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Governor Cuomo has relied more heavily on private hospital executives than on state officials. | Kevin P. Coughlin\/Office of Governor Andrew M. Cuomo<\/p><\/div>\n
A Monday report\u00a0from The New York Times<\/a>\u00a0describing a growing rift between Gov. Andrew Cuomo and state public health officials is the latest evidence of the governor\u2019s close relationship with the state\u2019s health care industry and hospitals. According to the article, Cuomo relied more heavily on private hospital executives than on state officials, such as Michael Dowling, CEO of Northwell Health, in making plans for COVID-19 vaccine distribution. This, the Times reports, contributed to at least nine top health officials resigning, retiring or otherwise leaving the state Department of Health in recent months.<\/p>\n This is not the first time that Cuomo has listened to or relied on the politically connected health care industry leaders. When Cuomo announced his\u00a014-person COVID-19 vaccine task force<\/a>\u00a0in September, it did not include a single epidemiologist and few public health experts. The task force did, however, include several influential leaders in the hospital industry, including Kenneth Raske, president of the Greater New York Hospital Association, Michael Dowling, CEO of Northwell Health, a large hospital system, and George Gresham, president of the health care workers union 1199SEIU. While not personally experts in infectious disease control, each leader is politically connected in Albany, and to Cuomo. The in-house lobbyist for Northwell, Dennis Whalen, was also heavily in planning for the vaccine rollout, according to the Times.<\/p>\n The governor\u2019s relationship with Dowling dates back to his father\u2019s era, when Dowling served in former Gov. Mario Cuomo\u2019s administration. He has since remained a close friend and adviser to the younger Cuomo, frequently appointed to commissions and panels created by the governor. Last year, Dowling\u00a0served as co-chair<\/a>\u00a0of Cuomo\u2019s Medicaid Redesign Team II after having been\u00a0a member of the first redesign team<\/a>\u00a0Cuomo assembled in 2011. Since the pandemic began, Dowling has appeared alongside the governor at a number of different press conferences, particularly those held at Northwell facilities. In addition to the vaccination task force, Cuomo also appointed Dowling to a\u00a0panel meant to \u201creimagine\u201d<\/a>\u00a0New York\u2019s future after COVID-19 in May \u2013 criticized for the many billionaires it included \u2013 as well as a\u00a0multi-state council<\/a>\u00a0focused on regional economic recovery back in April. Both Raske and Dowling additionally were tapped\u00a0to lead hospital efforts<\/a>\u00a0to increase capacity back in March. Once the vaccine rollout began, a Northwell nurse became the first person in New York \u2013 and the country \u2013 to get the shot.<\/p>\n Dowling is also\u00a0on the board of directors<\/a>\u00a0of the Greater New York Hospital Foundation, the non-profit arm of the hospital trade group Greater New York Hospital Association, headed by Raske. The group has been incredibly influential in Albany since long before the pandemic, and it\u00a0and its surrogates<\/a>\u00a0have donated heavily to politicians. \u201cThey have been a powerhouse in Albany for a couple of decades now,\u201d Bill Hammond, senior fellow for health policy at the Empire Center, a conservative think tank, said. \u201cAnd they owe part of their influence to an alliance with the big union for healthcare workers, 1199(SEIU).\u201d That union, led by Gresham, is one of the most politically influential labor groups in the state whose endorsement is sought after and has traditionally backed Cuomo.<\/p>\n Hammond made note of an unusually large donation \u2013\u00a0over $1 million<\/a>\u00a0\u2013 made by the Greater New York Hospital Association to the state Democratic Party\u2019s housekeeping account in 2018, shortly before Cuomo\u2019s reelection. Not long after that, the state\u00a0approved increased Medicaid reimbursement rates<\/a>\u00a0for hospitals, something the hospitals and 1199 were promoting. Money from that rate increase was then\u00a0used to pay for new employee contracts<\/a>. At the time, Cuomo\u2019s aides denied that there was any connection between the large donation and the Medicaid rate change.<\/p>\n Raske himself also enjoys a close relationship with Cuomo, often accompanying the governor on trips to Puerto Rico. When Cuomo visited Puerto Rico in the wake of a devastating earthquake early last year, Rakse\u00a0was in tow as well<\/a>. Soon after,\u00a0he was a part<\/a>\u00a0of the governor\u2019s deployment of mental health professionals to the territory to aid in recovery. Raske previously\u00a0traveled with Cuomo in 2018<\/a>, along with several elected officials, on one of his trips following Hurricane Maria.<\/p>\n <\/p>\n And earlier in the pandemic, Raske\u00a0told The Wall Street Journal<\/a>\u00a0that he got in touch with Cuomo\u2019s team, asking for help with nursing home patients, as many facilities would not accept COVID-19-positive residents but hospitals needed to discharge them to free up beds. Not long after, the Department of Health issued its controversial directive to nursing homes, telling them they were required to accept COVID-19 positive residents from hospitals. Cuomo and his aides have repeatedly said the directive was based on CDC guidelines and public health recommendations at the time.<\/p>\n Cuomo has relied on friends, allies and a close-knit group of aides, both present and past, throughout the pandemic. In addition to familiar names like Dowling getting appointed on numerous committees and panels, he brought back\u00a0three former secretaries<\/a>\u00a0to work on coronavirus response and recovery. Larry Schwartz, one of those former secretaries, has been heavily involved in the state\u2019s response,\u00a0reportedly applying pressure<\/a>\u00a0on hospitals to comply with state directives and more recently serving as a key member of Cuomo\u2019s vaccine planning team. Gareth Rhodes, a former Cuomo communications staffer who now works for the state Department of Financial Services, has also been a mainstay at the governor\u2019s coronavirus press conferences. \u201cThe governor trusts these people,\u201d Hammond said in reference to Dowling and Raske. \u201cSo I don\u2019t think it should be anybody\u2019s surprise that he consults them on really important things.\u201d<\/p>\n But Cuomo\u2019s ultimate decision not to rely on existing mass vaccination plans developed by county health departments, instead tasking hospital systems with distribution, was\u00a0met with frustration by local officials<\/a>\u00a0and surprise by some public health experts. \u201cIt doesn’t make sense, it still doesn\u2019t make sense. I don’t understand it,\u201d Dr. Robyn Gershon, a professor of epidemiologist at the New York University School of Global Public Health who in particular focuses on disaster preparedness, said. \u201c(Health departments) absolutely know how to roll out a vaccine and vaccinate a lot of people in a short amount of time. They know their community, they know what it takes to get them vaccinated and treated.\u201d<\/p>\n Once the state got his first shipment of vaccines, the governor announced that hospital systems would\u00a0coordinate regional vaccination hubs<\/a>\u00a0for the second phase of rollout, which included members of the general public. The Greater New York Hospital Association was put in charge of New York City, while Northwell would oversee Long Island.<\/p>\n Cuomo and aides said hospital systems would be capable of taking a region-wide approach, rather than individual counties each implementing their own plans. And in an interview with the Times, the governor said that the scale of the pandemic overwhelmed existing plans. After an initially sluggish start and remaining racial disparities in distribution, the state has sped up the pace of vaccinations and now is performing\u00a0about average<\/a>\u00a0among states when it comes to getting vaccines in arms.<\/p>\n When asked by the Times about criticism of the state\u2019s management , Cuomo said he is \u201ca fighter for the people of New York\u201d and believes he is \u201csaving lives.\u201d<\/p>\n Cuomo also has said that putting hospitals in charge of vaccinations would keep politics out of the equation and placing vaccinations squarely in the hands of medical professionals. Hammond said he found such rationale interesting. On the one hand, working with hospital systems enabled Cuomo to go around county governments run by Republicans who have been frequent critics. \u201cTo me, though, there was a heavy dose of politics involved with working with the hospitals, because they have a huge stake in state government and their major donors and the political side,\u201d Hammond said.<\/p>\n In response, Cuomo\u2019s senior adviser Rich Azzopardi pointed out to City & State that Dowling is a former deputy secretary for health during Mario Cuomo\u2019s time as governor, and that Whalen, the Northwell lobbyist, is a former deputy health commissioner in the state. He called the implication that Cuomo relied too heavily on influential healthcare industry leaders \u201cwrong and insulting.\u201d He added that hospitals made sense for vaccine distribution, and that the state now just needs an adequate supply from the federal government to keep up with the state\u2019s vaccination capabilities.<\/p>\n But even with members of the healthcare industry among those advising Cuomo on vaccine rollout, it did not save them from the governor\u2019s ire when the initial rollout was sluggish. Cuomo\u00a0threatened to fine hospitals<\/a>\u00a0that did not use their vaccine supplies, or else they would lose out on future allocations. He has called out hospitals by names whose vaccination rate and pace were not up to par. \u201c(Cuomo) has been known at times to be rough on hospitals,\u201d Hammond said, suggesting that, despite their role in planning and rollout, hospital executives may not have explicitly asked the governor for the responsibility. \u201cAnd it may be that they go along with the rough treatment, and they muffle their complaints, because they know in the long run that’s going to benefit them to be on his good side.\u201d<\/p>\n