CM Narcisse on H&H operating losses and state budget impact

We forecast operating losses in...

FY28, FY29, and FY30 from the HR1 ramp up.

How optimistic are we that the staffing increase won't get squeezed to make ends meet at the end of the day?

When I look at our system, I'm not cutting nurses because we're structured so that five medical surgical patients equals one nurse.

And that is the appropriate model.

I don't think there's any value in running hospitals that are understaffed.

So you have to maintain the basic staff levels.

Again, that's why I was going to, if one had to do something, it would probably be to look at the 11 hospitals and say, what is each borough going to have?

And maybe each borough is not going to have every service at every hospital.

But I don't want to ever run hospitals with too few nurses or doctors.

I don't see any valor in that.

That will only lead to bad care.

I don't want to ever provide bad care.

I would rather say something is not available than do something poorly.

I appreciate that.

Dr.

Katz, your testimony knows that you are still evaluating the impact of the newly enacted state budget.

And that you anticipate operating losses in out years from HR1.

Can you walk the committee through the challenges you see ahead, both from the state budget and the federal cuts, and how H&H is planning to meet them?

I think I did the planning to meet them, but John can do a better job than I on the cuts themselves.

Yeah, I think first on the state budget, right, we think for health and hospitals it should be very favorable.

We're still trying to understand the details.

But for hospitals in general, the governor and the legislature added over a billion dollars.

And that was $600 million for hospitals, $100 million for outpatient, and then there was a quality pool we're still trying to better understand.

The value of those additional resources are not yet reflected in our plan, right, because we didn't have enough time.

The budget was late.

So that should improve our out-year situation.

You know, as Mitch had said, you know, we're always forecasting years ahead.

The five-year operating deficit is $350 million.

We will need to attack that deficit, and we've seen to have, you know, good success, you know, thus far in that approach.

It was a year ago when we were here together, and HR1 had just...

You know, been released.

And our plan today is about $500 million stronger than it was then.

And it's because we try to

find opportunity in the midst of the turmoil.

And we've managed to do that.

You've heard us talk about the average commercial rate.

It's a state direct, it's a rate enhancement.

And we take advantage of that.

And that's benefited us, you know, rather significantly.

But yeah, we are today trying to figure out solutions for, you know, the fifth year of the plan to avoid those cuts that

Mitch had mentioned.

Thank you.

And like I said, again, I trust Dr.

Katz is going to do the best he can.

And I'm comfortable with a time like this to have Dr.

Katz, you know, doing the CEO of the H&H.