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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
October 9, 2008

IN THIS EDITION

Upcoming Budget Cuts

New York State

Governor Paterson met with legislative leaders on October 3, 2008 to discuss the economy and its impact on the State. In a webinar viewed by The Coalition, the Governor said that he expects the deficit to grow to $2 billion by the end of this fiscal year (2008-09) in March. Paterson then called for another special legislative session on November 18 to consider further budget cuts to balance the proposed deficit, asking for cost cutting plans to be submitted by November 7. Paterson also announced that he would submit his fiscal year 2009-10 budget to the Legislature on December 16 (over a month before the deadline) and plans for budget adoption before the start of the next fiscal year on April 1, 2009. Details have yet to be formulated and announced.

New York City

The Coalition has also learned that the City intends to make additional budget cuts in the November financial plan. In a letter sent out from the New York City Office of Management and Budget (OMB) to agency heads on September 23, 2008, the City plans to cut 2.5% in City funds in FY 2009 and 5% in FY 2010. This will impact the Department of Health and Mental Hygiene (DOHMH) by requiring the agency to meet a $10.3M reduction in FY 2009 and $18.9 in FY 2010. Agencies are required to submit budget savings proposals to OMB by October 8, 2008. Again, details are forthcoming.

The Coalition will be keeping close contact with our State and City officials on the effects of these cuts to behavioral funding and will notify our members as soon as we learn more.

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Legislation to Delay CMS UPL Rule Introduced by New York Legislators

In the last edition of Briefs, we reported that Coalition’s staff went to Washington D.C. to urge our Senators and Congress Members to delay the implementation of the CMS Medicaid Hospital Outpatient and Community Clinic regulation (also known as the upper payment limit or UPL rule). We are pleased to report that on September 30, 2008, Senators Schumer and Clinton along with Representative Engel introduced the “Preserving Access to Healthcare” (PATH) Act of 2008 (S.3656/H.R.7231), which proposes a 6 month delay on the UPL rule.

The UPL rule, if implemented, would limit Medicaid reimbursement for hospital outpatient services to only those reimbursed by Medicare. This will disapprove a number of essential and life sustaining services that are provided by community-based agencies, such as day treatment, intensive psychiatric rehabilitation and methadone services. The rule would also redefine the formula used to determine the maximum amount that Medicaid will pay for community clinic services. When Congress returns in November 2008 for a lame-duck session, The Coalition will be advocating for the passage of the PATH Act.

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President Bush Signs Mental Health and Substance Abuse Parity Legislation

On Friday October 3rd, President Bush signed the Emergency Economic Stabilization Act (H.R. 1424). We are grateful that the provisions of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 were included in the legislation. The law will require private insurance plans that offer coverage for behavioral health benefits to offer them on par with the medical-surgical benefits. This means that the financial requirements and treatment limitations for behavioral health coverage may not be any more restrictive than those imposed on medical-surgical services. Parity will now apply to such items as deductibles, copayments, out-of-network charges, frequency of treatment, and number of visits and days of coverage. The law is effective January 1, 2009, and is estimated to cost $3.9 billion over 10 years. It can be read on THOMAS (Library of Congress)

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Governor Paterson Vetoes Bill on Training Requirements for Non-Profit Boards

The Coalition is pleased with the Governor’s veto of proposed legislation S.8047/A.11499. This bill would have required OMH and OMRDD to establish minimum training requirements for board members and trustees of voluntary not-for-profits under their jurisdiction.

In summary, while The Coalition is supportive of increasing the knowledge and training of Boards of Directors of nonprofits, we opposed the training requirements bill for the following reasons:

  • The penalty for noncompliance could result in provider’s being denied recertification for license
  • Mandatory training would be time consuming for board members who serve as volunteers
  • The bill singled out providers who contract with OMH and OMRDD
  • Additional reporting requirements on conflict of interest and executive compensation is redundant
Furthermore, we felt that a bill like this should be implemented in a more remedial and flexible way. Please read our letter of opposition to this bill that we sent to the Governor’s Counsel on August 27, 2008

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Paterson Also Vetoes Most Integrated Setting Bill

Bill S.7337/A7277, requiring state programs to provide services to individuals with disabilities in the most integrated setting was vetoed by the Governor’s Office. The Coalition and its allies were concerned that the overbroad language of the bill would have rendered illegal, housing set aside for people with serious mental illness and substance abuse disorders. Paterson felt this bill was a costly unfunded mandate that was duplicative of the purposes of the Most Integrated Setting Coordinating Council (MISCC). In 2002, MISCC was created by statute to develop and implement a plan for service provision to persons with disabilities in community settings. It is comprised of the following State agencies: OMRDD, OMH, DOH, DOT, OCFS OASAS, SED and DHCR. To learn more about the progress of MISCC, please click on the following link: www.omr.state.ny.us/MISCC.

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Presidential Candidate Positions on Behavioral Health

Election Day is Tuesday, November 4, 2008. Before voting, The Coalition believes it is important to know where the candidates stand on behavioral health issues. We put together a summary below, which shows a side by side comparison of the positions of John McCain and Barack Obama’s on essential behavioral health matters.

 

John McCain

Barack Obama

Mental Health Parity

 

(Both indirectly supported federal parity by voting for federal “bailout “law”)

 

  • Mental health is a necessary complement to physical health
  • There should be incentives to treat physical and behavioral health together
  • Explicitly supports mental health parity laws
  • Believes in prohibiting group health plans from imposing limitations on mental health and substance-related disorder benefits that are different from medical and surgical services

Housing

  • Supports public housing programs that play a significant role in helping meet the housing needs of many seriously mentally ill Americans
  • Supports increasing housing opportunities for people who have serious mental illness

 

Military/Veterans

  • Supports coverage of mental health care in military retiree health plans
  • For eradicating homelessness among our Nation’s veterans –many of whom are fighting mental illness
  • Will work to improve mental health care at every stage of military service – recruitment, deployment and re-entry into civilian life

Source:  National Alliance on Mental Illness (NAMI)

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Coalition Sponsoring Conference on Changes to Medicaid System

The Medicaid Crystal Ball: Behavioral Health Transformation in New York

November 20th 9am - 4:30pm
HIP Corporate Headquarters
55 Water Street, New York, NY 10004
Corner of Old Slip. Breakfast and registration begin at 8:00am. Lunch will be served.

Keynote Speaker:
Charles G. Curie, MA, A.C.S.W. Principle, The Curie Group, former Administrator of SAMHSA, will focus on CMS's mission in funding health care and how it differs from the behavioral health care community's current thinking on rehabilitation, recovery, evidence based practice and consumer driven services. How can alignment be achieved to realize, within a Medicaid funded structure, the goals of a transformed behavioral health service delivery system?

Featured Speakers:
Michael Hogan, PhD. Commissioner, NY State office of Mental Health
Deborah Bachrach, JD, Deputy Commissioner, NY State Department of Health
David A. Rosin, MD, Executive Deputy Commissioner, NYC Department of Health & Mental Hygiene

Presentations:
Jeffrey Crowley, Health Policy Institute, Georgetown University
Mary Thornton, Principle, Mary Thornton and Associates

Register Now »

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Coalition’s Center and Member Agency Staffs Join Forces in Presentations at NYAPRS Conference

On September 25th, The Coalition’s Center for Rehabilitation and Recovery, along with member agency staff, facilitated workshops focused on aligning program operations with recovery best practices.  Drawn from The Center’s Youth Initiative experiences, Center Director Alysia Pascaris, Tammy Samms, Director, Taish Guzman, Peer Educator, and Marcus Maddux, Peer, from The Brooklyn Bureau of Community Service’s  Adolescent Employment and Education Program (AEEP) co-presented Supporting Youth Voice and Self-Direction in Transition-Age Programs. Their presentation detailed innovative ways for programs to utilize evidence-based practice and foster meaningful youth participation in program-level decision making.

Marc Kutner, The Center’s Director of Special Initiatives, alongside Institute for Community Living representatives David Kamnitzer, Acting Sr. Vice President Adult Mental Health Services Brooklyn, Tracy Coit, Treatment Apartment Program (TAP) Director, Jeanine Williams, TAP Case Manager and TAP residents presented Working on Recovery: The Role of Consumer Leadership in Improving Mental Health Programs. This interactive session focused on how peers in partnership with program staff and senior management can work together to build program identity and a greater sense of community through peer-to-peer support. We would like to extend congratulations and thanks to both Coalition member agencies!

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Around the Water Cooler

Kristen Riley was named by Commissioner Hogan as Acting Deputy Commissioner for the OMH Division of Children and Family Services. Ms. Riley will be providing leadership, program direction and policy development for all mental health services for children and their families. In addition she will supervise OMH operated hospital and community programs for children. The Coalition wishes her good luck in this new role.

The Service Program for Older People Inc. (SPOP) will be holding an educational seminar series called “Cultural Considerations in the Treatment of Older Adults with Mental Health Disorders” on October 23, 2008, and “Music Therapy with Older Adults on November 13, 2008. Each seminar will be held at 302 W. 91st street at West End Avenue, New York, NY. Seminar fee is $15. Please register in advance at www.spop.org or call 212-787-7120 x 520.

New York State Coalition for Children’s Mental Health Services is pleased to announce its agenda and registration information for the 2008 Annual Training Forum on November 13-14 at the Sagamore Resort in Bolton Landing, New York. Please find the final program brochure and agenda here.

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Coalition to Hold Medicare/Medicaid Billing Series

The Coalition presents a Medicare/Medicaid billing series led by Dr. Derek Jansen, Practice Management Associates, who brings 30 years of experience in community healthcare, ranging from direct care provision to hospital and outpatient administration as the Clinical Director of Adult and Dual Diagnosis Services for a regional psychiatric hospital system.  Five half day sessions are scheduled from October 14th through 16th, 2008. All sessions will be held at the Coalition's office located in lower Manhattan at 90 Broad St, 8th Fl. Registration begins a half hour before the start of each session.

Medicaid Billing 101:  Complying with the state's billing requirements for Medicaid can be a daunting task to the most experienced provider organizations. (October 14, 2008 1:30pm - 4:40pm)

Medicaid Spend-Down, A Provider Perspective:  Understanding Medicaid Spend-down rules in New York State. (October 15, 2008 9am – noon)

Medicare Billing 101, including Incident to Billing: Review Medicare's Local Coverage Determination and avoid improper claiming. (October 15, 2008 9am – noon)

 Nuts and Bolts of Cross-Over Billing:  Medicare to Medicaid, Commercial Insurance to Medicare, Commercial to Medicaid. (October 15, 2008 1:30 - 4:30pm)

Billing for Substance Abuse Services: Focus on Dually Eligible Beneficiaries: Maintaining Medicaid as the payer of last resort. (October 16, 2008, 1:30 - 4:30pm)

PMA is an approved provider of training for Health Care Compliance Association CEU's. CEU's for this program are in application. HCCA CEU's are recognized by many professional associations including, AAPC, AHIMA, AMA, and more. Check with your association for acceptance.

For more information or to register go to: http://www.coalitionny.org/prof_learn_ctr/training/series.php?series_id=1054

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Live Consultation at The Coalition: Assessing the Effectiveness of Your Medicaid Compliance Plan

Dr. Derek Jansen, author of numerous books about following the rules, will also be providing a live consultation with a small group of providers to review all of the elements required by the OMIG, discuss in detail the expectations regarding auditing and monitoring "effective", and offer ways one might immunize the organization by addressing important questions.

Friday, October 17, 2008 9am - 3pm, registration begins at 8:30am
Cost $150 - registration limited to 25 participants

Location - The Coalition’s office located at 90 Broad Street, 8th Floor in lower Manhattan

For more information or to register go to: http://www.coalitionny.org/prof_learn_ctr/training/series.php?series_id=1058

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Center Presents: Introduction to Mental Health, Rehabilitation and Recovery

The Coalition’s Center for Rehabilitation and Recovery will be presenting the following training:

Introduction to Mental Health, Rehabilitation and Recovery*

This two-day interactive training is designed for staff in various roles and settings who seek basic knowledge of mental health, psychiatric rehabilitation and promising practices that promote recovery.  Participants will explore the value and guiding principles of recovery and how they relate to consumers, practitioners, programs and mental health systems. The facilitator will use a combination of training techniques that encourage participants to become actively involved in the learning process.

Date:          November 5th – November 6th, 2008
Time:         9:30am - 4:30pm
Location:    The Coalition of Behavioral Health Agencies
Facilitator:  Marie Sabatino  |   Fee: $50

To register for any of these trainings, please visit: http://www.coalitionny.org/the_center/training/registration/registration.php?series_id=1059  Space is limited, so we encourage you to register yourself or your staff as soon as possible.

* All Center trainings qualify for credit hours toward the Certified Psychiatric Rehabilitation Practitioner (CPRP) credential.

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The Coalition Responds to DOHMH Family Support Network Concept Paper

The Coalition submitted comments to DOHMH on the Family Support Network Concept Paper. For the past year, the Coalition along with providers and family and youth advocates have been participating in DOHMH’s Family Support Stakeholder Workgroup on the restructuring of Family Support Services in New York City. In our letter to the Department, we expressed our disappointment that the concept paper did not incorporate the recommendations put forth by the workgroup.

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LifeNet Goes Online: www.800lifenet.org

The Coalition applauds the Mental Health Association of New York City’s (MHA of NYC) launch of a website created to provide free, confidential, crisis, information and referrals for anyone seeking help for mental health and/or substance abuse services in New York City. MHA operates LifeNet (1-800-LIFENET), the only 24/7, multilingual, multicultural information and referral hotline that is staffed by mental health professionals in the city and has the largest database of behavioral health resources.

The website includes:

  • Free, confidential links to mental services in New York City
  • Direct, anonymous email access to LifeNet
  • Refined ability to search for mental health services
  • A user-friendly option for providers to keep information up-to-date

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Center Presents Benefits Training Across NYC

Introduction to Benefits Management*

A half-day training offered in various locations across the City designed for clinicians and other staff new to benefits. This training will help staff understand the fundamentals of the Social Security System, comprehend the difference between SSI, SSDI, Medicaid and Medicare, and gain knowledge of resources that support consumers in their living and working goals. Fee: None

  • Friday, October 10th – Transitional Services for New York, Inc., 1:30 – 4:30pm
  • Thursday, October 16th – Postgraduate Center for Mental Health, 1:30 – 4:30pm
  • Thursday, November 6th – Odyssey House, 1:30 – 4:30pm
  • Thursday, November 13th – The Coalition of Behavioral Health Agencies, 1:30 – 4:30pm

To register for any of these trainings, please visit: www.coalitionny.org/the_center/training. Space is limited, so we encourage you to register yourself or your staff as soon as possible.

* All Center trainings qualify for credit hours toward the Certified Psychiatric Rehabilitation Practitioner (CPRP) credential.

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JBFCS Acknowledges Foster Care Mental Health Initiative

 The   Jewish Board of Family and Children's Services (JBFCS) held an event on September 25, 2008, which was attended by Coalition staff, to recognize the achievements of the Foster Care Mental Health Initiative. The occasion honored Michael Hogan, Commissioner of OMH and included special presentations by Adolfo Carrion, Bronx Borough President and Peter Rivera, Assemblyman, Chair of Mental Health Committee.

The Foster Care Mental Health pilot project was initiated in 2006 by JBFCS with foster care agencies Good Shepherd Services, a Coalition member located in the Bronx and Seamen’s Society of Children and Families in Staten Island. This collaboration’s placement of mental health services in locations where children and their foster families receive services has dramatically lowered the rate of transfers among children in foster care. Many of these kids are often in need of mental health treatment due to past traumas from abuse and neglect, and do not get to experience consistency and a sense of being a family. The pilot has now expanded to five mental health agencies and five foster care agencies in New York City. The Coalition and several of its members worked over several years with the Council of Family and Child Caring Agencies, Inc. (COFFCA) to expand the project into several working pilots around the City.

Lauded for his vision and persistence in pursuing this project was Paul Levine, Executive Vice President of the Jewish Board.

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Last Chance to Attend OMH Regional Clinic Forum

The last OMH Regional Clinic Forum will be held on October 23, 2008 from 9:00-5:00 (registration begins at 8:30) at the Association of the Bar of the City of New York on 42 West 44th Street New York, NY.

OMH forums are interactive in nature and provide current information and guidance on clinic operations in the areas of co-occurring disorders, clinical standards of care, and fiscal and regulatory budget initiatives for expanding outpatient treatment. The focus of the Forums will be on outpatient services for adults.

The preferable method for registering is electronically. Just follow the directions provided. Alternatively, you may call Deb Czupil at (518) 473-7612.

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Children’s Plan Submitted by OMH and Child-Serving Agencies

New York State’s first Children’s plan was jointly submitted by Commissioner Michael Hogan of OMH, and the heads of eight other New York State child-serving agencies, to Governor Paterson and members of the Legislature. The plan’s goal is to improve the social and emotional well being of New York's children and their families. It was developed with the involvement of community stakeholders, providers and advocates; and was written in accordance with the Children’s Mental Health Act of 2006.

Contributing agencies to the Children’s Plan comprise of the Office of Mental Health, Office of Alcoholism and Substance Abuse Services, Office of Children and Family Services, Office of Mental Retardation and Developmental Disabilities, Commission on Quality of Care and Advocacy for Persons with Disabilities, Council on Children and Families, Department of Health, Department of Probation and Correctional Alternatives and the State Education Department.

Key recommendations of the collaborative plan include:

  • A focused attention to behavioral issues and emotional disturbance in settings such as pediatric offices, child care and schools, with mental health treatment in a back-up and support role;
  • A shift toward more effective and less expensive early intervention and evidence-based preventive approaches, leading to a reduction in institutional costs; and
  • The collaborative use of family-centered and parent-driven approaches.

The Children's Plan and press release can be found on OMH’s website

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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
5263 Supportive Case Manager
5260

Development Associate

5258 Entitlements Specialist (P/T)
5251

CASA Bilingual Supervisor P/T (21 hrs/wk)

5244

Mica Case Manager - Residential

5237 Clinic / Psychiatrist

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