An Evolving Semi-Monthly Update on Community Mental Health in New York
March 17, 2009
New York City to Receive $1.9 Billion from FMAP Increase in Stimulus Plan
As part of the American Reinvestment and Recovery Act (ARRA) or economic stimulus plan, an estimated $2.7 billion will be passed through to New York State’s county governments and the City of New York from an increase in Federal Medical Assistance Percentages (FMAP) reimbursements for Medicaid. Of this amount, an estimated $1.9 billion will be made available to the City of New York, according to Governor Paterson’s analysis. City officials, including Mayor Bloomberg believe that New York City is entitled to $2.1 billion, and have been advocating with the State to pass down the additional money. We will keep you updated on what happens.
The Coalition has been insisting that a portion of the increase in FMAP funding be designated for the community behavioral health sector, as well as other health care services. This funding is desperately needed by community based providers and would support the Governor’s focus on increasing access to community-based services. Governor Paterson has unveiled a new website New York’s Guide to the 2009 American Recovery and Reinvestment Act outlining how New York State will spend Federal stimulus money. The site also provides resources for governments, organization and other entities to access.
On March 10, 2009, the Office of Mental Health (OMH) issued an implementation paper on mental health clinic restructuring. The Coalition has been actively involved in OMH’s advisory workgroup on restructuring the way the State delivers and reimburses publicly supported mental health services. We are concerned that with the simultaneous phase out of rate add-ons like Comprehensive Outpatient Programs (COPS), a fundamentally transformed Article 31 clinic system will be set up, with depleted and inadequate resources, having profound effects on the financial viability, quality and access of care in the community mental health sector.
Clinic reform must be predicated upon a new reimbursement methodology that provides a sustainable base rate and finances the cost of high intensive services for children, geriatrics, court mandated clients and treatment for co-occurring disorders. An inadequate plan to phase out COPS coupled with an inadequate rate design could potentially force large numbers of providers to reduce staffing and services levels, or even close down. During our advocacy days in Albany last month, we informed legislators how working and middle class access to the public mental health system is in jeopardy across communities. We are concerned that providers without adequate rate reimbursements will not be able to treat all consumers, beginning with those who pay on a sliding scale. Many agencies have already begun denying services to consumers enrolled in commercial insurance and managed care companies due to substandard and low priced rates. Consumers with severe and persistent mental illness will be at risk of being screened out of private and public practices.
The Coalition will continue to work with OMH to ascertain a cost analysis and rate models which will reimburse clinic services adequately. We will keep you updated on further developments that arise from the advisory workgroup.
In the absence of necessary programmatic alternatives for high needs consumers in New York City and Westchester, The Coalition is seeking restoration of SOMH sponsored cuts in the Governor’s budget to adult Continuing Day Treatment (CDT) programs in the amount of $2 million in State funds. On March 9, Coalition leaders and staff joined UJA Federation of New York in a day of Albany visits to legislators to advocate for restoration of the cuts to the CDT programs. While the total cut to CDT programs amounts to $4 million ($2 million State funding plus a Federal match) in FY 2009-10, resulting closures and mergers will cost New York State many multiples of this amount in more expensive emergency and inpatient hospitalization services for high-risk consumers who will no longer be able to be served by the CDT system, if the Governor’s proposal goes through. A companion advocacy effort by member agencies, their consumers, board members and staff is also underway. We hope to gain traction in this effort as the budget gets closer to agreement and enactment.
The Coalition Hires Government Relations Consultant for Social Work & Mental Health Licensing Issues
The Coalition has hired Jim Lytle of Manatt, Phelps and Phillips, LLP to represent us on addressing the systemic implications to public practice agencies of the Social Work and Mental Health Licensing Law of 2004. If the exemption in the law for public sector social workers and mental health professionals is allowed to sunset in 2010, as the law is currently written, regulations that govern practicing and billing will seriously obstruct practice and operations of the public sector behavioral health system. These professionals will no longer be able to bill Medicaid without LCSW supervision, and students will only be eligible to receive clinic experience towards an LCSW in Article 31 OMH licensed treatment programs. As a result, providers will experience workforce problems, especially in rehabilitation and other non-treatment programs. Moreover, treatment programs are likely to experience serious shortages in professional staff and be limited in their ability to provide requisite supervision for new license applicants. Such a state of affairs will threaten an agency’s ability to bill for services, and hence their very survival will be at stake.
The Coalition strongly supports extending the exemption until December 31, 2013, as proposed by Governor Paterson in the State’s Executive 2009-10 Budget. We also feel that State Education Department (SED) regulations need to be reformed to meet the needs of the public behavioral health sector. In addition, The Coalition is urging SED to reopen its grandparent provision for originally qualified applicants and supports Senate 2848 as submitted by Senator Diane J. Savino (D-Brooklyn and Staten Island).
We have signed onto a letter drafted by “The Coalition to End the Two-Year Wait for Medicare” that was sent to Senator Jeff Bingaman and Congressman Gene Green to enthusiastically support legislation to eliminate the unjustifiable delay in coverage for people with severe disabilities. The waiting period forces people with severe disabilities to endure two years, during which treatment and care of their condition are put at risk. To read the complete letter, click here.
Analysis of Rockefeller Drug Law Reform: Is a Deal Emerging?
Earlier this month, the State Assembly and Senate took steps to reform the Rockefeller Drug Laws. The Assembly bill, which was also approved by the Senate, eliminates mandatory sentencing in many low-level drug crimes, giving discretion to judges on whether offenders should be sent to drug treatment programs rather than prison. The bill would also allow 2,000 prisoners to ask for reduced sentences.
Governor Paterson will be proposing a similar bill which would also eliminate mandatory prison sentences for first time nonviolent drug offenders, and allow judges discretion on placing offenders in drug treatment programs, but would keep mandatory sentencing (with reduced prison times) for repeat offenders. According to the governor’s office, about 1,200 people each year would be diverted to treatment rather than prison if the bill is passed as is.
Paterson’s bill also differs from the Legislature’s in that it does not mandate treatment for drug offenders that are already in prison or upon release. It also would require new offenders to enter a guilty plea before they would be able to enter a drug rehab program. The Governor’s bill proposes spending $50 million to finance the treatment programs and drug courts. We will keep you updated as the Legislature and Governor work through the differences in the two proposals.
On March 20, 2009, Mary Thornton, of Mary Thornton and Associates, Inc., will lead two identical workshops exploring key criteria for determining compliance. She will discuss the critical nature of communication with payers and each other around compliance issues. Attendees will learn about federally sponsored fraud, abuse and waste investigations and the potential risks for behavioral healthcare providers. Ms. Thornton will also talk about NY State’s OMIG compliance regulations and review the OIG publication on Boards of Directors and Quality of Care.
Title: Comprehensive Benefits Training
This three day intensive training is designed for direct service staff whose positions require expertise in benefits counseling. Participants will learn how to utilize the Social Security Administration’s work incentive provisions to help consumers achieve their employment goals. Our expert trainer will discuss how recent legislative changes may affect consumers. Attendees will have an opportunity to apply newly acquired systems knowledge through in-depth case studies.
Center Seeks Resources for Peer Specialist Conference
As co-sponsors of the Peer Specialist Conference, the Center for Rehabilitation and Recovery is currently seeking resources for the Third Annual Conference entitled Peer Specialists in New York City: A Change We Can Believe In, which is scheduled to be held at New York University on June 22, 2009, 8:30am-4:30pm. This conference provides an opportunity for working peers to enhance their knowledge and skills, advance their careers and create greater balance and harmony in their lives and in the lives of the people they serve. The Planning Committee is inviting you to submit requests to showcase material and resources that enhance the lives of working peers. We are interested in resources ranging from program brochures to educational publications. A wide array of submissions will be considered.
Deadline to submit is March 27, 2009.
You may send your submissions via mail, fax or email to:
New York State Office of Mental Health
Around the Water Cooler
The Coalition congratulates Carmen Callado, LCSW, Director of Public Policy and Legislative Affairs, and Director of Immigrant Services and Latino/Hispanic Services at the Jewish Board of Family and Children’s Services (JBFCS), a Coalition member, on becoming President-elect of Hispanic Mental Health Professionals.
We mourn the recent passing of Rick Sostchen, Executive Director of Baltic Street AEH, Inc. Rick was a leader of New York City’s peer provider community and started Baltic Street, peer run group of programs.
The National Alliance on Mental Illness (NAMI) has released a new report, Grading the States 2009, assessing the nation's public mental health care system for adults. The report finds that while the national average grade is a “D.,” New York State received a “B.”
The Mary K. Selig Educational Institute at JBFCS presents a workshop: Through the Eyes of the Baby: The Importance of Attachment in Young Children’s Lives and the Impact of Separation and Loss, on March 20, 2009 from 9:30 – 4:30 at the Jewish Board of Family and Children’s Services at 120 W 57th Street, New York, NY. This workshop will focus on the early relationship development and, in particular, on how relationships can be derailed and/or supported among infants and toddlers in the child welfare system. Presenters will discuss the latest research on attachment/separation among infants and toddlers in the child welfare system and strategies for promoting smooth transitions from one caregiver to another. Presenters are Bruce Grellong, PhD and Dorothy Henderson, LCSW.
The Coalition is hosting its fourth annual training series geared to helping agency staff transition to top tier positions as current executive and managers retire from the field. The series consists of seven workshops. The first two sessions are:
March 18, 2009, 9am – Noon: Managing Difficult Employees / Mediating and Resolving Conflicts
April 15, 2009, 9am - 12 Noon: Developing and Managing Operating Budgets
Go to our website: http://www.coalitionny.org/prof_learn_ctr/training/#1077 for more information on these and the remaining workshops.
The Coalition has learned that at the end of June, the City plans on closing John Heuss House, a 24-hour drop-in center in Lower Manhattan that provides meals, showers, clothing and counseling for 150 individuals a day who are homeless. John Heuss serves consumers who are chronically homeless with behavioral health problems. The City provides most of the $2.5 million in funding to operate the drop-in centers and owns the space at 42 Beaver Street where Trinity Church runs John Heuss House. The center has been operating for twenty years, and is a Coalition member.
We are sorry to see John Heuss House close. The Coalition will be examining the City’s policies on drop-in centers to determine whether the City will be looking into new locations in Lower Manhattan for drop-in centers, or whether this is part of a larger initiative to phase them out. For more details on this story, including reactions by individual consumers, please the following articles from Downtown Express: http://www.downtownexpress.com/de_303/cityleavinghomeless.html and http://www.downtownexpress.com/de_307/willheuss.html.
Title: Building Recovery Based Programs
Community mental health agencies need effective leadership more than ever. Currently, agencies are being impacted by budget cuts, strong regulatory pressures, and greater demands for implementing recovery-focused services. Meeting these challenges will require smart, principled leadership. To help develop such leadership, the Center is presenting a series of highly dynamic leadership trainings. These trainings are designed for directors and managers who want to learn how to successfully build and sustain recovery-based programs. Participants will gain leadership skills that inspire creativity, collaboration and commitment. These skills will prepare them to lead organizational change efforts that enhance recovery practices and produce better outcomes for consumers.
NOTE: You are strongly encouraged to register for all three modules to derive full benefit from these trainings; however, you may opt to register for only one or two trainings if you prefer.
1) Leadership Development — Thursday, March 12th, 2009 / 2:00pm – 5:00pm
The NY State Office of Medicaid Inspector General released a new provider Self-Disclosure Guidance and disclosure form. This new guidance replaces the existing DOH disclosure protocol. The OMIG has developed this guidance “to encourage, and offer incentives for providers to investigate and report matters that involve possible fraud, waste, abuse or inappropriate payment of funds – whether intentional or unintentional – under the state’s Medicaid program.”
A few of the “incentives” the OMIG lists are:
Read the guidance document for all the details. The guidance and disclosure form can be found on the NYS OMIG website http://www.omig.state.ny.us/data/content/blogsection/25/162/.
The latest data that NYS DOH has available indicates that they are still receiving a significant number of claims that do not include an appropriate NPI. Please be sure to be to include the Billing Provider NPI on all your 837I claims. If you use a service bureau, check with them to ensure you are ready. If you are still experiencing difficulties please contact the eMedNY Call Center at 1-800-343-9000. Representatives will direct your issue to the appropriate technical staff for a quick response.
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
New York State will be one of eight states to receive funding from the Robert Wood Johnson Foundation (RWJF) to collect data on enrollment and retention of uninsured children in federal coverage programs. The grant aims to use data to expand access to Medicaid and the State Children’s Health Insurance Program (SCHIP) to eligible uninsured children and to assess its effectiveness. According to an RWJF press release, there are 9 million uninsured children in the United States, of whom 7 million are eligible for federal aid programs. Besides identifying eligible children, the initiative will work towards testing and improving enrollment strategies, easing program application processes, measuring retention systems, educating families on coverage programs and evaluating efficiency of the federally funded health care program. The National Academy for State Health Policy will oversee the grant program.
Coalition Members advertise staff positions for free on The Coalition’s Job Board! Here's a sample: