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The Coalition of Behavioral Health Agencies, Inc. Coalition Briefs
An Evolving Semi-Monthly Update on Community Behavioral Health in New York
                              July 13, 2010

 

In Memoriam: Senator Thomas P. Morahan

Senator Thomas P. Morahan, Chair of the Senate Mental Health and Developmental Disabilities Committee passed away on Monday, July 12, 2010, after a 6 month battle with leukemia. Senator Morahan's political career extended over thirty years, beginning with his election to the Rockland County Legislature in 1977. During his ten years as a State Senator, Morahan introduced 230 bills, which were signed into law. One of his many accomplishments includes the passage of Timothy's Law to establish mental health insurance parity in New York State. The Coalition is honored to have worked with Senator Morahan on significant behavioral health issues. We wish his family and loved ones our deepest condolences.

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State Lawmakers Fail to Pass FY 2010-11 Budget

While Albany lawmakers moved closer to passing the FY 2010-11 Budget, in the end a final agreement could not be reached. On Monday, June 28, 2010, the Senate and Assembly passed budget bills and Article VII legislation for Health/Mental Hygiene and Education, Labor and Family Assistance. Then Governor Paterson quickly moved to veto a restoration of $419 million in cuts to school aid that was restored by the Legislature, and vetoed approximately 6,900 member items and spending increases approved by the Legislature. It is very unlikely that both houses would be able to override the Governor's vetoes. The Democratic majority in the Senate is too slim, and the Republicans too uniform in their opposition, to gather up the necessary 2/3 of votes to do so.

On Thursday, July 1, 2010, the Assembly passed a revenue bill, the final piece of the 2010-11 Budget. It included new revenue increases from re-imposing the sales tax exemption on clothing items under $100, and reducing the tax exemption on charitable deductions made by individuals earning over $10 million annually. The charitable donations tax exemption was proposed to be cut from 50% to 25%, and would be retroactive to January 1, 2010. If implemented, this change will severely impact nonprofits and charities that rely on philanthropic funding. The Senate did not take up a vote on the revenue bill as they could not gather the necessary votes to pass it. Among the sticking points preventing a budget agreement is controversy over the development of a contingency plan for the State's potential loss of enhanced FMAP rates, and empowering SUNY and CUNY to set their own tuition rates. The Legislature adjourned, and as of now, it is not clear when they will return to Albany.

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City Adopts FY 2011 Budget with Cuts to Behavioral Health & Homeless Services

The New York City Council adopted a $63 billion FY 2011 Budget by a vote of 48-1 on Tuesday, June 29, 2010. While funding to mental health and substance abuse programs was restored, it did not reach FY 2010 levels. The Council is in the process of finalizing how the restorations will be allotted to specific agencies. More details on funding are listed in the chart below.

City Council Initiatives – Mental Health/Substance Abuse

Funding
Initiative FY 2010 FY 2011 Cut %
Alcoholism/Substance Abuse $550,000 $335,000 ($215,000) -39%
Autism Awareness $1,500,000 $1,250,000 ($250,000) -17%
Children Under Five $1,600,000 $1,250,000 ($350,000) -22%
Geriatric Mental Health $2,400,000 $2,000,000 ($400,000) -17%
Mental Health Contracts $975,000 $450,000 ($525,000) -54%

The City Council also restored funding to two programs that were slated to be cut by the Department of Health and Mental Hygiene (DOHMH). Samaritans of NY Suicide Prevention Hotline received a full restoration of $247,150. HHC Kings County Hospital Developmental Evaluation Clinics received a $400,000 restoration. These were the only Mental Hygiene programs to receive restorations by the City Council. The Mayor had proposed to cut a total of $10.5 million in funding from Mental Hygiene programs.

The City Council made a partial restoration of the Medical Services cuts to adult homeless shelters at $1.2 million (the cut was initially proposed at $1.7 million). The City will also cut its share of the SRO Support Services program at the NYS Office of Temporary and Disability Administration (OTDA), but maintained funding commitments for New York/New York III services and capital needs. The full Adopted Expense Budget for FY 2011 can be found online on the City Council's website.

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OMH Publishes 599 Clinic Regulations

The NYS Office of Mental Health (OMH) has posted the new Part 599 clinic regulations on their website. The regulations will be posted in the State Register on July 14, 2010, and become effective on October, 1, 2010. Despite the submission of numerous comments by The Coalition and many other stakeholders, OMH did not take them into account as substantive and submit significant changes to the Governor's Office of Regulatory Reform (GORR). Many members have expressed apprehensions about clinic reform moving forward without significant concerns from the field being recognized in the new regulations. Our advocacy team will convene with leadership and with members to discuss future Coalition advocacy.

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State Board of Regents Approves New Social Worker Licensing Rules

The State Board of Regents approved new regulations for social work licensing, effective June 29, 2010. They will be published by the State Education Department as Emergency Regulations with a 45 day comment period. The Coalition, in concert with its partners on the Social Work Alliance, worked with staff from the Office of the Professions to change the regulations which were so rigid and onerous they limited the ability of the social workers to obtain the experience necessary for licensure. You can view the rule making proposal in the NYS Register (scroll down to page 18), as well as the full text submitted by the State Education Department. Coalition members who would like to inform Coalition's comments on the regulations should submit comments to pgoldstein@coalitionny.org as soon as possible.

In summary, the following significant changes were made which should help increase the numbers of licensed social workers:

  • Lowers the number of hours in diagnosis, psychotherapy, and assessment based treatment planning from 2,880 to 2,000 though still over a minimum of three-years and a maximum of six years;
  • Allows hours to be aggregated over the full three to six year period rather than on a weekly basis, thus removing weekly minimum and maximum hours;
  • Lowers the number of supervision hours for the LCSW from 144 to 100; and
  • Allows supervision on an individual or group basis.

The Coalition thanks the State Education Department for its cooperation in meetings with The Alliance and for developing some of the more flexible changes to the regulations

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Federal Housing & Homelessness Update

House T-HUD Subcommittee Marks Up FY 2011 Spending Bill
The House Transportation, Housing, and Urban Development (T-HUD) Appropriations Subcommittee marked up its FY 2011 spending bill on Thursday, July 1, 2010. It included approximately $2 billion In HUD McKinney-Vento Homeless Assistance Grants, $75 million to support 10,000 new HUD-VA Supportive Housing (VASH) vouchers and $85 million to fund 10,000 housing vouchers for the Housing and Services for Homeless Persons Demonstration. The Coalition is pleased with the markup for funding for these provisions, which we supported during our Hill Day visits with Congressional Representatives on June 30, 2010.

New York City Coalition on the Continuum of Care Awarded $6.1M in New HUD Funding
The NYC Coalition on the Continuum of Care (CCoC) will receive $6.1 million from the U.S. Department of Housing and Urban Development (HUD) 2009 NOFA competition to fund new projects. The Funding will provide permanent supportive housing for two NYC Department of Housing Preservation and Development (HPD) sponsored projects. The first will serve 63 single adults (55 of whom will be chronically homeless living with severe and persistent mental illnesses) at the Lantern Organization's Hunterfly Trace residence. The second will serve a mixed population of special needs and low-income single adults at Geel's Grand Avenue Residence. This award will fund thirty-six of the units, to be reserved for homeless single adults exiting the NYC shelter system and living with severe and persistent mental illness.

New Federal Plan to Prevent and End Homelessness is Released
On June 22, 2010, the U.S. Interagency Council on Homelessness (USICH) released a new Federal strategic plan to prevent and end homelessness called Opening Doors. The plan's major goals include finishing the job to end chronic homelessness by 2015, preventing and ending homelessness among veterans by 2015, and preventing and ending homelessness for families, youth, and children by 2020.

HUD Publishes Annual Homelessness Assessment Report (AHAR) On June 16, 2010 the Department of Housing and Urban Development (HUD) released its 2009 Annual Homeless Assessment Report (AHAR) to Congress. According to the report, levels of homelessness remained about even between 2008 and 2009, with a 10% decrease of people experiencing chronic homelessness, and an increase in the number of families seeking shelter.

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Around the Water Cooler

Diana Jones Ritter, Commissioner of the NYS Office of Mental Retardation and Developmental Disabilities (OMRDD) has resigned her post to become the Managing Director of the Metropolitan Transit Authority (MTA).

President Obama has appointed Dr. Donald Berwick as the new Director of the Centers for Medicare and Medicaid Services (CMS). Dr. Berwick, a pediatrician, is president and co-founder of the Institute for Healthcare Improvement, a nonprofit organization in Cambridge, Mass. He is also a professor at Harvard Medical School and the Harvard School of Public Health.

September is National Alcohol and Drug Addiction Recovery Month: You can check out Recovery Month news and information at http://www.recoverymonth.gov. The Recovery Month website aims to promote the societal benefits of alcohol and drug use disorder treatment, laud the contributions of treatment providers, and promote the message that recovery from alcohol and drug disorders in all its forms is possible.

Visiting Nurse Service of New York (VNSNY), a member of The Coalition, has acquired the Pax Christi Hospice, a unit of Saint Vincent Catholic Medical Centers. VNSNY plans to open a self-contained inpatient hospice unit at Bellevue Hospital in the early fall. The purchase of Pax Christi also gives VNSNY hospice an outpost on Staten Island, making it the only hospice in New York City to provide services in all five boroughs.

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Coalition Goes to Washington D.C. for National Council's Hill Day 2010

The Coalition joined nearly 500 National Council members on Wednesday, June 30, 2010, to meet with members of Congress and advocate for mental health and substance abuse services funding. We were joined by members from the Institute for Community Living (ICL), the Jewish Board of Family and Children's Services (JBFCS), the Child Center of New York and Greenwich House. The four legislative priorities for Hill Day 2010 included: (1) Enlisting cosponsors for the Health Information Technology for Behavioral Health Services Act of 2010 (H.R. 5040), (2) Generating support for the creation of Federally Qualified Behavioral Health Centers (H.R. 5636), (3) Supporting a $210 million increase in the Substance Abuse Prevention and Treatment Block Grant and a $100 million increase in the Mental Health Block Grant, and (4) Requesting a six-month extension for the enhanced Federal Medical Assistance Percentage (FMAP) rates. The Coalition met with Representative Eliot Engel and Representative Edolphus Towns, and staff from Senator Charles Schumer, Senator Kirsten Gillibrand, Representative Charles Rangel and Representative Nita Lowey's offices. A special thanks is due to Congressman Engel who is an original cosponsor of HR 5636. It has been a pleasure for The Coalition to work with the Congressman on this issue.

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State Legislative Actions

OMIG Due Process
A bill to establish statutory standards to ensure that investigative actions and recovery of payments are conducted by the New York State Office of Medicaid Inspector General (OMIG) in a fair and consistent manner was held for consideration in the Assembly Committee on Codes i.e. “held up”. The Coalition and other advocates urgently tried to get the bill back on the Committee's agenda, but it was denied. Sponsored by Assembly Member Richard Gottfried, bill A10630-C would create auditing and due process procedures for providers that would not impede the State's attack on fraud and abuse.

Kendra's Law Extension
Governor Paterson signed into law on June 29th, a bill introduced by New York State Office of Mental Health (OMH) to extend the AOT program for an additional 5 years until June 30, 2015 (Chapter 139). It was sponsored by Assembly Member Felix Ortiz (A.10790) and Senator Thomas P. Morahan (S.7254). This bill, supported by The Coalition and other stakeholders, will allow for more time to conclusively determine the effect of the AOT program and whether it is more effective then voluntary methods.

Veterans Mental Health & Chemical Dependency Act
The Veterans Mental Health and Chemical Dependency Act (A.11098/S.7961) and a bill to take measures to eliminate stigma and misinformation about mental illness and chemical dependency among military service members (A.11054/S.8062) were passed, but have not been signed by Governor Paterson. The Coalition had signed on in support of both bills.

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Reduction in FMAP Payments Places Greater Risk on State & City Budgets

Both New York State and New York City are counting on enhanced Federal Medical Assistance Percentage (FMAP) in their budget. New York State has budgeted $1 billion in enhanced FMAP money, while New York City just passed its budget, which included $300 million in enhanced FMAP payments in each of FY 2011 and FY 2012. As it appears less likely that Congress will pass an extension of enhanced FMAP revenue to aid the states, the City and State may have to reconsider more cuts or tax and fee increases. Most likely, more cuts are in the offing.

The enhanced FMAP rate was originally passed as stimulus money under the American Recovery and Reinvestment Act (ARRA), and is scheduled to expire on December 31, 2010. Lawmakers in Congress are debating on whether to extend the increase in FMAP funding for an additional 6 months. New York State currently receives a 6.2% increase in the Federal share of FMAP, making the Federal/State share equal to 56.2%/43.8% (normally it is a 50/50 split).

Governor Paterson and leaders from other States visited Washington D.C. on June 30, 2010, to inform Congress about the impacts of not extending the enhanced FMAP rate. States are considering layoffs or cutting services to their most vulnerable citizens. During the State's budget negotiations last week, Governor Paterson proposed to cut the New York State's general fund in order to make up for the potential FMAP loss. This would affect the amount of undisbursed state aid available to localities. Preparing for a reduction in FMAP dollars has been a bone of contention between the Governor and State Legislature, that failed to pass a revenue bill to finalize the 2010-11 Budget.

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State Forced to Comply with Adult Homes Decision

On June 23, 2010, a Federal Appeals Court ordered New York State to immediately develop and implement a plan to move thousands of people with mental illness in New York City out of adult homes and into supportive housing units. The State is now mandated to build 1,500 units of supportive housing a year over the next 3 years for adult home residents. The ruling overturned a stay issued by a lower court after the State appealed a decision by Judge Nicholas G. Garaufis, which found New York State in violation of the Americans with Disabilities Act (ADA) for housing about 4,300 people with mental illness in adult homes instead of the most integrated setting possible.

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SAMHSA Raises Mental Health Awareness in Multicultural Communities

The U.S. Substance Abuse and Mental Health Services Administration (SAMHSA), in collaboration with the Ad Council, has announced the launch of a national public service advertising (PSA) campaign to promote recovery from mental health problems within multicultural communities. Efforts include educating and inspiring young adults to talk openly about issues of mental health. The culturally targeted PSAs seek to motivate societal change toward social acceptance and decrease negative attitudes that may surround mental illness. These PSAs are part of a larger multicultural public service effort designed to reach Hispanic/Latino, American Indian, Chinese American, and African American communities during National Minority Mental Health Awareness Month.

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