NYAPRS Note: Here’s what we’ve learned from a first look:
- Local Assistance: no COLA but a promise to establish a new program next year which will provide increases based on actual costs and outcomes, a 1.2% across the boards community programs cut, some cuts through audit, other reviews; moving funds and people from continuing day treatment to PROS and from sheltered employment to supported employment,
- Housing: commitments over the next three years to move 1,000 nursing home residents and 5,100 adult home and state PC residents into community housing and to create 3,400 NYNY III beds
- Commitments to create mobile rehab/crisis teams, ‘first break’/suicide prevention programs, fund increased IT needs of community providers in advance of the health home/managed care environment, and educate primary care doc around children’s’ mental health needs
- State Operations: closure of Kingsborough PC, movement of inpatients to community housing, greater use of the community supervision program for sex offenders.
Following are excerpts from the just released budget documents.
The Executive Budget proposals result in mental hygiene system funding of $8.2 billion in 2012-13, an annual spending increase of $85 million, or 1.0 percent.
(excerpts by NYAPRS)
Local assistance reforms include shifting resources to programs that are more effective in helping individuals recover and achieve gainful employment, providing aid to supported housing providers consistent with regional per-bed pricing models, and converting residential pipeline units to lower-cost alternatives where feasible.
No COLA: The Executive Budget maintains current levels of funding for certain programs rather than provide increases scheduled for 2012-13. Proposals are included to eliminate the planned 3.6 percent annual human services COLA and maintain existing rates for other programs including OMH residential treatment facilities, community residences, family based treatment, and various residential and day programs for individuals with developmental disabilities. A new program will be established for 2013-14 which will provide increases based on actual costs and meeting performance outcomes and will include limits on administrative expenses and executive compensation.
Local Assistance Efficiencies/Cuts: The local assistance reforms include efforts to
- recover State funds through enhanced audit activities and financial reviews of not-for-profit providers,
- restructuring the Continuing Day Treatment program to encourage use of the more effective Personalized Recovery Oriented Services program,
- shifting funding from targeted Sheltered Workshop programs to more effective supported employment models,
- providing aid to supported housing providers consistent with regional per-bed pricing models, and
- converting residential pipeline units to lower-cost alternatives where feasible.
The Executive Budget reinvests a portion of these savings to support
- 1,000 supported housing units for residents of nursing homes (600 by the end of 2013)…budget shows $10 million
- 5,100 supported housing beds over the next three years to deal with emerging needs, including individuals in adult homes (budget shows $16.8 million) and those moving to the community from State Psychiatric Centers (2,100 by the end of 2013)….
- 3,400 beds for the NY-NY III program (800 by the end of 2013).
The budget also includes funding for
- mobile rehabilitation and crisis teams to provide skill development for people with psychiatric disabilities;
- training for primary care physicians to improve early identification of behavioral health issues in children;
- regional First Episode Psychosis Teams and Suicide prevention programs to assist individuals with psychotic disorders; and
- one time IT enhancement grants for mental health providers to support the capacity development for transition to a managed care environment.
The Executive Budget continues efforts to reduce unnecessary State Operations and local assistance costs via stringent cost controls and reduced use of inpatient services, while investing some of these savings into more effective community based programs.
State Operations actions to reduce costs and improve operations include
- reducing agency administrative staffing levels, implementing enterprise-wide efforts to reduce purchasing costs, streamline IT applications,
- keeping certain individuals in the sex offender program in less costly prison settings longer when appropriate,
- authorizing the use of other entities to assist in providing sex offender programs,
- permitting video teleconferencing of certain sex offender proceedings, and
- continued placement of individuals from inpatient settings to the most integrated setting possible.
• Centralized 24-Hour Hotline for Reporting Abuse and Neglect Allegations. Pursuant to the preliminary recommendations of the Governor’s Special Advisor on Vulnerable Persons, a new centralized 24-hour hotline will be established for reporting allegations of abuse and neglect of children, the developmentally disabled, the elderly and other vulnerable persons. The reporting system will include certain programs operated, licensed or certified by the Office of Mental Health, Office for People with Developmental Disabilities, Office of Alcoholism and Substance Abuse Services, the Office of Children and Family Services, the Department of Health and the State Education Department. The hotline will have a trained staff to screen, classify and route reports of abuse and neglect to the appropriate State agency for investigation. Funding will be housed within OCFS.
• Behavioral Health Organizations. Consistent with the recommendations of the Medicaid Redesign Team, OMH and OASAS now have the authority to contract jointly with Managed Behavioral Health Organizations (BHOs). These BHOs will be charged with managing behavioral health services for individuals with substance abuse issues and serious mental illness.
OMH CAPITAL PLAN
In support of OMH’s mission, the Five-Year Capital Plan includes a total of $1.1 billion in new and future appropriations and $1.5 billion in disbursements for OMH State-operated institutions that will continue to fund projects necessary to meet health and life safety codes, Joint Commission accreditation standards, current Federal Medicaid certification requirements, and other projects that remediate environmental deficiencies, improve energy efficiency, preserve long-term facilities and consolidate campus facilities.
New FY 2013 appropriations of $177 million, reappropriations of $1.3 billion and $324 million in disbursements for OMH State-operated institutions support essential rehabilitation projects that preserve patient and staff health and safety, and ensure compliance with facility accreditation standards.
OMH’s capital maintenance plan ensures that the investments in the OMH infrastructure are preserved, both to realize maximum useful building life and to prevent costly repairs in the future…
AID TO LOCALITIES
For OMH community programs, the Five-Year Capital Plan includes $63 million in new and future appropriations and $515 million in disbursements to support ongoing development. New FY 2013 appropriations of $13 million and reappropriations of $714 million will make funds available for the completion of nearly 9,000 residential beds currently under development, for the preservation and maintenance of the community infrastructure, a total of $57 million in disbursements, including $6 million financed from the General Fund, is recommended for FY 2013.