January 13, 2016
First Look at the NYS 2016-17 Executive Budget Proposal
From: Tom Templeton, Public Policy Specialist
Harvey Rosenthal, Executive Director
New York Association of Psychiatric Rehabilitation Services
Here’s our preliminary look at Governor Cuomo’s budget proposal for the coming FY 2016-17 that offers our community some historic advances as well as several challenges to address in coming months.
The proposal makes unprecedented investments in housing for the homeless and some modest additions in other areas, but does not fully address the unmet need for supportive housing nor the crisis faced by existing OMH housing.
The Governor proposes a series of important criminal justice diversion and re-entry focused reforms and renews his strong commitment to “Raise the Age” of criminal culpability from 16 to 18 years of age. We will continue to seek inclusion of a Medicaid presumptive eligibility initiative to link discharged prisoners with critically needed services and supports.
While the proposed budget continues to make major investments in the Medicaid Redesign program, it would take down “prescriber prevails” patient protections.
The budget includes more OMH Reinvestment dollars and a wonderful boost in funding for children’s mental health services, but does not include any apparent expansion in funding to nonprofits to support their raising the minimum wage.
Ultimately, there’s much to celebrate and plenty of work to do, and we will dedicate ourselves to supporting our members to protect the first and address the second. Stay tuned…. Special thanks to Glenn Liebman at MHANYS for his partnership in parsing this budget proposal.
Here are more details on the budget proposal as we understand them currently:
- Housing for the Homeless
- The Governor makes an historic 5-year, $10.4 billion investment in affordable housing, homeless housing, and homeless services, as follows:
- $7.8 billion to support 44,000 supportive housing units, 77,000 shelter beds, and other homelessness-related activities
- $2.6 billion for 6,000 new units of supportive housing and 1,000 new emergency shelter beds.
- Within 15 years, the Governor’s plan will fund 20,000 new supportive housing beds across the state.
- New York/New York III Transitional and Pipeline Housing Beds
- 1200 New/New York III units to open this year, along with 800 other residential pipeline bed
- Shelter Conditions
- The State will partner with the NYC and Buffalo Comptrollers to review and inspect shelters in their respective jurisdictions. It is expected that OTDA will also be devoting substantial efforts to improve shelter conditions statewide.
- At this time, there does not appear to be any money allocated to address the crisis caused by steadily rising supported and congregate housing costs that are now about 50% higher than current funding levels. This is a top priority for NYAPRS this year, and we plan to move forward with vigorous advocacy in this area.
- The budget creates a most welcome Independent Special Counsel to review cases of police-involved civilian deaths, far too many of which involve people with mental health conditions.
- It includes a $1 Million commitment to “Raise the Age” of Criminal Culpability from 16 to 18. Further, beginning in August 2016, 16 and 17 year old youth will be housed at Hudson Correctional Facility, currently a DOCCS operated facility that is undergoing transformation to appropriately house and serve younger offenders.
- There’s a continuation of a previous authorization from the Assembly to invest $1 million to expand Crisis Intervention Team initiatives, training, and diversion programs; more details are pending.
- Through a Comprehensive Re-entry Initiative, NY will provide citizens who enter the criminal justice system the opportunity to rehabilitate, return home, and contribute to their communities. Included here are also transitional housing, employment, and immediate access medical/mental health services.
- There’s $1 million to invest in Alternatives to Incarceration for high-risk, high-need populations and $7.5 million for college-level education programs for incarcerated individuals
- NYAPRS hopes to work with the Administration and plans to continue to advocate for presumptive Medicaid eligibility that will provide true transitional support to those prior to and upon reentry into the community.
OFFICE OF MENTAL HEALTH
- $16 million from further state hospital bed reductions to fund an array of state and nonprofit crisis and respite beds, home and community based services waiver slots, supported housing, mental health urgent care walk-in centers, mobile engagement teams, first episode psychosis teams, family resource centers, evidence-based family support services, peer-operated recovery centers, suicide prevention services, community forensic and diversion services, tele-psychiatry, transportation services, family concierge services, and adjustments to managed care premiums.
Expansion of Children’s Mental Health Services
- An increase of $22.5 million (from $7.5 to $30 million) for crisis intervention, community psychiatric support and treatment, psychosocial rehabilitation services, family peer support services, youth peer training and support services, and services from other licensed practitioners.
No Merger of OMH and OASAS
- While statewide forums were held to explore the impact of a merger between the 2 agencies, there is not proposal here to do so.
Previously Authorized Items
Transitional Supports for Adult and Nursing Home Residents with Mental Health Conditions including:
- $38 million for transitional supports and supported housing for adult home residents and
- $12 million for care coordination, supported housing and services for current and future mentally ill residents of nursing homes, and persons with mental illness who are discharged from nursing homes
Mobile Recovery Support and Crisis Team
- $600,000 to provide 7-day a week, after hours clinical and peer recovery support and crisis intervention in collaboration with the mobile mental health teams in the Hudson Valley
Social Work Exemption
- The budget extends for five more years the current exemption for certain social work and mental health professional licensure requirements of those employed by a program or service operated, regulated, funded or approved by OMH, OPWDD, OASAS, DOH, SOFA, OCFS, OTDA, DOCCS, and/or local governmental units or social services districts.
The budget documents review the distribution to date of New York’s $8 billion, 5 year Medicaid waiver. In the first two years, $1.7 billion has been awarded under the waiver.
- $963 million to 25 Performing Provider Systems (PPSs)
- $280 million for Health Homes and other reform initiatives;
- $500 million for financially distressed safety net hospitals whose viability is critical to achieving ongoing reforms.
It also refers to the $2.5 billion in capital investments to make infrastructure improvements to stabilize health care providers to further advance transformation goals. Medicaid Redesign
- Pharmacy Proposals to
- reduce reimbursement rates for certain specialty drugs to align with rates achieved by managed care plans.
- eliminate the prescriber’s right of final determination, excluding mental health medications, when the justification for use is not clinically supported.
- Community First Choice
- The budget proposes the authorization of Advanced Home Health Aides (AHHAs) to perform specified advanced home care tasks under the supervision of a licensed registered professional nurse.
COLA: The budget includes an estimated.02% Cost of Living Adjustment for OMH, OPWDD and OASAS at a total cost of $12 million
Minimum Wage Hike: The Executive Budget includes provisions to further increase the minimum wage to $10.50 in New York City and $9.75 in the remainder of the State, effective July 1, 2016, gradually increasing the minimum wage to $15.00 in New York City on December 31, 2018 and across the rest of the State on July 1, 2021.
Yet, there are not funds to underwrite the increases to our most deserving and dedicated nonprofit workforce.
Stay tuned for lots more details and make sure you’re reserving your seat to get on NYAPRS buses from across New York to join our push on our February 23rd Albany Legislative Day!