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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 2, 2009

State Leaders Hold Budget Meeting: Midyear Cuts Expected

On September 23, 2009, state leaders gathered to discuss New York State’s growing fiscal crisis. The meeting was attended by Governor David Paterson, Lieutenant Governor Richard Ravitch, Senate Conference Leader John Sampson, Speaker Sheldon Silver, Senator Minority Leader Dean Skelos and Assembly Minority Leader Brian Kolb. By all accounts, we have reason to believe that there will be midyear agency budget cuts by as much as 5% or 6%.

All of the leaders were in agreement about not raising new taxes or fees to offset the State’s current year budget deficit of $2.1 billion (which is predicted to increase to $3 billion). In addition, they estimate that next year’s budget (State fiscal year 2010-2011) has a gap of $4.6 billion, and a $32 billion deficit over the next four years. Some advocates believe there are other alternatives to consider before cutting the budget, such as tapping into the State’s $1.3 billion rainy day fund.

Staff of the players listed above will work on options to address the budget emergency, and then coordinate with Lt. Governor Ravitch, who will oversee the consultation process. After an agreement is reached, Governor Paterson will call for a special legislative session.

As more details and options for dealing with the State’s budget deficit become known, The Coalition will weigh in at upcoming public hearings and meetings with State officials. Stay tuned.

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National Health Care Reform and its Impacts on New York State

Last month, it was reported by Crain’s New York that the number of people living without health insurance in New York State rose by 2% in 2008, meaning that nearly 3 million or 14% of New Yorkers had no health insurance coverage at some point last year. So how will New York State fare in covering its uninsured population under national health care reform? It all depends on which bill emerges from Congress.

As the Senate Finance Committee continues to deliberate the Chairman’s Mark of “America’s Health Futures Act of 2009” proposed by Senator Max Baucus, we thought you might be interested to compare this bill against the House of Representatives’ tri-committee bill: “America’s Affordable Health Choices Act of 2009,” that is expected to be reconciled this week. Much of the details in the chart below were discussed at the last meeting of the NYS Health Care Reform Stakeholders Meeting in Albany, New York on September 29, 2009, which was attended by Coalition staff.

Question

House Tri-Committee

Senate Finance

Will states be treated equally?

Federal Medicaid funding will be increased regardless of existing state eligibility requirements

Higher premium subsidies will be paid to states with high insurance costs like New York

Enhanced Federal funding is only available for states that have not previously expanded coverage, New York has already done so

Premium subsidies are not sufficient to address affordability in high cost states like New York

States like New York, which already prohibit denial of coverage based on preexisting condition will not be able to access a high risk pool of $5 billion

Will reform be affordable to all states?

By 2014, New York State would save $2 billion a year according to preliminary estimates

By 2014, New York State would bear a minimum cost of $900 million a year according to preliminary estimates

Will Federal funding be available to support expansion of state Medicaid programs?

Federal money is available for increased state costs associated with Medicaid expansion and rate enhancements

Federal money is not available for increased costs associated with currently eligible Medicaid recipients

Will reform be affordable for consumers and preserve state insurance laws?

States will be allowed to operate their own health insurance exchanges

Federal standards will establish a consumer protection floor, but states can provide greater safeguards if they choose so

Offers a public health insurance option to compete with private insurance companies

 

Allows for national products and interstate sale of insurance; consumers could lose New York State insurance protections

Does not offer a public health insurance option, will instead allow nonprofit member insurance co-ops

Will mental health & substance abuse services be covered at parity?

Mental health & substance abuse services must be at parity for all plans

Covers rehabilitation & habilitation services

Ensures parity for mental health & substance abuse in state health exchanges

Senate Finance Considers Amendments

The Senate Finance committee will consider amendments to the Baucus bill this week, which could cure some of the inequities described in the chart. Senator Charles E. Schumer and John D. Rockefeller IV introduced their own amendments to add a public health insurance option to the bill, but the committee voted down both proposals. Senator Debbie A. Stebanow has had more success. She has added amendments 1) to insure that the Federal Wellstone/Domenici mental health and addiction parity requirement applies to state exchanges, 2) to clarify that Medicaid eligible individuals with SPMI can receive integrated care via the new State Medicaid option promoting health care homes and integrated care, and to 3) define therapeutic foster care. The Coalition applauds Senator Stebanow’s efforts.

Then Congress Reconciles Competing Bills

Once a bill is passed by the Senate Finance committee, it will then need to be reconciled with the Senate Health, Education, Labor & Pensions (HELP) committee’s bill, which does offer a public option. The House and Senate will then need to reconcile their final bills before Federal health care reform can be passed by Congress and signed by President Obama. In the meantime, The Coalition is actively participating in meetings and conversations with our State and Federal representatives, and will keep you informed as circumstances change in Congress.

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Coalition Calls on NYS to Accept Federal Court’s Decision on Adult Homes

Last month, Judge Nicolas Garaufis of Federal District Court in Brooklyn issued a landmark ruling in which New York State was in violation of the American’s with Disabilities Act (ADA) for failing to house 4,300 individuals in the most integrated setting appropriate to their needs, and instead placing them in adult homes.

The Coalition has written a letter to Governor David Paterson, explaining how we understand that by following the court’s decision New York State will have to take on an expensive and complicated remedial plan, during difficult financial times, to find appropriate housing options in the community. But besides there being a moral argument for helping people with disabilities to live independently in the community with appropriate supports, we believe that in the long run, supported housing is less expensive to implement than keeping people with mental disabilities in adult homes.

The Coalition applauds our legislative leaders, Peter M. Rivera, Chairman of the NYS Assembly Mental Health Committee and Shirley L. Huntley, Chairwoman of the NYS Senate Mental Health Committee, for championing this cause in an editorial in the Buffalo News.

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Center Takes Active Role in “NewYorkMakesWorkPay” Initiative

The Coalition’s Center for Rehabilitation and Recovery is now part of a New York City-wide effort to enroll hard working consumers into the Medicaid Buy-In for Working People with Disabilities, as a part of the “NewYorkMakesWorkPay” initiative. This program is best suited for adults who already receive SSDI or who are working and never received benefits before.

Many consumers worry that by working or returning to work they could lose their health benefits. Most agree that learning the disability benefits system and maintaining health care coverage is a complex task that often leaves people uncertain on how to proceed. There is much misinformation that once someone is employed they are no longer eligible for Medicaid. This is not always true.

Coalition staffers, Pat Feinberg and Margie Staker are available to come to your agency and meet with consumers and providers to see who might be eligible and assist with any barriers that people may be facing in the application process. If interested, please contact them at: 212-742-1600 x 236 and x 237, and/or pfeinberg@coalitionny.org or mstaker@coalitionny.org.

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IMA Demonstration of Practice Management and EMR Solutions

The Coalition will host a demonstration of IMA’s newest version of its behavioral health software application. This year, a major focus of the presentation will be on understanding and addressing the significant changes that are occurring around us. OMH is implementing clinic restructuring and APG billing, Federal Stimulus Funds loom on the immediate horizon and OMIG audits are always around the corner. You are invited to participate in an interactive demonstration of the IMA Desktop on October 21, 2009 from 10am- Noon. Registration is required.

The IMA Application is designed for the management of behavioral healthcare organizations. It includes:

  • Practice Management - Registration, Scheduling, Client and Staff ID scanning, attendance and productivity reporting.
  • EMR (Electronic Medical Record) - online clinical documents, electronic signatures, and reference libraries.
  • Finance - Electronic billing, remittance, Managed Care authorizations, and full financial reporting

IMA is made exclusively to the unique requirements of NY State programs regulated by OMH, OASAS, and OMRDD. Its software may be used in programs like Article 31 clinics, Continuing Day Treatment Programs, Case Management, Residential Restorative Services, and PROS.

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Around the Water Cooler

  • F.E.G.S., a Coalition member, celebrated its 75th anniversary on September 17, 2009, and was also named by AARP as one of the best places to work. The Coalition congratulates them on both achievements.
  • The Coalition also congratulates Services for the Underserved (SUS), a member who was awarded two grants from SAMHSA to enhance their Wellness Works program. SUS will receive $2M to fund permanent supportive housing programs for people living with mental illness who are in recovery, and $1.75M to fund transitional housing programs for people living with AIDS.
  • The Coalition wishes the best of luck to Trix Niernberger, Executive Director of National Alliance on Mental Illness-New York State (NAMI-NYS), who will be leaving NAMI-NYS later in the month to pursue new opportunities.  
  • Dr. Lloyd I. Sederer and Eric Goplerud suggest paying for health reform with a tax on alcoholic beverages, in their column in the Washington Post.
  • On September 23, 2009, the State Court of appeals affirmed the appointment of Richard Ravitch as New York States Lieutenant Governor. He is already involved in coordinating State leaders in addressing the State’s fiscal crisis.

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Benefits Training at The Center  

Title:                Introduction to Benefits Management
Date:                Four dates to choose from below!
Time:               1:30pm - 4:30pm
Facilitators:      Margie Staker and Patricia Feinberg, MS

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. Participants will have the opportunity to: 1) Understand the fundamentals of the Social Security System 2) Comprehend the difference between SSI, SSDI, Medicaid and Medicare 3) Gain knowledge of resources that support consumers in their living and working goals 4) Learn how to help consumers effectively use benefits to support their recovery.

Register now » for ONE of the benefits trainings below:

  • Wednesday, October 7th – The Coalition of Behavioral Health Agencies, 1:30 – 4:30pm
  • Wednesday, October 14th – Transitional Services for New York, Inc.,1:30 – 4:30pm
  • Thursday, October 22nd – Odyssey House, 1:30 – 4:30pm
  • Wednesday, October 28th – Postgraduate Center for Mental Health, 1:30 – 4:30pm   

You may also register for this training at The Center’s web page: www.coalitionny.org/the_center/training.

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Coalition’s Government Relations Committee Reconvenes with New Changes Ahead

On September 15, 2009, The Coalition’s Government Relations Committee gathered for its first meeting of the fall advocacy season. Members took part in a lively discussion on future advocacy on the State budget and recent policy changes that will impact the community-based behavioral health sector, such as 1) the impacts of re-sentencing under Rockefeller Drug Law reforms, 2) developing a remedial plan to comply with the Federal Court’s decision on adult homes and 3) OMH clinic reform.

For quite sometime, our Government Relations Committee has been chaired by Jean Newburg of Weston United and Robert Tobing of University Settlement. As of October 1, 2009, Mr. Tobing has stepped down as Assistant Executive Director of Programs, and leave University Settlement after 12 years of dedicated service. When asked about his tenure, Mr. Tobing said, “I am impressed with how the committee takes the lead, or follows the lead that the Board has set, but has charted an active and progressive agenda. The great turnout at committee meetings shows that the membership recognizes how valuable it is, and staff has spearheaded it as well.” We wish Bob our best, and hope to be working with him again in the future.

Coalition President, Dr. Jonas Waizer of F.E.G.S. has appointed Dr. Amy Kohn of Mental Health Association of Westchester to co-chair the Government Relations Committee going forward. We will be alternating our meeting sites between uptown and downtown locations to make meetings more accessible to members.

We encourage our members to attend Government Relations Committee meetings, which convenes on the third Tuesday of every month. Our next meeting is on October 20, 2009. For more information, please contact Jason Lippman, Senior Associate for Policy and Advocacy at jlippman@coalitionny.org.

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DOHMH to Hold PROS Consumer Educational Forum

The NYC Department of Health and Mental Hygiene (DOHMH) will convene a consumer educational forum on the NYS Personalized Recovery Oriented Services (PROS) program. The forum will cover 1) the services offered by a PROS program, 2) the individual recovery plan, 3) the current status of PROS in New York City, and 4) the affect PROS will have on the services you currently receive. Consumers and recipients of mental health services are encouraged to attend this event on October 26, 2009 from 3:00-5:00 at Brooklyn Borough Hall at 209 Joralemon Street, Brooklyn, NY 11217. No registration is required and refreshments will be served. For more information call the DOHMH Office of Consumer Affairs at 212-219-5393.

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DOB Calls on State Agencies to Cut Expenses

On September 22, 2009, the NYS Division of Budget (DOB) issued its annual call letter to NYS Agency Commissioners, announcing that there will be midyear cuts to address the State’s current deficit of $2.1 billion. The call letter provided guidelines for 2010-11 budget requests that limit State agency spending to no greater than the prior year level. It asked Commissioners to identify opportunities to aggressively reduce non-personal expenditures (contractors, travel, postage and activities outside of the agency’s core mission) and immediately begin implementing them. Agencies are required to submit budget requests by October 16, 2009.

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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
5552 Vocational Rehabilitation Specialist
5555 Employment Specialist - Part Time (21 hrs/wk)
5556 Job Placement Specialist
5557

Program Director, Manhattan Scatted Site Apt Prog

5561 CASAC
5565 Director, Quality Assurance and Improvement for Financial Audits

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