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Concept: Funding

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Their "new hospital" idea came out of nowhere. No study of Utica's four existing campuses, including total abandonment of Utica's current (and defacto) Oneida County Medical District. All the public heard was politicians saying, "Albany has some money!" So we're tracking the money, said to originate due to a "federal waiver" from Federal Medicaid programs, read below. We also know NYS began Medicaid Redesign in 2011.

They say local taxpayers will not pay for this new hospital, MVHS will be fully responsible. Let's see how that works out!

In The Beginning

The news first came out publicly in winter of 2014, Mohawk Valley Health CEO: New hospital ‘worth exploring’...

Article states, "Few hospitals have been built in New York in recent decades. Cash-strapped facilities have opted to renovate existing buildings to suit modern needs rather than take on the expense of new construction."

Goes onto say, "The state program that MVHS officials are hoping will help fund their hospital is the Delivery System Reform Incentive Payment Program. The money for the $6.42 billion program comes from $8 billion in savings from Medicaid redesign that the federal government allowed the state to keep."

Story continues, "The program’s goal is to fund projects that will improve the quality of health care and reduce avoidable hospital admissions by 25 percent over the next five years. Faxton St. Luke’s Healthcare received one of the program’s 51 planning grants earlier this year. It has formed a coalition of local health care providers and agencies working together and with other upstate coalitions to develop project proposals for future funding."

Finally we learn, "Assemblyman Anthony Brindisi, D-Utica, said he was aware that the health system is interested in a new hospital, but that aren’t enough details yet for him to weigh in on the idea. “I’d be interested to know what their plans are going forward and learning about the proposed project," he said."

Oddly this comprehensice study, Final Report: 2014 Central New York Care Collaborative Community Health Assessment, offers many reccomendations, but none suggest a new hospital in Utica is a priority.

Where Has Money Come From ?

(1) MVHS has borrowed $338 million by selling municipal bonds on two occasions.

(2) New York State has paid a good part of the promised $300 million.

(3) The hospitals received Covid-19 (CARES Act) funding of $38.7M, probably no way to see how they spent it.

(4) Utica National donated $1M to MVHS.

(5) Steve Wynn was pitching-in $50M, but it might not come until later and over years, for new equipment. Again, no way to know details.

Regarding the debt… Mohawk Valley Health System bonded for $262.7M in fall of 2019. As a result MVHS owes $15M annually until 2049, a repayment total of $462.8M ($200M in borrowing costs due to fees, interest and closing costs). Then in 2020 MVHS added another $75M in debt making their new annual payment $19M+ rising total debt to $594.8M.

March 2, 2022 - City of Utica supplies spreadsheet of city funds expended in support of the downtown hospital.

Totalling: $28,273,772

In addition to the reocurring $112,529 due to lost real estate tax income. See a text version Here.

September 3, 2021 - More funds for Utica hospital operator, per MVHS gets $1 million in FEMA funding for pandemic recovery, we hear "Mohawk Valley Health System is getting more than $1 million in FEMA funding to help recover from the economic impact of the coronavirus pandemic."

August 24, 2021 - The Budget was never honest, so today we hear MVHS Seeks To Borrow Additional $75 Million For Wynn Hospital. Where the public hears...

"The Wynn Hospital is costing MVHS far more money than originally planned." and "Stromstad says $60 million is for cost overruns, and $5 million each for property acquisitions, insurance and interest."

May 28, 2021 - See page 2, $2.9 Million: Oneida County funds MARCH Associates For Hospital Parking Garage Design (Capital Project H-566, DPW Public Parking Facility), and the board approval, see page 21.

April 21, 2020 - MVHS offers an update, answers question: If the Mohawk Valley Health System (MVHS) is losing money due to the COVID-19 pandemic, how can it continue to move forward with building the new regional medical center?

March 4, 2020 - Minutes from Regular Meeting at DASNY’s New York City Office, where it was acknowledged, "The Acting Executive Director reported that over the past few weeks the markets have become volatile and in order to keep the Members informed of market conditions, he and Ms. Lee would provide an update to the Members. Ms. Lee reiterated that markets have been volatile due to the Coronavirus, noting that equities were down substantially last week, but rebounded this week in anticipation of a rate cut by the Federal Reserve Bank. She noted that the Fed took action yesterday with an emergency rate cut of 50 bps. She further noted that in times of global economic uncertainty there is a flight to quality by investors. Ms. Lee stated that to date, DASNY transactions have priced very well. She noted that going forward, Staff will keep in touch with investment banking firms who are providing feedback on the market, rates and investor demand. Ms. Lee noted that Staff will keep the Board updated. The Acting Executive Director concurred."

December 1, 2019 - Look at the debt, as MVHS borrowed $262.7 million via bonding.

August 17, 2019 - Read, County economic development agency OK’s bond issue for MVHS hospital in Utica, as MVHS looks to borrow up to $300 million.

Consider - The following DASNY reports...

Dormitory Authority of the State of New York (DASNY) ABO Annual Report – Operations and Accomplishments Fiscal Year April 1, 2018 – March 31, 2019 (PDF), reads "The HCFTP Oneida County is a $300 million capital grant program originally included in the 2016-17 State Budget to provide capital funding in support of projects located in the largest population center of Oneida County that consolidate multiple licensed health care facilities into an integrated system of care. A Request for Applications (RFA) was issued by DOH for this program on November 22, 2016, and an award of up to $300 million was made to Mohawk Valley Health System (MVHS) on April 3, 2017. Post-award work on the MVHS grant continues to date."

Dormitory Authority of the State of New York (DASNY) ABO Annual Report – Operations and Accomplishments Fiscal Year April 1, 2017 – March 31, 2018 (PDF). Which reads, "The HCFTP Oneida County is a $300 million capital grant program originally included in the FY 2015-16 State Budget to provide capital funding in support of projects located in the largest population center of Oneida County that consolidate multiple licensed health care facilities into an integrated system of care. A Request for Applications (RFA) was issued by DOH for this program on November 22, 2016, and an award of up to $300 million was made to Mohawk Valley Health System (MVHS) on April 3, 2017. Post-award work on the MVHS grant continues to date."

Dormitory Authority of the State of New York (DASNY) ABO Annual Report – Operations and Accomplishments Fiscal Year April 1, 2016 – March 31, 2017 (PDF). That reads "The HCFTP Oneida County is a $300 million capital grant program originally included in the FY 2016 State Budget to provide capital funding in support of projects located in the largest population center of Oneida County that consolidate multiple licensed health care facilities into an integrated system of care. On October 17, 2016, DOH and DASNY entered into the required administration agreement for the program, and provided notice thereof to the Senate Finance Committee, Assembly Ways and Means Committee and Division of Budget as required by law. A Request for Applications (RFA) was issued by DOH for this program on November 22, 2016, and State officials announced an award on April 3, 2017. The FY 2017 State Budget also authorized DOH and/or DASNY to make grants or loans to support debt restructuring, and capital and non-capital projects or purposes under the transformation and other qualifying health care programs. Under this separate authorization, set forth in the Unconsolidated Laws, the projects and purposes of these grants and loans must facilitate health care transformation and support a financially sustainable system of care. Grants and loans cannot be used to support general operating expenses that have no connection to the authorized projects and purposes. Each Health Care Facility Transformation Program is jointly administered by DASNY and the DOH in accordance with the terms of the applicable administration agreement, and the programs may be financed through the issuance of DASNY and/or the New York State Urban Development Corporation (UDC) bonds."

Dormitory Authority of the State of New York (DASNY) ABO Annual Report – Operations and Accomplishments, Fiscal Year April 1, 2014 – March 31, 2015 (PDF). Where it reads, "2015-16 State Budget – DASNY also is currently evaluating amendments to the CRFP and a new $1 billion Health Care Facility Transformation Program (HCFTP), included within the enacted FY 2015-16 State Budget. The HCFTP provides additional capital grant funding awards to strengthen and protect continued access to health care services in Kings County ($700 million) and Oneida County ($300 million)."

November 3, 2019 - A treasure trove of information! Read the MVHS/Onieda County Bond Offering [404 pages, 2.47 MB], or just Appendix A: MVHS Business Overview [98 pages, 4.58 MB]. As the hospital submits their plans to sell Oneida County-endoresed "Muni Bonds", inwhich they reveal huge budget increases...

Read and review these Oneida County Bonding: MVHS Debt & Other Notes. MVHS stated they'd save $15M to $17M per year with a single integrated facility. However, without a new hospital today, they only acquired a $15M annual debt payment- starting in 2020, running until 2049!

November 1, 2019 - As attorneys for MVHS were in court, the MVHS financial team was overseeing a bond sale, read their Preliminary Official Statement: Oneida County New York Local Development Corporation Revenue Mohawk Valley Health System Project (2.5 MB). See pages 73-125 to learn details of MVHS operations.

September 21, 2019 - Pproposed new Utica hospital now projected to cost $548M...

August 16, 2019 - Another $300M? An Albany-based NYS Grant would supply the first $300M, but now area residents learn...

"The Oneida County Local Development Corporation met Friday morning, and on the agenda was financing for the Mohawk Valley Health System’s downtown hospital project. Without the LDC's approval to get the county to issue the tax-exempt bonds, the debt would be – the issuance of bonds would be taxable, thus it would raise the cost through interest rates.".

July 5, 2018 - Albany claims to be "saving $6.42 billion", reconfirms their DSRIP (Delivery System Reform Incentive Plan) program in today's newspaper...

Guess we see their twist, yet is money spent (in the form of Bonded Debt for grants, that's piled onto taxpayers), able to be called "savings"?

April 12, 2018 - According to the minutes from Public Health and Health Planning Council Committee Day, MVHS is only seeking/recieving $150M from DASNY. See page 138 of 415, where it reads:

Financial Summary - Total project costs of $481,371,583 will be met via $31,371,583 of equity, a $300,000,000 HCFTP Oneida County grant award, and permanent financing for the remaining $150,000,000 to be funded via tax-exempt bonds (terms not currently provided) issued through the Dormitory Authority of the State of New York (DASNY). DASNY has provided a letter of interest to provide such financing, and Morgan Stanley has provided a letter of interest to underwrite the bonds.

Earlier on the page it reads, "The project will be funded, in part, through the Health Care Facility Transformation Program: Oneida County (HCFTP: Oneida County) capital grant authorized under Section 2825-b of the Public Health Law." However, these statements seem to conflict.

Medicaid 1115 Waiver Amendment

New York's DSRIP websites offers...

The Medicaid 1115 waiver amendment will enable New York to fully implement the MRT action plan, facilitate innovation, lower health care costs over the long term, and save scores of essential safety net providers from financial ruin. The waiver allows the state to reinvest over a five-year period $8 billion of the $17.1 billion in federal savings generated by MRT reforms.

The waiver amendment dollars will address critical issues throughout the state and allow for comprehensive reform through a Delivery System Reform Incentive Payment (DSRIP) program. The DSRIP program will promote community-level collaborations and focus on system reform, specifically a goal to achieve a 25 percent reduction in avoidable hospital use over five years. Safety net providers will be required to collaborate to implement innovative projects focusing on system transformation, clinical improvement and population health improvement. Single providers will be ineligible to apply. All DSRIP funds will be based on performance linked to achievement of project milestones.

Federal website, is at About Section 1115. There we learn...

"On March 14, 2017, the Department of Health and Human Services and CMS issued a letter to the nation’s governors affirming the federal government’s partnership with states to improve the integrity and effectiveness of the Medicaid program for low-income beneficiaries. The letter encourages states to bring forward proposals designed to accomplish this, grounded in ideas that reflect the dynamics and culture of a state."

September 16, 2017 - We heard that SEMC was slipping into bankruptcy, this news confirms troubles...

We also know that there's a Smoking Gun, and most recent intelligence reports that New York State taxpayers are making the payments to SEMC retirees!

August 25, 2017 - Who can borrow at a better rate? City of Utica Comptroller Morehouse suggests he can, but is that true?

Let's watch interest rates, plus both the County's & City's Bonding Ability...

July 25, 2017 - The public begins to learn about the publicly funded parking garage, as Steve DiMeo delivers, Warning To City: No Garage, No New Hospital. Follow the MOA/MOA Saga.

May 19, 2017 - We have not seen an honest, one-page, budget of all costs. However it appears this is nothing new, the NYS legislature has a long tradition of starting large projects well beyond the funding approvals...

On May 23, 2018 we see that New York Receives A Medicaid CHIP Waiver, what does this mean?

What was the funding intended for? We read Here, "The Delivery System Redesign Incentive Payment (DSRIP) Program seeks to transform New York State Medicaid health care delivery from a reactive, fragmented and inpatient-oriented system toward an integrated, pro-active system delivering care as close to the home as possible. The central goal is to achieve 25% reductions in avoidable hospital use while simultaneously structurally strengthening the state’s safety net system. This means aligning providers that previously had no relationships, or would compete with one another for volume, to come together in Performing Provider Systems (PPSs) that take responsibility for the health outcomes of their populations. These PPSs have to include the full continuum of care providers (including hospitals, health homes, skilled nursing, FQHCs, behavioral health, community based organizations and others), forming partnerships to execute a series of carefully constructed and monitored transformation plans."

The Oneida County region effort to use the $6.4B is called Central New York Care Collaborative (CNYCC), and includes Faxton St. Luke's and St Elizabeth Medical Center, but MVHS is not listed as their just a management team and not a hospital.

October 18, 2017 - Is it a hospital or parking prject?

December 28, 2016 - See page 12, Oneida County hires MVEDGE to move on downtown property owners for hospital... $250,000 Contract: Oneida County Hires MVEDGE For Downtown Hospital.

October 4, 2016 - We are reading, Utica still awaiting $300M from state for new hospital, where we hear hospital CEO, Scott Perra admit, "...this is a unique 'gift' that we are receiving and one that does not have precedence. This is a new process for everyone." Why is it new and unique? Where did the idea for a totally new hospital come from?

The above story refers to Politico's news report titled, Health Department still working on plan to award $300M for Utica hospital. Where we hear:

"According to a source familiar with the project, there's a sense of urgency to get the funding distribution allocated before the next budget cycle this upcoming year." However, the funding was repurposed...

Well residents and taxpayers ever come to know the story behind this $300M?

April 1, 2016 The community has endured, "The money is in the budget", "No it is not", then... State budget deal contains hospital funding

From March 12, 2015 - Read the NYS Comptroller's report, DiNapoli: Medicaid Redesign Presents Opportunities and Risks, where it states,

"A federal waiver may bring as much as $8 billion in additional aid as an incentive to drive further reforms. However, failure to meet key benchmarks would result in a loss of significant potential federal funding. That could force the state to increase its own spending on the program or rein in Medicaid costs in ways that have been largely avoided in recent years."

February 2, 2015 - The MVHS $300 is mentioned in this meeting of THE NEW YORK STATE SENATE FINANCE AND ASSEMBLY WAYS AND MEANS COMMITTEES...

December 5, 2014 - Read New health group aims to provide better care at a lower cost to CNY's Medicaid population and learn that, "... organizations have formed a new entity, the Central New York Care Collaborative, that will focus on overhauling services provided to about 291,000 people in Onondaga, Madison, Oswego, Cayuga, Oneida and Lewis counties."

April 14, 2014 - From the DSRIP Overview, we learn, "...Governor Andrew M. Cuomo announced that New York has finalized terms and conditions with the federal government for a groundbreaking waiver that will allow the state to reinvest $8 billion in federal savings generated by Medicaid Redesign Team (MRT) reforms."

On January 5, 2011 Governor Andrew M. Cuomo Had Said, "It is of compelling public importance that the State conduct a fundamental restructuring of its Medicaid program to achieve measurable improvement in health outcomes, sustainable cost control and a more efficient administrative structure."

Read Why We Oppose The Downtown Utica Hospital Concept. Then consider All The Advantages Of The 64-acre St. Luke's Campus. Next, hear four years and hundreds of Community Voices Of Opposition.

No Studies, No Reports, thus we remain #NoHospitalDowntown

Our research is ongoing, please check back. Our research is ongoing, please check back.