An Evolving Semi-Monthly Update on Community Mental Health in New York
June 25, 2008
Coalition Goes to Washington
Coalition leaders and staff visited last week with New York City’s Senate and House representatives in DC as well as officials of New York City and New York State. Joining colleagues from across the country at the Hill Day sponsored by the National Council of Behavioral Healthcare, Coalition leaders, Peter Campanelli and Constance Brown (ICL), Sandra Hagan (Child Center of NY), Jonas Waizer (F.E.G.S.), Heather Mermel and Phillip Saperia (Coalition staff) focused their advocacy on key issues facing our sector.
The Coalition delegation articulated arguments for imposing a Congressional moratorium on a package of CMS regulations that would disrupt vital rehabilitation and case management services. We also pushed for a federal parity bill that would provide a minimum of benefits and not preempt any stronger provisions of New York State’s Timothy Law.
Eager to protect funding for addiction treatment and addiction programs and fearing dire consequences for services in New York, the Coalition urged its delegation to oppose the Administration’s proposed cut to the addiction treatment and prevention programs, including the Substance Abuse Prevention and Treatment block grant.
We added our voices in support of The Community Mental Health Services Improvement Act, promoted by the National Council. This bill would advance policy directions in New York by encouraging integration within the behavioral health sectors and between behavioral and primary health. The coordination of that care would reside within mental health provider agencies, since these agencies have the deepest understanding of people with serious mental illness and co-occurring disorders.
2008 Leadership Awards Features Distinguished Honorees
Coalition members, colleagues and friends gathered at Pfizer’s reception facility to celebrate the behavioral health community and to bestow honors on several significant individuals and institutions that have made contributions to the sector.
Receiving the Coalition’s Leadership Awards was Deborah Bachrach, Deputy Commissioner of the Office of Health and Insurance Programs and State Medicaid Director who was cited by Coalition’s Executive Director, Phillip A. Saperia, for being a “driven and passionate advocate, consummate political strategist, organizer and issues analyst.”
Also accepting a Leadership award was Dr. Richard Rosenthal, Chair of St. Luke’s and Roosevelt Hospital’s Department of Psychiatry, on behalf of The Addiction Institute of New York. The Addiction Institute was lauded for becoming “a world renowned center for treatment and service to people who struggle with all kinds of addictions.” Leadership Award winner, Dr. Petros Levounis, renowned Director of The Addiction Institute received his own Coalition Leadership Award from William S. Witherspoon, Director of the Upper Manhattan Mental Health Center and Coalition Board member. Dr. Levounis, who has been an instructor in The Coalition’s Professional Learning Center was celebrated as having “cut an impactful swath through the addictions service world, the academy and the behavioral health sector.”
Alvin H. Perlmutter, President of Alvin H. Perlmutter, Inc. Sunrise Media LLC and Director of the Independent Production Fund, award winning film maker, was recognized for his lifetime of film making that “put your talents to the task of provoking public debate on difficult but significant issues, clarifying values and smashing the idols of superstition.” He was presented his award by Jonas Waizer, Chief Operating Officer for Behavioral and Health Related Services at FEGS and President of The Coalition’s Board of Directors.
Recipient of The Coalition’s Founders Award was our beloved Gayle DeRienzis, longtime Coalition leader and Board member, and recent Associate Director for Government Relations and Public Affairs for Catholic Charities Neighborhood Services of Brooklyn and Queens. Her award was presented by former colleague Coalition founder, Joyce Pilsner. She lauded Gayle with these words: “Every trip to Albany, every trek to city hall—you were there—pushing, engaging and in your disarming and kind personal way, staking out the important positions that would help us make our case. We miss your smile, your point of view, and we miss your caring, compassionate and comforting presence.”
Chances Improve on Hill for Moratorium on Devastating CMS Regs
On June 19, Congress and the White House negotiated inclusion in the Iraq war supplement of an amendment that would delay, for one year, implementation of six of seven regulations that The Coalition and advocates from around the country were seeking. These regulations would have negatively impacted case management, the rehabilitative services option and school based services. The House and Senate must vote on this version of the bill before it goes to the White House for the President’s signature. The proposed rule to clarify definitions of outpatient clinic and hospital facility services, sought by hospital advocates, was left off this bill, but may be attached to another measure before the end of the year.
NYS Legislature Puts PTSD Parity Bill on Hold
Last week, despite a persistent campaign by advocates, the Assembly Ways and Means Committee voted to “hold for consideration in committee” the PTSD parity bill (A10078). The bill would have included PTSD on the list of mental illnesses that is required to have equal or minimum coverage by employee health insurance plans. However, given the high number of co-sponsors of the bill (roughly 100 members), advocates are still pushing for the bill to be picked up and brought to the floor for a vote.
The Senate bill (S6818) is currently on the Senate Floor Calendar. Advocates have spoken with the sponsors of the legislation (Senators Morahan, Golden, Fuschillo, Larkin and Libous) about the status of the Assembly bill and are hoping they will continue to move their bill, thereby putting pressure on the Assembly.
A new website design has been chosen and published at www.coalitionny.org. New graphics, new materials, announcements and easier navigational features for members and non-members alike, have been added to this frequently visited site. Come visit and seek out our training and technical assistance activities at Coalition’s Professional Learning Center and Center for Rehabilitation and Recovery. Survey The Coalition’s Job Board, the news of our sector, many resources and publications available. Find current and past issues of RECOVERe-works and Briefs.
Federal Parity Maybe in Reach
A compromise agreement has been reached by House and Senate negotiators on a comprehensive mental health and substance abuse parity measure. Passage is expected in both houses, although the next hurdle will be finding an accommodation on sources of funding. The agreement protects stronger state laws, like New York State’s Timothy Law and other consumer protection laws. It also guarantees that out-of-network mental health and addictions services will be provided on an equal basis when a plan provides out-of-network services for physical health. When enacted and implemented, the law will end insurance discrimination against mental health and substance use disorder benefits, requiring full parity with physical health benefits. The timing of next steps is still uncertain.
After much study, consultation and due deliberation, Mayor Bloomberg and Governor Paterson announce the results of a panel report overseen by Deputy Mayor of Health and Human Services, Linda Gibbs and State Deputy Secretary of Health and Health and Human Services, Dennis P. Whalen.
Following several incidents of violence involving people with serious mental illnesses, the panel sought to make recommendations that would shore up the system of care and supports available to people with mental illnesses. The Panel noted that, contrary to public perception, mental illness is not a major driver of violence and that the incidence of violence by people with mental illness is low. Furthermore it noted that people with serious mental illness are most likely to be victims, not perpetrators, of crime.
The report focused on four broad categories: 1) coordination and accountability; 2) quality of care; 3) information sharing and 4) identification and engagement of individuals with mental illnesses in the criminal justice system. Recommendations include the creation of Care Monitoring Teams and a system of Family Care Coordinators. The former are designed to help improve the mental health care provided to high-needs adults and the latter, to help families navigate the mental health and juvenile justice systems.
The Panel recommends statewide standards of care for clinics and enhanced clinical interventions for youth. Also suggested were pilots for new programs and expanding New York City’s capacity for alternative-to-detention programs for individuals with mental illness who encounter the criminal justice system. The Panel proposed ways of improving information sharing between providers while being mindful of protections for client confidentiality and laws that govern that confidentiality. Finally, the panel supported the State and City policy direction of providing integrated care for people who have co-occurring psychiatric and substance abuse disorders.
NYS Commissioner of the Office of Mental Health, Michael Hogan, and NYCDOHMH Deputy Executive Commissioner of the Division of Mental Hygiene, Dr. David Rosin, in public and private comments have praised the efforts of providers and professionals in the mental health and criminal justice communities, who are working every day to provide high quality supports and services to thousands of consumers in our City and State. Our public officials pledged to continue supporting quality care, focusing on the need for consumers to have choices in their services, the value of involving family in an individual’s recovery, as well as the need to educate the public about the effects of stigma and to change public misperceptions about mental illness and its relation to violence. Download and read the report here.
Just a very few days from the ceremonial “handshake” between the Mayor and the City Council Speaker, signaling an agreement on the City budget, City Council restorations are in jeopardy. Some pundits predict across-the-board cuts to particular City Council funded programs and total defunding for some others. At the same time, the Department of Health and Mental Hygiene is planning how to absorb the cuts in State Local Assistance funding that the State Budget shortfall has dictated through the guidelines promulgated by SOMH. All in all, FY 2008-2009 promises to be a belt tightening year for behavioral health in New York State and City.
Join us in welcoming Jason C. Lippman who will become Senior Associate for Policy and Advocacy at The Coalition on July 14. Currently, he is Supervising Analyst for behavioral health in the Mayor’s Office of Management & Budget.
Jason has worked for the NYS Developmental Disabilities Planning Council and is familiar with special needs housing as well as finance. Jason received his BA in Political Science from SUNY Binghamton and earned a Master of Arts in Public Affairs and Policy from Rockefeller College of Public Affairs and Policy at SUNY/Albany.
On June 23, nearly 200 key stakeholders from the worlds of mental health, education, law, policy, and academia came together to investigate how to collectively address the diverse needs of disconnected transition-age youth for the first time in New York City. Consistent with our Center’s focus on seeking solutions to the challenges facing these young people, staff is now in the process of compiling suggestions for systems change that emerged from afternoon workshops focused on advocacy, continuing education, literacy, and integrating mental health and education. Within the coming weeks, we will publicize these findings via our website, www.coalitionny.org.
Special thanks to the New York State Office of Mental Health, New York City Field Office, New York City Department of Health and Mental Hygiene, Office of Consumer Affairs, The Frances L. & Edwin L. Cummings Memorial Fund, and New York University, Steinhardt School of Culture, Education and Human Development for making this day possible.
We send our congratulations to Peter Campanelli, Coalition Past President and active Board member, who has been elected to the Board of Directors of the National Council for Community Behavioral Healthcare. President and CEO of Institute for Community living, Peter will be representing Region 2, which includes NJ, NY, Virgin Islands, and Puerto Rico.
SOMH is appointing Ken Gnirke as Director of its Bureau of Inspection and Certification, replacing retiring James McQuide. Gnirke has worked in budget, was a program specialist in adult and children's services and brings both a technical and program expertise to the certification process.
Congratulations to Marie Sabatino, Training Specialist in the Coalition’s Center for Rehabilitation and Recovery, who was recently awarded The New York City Department of Health and Mental Hygiene’s (DOHMH) full tuition scholarship for graduate social work study in the Mental Hygiene Training Program/One Year Residence (MHTP/OYR) at Hunter College School of Social Work (HCSSW). The MHTP/OYR is a partnership between DOHMH and HCSSW.
Catharine Grimes of Bristol Meyers Squibb has been promoted from Atlantic coast manager to a national position, Director of Healthcare Quality Alliances. Catharine has been a special friend of The Coalition and we wish her great success in her new position within the company.
Among his first actions in the first week of June were Governor Paterson’s cuts to the State Budget. In addition to initial cuts to Local Assistance and to State Operations, the Governor announced a new budget initiative called the Program to Eliminate the Gap (PEG) to track Agency spending reduction targets and to address any additional current-year shortfalls or out-year gaps. This PEG is in addition to the announced Spending Plans in all the Mental Hygiene agencies. According to Commissioner Hogan, “it is important to understand that OMH's Plan represents actions required for immediate budget balance and further actions may be necessary to live within the State's budgetary constraints.” The Commissioner’s statement articulates a worst case scenario for all Mental Hygiene agencies that many prognosticators have been predicting if State revenue shortfalls continue and the economy resists a rebound.
SOMH Spending Plan Has Good and Bad News
OMH plans targeted hits to some programs and retains many positive features of its original budget proposal. The several measures that the Commissioner has referred to as a “down payment” on clinic reform will be preserved as will the multi-year COLA and new housing slots. Targeted for cuts are sheltered workshops, some Community Services programs, local government administration (which may show up as cuts to provider contracts on the local level), some Continuing Day Treatment rates and some high-end clinic supplemental rates. SOMH will try to save dollars by some increased conversion of State Aid money to Medicaid and by delaying the start of selected programs.
In early June, OASAS published its plan to implement the Governor’s budget cuts and the Executive’s proposed Program to Eliminate the Gap (PEG). Most of the Agency’s identified program priorities were preserved, including COLA, housing expansion and new treatment and prevention services. Savings are projected to be found through delayed implementation of some projects, through the establishment of Resource Centers and other prevention programs and by other cost savings that presumably will not reduce community services.
The Coalition’s submitted comments to the federal Centers for Medicare and Medicaid Services (CMS) on the proposed rule intended to amend Medicaid regulations to define and describe home and community-based State plan services by implementing a new section of the Social Security Act, 1915(i).
CMS has proposed, under a rule that was published in the Federal Register on April 4, 2008, a new framework under which services including but not limited to case management, habilitation, respite care, day treatment, psychosocial rehab, and clinic may be provided. We understand that SOMH may be interested in further exploring the potential applicability of 1915(i) in New York State.
You may view these comments as well as other Coalition Position Papers on our new website under Policy and Advocacy.
The Coalition staff and a number of member agency representatives are currently participating in the Office of Mental Health’s stakeholder workgroup to discuss three outpatient, or “ambulatory care” services for children: Children’s Day Treatment, Children’s Case Management and the Home and Community Based Waiver program. The workgroup will be evaluating the effectiveness of the three services and put forth recommendations to improve the fiscal and programmatic models of the programs.
Coalition Job Boards
Coalition Members advertise staff positions for free on The Coalition’s Job Board! Here's a sample: