Correction: 9 Things to Watch for in Pending NYS Budget Deal

Correction: In the section on Practice Requirements below, it should read “While NYAPRS has made sure that any proposed restrictions would NOT limit the work of psychiatric rehabilitation and peer service providers, other disciplines have been vulnerable.” Thanks to Peter B for pointing this out.

To:            NYAPRS Members and Friends                                                       March 28, 2018

From:        Harvey Rosenthal and Elena Kravitz         

From:         9 Things to Watch for in Pending NYS Budget Deal

A NYS budget deal is considered imminent: here’s what we’ve been pushing for even into the final hours, along with the sums that have been approved by all sides that can be added to state spending for the coming year:

Mental Hygiene: $35 million (expect that the majority of these funds go to battling the opioid epidemic):

  1. Housing Rate Hike: The Senate proposed a $5 million increase that is on top of the already approved $10 million offered by the Governor. The Bring it Home campaign has proposed that all of these funds be considered a down payment on a commitment that could amount to 4 times this amount.
    A multi-year commitment to address the crisis and preserve our existing community mental health housing is essential.  
  2. Living Wage for Community Mental Health Workforce: Last year, we helped win a commitment by the state to increase compensation to direct care workers by 6.5%, with a 3.25% increase for clinical staff, most of which will begin next week.
    The Senate has proposed a state budget commitment to 4 more rounds of a 3.25% increase for direct care staff and direct support professionals and clinical staff beginning next year.
    Our community mental health workers must see a progressive series of increases to accept and maintain work in our field. As of this morning, it’s unclear whether the legislature would make another commitment into future budgets in this year’s agreement.
  3. Criminal Justice Reforms: We’re hoping for a minimum of $1 million for such measures, with at least half going to help more jurisdictions to establish Crisis Intervention Teams in their areas. Over the past few years, we have led the way in securing almost $5 million for CIT expansions.
    The HALT bill to ban solitary confinement state prisons and local jails is poised to pass the Assembly, as we work with our allies to try and get it through the Senate as well. NYAPRS considers this a high priority issue and will continue to work on this through the legislative session that ends in June.  Passage will not effect this year’s budget, although increased state spending would be needed next year to pay for new rehabilitation units in those facilities. 
  4. Behavioral Health Ombuds Program: NYAPRS is a member of a coalition headed up by the Legal Action Center to establish a behavioral health ombuds function to help educate consumers and providers about insurance coverage requirements under Federal and State law and to assist them with denials of coverage, especially as regards the enforcement of mental health parity laws.
    Both houses are supportive and the Assembly has put up $1.5 million.

Health and Medicaid: $70 million

  1.  Health Homes $100 Million Cut: The Senate has proposed a cut that would total $200 million (when federal Medicaid share is included), that would drastically threaten efforts to better integrate and coordinate care for over thousands of New Yorkers with multiple ongoing health conditions, including mental health conditions. NYAPRS fears that the pathway to community and recovery based home and community based services will be closed for some if case management services are cut by this level of magnitude. 
    The Senate has been extremely tough on this issue and is also looking for savings to use elsewhere; at best, we’re hoping to see program improvements negotiated to avoid such a cut or, at minimum, to get away with a very small cut.
  2. Prescriber Prevails: $17.4 million would be needed to roll back the Governor’s repealing for “prescriber prevails” for all drug classes in Medicaid Fee-For-Service and Medicaid Managed Care, including atypical anti-psychotics and antidepressants.
    The legislature has always consistently restored prescriber prevails protections.
  3. Adult Home Residents’ Personal Needs Allowance Hike: We’re insisting that a $2.9 million Personal Needs Allowance increase be tied to the proposed $20 million increase in the state Supplemental Security Income (SSI) share allowance for Adult Care Facilities.
    This state cannot add money for adult home operators without recognizing the basic needs of the residents. We hope there’ll be enough money for this in this year’s budget.

Other Items

  1. Disability Funding Issues: NYAPRS is very supportive of proposals to increase funds for Independent Living Centers and the Access to Home program, as well as to restore the Office of the Advocate for the Disabled.
    This could be a very good year for our friends in the broader disability community.
  2. Practice Requirements for the Community Workforce: Both houses seem committed to approving a measure that would only allow social workers to make diagnostic determinations and provide some clinical functions. While NYAPRS has made sure that any proposed restrictions would limit the work of psychiatric rehabilitation and peer service providers, other disciplines have been vulnerable.
    NYAPRS and our allies have ended up pushing for another 2 year exemption to such a proposal.

Two NYAPRS priorities that made it to the Governor’s budget proposal that are sure bets:

  • $5 million for an Adult Home peer bridger initiative: NYAPRS is very pleased that our proposal to deploy peer bridgers to provide adult home residents with psychiatric disabilities with the encouragement and support to move to the community was approved by the Governor and enthusiastically supported by both houses.
  • $11 million increase in Community Reinvestment funding: NYAPRS is similarly very pleased that another significant increase in community services to help individuals to get supports to successfully leave and/or stay out of state hospitals will be approved once more.