Issue Position: Healthcare & the Opioid Epidemic

Issue Position

Whether it's access to affordable health care or the lack of a public hospital, from cancer to asthma rates -- Staten Island faces far worse than the rest of our city. We're also in the midst of grappling with a heroin and opioid epidemic that is ripping families apart. Our borough has continuously ranked as having one of the highest overdose rates in New York City, along with having the unhealthiest air quality among the 5 boroughs. It is unconscionable that in 2018 we have friends and neighbors deciding between quality care and paying their rent. We should not have one of the highest maternal mortality rates in the city. Typically, the socio-economic status of a community will dictate outcomes. With Staten Island having the highest median household income level across New York City, we still continue to have some of the worst health care outcomes. Access to quality health care means not only having adequate medical facilities that provide it, but also a public transportation system that can get people there, safe and supportive housing for those at-risk, a public education system that provides support/resources related to healthcare, and ensuring that no immigrant or minority communities decline care or go unserved because of a hostile federal government. Our borough deserves better, and we need bold leadership in Albany who is going to deliver for our community.
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Here is Charles' 5-Point Plan to create A Healthier North Shore

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1. ACCESS TO QUALITY AND AFFORDABLE HEALTH CARE
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Our state has made great progress towards the goal of universal coverage, but we still have work to do. I fully support a single-payer concept, which if legislated correctly and efficiently, shows the potential for mass savings. The unfortunate reality is that federal support is not there under the present administration, especially when it comes to the waivers needed in combining multiple public health care programs into one. I believe our state must work towards immediate, tangible solutions to ensure that the 5% of remaining uninsured New Yorkers gain access to quality health insurance, while we increase and improve access to care for the remaining 95%.

A major way in which we can ease the financial burden for those across New York is to institute a statewide individual mandate for health insurance. Since its repeal at the federal level, New Jersey became the first state to re-institute the individual mandate, and their most recent health insurance premiums for the marketplace will decrease on average by 15%. New York must follow the lead of our neighboring state and immediately re-institute the individual mandate.

New York must also explore options for a state-based public option which will not only give Staten Islanders another insurance provider but also lower costs across the board.Additionally, we must codify into state law the banning of short-term association health plans that circumvents the Affordable Care Acts (ACA) 10 essential benefits, along with not covering pre-existing conditions. These "junk" plans destabilize the insurance market, causing massive premium hikes, while also not providing adequate coverage when consumers need it the most.

2. FIGHTING THE HEROIN AND OPIOID EPIDEMIC

In 2016, the number of overdose deaths on Staten Island increased by 66%, the most of any borough. In 2017, 99 Staten Islanders lost their battle with addiction. The present heroin and opioid epidemics are the first in over a generation that does not discriminate. Every zip code, age, race, ethnicity, and socioeconomic status is affected. There is a story from every corner of our borough. Like far too many, I've lost neighbors and friends to this heinous epidemic. This is something that unites us all, in the hopes we can bring it to a swift end. From fighting fentanyl dealers to balancing treating pain versus overtreating pain, our state can do so much more. First and foremost, our approach must be rehabilitative, and supporting a local approach that empowers every resource possible.

District Attorney Michael McMahon and his office have taken crucial steps through the "Staten Island Heroin Overdose Prevention and Education" (SI HOPE) initiative, and in Albany I will partner with him to move forward with the major progress that has been made, and ensure we continue providing tools to empower local prosecutors and DAs. The state must give District Attorneys more flexibility in aggressively prosecuting mass dealerswho are wreaking havoc in our communities. Initiatives such as a continued, robust educational awareness campaign are crucial to stem the stigmatism that comes with drug addiction, while also ensuring victims and their families know of the resources in our communities. Substance Abuse Prevention and Intervention Services (SAPIS) are a major way to break through the onset of drug addiction in our schools, and the state must increase resources for these trained professionals who provide critical, education based, prevention intervention services to ensure that our youth do not succumb to this epidemic and promote healthy behaviors among them.

The use of Buprenorphine is heavily regulated by the federal government, but these initial treatments have proven to be life savers for our community that are a first step to additional, long-term recovery options. While there has been a steady increase in physicians who qualify to prescribe this treatment, we must expand the number of physicians, nurse practitioners, and physician assistants who qualify for the wavier. I will advocate that local hospitals and community health centers expand these waivers, while also increasing the amount of nurse case managers who can triage patients for treatment, so more locally trained professionals can provide this life saving option to patients.

The use of Naloxone, in which the blocking of opioid receptors helps reverse an overdose, has been crucial. The city has heavily invested in this course of action, along with support from the state. From first responders to "organizing trainings" to over-the-counter availability at all local pharmacies, I believe the state must utilize data to track the number of Naloxone kits dispensed, which will assist public policy makers in providing essential finical support on the ground, while granting the ability for more providers and every-day Staten Islanders the use of this life saving overdose reversal treatment.

Staten Island's Narcotics Part, also known as Part N, or the "Drug Court" has been a political football in current years. Recently, the state reworked this part to establish the Treatment Court (SITC). The fight to retain this court has been long, and it is not over. I will be a tireless voice in Albany for its continued sustainability and permeant status.

Our borough's HOPE program has taken major strides in offering first-time offenders' entrance into diversion programs rather than direct prosecution, but we must work to expand that program so more individuals who've had previous involvement with law enforcement are eligible. Our state must also fight "over-prescription," and I will work with state leaders to strengthen laws, such as Internet System for Tracking Over-Prescribing(I-STOP), to accomplish that goal, while also increasing prescriber training so physicians can adequately treat their patients without worsening this epidemic.

We are in the midst of a public health crisis, and in the Assembly, I will fight during the yearly budget process to expand the amount of inpatient and outpatient beds that directly deal with substance abuse. I will also work with all providers, specifically local hospitals and outpatient centers, to bridge the divide and ensure there is better communication and coordination between the two so overdose patients can have the option to make a seamless transition to medication-assisted treatments that these centers provide.

​ 3. SUPPORTING OUR HOSPITALS AND COMMUNITY BASED HEALTH

Our local hospitals and community health clinics are a life line for thousands of North Shore residents every day. As the only borough without a public hospital, it is vital that the state provides the financial resources to ensure existing facilities thrive. A major way to accomplish that is increasing the amount of money the state allocates to hospitals and health facilities for capital investments. To serve our community most effectively, facilities and equipment must move into the 21stCentury, and our state must put forward more financial resources to assist in that goal. We must continue to transform and restructure Medicaid reimbursement rates, and the way we deliver Medicaid, while also continuing to rein in costs while expanding delivery to quality care.

The Delivery System Reform Incentive Payment (DSRIP) Program has vitally transformed the way in which providers and the state work to decrease avoidable hospital use, while increasing savings and quality care to Medicaid recipients. As we approach the 5-year expiration mark on this program, I will work within the legislature to renew and expand this program so our state can continue with its creativity in ensuring we have a robust Medicaid program for generations to come.

Our state is seeing a massive exodus of primary care physicians, predominantly because of the high cost of living coupled with the cost of medical school. As we must continue focusing on primary care, significantly expanding The Regents Physician Loan Forgiveness Award Program across our state will take a major financial burden away from these new graduates, with an increased incentive to remain in the primary care field. We must also empower nurse practitioners, and expand education and employment options for these nurses who provide invaluable, front line primary care to thousands of Staten Islanders every day.

Our state must move away from the traditional fee-for-service model - where our current health care system works off of an incentive of profit -- to a system of value-based care, so we can make payments based on the quality of one's care and treatment. A major way in which we can accomplish this goal is by exploring alternative models, such as All-Payer Rate Setting, where all rate payments are equalized for all patients who receive the same treatments and services from the same provider, largely taking out the profit motive behind health care.

We are the only borough that does not have a public hospital. While it will be a difficult feat, there are many ways in which the city can help to expand access across the North Shore. NYC Health + Hospitals (H+H), New York City's public hospital system, just recently opened[ up its first community-based, full service healthcare center in Staten Island, right on the North Shore. This facility is going to serve on average over 15,000 patients in Staten Island. This is a major step in the right direction, but we must do more to give those on the North Shore the proper access to quality healthcare. Our state needs to make long-overdue investments in primary and preventative care, while also increasing funds and resources for outpatient, ambulatory, and community-based healthcare.

​ 4. REPRODUCTIVE RIGHTS AND FAMILY PLANNING

With access to reproductive health in jeopardy with the potential confirmation of Judge Kavanaugh to the Supreme Court, along with consistent attacks from the federal government, New York most do everything in its power to protect women and families. I am committed to strengthening affordable family planning on the North Shore, because no family should be denied health care based on their zip code or forego it based on what they can afford. In Albany, I will actively support organizations like Planned Parenthood and NIRH and work with them to pass into law the Reproductive Health Act, so we can codify into law Roe v. Wade and ensure New York stands on the right side of history in forever protecting a women's right to choose while also passing the Comprehensive Contraception Act, soour state mandates all insurers cover FDA-approved birth control. I will also fight to pass GENDA, to strengthen laws related to reproductive and sexual health, and a revamped sexual education curriculum for our youth.


​ 5. HOLDING PHARMACEUTICAL COMPANIES ACCOUNTABLE

There has been a massive price gauge of prescription medications. As taxpayers, we deserve to know we are getting the best value on pharmaceutical drugs. Absent federal intervention, and a lack of speedy generic approvals, our state must act, and I will support an activist Attorney General while ensuring the legislature partners and provides tools for the next AG to prosecute drug companies that work to circumvent the health and well-being of Staten Islanders. In the Assembly, I will support legislation that requires brand-name drug manufacturers to supply samples to generic drug companies in an effort to advance less expansive equivalents of these brand-name drugs, so there is no monopoly on life saving medications and their absurd prices. I will also support legislation that requires pharmacists provide consumers with affordable generics of brand-name drugs, and legislation that brings transparency to the pharmaceutical industry, specifically requiring drug companies to rationalize price increases over certain thresholds.

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