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Health, Department of

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Agency Web Site: https://www.health.ny.gov/Link to External Website

Mission

The mission of the Department of Health (DOH) is to ensure high quality health services are available to all New Yorkers. The Department is also the principal State agency that administers the Medicaid Program, the New York State of Health (NYSOH) Exchange, and other public health and health insurance programs.

The Department operates health care facilities including Helen Hayes Hospital, four veteran’s nursing homes, and the Wadsworth Centers for Laboratories and Research. In addition, DOH conducts oversight of health professionals and all other health care facilities to ensure that high quality, cost effective, health care alternatives are provided throughout the State.

Organization and Staffing

DOH is headed by a Commissioner, who is appointed by the Governor subject to Senate confirmation. The agency is organized into four major business units: the Office of Public Health; the Office of Primary Care and Health Systems Management; Institutional Management; and the Office of Health Insurance Programs which operates the Medicaid Program. Each of these business units contains multiple divisions and bureaus that work together to carry out DOH’s mission.

The workforce is spread out across the state, encompassing employees of the central office in Albany, four regional offices (located in Syracuse, New York City, Long Island, and Buffalo), the Wadsworth Center Public Health Laboratories, Helen Hayes Hospital (located in Haverstraw) as well as employees of the New York State Veterans’ Homes (located in Oxford, Queens, Batavia, and Montrose).

Budget Highlights

The FY 2022 Executive Budget recommends $188 billion for DOH, including $170 billion for Medicaid (represents two year appropriation authority), $5.5 billion for the Essential Plan, and $12.5 billion for remaining health program spending.

The Budget recommends a workforce of 5,418 full time equivalent employees (FTEs) for the Department. This is a decrease of 261 FTEs from the FY 2021 Budget. The decrease of 261 FTEs associated with a phased takeover of local district driven by a phase-in of employees to support the State’s takeover of local district administration of the Medicaid program (-222), with corresponding increases in the out year to restore to full target. These decreases are combined by a movement of 16 FTEs to the Office of Cannabis Management (OCM) for the medical cannabis program (-16), transition of HEMP/CBD monitoring to the proposed OCM (-17), and a removal of 6 special revenue FTEs that were offset in the prior year by a 10 FTE investment on the General Fund for family planning. (-6).

Major budget initiatives include:

For more information on this agency's budget recommendations located in the Executive Budget Briefing Book, click on the following link:

Program Highlights

Child Health Plus (CHP)

CHP provides comprehensive health coverage for children up to age 19 with family incomes above Medicaid eligibility levels. Like Medicaid, CHP is administered by states with guidance from the Centers for Medicare and Medicaid Services (CMS) and is jointly funded by the Federal government and states. Currently, more than 400,000 New York children receive health coverage through CHP. Families with incomes below 160 percent of the Federal Poverty Level (FPL) receive free coverage for their children while families with incomes over that threshold pay on a sliding scale from about $9-$60/month per child. Enrollees in CHP receive primary, preventive, specialty and inpatient care.

Federal funding for the Children's Health Insurance Program (CHIP) has been reauthorized through FFY 2027

Elderly Pharmaceutical Insurance Coverage (EPIC)

The EPIC program provides drug coverage to income-eligible seniors aged 65 and older to supplement out-of-pocket Medicare Part D costs. This program serves approximately 331,000 seniors annually and is financed entirely with State funds, which are offset by revenues from fees paid by EPIC members and rebates from drug manufacturers for generic drugs.

The Affordable Care Act (ACA) provides a phase-out of the Medicare Part D coverage gap (ended January 2020). The closure of the coverage gap will result in Medicare Part D picking up a larger share of program costs that were previously covered in EPIC.

Essential Plan (EP)

The EP provides health coverage for individuals with family incomes between 138 and 200 percent of the Federal Poverty Level (FPL) and for individuals from 0-200 percent FPL who are lawfully present in the United States but do not qualify for Medicaid due to their immigration status. The program has been extraordinarily successful, with nearly 800,000 New Yorkers enrolling at the end of FY 2020. The State receives Federal funding through the Essential Plan Trust Fund equal to 95 percent of what would have been provided to EP-eligible enrollees had they enrolled in the second lowest cost Silver Plan through the NYSOH. The EP offers a comprehensive package of benefits which include primary, preventive, specialty and inpatient care.

The Executive Budget makes significant investments through the Essential Plan through a three-point strategy as follows:

Medicaid

Medicaid is a means-tested program that finances health care services for over 6 million low-income individuals and long-term care services for the elderly and disabled, primarily through payments to over 80,000 health care providers and more than 45 fully and partially capitated managed care plans. The Medicaid program is financed jointly by the State, the Federal government, and local governments. Eligible services include inpatient hospital care, outpatient hospital services, clinics, nursing homes, managed care, prescription drugs, home care and services provided in a variety of community-based settings (including mental health, substance abuse treatment, developmental disabilities services, school-based services and foster care services).

New York State of Health (NYSOH)

In 2013, in accordance with the Federal Affordable Care Act, the Governor issued Executive Order #42 to establish a New York Health Benefit Exchange. The Exchange – NY State of Health – serves as a centralized marketplace to shop for, compare, and enroll in a health plan. The health plans offered through NY State of Health are, on average, 55 percent less expensive than those available in 2013, prior to the creation of the marketplace. Since its inception in 2014, the NY State of Health has enrolled more than 5.7 million New Yorkers in affordable health coverage. The number of uninsured New Yorkers has declined by 1.3 million since 2010, setting an uninsured rate of 5.2 percent. The Executive Budget includes $442 million in total funding in FY 2022 for the operation of NYSOH.

Public Health

DOH promotes and protects the health of people and the communities where they live, learn, work, and play. These efforts work to prevent people from getting sick or injured and promote wellness. DOH staff are responsible for a wide range of public health issues including tracking disease outbreaks, educating the public about the health risks caused by alcohol and tobacco, and developing school nutrition programs. Major programs include:

ALL FUNDS
APPROPRIATIONS
(dollars)
Category Available
FY 2021
Appropriations
Recommended
FY 2022
Change From
FY 2021
Reappropriations
Recommended
FY 2022
State Operations 3,502,705,000 3,273,961,000 (228,744,000) 3,178,432,000
Aid To Localities 157,481,972,171 184,551,596,800 27,069,624,629 185,474,197,758
Capital Projects 212,170,000 221,170,000 9,000,000 2,944,851,000
Total 161,196,847,171 188,046,727,800 26,849,880,629 191,597,480,758

ALL FUND TYPES
PROJECTED LEVELS OF EMPLOYMENT BY PROGRAM
FILLED ANNUAL SALARIED POSITIONS
Program FY 2021
Estimated FTEs
03/31/21
FY 2022
Estimated FTEs
03/31/22
FTE Change
Administration
General Fund 1,096 1,079 (17)
Special Revenue Funds - Federal 42 42 0
Special Revenue Funds - Other 118 118 0
Capital Projects Funds - Other 1 1 0
Child Health Insurance
Special Revenue Funds - Other 14 14 0
Center for Community Health
Special Revenue Funds - Federal 435 435 0
Special Revenue Funds - Other 64 58 (6)
Center for Environmental Health
Special Revenue Funds - Federal 79 79 0
Special Revenue Funds - Other 59 59 0
Capital Projects Funds - Federal 46 46 0
Capital Projects Funds - Other 50 50 0
Elderly Pharmaceutical Insurance Coverage
Special Revenue Funds - Other 8 8 0
Essential Plan
General Fund 6 6 0
Institutional Management
Special Revenue Funds - Other 1,472 1,472 0
Capital Projects Funds - Other 51 51 0
Medical Assistance Administration
General Fund 531 720 189
Special Revenue Funds - Federal 442 631 189
Special Revenue Funds - Other 10 10 0
Medical Cannabis
Special Revenue Funds - Other 23 0 (23)
New York State of Health
Special Revenue Funds - Other 74 74 0
Office of Health Insurance Programs
Special Revenue Funds - Federal 4 4 0
Office of Primary Care and Health Systems Management
Special Revenue Funds - Federal 65 65 0
Special Revenue Funds - Other 184 184 0
Wadsworth Center for Laboratories and Research
Special Revenue Funds - Federal 44 44 0
Special Revenue Funds - Other 131 138 7
Capital Projects Funds - Other 30 30 0
Total 5,079 5,418 339

STATE OPERATIONS
ALL FUNDS FINANCIAL REQUIREMENTS BY FUND TYPE
APPROPRIATIONS
(dollars)
Fund Type Available
FY 2021
Recommended
FY 2022
Change
General Fund 769,476,000 672,052,000 (97,424,000)
Special Revenue Funds - Federal 2,317,927,000 2,245,552,000 (72,375,000)
Special Revenue Funds - Other 415,302,000 356,357,000 (58,945,000)
Total 3,502,705,000 3,273,961,000 (228,744,000)
Adjustments:
Transfer(s) To
Medicaid Inspector General, Office of the
General Fund 1,296,000
Special Revenue Funds - Federal 1,296,000
Appropriated FY 2021 3,505,297,000

STATE OPERATIONS
ALL FUNDS FINANCIAL REQUIREMENTS BY PROGRAM
APPROPRIATIONS
(dollars)
Program Available
FY 2021
Recommended
FY 2022
Change
AIDS Institute
Special Revenue Funds - Federal 600,000 600,000 0
Administration
General Fund 160,191,000 157,742,000 (2,449,000)
Special Revenue Funds - Federal 11,188,000 11,188,000 0
Special Revenue Funds - Other 28,243,000 28,243,000 0
Center for Community Health
Special Revenue Funds - Federal 170,517,000 178,631,000 8,114,000
Special Revenue Funds - Other 5,030,000 5,030,000 0
Center for Environmental Health
Special Revenue Funds - Federal 18,488,000 19,293,000 805,000
Special Revenue Funds - Other 8,385,000 8,385,000 0
Child Health Insurance
Special Revenue Funds - Federal 138,500,000 138,500,000 0
Special Revenue Funds - Other 17,061,000 10,805,000 (6,256,000)
Elderly Pharmaceutical Insurance Coverage
Special Revenue Funds - Other 13,250,000 13,250,000 0
Essential Plan
General Fund 78,089,000 64,901,000 (13,188,000)
Health Care Reform Act Program
Special Revenue Funds - Other 8,470,000 7,370,000 (1,100,000)
Institutional Management
Special Revenue Funds - Other 166,448,000 166,448,000 0
Medical Assistance Administration
General Fund 531,196,000 449,409,000 (81,787,000)
Special Revenue Funds - Federal 1,318,177,000 1,258,883,000 (59,294,000)
Special Revenue Funds - Other 3,081,000 3,081,000 0
Medical Marihuana
Special Revenue Funds - Other 9,778,000 0 (9,778,000)
New York State of Health
Special Revenue Funds - Other 49,033,000 36,058,000 (12,975,000)
Office of Health Insurance Programs
Special Revenue Funds - Federal 625,491,000 603,491,000 (22,000,000)
Special Revenue Funds - Other 6,517,000 6,517,000 0
Office of Primary Care and Health Systems Management
Special Revenue Funds - Federal 21,353,000 21,353,000 0
Special Revenue Funds - Other 35,993,000 36,383,000 390,000
Wadsworth Center for Laboratories and Research
Special Revenue Funds - Federal 13,613,000 13,613,000 0
Special Revenue Funds - Other 64,013,000 34,787,000 (29,226,000)
Total 3,502,705,000 3,273,961,000 (228,744,000)

STATE OPERATIONS - GENERAL FUND
SUMMARY OF PERSONAL SERVICE APPROPRIATIONS AND CHANGES
FY 2022 RECOMMENDED
(dollars)
Program Total Personal Service Regular
(Annual Salaried)
Amount Change Amount Change
Administration 112,713,000 (1,049,000) 110,491,000 (1,049,000)
Essential Plan 4,428,000 (264,000) 4,410,000 (264,000)
Medical Assistance Administration 86,404,000 (1,288,000) 85,784,000 (1,288,000)
Total 203,545,000 (2,601,000) 200,685,000 (2,601,000)
STATE OPERATIONS - GENERAL FUND
SUMMARY OF PERSONAL SERVICE APPROPRIATIONS AND CHANGES
FY 2022 RECOMMENDED CONTINUED
(dollars)
Program Temporary Service
(Nonannual Salaried)
Holiday/Overtime Pay
Amount Change Amount Change
Administration 329,000 0 1,893,000 0
Essential Plan 0 0 18,000 0
Medical Assistance Administration 130,000 0 490,000 0
Total 459,000 0 2,401,000 0

STATE OPERATIONS - GENERAL FUND
SUMMARY OF NONPERSONAL SERVICE AND MAINTENANCE UNDISTRIBUTED
APPROPRIATIONS AND CHANGES
FY 2022 RECOMMENDED
(dollars)
Program Total Supplies and Materials
Amount Change Amount Change
Administration 45,029,000 (1,400,000) 6,555,000 0
Essential Plan 60,473,000 (12,924,000) 9,000 0
Medical Assistance Administration 363,005,000 (80,499,000) 1,048,000 0
Total 468,507,000 (94,823,000) 7,612,000 0
STATE OPERATIONS - GENERAL FUND
SUMMARY OF NONPERSONAL SERVICE AND MAINTENANCE UNDISTRIBUTED
APPROPRIATIONS AND CHANGES
FY 2022 RECOMMENDED CONTINUED
(dollars)
Program Travel Contractual Services
Amount Change Amount Change
Administration 1,944,000 0 34,420,000 (1,400,000)
Essential Plan 20,000 0 60,437,000 (12,924,000)
Medical Assistance Administration 600,000 0 359,157,000 (80,499,000)
Total 2,564,000 0 454,014,000 (94,823,000)
STATE OPERATIONS - GENERAL FUND
SUMMARY OF NONPERSONAL SERVICE AND MAINTENANCE UNDISTRIBUTED
APPROPRIATIONS AND CHANGES
FY 2022 RECOMMENDED CONTINUED
(dollars)
Program Equipment
Amount Change
Administration 2,110,000 0
Essential Plan 7,000 0
Medical Assistance Administration 2,200,000 0
Total 4,317,000 0

STATE OPERATIONS - OTHER THAN GENERAL FUND
SUMMARY OF APPROPRIATIONS AND CHANGES
FY 2022 RECOMMENDED
(dollars)
Program Total Personal Service
Amount Change Amount Change
AIDS Institute 600,000 0 0 0
Administration 39,431,000 0 15,236,000 0
Center for Community Health 183,661,000 8,114,000 62,789,000 0
Center for Environmental Health 27,678,000 805,000 12,865,000 0
Child Health Insurance 149,305,000 (6,256,000) 48,990,000 (26,000)
Elderly Pharmaceutical Insurance Coverage 13,250,000 0 2,275,000 0
Health Care Reform Act Program 7,370,000 (1,100,000) 0 0
Institutional Management 166,448,000 0 104,917,000 0
Medical Assistance Administration 1,261,964,000 (59,294,000) 74,458,000 706,000
Medical Marihuana 0 (9,778,000) 0 (3,670,000)
New York State of Health 36,058,000 (12,975,000) 5,281,000 (189,000)
Office of Health Insurance Programs 610,008,000 (22,000,000) 74,028,000 0
Office of Primary Care and Health Systems Management 57,736,000 390,000 21,423,000 0
Wadsworth Center for Laboratories and Research 48,400,000 (29,226,000) 15,687,000 776,000
Total 2,601,909,000 (131,320,000) 437,949,000 (2,403,000)
STATE OPERATIONS - OTHER THAN GENERAL FUND
SUMMARY OF APPROPRIATIONS AND CHANGES
FY 2022 RECOMMENDED CONTINUED
(dollars)
Program Nonpersonal Service
Amount Change
AIDS Institute 600,000 0
Administration 24,195,000 0
Center for Community Health 120,872,000 8,114,000
Center for Environmental Health 14,813,000 805,000
Child Health Insurance 100,315,000 (6,230,000)
Elderly Pharmaceutical Insurance Coverage 10,975,000 0
Health Care Reform Act Program 7,370,000 (1,100,000)
Institutional Management 61,531,000 0
Medical Assistance Administration 1,187,506,000 (60,000,000)
Medical Marihuana 0 (6,108,000)
New York State of Health 30,777,000 (12,786,000)
Office of Health Insurance Programs 535,980,000 (22,000,000)
Office of Primary Care and Health Systems Management 36,313,000 390,000
Wadsworth Center for Laboratories and Research 32,713,000 (30,002,000)
Total 2,163,960,000 (128,917,000)

AID TO LOCALITIES
ALL FUNDS FINANCIAL REQUIREMENTS BY FUND TYPE
APPROPRIATIONS
(dollars)
Fund Type Available
FY 2021
Recommended
FY 2022
Change
Fiduciary 250,000,000 250,000,000 0
General Fund 47,500,545,171 48,326,161,800 825,616,629
Special Revenue Funds - Federal 96,914,927,000 123,056,829,000 26,141,902,000
Special Revenue Funds - Other 12,816,500,000 12,918,606,000 102,106,000
Total 157,481,972,171 184,551,596,800 27,069,624,629
Adjustments:
Transfer(s) From
Temporary and Disability Assistance, Office of
Special Revenue Funds - Other (500,000)
Appropriated FY 2021 157,481,472,171

AID TO LOCALITIES
ALL FUNDS FINANCIAL REQUIREMENTS BY PROGRAM
APPROPRIATIONS
(dollars)
Program Available
FY 2021
Recommended
FY 2022
Change
AIDS Institute
General Fund 104,305,700 103,255,700 (1,050,000)
Special Revenue Funds - Federal 600,000 600,000 0
Administration
General Fund 266,000 213,000 (53,000)
Center for Community Health
General Fund 584,008,471 517,745,300 (66,263,171)
Special Revenue Funds - Federal 904,117,000 981,717,000 77,600,000
Special Revenue Funds - Other 6,165,000 6,165,000 0
Center for Environmental Health
General Fund 6,512,000 6,213,000 (299,000)
Special Revenue Funds - Federal 5,187,000 6,227,000 1,040,000
Special Revenue Funds - Other 9,560,000 9,560,000 0
Child Health Insurance
Special Revenue Funds - Federal 1,764,098,000 1,764,098,000 0
Special Revenue Funds - Other 658,149,000 733,304,000 75,155,000
Elderly Pharmaceutical Insurance Coverage
Special Revenue Funds - Other 104,413,000 103,417,000 (996,000)
Essential Plan
General Fund 386,218,000 386,218,000 0
Special Revenue Funds - Federal 4,884,774,000 5,460,884,000 576,110,000
Health Care Reform Act Program
Special Revenue Funds - Other 296,920,000 281,525,000 (15,395,000)
Medical Assistance
General Fund 44,982,549,000 45,884,519,000 901,970,000
Special Revenue Funds - Federal 87,590,169,000 113,077,321,000 25,487,152,000
Special Revenue Funds - Other 11,714,723,000 11,763,424,000 48,701,000
Medical Assistance Administration
General Fund 1,427,500,000 1,427,500,000 0
Special Revenue Funds - Federal 1,441,300,000 1,441,300,000 0
Office of Health Insurance Programs
General Fund 3,148,000 96,000 (3,052,000)
Special Revenue Funds - Federal 320,000,000 320,000,000 0
Special Revenue Funds - Other 2,930,000 2,508,000 (422,000)
Office of Primary Care and Health Systems Management
Fiduciary 250,000,000 250,000,000 0
General Fund 5,858,000 401,800 (5,456,200)
Special Revenue Funds - Federal 1,000,000 1,000,000 0
Special Revenue Funds - Other 12,560,000 10,048,000 (2,512,000)
Wadsworth Center for Laboratories and Research
General Fund 180,000 0 (180,000)
Special Revenue Funds - Federal 3,682,000 3,682,000 0
Special Revenue Funds - Other 11,080,000 8,655,000 (2,425,000)
Total 157,481,972,171 184,551,596,800 27,069,624,629

CAPITAL PROJECTS
ALL FUNDS FINANCIAL REQUIREMENTS BY PROGRAM
APPROPRIATIONS
(dollars)
Comprehensive Construction Program Available
FY 2021
Recommended
FY 2022
Change Reappropriations
FY 2022
All Payers Claims Database
Capital Projects Fund 10,000,000 10,000,000 0 0
Capital Restructuring Program for Health Care and Related Facilities
Capital Projects Fund - Authority Bonds 0 0 0 762,078,000
Facilities Maintenance and Operations
Capital Projects Fund 12,266,000 12,266,000 0 0
Health Care Facility Transformation Program
Capital Projects Fund - Authority Bonds 0 0 0 1,761,029,000
IT Initiatives Program
Health Care IT Capital 10,000,000 10,000,000 0 7,968,000
Laboratories and Research
Capital Projects Fund 8,000,000 8,000,000 0 31,772,000
Capital Projects Fund - Authority Bonds 0 0 0 372,000
Maintenance and Improvements of Existing Institutions
Capital Projects Fund 58,904,000 58,904,000 0 40,376,000
Statewide Health Information Network For New York
Capital Projects Fund 30,000,000 30,000,000 0 0
Veterans Affairs
Federal Capital Projects Fund 6,000,000 0 (6,000,000) 6,000,000
Water Resources
Capital Projects Fund - Authority Bonds 0 15,000,000 15,000,000 0
Federal Capital Projects Fund 77,000,000 77,000,000 0 335,256,000
Total 212,170,000 221,170,000 9,000,000 2,944,851,000

Note: Most recent estimates as of 01/19/2021