Budget: Medicaid 30 Days Prior to Prison/Jail Discharge, $30 Million in Capital Funds for CBOs

NYAPRS Note: We are extremely pleased that the budget that the NYS legislature and Cuomo Administration are expected to approve over the next few days will include several measures for which our members and partners had strongly advocated. Great thanks are due to the Legal Action Center and MHANYS for the 30 Day pre-release restoration of Medicaid benefits and to a coalition that included CHCANYS, the NYS Council, ASAP, the Home Care Association, the NYS Coalition for Children’s Mental Health Services, Family Planning Advocates, Medicaid Matters, MHANYS, the Coalition of Behavioral Health Services, the Schuyler Center for Analysis and Advocacy and the Primary Care Development Corporation that worked fervently to win approval for the Capital Infrastructure dollars for non- hospital-based community healthcare providers.

Restoration of Medicaid Benefits 30 days Prior to Release from Prison/Jail

Authorizes the provision of Medicaid benefits, for ‘high needs” inmates who were on Medicaid prior to incarceration in a state prison or local jail, for the 30 days prior to release to pay for transitional services including medical, prescription, and care coordination services. This is contingent on NY applying for and getting CMS approval for offer federal share Medicaid for such services.

Authorization of Criminal Justice Health Homes

$5 million dollars in rate adjustments to health homes participating in a criminal justice pilot project to establish coordination between the health homes and the criminal justice system and for the integration of information of health homes with state and local correctional facilities for those with serious mental illnesses and two or more chronic conditions, including substance abuse disorders, or HIV/AIDS.

Restoring Medicaid benefits 30 days before discharge with the option of enrollment into a specialized criminal justice health home help makes NYS a national leader in creating a continuum of care for individuals who frequently relapse and are re-incarcerated, hospitalized or become homeless.

Added to an anticipated additional $1.5 million to further expand Crisis Intervention Teams, NY will become a national leader in strengthening our capability to help divert individuals with mental health conditions from incarceration and to help these individuals to re-enter their communities with the assistance of improved discharge planning to specialized health home related supports.

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Capital Infrastructure Funding

Provides a minimum of $30 million (out of a total of $200 million) of funding to the following types of community based health care providers

  • diagnostic and treatment centers licensed or granted an operating certificate
  • article 31 licensed or certified mental health clinic
  • article 32 licensed or certified alcohol and substance abuse treatment clinic licensed or granted an
  • primary care providers; or
  • a certified home care provider

These grants will be awarded without a competitive bid or request for proposal process for capital grants to health care providers deemed by the OMH or OASAS commissioner to be a provider “ that fulfills or will fulfill a health care need for acute inpatient, outpatient, primary, home care or residential health care services in a community” according to the following criteria including, but not limited to the extent to which

  • the proposed capital project will contribute to the integration of health care services and long sustainability of the applicant or preservation of essential health services in the community or communities served by the applicant;
  • the extent to which the proposed project or purposeisaligned with delivery system reform incentive payment ("DSRIP") program goals and objectives
  • consideration of geographic distribution of funds;
  • the relationship between the proposed capital project and identified community need
  • the extent to which the applicant has access to alternative financing
  • extent that the proposed capital project furthers the development of primary care and other outpatient services;
  • the extent to which the proposed capital project benefits Medicaid enrollees and uninsured individuals;
  • the extent to which the applicant has engaged the community affected by the proposed capital project and
  • the manner in which community engagement has shaped such capital project; and
  • the extent to which the proposed capital project addresses potential risk to patient safety and welfare.

Restoration/Continuation of the EQUAL Program for Adult Home Residents

The "EQUAL program" improves the quality of life for adult care facility residents by means of grants to facilities that direct the funds in ways that are approved by Resident Councils.

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A Noteworthy Olmstead Related Measure:

Requirement for OPWDD Providers to Provide Alternatives to Sheltered Workshops

Individuals with developmental disabilities who were employed in sheltered workshops on or after July first, two thousand thirteen who are not interested in working or who are not able to work in a provider-owned business or private business in the community shall, to the extent practicable and in accordance with the principles of person-centered planning, be afforded the option of receiving other services of the office, including, but not limited to pathway to employment, community prevocational, day habilitation, community habilitation and self-directed services. The provision of such services shall consider, but not be limited to, the following factors:

  • assessment of the individual's skills, including social behavior, ability to handle stress, ability to work with others, job performance, communication skills, work ethic, and interests;
  • assessment of the individual's situation, including transportation needs family supports, and physical and mental health; and
  • creation of opportunities to explore different community and volunteer experiences to obtain information that will be used to create a person-centered plan.

For individuals with developmental disabilities who were employed in sheltered workshops on or after July first, two thousand thirteen interested in retirement, OPWDD services shall focus on connecting individuals to retirement-related activities, including participating in senior and community center activities, and other local activities for retirees.

Individuals with developmental disabilities who were employed in sheltered workshops on or after July first, two thousand thirteen who are not interested in working or who are not able to work in a provider-owned business or private business in the community shall, to the extent practicable and in accordance with the principles of person-centered planning, be afforded the option of receiving other OPWDD services of , including, but not limited to pathway to employment, community prevocational, day habilitation, community habilitation and self-directed services. The provision of such services shall consider, but

  • assessment of the individual's skills, including social behavior, ability to handle stress, ability to work with others, job performance, communication skills, work ethic, and interests;
  • assessment of the individual's situation, including transportation needs, family supports, and physical and mental health; and
  • creation of opportunities to explore different community and volunteer experiences to obtain information that will be used to create a person-centered plan.

For individuals with developmental disabilities who were employed in sheltered workshops on or after July first, two thousand thirteen interested in retirement, OPWDD services shall focus on connecting individuals to retirement-related activities, including participating in senior and community center activities, and other local activities for retirees.