2008 – 2009 Executive Budget Recommendation – Overview
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The mission of the New York State Office of Mental Health (OMH) is to promote the mental health of all New Yorkers, with a particular focus on providing hope and recovery for adults with serious mental illness and children with serious emotional disturbances. OMH envisions a future when everyone with a mental illness will recover, when all mental illnesses can be prevented or cured, when everyone with a mental illness at any stage in life will have access to effective treatment and supports which are essential for living, working, learning, and participating fully in the community.
The 2008-2009 Executive Budget Recommendation for OMH builds on prior year initiatives by addressing the systemic problems of difficulty in accessing services and service fragmentation. This Recommendation maintains the large array of services currently available to citizens of the State while recognizing the need for additional services and systemic changes to assure a high level of quality, improved access, and decreased fragmentation.
Sustaining and expanding the adult mental health ambulatory care system
Efforts to improve access and decrease fragmentation have been attempted many times in previous budgets. While some of these have met with limited success, real change cannot be achieved without addressing the inequities resulting from decades old funding mechanisms. The Executive Budget Recommendation takes steps to address these disparities in funding.
New funding
- Implementing the first steps in a multi-year plan to rationalize funding to mental health clinics to ensure accessibility to services
- Expanding access to employment services by adding targeted new funding to Personalized Recovery Oriented Services (PROS) programs
Improving access and decreasing fragmentation in the children’s community mental health system
Achieving the Promise for children and families is a highly integrated series of initiatives to improve outreach efforts, recognize emotional disturbance in children at earlier stages, improve treatment protocols, and access to services. The Executive Budget Recommendation further enhances children’s services through the following:
New funding
- Adding Family Support Services to the portfolio of covered services under the Child and Family Clinic Plus program which will allow for the universal implementation of an operational framework for treatment that is family-driven
- Removing barriers to specialty mental health services for children by allowing for the designation of more clinics that serve children enrolled in Medicaid managed care
- Expanding the Children’s Rural Telepsychiatry initiative by adding 10 more counties where child psychiatrists may not be available
Annualized funding
- Continuing the Achieving the Promise initiative which includes prior year commitments to Child and Family Clinic Plus, Rural Telepsychiatry, Home and Community Based Service (HCBS) waiver slots, and the Evidence-based Treatment Dissemination Center
- Expanding HCBS waiver slots for children by 180 as originally authorized in 2007-08, bringing total slots to 1,620
Improving access and decreasing fragmentation for high need and high cost populations
As a result of the People First forums held in the spring and summer of 2007, OMH, along with the Department of Health (DOH), the Office of Alcoholism and Substance Abuse Services (OASAS) and the Office of Mental Retardation and Developmental Disabilities (OMRDD), is taking steps toward implementing better communication and collaboration strategies to meet the needs of the many individuals that are served by multiple service systems. OMH also continues its work with the Department of Correctional Services (DOCS) to improve mental health services provided in prisons. Specific initiatives include:
New funding
- Collaborating with OASAS and DOH in demonstration programs to address the treatment needs of persons with psychiatric disabilities and addiction treatment needs
- Collaborating with DOH to implement two demonstrations of effective integration of health and mental health services — one located in Western New York and the second located in New York City
- Augmenting services for prison inmates with mental illness consistent with anticipated statutory changes
Annualized funding
- Continuing prior year funding for the Geriatric Mental Health Services initiative
- Continuing to work with DOCS to enhance mental health services to prison inmates with mental illness
Improving access to housing
As the Governor had previously committed, the Executive Budget Recommendation includes the creation of additional housing opportunities that, when completed, will result in nearly 41,000 community beds, including beds funded through New York/New York III. The Executive Budget Recommendation also advances Article VII language to allow for the development of housing that is more integrated into community settings by providing flexibility for agencies licensed by OMH to participate in integrated housing projects that will include access for individuals with mental illness. Proposals include the following:
New funding
- Expanding Supported Housing beds by 1,500 units
- Providing capital funding to develop 500 integrated Single Room Occupancy (SRO) beds
- Providing new capital funding to purchase Adult Homes for conversion into to OMH housing in partnership with DOH and the Commission on Quality of Care and Advocacy for Persons with Disabilities (CQCAPD)
Annualized funding
- Continuing the development of prior year commitments for community housing for children and adults, including 1,000 Supported Housing beds and 1,000 congregate care units originally funded in 2007-08.
Enhancing the ability to recruit and retain a qualified workforce to ensure the delivery of quality care
Quality services, in both institutional and community settings, are the foundation of a well-organized system of mental health care. In order to maintain quality, the Executive Budget Recommendation includes the following initiatives:
New funding
- Implementing the final year of the current three-year Cost of Living Adjustment (COLA) for certain locally-operated mental health programs
- Extending the COLA commitment for another three years through 2011-2012
- Implementing the second year of a three-year commitment to increasing funding to Community Residence and Family-Based Treatment (FBT) programs to enhance staffing and respond to inflationary pressures
- Enhancing reimbursement to Family Care providers to recruit and retain qualified providers and respond to inflationary pressures
- Addressing recruitment and retention issues in the State workforce by targeting salary enhancements to allow the State to offer more competitive salaries for certain clinical positions
Promoting public mental health
Although OMH places a particular focus on the needs of seriously mentally ill individuals, outreach to the public at-large is also part of the Agency’s mission. The Executive Recommendation addresses these needs through the following:
New funding
- Providing funding needed to support the implementation of the New York State Workplace Violence Prevention Law.
Annualized funding
- Continuing efforts to implement the New York State Suicide Prevention Plan aimed at increasing public awareness and promoting prevention
Enhancing mental health research to advance prevention, treatment, and recovery
Research is essential for the identification of interventions that are proven to be effective and can be incorporated into mainstream practice. The Executive Budget Recommendation includes the following enhancements to OMH’s Research Program:
Annualized Funding
- Continuing support for 25 research scientists at the New York State Psychiatric Institute and the Nathan Kline Institute initially authorized in 2007-08
- Annualizing funding for the Cultural Centers of Excellence to promote the development of best practices in the delivery of culturally and linguistically competent mental health services
Reforming Medicaid rate structures to rationalize provider reimbursement
Article VII Legislation
- The Executive Budget Recommendation advances Article VII legislation (in the DOH Budget) to update Article 28 hospital rates (phased on a multi-year basis) for inpatient psychiatric care and transition to a new case-mix adjusted payment methodology
- The Executive Budget Recommendation advances Article VII legislation (in the DOH Budget) to remove reimbursement inequities by eliminating specialty rates for Article 28 dually-licensed mental health outpatient programs