND ME HERE TO
SPEAK JUST FOR THEM. BUT THE PEOPLE OF MY DISTRICT, THOSE PEOPLE THAT
ARE SUFFERING EVERY DAY THAT HAVE LOST THEIR HOMES BECAUSE THEY HAVE
BEEN STRADDLED WITH ASTRONOMICAL MEDICAL DEBT, THOSE ARE THE PEOPLE
THAT VOTED FOR ME.
I THINK THIS IS A GOOD PIECE OF LEGISLATION, AND I URGE
MY COLLEAGUES TO RETHINK THIS. THANK YOU.
ACTING SPEAKER AUBRY: THANK YOU.
MR. PRETLOW.
MR. PRETLOW: GOOD -- GOOD AFTERNOON, EVERYONE
-- OR GOOD EVENING. WOULD MR. BUCHWALD RISE FOR A QUESTION?
ACTING SPEAKER AUBRY: MR. BUCHWALD, WILL
YOU YIELD?
MR. BUCHWALD: I WOULD, MR. SPEAKER.
ACTING SPEAKER AUBRY: MR. BUCHWALD
YIELDS.
MR. PRETLOW: DAVID, WE'VE BEEN TALKING A LOT
ABOUT WESTCHESTER HOSPITAL. HOW -- HOW DOES THIS DIRECTLY AFFECT THE
HOSPITAL?
MR. BUCHWALD: WESTCHESTER MEDICAL CENTER
RIGHT NOW IS IN THE MIDDLE OF A NEGOTIATION WITH A MAJOR INSURANCE
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COMPANY, BLUE CROSS BLUE SHIELD, WHICH I THINK IS UNDER THE ANTHEM
SET OF COMPANIES. AND RIGHT NOW, THIS BILL WOULD IMPACT THAT
NEGOTIATION BECAUSE IF THIS BILL BECAME LAW IT WOULD ESSENTIALLY MEAN
THAT ANTHEM WOULD NOT HAVE ANY PARTICULAR REASON TO HAVE WESTCHESTER
MEDICAL CENTER IN-NETWORK EXCEPT WITH REGARDS TO ELECTIVE SURGERIES.
BUT INSURANCE COMPANIES DO NOT PARTICULARLY NEED HOSPITALS TO BE IN-
NETWORK FOR ELECTIVE SURGERIES, BECAUSE THEY CAN INSTEAD TELL THEIR
CUSTOMERS, GO TO ANOTHER HOSPITAL FOR THOSE ELECTIVE SURGERIES. AND,
OF COURSE, THERE ARE OTHER HOSPITALS IN WESTCHESTER COUNTY WHO WOULD
BE HAPPY TO HAVE THAT LUCRATIVE BUSINESS. BUT FOR WESTCHESTER MEDICAL
CENTER, IT NEEDS THE REVENUES FROM THOSE ELECTIVE SURGERIES TO PROVIDE
THE SOCIAL SAFETY NET SERVICES THAT IT PROVIDES TO WESTCHESTER'S COUNTY,
BUT ALSO TO PROVIDE THE TRAUMA CENTER, BURN UNIT AND SO FORTH THAT IT
PROVIDES TO THE ENTIRE REGION.
MR. PRETLOW: AND IF THIS BILL WOULD PASS AS IS
WRITTEN, WOULD THERE WILL BE A DIRECT NEGATIVE IMPACT TO PATIENTS?
MR. BUCHWALD: IF WESTCHESTER MEDICAL CENTER
STOPPED BEING TO PROVIDE THOSE SERVICES, IT WOULD BE A DRAMATIC
NEGATIVE IMPACT TO THOSE POTENTIAL PATIENTS. AND I SHOULD -- IF I COULD,
MR. PRETLOW, JUST RESPOND THAT OTHERWISE, THIS BILL, IF IT GOES INTO EFFECT,
DOES NOT AFFECT THE BILLS PATIENTS GET AT HOME WITH CONNECTION -- IN
CONNECTION WITH EMERGENCY SERVICES. IT IS ALREADY SEPARATELY THE LAW
THAT WITH REGARDS TO EMERGENCY SERVICES, SOMEONE WHO HAS INSURANCE
WHO GOES TO A, QUOTE, UNQUOTE, "OUT-OF-NETWORK HOSPITAL" WILL BE
CHARGED THE IN-NETWORK RATE. SO IT IS -- AND WITH REGARDS TO THOSE
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SERVICES THAT COME AFTER ADMITTANCE TO THE HOSPITAL, POST-EMERGENCY
SERVICES, IS ALREADY THE LAW IN NEW YORK STATE THAT THE INSURANCE
COMPANY HAS TO PAY THE HOSPITAL'S STATED CHARGE. SO NONE OF THIS,
UNLIKE WHAT WE DID WITH SURPRISE BILLING FOR THE -- THE MEDICAL
PROVIDERS AND PHYSICIANS, IS ABOUT THE BILLS THAT GO TO PATIENTS AND
FAMILIES AND THAT DO, INDEED, CREATE BANKRUPTCIES -- OR AT LEAST DID,
ESPECIALLY HERE IN NEW YORK, BEFORE WE PASSED THAT SURPRISE BILLING
LEGISLATION. SO I HOPE THAT CLARIFIES THINGS FOR THE GENTLEMAN.
MR. PRETLOW: YES -- YES, IT DOES. AND, MR.
SPEAKER, I -- I KNOW THE SPONSOR OF THIS BILL HAD -- HAD ALL GOOD
INTENTIONS, BUT I THINK THAT THIS BILL NEGATIVELY AFFECTS THE COUNTY OF
WESTCHESTER, THE PEOPLE OF WESTCHESTER, WHICH YOU'VE HEARD FROM YOUR
WESTCHESTER REPRESENTATIVES. AND I HAVE -- I WANT TO OFFER AN
AMENDMENT TO THIS BILL, CHANGING THE -- THE PERCENTAGE FROM 60 PERCENT
TO 40 PERCENT OF THOSE THAT ARE ELIMINATED FROM THIS BILL. I HAVE THE --
THE AMENDMENT IN MY HAND, AND I WOULD LIKE TO HAND IT TO YOU NOW.
ACTING SPEAKER AUBRY: PLEASE HAVE IT UP AND
WE'LL LOOK AT IT.
(PAUSE)
MR. PRETLOW, WE HAVE EXAMINED YOUR WHAT APPEARS TO
BE A HOSTILE AMENDMENT. AND IT IS OUT OF ORDER IN ACCORDANCE WITH THE
CUSTOM AND PRACTICE OF THE HOUSE THAT HOSTILE AMENDMENTS BE DISPOSED
OF BEFORE CONSIDERATION OF THE BILL-IN-CHIEF AND NOT IN THE PROPER FORM.
MR. PRETLOW: BUT I APPEAL THE RULING OF THE
CHAIR.
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(LAUGHTER)
ACTING SPEAKER AUBRY: MR. PRETLOW APPEALS
THE RULING OF THE CHAIR. THE QUESTION BEFORE THE HOUSE IS SHALL THE
DECISION OF THE CHAIR STAND AS THE JUDGMENT OF THE HOUSE. THOSE
VOTING YES VOTE TO SUSTAIN THE RULING OF THE CHAIR, THOSE VOTING NO VOTE
TO OVERRIDE THE DECISION OF THE CHAIR.
THE CLERK WILL RECORD THE VOTE.
(THE CLERK RECORDED THE VOTE.)
MRS. PEOPLES-STOKES: MR. SPEAKER, CLEARLY,
SOME OF OUR COLLEAGUES --
(PAUSE)
ARE THERE ANY OTHER VOTES? ANNOUNCE THE RESULTS.
(THE CLERK ANNOUNCED THE RESULTS.)
THE RULING OF THE CHAIR IS SUSTAINED.
MR. -- MRS. GALEF.
MRS. GALEF: YES. THERE WERE A COUPLE OF
QUESTIONS THAT -- THAT HAVE COME UP, ONE OF WHICH -- IT WAS MENTIONED
THAT SENATOR SEWARD, WHO HAD THE BILL BEFORE HAD DEALT WITH IT, BUT I
BELIEVE THAT THE SENATE NEVER APPROVED IT. SO, YOU KNOW, IT WAS KIND
OF LIKE A NON-ISSUE. THERE HAVE BEEN A LOT OF QUESTIONS ABOUT WHO'S --
WHAT HOSPITALS ARE ON THIS LIST THAT ARE 60 PERCENT OR LESS WITH MEDICAID
PATIENTS. AND SINCE THE SPONSOR HADN'T REALLY GIVEN US MUCH
INFORMATION, I HAVE A LIST ABOUT SIX PAGES, AND I'D LIKE TO START TO READ
THEM SO THAT YOU KNOW WHETHER YOUR HOSPITAL MIGHT BE INCLUDED. THE
ALBANY MEDICAL CENTER IS AT 59, SO OBVIOUSLY, THAT IS LESS THAN 60
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PERCENT. I -- I WANT TO DO A CLARIFICATION, TOO, ON WHAT ONE OF MY
COLLEAGUES SAID. IF YOU'RE GOING TO THE EMERGENCY ROOM, YOU'RE NOT
OUT-OF-NETWORK. BUT WHAT WE'RE TALKING ABOUT HERE IS INPATIENT AND
BEING OUT-OF-NETWORK. SO, ALBANY MEDICAL CENTER IS 59 PERCENT. WE
GO TO ALBANY MEDICAL CENTER, WE'RE OUT-OF-NETWORK. ALBANY
MEMORIAL HOSPITAL IS 29 PERCENT. ST. PETER'S HOSPITAL IS 30 PERCENT.
CUBA MEMORIAL HOSPITAL IS 35. JONES MEMORIAL HOSPITAL IS 33.
LOURDES HOSPITAL - I DON'T KNOW WHETHER I PRONOUNCED IT RIGHT - 37.
OLEAN GENERAL HOSPITAL, 43 PERCENT. TLC HEALTH LAKESHORE HOSPITAL,
53 PERCENT. AUBURN MEDICAL HOSPITAL, 43 PERCENT. BROOKS MEMORIAL
HOSPITAL, 50 PERCENT. UPMC CHAUTAUQUA AT WCA, 53 PERCENT. ARNOT
OGDEN MEDICAL CENTER, 43 PERCENT. ST. JOSEPH'S HOSPITAL IS 67, BUT
YOU NEVER KNOW WHETHER THE NEXT YEAR IT MIGHT BE DOWN BELOW, AND
THAT'S IN ELMIRA. UHS CHENANGO MEMORIAL HOSPITAL, 51 PERCENT.
CHAMPLAIN VALLEY PHYSICIANS HOSPITAL, 20 PERCENT. COLUMBIA
MEMORIAL HOSPITAL, 47 PERCENT. CORTLAND REGIONAL MEDICAL CENTER, 48
PERCENT. MARGARETVILLE HOSPITAL, 19 PERCENT. UHS DELAWARE VALLEY
HOSPITAL, 58 PERCENT. O'CONNOR HOSPITAL, 15 PERCENT. NOW THESE ARE
ALL HOSPITALS THAT WOULD BE OUT-OF-NETWORK. VASSAR BROTHERS MEDICAL
CENTER, 31 PERCENT. NORTHERN DUTCHESS HOSPITAL, 27 PERCENT. ERIE
COUNTY MEDICAL CENTER IS AT 63, BUT THAT'S PRETTY CLOSE TO 60. MERCY
HOSPITAL OF BUFFALO, 33 PERCENT. ROSWELL PARK CENTER INSTITUTE, 22
PERCENT. SISTERS OF CHARITY HOSPITAL, 40 PERCENT. KALEIDA --
MISPRONOUNCED IT, PROBABLY -- HEALTH (INAUDIBLE), 28 PERCENT.
KENMORE MERCY HOSPITAL, 27 PERCENT. BERTRAND CHAFFEE HOSPITAL, 17
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PERCENT. BERLIN HOSPITAL IS 30 PERCENT. ELIZABETHTOWN COMMUNITY
HOSPITAL, 22 PERCENT. MOSES LUDINGTON HOSPITAL, 7 PERCENT.
ADIRONDACK MEDICAL CENTER, 33 PERCENT. NATHAN LITTAUER HOSPITAL, 58
PERCENT. UNITED MEMORIAL MEDICAL CENTER IS AT 64 PERCENT, SO CLOSE TO
THE 60. I'M NOT DOING THE OTHER HOSPITALS THAT ARE ABOVE. LITTLE FALLS
HOSPITAL, 34 PERCENT. SAMARITAN MEDICAL CENTER, 23 PERCENT. RIVER
HOSPITAL, 21 PERCENT. CARTHAGE AREA HOSPITAL, 40 PERCENT. LEWIS
COUNTY GENERAL HOSPITAL, 41 PERCENT. NOYES MEMORIAL HOSPITAL, 40
PERCENT. ONEIDA HEALTHCARE CENTER, 42 PERCENT. COMMUNITY
MEMORIAL HOSPITAL, 19 PERCENT. HIGHLAND HOSPITAL OF ROCHESTER, 41
PERCENT. ROCHESTER GENERAL HOSPITAL, 39 PERCENT. STRONG MEMORIAL
HOSPITAL, 39 PERCENT. UNITED HOSPITAL OF ROCHESTER, 36 PERCENT. ST.
MARY'S HEALTHCARE IN AMSTERDAM, 50 PERCENT. GLEN COVE HOSPITAL, 27
PERCENT. NYU WINTHROP HOSPITAL, 25 PERCENT. MERCY MEDICAL CENTER,
42 PERCENT. THAT'S PAGE ONE. I'VE GOT SIX PAGES. YOU WANT ME TO GO
THROUGH IT. SOUTH NASSAU COMMUNITY HOSPITAL, 34 PERCENT. NORTH
SHORE UNIVERSITY HOSPITAL, 24 PERCENT. PLAINVILLE HOSPITAL, 25 PERCENT.
ST. JOSEPH'S HOSPITAL BETHPAGE -- I'M SORRY, THEY'RE 10 PERCENT. ST.
FRANCIS HOSPITAL OF ROSLYN, 11 PERCENT. EASTERN NIAGARA HOSPITAL, 47
PERCENT. NIAGARA FALLS MEMORIAL MEDICAL CENTER, 57 PERCENT. MOUNT
SAINT MARY'S HOSPITAL, 37 PERCENT. ROME MEMORIAL HOSPITAL, 65, SO
THAT'S PRETTY CLOSE. AND ST. ELIZABETH MEDICAL CENTER, 64, PRETTY CLOSE.
FAXTON ST. LUKE'S HEALTHCARE, 47 PERCENT. ST. JOSEPH HOSPITAL IN
SYRACUSE, 30 PERCENT. UPSTATE UNIVERSITY HOSPITAL IN SYRACUSE, 47
PERCENT. CROUSE HOSPITAL, 31 PERCENT. GENEVA GENERAL HOSPITAL, 30
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PERCENT. CLIFTON HILLS [SIC] -- SPRINGS HOSPITAL AND CLINIC, 46 PERCENT.
F.F. THOMPSON HOSPITAL, 30 PERCENT. ST. LUKE'S CORNELL HOSPITAL, 43
PERCENT. ORANGE REGIONAL MEDICAL CENTER, 36 PERCENT. ST. ANTHONY'S
COMMUNITY HOSPITAL, 32 PERCENT. MEDINA MEMORIAL HOSPITAL, 40
PERCENT. OSWEGO HOSPITAL, 52 PERCENT. AURELIA OSBORN FOX MEMORIAL
HOSPITAL, 28 PERCENT. BASSETT MEDICAL CENTER, 25 PERCENT. PUTNAM
HOSPITAL, 25 PERCENT. SAMARITAN HOSPITAL IN TROY, 44 PERCENT. HELEN
HAYES HOSPITAL - GREAT HOSPITAL, 19 PERCENT. NYACK HOSPITAL, 53
PERCENT. THAT'S ONLY PAGE TWO. THEY'RE FOUR MORE TO GO. DID YOU SEE
HERE A HOSPITAL THAT, YOU KNOW, WOULD BE INCLUDED IN ALL THIS? MASSENA
MEMORIAL HOSPITAL IS 46 PERCENT. GOUVERNEUR HOSPITAL IS 37.
CANTON-POTSDAM HOSPITAL, 32 PERCENT. CLINTON-FINE HOSPITAL, 32
PERCENT. SARATOGA HOSPITAL, 41 PERCENT. FOUR WINDS OF SARATOGA, 39
PERCENT. ELLIS HOSPITAL, 38 PERCENT. SUNNYVIEW REHAB HOSPITAL, 17
PERCENT. COBLESKILL REGIONAL HOSPITAL, 17 PERCENT -- PERCENT. SCHUYLER
HOSPITAL, 11 PERCENT. CORNELL HOSPITAL, 29 PERCENT. ST. JAMES MERCY
HOSPITAL, 40 PERCENT. IRA DAVENPORT MEMORIAL HOSPITAL, 58 PERCENT.
BRUNSWICK HOSPITAL CENTER, 43 PERCENT. BROOKHAVEN MEMORIAL
HOSPITAL, 49 PERCENT. STONY BROOK SOUTHAMPTON HOSPITAL, 30 PERCENT.
EASTERN LONG ISLAND HOSPITAL, WELL, IT'S 61, SO IT'S CLOSE. JOHN T.
MATTHEW -- MATHER MEMORIAL HOSPITAL, 22 PERCENT. ST. CHARLES
HOSPITAL, 43 PERCENT. STONY BROOK UNIVERSITY MEDICAL CENTER, 37
PERCENT. HUNTINGTON HOSPITAL, 29 PERCENT. SOUTHSIDE HOSPITAL, 44
PERCENT. GOOD SAMARITAN HOSPITAL IN WEST -- WEST ISLIP, 40 PERCENT.
PECONIC BAY MEMORIAL CENTER -- MEDICAL CENTER, 22 PERCENT. ST.
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CATHERINE OF SIENA HOSPITAL, 28 PERCENT. SOUTH OAKS HOSPITAL, 57
PERCENT. CATSKILL REGION [SIC] MEDICAL CENTER AT HARRIS, 55 PERCENT.
CATSKILL REGIONAL MEDICAL CENTER HERMANN, 29 PERCENT. CAYUGA
MEDICAL CENTER AT ITH -- ITHACA, 36 PERCENT. HEALTH ALLIANCE HOSPITAL
MARY -- MARY'S AVENUE, 61, THAT'S CLOSE. HEALTH ALLIANCE HOSPITAL
BROADWAY, 41 PERCENT. ELLENVILLE HOSPITAL, 30 PERCENT. GLEN HALLS
HOSPITAL -- GLENS FALLS HOSPITAL, 37 PERCENT. NEWARK-WAYNE
COMMUNITY HOSPITAL, 49 PERCENT. NEW YORK PRESBYTERIAN HOSPITAL
VALLEY, 27 PERCENT. WHITE PLAINS HOSPITAL, 21 PERCENT. BURKE
REHABILITATION HOSPITAL, 14 PERCENT. MONTEFIORE MEDICAL CENTER IN
MOUNT VERNON, 63, IT'S CLOSE TO 60. MOUNT VERNON MONTEFIORE
MEDICAL CENTER IN NEW ROCHELLE IS 48 PERCENT. NORTHERN WESTCHESTER
HOSPITAL, 18 PERCENT. NEW YORK PRESBYTERIAN LAWRENCE, 29 PERCENT.
PHELPS MEMORIAL HOSPITAL, 39 PERCENT. WESTCHESTER MEDICAL
CENTER IS 47. FOUR WINDS, 55. WYOMING COUNTY COMMUNITY
HOSPITAL, 50 PERCENT. SOLDIERS AND SAILERS MEMORIAL HOSPITAL, 42
PERCENT. CALVARY HOSPITAL, 29 PERCENT. NEW YORK PRESBYTERIAN
BROOKLYN METHODIST, 53 PERCENT. MOUNT SINAI BROOKLYN, 41 PERCENT.
THESE ARE ALL HOSPITALS THAT WILL BE AFFECTED. MOUNT SINAI BETH ISRAEL,
56 PERCENT. HOSPITAL FOR SPECIAL SURGERY, 5 PERCENT. LENOX HILL
HOSPITAL, 30 PERCENT. MEMORIAL SLOAN KETTERING CANCER CENTER, 16
PERCENT. MOUNT -- MOUNT SINAI HOSPITAL, 48 PERCENT. MOUNT SINAI
NEW YORK EYE AND EAR INFIRMARY, 55 PERCENT. MOUNT SINAI
ST. LUKE'S AND WEST [SIC], 54 PERCENT. NEW YORK GRACIE SQUARE
HOSPITAL, 58 PERCENT. NEW YORK UNIVERSITY LANGONE TISCH HOSPITAL,
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41 PERCENT. NEW YORK PRESBYTERIAN HOSPITAL, 44 PERCENT. LONG ISLAND
JEWISH MEDICAL CENTER, 48 PERCENT. AND THE LAST ONE THAT I HAVE ON
THIS PAPER, YOU'LL BE GLAD, RICHMOND UNIVERSITY MEDICAL CENTER, 52
PERCENT. THAT'S A LOT OF HOSPITALS THAT ARE GOING TO BE AFFECTED BY THIS
LEGISLATION IF IT GETS PASSED TONIGHT. AGAIN, I DON'T THINK THERE HAVE
BEEN HEARINGS ON THIS BILL. I THINK HOSPITALS NEED TO EXPRESS THEIR
CONCERN ABOUT IT. WE DID HAVE AN AMENDMENT THAT WAS OFFERED THAT
WOULD BRING IT DOWN TO 40 PERCENT INSTEAD OF 60 PERCENT. NOW ALL
THESE HOSPITALS WOULDN'T BE HELPED BY THAT, BUT A GOOD NUMBER OF
HOSPITALS WOULD BE HELPED BY THAT. I THINK WE'RE MAKING A -- A TERRIBLE
DECISION TONIGHT IF WE GO FORWARD WITH THIS LEGISLATION. AND MAYBE WE
CAN JUST HAVE IT WITHDRAWN AND START THE PROCESS ALL OVER AGAIN AND
INVOLVE EVERYBODY THAT'S IN THE HOSPITAL COMMUNITY AND THE MEDICAL
COMMUNITY. THIS ALL AFFECTS PATIENTS, WHAT WE'RE DOING TONIGHT. IF WE
DON'T HAVE GOOD SERVICES IN OUR HOSPITALS BECAUSE THEY'RE NOT BEING
REIMBURSED, IT IS GOING TO HAVE A NEGATIVE IMPACT ON OUR PATIENTS. SO
THIS IS REALLY A PATIENT-RELATED PIECE OF LEGISLATION BEFORE US. IF
ANYBODY WANTS TO COME AND SEE -- SEE THIS LIST, THEY ARE WELCOME TO DO
IT. I'M SURPRISED THAT THE CODES COMMITTEE OR THE EXPRESSION AT -- AT
THE MEETING DID NOT HAVE THIS KIND OF INFORMATION AVAILABLE FOR PEOPLE
TO UNDERSTAND WHAT THE IMPACT WAS FOR THEIR COMMUNITY. THANK YOU.
ACTING SPEAKER AUBRY: MR. SAYEGH.
MR. SAYEGH: THANK YOU, MR. SPEAKER. ON A -- AS
A FOLLOW-UP, AND HAVING BEEN SOMEONE THAT'S BEEN INVOLVED, I OFTEN
SAY EDUCATION, BUT HEALTHCARE ALSO, I'VE HAD FIVE BROTHERS THAT ARE
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MEDICAL DOCTORS, AND I'VE HAD AN EXTENSIVE INVOLVEMENT SERVING ON
HOSPITAL BOARDS. AND I GOT TO TELL YOU, WHAT IS HAPPENING THIS EVENING
WITH THIS BILL TOOK PLACE A NUMBER OF YEARS AGO THAT DIMINISHED PRIMARY
MEDICAL PRACTICES. WE HAVE WITNESSED A WHOLE OVERHAUL IN THE WAY WE
CONDUCT MEDI -- MEDICINE IN OUR STATE, BECAUSE INSURANCE COMPANIES
AND LARGE BUSINESSES HAVE TAKEN OVER AND DICTATED WHAT AND HOW
MEDICAL DOCTORS PROVIDE MEDICAL SERVICES. TODAY OUR MEDICAL
GRADUATES NO LONGER LOOK TO OPEN PRIVATE PRACTICES. THE ONLY WAY YOU
CAN SURVIVE AS A MEDICAL DOCTOR IS YOU HAVE TO JOIN A GROUP, BECAUSE
INSURANCE COMPANIES AND BUSINESS EXECUTIVES THAT HAVE MADE THE MOST
OUT OF HEALTHCARE DOLLARS ARE THE BIG WINNERS IN THIS. AND TONIGHT, THIS
TYPE OF RESOLUTION THAT EMPOWERS INSURANCE COMPANIES AGAIN TO NOW
TARGET HEALTHCARE INSTITUTIONS LIKE HOSPITALS, IS REALLY LEADING US IN THE
SAME DIRECTION. MANY OF US THAT CALLED OUR DOCTORS MANY YEARS AGO
SPOKE TO THEIR PRIVATE STAFF AND WERE ABLE TO SET APPOINTMENTS. NOW
YOU'LL HEAR FROM A RECEPTIONIST IN CAROLINA OR ELSEWHERE AND OTHER PARTS
OF THE COUNTRY THAT TRY TO TELL YOU, WELL, YOU CAN'T REALLY SPEAK TO THE
DOCTOR BECAUSE THERE'S NO LONGER PRIMARY CARE PRACTICE. AND AS
SOMEONE -- I SPOKE EARLIER ABOUT WESTCHESTER MEDICAL CENTER BEING A
TRAUMA CENTER. AND I GOT TO TELL YOU, FOR MANY INDIVIDUALS THAT WOULD
BE IMPACTED, IT'S A SERIOUS PROBLEM. FROM A PERSONAL EXPERIENCE, ONE
OF MY BROTHERS A NUMBER OF YEARS AGO, A MEDICAL DOCTOR THAT HAD AN
ANEURYSM AND WAS BROUGHT TO THE LOCAL HOSPITAL AND BASICALLY WAS TOLD,
WE CAN'T SAVE HIM, AND THE ONLY WAY WAS TO SEND HIM TO WESTCHESTER
MEDICAL CENTER. NOW, THE AMBULANCE WENT ABOUT 70 MILES PER HOUR TO
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TAKE HIM FROM ST. JOHN'S RIVERSIDE IN YONKERS TO WESTCHESTER MEDICAL
CENTER. THEY WERE ABLE TO SAVE HIM AND WERE ABLE TO SHARE WITH HIM
FOR TWO YEARS - HE ENDED UP PASSING AWAY - BUT THOSE TWO YEARS WERE OF
GREAT VALUE FOR OUR FAMILY. AND THIS IS A SITUATION THAT WILL IMPACT
MANY FAMILIES, AND THIS IS NOT JUST THE WESTCHESTER DELEGATION. THE
ENTIRE LOWER HUDSON VALLEY WOULD BE IMPACTED BY POTENTIALLY
SHUTTING DOWN ONE OF THE MOST PRODUCTIVE AND MOST TECHNICAL AND
EXPERIENCED TRAUMA CENTERS IN THE ENTIRE STATE. SO I ASK MY COLLEAGUES
TO KEEP IN MIND THAT FOR ESPECIALLY MANY OF US, LIKE MYSELF, THAT -- THAT
WERE ELECTED RECENTLY AND ARE FRESHMEN MEMBERS OF THIS ASSEMBLY, I
DON'T WANT TO HEAR WHAT HAPPENED TWO YEARS AGO AND LAST YEAR. I WANT
TO BE ABLE TO LOOK AT A BILL, LOOK AT A RESOLUTION AND BE ABLE TO
UNDERSTAND IT TO MAKE A DECISION BASED ON THE FACTS BEFORE ME. NOT
WHAT WAS BEFORE LAST YEAR OR TEN YEARS AGO. SO I ASK US TO LOOK AT THIS
RESOLUTION AND TO RECOGNIZE THIS IS, IN MY OPINION, THE LAST MINUTE
BECAUSE I PERSONALLY BECAME AWARE OF IT THREE DAYS AGO. THAT'S ALL.
AND -- AND A DAY OR TWO AGO, WE THOUGHT THERE WAS NEGOTIATIONS GOING
ON. NOW WHY ARE THOSE NEGOTIATIONS BEING CUT BACK? WHY IS IT THAT
WE CAN'T PUT THIS ON THE TABLE AND HAVE THE PARTIES NEGOTIATE AND PUT IT
BACK SO THAT WE CAN BEGIN TO BECOME FAMILIAR WITH IT AND MAKE SURE
THAT WHATEVER OPTIONS ARE ON THE TABLE, SIMILAR TO THE ONE PRESENTED BY
MY COLLEAGUE, ASSEMBLYMAN PRETLOW, THAT SEEMS TO BE PRETTY
REASONABLE. BUT LET'S PUT ASIDE -- PARTY POLITICS ASIDE, AND LET'S MAKE
SURE WE LOOK AT THIS AND MAKE THE BEST DECISION IN THE BEST INTERESTS, AS
WAS STATED EARLY -- EARLY -- EARLIER, OF PATIENTS. BECAUSE WHEN WE TALK
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ABOUT HOSPITALS, WE'RE PRIMARILY TALKING ABOUT PATIENTS.
THANK YOU VERY MUCH.
(APPLAUSE)
ACTING SPEAKER AUBRY: MR. SCHMITT.
MR. SCHMITT: THANK YOU, MR. SPEAKER. WOULD
THE SPONSOR YIELD?
ACTING SPEAKER AUBRY: WILL YOU YIELD, MR.
CAHILL?
MR. CAHILL: YES, MR. SPEAKER.
ACTING SPEAKER AUBRY: THE SPONSOR YIELDS.
MR. SCHMITT: THANK YOU, MR. CHAIRMAN. I
APPRECIATE YOU TAKING A FEW MINUTES TO ANSWER A FEW MORE QUESTIONS.
MR. CAHILL: SURE.
MR. SCHMITT: COMING FROM ORANGE AND ROCKLAND
COUNTIES, WESTCHESTER MEDICAL CENTER IN PARTICULAR SERVICES MANY OF
MY CONSTITUENTS, THOSE WHO WORK, RESIDE OR VISIT MY AREA. IF THIS
LEGISLATION WERE TO PASS AND BE ENACTED, HOW DO YOU SEE IT AFFECTING
HEALTHCARE OVER THE NEXT 5, 10, 15 YEARS? I KNOW THAT WHEN IT COMES TO
-- TO HEALTHCARE, HEALTHCARE DELIVERY, THERE -- THAT'S KIND OF THE MODEL
THAT WE'RE LOOKING AT IN THE LONGER-TERM VIEW. WHAT IS YOUR OPINION?
MR. CAHILL: THANK YOU, MR. SPEAKER. ANYBODY
THAT PROFESSES TO KNOW WHAT'S GOING TO HAPPEN TO HEALTHCARE IN THE NEXT
15 YEARS OR TEN YEARS OR FIVE YEARS OR EVEN THE NEXT COUPLE OF YEARS IS
REALLY MAKING IT UP, BECAUSE HEALTHCARE IS DYNAMIC. IT'S CHANGING
CONSTANTLY IN -- IN UNPREDICTABLE WAYS. WE HAD THE AFFORDABLE CARE
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ACT, AND THEN WE HAD ATTEMPTS TO DESTROY THE AFFORDABLE CARE ACT THAT
WEREN'T SUCCESSFUL. AND THEN WE HAD ATTEMPTS THAT WAS DEATH BY A
THOUSAND CUTS AND IT SERIOUSLY HINDERED THE AFFORDABLE CARE ACT. WE
HAD A LEGISLATURE THAT CONSIDERED FOR MANY YEARS A SINGLE-PAYER BILL,
BUT IT LOOKED LIKE IT WOULD NEVER SEE THE LIGHT OF DAY. WE'RE NOW
CONDUCTING SERIOUS HEARINGS ON A SINGLE-PAYER BILL. WE HAD HOSPITALS
THAT WERE BORN AND BRED IN OUR COMMUNITIES, AS YOU HEARD SOME OF OUR
COLLEAGUES DESCRIBE WESTCHESTER MEDICAL CENTER HERE TODAY, AND WE'VE
SEEN THOSE HOSPITALS GOBBLED UP BY CONGLOMERATES. WE'VE HAD
HOSPITALS IN OTHER COMMUNITIES THAT HAVE CLOSED. WE HAVE SEEN HEALTH
INSURANCE COMPANIES HAD THEIR RATES DROP BY 40 PERCENT JUST A FEW
YEARS AGO, AND THEN WE'VE SEEN THEM CLIMB RIGHT BACK UP AGAIN. WE'VE
SEEN HEALTHCARE COSTS TAKE DRAMATIC TWISTS AND TURNS. WE'VE SEEN
CHANGES IN HEALTHCARE. SOMETHING I THINK NONE OF US ANTICIPATED THAT
IN OUR LIFETIMES WE WOULD SEE THE LIFE EXPECTANCY OF HUMAN BEINGS IN
THIS COUNTRY TO STOP RISING. WE'VE SEEN THAT. WE'VE SEEN AN OPIOID
EPIDEMIC. WE'VE SEEN LYME DISEASE. THERE IS NO PREDICTING WHAT THE
FUTURE HOLDS. BUT, WHAT IS THE IMPACT OF THIS BILL ON THE FUTURE OF
HEALTHCARE IN THE HUDSON VALLEY, IN THE -- IN THE WESTERN PART OF NEW
YORK, ON LONG ISLAND, IN THE CITY OF NEW YORK, IN THE ADIRONDACKS
AND ALL OVER THE STATE? IT I A STABILIZING FORCE. THIS IS A STABILIZING
FORCE. THIS WILL PREVENT THE DISLOCATION THAT WOULD OTHERWISE HAVE
OCCURRED WHEN A CONTRACT IS CONCLUDED. THIS WILL ALLOW A NEUTRAL
THIRD-PARTY APPOINTED BY US, FOR ALL INTENTS AND PURPOSES, TO DETERMINE
WHAT IS THE APPROPRIATE CHARGE TO -- TO CHARGE WHEN THE TWO PARTIES
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CANNOT DECIDE IT THEMSELVES. LET ME REITERATE THAT MOST OF THE TIME, OUR
PROVIDERS AND OUR INSURERS AGREE. MOST OF THE TIME. EVEN WHEN THEY
ARE NOT IN CONTRACT, THEY AGREE. THIS IS FOR THOSE OUTLIER CIRCUMSTANCES
THAT HAVE BEEN, UP TO THIS MOMENT, UNSOLVABLE. THIS WILL SOLVE IT. IT
DOESN'T SOLVE IT BY GIVING ONE SIDE A GUN TO POINT AT THE HEAD OF THE
OTHER SIDE. INSTEAD, WHAT IT GIVES THE TWO SIDES IS A THIRD NEUTRAL PLACE
TO GO, TO HAVE THE MERITS OF THEIR POSITION WEIGHED BY AN INDEPENDENT
THIRD-PARTY.
SO, WHAT IS THE FUTURE OF HEALTHCARE BECAUSE OF THIS
BILL? THIS VASTLY IMPROVES HEALTHCARE. NOTHING ABOUT THIS BILL
DIMINISHES HEALTHCARE. FOR ALL OF THE RHETORIC WE HEARD TODAY ABOUT
HOW IT WILL DESTROY HOSPITALS, IT WILL ABSOLUTELY NOT DESTROY HOSPITALS.
AND REST ASSURED, FOR MY COLLEAGUES WHO WOULD ASSERT THAT I WOULD
INTRODUCE A BILL THAT WOULD DESTROY HOSPITALS IS A LITTLE BIT PERSONALLY
OFFENSIVE. THIS BILL IS INTENDED TO BRING STABILITY. THIS BILL IS INTENDED
TO BRING AN OPPORTUNITY FOR UNRESOLVABLE ISSUES TO BE RESOLVED. IT WILL
BE A POSITIVE.
MR. SCHMITT: THANK YOU FOR THAT EXPLANATION, MR.
CHAIRMAN. YOU MENTIONED THE CHANGES OR, YOU KNOW, THE DIFFERENT
OPINIONS ON THE AFFORDABLE HEALTHCARE ACT, OBVIOUSLY, THE
SINGLE-PAYER DISCUSSIONS THAT WE'RE HAVING IN THE STATE AND WE'RE
SEEING ACROSS THE NATION. IN YOUR OPINION WILL -- I'M NOT SUPPORTIVE OF
THE SINGLE-PAYER MODEL, BUT SHOULD THAT BE ADVANCED OR SHOULD THERE BE
OTHER CHANGES AT THE FEDERAL LEVEL, WOULD THAT MAKE THIS LEGISLATION
NULL AND VOID AT THAT POINT? WILL THERE STILL BE A NEED FOR IT AT THAT POINT
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IF -- IF THAT'S THE ROAD THAT WE GO DOWN?
MR. CAHILL: MR. SPEAKER, MY COLLEAGUE, AT THIS
MOMENT I WOULD LOVE -- I WON'T DO IT, BUT I WOULD LOVE TO YIELD TO MY,
COLLEAGUE, MR. GOTTFRIED, SO HE CAN GIVE HIS CONSISTENT ANSWER TO THAT
QUESTION OF YES, YES, YES.
MR. SCHMITT: HE -- HE LOOKS READY, MR. SPEAKER.
(LAUGHTER)
MR. GOTTFRIED: I -- I THINK I'VE BEEN ASKED TO SAY
SOMETHING.
(LAUGHTER)
IN -- IN -- FOR MANY YEARS NOW IN ALMOST EVERY
MEETING --
ACTING SPEAKER AUBRY: MR. SMITH [SIC] HAS
THE FLOOR, SO IF HE WANTS YOU TO -- HE WOULD HAVE TO YIELD. MR. CAHILL
DID NOT HAVE THE FLOOR, HE WAS ANSWERING A QUESTION.
MR. GOTTFRIED: IT'LL BE QUICK.
MR. SCHMITT: MR. SPEAKER, I WILL GLADLY YIELD TO
THE CHAIR --
MR. GOTTFRIED: OH, COOL.
(LAUGHTER)
ACTING SPEAKER AUBRY: MR. SMITH [SIC]
YIELDS TO MR. GOTTFRIED.
MR. GOTTFRIED: I WASN'T PLANNING ON GETTING
INVOLVED IN THIS DISCUSSION, BUT IN ALMOST EVERY MEETING ABOUT HEALTH
POLICY THAT I'M IN, THERE COMES A POINT WHERE I SAY, THIS IS THE POINT IN
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THE MEETING WHERE I SAY IF THE NEW YORK HEALTH ACT WAS LAW, WE
WOULDN'T HAVE TO BE TALKING ABOUT THIS. THANK YOU.
(LAUGHTER)
ACTING SPEAKER AUBRY: AND I'M SURE THAT
PROVIDED SOME ILLUMINATION TO THE DISCUSSION.
NOW MR. SMITH [SIC].
MR. SCHMITT: THANK YOU, MR. SPEAKER. MR.
CHAIRMAN, I GO BACK TO THE -- THE 2014 BUDGET NEGOTIATIONS WHEN I WAS
A YOUNG STAFFER OVER ON THE SENATE SIDE, AND WE SAW THE INITIAL REAL
BREAKTHROUGH WHEN IT COMES TO, YOU KNOW, THE OUT-OF-NETWORK
PROTECTIONS THAT WE SAW. AND AT THAT POINT WE SAW DOCTORS, PATIENTS
REALLY WORKING TOGETHER AND I FEEL LIKE THERE'S KIND OF -- THERE ARE
SIMILARITIES HERE AND DIFFERENCES TO WHAT WE WENT THROUGH DURING THAT
2014 BUDGET NEGOTIATION UNTIL THE FINAL PRODUCT. DO YOU -- DO YOU
THINK THAT IT IS IN LINE WITH WHAT WE SAW OUT OF THAT 2014 BUDGET
NEGOTIATION? THIS IS AN OUTGROWTH OF IT OR THIS -- THIS IS REALLY A
MODIFICATION GOING IN A DIFFERENT DIRECTION?
MR. CAHILL: NO, I THINK -- AND -- AND, MR.
SPEAKER, IN RESPONSE TO THE QUESTION BY MY COLLEAGUE, YES, IT IS
CONSISTENT WITH WHAT THE FINDINGS WERE IN 2014. AND -- AND LET'S LOOK
DOWN THE ROAD A LITTLE BIT. TODAY THE INSURANCE COMMITTEE TOOK UP A
BILL BY OUR COLLEAGUE, MR. MAGNARELLI, CONCERNING AMBULANCE SERVICES.
WE HAVE TO RESOLVE THAT ONE AS WELL. OUR GOAL HERE IS TO GET HEALTHCARE
COSTS UNDER CONTROL TO MAKE SURE THEM PREDICTABLE FOR CONSUMERS, AND
TO MAKE SURE THAT OUR HEALTHCARE DELIVERY SYSTEM REMAINS INTACT IN THE
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PROCESS. I BELIEVE THIS IS ENTIRELY CONSISTENT WITH THOSE GOALS AS STATED
BACK IN '14, '16 AND '17 WHEN THE -- WHEN THE WORKING GROUP CAME OUT
WITH THEIR FINDINGS.
MR. SCHMITT: NOW, THERE SEEMS TO BE A -- A
CHANGE IN THE POSITION OF THE INSURANCE INDUSTRY IN THAT -- SINCE THAT
TIME, MR. CHAIRMAN. IS THAT JUST BASED ON THE EXPERIENCES THEY'VE SEEN
ON THE OTHER PARTS SINCE 2014, OR DO YOU FEEL THAT'S RELATED TO SOMETHING
ELSE OR...
MR. CAHILL: MR. SPEAKER, I CAN'T SPEAK FOR THE
INSURANCE INDUSTRY, AND -- AND IN SPITE OF THE PROTESTS OF SOME OF OUR
COLLEAGUES, I DON'T SPEAK FOR THE INSURANCE INDUSTRY. AND IF YOU ASK
THE INSURANCE INDUSTRY, I CAN ASSURE YOU THEY WILL TELL YOU THAT I DON'T
SPEAK ON THEIR BEHALF. BUT I WOULD SAY THAT THE -- THAT THE
DETERMINATION TO MOVE FORWARD WAS MOTIVATED BY A REFLECTION NOT JUST
FROM THE WORKING GROUP WHICH INCLUDED A NUMBER OF DIFFERENT ENTITIES,
INCLUDING HOSPITAL EMPLOYEES, INCLUDING CONSUMER GROUPS, INCLUDING
BUSINESS GROUPS, THAT SAID THAT WE SHOULD CONTINUE TO DO ALL WE CAN TO
RATIONALIZE OUR HEALTHCARE COSTS SO THAT WE DON'T COME TO THE POINT
WHERE WE HAVE TO RATION OUR HEALTHCARE.
MR. SCHMITT: ABSOLUTELY. NOW, MR. CHAIRMAN,
YOU HAD IN A PREVIOUS RESPONSE ALLUDED TO CLOSED HOSPITALS WHICH WE
HAVE SEEN, OBVIOUSLY, IN VARIOUS PARTS OF THE STATE. I'M SURE YOU'RE
AWARE IN MY DISTRICT IN PARTICULAR, WE SAW THE CLOSURE OF THE EMERGENCY
ROOM AT ST. LUKE'S CORNWALL HOSPITAL COMBINING WITH ST. LUKE'S
CAMPUS IN THE CITY OF NEWBURGH. AND OBVIOUSLY, SOME OTHER CHANGES
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IN -- IN THE SERVICES THAT ARE BEING PROVIDED IN ORANGE COUNTY AND IN
THE IMMEDIATE AREA OF MY DISTRICT. DO YOU BELIEVE THAT THIS LEGISLATION
WOULD HAVE IMPACTED THAT CLOSURE, OR WOULD IT POTENTIALLY AID IN
PREVENTING FUTURE CLOSURES OR HAVE ANY IMPACT IN THAT IN ANY WAY?
MR. CAHILL: MR. SPEAKER, IN RESPONSE TO THE
QUESTION I -- I -- I WOULD SAY I COULDN'T PREDICT OR EVEN REFLECT UPON
WHAT IT WOULD HAVE DONE IN THE ST. LUKE'S SITUATION. ST. LUKE'S
CORNWALL WAS -- WAS THE CLOSURE OF THAT EMERGENCY ROOM AND THAT --
THAT SERVICE WAS A PRODUCT OF A LOT OF DIFFERENT FACTORS, AND -- AND SOME
OF THEM LONGSTANDING AND HAVING NOTHING WHATSOEVER TO DO WITH THE
MATTER BEFORE US. WHAT I WOULD SAY IS THAT THIS WOULD LEND STABILITY
WHERE RIGHT NOW THERE'S SOME LEVEL OF UNPREDICTABILITY. YOU KNOW,
ONE OF THE THINGS THAT'S BEEN LOST IN THIS DISCUSSION WHERE WE TALK ABOUT
THE CHARGES THAT THE HOSPITALS MIGHT OR MIGHT NOT INCUR IS WHERE DO THE
PATIENTS GO? PATIENTS TEND TO STILL GO WHERE THEIR NETWORK IS. AND IN
THE CASE OF MY HOSPITAL, 40 OR 50 PERCENT OF THE PATIENTS STOPPED GOING
TO OUR COMMUNITY HOSPITAL AND THEY HAVE NOT RETURNED AS OF THIS TIME.
THEY HAVE NOT RETURNED TO OUR COMMUNITY HOSPITAL BECAUSE THERE WAS
THIS BREACH BETWEEN THE TWO PARTIES THAT -- THAT LEAKED OUT INTO THE
COMMUNITY AND CAUSED HEALTHCARE TO BE INTERRUPTED. ANYTHING THAT CAN
BRING ORDER WHERE THERE IS CHAOS, IN MY VIEW, PARTICULARLY IN
HEALTHCARE, IS -- IS HELPFUL. CAN WE STEM ALL OF THE PROBLEMS THAT WILL
EXIST NOW AND FOR THE FUTURE IN HEALTHCARE? WE SHOULD STRIVE TO. BUT
DO I THINK THIS BILL WILL DO IT? OF COURSE NOT. WILL IT CONTRIBUTE TO IT?
OF COURSE IT WILL.
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MR. SCHMITT: THANK YOU, MR. CHAIRMAN. I JUST
WANT TO -- TO READ A STATEMENT THAT WAS PROVIDED BY THE GREATER NEW
YORK HOSPITAL ASSOCIATION JUST TO GET YOUR OPINIONS ON IT, IF YOU
BELIEVE IT'S ACCURATE TO WHAT THE BILL REFLECTS. THEY STATED, "THERE IS NO
EVIDENCE TO SUGGEST THAT HOSPITAL CHARGES FOR OUR EMERGENCY SERVICES
ARE EXCESSIVE. THIS AMENDMENT PROVIDES NO ADDITIONAL CONSUMER
PROTECTIONS, AS CONSUMERS ARE ALREADY HELD HARMLESS FOR ANY ADDITIONAL
COSTS IN EMERGENCY SITUATIONS. THIS BILL WOULD HARM RATHER THAN HELP
CONSUMERS BY MAKING IT EASIER FOR INSURERS TO EXCLUDE HOSPITALS FROM
THEIR NETWORK, LIMITING CONSUMER ACCESS TO HOSPITALS OF THEIR CHOICE."
SO, DO YOU FIND THAT STATEMENT TO BE INACCURATE, ACCURATE, IN PART, IN
WHOLE, AND MAYBE WHAT WOULD BE A BETTER DIRECTION TO INTERPRET THE
LEGISLATION THAN THAT?
MR. CAHILL: MR. SPEAKER, INSOFAR AS THE STATEMENT
IS CONCERNED, I WILL ADDRESS THE FACTUAL PORTIONS OF IT AND LEAVE THE
OPINION PORTION OF THE GREATER NEW YORK HOSPITAL ASSOCIATION TO
THEM. I CAN'T SUBSTITUTE MY OPINION FOR THEIRS, AND I RESPECT THEIR
OPINION. BUT AS FOR THE FACTUAL PORTION OF -- OF THEIR STATEMENT THAT
THERE IS LITTLE EVIDENCE THAT -- THAT THE VAST MAJORITY OF CHARGES ARE -- ARE
NOT INAPPROPRIATE, I AGREE. THE VAST MAJORITY OF CHARGES ARE NOT
INAPPROPRIATE. MOST OF THE TIME, HOSPITALS AND INSURANCE COMPANIES
AGREE. THE VAST MAJORITY OF THE TIME, HOSPITALS AND INSURANCE
COMPANIES AGREE. THE VAST MAJORITY OF TIME, HOSPITALS ARE -- ARE
ASSERTING CHARGES THAT ARE LEGITIMATE, THAT ARE CONSISTENT WITH WHAT THEY
HAVE BEEN CHARGING BEFORE. THAT IS THE USUAL CIRCUMSTANCE, AND THAT IS
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NOT WHAT THIS BILL IS ADDRESSING. THE BILL IS ADDRESSING FOR THOSE
INSTANCES WHERE IT DOESN'T HAPPEN. AND IT DOESN'T HAPPEN SOMETIMES,
AND WE HAVE AN OBLIGATION TO MAKE SURE THAT WE INTERVENE TO PROVIDE
AN ORDERLY PROCESS FOR DEALING WITH THOSE ANOMALIES, THOSE UNUSUAL
SITUATIONS. YES, BY AND LARGE, I THINK THE PEOPLE WHO RUN OUR HOSPITALS
- AND I DON'T CONSIDER THEM TO BE THE ADMINISTRATORS, I CONSIDER THEM TO
BE THE BOARDS - THE PEOPLE WHO RUN OUR HOSPITALS ARE VERY RESPONSIBLE
AND RESPONSIVE TO THE COMMUNITIES. OCCASIONALLY, STRATEGIC DECISIONS
ARE MADE THAT DON'T REFLECT THAT RESPONSIBILITY, AND WHEN THAT OCCURS,
THAN THIS BILL WOULD TAKE HOLD. OCCASIONALLY, THOSE DECISIONS ARE
APPROPRIATE, EVEN IF THEY SEEM TO BE AN OUTLIER. THIS WOULD PROVIDE A
MEANS BY WHICH THOSE OUTLIER DECISIONS COULD BE VALIDATED AND CARRIED
FORTH WITH A PAYMENT BY AN INSURANCE COMPANY. SO, ORDER OUT OF
CHAOS.
MR. SCHMITT: THANK YOU, MR. CHAIRMAN. I -- I
KNOW PREVIOUS COLLEAGUES HAD MENTIONED VARIOUS DIFFERENT HOSPITALS,
HOSPITAL SYSTEMS. DO YOU HAVE ANY -- AND THEIR -- THEIR PERCENTAGES
READ OFF. BON SECOURS, ORANGE REGIONAL MEDICAL CENTER, ST. LUKE'S
THAT SERVICE ORANGE AND ROCKLAND COUNTIES, DO YOU HAVE ANY SPECIFIC
KNOWLEDGE OR ANY SPECIFIC REQUESTS THAT HAVE COME TO YOUR OFFICE FROM
ANY OF THESE ENTITIES?
MR. CAHILL: MR. SPEAKER, NO. I -- I AM NOT EVEN
AWARE OF THE SOURCE OF THE LIST THAT WAS CITED BY A COLLEAGUE HERE TODAY.
I'M SURE IT IS WELL-SOURCED AND I'M SURE IT CAME PROBABLY -- I'M NOT
SURE, BUT I BELIEVE IT PROBABLY CAME FROM PEOPLE AFFILIATED WITH THE
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HOSPITAL INDUSTRY WHO HAVE INDICATED THEIR OPPOSITION TO THIS BILL SO
THAT THEY COULD BOLSTER THEIR CASE AS TO WHY THEY ARE AGAINST IT.
MR. SCHMITT: THANK YOU FOR THAT ANSWER, MR.
CHAIRMAN. ALSO MENTIONED, SOME UNCERTAINTY IN WASHINGTON AT THE --
AT THE FEDERAL LEVEL AND HOW THAT COULD IMPACT OUR -- OUR HEALTH
SITUATION HERE IN THE STATE OF NEW YORK. AND I KNOW THAT ALSO THE
ROCHESTER REGIONAL HEALTHCARE ADVOCATES HAD SAID THEY FEEL THE -- THE
THREATS AND UNCERTAINTY FROM WASHINGTON ON THE ONGOING HEALTHCARE
DEBATE, THIS WILL EXASPERATE THEIR CONCERNS. DO -- DO YOU ALSO FEEL THAT
IS AN ADEQUATE OR INADEQUATE CONCERN, AND -- AND IS THERE ANY -- IS THERE
ANY OTHER AVENUE OTHER THAN THIS THAT MIGHT BE ABLE TO ALLEVIATE IT
WITHOUT PLACING AN EXTRA CONCERN ON THOSE ENTITIES?
MR. CAHILL: MR. SPEAKER, THERE ARE MANY THINGS
WE COULD DO OTHER THAN THIS, AND ONE OF THE THINGS WE COULD DO IS WE
COULD MANDATE FEES. WE COULD SAY, THIS IS WHAT YOU WILL BE PAYING,
AND, THIS IS WHAT YOU WILL PAY, INSURANCE COMPANIES. WE COULD DO
THAT. I THINK IT WOULD BE A BIG MISTAKE TO DO THAT. WE'RE NOT IN THAT
BUSINESS. BUT WE COULD DO IT, AND WE COULD DO IT IN A WAY THAT MAYBE
WOULD BE POLITICALLY POPULAR FOR A LITTLE BIT OF TIME BECAUSE WE WOULD
TELL OUR HOSPITALS HERE, HAVE ANYTHING YOU WANT, IT'S A BLANK CHECK, AND
TELL OUR INSURANCE COMPANIES, PAY IT. BUT THAT WOULD BE A SHORT-TERM
SOLUTION BECAUSE WITHIN VERY SHORT ORDER, OUR INSURANCE COMPANIES
WOULD BE BANKRUPT. IF WE DID THE OPPOSITE, OUR HOSPITALS WOULD BE
BANKRUPT.
MR. SCHMITT: THANK YOU, MR. CHAIRMAN. I
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APPRECIATE IT.
ACTING SPEAKER AUBRY: THANK YOU, SIR.
MR. RA.
MR. RA: THANK YOU, MR. SPEAKER.
ON THE BILL.
ACTING SPEAKER AUBRY: ON THE BILL, SIR.
MR. RA: THANK YOU. SO, YOU KNOW, I -- I THANK MY
COLLEAGUES FOR THEIR COMMENTS ON THE -- ON THIS BILL AND, YOU KNOW,
PARTICULARLY, WE'VE HEARD FROM A LOT OF OUR COLLEAGUES FROM
WESTCHESTER. BUT I -- I DON'T WANT ANYBODY TO FORGET THAT THERE ARE
OTHER PARTS OF THE STATE THAT ARE GOING TO BE GREATLY IMPACTED, AND I
HEARD -- WE HEARD FROM MANY OF OUR COLLEAGUES, FOR EXAMPLE, LONG
ISLAND. WE HAVE SOME HOSPITALS ON LONG ISLAND WHERE, YOU KNOW,
THEY'VE DROPPED OUT-OF-NETWORK ON CERTAIN PLANS AND IT'S CAUSED, YOU,
KNOW, LOCAL PATIENTS AND CONSUMERS A GREAT HARDSHIP TO HAVE A LOCAL
HOSPITAL THAT THEY COULD GO TO. SO WE ARE -- YOU KNOW, IT'S BEEN
ALLUDED TO THAT MANY PLANS ARE, YOU KNOW, IN THE PROCESS OF
NEGOTIATIONS WITH, YOU KNOW, WITH -- WITH DIFFERENT HOSPITALS, AND --
AND I THINK MANY ARE LOOKING AT THIS AND PAYING ATTENTION TO WHAT WE'RE
DOING. AND, YOU KNOW, I WOULD SAY FROM A BUSINESS STANDPOINT, WHY
WOULD YOU NOT WAIT TO SEE IF SOMETHING LIKE THIS IS GOING TO BE DONE
THAT MAY CHANGE THE PLAYING FIELD AND THE BALANCE OF THAT NEGOTIATION
AND WHO'S GOING TO HAVE THE LEVERAGE. YOU KNOW, I -- I CERTAINLY
WOULD SEE WHY AN INSURANCE COMPANY WOULD WAIT TO SEE THIS
LEGISLATION ENACTED.
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NYS ASSEMBLY JUNE 5, 2019
A FEW YEARS AGO, YOU KNOW, I HAD THE OPPORTUNITY
WHEN WE WERE TALKING ABOUT -- ABOUT, YOU KNOW, THERE HAD BEEN ALL
THIS TALK ABOUT THESE SURPRISE OUT-OF-NETWORK BILLS -- CHARGES AND, YOU
KNOW, I -- I WENT TO SOME OF THE ROUNDTABLES THAT WERE HELD AND, YOU
KNOW, THERE WAS A COMPREHENSIVE APPROACH PUT FORTH TO HELP PROTECT
THE CONSUMER AND -- AND HELP ENSURE THAT -- THAT BILLS GET PAID IN A
TIMELY MANNER AND THAT -- THAT WE, YOU KNOW, CERTAINLY STARTED WITH
THAT PREMISE. THE CONSUMER NEEDED TO BE PROTECTED. AND THEN WE PUT
TOGETHER PROCESSES IN CERTAIN AREAS TO HELP ENSURE THAT CLAIMS WERE PAID
AND THE SYSTEM COULD MOVE FORWARD.
YOU FAST FORWARD TO NOW, YOU KNOW, REGARDLESS OF
HOW YOU WANT TO LOOK AT IT, YOU KNOW, THIS -- THIS BILL WAS PUT ON AN --
AN AGENDA IN ONE COMMITTEE, MOVED TO ANOTHER, STRAIGHT OUT TO THE
FLOOR. WE -- WE DON'T SEE A TON OF THAT HERE OTHER THAN MAYBE, YOU
KNOW, THE BUDGET OR -- OR SOME BIG UGLY THAT MAYBE WE'LL SEE IN -- IN A
FEW WEEKS HERE. SO, I DO FEEL IT'S BENG RUSHED. I DO FEEL IT'S, YOU
KNOW, DEPRIVING US OF AN ADEQUATE OPPORTUNITY TO -- TO HEAR FROM
DIFFERENT HOSPITALS THAT WE REPRESENT. JUST DURING THE COURSE OF THIS
DEBATE, MY UNDERSTANDING -- YOU KNOW, I'VE HEARD FROM MULTIPLE
PEOPLE WHO SUDDENLY GOT MEMOS OR GOT SOME COMMENTS FROM THEIR
LOCAL HOSPITALS WHO DIDN'T REALIZE THAT THIS WAS MOVING FORWARD AT THIS
PACE, AND THEY WANTED TO WEIGH IN. AND THEY'RE DOING IT IN THE MIDDLE
OF A DEBATE. YOU KNOW, IT WAS ALLUDED TO EARLIER THAT WE HAD THESE
HEARINGS AND WE ARE HAVING HEARINGS ONGOING ABOUT AN ISSUE LIKE
SINGLE-PAYER, AND I PARTICIPATED IN A HEARING A FEW WEEKS AGO. AND,
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YEAH, THAT'S HOW IT SHOULD BE DONE. YOU KNOW, THAT'S LEGISLATING AND
HAVING HEARINGS ON -- ON IMPORTANT ISSUES AND -- AND HAVING THAT INPUT
REFLECTED IN WHAT A BILL ULTIMATELY LOOKS LIKE IS HOW THE LEGISLATIVE
PROCESS SHOULD BE DONE. AND -- AND, YOU KNOW, I FEEL THAT THERE'S
MANY THINGS THAT ARE LEFT UNANSWERED. YOU KNOW, IS THAT 60 PERCENT
NUMBER THE APPROPRIATE NUMBER FOR THE MEDICAID POPULATIONS? I - I'VE
LOOKED THROUGH THE LIST THAT MY COLLEAGUE HAD AND, YOU KNOW, THAT
AMENDMENT THAT, YOU KNOW, WAS DISCUSSED EARLIER. THERE'S A HOSPITAL
RIGHT IN MY OWN BACKYARD THAT -- THAT I'VE UTILIZED ON LONG ISLAND THAT
-- THAT WOULD HAVE BENEFITTED FROM -- FROM MAKING THAT TYPE OF CHANGE.
GREATLY, I'M SURE. YOU KNOW, IT -- IT'S ALWAYS DANGEROUS WHEN THE --
WHEN THE LEGISLATURE, YOU KNOW, MOVES FORWARD SOMETHING THAT IS
GOING TO HAVE FAR GREATER IMPACTS THAN WHAT'S ON THE PAPER THAT IT'S
PRINTED. AND IT'S CERTAINLY GOING TO IMPACT THOSE NEGOTIATIONS THAT ARE
ONGOING, AND -- AND I WANTED TO JUST, YOU KNOW, STATE FOR THE RECORD
HERE TODAY THAT IT'S GOING TO IMPACT LONG ISLAND AS WELL. I KNOW THERE'S
A VERY CLEAR IMPACT ON WESTCHESTER, AND I THANK MY -- MY COLLEAGUES
FOR THEIR, YOU KNOW, FOR THEIR COMMENTS TODAY. BUT THERE -- THERE'S
GOING TO BE AN IMPACT ON -- THROUGHOUT THE STATE. AND JUST ONE THOUGHT
TO LEAVE YOU WITH. WE WOULDN'T BE LOOKING AT A NUMBER OR A THRESHOLD
NUMBER FOR EXEMPTIONS IF WE WEREN'T OPERATING UNDER THE PREMISE THAT
THE HOSPITALS ARE GOING TO BE GIVEN LESS. THAT WOULD BE THE ONLY REASON
WE WOULD HAVE THAT THRESHOLD. SO WE HAVE TO, YOU KNOW, REMEMBER
THAT YOU'RE GOING TO DEAL WITH NOT JUST THE AMOUNT OF MONEY, BUT ALSO
CASH FLOW. HOW MANY TIMES HAVE WE HEARD ABOUT DIFFERENT CASH FLOW
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ISSUES THAT INSTITUTIONS UNDERTAKE? AND THIS HAS THE POTENTIAL, ALSO,
WITH THIS NEW PROCESS, TO DELAY THOSE CLAIMS BEING PAID WHICH -- WHICH
COULD HAVE, IN SOME CASES, CATASTROPHIC RESULTS.
SO, I -- I THANK MY COLLEAGUES, YOU KNOW, ON BOTH
SIDES OF THIS ISSUE AND BOTH SIDES OF THE AISLE FOR THEIR DEBATE TODAY.
BUT, AGAIN, I THINK THAT -- I THINK WE'RE MOVING FORWARD ON THIS WITH --
WITHOUT HAVING HAD TRULY THE, YOU KNOW, TYPE OF HEARINGS THAT WE
SHOULD HAVE ON AN ISSUE OF THIS MAGNITUDE.
THANK YOU.
ACTING SPEAKER AUBRY: THANK YOU, SIR.
MR. BUCHWALD FOR HIS SECOND.
MR. BUCHWALD: THANK YOU, MR. SPEAKER. AND,
MR. SPEAKER, LET ME FIRST, IF I COULD, ASK -- ASK YOU, AM I CORRECT THAT
UNDER YOUR PRIOR RULING, THIS IS THE FIRST TIME NOW THAT I HAVE THE FLOOR,
THAT I COULD MOVE TO ADJOURN IF I WANTED TO?
ACTING SPEAKER AUBRY: YOU COULD MOVE IT.
MR. BUCHWALD: BUT THIS IS THE FIRST TIME,
CORRECT? BEFORE NOW, ALL THE TIMES I'VE SPOKEN, I'VE ONLY BEEN YIELDING
SINCE I ASKED THAT LAST QUESTION, CORRECT?
ACTING SPEAKER AUBRY: FOR YOU, PERSONALLY,
TO MAKE THAT MOTION, YES.
MR. BUCHWALD: THANK YOU. AND I - -I WANT TO
SAY TO COLLEAGUES - AND I KNOW WE ARE NOW HITTING PAST 8:00 - THERE'S A
PART OF ME THAT IS TREMENDOUSLY SORRY, BECAUSE THIS IS NOT WHAT WE
SHOULD BE DOING RIGHT NOW. MEMBERS SHOULD BE AT THE WOMEN'S
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CAUCUS DINNER, SHOULD BE OTHERWISE ENJOYING WHATEVER THEIR NORMAL
PLANS WERE FOR THIS EVENING. BUT I -- I HAVE TO CONVEY, I'VE BEEN ASKED
BY LEADERSHIP NOT TO MOVE TO ADJOURN. IF OTHERS THINK THAT'S THE WRONG
DECISION, FEEL A CERTAIN POINT -- A DECISION FOR EACH PERSON TO CONVEY
THEIR THOUGHTS. I HAVE RESPECT FOR WHAT THE GENTLEMAN WHO SPOKE PRIOR
SAID IN TERMS OF THE IDEA THIS BILL MAY BE SUBJECTED TO HEARINGS AND SO
FORTH. I WANT TO MAKE IT CLEAR, THOUGH: MY REQUEST IS SIMPLY LET'S DO IT
ANOTHER DAY. WE'VE GOT ANOTHER TWO, TWO-AND-A-HALF WEEKS OF SESSION.
THERE IS NO PARTICULAR REASON THIS BILL HAS TO BE VOTED ON TODAY. I'VE
HAD NUMEROUS COLLEAGUES COME UP TO ME, ASKING WHAT IS THE IMPACT ON
THEIR HOSPITALS. AND I UNDERSTAND THAT NOT EVERY HOSPITAL EITHER HAS ITS
OWN GOVERNMENT RELATIONS TEAM OR IS AS PROACTIVE. THERE IS A --
STATEWIDE HOSPITAL ASSOCIATION. MY PERSONAL VIEW HAS ALWAYS BEEN I
CARE FAR LESS WHAT A STATEWIDE ASSOCIATION SAYS THAN WHAT MY OWN
HOSPITALS SAY. SOME OF THEM BECAUSE THEY'RE PARTICULARLY ON THE FRONT
LINES OF THIS - MAYBE BECAUSE THEY'RE IN THE MIDDLE OF NEGOTIATIONS -
HAVE BEEN VERY PROACTIVE. BUT MEMBERS DESERVE THE RIGHT TO LEARN
WHAT THE IMPACT IS ON THEM. AND I WANT TO CONVEY THANKS TO MY
NEIGHBORING COLLEAGUE, MRS. GALEF, FOR READING THAT LIST BECAUSE EVEN I
LEARNED OF ANOTHER HOSPITAL IN MY DISTRICT THAT IS SUBJECT, POTENTIALLY, TO
THIS; FOUR WINDS HOSPITAL, WHICH IS BOTH BASED IN KATONAH, CROSS
RIVER, IN MY DISTRICT BUT ALSO HAS A BRANCH IN SARATOGA SPRINGS, WHICH I
DON'T CONSIDER TYPICALLY A HOSPITAL BECAUSE THEY'RE NOT THE TYPICAL SORT
OF HOSPITAL. THEY PROVIDE, FOR THE MOST PART, INPATIENT PSYCHIATRIC
SERVICES, A CRUCIAL COMPONENT OF THINGS. AND MAYBE IT'S THE CASE THAT
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BECAUSE THEY DON'T HAVE TRADITIONAL EMERGENCY SERVICES, FOR THE MOST
PART THIS MIGHT NOT AFFECT THEM. I'D LOVE TO LEARN THAT. THERE ARE
ENOUGH HOSPITALS IN MY DISTRICT AND NEARBY THAT HAVE CONVEYED DIRECT
CONCERNS. THAT'S SUFFICIENT FOR ME. BUT TO HAVE THAT LIST READ DID SHED
LIGHT AND EVEN I WOULD HAVE SOME QUESTIONS. AND -- AND, MR. SPEAKER,
I DO HAVE SOME QUESTIONS. HAVING BEEN ESSENTIALLY REQUESTED TO MAKE
SOME QUESTIONS OF THE SPONSOR OF THE BILL, I WONDER WHETHER THE
SPONSOR WOULD YIELD FOR A QUESTION.
ACTING SPEAKER AUBRY: MR. CAHILL, WILL YOU
YIELD, SIR?
MR. CAHILL: YES, SIR.
ACTING SPEAKER AUBRY: MR. CAHILL YIELDS.
MR. BUCHWALD: THANK YOU, CHAIRMAN CAHILL.
AND THANK YOU, MR. SPEAKER. THE BILL REFERS TO BILLS FOR INPATIENT
SERVICES WHICH FOLLOW AN EMERGENCY ROOM VISIT. IS THERE ANY
DEFINITION OF WHAT "FOLLOWING AN EMERGENCY ROOM VISIT" IS? IN OTHER
WORDS, IS THERE ANYTHING ACTUALLY IN THE BILL THAT SAYS "IMMEDIATELY
FOLLOW" OR THE IN -- OR THE ADMITTANCE THAT IMMEDIATELY SUCCEEDS AN
EMERGENCY ROOM VISIT AS OPPOSED TO AN EMERGENCY ROOM VISIT THAT
OCCURRED MONTHS OR YEARS AGO?
MR. CAHILL: IS THAT THE END OF THE QUESTION, MR.
BUCHWALD?
MR. BUCHWALD: YES.
MR. CAHILL: NO, I THINK THE PLAIN READING OF THE
LANGUAGE INDICATES THAT IF AN ADMISSION IS FROM AN EMERGENCY ROOM
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VISIT AND THERE IS AFTERCARE FROM THERE WITHIN THAT FACILITY OR ASSOCIATED
WITH THAT FACILITY, THAT IS EXACTLY WHAT'S REFERENCED HERE. I THINK IT IS --
IT IS -- HOW CAN I PUT THIS? PROBABLY NOT A FAIR AND REASONABLE
INTERPRETATION TO THINK THAT IF YOU EVER WENT TO THE EMERGENCY ROOM
THAT THIS BILL INTENDS OR THAT ANYONE WOULD INTERPRET IT TO MEAN ANY
OTHER TIME THAT HOSPITAL PROVIDES YOU CARE, THAT IT WOULD BE COVERED.
SO, THAT WHICH IS DONE AT THE EMERGENCY ROOM AND THAT WHICH FOLLOWS
AS A COURSE OF CARE FROM THAT EMERGENCY ROOM. I -- I WILL POINT OUT THAT
THERE COULD BE SOME CONCURRENT CONDITIONS THAT ARE ASSOCIATED WITH IT
THAT MAY RAISE SOME QUESTION THAT WOULD BE SUBJECT TO REVIEW BY THE
DEPARTMENT OF FINANCIAL SERVICES, PERHAPS IF THERE WAS AN INDEPENDENT
DISPUTE RESOLUTION PROCESS. THAT'S WHERE IT COULD BE HASHED OUT.
MR. BUCHWALD: MR. SPEAKER, IF -- IF -- IF THE
SPONSOR WOULD CONTINUE TO -- TO YIELD TO QUESTIONS.
MR. CAHILL: YES.
ACTING SPEAKER AUBRY: HE'LL -- CONTINUES TO
YIELD.
MR. BUCHWALD: HAVING SAID THAT'S THE PLAIN
LANGUAGE AND PLAIN MEANING OF THE BILL, COULD -- COULD THE GENTLEMAN
BE SO KIND AS TO POINT TO WHAT LINE OR LINES OF THE BILL ACTUALLY CONTAIN
THAT PLAIN MEANING THAT ARE NOT SUBJECT TO INTERPRETATION?
MR. CAHILL: I -- THE LAST PART OF YOUR STATEMENT
DROPPED, SO I DIDN'T HEAR WHAT THE --
MR. BUCHWALD: WHICH -- WHICH ONE OF THE --
MAYBE, MR. SPEAKER, COULD WE HAVE SOME ORDER?
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ACTING SPEAKER AUBRY: CERTAINLY, SIR.
(BANGING GAVEL)
PLEASE, WE ARE STILL ON DEBATE AND IT WILL HELP US GET TO
THE END OF DEBATE IF YOU'RE QUIET.
MR. BUCHWALD: THANK YOU, MR. SPEAKER. MY --
MY -- MY QUESTION, JUST TO REITERATE, WAS IF -- IF THERE IS A PLAIN MEANING
OF THE LANGUAGE OF THE BILL THAT'S NOT SUBJECT TO INTERPRETATION, COULD THE
SPONSOR POINT TO THE LINE OR LINES OF THE BILL THAT CONTAIN THAT PLAIN
MEANING ABOUT WHAT FOLLOW AN EMERGENCY ROOM VISIT MEANS? I
UNDERSTAND WHAT THE GENTLEMAN'S INTENT IS, BUT HE SAID IT WAS A PLAIN
MEANING, AND SO I'D LIKE TO ASK WHERE IN THE BILL THAT PLAIN MEANING IS
CONTAINED.
MR. CAHILL: SURE. LINE 7 AND 8 ON PAGE 1 OF THE
BILL, THE PLAIN LANGUAGE REFERENCE IS MADE. I WOULD ALSO POINT OUT THAT
THERE ARE OTHER STANDARDS THAT COULD BE APPLIED IN THE CASE OF A DISPUTE
THAT WAS BEING RESOLVED, AND THOSE STANDARDS COULD INCLUDE, SAY, A
FEDERAL DEFINITION, AND A FEDERAL DEFINITION MIGHT BE, I THINK, UNDER
MEDICARE. WHEN A PATIENT IS STABILIZED. THAT'S WHAT CONSIDERED THE
AFTERCARE. A -- A PLAIN READING OF THE STATUTE HERE AND A PLAIN READING
OF ANY TIME THAT THIS MIGHT COME UP WOULD BE THAT IF A PATIENT IS
ADMITTED THROUGH THE EMERGENCY ROOM, THAT COURSE OF CARE CONTINUES
UNTIL THEY ARE DISCHARGED FROM THE HOSPITAL OR COMPLETE THE SERVICES
AFFILIATED WITH THAT EMERGENCY ROOM ADMISSION. THE IDEA THAT IT COULD
GO ON FOREVER IS -- IS SOMETHING THAT I THINK ANY REASONABLE DISPUTE
RESOLVER WOULD SEE THROUGH IN A HEARTBEAT. AND PRESUMABLY, MY
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COLLEAGUE AND MR. SPEAKER, IF PARTIES ARE SUBMITTING TO AN INDEPENDENT
DISPUTE RESOLUTION, THEY MAY FIND THEMSELVES - AS HAS BEEN THE
EXPERIENCE OTHER PLACES WHERE THIS FORM OF DISPUTE RESOLUTION HAS BEEN
USED - TO GET CLOSER AND CLOSER TO ONE ANOTHER WITH EACH DISPUTE
REDUCES THE NEED FOR THAT INTERVENTION IN THE FUTURE BECAUSE THE PARTIES
HAVE A BETTER UNDERSTANDING OF WHAT IS REASONABLE, WHAT IS ACCEPTABLE,
AND WHAT THEY WILL PREVAIL UPON WHEN THEY GO TO -- TO THE INDEPENDENT
DISPUTE RESOLUTION PROCESS. SO, YOU KNOW, IT -- IT MAY BE A
CASE-BY-CASE BASIS, BUT I THINK IT'S FAIR AND REASONABLE FROM THE
LANGUAGE IN THE BILL THAT A RESPONSIBLE DECISION CAN BE MADE BY AN
INDEPENDENT THIRD-PARTY, NOT AN INSURANCE COMPANY.
MR. BUCHWALD: I -- MR. SPEAKER, I RETAIN MY
TIME, BUT I THANK THE GENTLEMAN FOR -- FOR ANSWERING SOME QUESTIONS.
THE ONLY LINES PURPORTED TO CONTAIN THAT PLAIN MEANING WERE SECTIONS --
LINES 7 AND 8 OF THE FIRST PAGE OF THE BILL, WHICH SAY,"... A BILL FOR
INPATIENT SERVICES WHICH FOLLOW AN EMERGENCY ROOM VISIT", WHICH, TO
ME, IS NOT A CLEAR STATEMENT OF WHAT FOLLOWS. IF -- IF YOU WANT A CLEAR
STATEMENT YOU CAN SAY, "IMMEDIATELY FOLLOW" OR "DIRECTLY FOLLOW
WITHOUT AN INTERVENING DISCHARGE" OR ANYTHING TO THAT REGARD. THE FACT
THAT THOSE -- THAT LANGUAGE IS NOT THERE, PERHAPS NOT THERE BECAUSE THE
BILL MOVED THROUGH THE TWO COMMITTEES AND ONTO THE FLOOR WITH A
DEBATE IMMEDIATELY TODAY, THE PROCESS THAT COMMITTEES WOULD IDEALLY
GO THROUGH. TO ME, I UNDERSTAND THE INTENT THAT THE SPONSOR'S TRYING TO
PUT FORWARD WITH REGARDS TO THAT PHRASE. BUT I WOULD NOT SAY IT'S THE
PLAIN MEANING OF --OF THE LANGUAGE. AND, YOU KNOW, I -- YOU KNOW, I
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THINK UNTENABLE FOR HOSPITALS TO HAVE ANY UNCERTAINTY WITH REGARDS TO
THAT PROVISION.
AND SO, MR. SPEAKER, I WOULD -- I WOULD SAY ONCE
AGAIN, I -- I WOULD -- WOULD RECALL A CONVERSATION I HAD HERE IN MY FIRST
YEAR IN THE STATE ASSEMBLY WITH A COLLEAGUE WHO HAD LEGISLATION THAT
HAD A VERY SIGNIFICANT DIRECT HARM IN THAT CASE TO A PORTION OF MY
DISTRICT. NOT BECAUSE THAT WAS THE INTENT OF THE LEGISLATION, BUT BECAUSE
THAT WAS THE EFFECT OF THE LEGISLATION. THAT COLLEAGUE TOTALLY UNDERSTOOD
THAT IF IT WAS THEIR DISTRICT THAT WAS BEING ADVERSELY IMPACTED, IT WOULD
BE THEIR RESPONSIBILITY TO STAND UP FOR THEIR DISTRICT. AND SO I WOULD
ASK COLLEAGUES, AS INCONVENIENT AS A DEBATE AT 8:10 IN THE EVENING ON A
WEDNESDAY IS, TO UNDERSTAND THAT THOSE OF US WHO WERE SENT HERE
REPRESENTING PARTICULAR DISTRICTS, THAT WE FEEL ARE CONSIDERED GENUINE
BASIS ARE GOING TO BE PARTICULARLY HARMED HAVE A DUTY TO SPEAK UP.
AND I KNOW THAT IS NOT INHERENTLY AS COLLEGIAL AS IT WOULD BE NICE TO BE
ABLE TO BE. BUT WERE THE SHOE ON THE OTHER FOOT, I WOULD NOT EXPECT
OTHER COLLEAGUES TO NOT DEFEND THE NEEDS OF THEIR DISTRICTS.
AND SO I -- I STAND BY MY ORIGINAL PLEDGE, MR.
SPEAKER. I AM COMPELLED TO MAKE SURE THAT AS MANY COLLEAGUES AS
POSSIBLE UNDERSTAND THE IMPLICATIONS OF -- OF THIS -- THIS BILL FOR THEIR
DISTRICTS, AND ON THE PRINCIPLE THAT WE OPERATE, PARTICULARLY ON OUR SIDE
OF THE AISLE, OF LOOKING OUT FOR ISSUES THAT AFFECT IN THIS CASE NOT JUST
ONE MEMBER'S DISTRICT, BUT A WHOLE HOST OF MEMBERS' DISTRICTS TO TRY TO
TAKE INTO ACCOUNT THEIR CONCERNS, NOT BECAUSE IT ABSOLUTELY HAS TO BE
DONE TONIGHT, BUT BECAUSE ONLY WITH TIME WILL THERE BE A POSSIBILITY OF
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TRYING TO ADDRESS THIS. AND I -- AND I WOULD SAY, IT HAS BEEN CERTAINLY
MY APPROACH AND A NUMBER OF COLLEAGUES' APPROACHES TO SIMPLY ASK FOR
SOME EXPANSION OF THE EXCLUSION, AND I'VE NOT HEARD ANY PARTICULAR
WILLINGNESS TO ENTERTAIN THAT TONIGHT OR BEFORE TONIGHT. THERE'S BEEN
OPPORTUNITY; I'M NOT JUST REFERRING TO THE FORMAL AMENDMENT. THERE --
THERE IS NO DOUBT IN MY MIND THAT A LOT OF THE DEBATE TONIGHT COULD HAVE
BEEN AVOIDED IF THOSE TO WHOM THE WESTCHESTER DELEGATION AND OTHERS
CONVEYED CONCERNS WERE IN SOME FORM OR ANOTHER, THOSE CONCERNS WERE
HEARD AND ACCOMMODATED IN THE TEXT OF THE BILL. BUT THE TEXT OF THE BILL
HAS NOT BEEN AMENDED IN THE LAST FEW DAYS. THE LAST TIME IT WAS
AMENDED WAS MAY 17TH IN THIS HOUSE. AND I -- I VERY MUCH HOPE THAT
THIS EFFORT IS NOT IN VAIN, BUT THE EFFORT, NONETHELESS, MUST BE MADE.
AND I WANT TO THANK THOSE COLLEAGUES WHO'VE EITHER PARTICIPATED IN THE
DEBATE OR WHO HAVE CON -- CONVEYED THAT THEY BEGRUDGINGLY UNDERSTAND
THAT THIS BILL DID NOT NEED TO BE UP FOR CONSIDERATION THIS EVENING. THAT
THERE OTHER WAYS -- IT COULD STILL END UP BEING POSTPONED TO ANOTHER
DAY. BUT FOR NOW, MR. SPEAKER, I JUST VERY MUCH WOULD INSIST THAT IF
ANYONE HAD -- HAS EVIDENCE THIS WILL NOT ADVERSELY AFFECT WESTCHESTER
MEDICAL CENTER, PLEASE ASK ME TO YIELD TO THEM NOW AND I WILL YIELD
AND YOU CAN MAKE THE POINT ABOUT WHY WESTCHESTER MEDICAL CENTER,
WHICH IS AT THE BASELINE OF THE HEALTHCARE PROVISION IN WESTCHESTER
COUNTY AND LOWER HUDSON VALLEY, OF WHY WE SHOULD NOT BE NEARLY AS
CONCERNED AS WE ARE. BUT I ASSUME WITHOUT POINTS BEING MADE TO THAT
EFFECT, THAT INDEED, WE ARE CORRECT ON THAT POINT.
THANK YOU VERY MUCH, MR. SPEAKER.
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ACTING SPEAKER AUBRY: THANK YOU, SIR.
MS. PAULIN.
MS. PAULIN: SO, I -- I WANT TO JUST CLARIFY A COUPLE
OF THINGS THAT I HEARD ON THE FLOOR. THIS DISPUTE RESOLUTION IS NOT FOR
PATIENTS. IT HAS NOTHING TO DO WITH PATIENTS. THE -- THE CONCERN THAT THE
WESTCHESTER DELEGATION HAS IS ACTUALLY FOR THE PATIENTS. AND IF WE GAVE
A FALSE IMPRESSION THAT IT WAS FOR THE HOSPITAL, IT'S BECAUSE WE'RE
CONCERNED THAT THE HOSPITAL HAD THE SERVICES FOR THE PATIENTS. SO, THE
REASON -- OR THE DISPUTE RESOLUTION ONLY COMES INTO PLAY FOR THE CONTRACT
NEGOTIATIONS BETWEEN THE INSURANCE COMPANY AND THE HOSPITAL. AND, IN
FACT, THAT'S WHERE WE ARE WITH MANY OF THE HOSPITALS THAT ARE BEING
TARGETED BY THIS BILL. AND I WANT TO READ THE OPPOSITION MEMOS THAT I
HAVE SO THAT MY COLLEAGUES CAN UNDERSTAND EXACTLY WHY THESE -- THIS
PARTICULAR BILL WOULD BE A PROBLEM FOR THE PATIENTS. THIS IS FROM THE
GREATER NEW YORK HOSPITAL ASSOCIATION. "ASSEMBLY BILL 264/SENATE
BILL 31 -- 3171-A WOULD AMEND THE STATE FINANCIAL SERVICES LAW TO
EXTEND THE DISPUTE RESOLUTION PROCESS IN PLACE FOR EXCESSIVE PHYSICIAN
EMERGENCY CHARGES TO HOSPITAL EMERGENCY CHARGES." AGAIN, NOT FOR THE
PATIENT, FOR THE NEGOTIATION BETWEEN THE EMERGENCE -- BETWEEN THE
HOSPITAL AND THE INSURANCE COMPANY. "GNYHA OPPOSES THIS
AMENDMENT BECAUSE THERE IS NO EVIDENCE THAT HOSPITAL CHARGES FOR
EMERGENCY SERVICES ARE EXCESSIVE, AND THE AMENDMENT PROVIDES NO
ADDITIONAL CONSUMER PROTECTIONS. CONSUMERS ARE ALREADY HELD
HARMLESS FROM ANY ADDITIONAL COST IN EMERGENCY SITUATIONS. IN FACT, THE
BILL WOULD HARM CONSUMERS BY MAKING IT EASIER FOR INSURERS TO EXCLUDE
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HOSPITALS FROM THEIR NETWORK, LIMITING CONSUMER ACCESS TO THE HOSPITAL
OF THEIR CHOICE." AND I'M GOING TO PAUSE HERE FOR A MINUTE BECAUSE
THAT'S EXACTLY WHAT'S HAPPENING NOW WITH THE NEGOTIATION BETWEEN THE
MEDICAL CENTER AND EMPIRE. WHAT'S HAPPENING IS THAT EMPIRE DECI --
THE MEDICAL CENTER IN THE NEGOTIATIONS SAID, WE WILL EXTEND THE
NETWORK PROVISIONS FOR TWO WEEKS WHILE WE CONTINUE THE NEGOTIATION.
INSTEAD, EMPIRE REJECTED THAT AND SAID, NO, NO, NO. WE'D RATHER - IN
THEIR MINDS, I CAN IMAGINE - GET A HEADLINE ABOUT THE FACT THAT WE'RE
GOING TO GO OUT-OF-NETWORK BECAUSE IT SCARES PEOPLE, KNOWING THAT THIS
BILL MIGHT BE IN PLACE. I'LL CONTINUE. "WE STRONGLY BELIEVE THAT THERE IS
NO DEMON -- DEMONSTRABLE NEED TO EXPAND THE LAW WHICH WOULD
INCREASE GOVERNMENT INVOLVEMENT IN HOSPITAL AND INSURER PAYMENT
PROCESSES AND MAKE IT EASIER FOR INSURERS TO LIMIT CONSUMER ACCESS TO
THEIR PROVIDERS. NEW YORK STATE FINANCIAL SERVICES LAW ALREADY
PROVIDES A PROCESS FOR INSURERS, CONSUMERS AND PROVIDERS TO RESOLVE
DISPUTES OVER EXCESSIVE PHYSICIAN EMERGENCY CHARGES. THIS LAW WAS
PART OF A COMPREHENSIVE BILL THAT SIGNIFICANTLY ENHANCED CONSUMER
PROTECTIONS IN OUT-OF-NETWORK SITUATIONS, INCLUDING BY REQUIRING THAT
CONSUMERS BE HELD HARMLESS FROM ADDITIONAL COSTS IN OUT-OF-NETWORK
EMERGENCY SITUATIONS. THIS BILL WAS ENACTED AFTER YEARS OF DISCUSSIONS
AMONG THE LEGISLATURE, THE DEPARTMENT OF FINANCIAL SERVICES AND
STAKEHOLDERS ABOUT PROBLEMS SOME PATIENTS EXPERIENCED WHILE
RECEIVING OUT-OF-NETWORK CARE IN EMERGENCY SITUATIONS. IT WAS
PROMPTED PARTLY BY AN UNWELCOME SURPRISE, A MARCH 2012 DFS REPORT
THAT DETAILED THE SIGNIFICANT BURDEN IMPOSED ON CONSUMERS BY
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EXCESSIVE EMERGENCY SERVICE CHARGES. THE PROBLEMS WHICH WERE
IDENTIFIED IN THE REPORT AND IN THE DISCUSSIONS THAT PRECEDED THE LAW'S
ENACTMENT ALL PERTAINED TO PHYSICIAN CHARGES, NOT HOSPITAL CHARGES.
THE DFS REPORT GAVE SPECIFIC EXAMPLES FROM MORE THAN 2,000
COMPLAINTS THAT DFS RECEIVED ANNUALLY FROM CONSUMERS ABOUT PAYMENT
ISSUES, AND NOT A SINGLE EXAMPLE - NOT A SINGLE EXAMPLE - INVOLVED
HOSPITAL CHARGES. DURING THE NEGOTIATIONS LEADING TO ENACTMENT OF THE
INDEPENDENT DISPUTE PROCESS, THERE WAS NEVER ANY DISCUSSION OF
APPLYING IT TO HOSPITAL CHARGES." PERHAPS THAT THE WORK GROUP THAT
WE'RE TALKING ABOUT. "IF THERE WAS A SIGNIFICANT PROBLEM IN THIS AREA,
SURELY THE DFS REPORT WOULD HAVE IDENTIFIED IT OR WOULD HAVE -- HAVE
RAISED DURING THE YEARS OF NEGOTIATIONS LEADING UP TO THE LAW'S
ENACTMENT."
OPPOSITION MEMO TWO, 1199. "ON BEHALF OF THE 3,000
-- 300,000 NEW YORK STATE MEMBERS OF 1199 SEIU, WE WRITE TO
OPPOSE ASSEMBLY BILL 264/SENATE BILL 3171 WHICH WOULD AMEND THE
STATE FINANCIAL SERVICES LAW TO EXTEND THE DISPUTE RESOLUTION PROCESS
WHICH IS IN PLACE FOR EXCESSIVE OUT-OF-NETWORK PHYSICIAN EMERGENCY
CHARGES TO ALL HOSPITAL EMERGENCY CHARGES. UNLIKE THE ORIGINAL
LEGISLATION CREATING THE INDEPENDENT DISPUTE RESOLUTION PROCESS, THIS
BILL DOES NOT - DOES NOT - ADDRESS CONSUMER COMPLAINTS. ACCORDING TO
THE 2012 DEPARTMENT OF FINANCIAL SERVICES REPORT, AN UNWELCOME
SURPRISE, THOSE WERE DRIVEN BY SURPRISE PHYSICIAN, NOT HOSPITAL BILLS.
RATHER, IT ONLY SERVES TO PUT A THUMB ON THE SCALE IN FAVOR OF
MULTI-BILLION-DOLLAR INSURANCE COMPANIES BY LIMITING HOSPITALS' ABILITY
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TO NEGOTIATE. THIS AMENDMENT PROVIDES NO ADDITIONAL CONSUMER
PROTECTIONS. CONSUMERS ARE ALREADY HELD HARMLESS FOR ANY ADDITIONAL
COSTS IN EMERGENCY SITUATIONS. IT HARMS CONSUMERS BY MAKING IT EASIER
FOR INSURERS TO EXCLUDE HOSPITALS FROM THEIR NETWORKS, LIMITING
CONSUMER ACCESS TO HOSPITALS OF THEIR CHOICE. IT ALSO HARMS SAFETY NET
HOSPITALS WHO ARE ALREADY STRUGGLING TO COVER COSTS BY REDUCING THEIR
ABILITY TO INCENTIVIZE INSURERS TO INCLUDE THEM IN THEIR NETWORKS. FOR
THESE REASONS, WE REJECT THIS LEGISLATION." AND I WOULD SAY IF WE REALLY
WANTED TO PROTECT SAFETY NET HOSPITALS, WE WOULD INCLUDE ALL SAFETY NET
HOSPITALS AND NOT ARBITRARILY SET IT AT 60 PERCENT, WHICH INCLUDES OUR
HOSPITAL WHICH IS BEING TARGETED IN THIS BECAUSE WE ARE IN NEGOTIATIONS.
IF YOU WANT TO INCLUDE ALL SAFETY NET, INCLUDE ALL SAFETY NET AND INCLUDE
US, BECAUSE WE ARE A SAFETY NET HOSPITAL. WE SHOULD NOT BE ABSORBED
BY THIS BILL.
AND I WANT TO APOLOGIZE TO MY COLLEAGUES THAT WE ARE
HAVING THIS DEBATE RIGHT NOW. WE HAD ASKED TO POSTPONE THE DEBATE,
KNOWING THAT THERE WAS A DINNER TONIGHT. WE ASKED LEADERSHIP TO
POSTPONE THIS DEBATE. WE WERE TOLD THAT, NO, WE WERE NOT GOING TO
POSTPONE THIS DEBATE, WE'RE GOING TO HAVE IT NOW. SO WE ARE FORCED
INTO THIS POSITION. AND I WANT TO APOLOGIZE TO EVERYONE WHO WANTS TO
BE AT A DIFFERENT PLACE RIGHT NOW, WHICH I WANT TO BE AT, TOO.
SO, AGAIN, I AM SORRY. BUT THIS BILL IS SO IMPORTANT TO
US, CRITICALLY, IN WESTCHESTER COUNTY, TO THE PATIENTS AND TO OUR
CONSTITUENTS AND TO US AS A DELEGATION. THANK YOU.
(APPLAUSE)
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ACTING SPEAKER AUBRY: THANK YOU.
MR. ABINANTI.
MR. ABINANTI: THANK YOU, MR. SPEAKER. I WANT
TO FOLLOW UP ON THE APOLOGY FROM -- FROM MY COLLEGE -- COLLEAGUE. I
RECOGNIZE THAT THE HOUR IS LATE. I EVEN SUGGESTED WHY DON'T WE HAVE A
CONFERENCE ON THIS BILL BEFORE WE -- WE TAKE THE BILL UP AND BEFORE WE
HAVE A -- A FULL DISCUSSION ON IT, BECAUSE THERE ARE A LOT OF DETAILS TO THIS
BILL. THIS BILL COULD BE IMPROVED. IT COULD BE -- IT COULD BE MADE FAIR
FOR ALL OF THE -- THE HOSPITALS IN THE STATE. BUT INSTEAD, IT WAS
FAST-TRACKED. I DON'T UNDERSTAND WHY. THIS BILL COULD BE -- THIS IS NOT
THE END OF SESSION. WE COULD DO THIS BILL ANY TIME OVER THE NEXT TWO
WEEKS WITH SOME IMPROVEMENTS IF WE HAD A CHANCE TO BE CONSULTED,
AND TO HAVE ALL OF OUR COLLEAGUES CONSULTED TO SAY, HOW DOES THIS
IMPACT YOU AND WHAT CAN WE DO TO DEAL WITH THE ISSUE?
YOU KNOW, I -- I THOUGHT IT STRANGE THAT -- THAT THERE
WAS SOME REFERENCE TO CONSUMER PROTECTION. THIS BILL HAS NOTHING TO
DO WITH CONSUMERS. THIS BILL PROTECTS INSURANCE COMPANIES. IT GIVES
RIGHTS TO INSURANCE COMPANIES THAT THE CONSUMERS DON'T EVEN HAVE.
JUST LOOK AT THE FACE OF THE BILL. IT SAYS INSURANCE COMPANIES CAN
CHALLENGE BILLS. IT DOESN'T SAY CONSUMERS CAN CHALLENGE BILLS, IT SAYS
INSURANCE COMPANIES. IT ALSO TALKS ONLY ABOUT POST-EMERGENCY SERVICES
IN THE HOSPITAL. SO, IF SOMEBODY IS ADMITTED BECAUSE THEY HAVE TO BE
ADMITTED AFTER AN EMERGENCY, THAT'S WHAT WE'RE TALKING ABOUT HERE.
NOW, IT'S -- YOU KNOW, I FIND IT -- I -- I AGREE WITH THE
-- THE SPONSOR OF THIS LEGISLATION THAT WE NEED TO GET HEALTHCARE COSTS
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UNDER CONTROL. BUT I SUGGEST THAT YOU DON'T PUT THE FOX IN CHARGE OF THE
HENHOUSE. AND YOU DON'T PUT AN INSURANCE COMPANY IN CHARGE OF
HOSPITAL CHARGES. YOU DON'T PUT INSURANCE COMPANIES IN A POSITION
WHERE THEY CAN THWART THE SERVICES OF A HOSPITAL. THE INSURANCE
COMPANIES DON'T EVEN HAVE TO PAY ANY PART OF THE INITIAL BILL. THE BILL
-- THE LEGISLATION BEFORE US SAYS THAT AN INSURANCE COMPANY CAN PAY
WHAT THEY THINK IS REASONABLE. SO IF YOU HAVE SOMEBODY IN A
HIGH-ACUITY HOSPITAL, ANYONE IN THE STATE WHO IS THERE BECAUSE THEY
WERE IN AN EMERGENCY SITUATION AND THEY'RE NOW BEING ADMITTED, THE
INSUR -- AND THEY'VE BEEN THERE FOR TEN DAYS, THE INSURANCE COMPANY
COULD LOOK DOWN THE ROAD AT A SMALL HOSPITAL AND SAY THAT'S WHAT THEY
WOULD HAVE CHARGED, THAT'S WHAT I'M GOING TO PAY YOU, EVEN THOUGH IT'S
A THIRD OF WHAT YOU NORMALLY GET. SO IT'S -- IT'S -- PUTS EVERYTHING IN THE
HANDS OF THE INSURANCE COMPANY. AND THEN IT SUGGESTS THAT WELL, YOU
CAN -- YOU'LL HAVE AN INDEPENDENT THIRD-PARTY. WELL, WHO IS THE
INDEPENDENT THIRD-PARTY? IT'S THE INSURANCE DEPARTMENT. IT'S THE
FINANCIAL SERVICES DEPARTMENT. THEIR OBLIGATION IS TO MAKE SURE
INSURANCE COMPANIES ARE SOLID. WHY NOT PUT THE HEALTH DEPARTMENT IN
CHARGE OF THE -- OF THE -- OF THE DISPUTE? BECAUSE THE HEALTH
DEPARTMENT IS IN CHARGE OF MAKING SURE THAT HOSPITALS ARE SAFE. WE'RE
PUTTING IN THE HANDS OF THE INSURANCE REGULATORS THE DETERMINATION AS TO
WHAT SHOULD BE THE CHARGES IN THE HEALTH FIELD. WE HAVE 28 HOSPITALS
IN THIS STATE THAT ARE IN DANGER OF GOING DOWN THE DRAIN. THE HEALTH
DEPARTMENT IS MONITORING THEM. NOT THE FINANCIAL SERVICES
DEPARTMENT, THE HEALTH DEPARTMENT. SO WHERE IS THE CONNECTION
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BETWEEN THE TWO? WHERE IS THERE SOMEBODY WHO IS WORRIED ABOUT
HOSPITAL HEALTH AS OPPOSED TO INSURANCE COMPANY HEALTH? THIS BILL
DOES NOTHING TO DEAL WITH THE SKYROCKETING INSURANCE PREMIUMS. THERE
ARE 15 -- I'M SORRY, 28 FINANCIALLY-STRUGGLING HOSPITALS IN THIS STATE
WITH LESS THAN 15 DAYS CASH ON HAND, AND THEY'RE ON THE STATE WATCH
LIST. WHAT HAPPENS IF THE INSURANCE COMPANIES HOLD UP THE PAYMENTS
FOR MORE THAN 15 DAYS, WHICH IS CERTAINLY GUARANTEED TO HAPPEN?
THOSE HOSPITALS GO DOWN THE DRAIN. SO WE'RE PUTTING IN THE HANDS OF
THE INSURANCE COMPANIES THE ABILITY TO SINK OUR HOSPITALS AND FORCE THE
HOSPITALS TO PAY THEM ANYTHING THEY DEMAND -- OR ACCEPT WHATEVER THE
INSURANCE COMPANIES WILL OFFER -- OTHERWISE, THEY COULD GO DOWN THE
DRAIN. SO WE'RE SAYING THE -- THE INSURANCE COMPANIES ARE GOING TO
CONTROL THE HEALTH OF OUR HOSPITALS IN THIS STATE.
YOU KNOW, IT'S INTERESTING. WHILE THE HOSPITALS ARE IN
THIS SITUATION - AND THERE'S BEEN SOME REFERENCE TO THE WESTCHESTER
MEDICAL CENTER - THEY'RE A $220 BILLION OPERATION THAT IS $4 MILLION
CASH FLOW. THEY'RE AT THAT MARGIN. THEY'RE RUNNING THAT CLOSE. SO --
AND THEY'RE NOT ONE OF THE 28. THEY'RE NOT ONE OF THE 28. ON THE OTHER
HAND, LET'S TAKE A LOOK AT HOW THE INSURANCE COMPANIES ARE DOING. A
2019 RAND CORPORATION STUDY FOUND THAT THE RATES PRIVATE INSURERS IN
NEW YORK STATE PAYER HOSPITALS ARE THE THIRD-LOWEST IN THE COUNTRY. SO
THE INSURANCE COMPANIES IN THIS STATE ARE ALREADY GIPPING OUR HOSPITALS.
A 2019 STUDY BY THE RAND CORPORATION FOUND THAT THE RATES PRIVATE
INSURERS IN THE STATE-PAY HOSPITALS ARE THE THIRD-LOWEST IN THE COUNTRY.
AND WE'RE GOING TO GIVE THEM THE OPTION OF THE DETERMINING WHAT OUR
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HOSPITALS SHOULD BE PAID?
IT -- IT'S INTERESTING IF YOU TAKE A LOOK AT THE
EXPERIENCE. THE SPONSOR OF THIS LEGISLATION COULD POINT TO NO STUDIES.
COULD POINT TO NO HISTORY ANYWHERE WHERE THIS HAS BEEN APPLIED TO
HOSPITALS. THERE WAS SOME REFERENCE THAT OTHER STATES ARE LOOKING AT IT,
THEY MAY WANT TO FOLLOW OUR LEAD. BUT THERE'S NO EVIDENCE THAT IT WILL
NOT HURT OUR HOSPITALS AND HEALTHCARE. IN FACT, IT'S INTERESTING THAT
ANTHEM, WHICH IS THE PARENT OF EMPIRE, WHICH HAS BEEN THE -- THE
MAJOR SUPPORTER OF THIS BILL, HAS NATIONWIDE ANNOUNCED THAT IT'S GOING
TO TRIM BACK ITS NETWORKS. IN OTHER WORDS, WHAT IT'S GOING TO DO - IT'S
NOT HARD FOR US LAYPEOPLE TO FIGURE IT OUT - THEY'RE GOING TO FIND ALL THE
LESS EXPENSIVE HOSPITALS IN A REGION, FORM AGREEMENTS WITH THEM, FORCE
ALL OF THEIR CONSUMERS TO GO TO THOSE LESS EXPENSIVE HOSPITALS, AND THEN
WHEN A CONSUMER HAS TO GO TO A MORE EXPENSIVE HOSPITAL BECAUSE THEY
HAVE AN EMERGENCY, THEY'RE GOING TO RELY ON THIS BILL TO SAY, YES, YOU'RE
NOT GETTING THE BENEFIT OF THE NETWORKS. WE'RE NOT SENDING OUR PEOPLE
TO YOU FOR THE ELECTIVE SURGERIES. BUT WE'RE GOING TO DEMAND THAT YOU
PAY US THE NETWORK RATE FOR THOSE HOSPITALIZATIONS AFTER AN EMERGENCY
WHERE PEOPLE WERE BROUGHT TO YOU BECAUSE YOU'RE THE PLACE THEY HAVE
TO GO TO BE SAVED. SO THE -- THE INSURANCE COMPANIES ARE TRYING TO
INCREASE THEIR PROFITS ON THE BACKS OF THE HOSPITALS.
AND I SPOKE BEFORE ABOUT FAIRNESS. IF WE'RE WORRIED
ABOUT THE HOSPITALS THAT DO A LOT OF -- OF MEDICAID, WHY DON'T WE TAKE A
LOOK AT THE NUMBERS? THERE'S A LITTLE HOSPITAL HERE IN TROY THAT DOES
435 MEDICAID ADMISSIONS A YEAR, BUT THAT'S 60 PERCENT OF THEIR
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ADMISSIONS AND DISCHARGES. THEY'RE PROTECTED FROM THIS BILL. BUT
ALBANY MEDICAL CENTER, THAT DOES 11,000 DISCHARGES OF MEDICAID, IS
COVERED BY THIS BILL. LET'S TAKE ANOTHER LOOK AT ANOTHER ONE. WE HAVE
-- HERE WE GO. LONG ISLAND JEWISH MEDICAL CENTER, FROM MY
COLLEAGUES FROM LONG ISLAND. LONG ISLAND JEWISH DOES 28,000
MEDICAID A YEAR. 28,000 -- OH, THAT'S IN QUEENS? I'M SORRY. OH, I
THOUGHT IT WAS NASSAU. THESE TWO CAN ARGUE WHERE IT IS. YOU CAN BOTH
CLAIM IT, BUT YOU SHOULD BOTH BE AWARE, THEY DO 28,000 MEDICAID
DISCHARGES A YEAR, BUT THAT'S ONLY 48 PERCENT OF THEIR DISCHARGES, AND SO
THEY'RE COVERED BY THE BILL. THEY'RE NOT EXEMPTED. SO WHERE IS THE
FAIRNESS? WHERE'S THE -- WHERE'S THE ARGUMENT THAT THOSE WHO DO A LOT
OF MEDICAID DESERVE TO BE EXEMPTED FROM THE BILL? AND HOW ABOUT
GOING TO NYU LANGONE? 18,500 MEDICAID DISCHARGES. NEW YORK
PRESBYTERIAN, 36,000 MEDICAID DISCHARGES. AND YET, NEITHER ONE OF
THEM QUALIFIES WITH THE 60 PERCENT. SO WHERE'S THE INCENTIVE FOR THEM
TO TAKE -- TO CONTINUE TO TAKE MEDICAID? WHY DON'T THEY JUST CUT BACK
ON THEIR SERVICES AND SAY, WE'RE NOT TAKING MEDICAID ANYMORE. THIS
BILL IS GOING TO PENALIZE THEM ANYWAY. WE SHOULD BE INCENTIVIZING
THEM, NOT DISINCENTIVIZING THEM. AND I'VE ALREADY REFERRED TO THE LACK
OF -- OF STUDIES, THE LACK OF SUCCESS RATE ANYWHERE ELSE. BUT THE REAL
QUESTION IS WHY DID WE COME TO THE 60 PERCENT OUT OF NOWHERE? THERE
ARE SEVERAL PLACES IN NEW YORK STATE LAW THAT ALREADY DETERMINE WHAT
A SAFETY NET HOSPITAL IS. THIS IS A BRAND-NEW STANDARD DEVISED BY THE
INSURANCE COMPANIES FOR THE INSURANCE COMPANIES. AND I DON'T
UNDERSTAND WHY THIS BODY IS EVEN CONSIDERING A BILL THAT'S GOING TO
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BENEFIT INSURANCE COMPANIES TO THE DETRIMENT OF HEALTHCARE IN OUR
STATE.
THERE'S NOTHING IN THE BILL THAT SAYS ANY SAVINGS HAVE
TO GO TO CONSUMERS.
(PAUSE)
I WILL REPEAT THAT THERE'S OPPOSITION, AND I WANT TO
MAKE A CORRECTION IN THE RECORD. I'VE BEEN TOLD THAT THE LOCAL CSEA IN
WESTCHESTER MEDICAL CENTER OPPOSES THIS BILL. I STILL BELIEVE THAT THEY
OPPOSE THIS BILL. BUT I HAVE BEEN TOLD BY THE STATEWIDE CSEA THAT THE
LOCAL DOESN'T OPPOSE THE BILL BECAUSE THE STATEWIDE IS SUPPORTING THE
BILL. SO I CAN'T -- I JUST WANT TO MAKE SURE THAT THE STATEWIDE CSEA
THAT'S LISTENING TO THE DEBATE THINKS I SHOULD CORRECT THE RECORD, SO I
WILL TELL YOU WHAT I UNDERSTAND TO BE THE CASE. BUT I DON'T THINK THAT
MATTERS. I THINK WHAT MATTERS IS THE -- IS THE MERITS OF THE BILL. AND I
HOPE THAT WE'VE EXPLAINED TO YOU THAT PRICE CONTROL BY INSURANCE
COMPANIES OVER HOSPITALS IS NOT THE WAY THAT WE SHOULD BE RUNNING OUR
HEALTHCARE SYSTEM IN THIS STATE.
I KNOW I HAVEN'T USED MY FULL 15 MINUTES, BUT I'M NOT
GOING TO TAKE UP 15 MINUTES. I THINK WE WANT TO GET OUT OF HERE. I
THINK WE, FROM WESTCHESTER COUNTY, HAVE TRIED TO POINT OUT TO YOU THAT
THIS IS A BAD BILL FOR THE STATE OF NEW YORK. WE'RE JUST FEELING THE
BRUNT OF IT RIGHT NOW BECAUSE EMPIRE WALKED OUT OF NEGOTIATIONS OVER
THE WEEKEND. AS SOON AS IT BECAME CLEAR THAT THIS BILL WAS GOING TO
MOVE IN THE ASSEMBLY, THEY CUT OFF NEGOTIATIONS WITH THE WESTCHESTER
MEDICAL CENTER. AND WE'RE NOW HEARING FROM NYU THAT THEY'RE
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HAVING SIMILAR ROUGH -- A SIMILAR ROUGH ROAD AS THIS BILL IS MOVING
FORWARD. THIS BILL IS ABOUT GIVING THE INSURANCE COMPANIES MORE
LEVERAGE OVER HOSPITALS THROUGHOUT THE ENTIRE STATE.
SO I APPRECIATE ALL OF YOUR LISTENING. I DO HOPE THAT
YOU WILL -- YOU WILL CONSIDER VOTING WITH US AND -- AND -- AND SENDING A
MESSAGE THAT WE'RE VERY CONCERNED ABOUT THE COST OF HEALTHCARE IN THIS
STATE. BUT GIVING THE INSURANCE COMPANIES THE RIGHT TO SET THE RATES IS
NOT THE WAY TO SOLVE THE PROBLEM.
ACTING SPEAKER AUBRY: MR. MCDONALD.
MR. MCDONALD: THANK YOU, MR. SPEAKER.
WOULD THE SPONSOR YIELD?
ACTING SPEAKER AUBRY: MR. CAHILL, WILL YOU
YIELD?
MR. CAHILL: OVER MR. ABBATE'S OBJECTIONS, YES.
MR. MCDONALD: OVER MANY PEOPLE'S OBJECTIONS,
I'M SURE. SO, I -- I HAVE A QUESTION, AND THIS IS A QUESTION I PROBABLY
WOULD HAVE ASKED IN CONFERENCE IF WE HAD THE OPPORTUNITY TO ASK THIS
QUESTION. AND IT CAME UP BRIEFLY IN OUR INSURANCE COMMITTEE MEETING
THIS MORNING. I JUST WANT TO UNDERSTAND THE PROCESS. AND, YOU KNOW, I
GET THE CONTEXT WHAT'S GOING ON. HEALTH SYSTEMS AND HOSPITALS ARE
GROWING DEEPER INTO THE COMMUNITY. THEY'RE GOBBLING UP MORE
PRACTICES. IT'S MAKING IT DIFFICULT FOR THE INSURANCE COMPANIES TO
NEGOTIATE, BECAUSE THERE'S LESS TO NEGOTIATE WITH. BUT IN THIS SITUATION, I
JUST WANT TO MAKE SURE I'M CLEAR. WE'RE ONLY TALKING ABOUT SITUATIONS
WHERE A PERSON MIGHT BE FLOWN IN FROM THE ADIRONDACKS TO
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WESTCHESTER, BAD BURNS. THEY'RE ADMITTED INTO THE ER, AND THEN THEY
ARE ADMITTED INTO THE HOSPITAL FOR FOLLOW-UP TREATMENT. IS THAT -- IS THAT
A GOOD WAY OF DESCRIBING THE SITUATION?
MR. CAHILL: MR. SPEAKER, THE ANSWER TO THAT
QUESTION IS NO. THAT IS NOT THE CIRCUMSTANCE THAT THIS BILL COVERS. THAT
IS A CIRCUMSTANCE THAT MAY BE COVERED BY THIS BILL, BUT THIS BILL COVERS
WHEN EMERGENCY CARE IS GIVEN AND THE AFTERCARE FROM AN EMERGENCY IS
-- IS PROVIDED BY A HOSPITAL AND A CONTRACT DOES NOT EXIST, AND THE TWO
PARTIES CANNOT AGREE TO AN AMOUNT THAT SHOULD BE PAID, AND THEN THIS
WOULD PROVIDE A MEANS BY WHICH AN INDEPENDENT THIRD-PARTY COULD
DETERMINE WHAT THE APPROPRIATE CHARGES ARE, BASED UPON THAT WHICH
WAS SUBMITTED BY THE HOSPITALS AND BY THE INSURANCE COMPANIES.
MR. MCDONALD: AND -- AND WHO IS THAT
INDEPENDENT THIRD-PARTY? WHO IS THAT INDEPENDENT THIRD-PARTY?
MR. CAHILL: IT WOULD BE AN INDEPENDENT DISPUTE
RESOLUTION PERSON APPOINTED BY THE DEPARTMENT OF FINANCIAL SERVICES.
MR. MCDONALD: BY DFS.
MR. CAHILL: CORRECT. THE REGULATORY AGENCY THAT
OVERSEES AND REGULATES INSURANCE.
MR. MCDONALD: AND IN THAT PROCESS, DO THEY USE
NATIONAL OR STATEWIDE BENCHMARKS TO HELP GET TO A -- AN APPROPRIATE
REIMBURSEMENT?
MR. CAHILL: THEY MAY -- THEY MAY REFER TO
NATIONAL OR STATEWIDE BENCHMARKS, BUT THE GUIDELINES ARE LINED OUT
RIGHT IN THE EXISTING LAW TODAY OF WHAT THEY HAVE TO FOLLOW. AND QUITE
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FRANKLY, IN SPITE OF SOME OF THE COMMENTS HERE TODAY, ONE OF THE MOST
IMPORTANT CRITERIA THAT GETS USED IS HOW MUCH THAT HOSPITAL CHARGES
PEOPLE. THAT HOSPITAL, NOT OTHER HOSPITALS. HOW MUCH DOES THAT
HOSPITAL CHARGE PEOPLE.
MR. MCDONALD: AND DO THEY GET INTO WHAT WENT
INTO THAT SERVICE BEING PROVIDED?
MR. CAHILL: THERE'S AN ACUITY FACTOR THAT IS
REQUIRED FOR THE INDEPENDENT BODY TO CONSIDER. THERE ARE THE
COMPLEXITIES THAT -- THAT THE PATIENT BRINGS TO THE TABLE. THERE IS THE --
THE NATURE OF THE FACILITY, AS WE'VE TALKED ABOUT A BURN CENTER WOULD
SECURE ONE RATE. AN EMERGENCY ROOM MAYBE IN MY TOWN WOULDN'T GET
THE SAME RATE. SO, ALL OF THOSE FACTORS ARE REQUIRED OF THE INDEPENDENT
THIRD-PARTY TO JUDGE WHICH PARTY IS COMING IN WITH THE APPROPRIATE
CHARGE OR PAYMENT PROPOSAL.
MR. MCDONALD: AND BECAUSE I DON'T KNOW THE
LAW, IF YOU CAN EXPLAIN TO ME. WHAT IS THE -- HOW LONG IS -- IS THERE --
IS THERE A DEFINED TIMELINE FOR THE PROCESS?
MR. CAHILL: THERE'S MUSIC IN MY BACK EAR, SO --
MR. MCDONALD: THAT'S OKAY.
MR. CAHILL: -- I'M HAVING A LITTLE BIT --
MR. MCDONALD: I HEAR IT -- I HEAR IT, TOO. IS THERE
A DEFINED --
MR. CAHILL: THIRTY DAYS. I THINK 30 DAYS.
MR. MCDONALD: THIRTY DAYS? OKAY. THANK YOU,
MR. SPEAKER.
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ACTING SPEAKER AUBRY: READ THE LAST SECTION.
(APPLAUSE)
THE CLERK: THIS ACT SHALL TAKE EFFECT IMMEDIATELY.
ACTING SPEAKER AUBRY: THE CLERK WILL
RECORD THE VOTE.
(THE CLERK RECORDED THE VOTE.)
MR. CAHILL TO EXPLAIN HIS VOTE. AND THE MUSIC YOU
HEARD WAS "GOODNIGHT, IRENE."
(LAUGHTER)
MR. CAHILL: I THINK THAT'S WHAT IT WAS. THANK YOU,
MR. SPEAKER, AND COLLEAGUES. I -- I APPRECIATE THE TIME THAT YOU'VE
GIVEN THIS, AND I APPRECIATE THE THOUGHT THAT'S GONE INTO THE DEBATE
FROM EVERYBODY WHO STOOD UP TO SPEAK TONIGHT. AND LET ME BE CLEAR
THAT IF I FELT THAT THIS WAS DETRIMENTAL TO MY HOSPITAL, TO HEALTHCARE IN
MY COMMUNITY, I WOULD ARGUE AND DEBATE WITH THE SAME FERVOR THAT
OUR COLLEAGUES DID HERE TONIGHT. THAT IS NOT THE CASE. THIS DOES NOT
PUT POWER IN THE HANDS OF INSURANCE COMPANIES. THIS PUTS POWER IN
THE HANDS OF AN INDEPENDENT THIRD-PARTY TO RESOLVE DISPUTES THAT WOULD
OTHERWISE NOT BE ABLE TO BE RESOLVED AND COULD RESULT IN PROTRACTED
LITIGATION OR INTERRUPTION OF SERVICE, AS IT DID IN MY COMMUNITY. AND
THERE ARE MANY ASPECTS OF THIS BILL THAT ARE NOT WHAT WERE REPRESENTED
HERE TONIGHT IN THIS DEBATE. I CHOSE NOT TO ENGAGE, JUST AS MY
COLLEAGUES WHO MADE THOSE REPRESENTATIONS CHOSE INSTEAD OF ASKING ME
THOSE QUESTIONS SO I COULD ANSWER THEM WITH SOME AUTHORITY. THEY --
I CHOSE NOT TO ASK THEM TO GIVE ME THE OPPORTUNITY TO -- TO RESPOND SO
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THEY COULD USE THEIR FULL 30 MINUTES AND FILIBUSTER AS THEY DID.
I THINK THE BILL STANDS ON ITS MERITS. I THINK THE BILL IS
ONE THAT WILL ADVANCE HEALTHCARE, STABILIZE HEALTHCARE, CONTAIN SOME
COSTS, BUT ALSO PROVIDE A MEANS BY WHICH THOSE DISPUTES THAT COULD NOT
BE RESOLVED CAN NOW BE RESOLVED.
AND I WOULD WITHDRAW MY REQUEST, MR. SPEAKER, AND
URGE A VOTE IN THE AFFIRMATIVE, AND I WILL CAST MY VOTE IN THE
AFFIRMATIVE.
ACTING SPEAKER AUBRY: MR. CAHILL IN THE
AFFIRMATIVE.
MR. GOODELL.
MR. GOODELL: THANK YOU, SIR. BY NOW I THINK IT
SHOULD BE CLEAR TO EVERYBODY HERE THIS IS NOT A BILL ABOUT PATIENTS
BECAUSE IT DOESN'T AFFECT THE AMOUNT THAT A PATIENT PAYS IN CO-PAYS AND
DEDUCTIBLES. WE'VE ALREADY ADDRESSED THAT ISSUE AND WE'VE ALREADY
MADE IT CLEAR BY LAW THAT WHAT A PATIENT PAYS, WHETHER IT'S IN-NETWORK
OR OUT-OF-NETWORK, IS UNAFFECTED BY THIS LEGISLATION. AS HAS BEEN
REPEATEDLY POINTED OUT, THIS IS ALL ABOUT WHETHER WE WANT TO HELP
INSURANCE COMPANIES AT THE EXPENSE OF THE LOCAL HOSPITALS. THAT'S WHAT
IT'S ALL ABOUT. WE'RE TOLD IT'S AN INDEPENDENT DISPUTE RESOLUTION, BUT WE
DON'T ASK THE ONE AGENCY IN OUR STATE GOVERNMENT THAT MONITORS THE
REIMBURSEMENT RATES FOR DOCTORS AND HOSPITALS, WHO HAS A FULL STAFF,
THAT HAS A MULTI-BILLION-DOLLAR BUDGET THAT MONITORS HEALTHCARE COSTS,
AND THAT'S THE DEPARTMENT OF HEALTH. SO THIS IS NOT ABOUT MAKING SURE
IT'S AN INDEPENDENT PARTY. THIS IS AN INSURANCE BAILOUT BILL WITH THE
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INDEPENDENT REVIEW BEING DONE BY THE INSURANCE DEPARTMENT AND NOT
THE HEALTH DEPARTMENT THAT ACTUALLY HAS THE DATA AND THE EXPERTISE.
SO MAKE NO MISTAKE ABOUT IT. IF YOU HAVE A HOSPITAL
IN YOUR DISTRICT THAT'S FACING TOUGH FINANCIAL ISSUES, THIS BILL WILL HURT
YOUR LOCAL HOSPITALS. NOW ON THE OTHER HAND, IF YOU HAVE AN INSURANCE
COMPANY IN YOUR DISTRICT THAT'S FACING FINANCIAL ISSUES AND YOU'RE
WORRIED ABOUT THEM GOING OUT OF BUSINESS, THEN I WOULD RECOMMEND
YOU VOTE FOR THIS. IN MY DISTRICT, IT'S THE HOSPITALS THAT ARE STRUGGLING,
NOT THE INSURANCE COMPANIES.
THANK YOU, SIR.
ACTING SPEAKER AUBRY: MR. GOODELL IN THE
NEGATIVE.
MR. WALCZYK.
MR. WALCZYK: THANK YOU, MR. SPEAKER. I -- I
HAD ONE FINAL QUESTION FOR THE SPONSOR THAT I JUST RAN OUT OF TIME TO ASK
TODAY. BUT I WOULD HAVE ASKED HIM HOW -- HOW -- IF HE HADN'T HEARD
FROM THE HOSPITALS IN HIS REGION, IF THEY HADN'T BEEN AN INTEGRAL PART OF
CRAFTING THIS LEGISLATION, HOW HE COULD VOTE FOR THIS BILL TODAY. BECAUSE
ON -- ON PROCESS -- AND -- AND MANY MEMBERS FROM BOTH SIDES OF THE
AISLE TODAY HAVE BROUGHT UP THE LACK OF INPUT, THE USHERING THROUGH, THE
RUSHING THIS LEGISLATION THROUGH. BUT ON PROCESS, WITHOUT THE
OPPORTUNITY TO ASK MASSENA MEMORIAL HOSPITAL, TO ASK CLAXTON
HEPBURN, TO ASK CANTON POTSDAM HOSPITAL OR RIVER HOSPITAL OR
SAMARITAN MEDICAL CENTER WHAT THIS WOULD DO TO THE CONSTITUENTS THAT I
REPRESENT, THERE'S NO WAY IN GOOD FAITH THAT I COULD VOTE FOR THIS BILL.
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NYS ASSEMBLY JUNE 5, 2019
SO, I WITHDRAW MY REQUEST AND I VOTE IN THE NEGATIVE.
THANK YOU, MR. SPEAKER.
ACTING SPEAKER AUBRY: MR. WALCZYK IN THE
NEGATIVE.
MS. FAHY TO EXPLAIN HER VOTE.
MS. FAHY: THANK YOU, MR. SPEAKER. I RISE TO
EXPLAIN MY VOTE. AND I'VE -- THE ONE GOOD THING ABOUT A LATE HOUR IS
YOU ACTUALLY GET A LITTLE BIT OF A CHANCE TO LISTEN TO THE DEBATE INSTEAD OF
BEING DISTRACTED WITH 15 OTHER THINGS. AND THE DEBATE, QUITE FRANKLY,
HAS BEEN DISTURBING. WHILE I THINK THIS BILL IS WELL-INTENDED IN TERMS OF
TRYING TO ASSIST AND -- IN INDIRECTLY PROTECT THE CONSUMERS OR -- OR TRYING
TO KEEP THE CONSUMERS IN MIND, I -- I WOULD BE REMISS IF I DID NOT SAY
THIS PROCESS HAS BEEN INCREDIBLY UPSETTING. AND I DID NOT KNOW WHEN I
WAS VOTING TO REPORT THIS OUT OF CODES TONIGHT THAT THE BILL WOULD BE ON
THE FLOOR TONIGHT. I -- I MADE A SPECIFIC POINT -- I MADE A SPECIFIC POINT
IN CODES TONIGHT -- THIS MORNING OR THIS AFTERNOON -- ASKING THAT WE GO
BACK AT THIS AND ADDRESS A NUMBER OF THE QUESTIONS THAT I THOUGHT WERE
VERY LEGITIMATE, VERY FAIR QUESTIONS THAT HAVE COME UP. AND EVEN IN
LISTENING TO THE DEBATE TONIGHT, THE QUESTIONS HAVE NOT COME UP -- OR
HAVE NOT BEEN ANSWERED TO THE EXTENT THAT I THINK THEY SHOULD HAVE.
AND I CAN ONLY COME AWAY FROM THIS THINKING THAT THIS IS BIG INSURANCE
AGAINST BIG HOSPITALS. AND -- AND THAT REALLY -- AND I THINK THE PATIENTS
ARE SOMEHOW BEING A LITTLE LEFT -- LEFT ASIDE HERE. AND I DO WORRY THAT
THIS IS INSURANCE COMPANIES BEING LEFT IN CHARGE OF HOSPITALS. I DON'T
BELIEVE THIS IS A WAY TO BRING COSTS DOWN. I DON'T BELIEVE THAT THIS IS
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THE WAY TO HELP HEALTHCARE. IN THE END, THOUGH, HOWEVER, I HAVE TO GO
BACK TO WHAT I'M HEARING FROM ALBANY MED. AND BY THE WAY, ALBANY
MED SERVES 80 -- TAKES IN 80,000 ER PATIENTS JUST IN 2018. OVER
80,000. HOWEVER, I'M TOLD, QUOTE, UNQUOTE, THEIR IMPACT FROM THIS BILL
COULD POSSIBLY BE MODERATE BECAUSE THE SIZE OF THE NETWORK IS SO LARGE.
CONSEQUENTLY, BECAUSE I AM HEARING MORE FROM THE
ADVOCATES AND THE CONSUMER GROUPS, I'M GOING TO SUPPORT THIS
LEGISLATION BUT VERY RELUCTANTLY. THANK YOU, MR. SPEAKER.
ACTING SPEAKER AUBRY: MS. FAHY IN THE
AFFIRMATIVE.
ARE THERE ANY OTHER VOTES? ANNOUNCE THE RESULTS.
(THE CLERK ANNOUNCED THE RESULTS.)
THE BILL IS PASSED.
MRS. PEOPLES-STOKES.
MRS. PEOPLES-STOKES: DO YOU HAVE ANY FURTHER
HOUSEKEEPING OR RESOLUTIONS?
ACTING SPEAKER AUBRY: AT THE REQUEST OF MR.
GOTTFRIED, CALENDAR NO. 100, BILL A1125, THE BILL IS STARRED.
ON A MOTION BY MS. ROSENTHAL, PAGE 5, CALENDAR NO.
19, BILL NO. 1024-A ON THE MAIN CALENDAR, AMENDMENTS ARE RECEIVED
AND ADOPTED.
ON A MOTION BY MS. PAULIN, PAGE 22, CALENDAR NO.
316, BILL A225 ON THE MAIN CALENDAR, AMENDMENTS ARE RECEIVED AND
ADOPTED.
WE HAVE NUMEROUS FINE RESOLUTIONS WHICH WE WILL
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NYS ASSEMBLY JUNE 5, 2019
TAKE UP WITH ONE VOTE.
ON THE RESOLUTIONS, ALL THOSE IN FAVOR SIGNIFY BY SAYING
AYE; OPPOSED, NO. THE RESOLUTIONS ARE ADOPTED.
(WHEREUPON, ASSEMBLY RESOLUTION NOS. 499-504
WERE UNANIMOUSLY ADOPTED.)
MRS. PEOPLES-STOKES.
MRS. PEOPLES-STOKES: MR. SPEAKER, I MOVE
THAT THE ASSEMBLY STAND ADJOURNED UNTIL 10:00 A.M. TUESDAY --
THURSDAY, JUNE THE 6TH, TOMORROW BEING A SESSION DAY.
ACTING SPEAKER AUBRY: THE ASSEMBLY WILL
STAND ADJOURNED.
(WHEREUPON, AT 8:49 P.M., THE HOUSE STOOD ADJOURNED
UNTIL THURSDAY, JUNE 6TH AT 10:00 A.M., THAT BEING A SESSION DAY.)
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