NYAPRS: More Details on Proposed 2013-4 NYS Mental Health Budget

NYAPRS Note: Here’s more information about certain provisions aligned with yesterday’s release of the Governor Andrew Cuomo’s proposed 2013-4 state budget of interest to our community, obtained from the Health/Mental Hygiene bill memo to be found at http://publications.budget.ny.gov/eBudget1314/fy1314artVIIbills/HMH_ArticleVII_MS.pdf.

One additional factoid from the Journal News: The Governor has allocated “$35.9 million to implement the state’s new gun-control law... the largest portion (of which), $32.7 million, will pay for the creation of a database of gun-license holders. The statewide database will also include information about potentially dangerous mentally ill people, giving law enforcement the ability to revoke their licenses or confiscate their firearms, if necessary. The remaining $3.2 million will cover staffing needs.”


State Hospital Downsizing Criteria and Appropriate Prior Notice

This bill would continue the OMH Commissioner’s authority “to identify potential closures, consolidations, mergers, reductions, transfers, or redesign of services of hospitals, facilities, and programs operated by OMH, including the closure of wards or the conversion of beds to transitional placement programs.”

It requires OMH to give 75 days prior notice for facility closures and 45 days prior notice for ward closures or conversions.

“This bill would continue the existing flexibility for the Commissioner of OMH to reduce inpatient capacity, and to implement other reductions and actions as necessary for the cost-effective and efficient operation of hospitals, facilities and programs, consistent with Federal Olmstead requirements and Executive Order 84. This continued flexibility would help redirect funding to enhance community-based mental health services.

Determinations regarding the closure of beds shall be made by the Commissioner of OMH based on facility-specific criteria, including, but not limited to: what services are provided; long term capital needs; proximity to other facilities that can meet anticipated service needs; and what community mental health services exist in the catchment area.”


Streamline the Organizational Structure at OMH

This bill would give the Commissioner of OMH “statewide appointing authority concerning the assignment and reassignment of staff as needed to ensure the continuity of services provided to patients by OMH.”

The bill transfers that authority in statute from the current jurisdiction of the 24 separate facility directors.

This is a new bill that is designed to streamline decision-making and better align responsibility to best serve individuals with mental illness. Similar appointing authority was given to the OPWWDD Commissioner last year.


Community Reinvestment

1 year extension: The Community Mental Health Reinvestment program and the community services boards authorized under Section 41.11 of the MHL would both be reauthorized for one year.

Reinvestment in areas where a facility closes: It appears that reinvestment is being proposed to be authorized ONLY in areas where state hospitals close. The section creating a statewide fund consistent with the original legislation has been ‘notwithstood’ or eliminated for this year.


Improve the State and Local Response to Violent Incidents Involving Persons with Mental Illness through the Establishment of Mental Health Incident Review Panels

This bill would authorize the Commissioner of the Office of Mental Health (OMH) to convene panels of State and local officials to review violent incidents involving persons with mental illness who either harm others or are themselves harmed. Such panels must include mental health officials, but may also include members from local law enforcement and social service agencies. To encourage candid assessments of systemic or other problems that led to the incident under review, the information obtained by the review panel will be deemed confidential.

The panel “will permit more effective and comprehensive evaluations of any gaps or failures that may have contributed to a violent incident in the community involving a person with a mental illness.”

The panels will “frankly and freely discuss and analyze any errors or shortcomings in the mental health and/or criminal justice system that may have led to the incident's occurrence, thus leading to both improved quality of care for persons with mental illness and enhanced protection for the public.”

These reviews will result in policy recommendations to help prevent future occurrences and to enhance public safety.


Recovering Medicaid Exempt Income From Providers Of Community Residences

“This bill would continue and permanently clarify OMH's authority to recover Medicaid exempt income from providers consistent with legislation enacted in prior years and a recent court decision.

“This proposal allows OMH to recover an amount equal to fifty percent of the Medicaid revenue received by providers that exceeds the fixed amount of annual budgeted Medicaid revenue, as established by OMH. This authority is consistent with contractual agreements between OMH and residential providers. This legislation is necessary to continue existing practice and avoid a loss of $3 million in annual exempt income recoveries.”

“Enactment of this bill... will avoid a potential loss of $3 million in recoveries on an annual basis.