An Evolving Semi-Monthly Update on Community Mental Health in New York
November 6, 2006
Ladies and gentlemen, boys and girls, STEP RIGHT UP! It’s the 29th season of the Big Apple Circus, guaranteed to delight one and all. Watch as a wondrous Amusement Resort by the Sea materializes before your very eyes.
Jugglers, acrobats, equestrians, aerialists, horses, dogs, jesters and Grandma the Clown will sweep you into a bygone world, where everyone wins and memories are golden.
Wednesday, November 8, 2006 6:30PM, Lincoln Center’s Damrasch Park, West 63rd Street
Place your ticket order by going to our website www.coalitionny.org/circus2006.php. You may order directly by credit card or download the order form and fax it to us. Ticket purchases are totally tax deductible.
The proceeds from this benefit performance of the Big Apple Circus assist The Coalition to carry out its programs on behalf of people with psychiatric and addictive disorders and provide an opportunity for consumers, staff and friends of its members agencies to spend an magical night at the circus.
TUESDAY IS ELECTION DAY, EVERY VOTE COUNTS!
Voting site locations can be found on the Board of Elections in the City of New York website.
OMH Allows Use of Psychiatric Nurse Practitioners on ACT Teams
OMH recently announced that it will now allow ACT providers throughout the State to utilize licensed Psychiatric Nurse Practitioners (PNP) to fulfill a portion of the psychiatric hours required in the model. Previously, the State required ACT providers to rely entirely on psychiatrists.
The decision from OMH includes a number of guidelines for how ACT providers should utilize PNPs in concert with the duties required by psychiatrists. Initial psychiatric assessments must still be done only by psychiatrists, but PNPs can be used to offset a portion of the psychiatric hours in subsequent visits. There must be broad coverage with some overlapping hours each month in order to allow for coordination of care. Either the PNP or the psychiatrist must attend daily team meetings, depending on which of the two is on duty that day.
The psychiatrist and the PNP can either divide the client caseload, or elect to share it. Each option carries its own set of requirements to fulfill OMH’s guidelines. Finally, the PNP must consult regularly with an agency’s psychiatrist to “review and implement appropriate changes to the ACT model”.
There are a number of concerns that we have with the manner in which ACT is structured – particularly in a dense, urban environment like New York City – and we will continue to advocate with OMH to make this program a successful one for high-service need consumers and the providers who treat them.
OMH Files Emergency PROS Regulations
We have just learned that emergency regulations have been issued by New York State to allow OMH to continue working with a small number of providers in early adopter counties. According to OMH, these regulations strengthen the definition of “medical necessity”.
Under PROS, many services will be billed under the “rehab option” of Medicaid. Individuals and providers need to understand the meaning of “medical necessity” and how to bill Medicaid for rehab oriented services.
The issuance of these regulations does not yet impact New York City providers, which were always scheduled to follow the implementation of PROS in upstate counties. This arrangement allows local providers to learn from the experience of upstate providers.
Please visit http://www.omh.state.ny.us/omhweb/pros/ for more information on the State’s issuance of emergency PROS regulations.
Coalition’s Executive Committee Meets with DOB and OMH in Albany
The Coalition, joined by three of its Executive Committee members, brought its budget advocacy to senior officials at the Governor’s Division of Budget and the State Office of Mental Health last month. The agenda included a discussion about the Coalition’s Article 31 Clinic rate methodology project; the need for enhanced rates and flexible reimbursement for licensed and supported housing; a significant rate increase for children’s day treatment programs; and a number of proposals to assist providers who treat consumers with co-occurring addictive and psychiatric disorders.
The Coalition’s advocacy was well-received by both DOB and OMH. Much of the discussion centered around the rate methodology project for clinics, and what effect a new reimbursement mechanism would have on reducing the number of high Medicaid users across many sectors – an issue of great concern to the State as it prepares for a new Governor.
The Coalition will return to Albany in December to discuss our agenda in detail with the new Governor’s transition team.
Quality in Urban Behavioral Health: From Vision to Practice
A leadership conference on the introduction of best practices in urban behavioral healthcare settings was held in NYC on October 25th sponsored by The Coalition, along with The Urban Institute for Behavioral Health, New York State Office of Mental Health, NYC Department of Health and Mental Hygiene, and The Geriatric Mental Health Alliance. The conference brought together leaders from practice, academia, advocacy and government to address challenges, successes and opportunities in implementing evidence based practices in urban areas like NYC.
The Hon. Sharon E. Carpinello, RN, PhD, commissioner of the NY State Office of Mental Health was the keynote speaker. Click here for her presentation.
Center’s Director Presents at 2006 Urban Behavioral Health Conference
The Coalition's Center for Rehabilitation and Recovery Director Alysia Pascaris joined a panel of experts from the Brooklyn Bureau of Community Service and the NYU Wagner School at the Urban Behavioral Health conference, held on October 25, 2006. The topic of the presentation was Embracing Innovation: Making it WORK. Drawn from the experience of the Center’s Ways to Work Demonstration Project, the presentation focused on two main themes: the utilization of supported employment as an evidence based practice, and the organizational change process associated with integrating clinical and vocational services within Continuing Day Treatment Programs (CDTPs). To learn more about the Ways to Work project, go to: http://www.coalitionny.org/the_center/projects/. To download Embracing Innovation: Making it WORK, go to: http://www.coalitionny.org/the_center/projects/documents/QualityinUrbanBehavioralHealthW2WPresentation2-webversion.pdf
Continuum of Care Update
In the face of overwhelming opposition by members of the New York City Coalition on the Continuum of Care, the City temporarily withdrew its proposal to establish per-unit caps on housing funded in part with HUD McKinney dollars. For programs that receive HUD McKinney dollars to support housing for special needs populations, this news was most welcome. The City’s proposal would have created caps of $30,000 per unit for single adults and $40,000 per unit for families.
An Ad-Hoc Task Force (of which the Coalition is a participant) continues to meet regularly to look more closely at the issue of how to evaluate the financing of existing programs, and will present its recommendations at the November Steering Committee.
The Coalition thanks all of the providers who attended the October meeting and spoke so forcefully about the need to preserve programs that effectively meet the needs of their tenants, particularly those living with psychiatric and/or addictive disorders.
Medicare Part D - New Plans, New Formularies, Annual Enrollment Period begins 11/15/06
It is becoming clear that Medicare Part D anxiety will be an annual event. Along with the beginning of a new year, formularies are changing, without individual notices; premium prices are going up; new plans will be available; some old plans will disappear; some plans have merged; and the annual open enrollment period begins November 15, 2006.
Everyone who is in a Part D plan now needs to find answers to the following questions and possibly make a better choice before the year ends.
For dual eligibles the questions also include
The next Coalition Part D trainings include a Washington Legislative Update on November 20 9:30am-10:30am and Medicare Part D breakfast discussion on November 21 9:00am - 10:30am. RSVP to Karyn Krampitz at email@example.com.
Mental Health Community Loses A Pioneer
The Coalition is saddened to learn of the passing of Jim Rice, a former City official at DMH who was instrumental in developing innovative programs – including supportive housing – for homeless New Yorkers living with mental illness. He will be greatly missed.
Congressional Study Finds Mental Health Services Lacking For Veterans
A new study commissioned by House Democrats found an alarming lack of available mental health treatment for veterans who served in our country’s wars in Afghanistan and Iraq. The report found that over an eight month period, the number of veterans seeking mental health counseling nearly doubled, and that many VA centers are now reporting significant waiting lists. The full report can be found here (http://veterans.house.gov/democratic/officialcorr/pdf/vetcenters.pdf)
Center’s Basic Benefits Training to be Re-offered in Spring 2007
Due to high demand, The Center’s Basic Benefits Training Series offered in October and November will be offered again this spring. This free half-day training provides an overview of the Social Security system, the differences between SSI and SSDI, the differences between Medicare and Medicaid as well as other knowledge that supports consumer participation in recovery and the achievement of their goals. Our fall series provided training to over 200 participants from a wide array of provider agencies, and spring dates and locations will be made available in the coming months.
Ring the Bell with ICL
In honor of their twenty years of providing award-winning housing and services to individuals and families living with disabilities, Peter Campanelli, CEO of the Institute for Community Living, rang the NASDAQ’s stock market closing bell this afternoon. ICL serves over 8,000 people in New York City and Pennsylvania.
Coalition Job Boards
Coalition Members advertise staff positions for free on The Coalition’s Job Board! Here's a sample:
We also have a job board for psychiatrists only. APA members regularly look at this listing for potential hourly or per diem positions.