An Evolving Semi-Monthly Update on Community Mental Health in New York
September 16, 2008
Update on New York State Budget Cuts
The Coalition is closely tracking the impacts on behavioral health funding from the State budget cuts that were passed in last month’s emergency legislative session. Since our last edition of Coalition Briefs, we have confirmed a 6% reduction to all unspent local assistance funds, a 6% reduction to new and enhanced legislative programs, and a 50% reduction to new and enhanced executive programs.
Impact to OMH: Coalition staff, in conversation with State officials at the New York State Office of Mental Health (OMH), has been informed that the specific programs that will be affected by the cuts to local assistance are not certain yet. However, such cuts are estimated to be in the range of $1.9M in 2008-09 and $7.3M in 2009-10. OMH also received a $39M cut to new and enhanced programs funded by legislative and executive additions, as well as a reduction of $75M in state operations funding for 2009-10. We have confirmed from OMH that programs such as housing, COPS rate restructuring and COLAs will not be affected by this round of cuts. We will keep our members posted on future budget developments when information becomes available.
Zero Growth Target: Governor Paterson called on agency heads and commissioners to submit a budget request for 2009-10 that would keep agency spending flat compared to 2008-09 levels. The Governor also asked agencies to reevaluate their programs in terms of value to core missions. This would mean that low priority programs would be considered first for funding reductions, and that new programs could be rolled out slower than expected.
The Coalition has been featured in two pieces in New York Nonprofit Press (NYNP) on the financial issues leading to the demise of Brooklyn CareWorks (a provider of community mental health services and former Coalition member) and the impact of the proposed rule on “Hospital Outpatient and Community Clinic Services” (CMS 2213-P), also known as the Upper Payment Rule. Both articles included comments from The Coalition’s Executive Director, Phillip Saperia.
We were also mentioned in Crain’s Health Pulse, a daily newsletter put out by Crain’s New York Business, on the Upper Payment Rule. This rule would cost New York State providers approximately $350 million by limiting Medicaid reimbursement only to those services which are also reimbursable under Medicare. This issue has been one that The Coalition, NYS and national advocates have actively been advocating against.
The Coalition joined advocates from the Legal Action Center, National Council for Community Behavioral Healthcare, ASAP, COMPA, Family Planning Advocates of New York State, and Planned Parenthood of NYC in Washington, D.C. on September 10, 2008, urging New York Senate and House representatives to delay the CMS rule on upper payment limits and pass the FMAP increase.
The group organized to advocate for the above issues. The proposed rule narrows the scope of outpatient services covered by Medicaid, which would lead to lower payments to community-based clinics and hospital outpatient services, resulting in the loss of over $350 million in Federal Medicaid dollars.
The group also advocated for a temporary increase in the federal matching rate for Medicaid, otherwise known as the Federal Medical Assistance Percentage (FMAP), as part of a Federal economic stimulus package this fall. For every dollar a state spends on Medicaid, the federal government contributes a matching percentage (the FMAP). This amount varies by state (NYS currently receives 50% in Medicaid funds for every dollar spent). An increase in FMAP would help to close New York State’s estimated budget deficit of $5.4 billion in 2009-10.
Update: Led by Representatives Eliot Engel and Peter King, the entire NYS congressional delegation has signed on to a letter supporting a temporary increase in FMAP and the placement of a moratorium on the CMS Upper Payment Limit Regulation. We have learned that the House leadership is now working on passing a stimulus package before Congress adjourns at the end of September, which includes FMAP, but it is uncertain whether this bill would pass through the Senate or get signed by President Bush. Congress is also expected to pass a continuing resolution (CR) by the end of this month to keep Federal programs funded into the next fiscal year beginning on October 1, 2008. While details have not been finalized, the NYS delegation has expressed interest in including a one year moratorium on the implementation of the CMS Hospital Outpatient & Community Clinic Regulation.
The Coalition Center’s Work and Recovery Project Featured in Published Journal Article
We are very proud of an article that was published in The Psychiatric Rehabilitation Journal, called “The Work and Recovery Project: Changing Organizational Culture and Practice in New York City Outpatient Services.” Congratulations to the article’s author Alysia Pascaris, Director of The Coalition’s Center for Rehabilitation and Recovery, and her co-authors, Leslie Reed Shields and Jessica Wolf.
The article focuses on the barriers to promoting recovery and addressing mental health recipient’s work-related goals in out-patient programs. It describes an organizational change project within New York City outpatient psychiatric services. The project aimed to increase staff exposure, understanding and use of work-related and recovery-based concepts to promote consumers’ recovery and achievement of employment goals.
CEU Credits Available Through E-Learning Collaborative
The Coalition has partnered with Essential Learning, the largest provider of e-learning services in the behavioral health and human services industry, to offer Coalition members state-of-the-science educational resources at a discounted rate. New courses are always being added and most recently online training was developed to help mental health organizations address the mental health needs of veterans.
Essential Learning, founded in 2002 and based in San Diego, California, serves more than 450 organizations, governmental agencies and trade associations in 46 states. Essential Learning’s Organizational Learning Management System features 400 behavioral health, addiction, child welfare, suicide prevention courses that are accredited for continuing education credit by national and state licensing boards for nurses, psychologists, counselors, social workers and other clinical professionals.
Please join us at our October 23rd membership meeting to learn more about the benefits of this partnership. If you have any questions please contact Karyn Krampitz at firstname.lastname@example.org.
State Office of Medicaid Inspector General Recovers $269M in Medicaid Payments
The Coalition has learned that the State Office of Medicaid Inspector General (OMIG) has recovered $269M in Medicaid payments from providers between October 2007 and March 2008. This amount exceeds the $215M agreed upon by the State and Federal government for the current Federal fiscal year, which ends on September 30, 2008. The total amount to be recouped from the State’s Medicaid program is targeted at $1.5 billion; this is expected to be achieved by 2011. An article appeared in The New York Sun on September 9, 2008 on OMIG Medicaid recoupment.This is particularly alarming to us, as The Coalition has been closely following OMIG’s process for auditing and seeking a recoupment from providers for COPS payments related to COPS-only managed care billings. On August 7, 2008, OMH issued a letter to providers clarifying COPS only billing requirements, stating that managed care companies must be billed prior to seeking reimbursement through COPS. Based upon our research and understanding, we do not believe this instruction has any retroactive applicability, and we believe contradicts past OMH-provider understandings.
We would like to wish Barry Brauth, Director of Financial Planning at the New York State Office of Mental Health a fond farewell and best wishes in his retirement from OMH. Barry will be working on a SAMHSA grant for the national organization of State mental hygiene directors that will look at Federal financing methodologies.
Brooklyn Bureau of Community Service is partnering with the New York City Department of Education and New Visions for Public Schools to launch a new high school to help at-risk students graduate with Regents diplomas. The Brooklyn High School for Leadership and Community Services is located at 300 Willoughby Avenue in Fort Greene and will assist 150 over-age and under-credited students.
The Addiction Institute of New York will be holding a discussion on Sober Siblings, an empowering practical guide that helps brothers and sisters of alcoholics. It will take place on Thursday, September 18, 2008 from 6-8 PM at Roosevelt Hospital, which is located at 1000 Tenth Avenue (between 58th and 59th Streets) in the Hospital Lobby. For more information or to RSVP, please call (212) 523-6897.
Comunilife has office space available as well as an institutional kitchen. For lease: 2,600 square feet NYC DOHMH compliant institutional kitchen. For more details and information about the office space, please contact Ernesto Vigoreaux at (212) 219-1618 x 6144 or email: email@example.com if interested.
Center Presents Benefits Training Across NYC
The Coalition’s Center for Rehabilitation and Recovery will be presenting the following training:
Introduction to Benefits Management*
A half-day training offered in various locations across the city designed to help clinicians and other staff understand the fundamentals of government benefits, including: Social Security, SSI, SSDI, Medicaid and Medicare, and gain working knowledge of resources that support consumers in their living and working goals. Fee: None
To register for this training, please visit: www.coalitionny.org Click Center for Rehabilitation and Recovery, then click Trainings. 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.
The Coalition will be sponsoring The Medicaid Crystal Ball: Behavioral Health Transformation in New York.
Keynote Speaker: Charles G. Curie (Principal, The Curie Group and former Administrator of the Substance Abuse and Mental Health Services Administration –SAMHSA).
Featured Speakers: Michael Hogan, PhD (Commissioner of NYS Office of Mental Health), Deborah Bachrach (Deputy Commissioner, NYS Department of Health) and David A. Rosin, MD (Executive Deputy Commissioner, NYC Department of Health and Mental Hygiene).
When: November 20, 2008 – 8:00am to 4:30pm
Where: HIP Health Plan of New York at 55 Water Street, New York, NY 10041For more information please go to www.coalitionny.org or call 212-742-1600 x 106.
The Coalition welcomes our newest member the Mental Health Association of Westchester, Inc (MHA). We are looking forward to their active participation in The Coalition. MHA was founded in 1946, and is a voluntary, not-for-profit organization dedicated to promoting mental health through advocacy, community education and direct services.
Dr. Amy Kohn, CEO/Executive Director
We are happy to report that House and Senate legislators have reached an agreement on the terms for mental health and addictions parity legislation. While parity legislation is expected to move quickly through both Houses, officials are still working on securing $4 billion in funding to pay for this bill over the next 10 years.
According to reports from the Mental Health Liaison Group, a final agreement was reached once three key outstanding issues were addressed:
Preemption: House negotiators accepted the Senates stronger preemption language, which defers to the current HIPAA standard and is extremely protective of state law. Under the language agreed upon by negotiators, stronger state parity and other consumer laws will NOT be preempted and states will be able to enforce higher standards.
Out-of-Network Services: Senate negotiators accepted the Houses stronger language that makes clear 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.
Covered Services: House negotiators agreed to drop their provision mandating coverage for all diagnoses listed in the DSM, but ensured that all mental health conditions and addictions would be covered by mirroring the standard for mental health under the current parity law.
The sponsors of the parity bill – Senators Domenici, Kennedy and Enzi and Representatives Kennedy and Ramstad – are also working to find a legislative vehicle that will allow the parity bill to go to the President with assurances that it will be signed in to law.
We have another development to report on parity. In the State of Pennsylvania, a Commonwealth Court has ruled that alcohol and drug treatment costs must be covered by HMOs and group insurance companies for policyholders who are referred to detoxification, rehabilitation and outpatient programs by a doctor or psychologist. According to an article that was posted on Times of the Internet, the court’s ruling will allow 15,000 Pennsylvania State residents per year to receive coverage from private insurance for drug detoxification and rehabilitation services. The Coalition is hopeful that this trend continues in other states.
New analysis published by the NYC Department of Mental Health and Hygiene (DOHMH) in the Journal of Urban Health found that two to three years after the disaster, psychological trauma and new respiratory problems were still elevated across all groups.
The study examined the health effects among all 71,437 participants of the World Trade Center Health Registry, which includes rescue and recovery workers, Lower Manhattan residents, area workers, commuters and people passing by. The Registry was launched in 2003 to track the health effects of 9/11.The full press release can be found by clicking here.
The Center for Urban Community Services (CUCS) along with the New York State Office of Mental Health (OMH) and the New York State Department of Correctional Services (DOCS) will introduce Wellness Self Management (WSM), an evidence-based program for persons with mental illness, at three state correctional facilities: Bedford Hills, Fishkill and Sing Sing.
With funding from the Jacob and Valeria Langeloth Foundation, CUCS will help inmates with mental illness through incarceration and release. Strategies include skills for better managing the inmate’s mental illness and life while incarcerated, planning for and assisting in transition to the community, evaluating the extent to which WSM improves patient outcomes and training correctional facility staff.CUCS will provide these services to at least 126 inmates and train a minimum of 35 OMH or DOCS staff. If this project succeeds, the program could serve as a national model.
Emergency Phones Link Callers in Need of Suicide Prevention Hotline
The Coalition joins the Mayor’s Community Affairs Unit (CAU) and members of the Staten Island Suicide Prevention Task Force in applauding the Metropolitan Transportation Authority (MTA) on the installation of emergency phones on the Verrazano-Narrows Bridge.
The CAU convened the Staten Island Suicide Prevention Task Force in January 2008 to proactively address depression and suicide. Membership includes the NYC Department of Health and Mental Hygiene (DOHMH), State Senator Andrew Lanza (member of NYS Senate mental health committee), Assembly Member Michael Cusick (member of NYS Assembly mental health committee), NYS Office of Mental Health (OMH), Staten Island Mental Health Society, and South Beach Psychiatric Center.
Since its commission, the taskforce has conducted several Applied Suicide Intervention Skills Training (ASIST) workshops, and has partnered with Staten Island University Hospital to target primary care physicians for training on depression screening and care. In addition, legislation was introduced by State Senator Andrew Lanza and Assembly member Michael Cusick requiring emergency phones on New York City bridges.
Coalition Job Board
Coalition Members advertise staff positions for free on The Coalition’s Job Board! Here's a sample: