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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
November 6, 2009

Local Election Results 2009

On November 3, 2009, New Yorkers went to the polls for Election Day 2009.The Coalition has compiled local results, and they are as follows.

In Citywide races, Michael R. Bloomberg won a third term as Mayor over William C. Thompson Jr., by a surprisingly low 5% margin of victory. The voters also decisively elected Bill de Blasio as the City’s new Public Advocate, and John Liu as Comptroller. In Manhattan, Cyrus Vance Jr. will now officially become the borough’s first new District Attorney in almost five decades. In the races for Borough Presidents, all five incumbents will retain their positions. Here are the Presidents listed by borough: Bronx – Ruben Diaz, Jr.; Brooklyn – Marty Markowitz; Manhattan – Scott Stringer; Queens – Helen Marshall; and Staten Island – James Molinaro.

In City Council races, Christine Quinn, the current Speaker of the Council, was reelected by a large majority. All five members of the Committee on Mental Health, Mental Retardation, Alcoholism, Drug Abuse and Disability Services will retain their City Council seats. The Committee is currently chaired by G. Oliver Koppell (Bronx), and also made up of the following members: Gale Brewer (Manhattan), Simcha Felder (Brooklyn), James Gennaro (Queens) and Annabel Palma (Bronx). For the results of all City Council district races, please follow this link: http://elections.nytimes.com/2009/results/city-council.html. The Coalition congratulates all of the candidates who won victories yesterday. We encourage members to reach out to the Council Members in their districts to congratulate them as well.

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State Fiscal Crisis Deepens: $10B Deficit Projected Over Next 2 Years

Governor Paterson announced on October 30, 2009, that New York State must address a deficit of $3.2 billion in the current fiscal year and $6.8 billion in 2010-11. According to NYS Division of Budget’s mid-year report, State revenues continue to decline, mainly from reductions in personal income tax collections. The total deficit is now estimated to be at $10 billion for the current and next fiscal years.

This announcement comes just weeks after the Governor proposed a two-year deficit reduction plan. The DRP would now only cover half of the State’s budget deficit. The DRP makes up for $3 billion of the State’s current fiscal year deficit. It includes $1.3 billion in cuts to local assistance spending, $1.2 billion in one-time revenue items, and $500 million in State agency administrative expenses. The remaining $2 billion would impact the FY2010-11 deficit. Changes made to local assistance funds and revenue items require approval by the Legislature, which will convene in a special session on November 10, 2009.

The Coalition is greatly concerned about cutting aid to localities during this recession. Local assistance funding pays for the provision of human services, including programs in the Office of Mental Health (OMH) and Office of Alcoholism and Substance Abuse Services (OASAS). Such services are in greater demand during a recession. In the Governor’s proposal, the State share to Medicaid programs would be cut by $287 million. However, this action would amount to a total cut of $747 million, as New York would lose the Federal share of Medicaid, which is now up to 62% since the increase to FMAP under the Federal stimulus plan.

The Coalition will join advocates who are proposing new ideas for the State to consider instead of cutting human services. Some of the proposals being suggested are increasing the tax on alcoholic beverages, allowing the State Department of Health (DOH) to negotiate the bulk purchase of pharmaceuticals or tapping the State’s rainy day fund. We will also continue to track and respond to future budgetary decisions made by the Governor, and the Legislature in next week’s special session.

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Speaker Pelosi Releases House Leadership Bill on Health Care Reform

With the House of Representatives scheduled to debate the Affordable Health Care for America Act, H.R. 3962 on the floor this week, and the Senate finishing up its own version, passage of a national health care reform bill is moving into the final stages of legislation. On October 29, 2009, Speaker of the House Nancy Pelosi (D-CA) released the House’s version of health care reform, and Senate Majority Leader Harry Reid (D-NV) is expected to do so in the coming weeks.

Among the reforms in the House bill are requirements on behavioral health services, which include:

  • Coverage for mental health and substance abuse disorders in all health plans participating in the health insurance exchange, these services must also comply with the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act (HR 6983).
  • Definition of criteria to certify Federally Qualified Behavioral Health Centers (FQHBC). The Coalition joined the National Council for Community Behavioral Healthcare in supporting an FQHBC amendment during the early phases of debate. We thank Congressman Elliot Engel (D-NY) for his leadership on the FQHBC proposal.
  • Clarification of Medicaid coverage for therapeutic foster care services (TFC). The Coalition recently signed onto a letter in support of covering TFC services in the health care reform bill, and applauds the House leadership for including these terms in their final bill.
  • Expansion of eligibility for public mental health and substance abuse providers to participate in the Medicaid 340B drug discount program.
  • Create a long-term care insurance program called the Community Living Assistance Services and Support (CLASS) program. This will help individuals with psychiatric disabilities receive care and still be eligible for Medicaid coverage.
  • Support the integration of primary and specialty care, including behavioral health care, through medical homes.
  • Require the Federal government to perform outreach services on the health exchanges to specific populations, including people with mental illness.

The House’s Act extends the FMAP increase to states through June 2011; it is currently set to expire in after December 2010. It will also extend Medicaid coverage to individuals up to 150% of the federal poverty line, including adults without children. Health care reform is evolving and we will keep the updates flowing.

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OASAS Extends Deadline for Drug Law Reform Funding

The application submission date for increased funding from the NYS Office of Alcoholism and Substance Abuse Services (OASAS) to provide services as a result of Rockefeller Drug Law Reform has been extended from November 17, 2009 to December 1, 2009. Eligible New York City providers can access an RFP for additional chemical dependence outpatient treatment and assessment services online at http://www.oasas.state.ny.us/admin/rfp/index.cfm. With respect to Westchester and Orange counties (Nassau and Suffolk too), the LGU’s may apply for planning supplements online at http://www.oasas.state.ny.us/hps/state/state.cfm.

The impact of resentencing 1,500 inmates statewide and diverting current drug offenders to treatment programs under Rockefeller Drug Law Reform has been part of an ongoing discussion among membership at The Coalition’s Government Relations Committee. One member, CASES (Center for Alternate Sentencing and Employment), invited Coalition staff last week to attend a training, where a representative from Legal Aid explained the process of resentencing and judicial diversion more clearly.

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 Around the Water Cooler

The Coalition sends congratulations to Zhanna Beyl, who is the Coordinator of the Jewish Child Care Association’s (JCCA) Bukharian Teen Lounge, for winning a Young Professional Award of the Jewish Communal Service Association. JCCA is a member of The Coalition.

Congratulations to Cindy Peterson-Dana, LMHC, for being awarded Family Advocate of the Year! Cindy is a Family Advocate at the Mental Health Association of Westchester County, a member of The Coalition. She received the award from the Mental Health Association in New York State (MHANYS).

Astor Services for Children & Families, a Coalition member, received the first Stefan de Schill Award, which was presented by the American Mental Health Foundation (AMHF). We congratulate them on this achievement!

A member of The Coalition, Odyssey House, received a grant worth $25,000 from Aetna to support its enhanced health literacy program. The initiative will help residents at the Family Center of Excellence, which provides supports for pregnant women, women with infants, and parents with young children.

The Association for Rehabilitative Case Management and Housing (ACMH), a Coalition member, is featured in an article called “Out of the Ashes, Into a Home” on CUNY’s “Interactive Journalism” blog. ACMH plans to construct supportive housing for persons with mental illness in Jamaica, Queens.

In Dr. Lloyd I. Sederer, M.D.’s latest article to be featured in the Huffington Post, he argues that mental illness is not a major driver of violent crime. The article titled, “Is There a Relationship Between Mental Illness and Violence?”, explains how better identification of mental illness and coordination of care has the greatest impact on individuals with mental illness and community safety. Dr. Sederer is the Medical Director in the New York State Office of Mental Health (OMH).

Families Together in New York State will hold its 2010 annual conference called “Empowering, Engaging, and Enlightening: Sharing the Family Voice to Build Stronger Communities” from April 25 – April 26, 2010 at the Crowne Plaza Hotel in Albany, New York.

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Fountain House Helps to Cultivate National Anti-Stigma Campaign

When Hollywood actress, Glenn Close volunteered at Fountain House, a Coalition member, the idea of a national anti-stigma campaign was born out of a partnership between Ms. Close and Fountain House’s Executive Director, Ken Dudek. Glenn Close decided to volunteer at Fountain House in order to learn about mental illness, which both her sister Jessie and nephew live with. Glenn and Jessie Close were interviewed recently on ABC-TV about their stigma campaign.

A new organization called BringChange2Mind.org was created by Glenn Close, the Child and Adolescent Bipolar Foundation (CABF), Fountain House, and Garen and Shari Staglin of IMHRO (International Mental Health Research Organization). BringChange2Mind.org is a not-for-profit organization that provides people who have misconceptions about mental illness with quick and easy access to information to combat stigma. It also provides people with mental illness, and those who know them, with quick and easy access to information and support.

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Adult Homes Decision: State Granted an Extension; City Council Holds a Hearing

The Federal Circuit Court has granted New York State an extension to respond to the Judge Garaufis’ decision, which found the State in violation of the Americans with Disability Act (ADA). According to the decision, the State failed to house 4,300 people with mental illness in the most integrated setting according to their needs, and now has until November 6, 2009, to submit a remedial plan to the court. The Coalition, in a letter to the Governor, has asked the State to not appeal the court’s decision, and offered to be part of the discussion to develop a plan that is thoughtful of all stakeholders involved. The process to transition consumers into supported housing units, will be long and complicated one, but will save the State money in the long-run, and allow people with mental illness to live independently in the community with necessary supports in place.

On October 29, 2009, Coalition staff attended a hearing at the New York City Council on the quality and support in adult homes, and the ramifications of the court’s decision. The hearing was held by the Committee on Mental Health, Mental Retardation, Alcoholism, Drug Abuse and Disability Services, which is chaired by Council Member G. Oliver Koppell. Testimony was presented by Disability Advocates Incorporated (DAI), who had filed the lawsuit against the State, as well as other advocates who called upon the State to not appeal the court’s decision. The adult homes providers did not testify at the hearing in person, but submitted written testimony to the committee to voice their concerns about transitioning residents out of adult homes.

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HHS Issues Interim Final Rule on Enforcement of HITECH Act

On October 29, 2009, the U.S. Department of Health and Human Services (HHS) issued an interim final rule confirming the revisions made to HIPPA (Health Insurance Portability and Accountability Act) on the meaningful use of health information technology under the HITECH (Health Information Technology for Economic and Clinical Health) Act. Effective February 18, 2009, HHS may impose a tiered level of monetary penalties with increasing fines, and encourage prompt corrective action for privacy and security violations during the electronic transmission of health information. This interim final rule will become effective on November 30, 2009.  HHS has invited public comments on the interim final rule until December 29, 2009.

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OMH Submits Draft Clinic Restructuring Regulations

The Coalition prepared comments in response to the first two drafts of the new clinic restructuring regulations circulated to the clinic stakeholder group. The second draft, dated October 15, 2009 was submitted to the Governors Office on Regulatory Reform on October 15, 2009.

The Coalition produced talking points outlining our major concerns about the entire reform process.  In particular are issues with Medicaid managed care and private insurance rates as well as workforce losses. The new regulations raise some additional concerns:  1) the potential of less than one year for the 75% COPS payments, 2) continuing concern that OMH has not preformed a system stress test, and 3) the lack of parity in rates between peer groups.

OMH just completed 5 clinic reform training sessions across the state.  Handouts are available for download from our website:  http://www.coalitionny.org/news_resources/#OMHReforms.

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Keeping It Positive: Using Contingency Management in Addiction Treatment Workshop

The Professional Learning Center is please to present this workshop on Contingency Management (CM) . CM interventions among alcoholics, problem drinkers, and illicit-drug abusers have been found to be effective in reducing use; retaining patients in treatment; improving medication compliance; and  promoting participation in other treatment-related goals, such as employment. 
 
Date:  
           November 19, 2009
Time:             9:00 - 11:00 am
Location:       The Coalition of Behavioral Health Agencies,
                     90 Broad St., 8th Fl. (directions)
Presenter:     Scott Kellogg, PhD | Fee:  Free

Scott Kellogg, PhD, Clinical Assistant Professor of Psychology at NYU, will speak about following core Contingency Management topics:

(1) The learning theory foundation (i.e., Skinner)
(2) Applications of contingency management in nonsubstance abuse settings
(3) The early applications of contingency management in the addictions field -- behavioral pharmacology and clinical alcohol studies
(4) The modern classic studies: Higgins voucher incentive program; Silverman's voucher incentive; Petry's intermittent reinforcement, fishbowl model; and the NIDA Clinical Trials Network Contingency Management study (Stitzer and Petry)
(5) The Seven Core Principles of Contingency Management

Register now, seats still available:  http://www.coalitionny.org/prof_learn_ctr/training/series.php?series_id=1098

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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
5571 Job Coach
5573 Associate Director - Mental Health Clinic Satellite
5577 Staff Accountant
5579

Program Director, Clubhouse

5580 Case Manager
5582 Licensed Master's Social Worker

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