[ THEME MUSIC ] ON THIS WEEK'S EDITION OF "NEW YORK NOW," WE'LL SPEAK WITH SENATE MAJORITY LEADER ANDREA STEWART-COUSINS TO LEARN WHAT BIG TICKET POLICIES, IF ANY, CAN GET DONE IN THE FINAL TWO EBBING WAS OF THE LEGISLATIVE SESSION AT THE CAPITOL, AND LATER IN THE SHOW, WE'LL CONSIDER WHAT THE FUTURE HOLDS FOR PHYSICIAN ASSISTANTS WHO ARE GIVEN EXPANDED AUTONOMY DURING THE PANDEMIC.

I'M DAVID LOMBARDO, AND THIS IS "NEW YORK NOW."

[ THEME MUSIC ] WELCOME TO THIS WEEK'S EDITION OF "NEW YORK NOW."

I'M DAVID LOMBARDO, HOST OF THE CAPITAL PRESS ROOM, FILLING IN FOR DAN CLARK.

OUTSIDE OF THE STATE BUDGET, THE END OF THE LEGISLATIVE SESSION IS TRADITIONALLY WHEN MAJOR POLICIES ARE ADOPTED AT THE CAPITOL.

WITH TIME RUNNING OUT ON THE LEGISLATIVE CALENDAR, IT'S NOT CLEAR IF STATE LAWMAKERS OR GOVERNOR KATHIE HOCHUL HAVE THE APPETITE TO WHEEL AND DEAL IN A SIGNIFICANT WAY.

FOR INSIGHTS INTO WHAT COULD GET DONE AND FOR SOME POST-BUDGET ANALYSIS, WE RECENTLY SAT DOWN AT THE CAPITOL WITH SENATE MAJORITY LEADER ANDREA STEWART-COUSINS.

[ THEME MUSIC ] WELL, WELCOME TO THE SHOW, LEADER.

THANKS FOR MAKING THE TIME.

IT'S GOOD TO BE WITH YOU.

SO THIS YEAR'S BUDGET WAS ABOUT A MONTH LATE.

IN PART BECAUSE GOVERNOR KATHIE HOCHUL WAS INSISTENT ON GETTING CHANGES TO THE STATE'S PRE-TRIAL DETENTION LAWS AND ULTIMATELY, SHE SECURED WHAT SHE SAYS IS GOING TO RESULT IN A SYSTEM WHERE JUDGES CAN IMPOSE BAIL FOR MORE CONDITIONS.

DO YOU FEEL LIKE WHAT WAS INCLUDED IN THE BUDGET WILL ULTIMATELY MAKE NEW YORKERS SAFER, MAKE THEM FEEL SAFER, A LITTLE BIT OF BOTH OR NEITHER?

WELL, THE CONVERSATION, AGAIN, AROUND BAIL, I ALWAYS TRY AND CONTEXTUALIZE.

NUMBER ONE, THE BAIL REFORMS THAT WE DID DEALT MOSTLY WITH MISDEMEANOR AND NON-VIOLENT FELONIES, AND THERE HAD BEEN, YOU KNOW THIS BROAD CONVERSATION THAT VIOLENT FELONS WERE GETTING OUT WITHOUT BAIL.

THAT WAS NEVER WHAT WE CHANGED.

IT WAS ALWAYS ABOUT NOT CRIMINALIZING AND KEEPING IN RIKER'S ISLAND FOR YEARS SOMETIMES PEOPLE WHO HAD BEEN ACCUSED OF MISDEMEANOR BEHAVIOR.

PEOPLE WERE LOSING THEIR LIVELIHOODS.

THIS HE WERE LOSING THEIR HOMES.

THEY WERE LOSING EVERYTHING AND STILL DIDN'T HAVE A TRIAL.

SO WE WANTED TO FIX THAT.

THE IDEA THAT JUDGES DIDN'T HAVE DISCRETION WAS TALKED ABOUT, AND SO WHAT WE WANTED TO MAKE SURE IS THAT JUDGES UNDERSTOOD THAT THEY, INDEED, HAVE DISCRETION, THAT WE EXPECT, AGAIN, JUSTICE TO BE FAIR FOR EVERYONE.

WE CERTAINLY DO NOT WANT CRIMINALS TO BE NOT HELD ACCOUNTABLE BUT WE DID NOT WANT TO CRIMINALIZE POVERTY.

I BELIEVE THAT THE CHANGES WILL, INDEED, CLARIFY THAT JUDGES HAVE DISCRETION AND MAKE SURE, AGAIN, THAT THE SYSTEM IS FAIRER FOR EVERYONE INVOLVED, AND I DO BELIEVE THAT NEW YORKERS WILL ULTIMATELY BE SAFE, FEEL SAFER, AND THE WORDS OF THE DATA SPEAKS FOR ITSELF.

I MEAN, THE CRIME IN NEW YORK IS-- IS LOWER THAN CERTAINLY MANY STATES AND IN NEW YORK CITY, ITSELF.

IT IS LOWER THAN MOST MAJOR CITIES.

SO I THINK THE DATA SPEAKS FOR ITSELF.

WE CONTINUE TO WANT TO LOOK AT DATA AS WE DO ANY OF THESE CRIMINAL JUSTICE REFORMS BUT YES, INDEED.

WE DO BELIEVE THAT JUDGES NOW KNOW EXACTLY WHAT THEY ARE ABLE TO DO AND I BELIEVE THAT PEOPLE WILL FEEL SAFER AND WE CONTINUE TO, YOU KNOW, WANT TO DO THINGS TO MAKE NEW YORK SAFER AND, YOU KNOW, A GREAT PLACE TO BE.

WELL, TURNING TO SOME UNFINISHED BUSINESS FROM THE STATE BUDGET, THE LEGISLATURE AND THE GOVERNOR WERE UNABLE TO COME TO AGREEMENT ON PART OF THE GOVERNOR'S SO-CALLED HOUSING COMPACT.

SPECIFICALLY, I THINK ABOUT THE PART OF THE GOVERNOR'S PLAN THAT WOULD HAVE ALLOWED THE STATE TO OVERRIDE LOCAL ZONING IN SITUATIONS WHERE COMMUNITIES WEREN'T HITTING GROWTH TARGETS THAT THE GOVERNOR WAS HOPING TO LAY DOWN.

DO YOU SEE THAT AS AN AREA WHERE THERE COULD BE COMPROMISE BETWEEN THE GOVERNOR AND THE LEGISLATURE, ESPECIALLY YOUR SUBURBAN LAWMAKERS, OR IS THAT AN AREA WHEN YOU THINK ABOUT WHAT CAN GET DONE IN THE REMAINING DAYS OF SESSION THAT IS JUST OFF THE TABLE AT THIS POINT?

WE ALWAYS WANT TO BEGIN WHERE WE ALL AGREE.

WE KNOW THAT WE NEED MORE HOUSING IN NEW YORK.

WE KNOW THAT WE CERTAINLY NEED MORE AFFORDABLE HOUSING IN NEW YORK.

THE APPROACH IN THE COMPACT WAS MULTIFACETED, AND IT JUST WAS NOT ANYTHING THAT WE COULD DO COMPREHENSIVELY IN THE SHORT AMOUNT OF TIME THAT WAS REQUIRED TO PASS A BUDGET.

WE CONTINUE TO TALK ABOUT HOUSING.

OBVIOUSLY, OUR APPROACH WAS MORE OF THE INCENTIVES.

WE WANTED TO MAKE SURE THAT WE, A, RECOGNIZE MUNICIPALITIES AND GOVERNMENTS THAT WERE ACTUALLY CREATING HOUSING AND CREATING AFFORDABLE HOUSING AND DOING THINGS THAT WERE PROMOTING HOUSING, AND AS WELL AS ENCOURAGE COMMUNITIES WHO MIGHT DO IT IF THEY WERE INCENTIVIZED TO DO IT TO DO THAT.

SO THE CONVERSATION FROM OUR END HAS ALWAYS BEEN LET US BEGIN WITH, A, EXPLAINING WHAT THE NEED IS, MAKING SURE THAT PEOPLE WERE COLLABORATING WITH US AS WE MOVE FORWARD AND THEN TALKING ABOUT INCENTIVES TO DO WHAT WE KNOW IS IMPORTANT.

AND I ALWAYS SAID THAT I WAS WILLING, CERTAINLY, TO HAVE A CONVERSATION ABOUT WHAT WE DO WHEN COMMUNITIES, YOU KNOW, WERE UNWILLING TO DO ANYTHING, BUT I NEVER FELT THAT CONVERSATION SHOULD BEGIN WITH US OVERRIDING LOCAL JURISDICTIONS.

SO THE CONVERSATION DOES CONTINUE.

THE NEED, OBVIOUSLY, EXISTS, AND WE'RE HOPING THAT WE WOULD BE ABLE TO GET THINGS DONE.

THE OTHER THING THAT OUR CONFERENCE WAS PRETTY CLEAR ABOUT AND IS IMPORTANT IS WE WANTED TO MAKE SURE WE DID TENANT PROTECTIONS.

WE WANTED TO MAKE SURE THAT WHILE WE ARE TRYING TO BUILD HOUSING THAT PEOPLE WHO ARE CURRENTLY BEING ABLE TO RENT HOUSING SMALL HOMEOWNERS WILL BE ABLE TO KEEP THOSE UNITS AS WELL, AND SO YOU KNOW, THAT WE ARE ALSO LOOKING AT THE PRINCIPLES OF GOOD CAUSE AND CONTINUING TO FIND WAYS TO MAKE SURE THAT WHILE THESE RENTS ARE JUST ALMOST-- MANY OF THEM, JUST BEING RAISED OUT OF CONTROL THAT WE FIND SOME WAY THAT ALLOWS PEOPLE TO STAY IN THEIR HOMES WHILE WE BUILD MORE.

HOW COMFORTABLE WERE YOU WITH THE TENOR OF THE DEBATE OVER THE HOUSING EXACT?

BECAUSE A LOT OF THE PROBLEMS THAT THE HOUSING EXACT IS HOPING TO ADDRESS IN TERMS OF STAGNANT HOME GROWTH ARE LOCAL RULES THAT ARE A PRODUCT OF KEEP PEOPLE, SAY, PEOPLE OF COLOR OUT OF CERTAIN COMMUNITIES.

DO YOU FEEL LIKE THE DEBATE REVERTED TO TOO MANY DOG WHISTLE CONVERSATIONS AND CLAIMS FROM STATE LAWMAKERS WHO PUSHED BACK WITH IDEAS OF NOT IN MY COMMUNITY AND WE LIKE THE WAY THINGS ARE NOW?

WERE YOU COMFORTABLE WITH ANY OF THAT?

LISTEN, I REPRESENT WESTCHESTER COUNTY.

I REPRESENT SUBURBAN, AND I WILL SAY THAT DIFFERENT MUNICIPALITIES IN WESTCHESTER AS WELL AS EVEN THE WESTCHESTER COUNTY EXECUTIVE WAS VERY, VERY CLEAR THAT WE KNOW THAT WE CAN DO MORE IN HOUSING AND WE CONTINUE TO PUSH FOR THAT HOUSING.

I KNOW A LOT OF MUNICIPALITIES WHO STEPPED UP AND SAID, LOOK, I'M WILLING TO DO THIS OR THAT AND THEN WE FELT SOME WHO MAYBE THEY DIDN'T HAVE THE INFRASTRUCTURE.

AGAIN, I'M A BLACK WOMAN AND YOU KNOW, WHO OBVIOUSLY KNOWS THE HISTORY, AND WE SEE, AGAIN, WHEN WE LOOK AT A LOT OF THE DIFFERENT SYSTEMS, WE SEE A LOT OF THINGS WERE PUT IN PLACE TO MAKE SURE THAT PEOPLE OF COLOR, OTHER PEOPLE DID NOT HAVE THE OPPORTUNITIES.

WE KNOW THAT.

BUT I CANNOT ASSUME THAT EVERY SINGLE COMMUNITY IS WANTING TO DISCRIMINATE OR EVERY COMMUNITY DOESN'T WANT TO DO SOMETHING OR THAT THE LEADERSHIP DOESN'T WANT TO DO SOMETHING.

THAT'S WHY I SAID, WE HAVE TO START WITH AN EDUCATION PIECE, TALK ABOUT WHAT WE CAN DO TOGETHER, TALK ABOUT WHAT NEEDS TO BE DONE, GIVE PEOPLE, YOU KNOW, AN OPPORTUNITY TO STEP UP TO THE PLATE, CONGRATULATE THOSE WHO DO, INCENTIVIZE THOSE WHO ARE KIND OF ON THE FENCE AND THEN WE'LL DEAL WITH PEOPLE WHO ABSOLUTELY DON'T WANT TO DO ANYTHING BECAUSE THEY JUST DON'T WANT TO DO IT.

BUT I THINK THAT THERE IS AN APPROACH THAT WE CAN TAKE THAT WILL BE COLLABORATIVE WITH LOCAL COMMUNITIES THAT WILL GET US WHERE WE NEED TO GO AND ALSO, WE NEED TO DO SOMETHING FROM A STATE LEVEL THAT CREATES THE NEXT AFFORDABLE HOUSING PROJECT FOR THE STATE.

I MEAN, MITCHELL-LAMA WAS SOMETHING THAT HAPPENED DECADES AGO.

IT ORIGINATED WITH TWO STATE LEGISLATORS AND IT WAS AN AFFORDABILITY SCHEME THAT ALLOWED FOR PEOPLE WORKING-- WORKING-CLASS PEOPLE TO KNOW THEY WOULD HAVE SECURITY IN AFFORDABLE HOMES.

WE IN NEW YORK STATE, AGAIN, HAVE TO DO SOMETHING LIKE THAT AND WE NEED EVERYBODY AT THE TABLE.

WE NEED THE DEVELOPERS ON THE TABLE.

WE NEED THE TENANT ADVOCATES AT TABLE.

WE NEED, YOU KNOW, REAL ESTATE, WE NEED LABOR, WE NEED LABOR.

WE NEED EVERYBODY AT THE TABLE SO THAT WE CAN CREATE THAT NEXT AFFORDABLE PROJECT BECAUSE THAT'S WHAT'S GONNA KEEP OUR KIDS IN OUR COMMUNITIES.

IT'S GONNA KEEP OUR SENIORS IN THE COMMUNITIES BECAUSE PEOPLE DON'T WANT TO LEAVE.

THEY WANT TO STAY.

SO ANOTHER ISSUE THAT'S BEEN KICKING AROUND THE CAPITOL FOR YEARS IN DIFFERENT FORMS IS THIS IDEA OF MAKING PAROLE OPPORTUNITIES MORE ACCESSIBLE TO NEW YORKERS.

SO WHAT PLANS, IF ANY, IN THE WANING DAYS OF THE LEGISLATIVE SESSION DO YOU HAVE TO CONSIDER EITHER ON THE FLOOR OR IN CONFERENCE SOME OF THE DIFFERENT BILLS THAT ADDRESS OPPORTUNITIES OF PAROLE?

WELL, WE'RE ALWAYS TRYING TO ADDRESS, AGAIN, OPPORTUNITIES TO CREATE A PATH FORWARD.

ONE OF THE THINGS THAT WE KNOW IS THAT ONCE YOU'VE BEEN CONVICTED AND YOU'VE DONE YOUR TIME AND YOU'VE REPAID YOUR DEBT, THERE ARE OBSTACLES TO BEING ABLE TO RESUME YOUR LIFE AS A PRODUCTIVE CITIZEN.

WE'RE TRYING TO MAKE SURE THAT THOSE OPPORTUNITIES-- THERE'S A LOT OF DIFFERENT THINGS THAT ARE ON THE TABLE THAT WE DON'T KNOW WHAT WE'LL BE ABLE TO COMPLETE WITHIN THE NEXT THREE WEEKS OR SO BUT WE ARE DEFINITELY LOOKING AT VERY SERIOUSLY SOME OF THESE BILLS AROUND PAROLE AND CERTAINLY AROUND CLEAN SLATE BECAUSE THE OTHER THING THAT HAPPENS IS YOU GET OUT AND YOU'VE DONE YOUR TIME AND NO MATTER WHEN IT HAPPENED IN YOUR LIFE, YOU CAN GO FOR-- I RAN INTO SOMEBODY AT A LOCAL CHURCH FUNCTION WHO WAS BEGGING.

HE'S A COMPUTER SOFTWARE-- HE'S A SOFTWARE TECHNICIAN AND BEEN SUCCESSFULLY IN HIS OWN BUSINESS FOR ABOUT 20 YEARS AND YOU KNOW, 35 YEARS AGO, HE RAN AFOUL OF THE LAW WHEN HE WAS IN HIS EARLY 20S.

EVERY TIME HE MAKES A BID FOR A JOB, THIS COMES UP IN HIS RECORD.

IT'S AN IMPEDIMENT.

HE STILL OBVIOUSLY IS ABLE TO GET SOME WORK.

BUT YOU KNOW, AT SOME POINT, WE NEED TO BE ABLE TO CLOSE THE BOOK ON CERTAIN CRIMES AND ALLOW PEOPLE WHO HAVE, AGAIN, SHOWN THAT THEY ARE WILLING AND ABLE TO BE A PRODUCTIVE MEMBER OF SOCIETY TO BE THAT.

SO THERE ARE THINGS THAT WE WILL DO AND CONTINUE TO DO IN ORDER TO, AGAIN, NOT PUNISH PEOPLE FOREVER.

GIVE PEOPLE AN OPPORTUNITY TO GET BACK IN THERE BECAUSE WE NEED ALL HANDS ON DECK.

THAT IDEA OF A TIMEFRAME FOR BEING ABLE TO MOVE PAST MISTAKES OR ISSUES IN YOUR PAST IS KIND OF THE STICKING POINT, IT SEEMS LIKE, IN CLEAN SLATE DISCUSSIONS RIGHT NOW.

SO AS YOU THINK ABOUT COMPROMISE, IS THERE A BRIDGE TOO FAR WHEN IT COMES TO COMPROMISING UNCLEAN SLATE WHERE MAYBE YOU FEEL THE WINDOW IS TOO LONG AND YOU WON'T WANT TO BUDGE, OR WOULD YOU RATHER HAVE SOMETHING THAN NOTHING IF THAT'S WHAT IT TAKES TO GET THE ASSEMBLY AND GOVERNOR ONBOARD?

I MEAN, IF IT'S TOO LONG THEN WHAT'S THE POINT?

I MEAN, AGAIN, WE ARE TRYING TO ADDRESS THE REALITIES OF A PERSON WHO PAID THEIR DEBT TO SOCIETY AND HAVE BEEN IN SOCIETY FOR A NUMBER OF YEARS, WHATEVER THAT NUMBER IS.

IT HAS TO BE 40 YEARS, WHAT'S THE POINT?

YOU KNOW, WE NEED TO COME TO A REASONABLE NUMBER AND BE ABLE TO AGREE THAT THIS IS, YOU KNOW, A DECENT AMOUNT OF TIME WHERE PEOPLE HAVE PROVEN THAT THEY-- THEY'RE FINE AND THEY WILL GO ON AND ADHERE TO, YOU KNOW, SOCIETY'S NORMS.

IT'S WHATEVER IT IS AND MOVE ON.

ANYTHING WILL NOT DO, BUT I DO BELIEVE THAT THERE IS ENOUGH DESIRE NOT ONLY, YOU KNOW, WITH MY COLLEAGUES IN THE ASSEMBLY BUT WITH THE GOVERNOR AS WELL.

I MEAN, WE ALL UNDERSTAND AND YOU KNOW, A LOT OF PEOPLE ARE SUPPORTIVE OF THIS, BUSINESS COMMUNITY, A LOT OF FOLKS BECAUSE WE NEED PEOPLE IN THE LABOR FORCE.

WE NEED PEOPLE TO HELP CONTINUE TO BUILD OUR ECONOMY, SO TO CONTINUE SHUTTING PEOPLE OUT BECAUSE OF A MISTAKE THEY'VE ATONED FOR YEARS AND YEARS AGO.

IT JUST SEEMS SILLY.

WELL, FINALLY, A HALLMARK OF LEGISLATIVE SESSIONS IN YEARS PAST ARE THE BIG UGLIES THAT ARE ADOPTED.

THESE SO-CALLED OMNIBUS BILLS THAT INCLUDE DIFFERENT PRIORITIES FROM THE ASSEMBLY, SENATE AND GOVERNOR.

RIDE NOW, THOUGH, AS I TAKE THE TEMPERATURE OF THE CAPITOL, I DON'T EVEN KNOW WHAT WOULD BE IN A BIG UGLY IF THERE WERE TO BE NEGOTIATIONS IN ONE.

DO YOU FEEL LIKE WE'RE HEADING TOWARD SOME SORT OF COMPROMISE ON A WHOLE VARIETY OF ISSUES, OR IS IT POSSIBLE THIS SESSION, FOR WHATEVER REASON, WHETHER IT'S BECAUSE OF THE LATE BUDGET OR OUTSIDE FORCES IS GOING TO KIND OF END MORE QUIETLY THAN MOST LEGISLATIVE YEARS?

WELL, I THINK THE BUDGET PERIOD THAT WE HAD CERTAINLY HAD ITS SHARE OF DRAMA AND SUSPENSE AND HAD A RELATIVELY LARGE QUOTE, UNQUOTE, BIG UGLY IN THE BUDGET, BUT I'M ALSO SAYING THAT WE'VE DONE A LOT.

I MEAN, A LOT OF THE THINGS THAT STATES AROUND THE COUNTRY ARE GRAPPLING WITH, WHETHER IT'S ENSURING REPRODUCTIVE RIGHTS OR WHETHER IT'S ENSURING LGBTQ RIGHTS, ENVIRONMENTAL, YOU KNOW, INITIATIVES THAT WE'VE DONE, CRIMINAL JUSTICE THINGS THAT WE'VE DONE, EDUCATION IS A BIG DEAL FOR OUR COMMUNITY.

WE'RE DELIVERING BILLIONS OF DOLLARS.

EVERY SCHOOL NOW IS FULLY FUNDED.

WE'RE EXPANDING CHILD CARE AND UPK AND AFTERSCHOOL AND DEALING WITH MENTAL HEALTH ISSUES IN WAYS THAT WE NEVER DID BEFORE.

WE'VE TALKED A LOT ON GUN VIOLENCE WE HAVE DONE, I THINK, AN INCREDIBLE AMOUNT OF WORK THAT A LOT OF STATES ARE STILL TRYING TO FIGURE IT OUT.

SO DO I THINK IN THE, YOU KNOW, NEXT TWO, THREE WEEKS, WE WILL CERTAINLY TRY AND REACH COMPROMISE AND KEEP MOVING THE BALL FORWARD AS WE KEEP PRESSING TO BUILD OUR ECONOMY AND TO CREATE THE GROWTH AND WILL WE KEEP TRYING TO FIGURE OUT THIS HOUSING THING, YES, WE WILL.

BUT DO I EXPECT SOME-- SOME GRAND, BIG UGLY?

PROBABLY NOT.

BUT I THINK THAT WE CAN ASSURE EVERYONE THAT WE ARE ALL WORKING, AS YOU SAID, THE ASSEMBLY, THE GOVERNOR, OUR SENATE WORKING TOGETHER IN ORDER TO MAKE SURE THAT WE, A, MEET THE NEEDS OF NEW YORKERS AND KEEP NEW YORK MOVING FORWARD IN EVERY WAY POSSIBLE.

AND SO YOU STILL FEEL THEN BASED ON WHAT'S HAPPEN SOD FAR EVEN WITHOUT A SO-CALLED BIG UGLY-- TO THROW IT OUT THERE ONE MORE TIME-- THERE CAN STILL BE A SUCCESSFUL SESSION?

ABSOLUTELY!

I THINK IT'S-- LISTEN, EVERYTHING DOESN'T HAVE TO BE PAINFUL AND DRAMATIC TO BE SUCCESSFUL.

I, FRANKLY, LIKE THINGS TO BE SUCCESSFUL AND FOR PEOPLE TO WALK AWAY NOT FEELING BRUISED AND BATTERED.

WHY DON'T WE SAY THIS?

IT WILL BE A SUCCESSFUL SESSION AND PROBABLY WON'T BE AN UGLY END TO IT.

WELL, WE'VE BEEN SPEAKING WITH STATE SENATE MAJORITY LEADER ANDREA STEWART-COUSINS.

LEADER COUSINS, THANK YOU FOR MAKING THE TIME.

TONIGHTS GREAT TO BE WITH YOU TODAY.

THANK YOU.

[ THEME MUSIC ] AND AS A REMINDER TO VIEWERS, IF STATE LAWMAKERS ARE GOING TO TAKE ACTION ON HOUSING CREATION, CRIMINAL JUSTICE, OR ANYTHING ELSE, THERE'S JUST SEVEN DAYS LEFT ON THE LEGISLATIVE CALENDAR FOR 2023.

BUT TURNING NOW TO THE STATE'S HEALTH CARE WORKFORCE WHICH IS FACING CHALLENGES EVEN BEFORE THE ARRIVAL OF COVID-19, A SHORTAGE OF MEDICAL PROFESSIONALS DURING THE PANDEMIC LED THEN-GOVERNOR ANDREW CUOMO TO ISSUE AN EXECUTIVE ORDER GIVING PHYSICIAN ASSISTANTS AUTONOMY TO ACT WITHOUT TRADITIONALLY REQUIRED OVERSIGHT.

AFTER OPERATING THIS FLEXIBILITY FOR A COUPLE OF YEARS, PAS ARE NOW LOOKING TO THE LEGISLATURE TO MAKE THIS EXPANDED POWER PERMANENT.

FOR MORE ON THE ISSUE INCLUDING THE ROLE PAS PLAY IN THE HEALTH CARE SYSTEM, WE SPOKE WITH PATTI CUARTAS, A PA AND THE PRESIDENT OF NEW YORK STATE SOCIETY OF PHYSICIAN ASSISTANTS.

PATTI, THANK YOU SO MUCH FOR BEING HERE.

OH, THANK YOU FOR HAVING ME.

SO THIS SITUATION IS KIND OF FROM BIRTH OF THE COVID PANDEMIC.

I WANT TO TALK TO YOU ABOUT, FIRST, HOW WERE PAS OPERATING BEFORE THE PANDEMIC?

THIS WAS A BIG CHANGE WHEN THE PANDEMIC STARTED.

WHAT WAS IT LIKE BEFORE?

WELL, PAS ARE TRAINED IN GENERAL MEDICAL MODEL.

WE ARE ALL GENERALISTS.

YOU KNOW, WE GO TO SCHOOL.

WHEN WE GRADUATE, WE ARE LICENSED IN THE STATE OF NEW YORK TO PRACTICE EVERYWHERE AND SO WHEN WE THEN GET A JOB, THAT'S WHEN THERE'S A LOT OF ON-THE-JOB TRAINING.

SO PAS CAN BE IN ORTHOPEDIC SURGERY.

PAS CAN BE IN NEUROLOGY.

PAS CAN BE IN DERMATOLOGY, THE EMERGENCY DEPARTMENT.

AS A PA, YOU KNOW, WE HAVE A VERY BROAD SCOPE AND SO PAS WERE WORKING-- LIKE FOR ME, I WORKED IN THE EMERGENCY DEPARTMENT AND IN THE SURGICAL ICU AND IN ONCOLOGY.

IT'S REALLY DEPENDENT ON ACTUALLY PAS PERSONALITIES.

SOME PEOPLE ARE DRAWN TO ONE AND SOME PEOPLE LIKE TO DO DIFFERENT THINGS OR THEY'RE GOOD AT IT.

THAT WAS BEFORE COVID.

OKAY.

SO ONCE YOU GET TO THAT SCHOOLING AND YOU GO OUT INTO THE PROFESSION, LET'S TURN TO THE BILL WE'RE TALKING ABOUT.

IT WAS BORNE FROM THE EXECUTIVE PANDEMIC.

THERE'S THIS EXECUTIVE ORDER THAT ALLOWS PAS TO PRACTICE WITHOUT THE SUPERVISION OF A PHYSICIAN.

THAT WAS ORIGINALLY DESIGNED BECAUSE THERE WAS SUCH A GREAT HEALTH CARE NEED DURING COVID.

DO YOU STILL THAT HEALTH CARE NEED IN FACILITIES TODAY?

EVEN WORSE.

I THINK THAT COVID HIGHLIGHTED A LOT OF THE ISSUES WITH ACCESS.

OBVIOUSLY, A LOT OF THE ACCESS AND THE NEED WAS IN THE CRITICAL CARE AREAS, RIGHT, IN THE EMERGENCY MEDICINE DEPARTMENTS AND IN THE, YOU KNOW, ICUS.

SURE.

BEFORE COVID, JUST TO BE CLEAR, THE PHYSICIAN SUPERVISION WAS ALWAYS-- NEVER ON-SITE.

RIGHT.

NEVER IN THE SAME PLACE.

I WORKED, FOR EXAMPLE IN THE SURGICAL ICU AND I TEXTED MY, YOU KNOW, ATTENDING AT THE TIME OR THE ATTENDING OF THE DAY, AS LONG AS THERE WAS SOME COMMUNICATION.

WHEN COVID OCCURRED, I THINK THAT EVERYONE REALIZED, INCLUDING THE GOVERNOR AT THE TIME THAT PAS WERE REALLY FLEXIBLE AND NIMBLE AND THE TRAINING ALLOWED TO BRING PAS THAT WERE NO LONGER DOING ORTHOPEDIC SURGERY BECAUSE THERE WAS NO ORTHOPEDIC SURGERIES HAPPENING.

RIGHT.

TO BRING THEM TO THE EMERGENCY DEPARTMENT WHERE THEY WERE NEEDED, AND WHAT DIDN'T ALLOW FOR THAT EASILY WAS THIS TETHERING OF ONE PA TO ONE PHYSICIAN.

RIGHT.

THAT'S WHERE THE EXECUTIVE ORDER CAME IN AND BASICALLY REMOVED THAT LEVEL OF SUPERVISION.

AND THAT'S WHY IT WAS, YOU KNOW, IT REALLY ALLOWED THE PAS TO BE UTILIZED, REALLY, WHERE THEIR SKILLS WERE NEEDED THE MOST.

SO THIS ENDS ON MAY 22ND.

THIS WILL AIR AFTER THAT.

WHAT DO YOU THINK THE CONSEQUENCES ARE OF THIS EXECUTIVE ORDER EXPIRING?

LIKE, HOW DO WE SEE OUR HEALTH CARE SYSTEM SHIFT?

SO, YOU KNOW, COVID HIGHLIGHTED ALL OF THAT.

YEAH.

THE EXECUTIVE ORDER HAS BEEN RENEWED EVERY MONTH SINCE MARCH OF 2020.

RIGHT.

HERE WE ARE MAY OF 2023.

IT IS ONE OF OUR BIGGEST CONCERNS THAT, YOU KNOW, EVEN THOUGH COVID IS NO LONGER A PANDEMIC, THE PANDEMIC THAT DOES EXIST ARE THE DESERT AREAS.

YES.

YOU KNOW, WHERE RIGHT NOW, PAS ARE TAKING CARE OF PANELS OF PATIENTS AND THOSE PATIENTS MAY LOSE ACCESS TO THEIR PROVIDER WHEN THIS EXECUTIVE ORDER EXPIRES.

I WANT TO CLARIFY THE BILL.

BECAUSE THE BILL IS NOT SAYING THAT YOU GO TO PA SCHOOL.

YOU GET OUT AND NOW YOU DON'T NEED PHYSICIAN SUPERVISION.

THE BILL SAYS, IF THEY HAVE PRACTICED FOR MORE THAN 3,600 HOURS.

HOW LONG WOULD IT TAKE A PA TO GET THERE?

I TIMED IT OUT.

IT'S 450 8-HOUR WORKDAYS, 90 WEEKS, BUT I'M ASSUMING IT'S NOT THAT SHORT BECAUSE YOU'RE NOT WORKING EVERY DAY.

THAT'S RIGHT.

IT'S ABOUT TWO YEARS.

YEAH.

THE 3,600 HOURS REALLY IS FOR PARODY WITH WHAT THE NURSE PRACTITIONERS GOT LAST YEAR.

AND YOU KNOW, BUT THE REALITY IS THAT NO ONE WORKS AND PRACTICES BY THEMSELVES.

YEAH.

WE ALL WORK IN CARE TEAMS, ALL OF US.

YOU KNOW, WHAT WE REALLY WOULD LIKE THE BILL TO DO AND WHAT IT SAYS IT DOES IS IT JUST REMOVES THAT TETHER OF SUPERVISION.

THAT'S IT.

SO WE ARE NOT TETHERED TO ONE PHYSICIAN.

BUT THE REALITY IS THAT WE ALL WORK IN TEAMS.

IF YOU GO TO THE EMERGENCY DEPARTMENT, YOU SEE THAT THERE'S TEAMS OF PEOPLE, YOU KNOW, YOU NEVER SEE-- AND NOW THE-- THE INDEPENDENCE OF ONE SINGLE DOC OR ONE SINGLE PROVIDER IS NO LONGER THE CASE FOR A LOT OF REASONS.

YEAH.

YOU KNOW, WHEN I'M THINKING ABOUT THIS ISSUE, I'M THINKING ABOUT TRIPS TO THE EMERGENCY ROOM THAT I'VE BEEN ON WHERE I SEE EXCLUSIVELY A PA WHO, YOU KNOW, WILL TELL ME WHAT'S WRONG WITH ME, GIVE ME SOME CARE HOPEFULLY, BUT WHAT I ALSO NOTICE IS THAT THERE ARE JUST NOT ENOUGH PEOPLE WORKING IN THESE HOSPITALS AND EMERGENCY ROOMS.

DO YOU THINK THAT THIS CHANGE WOULD HELP THAT; ATTRACT MORE PEOPLE TO BEING A PA SO WE CAN FILL THESE GAPS?

YES, ABSOLUTELY.

RIGHT NOW, IT IS A BIT DIFFICULT TO GET INTO PA SCHOOL BUT THERE ARE 28 PROGRAMS IN THE STATE OF NEW YORK, OVER 250 PROGRAMS IN THE ENTIRETY OF THE UNITED STATES AND GROWING.

BECAUSE THE PROFESSION IS GROWING.

IT'S GROWN 74% JUST IN THE LAST 10 YEARS.

WOW.

IT'S PROJECTED TO GROW 30% JUST IN THE NEXT 7 TO 10 YEARS AS WELL.

SO YES.

ABSOLUTELY.

THE PATIENT ACCESS, YOU KNOW, THE BARRIER TO ACCESS, WHETHER IT'S PATIENTS WITH MEDICAID OR COMMERCIAL INSURANCE REALLY IS GETTING TO SEE THAT PROVIDER.

IT'S NOT EVEN ABOUT SPECIALISTS, IT'S THAT PROVIDER.

I WANT TO END BY TALKING ABOUT THE TRAINING AND THE EXPERIENCE OF PAS.

BECAUSE I IMAGINE SOME PEOPLE MAY THINK, WELL, I DON'T KNOW IF I WANT TO BE SEEN BY A PA VERSUS A PHYSICIAN.

I WOULD LIKE YOU TO KIND OF QUALM THOSE FEARS.

TELL ME WHAT GOES INTO THAT TRAINING?

WHAT GOES INTO THAT CLINICAL TRAINING THAT QUALIFIES PAS TO DO THIS?

SO THE TRAINING IS INCREDIBLY RIGOROUS.

YOU KNOW, THE JOKE IS SAY BYE TO YOUR FAMILY AND YOUR FRIENDS ONCE YOU GO INTO PA SCHOOL BECAUSE IT IS 9:00 TO 5:00, JUST IN DIDACTIC FOR AN ENTIRE YEAR EVERY DAY.

IT IS ENGRAINED IN ALL OF US BECAUSE OF OUR CURRICULUM, WHICH IS NATIONALLY CREDENTIALED ART PA.

IT IS ENGRAINED THAT THE PATIENT IS FIRST.

THE PATIENT IS THE CENTER OF EVERYTHING.

BECAUSE OF THAT TRAINING, WE ALSO KNOW THAT, YOU KNOW, WE ARE GENERALISTS.

SO WHEN THE PATIENT NEEDS MORE CARE, BECAUSE WE ARE IN A CARE TEAM AND THAT'S BEEN PART OF OUR TRAINING, WE ALWAYS GO TO WHERE THE PATIENT NEEDS CARE THE MOST.

SO EVEN FOR MYSELF, I HAVE BEEN A PA FOR 23 YEARS.

I WORKED IN THE EMERGENCY DEPARTMENT, AS I MENTIONED.

I WORKED IN ICU.

I WORKED IN ICU TAKING CARE OF INCREDIBLY CRITICAL PATIENTS BUT I WASN'T BY MYSELF.

I ALWAYS WORK WITH THE NURSES, INCREDIBLE NURSES, AND SOME OF THE PHYSICIANS THAT WERE SPECIALISTS BUT THEY WEREN'T SITTING IN THE ICU WITH ME.

YOU KNOW, WHATEVER THE PATIENT NEEDED AT THE TIME, I WOULD ALWAYS MAKE SURE TO GO TO THE LEVEL OF CARE THAT THE PATIENT NEEDED.

THAT'S OUR TRAINING.

YOU ARE THE PERSON IN THE ROOM WHEN NOBODY ELSE CAN BE IN THE ROOM, I IMAGINE.

EXACTLY.

THAT'S A BIG ROLE OF PAS.

PATTI CUARTAS FROM THE NEW YORK STATE SOCIETY OF PAS, THANK YOU SO MUCH.

THANK YOU FOR HAVING ME.

[ THEME MUSIC ] AND THAT'S OUR SHOW.

FOR REGULAR UPDATES FROM THE STATE CAPITOL, HEAD TO OUR WEBSITE, NYNOW.ORG WHERE YOU CAN ALSO WATCH PAST EPISODES OF THE SHOW.

AND WHILE YOU'RE AT THE WEBSITE, YOU CAN SIGN UP FOR OUR NEW WEEKLY NEWSLETTER HE WHICH PROVIDES A QUICK AND COMPREHENSIVE ROUNDUP OF STATE GOVERNMENT NEWS FROM THE WEEK BEFORE AND YOU GET EARLY ACCESS TO THIS SHOW.

ALL THAT AND MORE IS AT NYNOW.ORG.

UNTIL NEXT TIME, I'M DAVID LOMBARDO.

DAN CLARK WILL BE BACK WITH YOU NEXT WEEK.

THANKS FOR WATCHING.

[ THEME MUSIC ] ANNOUNCER: FUNDING FOR "NEW YORK NOW" IS PROVIDED BY WNET.