MONTICELLO, NY — After the One Big Beautiful Bill was signed into law, many states, including New York, scrambled to fill in the resultant budget shortfalls for health care. Adding to this strain is financial pressure on rural hospitals, which have had to cut back on services or close entirely. 

Assembly Member Paula Elaine Kay (D-100) represents most of Sullivan County, which have seen these pressures leave large impacts on its health care. Assembly Member Kay sat down with the River Reporter to discuss health care in Sullivan County and what the state is doing to improve it. Responses and questions have been edited for length and clarity.

What is the state of health care in Sullivan County?

It’s a changing situation, and obviously there is a lot of improvement that needs to happen, partially because of the federal cuts that are going to take effect. Really, we’re going to start seeing them at the beginning of 2027, and also because of some local issues that are playing out throughout Sullivan County with regard to Optum and the reduction in services from Optum and the impacts that that’s having throughout the county. 

But at the same time, I think that there are some bright spots that we need to look at that are up and coming that are really going to make a positive difference for health care. The Highland Health Initiative [is taking shape] in the Town of Highland, which my office has contributed toward, and as that project gets off the ground, that’s going to be an incredible community health care center.

You have a long tenure in public service, working with the New York City Council, as well as former assembly members Jake and Aileen Gunther. Does that history give you an insight into health policy?

I’ve had almost 30 years of experience in government in all different types of government. I started with the New York City Council, where I was counsel to the general welfare committee, which included health care. So throughout my career, I’ve certainly been exposed to health care policy, even on the municipal level, with working with the towns that I do.

I’ve also had a lot of experience with it working in the legislature first for Jake Gunther and then later for Aileen. So the short answer is yes, having experience and working in government, you do see a lot of things. And living and working in Sullivan County, you can’t help but see the need that we have here for additional and better health care and access to health care.

What has the state done to counteract the changes that are happening at the federal level?

Well, the state budget has done a lot of things to invest in health care, but the state can’t replace all of the lost federal funding. That’s just impossible. But we made some strategic investments to help protect access to care and strengthen our health care workforce. 

In the budget there was more than $750 million to increase reimbursement rates for hospitals and nursing homes. There also was $2.2 billion for the health care stability fund to help health care providers respond to some of these federal cuts. The state of New York can’t combat all of it, but we’re doing what we can.

An additional $500 million reserved for fiscally distressed hospitals. That’s throughout the state. I represent the 100th district, which means I represent Garnet in Harris, Callicoon and Middletown. We don’t know yet what the share is going to be with that, but we certainly deserve it, and I’m fighting for it. As I know the hospital is as well. 

Then there’s $433 million dedicated to nursing homes to support operations, workforce recruitment and long-term sustainability. 

Anything that we can do to support our medical professionals, our nurses who are working incredibly long hours—everybody in the medical field, we need to help them. I work with the unions all the time, and I really listen. 

Remember, during COVID, they were the health care heroes. At five o’clock every day, everyone would go outside and clap for our health care heroes? We don’t treat them quite so well anymore. We need to do better.

What steps could the county take to help improve the state of Sullivan County’s health care?

Recently, Speaker [of the Assembly Carl] Heastie (D-83) came with me and did a tour of our district, and one of the places that I took him to was Hanofee Park in the Town of Liberty. It is a place for kids of all ages to recreate and be outside and exercise. There’s walking paths and all the things that you need to be outside. 

The speaker and I were able to deliver basically a reconstruction of the entire park to the Town of Liberty with a grant of $2.365 million, and that’s health. That being active and being outside is health care too. We know that there’s a lot of folks in Sullivan County who aren’t as healthy as they could be, and having access to a park like Hanofee that’s open to everyone is really going to make a difference, I think.

Do you have anything else to add?

I have two district offices: one in the City of Middletown and one in Monticello on Broadway. And one of the reasons that I moved the office to Broadway in Monticello was I wanted to be accessible to as many people as possible, maybe including folks who may not have access to their own transportation. 

A lot of the things that you and I talked about were bigger picture things, but we also work one-on-one with constituents every day who come into the office. Sometimes they choose to come in and they have an appointment, or they walk in or sometimes I see or someone on my staff sees someone who’s obviously either having an immediate crisis, or we’ve seen people, you know, who are just hungry, and so we’re able to meet that need almost every day.