An Evolving Semi-Monthly Update on Community Behavioral Health in New York
June 17 , 2010
Budget Extender Passes with Cuts to Mental Hygiene and Human Services
Since April 1, the State budget has been late. This has led to a weekly cycle of emergency budget extenders submitted by Governor Paterson to the Legislature to keep basic government operations functioning. The latest extender allows funding to flow through June 20, 2010. Along with the emergency bill passed on Monday, June 14, 2010 came $151M in cuts to Mental Hygiene programs and $175M in cuts to Human Services programs. While passage of the bill authorizes the State to release funding for community-based behavioral health services for FY 2010-11, cash flow problems will disrupt its ability to pay for full quarterly advances to localities and providers. Funding will most likely be released in smaller amounts on a more frequent basis (possibly monthly). While regrettable, the cuts did not seriously harm the behavioral health safety net.
Mental Health Services
Budget cuts will slow down the rollout of the Personalized Recovery Outpatient Services (PROS) program by the Office of Mental Health (OMH). However, this action will not decrease funding for programs that are already up and running. OMH will also realize additional savings from delaying the pipeline for new residential development, implementing inpatient restructuring and through reforms of the Sex Offender Management and Treatment Act (SOMTA) program. On the positive side, we have also confirmed that the budget bill authorizes the OMH proposed transfer of funds from OMH to the Department of Health (DOH) that would cover a needed increase to providers of managed care fees in the mental health clinic restructuring.
Alcoholism and Substance Abuse Services
OASAS will defer the startup of new gambling prevention programs and slow the growth of anticipated expenses for outpatient services. OASAS will also end separate funding that was sent to DOH for noncore HIV/AIDS services that are already provided by the service community. OASAS plans to increase the use of e-technology for communications and streamline various administrative functions to achieve further budgetary savings.
Housing and Homeless Services
The emergency budget bill included a 13% cut to SRO Support Services. As such, $17.7M in SRO Support Services dollars will have to fund existing units plus hundreds of new ones that have opened in the last year and are scheduled to open. The extender bill did however restore $2.5 million of the proposed cut to Supportive Housing for Families and Young Adults (SHFYA) (a 50% restoration) and $1M for the Supplemental Homelessness Program (SHIP) (a 20% restoration). Both the Homeless Prevention Program (HPP) and Homeless Intervention Program (HIP) were cut by $700K (16%) and $1M (28%) in that order.
Included in the State emergency budget bill this week was an extension of the exemption for social workers and certain mental health professionals from current licensure law until March 31, 2011. The Coalition was pleased that this action will keep service delivery system from further chaos had the current exemption expired. We are also happy to report further movement this week in the Assembly and Senate to lengthen the term of the extension until July 1, 2013.
On June 15, 2010, the Senate passed a bill sponsored by Toby Ann Stavisky to extend the exemption for social workers and certain mental health professionals until July 1, 2013. The Assembly had already passed legislation sponsored by J. Gary Pretlow authorizing the extended exemption on June 14, 2010. In addition, the bill will address unresolved corporate practice issues and mandate that a number of State agencies submit workforce data 2011. A larger stakeholder meeting will be convened after this date to address workforce problems that occurred from changes to the professional licensing laws. As active players in this issue in Albany, The Coalition will continue its involvement by fully participating in these meetings. We will also keep you updated on when this bill becomes law.
Things are beginning to move very fast with our City budget advocacy. The City Council budget negotiation team (BNT) is meeting to decide which programs will be funded in FY 2011. The Coalition is strongly advocating for the City Council to restore funding for the following programs: $550,000 for Alcoholism/Substance Abuse Voluntary Sector; $1.6M for Children Under Five; $2.4M for Geriatric Mental Health Initiative; and $975,000 Mental Health Contracts.
Funding for The Coalition’s Professional Learning Center (PLC) seems to be at risk. The primary goal of the PLC is to provide training and technical assistance to the behavioral health sector on issues that have direct financial and regulatory consequences to community based organizations. This is the type of training and education that is not provided by public agencies and is prohibitive for individual agencies to sponsor themselves. For the past 12 years, the City Council has restored $100,000 to the PLC allowing thousands of staff at every level of operations to participate in training. This year we delivered 25 workshops to1,800 people with this funding.
The Coalition is also aggressively working to restore $10.5M in cuts to Mental Hygiene programs for outreach, advocacy, non-Medicaid reimbursable case management, and medically supervised drug and alcohol outpatient treatment. We presented testimony on June 7, 2010 before the City Council on the Mayor’s Fiscal Year 2011 Executive Budget. It is very important to reach out to your Council Member and tell them to restore these cuts.
The Coalition’s Center for Rehabilitation and Recovery held a PROS Learning Collaborative meeting on June 15th which featured a presentation from Veronica DeKoning (“Roni”) of the Clubhouse of Suffolk. Roni spoke to a group of 35 professionals representing a variety of agencies in New York City, all of whom were eager to learn how to start and successfully run a PROS program. Beyond sharing operational tips, Roni described leadership strategies that have helped to create a strong culture of recovery at her program. These include involving Clubhouse members in the hiring of new PROS staff, co-creating program schedules with staff and members, and providing regular staff supervision and training to support effective teamwork. Taken together, these approaches have helped to build and maintain a culture of recovery that values learning, empowerment, and responsibility, all of which encourages members to create a life beyond the program.
Participants in the PROS Learning Collaborative were given ample opportunity to ask Roni questions and exchange ideas with each other. In the last hour of the meeting, David Bucciferro and Susan Friedlander of the State Office of Mental Health joined the discussion and addressed questions regarding regulatory compliance and effective programming. Given the success of these meetings, the Center plans to continue them next fiscal year.
Privacy of Individually Identifiable Health Information
On June 16, 2010 , the Substance Abuse & Mental Health Services Administration (SAMHSA) and the Office of the National Coordinator (ONC) for Health Information Technology released an educational document in the form of Frequently Asked Questions (FAQs) called "Applying the Substance Abuse Confidentiality Regulations to the Health Information Exchange (HIE)".
Federally funded substance abuse programs are governed by the Substance Abuse Confidentiality Regulations, 42 CFR Part 2, which outlines permissible use and disclosure of alcohol and drug abuse patient records. The FAQs outline the general provisions of 42 CFR Part 2, provide guidance on its application to electronic health records, and identify methods for including substance abuse patient record information into health information exchange that is consistent with the Federal statute. The announcement clearly states that the FAQs are not meant to provide legal advice. Read the FAQs and more about Health Privacy on the SAMHSA website.
The Schuyler Center for Analysis and Advocacy (SCAA), a statewide nonprofit working to shape policies to improve health, welfare and human services in New York State, announced Kate Breslin as its new President and CEO. Breslin, who currently serves as Director of Policy for the Community Health Care Association of New York State (CHCANYS), takes the reins from Karen Schimke, who is retiring at the end of the month.
Coalition Member Notes
Westchester Jewish Community Services (WJCS) named Megan Flynn, PhD as Assistant Executive Director for Community-Based Programs. She will be responsible for the agency’s educational, mental health and supportive programs that help children and families.
F·E·G·S Health and Human Services System celebrated 75 years of serving New Yorkers at its “Partnerships for a Changing World Benefit Dinner.” The event, held on May 17 was attended by almost 500 people and raised over one million dollars to support the comprehensive network of F·E·G·S programs and services that reaches over 100,000 individuals and families each year.
Coalition Members in the News
In the June 15, 2010 edition of the New York Times, an article titled “NYC: City Budget May Cut Short Cries for Help “ focused on a suicide prevention hotline run by Samaritans of New York that is slated to be cut in the Mayor’s FY 2011 Budget.
On June 9, 2010, the New York Daily News ran a story about the 50th anniversary of the Puerto Rican Family Institute, and it’s President Maria Elena Girone, who was named “"civic godmother" of last Sunday's National Puerto Rican Day Parade. The full article can be found here: Institute celebrates 50 yrs. of help to thousands.
Peter Campanelli of the Institute for Community Living (ICL) and Christine Molnar of Safe Space were quoted in the Wall Street Journal news article on nonprofits losing money due to slowed down negotiations on the very late State budget.
The June 8, 2010 New York Times, WCBS-TV and WNBC-TV featured the Brooklyn Bureau of Community Service and their Preventive Services program during yesterday's City Hall Rally to stop budget cuts to Preventive Services.
Coalition Holds 26th Annual Leadership Awards Reception
The Coalition will celebrate its 26th annual awards reception today (Thursday, June 17, 2010). This year’s honorees are Anita Appel, LCSW, Director of the New York City Field Office, State Office of Mental Health; Peter Campanelli, Psy. D., President/CEO, Institute for Community Living (ICL); Michael Friedman, LMSW, Director, Center for Public Policy, Mental Health Association of New York City; and Fred Scaglione, Editor, New York Nonprofit Press. Pfizer will once again host the awards event for The Coalition at Pfizer World Headquarters at 235 East 42nd Street in New York City. You can still register on our website at: www.coalitionny.org. To see pictures from the event, please visit our website next week.
Coalition Federal Advocacy and FMAPThe Coalition will head to Washing D.C. for Hill Day on June 30, 2010, organized by the National Council for Community Behavioral Healthcare. We will be advocating for making Health Information Technology (HIT) funding available to behavioral health providers. Currently these dollars are targeted to primary care physicians and hospitals only. We will also ask for the continued funding of the Mental Health Services Block Grant and the Substance Abuse Prevention Treatment Block Grant for New York State. Another important issue is the extension of the enhanced Federal Medical Assistance Percentage (FMAP) rates. The Senate version of H.R. 4213, that will restore a 6-month extension of that measure, was removed from the House version passed last month. Many Senators are worried about voting for the FMAP increase in States where constituencies are worried about increasing Federal spending and adding to the budget deficit. The National Council has issued an action alert in support of the FMAP extension, as has The Coalition. Your support is very critical.
Ambulatory Patient Groups (APGs) within OASAS certified outpatient chemical dependence programs. OASAS anticipates that all programs will have converted to APGS by January 2011. If you missed or had technical difficulties accessing the OASAS webcast on APG’s, which was held last week, you can access the archived version online.
The Center for Rehabilitation and Recovery continues to provide on-site staff training for PROS implementation by NYC agencies The first wave of consultations targeted culture change, reviewing the large accumulation of both short and very long term research evidence which supports the recovery model and the implications for changing care strategies. The second wave focused upon the 20 critical questions whose answers may help explain why a participant appears stuck on the road to recovery and how to overcome such obstacles.
A third wave included training on acquisition of a life history on one page and one line, with a short semi structured format, with the end result of building a closer therapeutic relationship. The fourth wave of consultations presented more strategies and research evidence for the efficacy of rehabilitation using evidence-based and promising practices in a highly collaborative way.
And lastly, The Center has offered presentations and problem-solving for both staff and participants around the Medicaid Buy-In (MBI) which allows participants to earn and keep more of their money than the Medicaid Spend-Down process and still keep all comprehensive Medicaid services. This process should encourage more people to keep working. The Center has published information in both Chinese and Spanish as well. All of these onsite staff consultations and more will be offered free of charge for the next fiscal year.
The Professional Learning Center still has seats available for three workshops being offered in the coming weeks:
Cultural Competence: A Way of Connecting with Our Clients - June 22, 2010.
Go to our website for more information and online registration for our Cultural Competency Workshop.
The Stages of Change: A Practical Model of Treatment Planning (for clinicians).
A Practical Model of Supervision: Assuring the Integration of Quality of Care and Compliance in the Public Sector (for supervisors).
Go to our website for more information and online registration for our Treatment Planning Workshops.
Coalition Members advertise staff positions for free on The Coalition’s Job Board! Here's a sample: