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Governor Cuomo proposed a $142.6 billion budget for New York State.  While Governor Cuomo’s budget proposal called for full implementation of the federal health care reform law and the expansion of Medicaid coverage, there is a darker side to his budget proposal.   As part of the 2014 budget, Governor Cuomo has suggested cutting funding for public health programs. The proposed budget would lump together public health programs into one appropriation of state money, ultimately leaving public health advocates wondering which one of their programs will take a budget cut and how much will be cut.  Cuomo’s proposal to the Legislature calls for the consolidation of 89 public health programs into six pools.  A total of $40 million in funds or 10% will be cut from these programs. The cuts will be distributed throughout these six pools.  

What does this all mean? Such a cut will make it increasingly difficult to achieve important public health goals.  For example, according to the Centers for Disease Control and Prevention, to maximize impact, New York should be spending $254 million on its on anti-smoking programs based on its population and other factors.[i]  Currently the state spends only $41 million on tobacco control and prevention or $2.12 cents per person but spends over $2.7 billion on tobacco-related Medicaid costs each year. The proposed cuts by the Governor would likely reduce spending by 10% or more to help people quit smoking and prevent youth from starting. That is simply unacceptable when New York raised $10.5 billion in tobacco revenues over the past six years and spent less than four cents on the dollar to help people quit smoking.  We know tobacco control and other prevention programs save money. A study of California’s program showed that spending on tobacco control had a 50 to 1 return on investment for the state because of reduced healthcare spending.[ii]

The funding for these public health programs is essential to protect and promote the health of our most vulnerable citizens. This proposed plan will lead to cuts for lifesaving programs such as cancer screening, child obesity prevention, smoking cessation, HIV prevention, and many other areas.  Short-sighted cuts meant to save money will actually cost the state more in the long run when sicker people consume more publically-funded healthcare.  Likewise, cuts to these public health programs mean New York State residents will suffer the consequences from both a human and financial toll.  Without the help of these programs the health of New Yorkers is in jeopardy and many more New Yorkers will be at an increased risk for health problems.

State cuts will affect your community. Call your legislator today to support public health and stop the consolidation of the NYS Department of Health’s budget!

Click here or put into browser to urge your legislator to oppose the cuts



[i] Centers for Disease Control and Prevention. (2007). Best Practices for Comprehensive Tobacco Control Programs.

[ii] Lightwood JM, Dinno A, Glantz SA (2008) Effect of the California Tobacco Control Program on personal health care expenditures. PLoS Med 5(8): 178. doi:10.1371/journal.pmed.0050178



Marie Ostoyich, RN, MS, CDE

President of the New York State Association of County Health Officials (NYSACHO)  & Public Health Director, Greene County

Exerpts of NYSACHO’s Testimony to Joint Legislative Committees on Health and Finance/Ways and Means Regarding the 2013-14 Executive Budget Proposal


NYSPHA is in agreement with the following comments:



Streamlining the process that health departments must follow to report their public health activities and seek state aid reimbursement will bring welcome administrative relief to local governments and should reduce the delays in reviews, revisions and payments that have plagued the existing process at both the state and local levels. A more efficient reporting and claims process will also provide the state with the necessary fiscal oversight and help to assure local provision of core public health services.


The proposed increase in the State Aid base grant is a concrete and vital step toward strengthening the basic infrastructure of local health departments and allowing greater flexibility for decision-making about local public health needs. The current influenza epidemic highlights the importance of having a strong foundation for the local government public health system. As this epidemic has emerged, local health departments have been encouraging and providing flu vaccinations, monitoring incidence of disease, and promoting efforts to prevent the spread of the flu.


Recognition of Chronic Disease prevention as a core public health service is an important acknowledgement of local health department priorities in their communities today. Chronic Diseases such as diabetes, heart disease and cancer are among the leading causes of death in New York State, and their prevention must be viewed as a public health essential service today.


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