An Evolving Semi-Monthly Update on Community Behavioral Health in New York
October 6 , 2010
OMH Clinic Reform Begins
On October 1, 2010, the NYS Office of Mental Health moved forward with its implementation of mental health clinic restructuring and reform despite the lack of approval of a State Plan Amendment (SPA) by the Centers for Medicaid and Medicare Services (CMS). The absence of CMS approval for the new APG reimbursement system creates many administrative and compliance hurdles for providers as they struggle to follow interim billing instructions. In addition, vulnerable populations such as the homebound elderly cannot be served because approval for off-site visits also has not been obtained. Other essential components on which the reforms fundamentally rely also have not yet been approved, including supplementation of Medicaid managed care rates and an indigent care pool. Letters submitted by The Coalition alone and with other partners can be found on our website at http://www.coalitionny.org/news_resources/#OMHReforms requesting delay of the initiative until CMS approval is obtained.
OASAS Posts Updated APG Billing Manual
An updated version of the Ambulatory Patient Groups (APGS) Policy and Medicaid Billing Guidance for OASAS Certified Outpatient Chemical Dependence Programs has been posted on the NYS Office of Alcoholism and Substance Abuse Services’ (OASAS) website. It can be accessed at: http://www.oasas.state.ny.us/admin/hcf/APG/documents/APGManual-Sept2010.pdf. Changes to the guidance document include the removal of outreach as a billable service due to problems with obtaining Federal approval for clinical services provided offsite. OASAS is looking into other billing options for offsite services. Sections have also been added to the manual with information on billing for co-occurring disorders, physical health services and smoking cessation.
More Details Emerge on FMAP Contingency Plan
As we have reported, effective September, 16, 2010 through March 31, 2011, the State will implement an across the board cut of 1.1% to Medicaid and most general and special revenue funds that are undisbursed. This means that providers should expect to see that all payments from direct contracts with the NYS Office of Mental Health (OMH), NYS Office and Alcoholism and Substance Abuse Services (OASAS) and other State agencies will be reduced. During this period, payment vouchers from the State will reflect the 1.1% reduction amount as a recoupment identified by Financial Reason Code “FCF” with a corresponding description of “FMAP CONTIGENCY FUND.” As more information becomes available, it will be placed on the NYS Department of Health’s (DOH) website, where certain exemptions are posted too. If you have additional questions, you can submit them via e-mail to: firstname.lastname@example.org.
City Council Passes FY11 Cuts in Funding for Behavioral Health Initiatives
On Wednesday, September 29, 2010, the NYC City Council passed a transparency resolution to approve FY 2011 funding allocations for “Alcoholism/Substance Abuse – Voluntary Sector” at $335K, “Children Under Five Mental Health Initiative” at $1.25M and “Mental Health Contracts” at $450K. FY 2011 funding for these initiatives represent significant cuts. In comparison to FY 2010, Alcoholism and Substance Abuse services has been cut by 39%, Children Under Five by 22% and Mental Health Contracts by 54%. The Coalition actively worked with City Council Members and staff to maintain as much funding as possible given the fiscal constraints faced by the City during the budget negotiation process. We are thankful to them for working with us to prevent the total elimination of these initiatives.
International Center for the Disabled (ICD) received two grants to help fund their Article 31 clinic. ICD was awarded a HEAL grant of $428,757 to construct a walk-in/urgent care assessment area, and a four year primary health care integration grant from SAMHSA to work on improving the health of enrolled clients.
Brooklyn Bureau of Community Services is now Brooklyn Community Services (BCS). You can visit their website at: http://www.bbcs.org/.
Westchester Jewish Community Services (WJCS) has officially opened Claremont House in Mount Vernon, New York. Claremont House is WJCS’ 13th residence for persons with developmental disabilities.
Odyssey House’s Family Center of Excellence will hold an open house on Wednesday, October 27, 2010, from 12 - 3 pm at its Manor Family Center, 219 East 121st Street, New York, NY 10035. To RSVP, please contact Ayodele Oliver-Carnagie at 212-987-5110 or email@example.com by October 20.
Benefits Management Training at The Center
The Coalition’s Center for Rehabilitation and Recovery presents Introduction to Benefits Management, to help clinicians and other staff interested in learning the nuts and bolts of benefits management. Participants will have the opportunity to understand the fundamentals of the Social Security system, comprehend the difference between SSI, SSDI, Medicaid and Medicare, gain knowledge of resources that support consumers in their living and working goals, and learn how to help consumers effectively use benefits to support their recovery. Introduction to Benefits Management is a free half-day training being offered in various locations throughout the City on October 21 and 24, and November 4 and 18. It will be facilitated by Coalition Center staff Margie Staker and Patricia Feinberg, MS. Please note, this introductory training is intended for staff new to the subject of benefits. To register for one of these trainings, please visit The Center’s web page at: www.coalitionny.org/the_center/training.
OMH Releases 2010-2014 Statewide Comprehensive Plan
The New York State Office of Mental Health (OMH) has published its 2010-2014 Statewide Comprehensive Plan. The plan covers anticipated OMH actions around recovery, services for adults, children, families, as well as maintaining program quality. To access the plan, please go to: http://www.omh.state.ny.us/omhweb/planning/statewide_plan/2010_to_2014/.
The Substance Abuse and Mental Health Administration (SAMHSA) has published “Leading Change: A Plan for SAMHSA’s Roles and Actions 2011-2014.” From now through October 22, SAMHSA encourages you can read the plan for achieving SAMHSA's eight strategic initiatives and submit your comments online.
CHCS Issues Report on Performance Measurement in Fee-for-Service Medicaid
The Center for Health Care Strategies (CHCS) has published a report outlining emerging best practices for measuring the quality of Fee-for Service care. Research is collected from nine states and numerous interviews with key stakeholders across the country. Key recommendations from the report include the involvement of providers and relevant stakeholders in the process of developing and collecting
performance measures, start with a small number of Healthcare Effectiveness Data and Information Set (HEDIS) measures (but be clear with caveats), look outside HEDIS for measures of behavioral health service delivery, use a multi-faceted measurement set including both HEDIS and specialized measures, set clear and reasonable goals for public reporting, devote resources to auditing measures, consider opportunities to use health information technology and value the role of leadership in the process.
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