NYAPRS 1st Look at Executive Budget: Reinvestment, Housing, Extends Gov't Medicaid Rates to 2020, Minimum Wage Hikes

 

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NYAPRS’ First Look: Some Highlights from the 2017-18 NYS Executive Budget Proposal
January 17, 2017

NYAPRS Note: Here are some highlights from Governor Cuomo’s Executive Budget proposal that was released late Tuesday evening. Most notably, the budget is relatively flat (no cuts) but does add $11 million in Community Reinvestment dollars to fund more recovery and peer support services, $10 million in increases for existing supported housing and SRO beds and funding for 280 new supported housing beds.

It also adds almost 2 more years to protections for clinic (and now some additional non clinic behavioral health services) to keep them at government rates vs reduced rates from health plans, funds minimum wage hikes, funds $30 million for capital expenses by community health and behavioral health providers and raises the age of criminal liability from 16 to 18.

We’ll provide an analysis and more details tomorrow. We’ll also be providing more details about buses to our February 28th Albany Legislative Day to press for our housing, community services, criminal justice, workforce and alternatives to coercion priorities.

That will be a particularly exciting day, with some NYAPRS members attending that day’s legislative mental hygiene budget hearing, a news conference and rally around community housing and a large number of meetings with state legislators. Here’s some very basic information culled from the various budget documents:

Office of Mental Health

  • Invest $11 Million in Community Reinvestment dollars based on the elimination of state psychiatric beds that have been unused for over 90 days.
  • Support 280 Additional Community Beds. “OMH will develop 280 community-based, scattered site supported housing units in the same geographic area by reconfiguring 140 state-operated residential beds, which are less integrated and more costly to operate.”
  • Provide $10 Million to Enhance Support for Existing Residential Programs. The Budget increases funds for supported housing and single residence occupancy (SRO) programs.
  • Redesign Service Dollars Administration. Re-direct $3.5 million in consumer wrap around service dollars to fund “a variety of emergency and non-emergency expenses.”
  • Transform OMH State-Operated Outpatient Clinics. “OMH will review clinic treatment services at all 85 state-operated facilities to reduce any overlap of services and ensure that clinics are operating at optimal patient capacity to address community need. Reductions will be targeted to low-performing facilities, which will enable remaining resources to be directed to clinics with higher productivity and capacity.”
  • Revamp Hutchings Children & Youth Services. “The plan is anticipated to involve working closely with an Article 28 hospital that could be utilized to deliver existing OMH services, expand the current bed capacity, and improve the coordination and delivery of medical and mental health services for children in the central New York region.”
  • Establish Jail-Based Restoration Programs for Certain Defendants. “NYS counties would be voluntarily authorized to develop residential mental health pod unit(s) within local jails for the purposes of housing, treating, and restoring felony-level defendants to competency as they await trial. Similarly, this proposal would voluntarily authorize DOCCS, by agreement with OMH, to develop similar restoration unit(s) within the NYS correctional system.”

Extends Behavioral Health Provider Government Rates Till March 2020

  • Extends government rates for clinic services from June 2018 to March 31, 2020; e.g. those services are not to be reduced by health plans below existing government rates.
  • Extends this provision to non-clinic Medicaid behavioral health services, except inpatient services.
  • Adds a value based payment requirement.

Minimum Wage Increases

  • The budget invests $17 million to support the direct cost of FY 2018 minimum wage increases for OPWDD, OMH and OASAS not-for-profits.
  • More broadly, it adds $225 million to support the direct cost of the FY 2018 minimum wage increases for health care workers that provide services reimbursed by Medicaid.

Raise the Age of Juvenile Jurisdiction

  • Raises the age of criminal liability from age 16 to 18

Eliminates Prescriber Prevails for Non Mental Health Medications

  • The budget “eliminates the prescriber’s right of final determination in both FFS and managed care, excluding mental health medications, when the justification for use is not clinically supported.”

Health Care Facility Transformation Program

  • Establishes a statewide Health Care Facility Transformation Program to provide funding to “support capital projects, debt retirement, working capital, and other non-capital projects that facilitate health care transformation and expand access to health care services.”
  • This includes $500 million in new bonded and hard dollar funding to support capital projects and debt relief for health care institutions.
  • A minimum of $50 million would be specifically awarded to Montefiore Medical Center
  • A minimum of $30 million would be made available to community based health care providers who “demonstrate that they would fulfill a health care need for acute inpatient, outpatient, primary, home care, or residential health care services in a community. These providers include diagnostic and treatment centers, mental health clinics, alcohol and substance abuse treatment clinics, primary care providers, and home care providers.”

Health Care Regulation Modernization Team

  • Establishes the Health Care Regulation Modernization Team to “create a more efficient health care system by modernizing the State’s health regulatory framework.” This team would begin its work no later than July 1, 2017, and report its findings and recommendations to the Governor by December 31, 2017. The work group’s specific areas of focus would include:
    • “Streamlining Certificate of Need and other licensure or construction approval processes;
    • Creating more flexible rules related to: licensing and scope of practice for clinicians and caregivers; telehealth; and alternative models of delivering health care services;
    • Streamlining and simplifying the provision of primary care, mental health and substance use disorder services in an integrated clinic setting;
    • Aligning care models around home and community based services consistent with New York State’s Olmstead Report;
    • Evaluating where changes in statute, regulation and policy can support timely and effective emergency medical services and pre-hospital care; and
    • Authorizing the implementation of pilot programs to test and evaluate new and innovative models of health care.”

See the complete set of budget documents at https://www.budget.ny.gov/.