OMH State Hospital Reconfiguration Plan Could Create $72m in New Community Services

In yesterday’s meeting of the NYS Office of Mental Health’s Regional Centers of Excellence steering committee, we learned that the coming state budget should include multiple new infusions of resources to expand and improve the performance of our community mental health systems.

These include:

  • Up to $25 million in state hospital pre-investment dollars
  • Medicaid Redesign pre-investment dollars derived from recent year savings derived from reductions in Medicaid behavioral health inpatient, emergency room and clinic utilization
  • Community housing and supports to help the transition of both adult home and nursing home residents with psychiatric disabilities into the community, per recent legal settlements
  • An increase in downstate supported housing rent increase

NYAPRS members should be preparing to come up to Albany on January 28 to make it our biggest Legislative Day turnout ever to support and protect these unprecedented investments in recovery services expansion!

See http://www.nyaprs.org/documents/GetOnTheBus2014.pdf and look for more details about this next week.

 

Here’s more details about the projected impact of the state hospital reconfiguration plan:

 

  • If the RCE plan is implemented over the next 3 years as proposed, it will create $72 million annually to establish State Community Hubs (especially in areas where beds are proposed to close) and will accordingly significantly expand community services. The $72 million includes both the value of the state staff who will transferring to more needed community positions and cash savings that will be infused into nonprofit systems.

 

  • Even in advance of the RCE plan’s implementation, the state is committing $25 million in the upcoming budget to prime the pump in what we are calling ‘pre-investment’ dollars to allow community services to come up in advance of the reconfiguration plan’s implementation. This is something we have pushed hard for and are delighted to see.

 

  • This new community funding is made possible by a hospital reconfiguration plan that, commits about $110,000 per bed is available for community services, an increase of $40,000 per bed from the current statutory level of $70,000.  Again, this is something we have been pressing for in a number of meetings we’ve had with state officials since the summer.

 

  • OMH expects that these expansions will enable us to serve 7,000 more individuals.

 

  • OMH estimates that about $54 million of the reinvestment will be allocated for new and expanded services to adults and $18 million for children and families with significant new community resources being dedicated areas impacted by the RCE plan.  

 

  • The regional service packages will be built on the recommendations that were presented yesterday from the Regional RCE teams. Included below are some common recommendations across the 5 regions:

 

For Adults

  • Expanding Crisis and Respite Beds to provide relief for emergencies.
  • Expanding Supported Housing to promote recovery by supporting the transition to integrated settings in the community.
  • Establishing Mental Health Urgent Care Walk-in Center services with expanded hours open 7 days per week to provide relief for emergencies and hospital diversion services, including open access appointments and new satellite locations.
  • Establishing Mobile engagement teams to respond to calls and to provide assessment, consultation, first-line treatment and referral to services.
  • Expanding First Episode Psychosis teams to address the unique needs of young adults experiencing the critical early stages of schizophrenia or other psychotic illness.   Services to be offered include: state-of-the-art evaluation, medication treatment, education and family support and cognitive behavioral therapy.
  • Expanding peer-operated Recovery Centers where individuals receive assistance in achieving their goals from persons with lived experience and provide support with issues including housing, employment, wellness, parenting, empowerment, mutual decision-making related to treatment planning, and avoiding and managing crisis.
  • Expanding suicide prevention including education services, specialized screening, assessment and treatment.
  • Establishing forensic diversion services to reduce incarceration and pressures on jails. 
  • Transportation to improve access to services in rural areas.

 

Children and Youth

  • Expanding Crisis and Respite Beds to provide relief for emergencies and establishing a new service for in-home/in-place respite services to provide support for families and caregivers.
  • Significantly expanding Home and Community Based Services (HCBS) Waiver slots for children.
  • Establishing Mental Health Urgent Care Walk-in Center services with expanded hours open 7 days per week to provide relief for emergencies and hospital diversion services, including open access appointments and new satellite locations in schools and co-located with primary care settings.
  • Establishing Mobile crisis/engagement teams to respond to calls from schools, families, and pediatric services to provide assessment, consultation, first line treatment, and linkages to services.
  • Establishing a family resource center modeled after the “one-stop shopping” concept provider information and access to child care services and family and peer advocates.  Services will include an outreach team to provide “boots on the ground” help to families.  Other child serving systems will be invited to co-locate at the Children’s Community Services Center.
  • Expansion of evidence-based family support services, including Multi-Systemic Therapy (MST) and other modalities to improve children’s recovery outcomes.
  • Tele-psychiatry to improve access in rural settings.
  • Transportation and family concierge services.