An Evolving Semi-Monthly Update on Community Mental Health in New York
February 18, 2009
Coalition Advocacy Day in Albany – A Productive Day with Legislators
The Coalition held its annual Albany Advocacy Days on February 2nd and 3rd, joined by members for face-to-face meetings with State legislative chairs of key committees on mental health, substance abuse and health insurance issues. We would like to thank our State representatives and their staff who met with us, and extend special thanks to the new Chair of the Senate Mental Health and Developmental Disabilities Committee, Senator Shirley Huntley, and the Chair of the Assembly Mental Health Committee, Assemblyman Peter Rivera.
A detailed New York State Budget Briefing Book for FY 2009-2010, outlining The Coalition’s agenda in response to the current state fiscal environment was sent to every member of the legislature prior to our meetings. In meetings, Coalition staff and members proposed revenue raising options: 1) increasing the Personal Income Tax on high income earners, and 2) increasing the sales tax on alcoholic beverages (beer, wine and liquor) and reinvesting alcohol sales revenue in community-based OASAS prevention, treatment and recovery programs. The Coalition also voiced its opposition on cuts proposed to the following programs that serve New York State’s most vulnerable citizens: Supplemental Security Income (SSI), Continuing Day Treatment (CDT) programs, and Personal Needs Allowance (PNA) for OASAS recipients. In addition, we urged legislators not to defer the trend factor to Children’s Residential Treatment Facilities by one year. We also raised our concerns on policy decisions that affect professional licensing issues, clinic rate restructuring and the Sex Offender Management and Treatment Act (SOMTA). Finally, we urged legislators to ensure that any increase to the Federal Medical Assistance Percentage (FMAP) be used solely for Medicaid expenditures. For more information please consult our briefing book.
The Coalition urges all members to meet with legislators in district to explain the impact of proposed budget cuts and regulatory changes. It is very important that your State representatives know of the substantial impact to community programs and their constituents.
Yesterday, President Obama signed into law the American Recovery and Reinvestment Act (ARRA). In total, the bill provides $787 billion for tax relief, state and local fiscal relief, infrastructure, science, health care, education, training, energy and several other areas. Based on our preliminary analysis of the bill, New York State will receive $21 billion in Federal aid, of which $4 billion will be allocated to New York City. The Coalition and other stakeholders strongly advocated for the following:
The Obama Administration also unveiled a new website www.recovery.gov outlining the implementation of the stimulus plan. The Coalition is in close communication with the DC staff from Mayor Bloomberg and Governor Paterson’s offices to flesh out all of the details of the legislation.
A bill called the Fair Share Tax Reform Act of 2009 was introduced by Senator Eric T. Schneiderman who represents parts of the Upper Westside and the Bronx. If passed, this bill could increase New York State income tax revenues by $5 billion to $6 billion next year potentially offsetting the need for the State to cut social service programs including mental health and substance abuse. Currently, New Yorkers earning $40,000/year or $4 million a year pay the same rate of 6.85% of their income in State taxes. The Fair Share Tax Reform Act proposes a tax rate of 8.25% on those who earn $250,000 to $500,000 per year; 8.97% on those who earn $500,000 - $1M per year; and 10.3% for those who earn above $1M per year.
The Coalition supports a more progressive tax structure for New York State. We conveyed this position to our State legislators in Albany during our Advocacy Day events at the beginning of this month. We will keep you informed on the status of this and other income tax raising bills in the State legislature.
New York State Deficit Reduction Plan Restores a COLA but Cuts Health Care
On February 3, 2009, Governor Paterson, Assembly Speaker Sheldon and Majority Leader Smith announced an agreement to close the State’s 2008-09 budget deficit of $1.6 billion. The Coalition has analyzed the plan’s impact on behavioral health policy, noting that the reduction to the Human Services Cost of Living Adjustment (COLA) that was proposed in the Governor’s Executive 2009-10 Budget is now restored for fiscal year 2008-09 only. This restoration means that providers who contract with the Office of Mental Health (OMH) and the Office of Alcoholism and Substance Abuse Services (OASAS) (or other human service State agency) will receive a 3.2% COLA for fiscal year 2008-09. The deficit plan did not restore COLA funding in 2009-10 but we will keep you apprised of any changes as a result of continuing budget negotiations.
In addition, new legislative member items will be reduced by 20% of remaining unspent funds. This equals a total cut of $26 million in 2008-09 and $5 million in 2009-10 on appropriations that include funding for mental health and alcohol/substance abuse programs. Cuts on the health care side of the budget, reductions consisting of $359 million in 2008-09 and $386 million in 2009-10 were made as part of the deficit reduction act. A significant portion of health care savings will occur from new fees being levied on insurance companies and health maintenance organizations. Some of these fees are likely to be passed onto consumers.
The State’s budget deficit for 2009-10 now stands at $14 billion dollars. While the Governor, Assembly and Senate work out a plan to balance the 2009-10 budget, The Coalition will be aggressively advocating for the behavioral health sector and providing ongoing analysis on updates as they emerge.
Mayor Bloomberg Releases FY 2010 Preliminary Budget with Cuts to Providers
On January 30, 2009, Mayor Bloomberg released the City’s Fiscal Year 2010 Preliminary Budget. In the Department of Health and Mental Hygiene (DOHMH), the Mayor proposed cutting funds in two initiatives that affect community based behavioral health providers.
The budget for community-based mental hygiene programs will be cut by $1M in FY10 and $3M in FY11-13. According to DOHMH, savings will be realized from providers that are scheduled to close, are underperforming or have access to funding through other revenue sources. Currently, we do not know which programs will be affected but will maintain close communication with DOHMH to learn more. The Department also performed a re-estimate the cost of New York/New York III supportive housing development, reducing the budget by $4.5M in FY10 and $2.5M in FY11-13. According to DOHMH, New York/New York III congregate unit development has been delayed due to longer lead times and complexities in construction. We are being told by City officials that funding will be restored if new unit development accelerates to earlier projections.
The Mayor’s Preliminary Budget also proposed adding funding to support the implementation of recommendations made by the joint City and State Mental Health Criminal Justice Panel, which examined highly publicized violent incidents involving individuals with mental illness. The initiative will pay for case management teams to monitor the care of individuals with high needs and help improve treatment and service provision. Funding will be allocated as follows: $0.5M in FY09, $1.9M in FY10, $3.1M in FY11, $1.6M in FY12 and $1.7M in FY13. As next year’s budget is negotiated with City Council and economic forecasts shift, The Coalition will keep you informed of other changes.
The Coalition is pleased that The Children's Health Insurance Program (CHIP) Reauthorization Act was signed into law by President Obama on February 4, 2009. The CHIP Act will provide $32.5 billion in new spending over five years, financed primarily by a 61 cent increase in the Federal cigarette tax. The reauthorization maintains coverage for nearly 7 million children currently enrolled in CHIP and extends coverage to an additional 3.2 million uninsured children.
This legislation requires states offering mental health services under CHIP to offer parity between mental health services and medical and surgical benefits thereby increasing access to behavioral health services. CHIP will eliminate higher co-pays and stricter limits on the number of treatment visits for mental health. The plan also eliminates the five-year waiting period on eligibility for legal immigrant children and pregnant women.
In addition, President Obama rescinded a letter issued Centers for Medicare and Medicaid Services (CMS) on August 17, 2008, which limited the State's flexibility on setting CHIP program income eligibility standards, and imposed additional requirements for covering children (including plans that CMS had previous approved). The President’s memorandum was published and authorized in the Federal Register on February 6, 2008.
Benefits Training at The Center
Title: Introduction to Benefits Management
The Coalition’s Center for Rehabilitation and Recovery presents a FREE half-day training offered in various locations across the city designed to help clinicians and other staff interested in learning the nuts and bolts of benefits management. The latest changes in SSA guidelines will also be discussed. Participants will have the opportunity to: 1) Understand the fundamentals of the Social Security System 2) Comprehend the difference between SSI, SSDI, Medicaid & Medicare 3) Gain knowledge of resources that support consumers in their living & working goals 4) Learn how to help consumers effectively use benefits to support their recovery.
Register now » for ONE of the benefits trainings below:
You may also register for this training at The Center’s web page: www.coalitionny.org/the_center/training.
Effective Wednesday, March 25, 2009, the Department of Health will begin denying claims that do not include the Billing or Pay-to (Group) NPI. This requirement will impact all providers who are currently seeing Edits 2020 (Missing Billing Provider NPI) or 2021 (Missing Pay-to i.e. Group) on their electronic supplemental remittances or on their paper remittances. Letters will be mailed to affected providers informing them of the compliance date and steps they need to take to avoid denial of their claims.
Donna Colonna, CEO of Services for the Underserved (SUS), and a Coalition member, was 1 of 5 women in the non-profit industry recognized by the National Association for Women Business Owners (NAWBO) for operating their organizations in a fiscally responsible and successful manner. We congratulate Donna on her achievement.
Doris Hohman, Director of the WeCARE program at Brooklyn Bureau of Community Service, and a Coalition member, participated in a Q&A with the New York Times on healthcare for the ill and uninsured. It is published online at www.nytimes.com/neediest. Doris offers an expert opinion on how illness and disability can cause disruptions in life, depicting what it is like to be on SSI, public assistance as well as the difficulties with maintaining employment and benefits simultaneously.
Rima Cohen, former Director of Health and Social Services for New York City Deputy Mayor Linda Gibbs, will now be serving as a Senior Advisor for Health Reform in the Federal Department of Health and Human Services. According to Phillip A. Saperia, The Coalition’s Executive Director, “It’s a big loss for the Mayor and New York City. It’s a big credit to Obama and the administration! She was wonderful to work with. Very smart, organized, reliable and personable.”
The Coalition mourns the passing of Miriam “Mimi” Kravits a passionate leader of the consumer movement. Mimi founded one of the nation’s first consumer run agencies to help people with mental disabilities start their own businesses. This was a bold move during a time when employment altogether was being discouraged. Her tenacity and vision will be missed.
SPOP Wins Award for Excellence & Innovation in Geriatric Mental Health Services
The Coalition congratulates Service Program for Older People, Inc. (SPOP) for being named the first recipient of The Geriatric Mental Health Foundation (GMHF) and the American Association for Geriatric Psychiatry (AAGP) Deirdre Johnston Award for Excellence and Innovation in Geriatric Mental Health Outreach Services. SPOP is a Coalition member and leader in providing services to older adults at senior sites in New York City and in the homes of consumers. SPOP earned the award for its provision of mental health services to homebound older adults in Manhattan. SPOP serves 1,000 individuals each year, the majority of which live with depression and anxiety.
The Coalition drafted a letter to the Daily News last month on the newspaper’s editorial policy that promotes and perpetuates the stigma against people with mental illness by referring to these individuals as “wacko” and “crazy.” We noted that people with mental illness are more likely to be victims of crime than perpetrators and the report issued by the City and State’s joint panel Mental Health and Criminal Justice. The complete letter can be accessed here.
The Coalition's Professional Learning Center will be hosting two presentations, lead by Dr. Petros Levounis, Director of the Addiction Institute of New York, to educate staff from chemical dependency and mental health programs on the principles of psychopharmacology as applied to consumers who suffer from mental illness and substance abuse disorders.
The first session, scheduled for Tuesday, February 24, 2009 is directed to clinicians from chemical dependency programs. They will learn about the principles of psychopharmacology for consumers who suffer from mental illness. Dr. Levounis will discuss advances in the pharmacological management of psychiatric disorders (including schizophrenia, bipolar disorder, depression, anxiety, PTSD, and insomnia) for the addicted consumer who also suffers from co-occurring mental illness.
The second session, scheduled for Tuesday, March 3, 2009 is for clinicians from mental health programs who will learn about the principles of psychopharmacology for consumers who suffer from substance abuse disorders. Dr. Levounis will review medications that target directly the addictive process (including dependence on alcohol, cocaine, nicotine, heroin, and prescription opioids) with emphasis on newer agents that have been recently approved by the FDA. Seats are still available for both sessions. Go to our website for more information and registration »
Our great friend Petros Levounis, will also be the keynote speaker at the fourth annual addictions conference. The topic of the March 6th conference is Treating Lesbian, Gay, Bisexual and Transgender People. For information call 212-523-8375 or go to http://www.addictioninstituteny.org.
With a $14 billion budget deficit, the New York State Senate Majority has launched a website that is asking for feedback from state residents on how to close the states budget gap. Please visit www.nybudgetideas.org and let them know how you would balance the state budget. How would you increase revenues (income tax on high earners or tax on alcohol)? What areas of the budget would you trim down?
Adopts Regulation to Extend Age of Eligibility for Children’s Day Treatment
In the February 11, 2008 edition of the NYS Register the Office of Mental Health posted a notice of adoption to increase the age of individuals receiving services in day treatment programs for children. A day treatment program may now continue to serve individuals over the age of 18, but under the age of 22, if it prevents a disruption in the provision of educational services necessary to complete the educational plan.
Receives Waiver Authority - (Correction to January 22, 2009 Publication)
In The Coalition’s last edition of Briefs we reported that The Commissioner of the State Office of Mental Health (OMH) was granted waiver authority under certain circumstances. OMH has informed The Coalition that the waiver is to be granted upon individual requests and not by OMH officials as stated. Waiver authority will be decided on a case-by-case basis and will not be universally applied.
The State Board Training Consortium is offering two board member trainings at various locations around the state. These trainings are for board members of nonprofit organizations funded, licensed or authorized by DOH, OASAS, OMH, OCFS, and OMRDD. The trainings have been reviewed by staff from the NYS Office of the Medicaid Inspector General (OMIG). The Manhattan schedule is as follows:
Nonprofit Board Governance of Medicaid-Supported Programs
New IRS Form 990: A Focus on Board Governance
Coalition Members advertise staff positions for free on The Coalition’s Job Board! Here's a sample: