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| Department overview | |
|---|---|
| Formed | February 19, 1901 |
| Jurisdiction | New York |
| Headquarters | Albany, NY |
| Department executive |
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| Key document | |
| Website | www |
The New York State Department of Health is the department of the New York state government responsible for public health. Its regulations are compiled in title 10 of the New York Codes, Rules and Regulations .
New York State relies on a county-based system for delivery of public health services. [1] The Department of Health promotes the prevention and control of disease, environmental health, healthy lifestyles, and emergency preparedness and response; supervises local health boards; oversees reporting and vital records; conducts surveillance of hospitals; does research at the Wadsworth Center; and administers several other health insurance programs and institutions. [1] 58 local health departments offer core services including assessing community health, disease control and prevention, family health, and health education; 37 localities provide environmental health services, while the other 21 rely on the state's Department of Health. [1]
At the local level, public health workers are found not only in local health agencies but also in private and nonprofit organizations concerned with the public's health. [2] The most common professional disciplines are physicians, nurses, environmental specialists, laboratorians, health educators, disease investigators, outreach workers, and managers, as well as other allied health professions. [2] Nurses represented 22% of the localities' workforce (and 42% of full-time equivalent workers in rural localities), scientific/investigative staff represented 22%–27% of the workforce, support staff represented 28%, education/outreach staff represented 10%, and physicians represented 1%. [1] In 2018 the Department of Health had over 3300 personnel in its central office, three regional offices, three field offices and nine district health offices, and an additional 1400 personnel in its five healthcare institutions. [3]
The certificate of need (CON) process is a regulatory mechanism used to oversee the establishment, construction, renovation, and major equipment acquisition of healthcare facilities. [4] [5] The CON process aims to control health care costs and prevent duplicative services by ensuring new investments meet a community need. [6] [7] The process is governed by Article 28 of the Public Health Law and administered by the department with guidance and approval from its Public Health and Health Planning Council (PHHPC).
New York's CON requirements are among the most extensive in the nation, covering all six major categories of health services: hospital beds, non-hospital beds, medical equipment, new facilities, new services, and even emergency medical transport, and New York is unique in applying CON laws to dentists' offices. [8]
The Department, through the NY State of Health marketplace, manages eligibility and enrollment for Medicaid applicants. [9] [10] [11] New York has transitioned to Medicaid managed care away from the fee-for-service model, and most beneficiaries enroll in "mainstream" Medicaid managed care plans. [12] [13] [14] The Medicaid behavioral health system has also transitioned to Medicaid managed care. [15]
To help offset financial losses from serving Medicaid and uninsured patients, disproportionate share hospital (DSH) payments are distributed through multiple mechanisms. [16] [17] These include the Health Care Reform Act (HCRA)-funded Indigent Care Pool and adjustments for hospitals, DSH intergovernmental transfers for public hospitals, and DSH payments to Institutes for Mental Disease (IMDs). The Indigent Care Pool (ICP) is intended to help cover hospitals’ costs from providing charity care and from unpaid bills classified as bad debt, in addition to their Medicaid shortfalls. [18] [19]
State directed payments (SDPs) allow states to require Medicaid managed care plans to pay providers at specific rates or using defined methods — such as uniform payment increases, minimum fee schedules, or value-based payment models — in addition to the base payment rates negotiated between plans and providers. [20] [21] New York's SDPs include value-based payment initiatives such as primary-care population-based payments. [22] Directed Payment Template programs (DPTs) are enhanced reimbursements for safety-net, critical access, and sole community facilities, as well as for NYC Health + Hospitals' outpatient services. [23] [24] [25] [26] [27] These payments are delivered through higher capitation rates paid to managed care plans, with the nonfederal share financed by state general funds, HCRA provider taxes, and intergovernmental transfers.
The Health Department's State Board for Professional Medical Conduct and Office of Professional Medical Conduct are responsible for investigating and adjudicating complaints against physicians, physician assistants, and specialist assistants. [28] [29] The Education Department's State Board for Medicine advises on licensing, practice standards, and professional conduct for physicians and physician assistants. [30] The Education Department's State Board for Nursing advises on licensing, professional practice, education standards, and conduct for licensed practical nurses, registered professional nurses, nurse practitioners, and clinical nurse specialists. [31]
The Statewide Health Information Network for New York (SHIN-NY, pronounced "shiny") is a health information exchange that allows healthcare providers to access and share patient data, managed by the nonprofit New York eHealth Collaborative. There are several regional health information organizations such as Hixny.
The earliest New York state laws regarding public health were quarantine laws for the port of New York, first passed by the New York General Assembly in 1758. [32] [33] The 1793 Philadelphia yellow fever epidemic precipitated the 1799–1800 creation of the New York Marine Hospital, and in 1801 its resident physician and the health officers of the port were constituted as the New York City board of health. [34] [35] [36] The 1826–1837 cholera pandemic precipitated further legislation. In 1847 a law mandated civil registration of vital events (births, marriages, and deaths). In 1866, the state legislature passed the Metropolitan Health Law and established the NYC Metropolitan Board of Health, and in 1870 the legislature replaced it with the NYC Department of Health. [37] [38]
The State Board of Health was created 18 May 1880 by the 103rd Legislature. [39] The 1881–1896 cholera pandemic further caused an expansion of its powers to compel reporting and to perform the duties of local boards of health. [40] The State Department of Health and its commissioner were created by an act of 19 February 1901 of the 124th Legislature, superseding the board. [41]
The certificate of need (CON) requirement was created by New York in 1964. [42] [6] [43]
The state implemented Medicaid in 1966 and designated the state Department of Social Services as the "single state agency" but required it to contract with the Health Department. [44] [45] The Social Services Department and local social districts were responsible for eligibility determinations and paying claims, while the Health Department and local health districts were responsible for settings standards (including fees schedules) and supervising and surveilling providers. [45] In 2012, the Health Department started assuming administrative responsibilities for Medicaid from the counties. [9] [46] [47] [10]
By 1970 the state began to regulate health insurance reimbursement rates, in 1983 began all-payer rate setting, and by 1986-1988 had moved to a case-based system. [48] [49] [50] In 1996 these were replaced by the current Health Care Reform Act (HCRA), allowing negotiated reimbursement rates and establishing tax funding for public goods like graduate medical education, charity care, and public health. [51] [52] [53] The Health Care Reform Act of 2000 (HCRA 2000) was a major extension and modification that made significant changes to how New York State funded hospitals, subsidized care for the uninsured, and managed health insurance programs. [54] [55]
| Name | Dates in Office | Governors Served | Comments |
|---|---|---|---|
| Daniel Lewis | March 6, 1901 [56] – Early 1905 | Benjamin B. Odell, Jr. | Previously was President of the State Board of Health, which became the Department of Health, and served out full term |
| Eugene H. Porter | May 1905 [57] – Early 1914 | Frank W. Higgins, Charles Evans Hughes, Horace White, John Alden Dix, William Sulzer, Martin H. Glynn | Served out his term |
| Hermann M. Biggs | January 19, 1914 [58] – June 28, 1923 [59] | Martin H. Glynn, Charles S. Whitman, Alfred E. Smith, Nathan L. Miller | Died while serving |
| Matthias Nicoll Jr. | July 12, 1923 [60] – January 11, 1930 [61] | Alfred E. Smith, Franklin D. Roosevelt | Resigned to become Commissioner of the Westchester County (New York) Department of Health |
| Thomas J. Parran, Jr. | March 5, 1930 [62] – May 6, 1936 [63] | Franklin D. Roosevelt, Herbert Lehman | Resigned to become Surgeon General of the United States Public Health Service |
| Edward S. Godfrey | April 21, 1936 [64] – May 1, 1947 [65] | Herbert Lehman, Charles Poletti, Thomas E. Dewey | Retired |
| Herman E. Hilleboe | July 1, 1947 [66] – January 7, 1963 [67] | Thomas E. Dewey, W. Averell Harriman, Nelson A. Rockefeller | Became head of the Division of Public Health Practice at the Columbia University School of Public Health [68] |
| Hollis S. Ingraham | January 7, 1963? [67] – January 2, 1975 [69] [70] | Nelson A. Rockefeller | Served out full term |
| Robert P. Whalen | January 2, 1975 [69] – April 29, 1975 [71] (acting) April 29, 1975 [71] – December 31,1978 [72] | Hugh Carey | Resigned to become Vice chairman of the New York State Health Planning Commission |
| David Axelrod | January 1, 1979 [73] – May 12, 1991 [74] | Hugh Carey, Mario M. Cuomo | Resigned after a severe stroke [75] |
| Lorna McBarnette | February 25, 1991 – June 9, 1992 | Mario M. Cuomo | Acting [76] |
| Mark R. Chassin | June 9, 1992 [77] – December 31, 1994 | Mario M. Cuomo | Served out full term |
| Barbara Ann DeBuono | Early February 1995 [78] – November 1, 1998 [79] | George E. Pataki | Resigned to become an executive in the NewYork-Presbyterian Healthcare System |
| Dennis P. Whalen | November 1, 1998 – June 1999 | George E. Pataki | Acting [80] |
| Antonia C. Novello | June 1999 [81] – December 31, 2006 | George E. Pataki | Served out full term |
| Richard F. Daines | February 2007 [82] – December 31, 2010 [83] | Eliot Spitzer, David Paterson | Served out full term |
| Nirav R. Shah | January 24, 2011 [84] – May 4, 2014 | Andrew Cuomo | Resigned to become chief operating officer at Kaiser Permanente in Southern California [85] |
| Howard A. Zucker | May 4, 2014 – May 5, 2015 (acting) May 5, 2015 [86] – December 1, 2021 | Andrew Cuomo, Kathy Hochul | Part of Governor Cuomo and Hochul's COVID-19 task force during the pandemic [87] |
| Mary T. Bassett | December 1, 2021 – January 1, 2023 | Kathy Hochul | Part of Governor Hochul's COVID-19 task force during the pandemic [88] |
| James V. McDonald | January 1, 2023 – June 9, 2023 (acting) June 9, 2023 [89] – current | Kathy Hochul | Current commissioner |
This article incorporates text from this source, which is in the public domain .It wasn't until 1964, however, that New York State enacted the first CON law in health care.
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