Cuomo Budget 2012-3: NYAPRS Second Look
Yesterday, we summarized some key first findings relative to our mental health and Medicaid community, including:
- Local Assistance: no COLA but a promise to establish a new program next year which will provide increases based on actual costs and outcomes, 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 Kingsboro PC, movement of inpatients to community housing, greater use of the community supervision program for sex offenders.
- Centralized 24-Hour Hotline for Reporting Abuse and Neglect Allegations: 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,” specific to 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.
NYAPRS January 31 Albany Legislative Day
Many hundreds of NYAPRS members from across the state will be coming to press for our annual budget/legislative priorities, most notably pressing the Administration and Legislature to ensure that a significant portion of savings from reduced use of state and Medicaid hospital/ER be explicitly committed to be reinvested into local housing, peer support and employment services. The day will feature a Capital rally and march, “Reinvest in Recovery!” Other priorities include: Person Centered State Hospital Discharge Planning, Protect Consumer Rights & Choices in New Medicaid Initiatives, Adopt Medicaid Self Directed Services Option, Unfreeze the Community Housing Pipeline, Expand Employment Options and Services, Bring Justice to Adult Home Residents and Alternatives to Involuntary Outpatient Commitment.
Please make sure our message and our voices are heard by helping to fund and fill buses. Contact us at mary@nyaprs.org or your local NYAPRS reps below!
Draft Schedule for the Day
9:30 am Breakfast, Check-In (get your up-to-date issue paper packets)
10:00 am Welcome
10:05 am Remarks by Legislative Mental Health Committee Chairs Assemblyman Felix Ortiz and Senator Roy McDonald
10:30 am Presentations on This Year’s Legislative Priorities
11:30am Award Presentations to: Governor Cuomo, Clarence Sundram, Michael Hogan & Liz Benjamin of YNN
11:45 am Role-Play Discussion with your Legislator
Noon Lunch provided by NYAPRS
1:00 pm Capitol Rally: Reinvest for Recovery!
2:00 pm Meet with Your Legislators – make appointments with your Senator & Assemblyperson NOW!
4:00 pm Re-group at Your Buses, Return Home
For more details about buses leaving your area contact:
Eastern Long Island Sue Parrinello, 631-727-6220 x207 sparrenello@addny.com or Melissa Firmes, 631-691-7080 x238 mfirmes@fegs.org
Western Long Island Barbara Tedesco, 516-489-0100 x1201 btedesco@mhanc.org
New York City Carla Rabinowitz, 212-780-1400 x7726 crabinowitz@communityaccess.org
Westchester Guy Fessenden, 914-576-0173 choicenr@gmail.com or Paul Babb, 914-925-5065 jbabb@svwsjmc.org
North Country east Kellie Trombley, 518-585-9072 kellie@mhainessex.org
North Country west Daun Whitaker 315-788-8097, dburk@mhajc.org
Central/Syracuse Anthony Ciccarino, 315-472-7363 x245 aciccarino@ocmsinc.org
Southern Tier Lori Albrechta, 607-723-9991 x417 lalbrechta@ccbc.net or Kim Taro, 607-771-8888 x319 kim.taro@yourmha.com
Western Daniel Neal, 716-433-1086 dneal@communitymissions.org
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Cuomo Budget: NYAPRS’ Second Look
Here are more details about the these and other initiatives, based in part on a reading of supporting “Article VII” legislation and memos:
Housing: the commitment to create thousands of additional new community supported housing beds will come from a newly devised Supportive Housing Reinvestment Fund, based on “Medicaid savings from hospital and nursing home closures or bed decertifications to expand supportive housing and related services.”
- Such funds will be identified and allocated by the DOH Commission based on the following criteria:
(a) the efficiency and effectiveness of the use of funding for the development of adequate and accessible housing to support vulnerable persons in the community and to ensure access to supports necessary to maximize expected outcomes; and
(b) other relevant factors relating to the maintenance of existing supportive housing and the development of new supportive housing and associated services.
- These funds can only “be used only to fund housing development activities and other general programmatic activities to help ensure a stable system of supportive housing for vulnerable persons in the community”
- DOH will be making “inspections and examine records of any entity funded through this program, including “all medical, service and financial records, receipts, disbursements, contracts, loans and other moneys relating to the financial operation of the provider.”
- The amount of supportive housing development reinvestment funds for the department shall be itemized each year by DOH and DOB and will only “include the amount of general fund savings directly related to inpatient hospital and nursing home bed decertification and/or facility closure.”
- “All appropriations for supportive housing development shall be adjusted in the following fiscal year to reflect the variance between the initial and revised estimates of bed decertification and/or facility closure.”
Medicaid Beneficiary Education And Enrollment Assistance:
- The budget authorizes DOH to contract with one or more entities to engage in education and outreach and enrollment assistance for aged, blind and disabled Medicaid applicants, “without a competitive bid or request for proposal process” as long as DOH posts such bids on its website, for a period of no less than thirty days, identifies services to be delivered, criteria for contractors.
- The budget also requires counties operating a mandatory Medicaid managed care program to use enrollment brokers, which DOH contracts with “one or more independent organizations to provide enrollment counseling and enrollment services, for participants required to enroll in managed care programs.” Such organizations shall not be owned, operated, or controlled by any governmental agency, managed care provider, comprehensive HIV special needs plan, mental health special needs plan, or medical services provider.
Authorization for DOH, OMH, OPWDD And OASAS to Integrate Health and Behavioral Health Services.
- This bill would grant the Department of Health (DOH), the Office of Mental Health (OMH), the Office for People with Developmental Disabilities (OPWDD) and the Office of Alcoholism and Substance Abuse Services (OASAS) broad authority and flexibility in order to more fully integrate health and behavioral health services.
- This bill would provide the Behavioral Health agencies and DOH the authority to jointly establish operating, reporting and construction requirements for service providers that can demonstrate experience and competence in the delivery of health, mental health and alcohol and substance abuse services to persons with developmental disabilities.
- This bill would also clarify that providers that meet standards established by the State are not required to be an integrated provider. In addition, the bill would authorize the four above State agencies to waive regulatory requirements or determine that compliance with another agency’s requirements is sufficient in order to avoid duplication.
- The authority granted to the commissioners of these agencies is intended to complement and supplement the authority provided to the commissioners pursuant to section 365-l of the Social Services Law which established health homes for NYS Medicaid enrollees with chronic conditions.
Creating a Behavioral Health Advisory Council, Consolidating The Statewide Comprehensive Planning Process
- This bill would make efficiencies in the planning and delivery of mental hygiene services by:
- creating a Behavioral Health Services Advisory Council (Council) to replace and assume the responsibilities of existing bodies that advise the Office of Alcoholism and Substance Abuse Services (OASAS) and the Office of Mental Health (OMH); “
- consolidating the OASAS and OMH roles in the statewide comprehensive planning required under mental hygiene law
Procedures to Close/Convert State Hospitals/Wards, Creation of New York City Children’s Center, Kingsboro Closure/Reinvestment
- requires the Commissioner to give either 60 or 30 day notice before taking such actions to facilitate timely placement of individuals in the most integrated settings.
- In addition, this bill will restructure the New York City Children’s Psychiatric Centers (Bronx, Brooklyn, and Queens) to create a single appointing authority named the New York City Children’s Center.
- These actions include, but are not limited to, the closure of the inpatient program of Kingsboro Psychiatric Center consistent with the recommendation in the November 2011 report of the Brooklyn Work Group of the Medicaid Redesign Team, and reinvestment of resources to community services in Brooklyn and to inpatient capacity at the South Beach Psychiatric Center in Staten Island.
- Further determinations regarding the closure of beds would be made by the Commissioner based on ten criteria including, among other things: the current and long term needs for services provided at the facility within its catchment area; the availability of staff to provide such services; any capital investments needed at the facility; the proximity of the facility to other facilities that could accommodate anticipated need; the
relative quality of the services provided at the facility; the obligations of the State to place persons with mental disabilities in community settings rather than in institutions; and the anticipated impact of the closure on access to mental health services.
Implementation of these systemic efficiencies is consistent with the State’s goal and obligation to transform the locus of care from inpatient settings to community-based settings.
Greater Use of Strict and Intensive Supervision and Treatment for Civilly Confined Sex Offenders
- This bill would amend the Sex Offender Management and Treatment Act (SOMTA) to improve the care and treatment of sex offenders who are civilly confined and to encourage sex offenders to participate in treatment and to otherwise comply with conditions of confinement and Strict and Intensive Supervision and Treatment (SIST). It also will change the timing of required evaluations of civilly confined sex offenders and will create a new crime to address assaults by sex offenders at a Secure Treatment Facility (STF).
- The bill would encourage participation in treatment in an STF by providing that failure to “meaningfully” participate in such treatment will constitute a violation by the confined sex offender of the order of confinement; allow respondents and witnesses to appear in court by means of videoteleconferencing (VTC) to reduce the amount of travel; provide biennial rather than annual examinations of sex offenders and petitions for discharge of a civilly committed sex offender; authorize parole revocation when applicable and criminal penalties for material violations of court-order conditions of SIST.
Continue OMH’s Authorization To Recover Exempt Income For Community Residence And Family Based Treatment Programs.
- This bill would extend the fiscal periods for which the Office of Mental Health (OMH) is authorized to recover Medicaid exempt income as authorized pursuant to legislation enacted in 2010. It would allow for the continuation of such recoveries from January 1, 2011 through December 31, 2013 for programs located outside of the City of New York, and from July 1, 2011 through June 30, 2013 for programs located within the City of New York.
- Exempt Income is Medicaid income received in excess of budgeted amounts set forth in the fiscal plans of OMH providers operating residential programs.
- Enactment of this bill avoids a potential loss of $3 million on an annual basis.
Safe RX (from NY Lawyers for the Public Interest)
SafeRx will ensure that prescription drug labels are easier to understand for patients with limited English proficiency, and makes important strides toward ensuring accessibility for seniors, people with disabilities, and many others. The Governor’s decision to include SafeRx in his budget marks a significant step forward towards the goal of redesigning the health delivery system in New York State to save costs and lives in the long term. SafeRx requires that:
- All chain and mail order pharmacies, as well as emergency orally prescribed prescriptions, provide translation and interpretation services for limited English proficient (LEP) patients;
- For the Department of Education and Department of Health to develop requirements related to the sale, distribution and dispensing of drugs to address the special needs of persons who are elderly, of limited vision or of limited English proficiency; and
- Prescription pads be modified to allow prescribers to indicate if a patient is LEP.
http://publications.budget.ny.gov/eBudget1213/fy1213artVIIbills/HMH_ArticleVII_MS.pdf