An Evolving Semi-Monthly Update on Community Mental Health in New York
August 29, 2007
Coalition’s Article 31 Clinic Rate Reform Project Gains Steam
The Coalition’s proposal to reform the way in which Article 31 clinic rates are structured continues to gain traction with key policy makers across the State. Over the month of July, Coalition staff and leadership traveled to Albany on several occasions and had substantive meetings with Commissioner Michael Hogan and his senior staff from the State Office of Mental Health; Deputy Commissioner Deborah Bachrach from the Department of Health; and Assistant Chief Budget Examiner Michael Atwell and his staff from the Governor’s Division of Budget.
The Coalition’s proposal establishes a regionalized base fee for Article 31 mental health clinics, trended to inflation and discounted for contract staff models. Clinics in position to serve State-identified priority populations would receive a supplement to the base fee, but would also be held accountable to certain performance standards in order to continue receiving the supplement.
Commissioner Hogan has repeatedly said that reforming the way Article 31 mental health clinics are reimbursed is one of his top priorities for the year ahead. The Coalition is grateful to the Commissioner and his colleagues in State government for considering our proposal which would preserve the fiscal integrity of the clinics, widely recognize as the portal to the community-based mental health system.
Governor Signs Long-Awaited Legislation
Governor Eliot Spitzer signed two important pieces of legislation in July that will benefit the community-based behavioral health sector. The first law, introduced by Senator Kemp Hannon (R-Nassau County) and Assembly Member Keith Wright (D-Manhattan), preserves Medicaid eligibility for individuals during incarceration. In effect, the law will “suspend” their Medicaid benefits until they’re released from State or local correctional facilities, at which time obstacles to medical care, medication, mental health and/or substance abuse treatment would be overcome.
Governor Spitzer also signed legislation introduced by Senator Joseph Robach (R-Rochester) and Assembly Member Joseph Bing (D-Manhattan) that will expedite the procurement process for non-for-profit organizations that contract with the State. In particular, it will require State agencies to notify providers at least 90 days prior to the end of a contract term whether or not their contract will be renewed.
The Coalition congratulates the legislature and the Governor for passing these important laws.
Jane Plapinger Lands in Baltimore
Jane Plapinger, formally the Assistant Commissioner in the Bureau of Planning, Evaluation and Quality Improvement at the New York City Division of Mental Hygiene, is set to become the new President and CEO of Baltimore Mental Health Systems, the local mental health authority for the City of Baltimore. The Coalition has every reason to believe that Baltimore’s mental health community will benefit from the same tireless energy, thoughtful planning and collaborative spirit that we saw here in New York. We wish Jane all the best in her new career.
Marie Sabatino Joins Staff at the Center
We are pleased to announce that Marie Sabatino has joined the staff at the Coalition’s Center for Rehabilitation and Recovery as a Training Specialist. Marie formerly coordinated a MICA residential program at the Educational Alliance, a Coalition member agency. She brings valuable clinical and administrative experience to our team and will contribute to the training endeavors at the Center. She can be reached at (212) 742-1600 ext. 104 or at email@example.com.
Coalition Offers DRA Compliance Guidance
The Coalition is pleased to bring back Robert Belfort, of Manatt, Phelps & Phillips, LLP to present an overview of the Deficit Reduction Act (DRA) requirements and discuss related compliance steps. The session will focus on recent developments in DRA compliance guidance from the State and Federal government as well as practical compliance advice.
The Deficit Reduction Act (DRA) requires that any health care entity which receives $5 million or more from Medicaid must have written policies and procedures about federal and state false claims acts and whistleblower protections. Providers must certify to the New York State Office of the Medicaid Inspector General that they have complied with the employee education requirements by October 1, 2007 and each year thereafter by January 1. Go to http://www.omig.state.ny.us/data/content/view/81/65/ for employee education requirements, certification form and relevant legal statutes.
The training session will cost $75 for members and $125 for non-members:
Also, available in two weeks will be a set of template policies and procedures created by Mr. Belfort, which providers can customize and add to the agency's corporate compliance plan. Each of the following templates is 3-4 pages long.
The set will cost $150 for members and $225 for non-members. Check our website for availability.
Coalition Board Member and Honoree Doris Clark Passes Away
The Coalition was saddened to learn of the passing of Doris Clark, one of our former Board members and Mental Health Award honorees,after a long battle with cancer. For over twenty years, Doris ran Brooklyn Community Housing & Services (BCHS), creating innovative housing programs that provided a nurturing and affordable living environment for hundreds of chronically mentally ill homeless New Yorkers. When she retired from BCHS in 2005, the Coalition honored Doris at its annual award ceremony in recognition of her lifelong commitment to helping the less fortunate among us.
A memorial service for Doris will be held Tuesday, September 18th, at 10 AM, at Presbyterian Church on Lafayette Avenue in Brooklyn.
The Coalition extends its sincere condolences to the family and friends of Doris Clark.
Governor Vetoes Housing Waiting List Bill
To the dismay of advocates throughout the State, Governor Spitzer vetoed legislation introduced by Senator Thomas Morahan (R-Rockland County) and Assembly Member Peter Rivera (D-Bronx) that would have compelled the State Office of Mental Health (OMH) to establish housing waiting lists for adults with psychiatric disorders. The intent of the legislation was to more accurately quantify the need for mental health housing in regions throughout the State, based on requests made by providers, adult homes, hospitals, and other entities.
Young People Inform Development of Center for Rehabilitation and Recovery’s Online Youth Resource Guide
Expanding upon the success of the ongoing Youth Initiative, in 2008 the Center expects to launch an online guide to services designed for disconnected youth in New York City. Conscious of the need to meaningfully incorporate the specific needs of youth when developing adolescent services and complimentary resources, Center staff recently conducted five focus groups with 60 young people aged 16-25 representing programs and agencies throughout the five boroughs. The Coalition is grateful to all of the participating providers for facilitating these focus groups. Data generated by the focus groups have already begun to influence the design, content and features of our forthcoming website. Throughout the course of 2007-2008, the Center will convene a standing advisory board of young people to assure the creation of the best possible product. Again, we thank all of the focus group participants and agency staff.
Governor, Legislature Agree to “SHU” Legislation
Governor Spitzer has indicated that he is prepared to sign into law a bill introduced by Senator Michael Nozzolio (R-Seneca County) and Jeffrion Aubrey (D-Manhattan) that will, in most cases, end the practice of placing severely mentally ill State prison inmates into solitary confinement as a punitive measure. These confinement settings, known as Special Housing Units or “the SHU”, have been recognized as greatly exacerbating psychiatric conditions in certain inmates with mental health diagnoses, contributing to higher incidences of decompensation and suicidality.
The Senate has already passed this bill, and the Assembly is expected to do so shortly. Assuming no last minute changes, the Governor will then sign it into law. The Coalition congratulates the thousands of consumers, providers, family members and advocates who worked for years on this campaign.
Release of Family Support Services RFP Postponed
On August 13, Dr. Myla Harrison, Assistant Commissioner, Office of Child and Adolescent Services, DOHMH, sent a letter to all family support service providers informing them that the Department is delaying the release of the RFP for family support services. All existing family support programs will therefore be funded by DOHMH through Fiscal 2009. We are grateful to Dr. Harrison and her staff for collaborating with the Coalition and other stakeholders in exploring the needs of consumers, families and providers.
OCFS and DOH Receive Federal Approval for New Bridges to Health (B2H) Program
The New York State Office of Children and Family Services (OCFS) and the Department of Health have received Federal approval of Medicaid waivers for the new Bridges to Health (B2H) Program. Children in foster care with any of the following three disabilities - serious emotional disturbance (SED), developmental disability, or medically fragile – will be eligible to receive home and community based B2H services. Once enrolled in one of the three waivers, the services may follow the child to any small, residential setting as long as they remain otherwise eligible for the program. Children will be able to continue receiving services if they return home or move into adoption.
OCFS will begin enrolling children in foster care in January 2008. The first three regions to implement the program will be Albany, New York City and Rochester. Maps of the planned roll out are available on the OCFS site. Approximately 1,864 waivers will be assigned to New York City, 1,491 of which will be dedicated to SED children.
Additional information on the Medicaid Waiver for Foster Care Bridges to Health (B2H) Program can be found on OCFS’s website at http://www.ocfs.state.ny.us/main/b2h/.
Update on Federal Mental Health and Addiction Treatment Parity Bills
On July 18, the House Education and Labor Committee approved the Paul Wellstone Mental Health and Equity Addiction Act of 2007 (H.R. 1424). This bill would close the loopholes that allow insurance plans to offer limited coverage for mental health and substance abuse services, including the number of inpatient and outpatient visits, and impose increasingly higher co-pays, deductibles and out-of-pocket expenses.
Meanwhile, the Senate is considering their own version of a parity bill – the Mental Health Parity Act of 2007 (S.558), which has some similar features as the House bill. A number of legislators proposed dropping language in the Senate bill that would pre-empt existing State parity laws, such as New York’s “Timothy’s Law”, that exceeded coverage under the Federal plan. Unfortunately, Senator Jim DeMint (R-SC) took legislative steps to prevent the pre-emption provision from being dropped earlier this month. The bill is expected to be considered when the Senate returns from their August recess.
CMS Proposes New Regulations for Medicaid Rehabilitative Service Option
On August 13, 2007 the Centers for Medicare and Medicaid Services (CMS) published proposed new regulations for the Medicaid Rehabilitative Service Option. The rules are comprehensive and would significantly affect behavioral health providers who serve children and adults with social and emotional disorders, physical or developmental disabilities.
The proposed regulations would provide guidance to ensure that services claimed under the optional Medicaid rehabilitation benefit are:
CMS estimates that the proposed changes would save the federal government an estimated $180 million in 2008 and $2.2 billion over a five-year period. None of those savings would accrue to state and localities, which would have to either reduce services or pick up the cost for the lost federal revenue.
The public has an opportunity to submit comments on the proposed rule. Comments must be received by 5:00 pm on October 12, 2007. The Coalition encourages all members to submit comments in response to this proposed regulation.
The Coalition is in the process of analyzing the new regulation and developing comments. We will continue to update you on the proposed changes as more details emerge.
The entire proposed rule can be accessed on the Federal Register website:
NY Times Honors CUCS, Good Shepherd Services
In recognition of the superb care they offer each day to New Yorkers in need, the New York Times bestowed their prestigious Nonprofit Excellence Awards to two Coalition member agencies – CUCS and Good Shepherd Services. Both agencies received cash awards.
CUCS received the “Excellence in Sustained Impact” in recognition of its innovative use of data and research to drive outcomes, and for “its strong focus on diversity and cultural competence in developing and managing its human resources.” Good Shepherd Services received the “Overall Excellence Award” for its impressive growth as an agency and for its model financial management practices. The Coalition congratulates the leadership and staff of both agencies for their hard work and commitment to serving New York's most vulnerable citizens.
CMS Issues Policy Letter to State Medicaid Directors on Peer Support Services
On August 15, the Centers for Medicare and Medicaid Services (CMS) provided guidance to States interested in peer support services under Medicaid. CMS explained how States may provide these services that include the requirements for supervision, care-coordination, and minimum training criteria for peer support providers.
In the letter (SMDL #07 011), CMS states “Peer support services are an evidence-based mental health model of care which consists of a qualified peer support provider who assists individuals with their recovery from mental illness and substance use disorders. The experiences of peer support providers, as consumers of mental health and substance abuse services, can be an important component in a State’s delivery of effective treatment. CMS is reaffirming its commitment to State flexibility, increased innovation, consumer choice, self-direction, recovery, and consumer protection through approval of these services.”
States may choose to deliver peer support services through several Medicaid funding authorities in the Social Security Act, including Section 1905(a)(13) or the waiver authorities under Section 1915(b) and (c).
To read the full letter to State Medicaid Directors, click here: http://www.cms.hhs.gov/SMDL/downloads/SMD081507A.pdf
Around the water cooler…
New Leadership at the United Way of New York
Gordon Campbell, the Chief Executive Officer of Safe Horizons, Inc., and current board member of the Coalition, will leave the organization on September 17th to become the new President and CEO of the United Way of New York. During his nine-year tenure at Safe Horizons, Gordon made the organization a national leader in providing assistance, including mental health counseling, to crime victims and their families. Scott Millstein, the organization’s Chief Operating Officer, has been named the Interim CEO during this transition period. The Coalition wishes all the best at the United Way for Gordon.
DOHMH’s Lisa Green Moves On
Lisa Green, the Director of Housing Services for the Division of Mental Hygiene, is heading to the Bowery Residents’ Committee (BRC) to become a Deputy Executive Director overseeing a range of programs, including the organization’s housing portfolio. During her tenure at DOHMH, Lisa was instrumental in helping to craft the historic New York/New York III Supportive Housing Agreement which will create 9,000 units of housing over ten years, including over 5,000 units for populations with serious and persistent mental illness. This entailed coordinating procurement processes, eligibility criteria, and funding rates with nine different City and State agencies. She also played a major role in the redesign of homeless street outreach. The Coalition will miss Lisa’s leadership at DOHMH, but looks forward to working with her at BRC, one of our member agencies.
Leadership Change at CCC
After fifteen years as Executive Director, Gail Nayowith is leaving the Citizens’ Committee for Children. She will be replaced on an interim basis by CCC’s Associate Executive Director Jennifer March-Joly, effective September 1st. The organization will embark on a national search to find a permanent replacement for Gail, who led the way in making the organization the City’s most respected and effective voices for child advocacy. The Coalition was fortunate to have partnered with Gail on a number of projects over the years, and looks forward to continuing this relationship with Jennifer March-Joly and her staff over the coming months.
Despite Presidential threats of a veto, both the House and Senate passed legislation to re-authorize the State Children’s Health Insurance Program (SCHIP). A conference committee will begin shortly to decide how to merge each house’s bill into a single CHIP reauthorization bill. Another round of floor votes is expected to take place in September.
On August 17, 2007, the Centers for Medicare and Medicaid Services (CMS) issued a letter to State health officials (SHO #07-001) outlining new enrollment standards for the State Children’s Health Insurance Program (SCHIP) that would limit states’ ability to expand eligibility to children in families with income levels above 250 percent of the Federal poverty level (FPL), unless a state has made the following assurances: 1) 95% of children below 200% of the FPL who are eligible for SCHIP or Medicaid are enrolled, 2) private insurance will not decline by more than 2 percentage points over a 5-year period and 3) data relating to crowd-out requirements must be reported on a monthly basis (procedures to ensure that SCHIP coverage does not substitute for coverage under group health plans).
Currently, no state in the country covers 95% of its children under 200% of the FPL. There are a total of 23 states at or above 250% of the FPL that would be impacted by CMS’s administrative action. New York State’s current SCHIP program and proposed Child Health Plus expansion would be drastically impacted by this decision.
We urge CMS to rescind their letter and are asking our Congressional delegates to oppose the new policy.
To read the full letter to State Health Officials online, click here: http://www.cms.hhs.gov/smdl/downloads/SHO081707.pdf
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.