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The Coalition of Behavioral Health Agencies, Inc. Coalition Briefs
An Evolving Semi-Monthly Update on Community Mental Health in New York
July 16, 2008


Medicare Bill, with Mental Health Parity, Passes; Congress Overrides Bush Veto

The Medicare bill (HR 6331) that The Coalition and advocates around the State and country have been supporting passed the Senate with a 2/3 majority, 69 to 30, that saw the dramatic return of ailing Senator Edward Kennedy to the Senate to cast the decisive vote. The Medicare Improvements for Patients and Providers Act, which rolled back Medicare rate cuts for physicians, was vetoed by the President and on June 15 was overridden by both Houses of Congress. The numbers on override (383-41 in the House; 7-26 in the Senate) is a sign of Presidential weakness in the waning tenure of this Administration and a sign that Republicans are worried about the verdict of the electorate in upcoming elections. The Notable provisions include:

  • Lowers co-insurance payments from 50% to 20% for mental health treatment, providing parity with primary/surgical care in a plan that phases in over several years;
  • Life insurance policies and “in-kind” help from friends and family will no longer disqualify people from help with their drug expenses;
  • Medicare private health plans will be mandated to provide care coordination and other special needs of their enrollees;
  • Part D Medicare prescription benefit will cover benzodiazepines, now excluded from coverage
  • Improves the Part D program by limiting out-of-pocket costs for dual eligibles—people who are eligible for both Medicare and Medicaid;
  • Provides money for States to increase the ability of rural hospitals and clinics to provide mental health services to veterans of the wars in Iraq and Afghanistan.

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Moratoria on Six Negative CMS Medicaid Regulations Passes as President Signs War Supplemental Appropriations Act

Over the past year, the Coalition has worked closely with the New York Congressional delegation to pass legislation that would place moratoria on seven CMS Medicaid regulations. Through the combined efforts of advocates, both locally and nationally, we were successful!

On June 30, 2008, President Bush signed the Supplemental Appropriations Act of 2008 (H.R. 2542), ensuring moratoria until April 2009 on six administration-sponsored CMS Medicaid regulations. If implemented, the six regulations would have been extremely detrimental to the behavioral health sector (including targeted case management, rehabilitative services and school-based health). The regulation that was not included in the moratoria pertains to the reimbursement for certain outpatient hospital services. Advocates will continue to press for a moratorium on implementation of the latter regulation.

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OMH Clarifies Intent of Children’s Ambulatory Care Restructuring Project

The NYS Office of Mental Health recently clarified the purpose of the Children’s Ambulatory Care Services Restructuring Project, which was established to examine three outpatient, or “ambulatory care” services for children: Children’s Case Management, Day Treatment and Home and Community Based Waiver program. The stakeholder workgroup comprises Coalition staff and members, other providers, parent and youth advocates, and representatives from fellow trade associations.

The stakeholder workgroup’s mission is the following:

  • Identify the characteristics and needs of children and adolescents who are currently served in Day Treatment, Case Management and the Home and Community Based Waiver;
  • Review and make recommendations regarding the three services (i.e. what and how services should be constructed to best meet the needs of the children and their families);
  • Make recommendations on mental health interventions that support academic success and achievement;
  • Identify measurable outcomes that support the needs of children and their families;
  • Present recommendations for a fiscal model that will support the identified programs or services;
  • Produce a consensus document for submission to the Office of Mental Health.

Furthermore, the work of the stakeholder workgroup will be guided by several of the recommendations put forth by the Children’s Mental Health Plan. These include, strengthening our capacity to engage and support families, focusing on the social and emotional development of a child, creating optimal learning environments, early identification, creating accountability and collaboration, and having an adequately sized workforce.

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Good News from DOHMH on Contracts At Last

As of July 7, 2008, 103 of the DMH FY09 Renewals and Solicitation contracts have been sent to contractors for signature. 101 of these have been returned signed. Of the 101 signed contracts:

  • 78 have been submitted to the Comptroller
  • Of 78 contracts submitted to the Comptroller, 48 have been registered, leaving 30 pending registration with the Comptroller who is allowed 30 days to register a contract.

Of course, many more contracts are still in various phases of the processing procedures, but this news is a hopeful forecast of new times a’comin’ at DOHMH. Thanks go to DMH staffers, Assistant Commissioner Patricia Pate and Senior Director of Contracts Melissa Mink. The Coalition will keep you posted of updates as we receive them.

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NYC Department of Health & Mental Hygiene Launches MySpace Campaign to Help Young New Yorkers Cope

On July 7th, the NYC Department of Health and Mental Hygiene announced a new online campaign to engage teenagers grappling with depression, drugs, and violence, and to encourage them to seek help. The MySpace page, NYC Teen Mindspace, includes video blogs and stories about adolescents using drugs or suffering from depression, opportunities to reach out for help, quizzes, games, fact sheets and music downloads. This is the Department’s first effort to promote health through web-based social networking.

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Center Publishes Ideas Emerging from 6/23/08 Conference on MH and Literacy

The Center’s day-long conference Reading between the Lines: Rethinking Mental Health and Literacy, held at New York University on June 23rd, 2008 sought to address the current crisis facing a growing number of transition-age youth, ages 16-25, who are disconnected from school and deprived of the academic foundation necessary to their survival.  After hearing from experts in the AM, four afternoon workshops provided opportunities to brainstorm possible suggestions to enhance opportunities for increased literacy attainment in the following domains:

1) advocacy for youth and families; 2) making literacy relevant to marginalized youth; 3) bridging secondary and higher education and 4) integrating mental health and education.

You may read these suggestions at http://www.coalitionny.org/the_center/youth_initiative/. Center staff plans to consult with an advisory group after the summer to think about ways to build upon these initial ideas and present them to key stakeholders.  Stay tuned for further updates.

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Around The Water Cooler

F.E.G.S. was lauded by Nassau County for its work in placing people with disabilities in competitive employment. County Executive, Thomas Suozzi, presented a citation on June 13.

Our friend and colleague, Michael Seereiter, has been promoted by Governor Paterson. Formerly a Program Associate in the Governor’s Office, he has been elevated to the position of Program Director for Mental Health Services. This is much deserved recognition of a knowledgeable and skilled professional. Michael also is a consummate advocate and The Coalition congratulates him on this recognition.

DOHMH has announced the appointment of Shirley Berger to the newly created position of Research and Policy Coordinator within the Bureau of Child and Adolescent Services, Division of Mental Hygiene. She will be responsible for consulting on program evaluation and quality improvement in child and adolescent services; linking with child mental health services researchers; advising on the use of evidence and data to inform program planning; and promoting policies that advance the mental health and wellbeing of children, youth and families.

Shirley holds a B.S. and an M.A. in Clinical Psychology from the University of Cape Town, South Africa. She most recently earned a Master of Public Health degree in January 2008 from UMDNJ's School of Public Health, and a Certification as a Health Education Specialist. The Coalition welcomes Shirley to her new post and looks forward to future collaborations.

Homes Away from Home: Foster parents for a new generation, is the title of a new report published jointly by The Center for New York City Affairs at the New School and the Center for an Urban Future. The report documents the City’s increased reliance on foster families to care for children with emotional and mental health needs. The report shows that “foster parenting is harder than ever,” and documents how the parents are adjusting to their more demanding roles as well as how the system tries to meet their needs.

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Geriatric Chemical Dependency Legislation

Governor Paterson vetoed legislation (A9846/S6817) last week, which would have included chemical dependency and mental health needs of older veterans among the concerns of the Geriatric Mental Health Council. Also defeated as part of the Governor’s veto, were alcohol and substance abuse service demonstration grants.

What the Governor did sign was legislation (A10934/S07537) that expanded the concerns and duties of the Council, but did not include the service demo grants.

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Social Work License Initiative Waits for Next Session

Efforts by The Coalition, NASW-NYC and UJA/Federation to reopen the grandparenting clause in the Social Work License law have ended this year with the close of the legislative session. Despite the introduction of a bill by Senator Charles Fuschillo, Jr. (S8636), and a willing sponsor in the Assembly, Patricia A. Eddington, it was not possible to make progress on this issue, despite its importance to the sustainability of the behavioral health workforce. Efforts will be revived next session to make the case to our lawmakers. Dire consequences are predicted for the sector if the 2010 exemption for State Mental Hygiene Agencies expires without change.

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Whelan and Baker Promoted by Governor Paterson

In a vote of confidence, the Governor named Dennis Whelan interim Director of State Operations and Joe Baker as Acting Deputy Secretary for Health and Human Services. Whelan is moving up from his former position as Deputy Secretary and Baker moves into Whelan’s job from his former position as Whelan’s Assistant Deputy Secretary.

The Coalition has enjoyed cordial and productive relations with the two officials. Both appointments have been roundly applauded in the healthcare and behavioral health sectors. The Coalition sends its hearty congratulations.

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In Memoriam, Tere Fighetti

Long time colleague, DOHMH staffer and friend, Maria Teresa Fighetti died unexpectedly recently in Puerto Rico, where she had retired with her husband, Carlos. The Coalition expresses its condolences to Tere’s husband and children. Anyone wishing to make a contribution in her memory may donate to the Heritage Collection of the American Orchid Society by contacting Susan Wayman at 561-404-2031or email at swayman@aos.org. Expressions of sympathy may be sent to her husband Carlos and family at HC-03 Box 8125; Guaynabo, PR 00971-9710 or cfighetti@prtc.net.

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“Healthy Transition Act of 2008” Sits in Senate Committee

Senators Gordon Smith (R-OR) and Chris Dodd (D-CT), held a June 25 press conference to introduce legislation (S3192/HR6375) that would address problems of young adults with mental illness. The legislation is based on a newly released report by the Government Accountability Office (GAO) about the challenges faced by young adults with serious mental illness.

The GAO report, Young Adults with Serious Mental Illness: Some States and Federal Agencies Are Taking Steps to Address Their Transition Challenges, supports and reflects the work of The Coalition’s Center for Rehabilitation and Recovery’s work on youth in transition and the findings of the Center’s own report, A Chance for Change: Supporting Youth in Transition in New York City. In fact, The Coalition’s authors, Alysia Pascaris (Center Director) and Amy Smiley (Consultant to The Center) are listed in the GAO report’s select bibliography along with our white paper.

The GAO report showed that at least 2.4 million young adults (ages 18-26) had a serious mental illness in 2006 and outlines challenges faced by this group in finding services that facilitate their transition to adulthood.

The bill would provide funds to states for planning and implementation to help adolescents and young adults with serious mental illness obtain skills and resources for a healthy transition to adulthood. The bill has been referred to the House Committee on Energy and Commerce. In the Senate, it has been read twice and referred to the Committee on Health, Education, Labor, and Pensions where it likely will sit unless it is attached to the SAMHSA reauthorization act, which may or may not happen in the 111th Congress.

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Coalition Job Board

Coalition Members advertise staff positions for free on The Coalition’s Job Board!  Here's a sample:

Job #  Job Title
5189 Manager/Associate Director Youth Transition Program
5188

Intensive Case Manager

5184 Assistant Manager
5182

Financial Comptroller

5178

Social Worker

5170 Court Representative

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