April 23, 2015
2015 Annual Leadership Awards Reception
Please join us on June 18, 2015 for our annual Leadership Awards event.
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9th Annual Conference for Working Peer Specialists
July 23, 2015 | NYU Kimmel Center
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Coalition Parachute Wiki
Resources for behavioral health providers on the value of integrating peer staff to improve care and outcomes.
Visit our Parachute Wiki »
HIPAA Omnibus Policy, Procedure & BAA Template Kit
The Coalition is pleased to announce the availability of a set of 38 HIPAA Policy Templates for HIPAA Privacy, Security and Breach Notification Rules and an updated Business Associate Agreement all of which conform to the HIPAA Omnibus Update released January 25, 2013 and the technical correction published June 7, 2013.
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Professional Learning Center Store
HIPAA Business Associate Agreement Templates, now available. HITECH and Breach Notification changes apply to BAAs.
Be compliant, purchase now!! »
Coalition Video on YouTube
Empowering Lives Through Community Behavioral Health - Five stories narrated by Mike Wallace in two parts.
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Final Budget Approved by NYS Legislature
The Final NYS budget for FY ’15 – ’16 was approved by the legislature on April 1, 2015. It was a mixed bag for the behavioral health sector with some measured victories and many issues pushed down the road. We will continue advocacy in the post-budget session. Some of the highlights include:
- $10 Million for Medicaid Managed Care IT Transition Costs
- APG Rate Extension comporting with the new MRT timeline.
- Child Health Plus Reimbursement Aligned with APG Rates
- Value Based Payments Rejected
- Prescriber Prevails Maintained
- $50 million for Behavioral Health Vital Access Providers (VAP)
- $1.5 million for Crisis Intervention Teams & Diversion Services
- Opioid Overdose Prevention in Schools Expanded
- $74.5 million for Statewide Supportive Housing Services
- Enhanced Rates for OMH Supportive Housing Services
- MRT Affordable Housing Continued
- NY/NY III Fully Funded
- COLA Confirmed
For more information, please see our complete summary, which can be found here.
Post-NYS Budget Advocacy
Unfortunately, our proposals to soften and mediate the impact of Medicaid managed care on providers which we distributed in the format of Article VII (budget) language, did not make it into the final. Fortunately, all, or at least most, of the language has little or no fiscal implication plus we have heard that our proposal for a revolving loan pool to address cash flow issues arising from the transition to Medicaid managed care has gained some traction in the Capitol. This means we will return to Albany in the post-budget period and advocate for our agenda through the normal legislative process.
The Coalition’s post-budget agenda emphasized, among other issues, proposals related to behavioral health’s mandated transition to Medicaid managed care. Specific agenda items include:
- DOH, OMH and OASAS should develop contract templates to explicitly delineate a broad scope of services that are available in the benefit packages offered by MMCOs.
- Contract templates should also be used to implement standardized billing, authorizations, claims procedures, documentation requirements and appeals processes.
- Do not permit pre-authorizations for access to behavioral health clinic treatment services on parity with primary care services.
- Strict NYS enforcement of APG rates for behavioral health clinic treatment services.
- NYS must stringently enforce prompt payment rules.
- The Office of Mental Health (OMH) and The Office of Alcoholism and Substance Abuse Services (OASAS) should be given oversight and monitoring authority for MCO compliance, network adequacy and evidenced based behavioral health outcomes.
- As the very complex system of care for children, adolescents and families moves toward managed care, the State should adopt rigorous, senior, adult, child and youth-focused behavioral health metrics that monitor plan and network access and performance, ensure high quality care, and gauge short and long-term outcomes; commit to requiring Plans, networks and providers to work with State and local government to periodically and publicly issue reports on utilization, capacity and other quality and performance measures
- APG rates with an inflation adjuster should be continued until 2020, unless and until the Commissioners of the Office of Mental Health, the Office of Alcoholism and Substance Abuse Services and the Department of Health together develop and certify an alternative value-based payment methodology that is actuarially sound and will provide reimbursement to providers at rates that are at least comparable to current Medicaid rates (APGs).
Non-Medicaid Managed Care Agenda
- Extend the unlicensed practice exemption through 2020
- Enact legislation to “Raise the Age” of criminal responsibility in a comprehensive manner -- We support the Governor’s recommendations regarding raising the age of criminal responsibility to age 18 and we want to ensure that appropriate behavioral health services are provided.
- Create 30,000 Units of NY/NY IV Supportive Housing over the Next 10 Years
- Enact S.3229 (Golden)/A.828 (Cymbrowitz).
Provides for the reinvestment of funds generated by savings due to declines in the State prison census into community-based services for persons suffering from chemical dependence and for the establishment of the chemical dependence reinvestment fund. We strongly support this proposal.
In this edition: