NYAPRS 2nd Look at the NYS Executive Budget Proposal

NYAPRS Note: Here’s a deeper dive into the Executive Budget proposal released yesterday by NYS Governor Andrew Cuomo. 


NYAPRS is very pleased to see small increases rather than cuts to OMH programs and is very supportive of proposals to expand crisis respite and Act programs, extend our groundbreaking Reinvestment program, bring the power of peer support to adult home residents with major mental health conditions and to fund the promised workforce enhancements we helped win last year.


On the other hand, the budget fails to address the financial crisis within our existing housing services and proposes once more to eliminate the prescriber prevails patient protection. We are also very concerned about the viability of proposed new Medicaid revenue sources and ‘scope of practice’ proposals that could restrict members of our workforce from delivering critically needed treatment and rehabilitation services. 
NYAPRS upcoming February 27th Annual Legislative Day in Albany will bring upwards of 700 advocates to continue to lead the way in the push for housing rate hikes, consideration of additional workforce increases, advancement of criminal justice reforms like additional Crisis Intervention Teams and a full ban on solitary confinement in our state prisons for vulnerable groups, an increase in the Personal Needs Allowance for adult home residents and a rejection to the elimination of prescriber prevails. We’ll have program details next week!

 

January 17, 2018

NYS 2018-19 State Budget Second Look

  1. Even in a ‘flat budget’ environment, the NYS Office of Mental Health’s aid to localities budget went up by $72.4 million. Great thanks are due to the Executive Chamber and the committed and creative leadership at the Division of the Budget and Office of Mental Health.

    OMH has proposed expansions in a number of critically important areas:
    • It builds on New York’s pioneering role in the development of brief crisis respite residential programs like PEOPLe, Inc’s Rose House model and New York City’s Parachute programs, committing $50 million to the development of program property, housing and general infrastructure for a currently unspecified number of new programs. Crisis respite programs are a powerful strategy to help address crisis and arrest relapses that might otherwise lead to costly and too often traumatizing admissions to hospital emergency and inpatient departments.
    • It funds 20 new Assertive Community Treatment programs, 10 aimed specifically at engaging and supporting homeless individuals with serious mental health conditions in New York City and another 10 to do the same for people with very significant needs across the rest of the state.
    • The budget includes a commitment to launch a peer support initiative for adult home residents with mental health conditions to help thousands more to successfully transition to lives of recovery in the community, a measure for which NYAPRS and our colleagues in the NYS Coalition for Adult Home Reform have long advocated.
    • It also funds 200 new supported housing beds at cost of $1.2 million
  2. The budget also keeps faith with New York’s long, progressive commitment to moving resources to best support people with more serious mental health needs to succeed in the community, in place of long or repeat stays in our state psychiatric hospitals. Towards those ends, it funds another Community Reinvestment allocation of $11 million in locally selected services and supports that is derived from the closure of 100 hospitals beds.
    In recent years, community reinvestment dollars have been used to create critically needed mobile intensive outreach teams, peer bridger and respite programs, crisis intervention, warm line and housing services for adults and children, family empowerment services, managed care transitional supports, forensic ACT team and social club services.
  3. The budget fails by a long shot to address the crisis in our community mental health housing services, where costs and demands have far outstripped additional funding investments. While it invests another $10 million to boost stipends to supported housing and SRO units, it fails to make the level of investment that is required!
    As a very active member of the ‘Bring It Home’ campaign, NYAPRS members will turn our attention to the state legislature, most notably at our upcoming February 27th Annual Legislative Day. Save that date!

Office of Alcoholism and Substance Abuse Services

The budget includes an increase of $26 million (4.5 percent) in operating and capital support for OASAS to continue to enhance prevention, treatment and recovery programs, residential service opportunities, and public awareness and education activities and to further expand efforts to address our opioid crisis.

NONPROFITS

  • The Budget includes funding of $262 million to support the 6.5 percent salary increase provided to OPWDD, OMH and OASAS funded direct care professionals (3.25 percent in January 1, 2018 and 3.25 percent in April 1, 2018). 
    NYAPRS and our mental health advocacy partners are especially pleased that we were able to see that the 3.25% increase was also extended to our clinical workers.
  • “To incentivize workers to begin or continue employment in the not‐ for‐profit sector, the State is exploring ways to help not‐for‐profits improve the quality of employee benefit packages. This includes considering the feasibility of allowing not‐for‐profit organizations to access group insurance coverage through the NYSHIP Empire Plan.

MEDICAID

  • The Medicaid program grows by 2.5% for a state total of $18.9 billion.
  • The Budget supports initiatives to incentivize for Health Home members to stay engaged in Health Home care management and for plans to refer individuals to Home and Community Based Services. More details pending.
  • It also requires “managed care providers to work collaboratively with health homes” and may assess penalties against plans that fail to meet the participation targets, except when health homes are determined to be at fault.
  • In anticipation of federal cuts, the Governor has created a $1 billion Healthcare Reserve Shortfall fund to cover potential shortfalls. This relies on strategies that include claiming profits from the conversion of nonprofit to for profit health plans. A most notable example is proposal for profit Centene to purchase the nonprofit Catholic Health Plan (Fidelis). Plans are already pushing back against this measure.
  • The Governor also allotted $425 million toward the third iteration of the Health Care Facility Transformation Program to support mergers, acquisitions, capital projects, debt retirement or renovations. Of the funding, $60 million will go to community-based health centers, with up to $20 million set aside for assisted living facilities. A $45 million pool will be earmarked for residential health care facilities. Another $396 million will provide operating support to financially-distressed health care providers. The funding is contingent upon the providers creating plans to become more financially sustainable.
  • Once again, the Governor proposes to eliminate the prescriber prevails provision that allows a prescriber and patient, rather than a health plan, to decide on an appropriate medication and once again NYAPRS will be working with our colleagues to reject this measure.