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Ann Marie T. Sullivan, M.D., Acting Commissioner
Governor Andrew M. Cuomo

2006 Interim Report
Statewide Comprehensive Plan for Mental Health Services
2006-2010 Statewide Comprehensive Plan for Mental Health Services - January 2006

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New York State
George E. Pataki
Governor

Office of Mental Health
Sharon E. Carpinello, RN, PhD
Commissioner

Keith E. Simons
Deputy Commissioner
Division of Planning

October 2006

Table of Contents

Introduction

The New York State Office of Mental Health (OMH) issued the 2006–2010 Statewide Comprehensive Plan for Mental Health Services in January 2006. This 2006 Interim Report presents progress on major initiatives that have resulted from use of the Office’s strategic planning framework and processes.

In addition to providing an overview of the 2006–2010 Plan, this report outlines this year’s Executive Budget and Legislative actions and provides strategic planning updates. These include stakeholder input for consideration in producing the 2007–2011 Statewide Comprehensive Plan, the major County planning initiative being conducted by the Conference of Local Mental Hygiene Directors, in collaboration with the Office of Mental Health, and the implementation of performance management via the Balanced Scorecard and related activities.

Message from the Commissioner

The goal of the 2006 Interim Report to the 2006–2010 Statewide Comprehensive Plan for Mental Health Services is to provide an account of efforts under way this year to promote positive change within the public mental health system in New York State. This movement toward positive change has been proceeding in parallel with the implementation of a number of projects to advance a set of strategic priorities central to the mission, vision and values of the Office of Mental Health (OMH). The priorities for the 2006 Statewide Plan emerged directly from discussion with stakeholders and from a systematic review of environmental trends, challenges, and opportunities faced by the State public mental health system. The priorities were also the result of a multiyear approach to broad-based planning and the strengthening of the agency’s strategic planning framework.

The two insights I shared in last year’s Interim Report still hold true and are worthy of mention once again. People are hungry for information and for their voices to be heard. This continues to be evident by the greater numbers of people providing input into the planning process and the thought and care they give in providing their feedback. Additionally, to be comprehensive and inclusive, the planning process emerges slowly, but steadily in the direction of positive growth. OMH continues to be committed to this process and to the attainment of a recovery-oriented system of care.

I am pleased with the progress we have been making in moving toward positive change, particularly in relation to the critical areas of children’s mental health, performance management, and health promotion. In other areas we have energetically endeavored to move forward and achieve progress in addressing priorities. In this message, however, I would like to concentrate my remarks on the three areas I have mentioned.

Achieving the Promise

The Governor’s budget initiative this year provided the single largest one-year investment in children’s mental health services in the State’s history. The initiative, called Achieving the Promise for New York’s Children and Families, includes the Child and Family Clinic Plus program, the Evidence-Based Treatment Dissemination Center, the Home and Community-Based Waiver expansion and rural tele-psychiatry.

Complementing these targeted strategies to improve mental health services to children and their families is the creation in law of the Children’s Mental Health Act of 2006. The law supports cross-system collaboration and coordinated provider services and interagency networks to maximize resources and minimize duplication of services. The law also calls for OMH and the State Education Department to develop joint guidelines for voluntary incorporation of social and emotional development of children into elementary and secondary school educational programs.

In concert with these changes, OMH received good news in September when it learned that a team of researchers from OMH and collaborating State institutions had been awarded a five-year, $2.25 million grant from the National Institute of Mental Health. Under the direction of Principal Investigator Kimberly Hoagwood, PhD, the children’s “developing center” is the first of its kind to be funded within a state mental health authority. Its primary goal is to improve our understanding of ways to implement and sustain evidence-based clinical services effectively for children and families being served within New York’s community-based mental health system.

A great deal of work has also been accomplished since January in laying the foundation for success. Child and Family Clinic Plus, the cornerstone of Achieving the Promise, is scheduled to begin in January 2007 in upstate New York. The Child and Family Clinic Plus program is aimed at improving the emotional well-being of thousands of children in New York State by providing early intervention and treatment. These in turn are expected to enhance school performance, improve social relationships and go a long way toward preventing long-term mental health problems. Early intervention is seen as a pivotal public health strategy to promoting children’s emotional growth, social interactions, intellectual development, and overall health and well-being.

The Evidence-Based Treatment Dissemination Center is active and offering clinical training in cognitive behavioral therapy, a best practice in children’s mental health care. These new and effective treatments are being integrated into day-to-day services, bringing the benefits of the latest scientific knowledge and quality care to children and their families. Our target was to train by the end of this year 400 clinicians in providing evidence-based treatments to address the effects of trauma and depression in children; I am proud to say that as of mid-October, 426 have been trained. These clinicians are continuing to participate in regular and ongoing consultation to ensure quality care and to embed these practices into the mainstay of their work with children and families. The response and continued participation in the ongoing training have been very positive.

Efforts to expand in-home services for children with serious emotional disorders and their families as well as to introduce tele-psychiatry in rural areas are moving ahead. Funding for more in-home services has become available to families in need. Upgrades to infrastructure and staff hiring for the tele-psychiatry project are in progress. Rural counties look forward to the implementation of tele-psychiatry and the availability of psychiatric consultations and treatment for children and families in need.

While a great deal of attention is being given to community-based care for children and families, OMH has also continued to invest in quality hospital-based clinical treatment and supports for children and families. We broke ground in August for a new, state-of-the art Rockland Children’s Psychiatric Center building. The new Children’s Psychiatric Center building will provide a modern therapeutic environment that will support the recovery of children and their families. Additionally, in late June, the Greater Binghamton Health Center opened a newly renovated 14-bed inpatient unit for children and adolescents and hospitality house to provide temporary accommodations for families of children living outside the Greater Binghamton area. The new unit is truly designed to support recovery; it balances individual privacy and appropriate supervision, provides a safe and therapeutic environment, and is family friendly, especially in the visiting areas.

The Balanced Scorecard

The 2006–2010 Statewide Comprehensive Plan promised delivery of an online Balanced Scorecard to monitor indicators of performance. It became available on the OMH website in March 2006 and continues to be updated regularly.

The Balanced Scorecard builds on the many years of success in performance measurement by OMH. It relies upon up-to-date quantitative data to compare actual performance against specific measurable targets. Content areas include outcomes experienced by the individuals served in the State public mental health system, results of public mental health efforts undertaken by OMH and critical indicators of organizational performance.

The initial release of the Balanced Scorecard presented eight indicators, primarily focusing on services offered by OMH in hospitals and outpatient settings. The set of eight doubled in July 2006 and included a number of indicators that will follow the progress of new initiatives such as the implementation of training in children’s evidence-based practices and the utilization of additional home and community-based services capacity.

Mental Health Promotion

In addition to the health promotion efforts that are part of the Achieving the Promise initiative, OMH is committed to other strategies that strengthen the mental health and well-being of children and families.

One recent project has great promise for young children dealing with the sense of loss experienced when a parent must leave for service in the Mid-East. In collaboration with Sesame Workshop and Wal-Mart, OMH has spearheaded the “Talk, Listen, Connect” campaign for military children and their families. The multimedia, bilingual initiative strives to help military families manage the challenges, such as stress caused by a parent’s deployment, frequent relocations, and the other difficult issues faced by children in the military. The components of the campaign are a Sesame Street video for parents and preschoolers dealing with various stages of deployment, a guide for parents and caregivers, a delightful poster, and online resources and activities for children and families. Currently, 450,000 kits are being distributed nationwide and the feedback has been affirming of OMH’s commitment to promoting healthy coping and resilience.

Another mental health promotion activity of importance to New Yorkers has been the creation of a crisis counseling program for victims of the June 2006 flooding along the southern tier of the State. Called Project Recovery, the program is funded by the Federal Emergency Management Agency with support from the Center for Mental Health Services. The program is providing an immediate disaster mental health response in four flood-stricken counties. The services are helping victims, many of whom have suffered innumerable losses from this and past floods, to cope effectively and regain their pre-disaster level of functioning.

The SPEAK campaign also continues to be active and responsive to our aims of assisting New Yorkers to understand the terrible frequency and toll of suicide, and to discover ways and methods to help prevent it. The Chinese version of SPEAK, which was released in May, is another important step in our suicide prevention efforts in the Asian American community.

As I reflect upon the progress in just these three areas, I am reminded of the momentum we have gained in strengthening our strategic planning processes, having them inform the development of priorities, promoting investments in areas defined by stakeholder input and the latest science, and measuring and monitoring progress toward achieving our goals. The Winds of Change have helped to shape a mental health agenda consonant with the mission, vision and values we have all adopted and embraced.

I look forward to our shared efforts to contribute to the base of knowledge that leads to developing evidence-based assessment, treatments and supports, to bring best practices into clinical and supportive settings, to strive for positive outcomes, and to promote recovery for individuals with mental illnesses.

Sharon E. Carpinello, RN, PhD

Overview of the 2006–2010 Statewide Comprehensive Plan for Mental Health Services

The 2006–2010 Statewide Comprehensive Plan for Mental Health Services complements and expands the 2005–2009 strategic planning framework through the alignment of performance management and financial decision making.

With the introduction of the balanced scorecard model, the Plan introduced an integrated strategic planning process that utilizes the balanced scorecard approach and builds upon the Office of Mental Health (OMH) data-driven continuous quality improvement model. This includes gathering input from stakeholders on relevant areas of performance, collecting and analyzing performance data, reporting results, and using the data to improve services and to inform health care decision making. A brief synopsis of each chapter follows:

Chapter 1

Chapter 2

Chapter 3

Chapter 4

Chapter 5

Chapter 6

Chapter 7

Chapter 8

The 2006–2010 Plan, which is available on the OMH website at www.omh.state.ny.us/omhweb/statewideplan/, is intended to be read and utilized in conjunction with the 2005–2009 Statewide Comprehensive Plan, which introduced an initial set of goals, and objectives to guide services and operations, and the 2004–2008 Plan.

Executive Budget Actions

The New York State budget process relies upon an Executive Budget model. Under this system, the Executive develops and prepares a comprehensive balanced budget proposal, which the Legislature modifies and enacts into law. The Governor is required by the State Constitution to seek and coordinate requests from agencies of State government, develop a plan of proposed expenditures and the revenues available to support them, and submit a budget to the Legislature along with the appropriation bills and other legislation required to carry out budgetary recommendations.

The Legislature, primarily through its fiscal committees ― Senate Finance and Assembly Ways and Means ― analyzes the Executive spending proposals and revenue estimates, holds public hearings on major programs and seeks further information from the staffs of the Division of the Budget and other State agencies. Following that review, the Legislature acts on the appropriation bills submitted with the Executive Budget to reflect its decisions.

The 2006–2007 Executive Budget for the Office of Mental Health (OMH) aims to advance the Governor’s agenda for change within the New York State public mental health system by continuing to redirect resources to community settings, provide funding for targeted service expansion in science-based treatments, and provide funding to preserve and reinforce the existing service system. The 2006–2007 Budget recommendations are integral to the promotion of recovery and community integration for individuals with mental illness. The Budget strengthens key community programs and maximizes access to quality mental health care, while still achieving the necessary efficiencies to ensure the most cost-effective use of all resources.

Actions on Executive Budget items for the 2006–2007 Fiscal Year are organized under the categories of State Operations and Aid to Localities. They include the following:

State Operations

Improving the Quality of Clinical Interventions for New York’s Children and Families


Reinvesting Middletown Psychiatric Center Savings


Increasing Public Safety through the Civil Commitment of Sexually Violent Predators, Where Appropriate, to Secure Treatment Facilities


Other 2006–2007 State Operations Executive Budget Actions


State Operations: Legislative Additions

New York Psychiatric Center Research


Nathan Kline Institute Research


Study to Review the Current System of Financing of Mental Health Services


Aid to Localities

New York/New York III


Clinic Plus


2.8% Cost-of-Living Adjustment


Supported Housing


Home and Community-Based Services Waiver


Suicide Prevention


Geriatric Mental Health


Tele-medicine


Community Bed Development


Mental Health Medicaid Reform Actions

Psych Day/Night Rate


Alternate Reimbursement Methodology


Annualization of Prior Year’s Initiatives


Aid to Localities: Legislative Additions

Children’s Day Treatment


$7.7 Million Restoration


Conference of Local Mental Hygiene Directors


Transitional Housing for Children


Adult Home Supported Housing


Family Support


Upstate Supported Housing


Leveling Up Outpatient Base Fees and Non-Comprehensive Outpatient Program Services


Member Items

Summary of Legislation for the 2006 Session

This section contains brief summaries of bills affecting OMH that were Approved, Vetoed, or not yet delivered to the Governor as of late October 2006, when this report was being prepared. The summaries are based on the latest available information from the Legislative Retrieval System (LRS) operated by the State of New York Legislative Bill Drafting Commission. Status of legislation, copies of bills, veto messages, chapter laws, and other related information are available to the public on the LRS web site at http://public.leginfo.state.ny.us Leaving OMH site. The summaries are grouped by community services, state facilities and operations, and miscellaneous.

Community Services

Children's Mental Health Act
Approved
Chapter 667 S.6672-C

This legislation establishes the “Children’s Mental Health Act of 2006” and requires the Commissioner of Mental Health to develop and monitor an annual children’s mental health plan, which would include coordinated services and referral networks; guidelines for incorporating social and emotional development into school programs; recommendations regarding appropriations for children’s mental health assessments, early intervention and treatment to State and local agencies; recommendations for methodologies for integrating and coordinating funding; recommendations for building a qualified and adequately trained workforce; recommendations related to research on best practices; and recommendations for other systems improvements. Additionally, Education Law Section 305 will be amended to require that the Commissioner of Education, in cooperation with the Commissioner of Mental Health, develop guidelines for the voluntary incorporation of social and emotional development into school district programs.


Children’s Restraint Council
Approved
Chapter 624 A.11055-A
Effective: December 14, 2006

This legislation amends the Social Services Law to add a new Section 483-e, which establishes a new Restraint and Crisis Intervention Technique Committee within the New York State Council on Children and Families. This committee is to be comprised of the Commissioners of the Office of Children and Families Services, OMH, Office of Mental Retardation and Developmental Disabilities, State Education Department, and Department of Health. Additionally, the committee is to include at least two representatives of organizations that represent providers of educational and residential services to children, at least two mental health professionals who provide services to children, and at least one representative of parents of children requiring special services.

The new Section 483-e also directs the committee to “identify the most effective, least restrictive and safest techniques for the modification of a child’s behavior in response to an actual or perceived threat by such child of harm or bodily injury to such child, or to another person,” when such child is a recipient of services of certain residential and nonresidential programs. The techniques to be identified shall include various types of restraint and crisis prevention, intervention and management. The committee is directed to review models of crisis prevention and intervention, including physical restraint. In addition, the committee “shall establish uniform and coordinated standards giving preference to the least restrictive alternative for such techniques in such children service settings.” Finally, the committee is directed to develop recommendations regarding crisis intervention and proposed regulations to be included in a report to be submitted to the Governor and the Legislature due no later than September 1, 2007.


Mental Health Practitioner Extension
Approved
Chapter 130 S.6421
Effective: January 1, 2006

This legislation amends Section 19 of Chapter 676 of the Laws of 2002 to provide an extension of time for the processing, by the State Education Department, of certain applications for professional licenses as one of the four new mental health practitioners (mental health counselor, marriage and family therapist, creative arts’ therapist and psychoanalyst). The State Education Department is still in the process of reviewing applications that it received by the December 1, 2005, submission deadline, and this amendment extends until January 1, 2007, the deadline for the State Education Department to process these applications. Persons who have a pending application may continue to practice, without a license, during the period that their application is under review. This act was deemed to be effective on January 1, 2006.


FBI Fingerprint Checks
Approved
Chapter 673 S.6825-A
Effective: March 12, 2007

This legislation amends the Executive Law to require the Division of Criminal Justice Services to forward fingerprints submitted by OMH for employees and volunteers of providers of services to individuals with mental illness, mental retardation, and developmental disabilities to the Federal Bureau of Investigation so that a nationwide criminal history check may be conducted on such employees or volunteers.


Mental Health Insurance Parity “Timothy’s Law”
Agreement reached, has passed Senate, but has not yet passed Assembly S.8482

This legislation, which passed the Senate on September 15, 2006, mandates that health insurance policies provide 30 days of inpatient and 20 days of outpatient coverage for the diagnosis and treatment of mental, nervous or emotional disorders. For employers with 50 or more employees, the legislation requires health insurance policies that provide medical coverage to provide comparable coverage for adults and children with “biologically based mental illness” and also comparable coverage for “children with serious emotional disturbances.” At the time of this writing, the bill had not passed the Assembly.

“Biologically based mental illness” is defined to include a mental, nervous, or emotional condition that is caused by a biological disorder of the brain and results in a clinically significant, psychological syndrome or pattern that substantially limits the functioning of the person with the illness. Such biologically based mental illnesses are defined as schizophrenia/ psychotic disorders, major depression, bipolar disorder, delusional disorders, panic disorder, obsessive compulsive disorder, bulimia, and anorexia.

“Children with serious emotional disturbances” is defined to include persons under the age of eighteen years who have diagnoses of attention deficit disorders, disruptive behavior disorders, or pervasive development disorders, and where there is one or more of the following: serious suicidal symptoms or other life-threatening self-destructive behaviors; significant psychotic symptoms (hallucinations, delusion, bizarre behaviors); behavior caused by emotional disturbances that places the child at risk of causing personal injury or significant property damage; or behavior caused by emotional disturbances that places the child at substantial risk of removal from the household.

Plans must make available comparable mental health coverage for employers with 50 or fewer employees and the State general fund will cover the excess costs. Such comparable coverage is subject to utilization review and to out-of-network requirements and not available to correctional inmates and not available to cover cosmetic procedures for mental health reasons.

The Insurance Superintendent is charged with monitoring compliance. The Insurance Superintendent, in consultation with OMH, shall study and report to the Governor and Legislature by April 1, 2009, regarding the effectiveness of mental health parity, including the costs associated with parity, the number of policyholders electing parity coverage, and the types of illnesses for which coverage was provided. If enacted, this law would sunset on December 31, 2009.


Contracts with Not-for-Profit Organizations
Vetoed
Veto #315 S.8026

This bill would have amended provisions of the State Finance Law to clarify the time frames for State agencies to execute contracts with not-for-profit (NFP) organizations and to notify such organizations of their intention regarding renewal of a contract. Additionally, the bill would have provided for the following: (i) if a State agency did not notify an NFP organization of its intention not to renew a contract within the prescribed time frames, the contract would remain in effect and expenses incurred by the NFP organization would have been reimbursable in accordance with the expired contract until such notification is provided; (ii) if a State agency were not able to comply with the prescribed time frames due to circumstances beyond its control, such an agency would have been required to provide written notice to the Division of Budget and the Office of State Comptroller, and the Comptroller’s Office would have determined whether the basis for such noncompliance was supported; (iii) interest due on a contract with a retroactive start date would have only been waived if a State agency could have demonstrated that such waiver is required by unusual circumstances and would benefit the NFP organization; (iv) a waiver of interest could not have been a prerequisite to the execution of a renewed contract; (v) in the event that the State Office of the Comptroller did not approve an interest waiver, a State agency would have been required to immediately pay the NFP organization the amount owed; and (vi) if interest had not been paid within 30 days of the Comptroller’s Office denial of the waiver, it would have been authorized to assess the interest.


Suburban/Rural CPEP Repeal
Approved
Chapter 57 Part M
Effective: April 10, 2006

This legislation, which was part of the enacted budget (Article VII), amended Section 31.27 of the Mental Hygiene Law, to eliminate the Commissioner’s authority to designate Suburban/Rural Comprehensive Psychiatric Emergency (CPEP) programs.


Limited Liability Companies
Approved
Chapter 75 S.5559
Effective: June 7, 2006

This legislation amends the Mental Hygiene Law to clarify that limited liability companies that operate facilities providing services to persons with mental illness in New York State are subject to the licensing statutes and regulations of OMH. This law achieves consistency among the licensing statutes for OMH, the Department of Health and the Office of Alcoholism and Substance Abuse Services. The Department of Health and Office of Alcoholism and Substance Abuse Services licensing statutes were previously amended to similarly clarify that limited liability companies are subject to regulation by those agencies. Consistency among the Department of Health, Office of Alcoholism and Substance Abuse Services, and OMH licensing statutes is desirable since providers or business entities may hold or apply for a variety of licenses from these agencies to provide health, chemical dependence and mental health services.


SONYMA Funding
Approved
Chapter 402 S.8032-A
Effective: July 26, 2006

The purpose of this legislation is to amend the definition of “rehabilitation loan,” as set forth in Subdivision 12 of Section 2426 of the Public Authorities Law. The amendment adds language exempting community residences, as defined in Subdivision 28 of Section 1.03 of the Mental Hygiene Law, and any other residential facility regulated by, or under the jurisdiction of, the Department of Mental Hygiene, from the minimum rehabilitation percentage requirement contained in the definition of rehabilitation loan.


Adult Housing Waiting List
Vetoed
Veto #323 A.2895-A

This bill would have amended Section 7.15 of the Mental Hygiene Law to require OMH to establish community housing waiting lists for adults seeking housing in the “OMH service system” and to publish such lists on a monthly basis. The waiting lists were to include all adults who “have been referred to or applied for but have not yet received supported, supportive, supervised or congregate housing services.”

As indicated in the Governor’s veto message, the legislation had no requirement that the individual who applies or is referred to receive housing have a mental illness. The bill would have also directed each provider of housing services in the OMH system to provide OMH, on a monthly basis, a list of each person referred to, admitted to, applying for, withdrawing an application for and denied admission to housing provided by such provider; it also would have required community-based assessors of persons with disabilities to provide a list of persons who would benefit from such housing.


Discharges to Adult Homes
Approved
Chapter 534 S.8029
Effective: August 16, 2006

The purpose of this legislation is to require that patients to be discharged from an OMH-licensed or operated inpatient facility, be discharged only to an appropriate adult home residential placement. Section 29.15 of the Mental Hygiene Law is intended to support safe and appropriate discharge from all mental hygiene inpatient facilities.

Mental Hygiene Law, Section 29.15, was amended in 2004 as part of the enacted budget language bill for the 2004–2005 State fiscal year. The 2004 amendment, however, eliminated OMH facilities from the requirements of Mental Hygiene Law Section 29.15. This appears to have been a technical error in the drafting of the bill.

The current bill corrects the technical error and ensures that OMH patients will now receive protection under this section of law similar to the protections provided to patients who are discharged from facilities under the jurisdiction of the Office of Mental Retardation and Developmental Disabilities and the Office of Alcoholism and Substance Abuse Services. These protections include a requirement that patients be referred only to adult homes that are consistent with their individual needs and that are operated in compliance with Social Services Law, Section 460, which relates to requirements for residential care programs. Further, patients discharged from OMH-licensed or operated facilities cannot be referred to any adult homes under an enforcement action by the Department of Health or homes that are on the Department’s Do-Not-Refer List.


SRO Tax Benefits
Approved
Chapter 609 A.10568
Effective: August 16, 2006

This bill amends Section 488-a of the Real Property Tax Law to extend the date by which NPF and for-profit owners rehabilitating buildings qualifying as single-room occupancy (SRO) housing are eligible to receive certain tax benefits. Under current law, any increase in assessed valuation resulting from eligible improvements to an SRO receives a tax exemption, provided that such improvements are commenced prior to December 31, 2007, and are completed within 36 months of commencement. This amendment extends the expiration date for eligibility of tax benefits from December 31, 2007, to December 31, 2011.


State Facilities and Operations

Creedmoor Land Transfer
Approved
Chapter 156 S.8453
Effective: July 7, 2006

This legislation authorizes the Dormitory Authority of the State of New York to sell certain land in Queens County to the Indian Cultural and Community Center, Inc. The land in question is a portion of the campus of Creedmoor Psychiatric Center.


Binghamton Name Change
Approved
Chapter 32 A.6078
Effective: May 16, 2006

This bill amends Section 1 of Chapter 564 of the Laws of 2003, amending the Mental Hygiene Law, which renamed the Binghamton Psychiatric Center as the Greater Binghamton Health Center. This bill adds language to such section, to require that any reference in any law, rule, regulation, contract or any place wherever to “psychiatric center” shall be deemed to include the Greater Binghamton Health Center unless otherwise provided. Further, any reference in any law, rule, regulation, contract or any place wherever to “health center” shall be deemed to exclude the Greater Binghamton Health Center, unless otherwise provided.


Procurement Purchasing Thresholds
Approved
Chapter 56 (Part D)
Effective: April 10, 2006

The threshold for purchases, which may be made without a formal competitive process by State agencies, was raised from $15,000 to $50,000. In addition, the competitive bidding limit for the purchase of recycled or re-manufactured commodities or technologies has been raised to $100,000 and the Office of General Services may purchase up to $85,000 of goods or services without competitive bidding. Contracts that provide for expenditures of up to $50,000 no longer require Office of State Comptroller approval; however, if the State is giving a consideration other than the payment of money which has a value in excess of $10,000, Office of the State Comptroller approval is still required. [Note: The threshold for publication of procurement opportunities in the Contract Reporter has not been changed, meaning OMH must continue to publish procurement opportunities for purchases more than $15,000.]


Consultant Contract Disclosure
Approved
Chapter 10 A.9421
Effective Date: June 19, 2006

The purpose of this legislation is to amend the information required to be included in annual reports issued by the Department of Civil Service and the Office of the State Comptroller regarding the employment of persons hired under contracts for consulting services by State agencies. These reports include the number of contract employees performing consulting services, the types of services consultants perform and their total compensation, and the types of services provided.


Electronic FOIL Requests
Approved
Chapter 182 A.7993-B
Effective: October 26, 2006

This bill amends the Public Officers Law to require all entities subject to the Freedom of Information Law (FOIL) to accept and respond to electronic requests for records using forms developed by the Committee on Open Government. Further, this legislation authorizes an entity to respond in another format, if so requested.


Electronic Records
Vetoed
Veto 257 A.8007

This bill would have amended the Public Officers Law to require that, to the extent practicable and reasonable, agencies design information retrieval methods to permit segregation of publicly available records, where such agencies maintain records electronically and such records are subject to public disclosure while others are exempt from disclosure.


FOIL Attorney’s Fees
Approved
Chapter 492 S.7011-A

This legislation amends the Public Officers Law to authorize a court to award attorney’s fees and court costs, under certain conditions, in regard to litigation associated with FOIL requests. It applies when a government agency has no reasonable basis for denying a FOIL request or a government agency fails to respond to a FOIL request within the time permitted by statute.


OMH Community Safety “Judi Scanlon Bill”
Vetoed
Veto #247 A.2570

This legislation would have required that in any outpatient program staffed in whole or in part by OMH employees, no employee shall have been required to enter the residence of a recipient of services, who was an individual with a serious mental illness as defined in Mental Hygiene Law, Section1.03 (52), unless the employee was accompanied by at least one other OMH employee. Further, all such employees, when required to enter the residence of a recipient, would have been required to be provided with a cell phone or comparable device for emergency communication. Also, all OMH intensive case managers (ICMs) would have been required to receive annual training in safety and violence prevention. Funds appropriated to OMH for operation of outpatient programs would have been required to be expended by OMH to insure that sufficient staff were employed as ICMs such that there were no fewer than one ICM for each 12 individuals receiving ICM services. In addition, in the case of assertive community treatment (ACT) teams, the same such ratio would have also been required. Finally, in the event that any such staff positions became vacant, OMH and the Division of Budget would have been required to promptly fill such positions in order to maintain the required staff-to-recipient ratio.


SSO Binding Arbitration
Vetoed
Veto #403 S.7750

This legislation would have amended the Civil Service Law to include within its provisions requiring binding arbitration for those members of the Security Services collective bargaining unit who are in a Safety and Security Officer (SSO) title with OMH, the Department of Health, or the Office of Mental Retardation and Developmental Disabilities.


SHTA Binding Arbitration
Vetoed
Veto #405 S.7757

This legislation would have amended Section 209 of the Civil Service Law to include within its provisions requiring binding arbitration those members of the Security Services collective bargaining unit who are in a Security Hospital Treatment Assistant (SHTA) title.


SHTA Retirement
Vetoed
Veto #249 A.3340-A

This legislation would have amended the Retirement and Social Security Law to allow Tier 3 Correction Officers and Tier 3 and Tier 4 SHTAs to choose between the 25-year retirement plan offered to Corrections Officers and SHTAs, or the regular Tier 4 option to maximize their retirement benefit.


Employee Reassignment
Vetoed
Veto #280 A.6477-A

This bill would have amended the Civil Service Law regarding reassignment of employees. Specifically, employees would not be reassigned without their consent if the reassignment required a change to a county other than the county of their current work location, or to a county which was not contiguous to the county of their current work location. Further, should the reassignment have been deemed necessary, the incumbent would have been given at least 12 months notice, and the option to transfer to other positions pursuant to Section 78 of the Civil Service Law.


Labor Class Employee Rights
Vetoed
Veto #258 A.8074

This bill would have amended Section 75 of the Civil Service Law to include tenured labor class employees among those who could not be removed or subject to discipline except for incompetence or misconduct shown after a hearing of charges. This amendment would have afforded the same rights currently available to noncompetitive employees to labor class employees. [Note: Labor class positions, such as cleaners, have few or no minimum civil service qualifications, no official line of promotion, and are not eligible for transfer.]


Employee Representation
Vetoed
Veto #278 S.4508

This bill would have amended the Civil Service Law to make it an improper practice for an employer to deny a public employee the right to representation by an attorney or other representative of the certified or recognized employee organization representing the employee when the employee was being questioned by the employer and it reasonably appeared that the employee may be the subject of a potential disciplinary action. Under the bill, if representation was requested, a reasonable period of time was to be afforded to the employee to obtain such representation.


Whistleblower Protection
Vetoed
Veto #370 S.5376-B

This bill would have amended Section 75-b of the Civil Service Law to expand protections afforded to employees (“whistleblowers”) who report violations of law that present a significant danger to public health and safety. This bill provided coverage to employees who exposed situations that could have led to endangering the welfare of a minor; redefined the actions of employers to impose retribution on these employees to include eliminating the job title of the employee; and awarded attorney fees to employees who prevailed in court when challenging employer actions.


Contracts for Personal Services
Vetoed
Veto #322 A.1259

This bill would have amended the State Finance Law to provide that State agencies may only enter into a contract for personal services if (i) the services contracted for were not currently available within a State agency and could not be performed satisfactorily by a civil service employee; (ii) the services were incidental to a contract for the purchase or lease of personal property; (iii) the legislative, administrative or legal goals and purposes could not be accomplished by using persons selected pursuant to the civil service system; (iv) the State agency needed private counsel due to a conflict of interest; (v) the State could not feasibly provide the equipment, materials, facilities or support services in the required location; (vi) appropriately qualified civil service instructors were not available; (vii) the services were of such an urgent nature that any delay that would have been a byproduct of utilizing the civil service system would have frustrated the purpose; (viii) the contracting agency demonstrated a quantifiable improvement that could not be duplicated; or (ix) the agency demonstrated an actual cost savings.


Workplace Violence Prevention Act
Approved
Chapters 82 & 542 S.6441 and S.8159
Effective: August 16, 2006

This legislation, titled “The Workplace Violence Prevention Act of 2006,” amends the Labor Law to require that public employers, with at least 20 full-time employees, develop and implement programs to prevent workplace violence. Such employers must evaluate the potential risks of workplace violence that exist within their workplaces and develop and implement a written workplace violence prevention program to prevent and minimize the hazards of workplace violence to their employees.


Miscellaneous

IOCC Report
Vetoed
Veto #356 A.11749

This legislation would have amended subdivision (b) of Section 5.05 of the Mental Hygiene Law to require that the Inter-Office Coordinating Council (IOCC) submit an annual report to the Legislature. The IOCC is made up of the Commissioners who head the three agencies of the Department of Mental Hygiene: OMH, the Office of Mental Retardation and Developmental Disabilities and the Office of Alcoholism and Substance Abuse Services.

The annual report would have been required to include, but not be limited to: information regarding treatment models and programs for persons with multiple disabilities, and suggested improvements to such models and programs; research projects of the research institutes associated with the Offices of the Department of Mental Hygiene and their coordination with each other; collaborations and joint initiatives undertaken by the Offices; consolidation of regulations of each Office to reduce inconsistencies; activities related to workforce training data on prevalence, availability of resources and service utilization by persons with multiple disabilities; eligibility standards of each Office affecting clients with multiple disabilities, and eligibility standards under which a client is determined to be an Office’s primary responsibility; agreements or arrangements on statewide, regional and local government levels addressing how determinations over client responsibility are made and client responsibility disputes are resolved; information on substantial barriers for any specific group of clients with multiple disabilities in accessing appropriate care; and coordination of planning, standards or services for persons with multiple disabilities between the IOCC, the Offices of the Department and local governments.


Centers for Excellence
Vetoed
Veto #338 A.9593-B

This legislation would have required that OMH support the development of two centers of excellence in culturally and linguistically competent mental health. These centers would have been operated in a collaborative manner with the Nathan S. Kline Institute for Psychiatric Research and the New York State Psychiatric Institute and other appropriate organizations. Further, the centers would have consulted with the OMH Multicultural Advisory Committee and investigated and disseminated best practices for delivery of culturally and linguistically competent mental health services to underserved populations affected by disparities due to cultural, linguistic and systemic barriers.


Alternative DNR Forms
Approved
Chapter 325 S. 6365-A

This bill amends Section 2977 of the Public Health Law, which allows the Commissioner of the Department of Health to authorize the use of alternative non-hospital do-not-resuscitate (DNR) forms in demonstration programs operating in Monroe and Onondaga counties. The statutory authority for the use of alternative DNR forms in these counties was established by Chapter 734 of the Laws of 2005. This bill amends that law to require OMH approval of any such authorized alternative DNR forms intended for use for persons with mental illness who are incapable or making their own health care decisions or who have a “guardian of the person” appointed pursuant to article 81 of the Mental Hygiene Law.


Public Hearings on State Medicaid Plan
Vetoed
Veto #219 A.11809

This bill would have amended the SSL to limit the authority of the State to timely file State Plan Amendments (SPAs) with the Federal government. Under Federal law, SPAs are necessary to obtain Federal financial participation for the State’s Medicaid program. The bill would have required the Department of Health to submit SPAs to the Chairs of the Senate Finance and Health Committees and Assembly Ways and Means and Health Committees at least 30 days prior to filing with the Federal government. The committee Chairs would then have had 30 days to elect to file a notice with the Department of Health setting forth their intention to hold a public hearing and provide comments on the proposed amendments. If such notification was provided, the Department of Health would then have been barred from submitting such SPA to Federal government until there had been a 60day period for public hearings and comments. In addition, the bill would have provided that within 90 days of the original submission, the Chairs may have submitted written questions and comments to the Department of Health. In such cases, the Department of Health would have had 30 days to respond. The bill would have taken effect immediately, and would have applied to all SPAs submitted after May 1, 2006.


Special Housing Unit (SHU)
Vetoed
Veto #324 A.3926-A

The bill would have required the establishment of Residential Mental Health Treatment Programs (RMHTPs) in the Department of Correctional Services facilities. These programs would have been jointly operated by OMH and the Department of Correctional Services and would have provided medically appropriate custodial care, supervision, treatment and, where appropriate, discipline, for inmates with serious mental illness.

Inmates with serious mental illness would have been excluded from confinement in a Special Housing Unit (SHU). The list of the serious mental illnesses requiring exclusion or removal from SHU included: (1) a diagnosis, or currently displaying symptoms of one or more of the following types of Axis I diagnoses as described in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (schizophrenia and other psychotic disorders; major depressive disorders; bipolar disorders; cognitive disorders, specifically delirium, dementia and amnesiac disorder); (2) a diagnosis of traumatic brain injury; (3)inmates determined to be at risk of suicide; or (4) inmates who have otherwise substantially deteriorated mentally or emotionally while confined in isolation where a transfer is deemed to be clinically appropriate by a mental health clinician.

The bill also would have provided for the assessment of inmates by mental health clinicians where such inmates are subject to SHU confinement related to discipline or maintenance of order after 24 hours and reassessment at least every seven days thereafter. Where such inmates met the criteria for serious mental illness, they would have been removed and placed in an RMHTP or any other clinically appropriate program. In addition, the Department of Correctional Services Superintendent was required to report to the OMH Commissioner on the mental health treatment or confinement of such inmates.

The Department of Correctional Services and OMH would have been required to provide all staff working in an RMHTP 40 hours of initial training and eight hours of annual training.


Physician Assistant/Nurse Practitioner Restraint Orders
Vetoed
Veto #340 A.9986-A

The purpose of this legislation was to amend Section 33.04 of Mental Hygiene Law to extend the authority to issue orders for the restraint of patients in psychiatric facilities to a physician assistant, under the supervision of a physician, or a nurse practitioner. This authority is currently only provided to a physician.


Medicaid Inspector General
Approved
Chapter 442
Effective: July 26, 2006 (except that certain sections are effective on other dates)

This legislation amends Article 1 of the Public Health Law to add a new Title III, establishing the Office of the Medicaid Inspector General (MIG). The MIG shall be appointed by and serve at the pleasure of the Governor. It further amends certain other laws to recognize the authority of the MIG.

This legislation also includes amendments to the Penal Law to establish and define “Health Care Fraud” crimes: (1) the least serious, health care fraud in the fifth degree, a class A misdemeanor, which involves knowingly and willfully providing false information or omitting material information, to a health care plan and, as a result, receiving an improper payment; (2) health care fraud in the fourth degree, a class E felony, includes the same elements as health care fraud in the fifth degree and wrongful receipt of payment from a single health plan, in a single year, that exceeds $3,000; (3) health care fraud in the third degree, a class D felony, includes the same elements as health care fraud in the fifth degree and wrongful receipt of payment from a single health plan, in a single year, that exceeds $10,000; (4) health care fraud in the second degree, a class C felony, includes the same elements as health care fraud in the fifth degree and wrongful receipt of payment from a single health plan, in a single year, that exceeds $50,000; and (5) health care fraud in the first degree, a class B felony, includes the same elements as health care fraud in the fifth degree and wrongful receipt of payment from a single health plan, in a single year, that exceeds $1,000,000.


Technical Corrections to Mental Hygiene Law
Approved
Chapter 401 S.8027
Effective: July 26, 2006

This legislation corrected a number of minor technical errors in various sections of the Mental Hygiene Law.

2006 Statewide Comprehensive Plan Stakeholder Input

Stakeholder input is received through a wide variety of opportunities provided each year by OMH. As part of the OMH annual planning cycle, a series of informational briefings and public hearings serves as one vehicle for broadly gathering stakeholder input. This year these briefings and hearings were held across the five regions of New York State from April 20, 2006, to May 12, 2006. The meetings were publicized on the OMH web site, among the Commissioner’s advisory groups, and by way of targeted mailings and e-mail notices to advocacy, provider, and trade organizations.

Each regional meeting included two components: a morning informational briefing by Keith Simons, Deputy Commissioner of Planning, and Sheila Donahue, Director of Data Analysis and Performance Measurement, as well as a formal public hearing in the afternoon. The afternoon session provided individuals with the opportunity to present prepared testimony and submit copies of the written testimony for the record. Overall, approximately 220 individuals participated in the hearings and the briefings.

Informational Briefings and Public Hearing Testimony Process

Attendees of each Informational Briefing were presented with a structured overview of how public feedback from last year’s hearings was incorporated into the refinement of the strategic planning framework. They also learned about OMH’s role as a pilot agency for a shared planning initiative with the Division of Budget and heard details of a working model constructed to guide policy and strategic decision making and to align strategic priorities and budget initiatives as described in Chapter 6 of the 2006–2010 Statewide Comprehensive Plan. Participants were also provided with highlights of the Balanced Scorecard initiative, given a report card demonstration, and engaged in discussion of technical and content issues.

During each of the briefings, stakeholders widely acknowledged OMH’s substantive role in improving the planning process and the Strategic Plan Framework. They expressed appreciation for OMH’s role in providing progress reports and satisfaction with the extensive investments made in the public mental health system in the Governor’s Executive Budget Recommendations.

During the public hearings and via e-mail and U.S. Mail, we received testimony from 56 individuals and, as such, the testimony represents the views of the individuals and/or groups they represented. Full testimony is available on the OMH web site at http://www.omh.state.ny.us/omhweb/statewideplan/2006/testimony/.

While five counties provided formal testimony, all counties have also been contributing substantive input into strategic priorities through the formal planning process developed by the Conference of Local Mental Hygiene Directors.

What follows is a compilation of themes emerging from the testimony of distinct stakeholder groups. The stakeholder groups include advocates/advocacy organizations, counties, parents/families, providers /provider organizations, recipients/concerned citizens, and trade associations. Appendix 1 shows the names of the individuals and groups and in which group they were placed for the purpose of analysis.

In identifying into which group to place testimony, we recognize that some organizations have multiple roles. In these cases, we made the best determination possible, based on the primary focus relative to the testimony. For the purpose of examining the unique perspective of each group, we relied upon following descriptions to categorize the testimony:

The thematic compilation is provided within the three major domains of the Strategic Plan Framework: outcomes of services, mental health services, and system management. The values and beliefs expressed by each group shed light on the areas of high priority and provide a backdrop for the myriad diverse and sometimes unique approaches to addressing priorities for systems of care and support.

Interestingly, there seems to be a consensus among stakeholders with respect to the areas of high priority, areas that are consonant with the eight strategic plan goals within the three domains. What differs, however, is what stakeholders recommend to address these priorities. There is a wide degree of variation in strategies to meet identified priorities, which may be informed partly by the nature of the counties and regions in which the stakeholders live and work (e.g., rural, urban, dense population centers), populations that reside in each, the existing service systems, and other relevant factors (e.g., a statewide shortage of psychiatrists, particularly child psychiatrists).

Compilation of Stakeholder Input from Public Hearing Testimony

Advocates

Eighteen advocates/advocacy organizations focused their testimony on improving services and supports for a number of populations, including persons involved in the criminal justice system, young children and adolescents, adult home residents, older adults and underserved populations. They offered suggestions for improvement in all three domains, with most clustered in the areas of access to services and service system capacity. In the outcomes area, advocates did note the importance of promoting early identification and intervention strategies, including suicide awareness and prevention.

In the mental health services domain, advocates gave high priority to persons with mental illness in need of housing and those who have involvement with the criminal justice system. They urged adapting and expanding the New York/New York III model within and outside of New York City and asked for a greater emphasis on recovery-oriented assessment, treatment, and supports for individuals with mental illness who are being served by the criminal justice system. Advocates also identified opportunities for improvement in access to appropriate and effective services for children and youth, older adults, persons residing in adult homes, and parents who have mental illness.

In the domain of system management, much attention was focused on fiscal, policy and regulatory issues as well as workforce and care coordination matters. Advocates urged strategies from providing incentives to providers excelling in the delivery of recovery-oriented services to addressing barriers to overcoming shortages of qualified persons to provide services tailored to the unique needs of older adults.

The work of the Commission on Health Care Facilities in the 21st Century was of concern to advocates; they asked OMH to provide the Commission with data and information to inform planning and maintenance of vital behavioral health services in communities.

In voicing support for care coordination, advocates praised OMH’s collaboration with the Office of Children and Family Services to provide Home and Community-Based Waiver slots and indicated the importance of this type of partnership in improving care systematically. Specific recommendations, by outcome domain, include the following:

Outcomes Domain

Public Mental Health Promotion

Positive Outcomes for Children, Families and Adults

Mental Health Services Domain

Continuous Quality Improvement

Access to Services

Children and youth services

Persons residing in adult homes

Parents with mental illness

Older adults

Forensic services

Housing

System Management Domain

Service System Capacity

Fiscal, policy and regulatory

Workforce development

Accountability for Results

Care Coordination

Children and youth services

Older adults

Persons in need of sexual offending treatment

Counties

Five representatives of County government provided testimony on priorities for the public mental health system. As noted previously, led by the Conference of Mental Hygiene Directors, counties have been actively participating in a multiyear effort to develop a local strategic planning framework for informing the designation of local and statewide priorities. The hearings provided an important opportunity for counties to describe qualitatively and in greater detail the importance of the priorities that have been identified for their localities.

Areas of emphasis for the counties providing testimony fall primarily into the mental health services and systems management domains. In particular, counties identified a number of areas for improvement in access to services for children, persons involved with the criminal justice system, older adults and persons in need of safe and affordable housing. Counties also described opportunities for fiscal enhancements and workforce development. Importantly, they provided suggestions for strengthening care coordination for children and persons with co-occurring mental health and substance abuse disorders. Specifically, recommendations, by domain, include the following:

Outcomes Domain

Public Mental Health Promotion

Mental Health Services Domain

Continuous Quality Improvement

Access to Services

Children and youth

Adults

Older adults

Housing

Forensic services

System Management Domain

Service System Capacity

Fiscal, policy and regulatory

Workforce development

Accountability for Results

Care Coordination

Children and youth

Persons with co-occurring disorders

Primary health and mental health care coordination

Parents/Families

Testimony was offered by three parents who advocated for the needs of their children and all children being served in the public mental health system. They also pointed to the importance of supporting parents with mental illness as they strive to help their children grow and prosper.

Their suggestions for improvement fell primarily in the outcomes and mental health services domains and emphasized the importance of stigma reduction, positive outcomes, and reliance upon parent input into research to orient it toward a recovery focus. In the mental health services domain, areas for continuing improvement included increasing the number of child psychiatrists and providing age-appropriate settings for emergency psychiatric care. Specific strategies and recommendations include the following:

Outcomes Domain

Public Mental Health Promotion

Positive Outcomes for Children, Families and Adults

Mental Health Services Domain

Research to Practice

Continuous Quality Improvement

Access to Services

Children and youth services

Parents with serious mental illness

System Management Domain

Service System Capacity

Workforce issues

Care Coordination

Providers/Provider Organizations

Sixteen provider representatives focused their comments primarily in the domains of mental health services and system management, but comments in the outcomes domain reflected support for the values underlying the Plan Framework. In the outcomes domain, providers noted the imperative of basing treatment and supportive services on a strength-based, outcome-oriented approach, one that recognizes recovery is attainable and taps into individual strengths, capacities and interests.

Mental health service improvements were recommended for older adults, pointing to recognition by providers of the aging baby boomer population and a need to prepare the system of care for greater demands in mental health care for the elderly. Additionally, improvements were suggested in the area of housing, especially for adolescents and youth, and continuous quality improvement, where providers called for Balanced Scorecard measures focused on individual progress toward recovery.

System management issues that providers focused on largely were policy, fiscal and regulatory. The offered recommendations aimed at examining the fiscal impacts of the various funding streams within the system of care and strengthening the State’s ability to manage fiscal resources to support recovery-oriented services based on best practices and strategies deemed necessary for recovery by the individuals served. They also voiced ongoing support for the Geriatric Mental Health Act demonstration projects.

The areas of cultural competence and workforce development were other priority areas for providers, who expressed a need for more attention to meeting the cultural and linguistic needs of the Latino and Asian populations, particularly among older adults, as well as underserved populations, among them individuals in the lesbian, gay, bisexual, and transgender community. Similarly, providers called for a greater emphasis for preparing the workforce to deal with the unique mental health needs of older adults, at risk for depression, social isolation, and other mental health problems associated with aging. In addition, providers recommended attention to improving care coordination at the local and interdepartmental levels.

Outcomes Domain

Public Mental Health Promotion

Positive Outcomes for Children, Families and Adults

Mental Health Services Domain

Continuous Quality Improvement

Access to Services

Children and youth

Adults

Older adults

Housing

System Management Domain

Service System Capacity

Fiscal, policy and regulatory

Cultural competence

Workforce development

Accountability for Results

Care Coordination

Recipients/Concerned Citizens

The 12 recipients and concerned citizens who provided testimony focused many of their comments on quality-of-life issues. Their suggestions were provided within the context of the recovery paradigm and most fell into the mental health services domain. Within the outcomes domain, however, they emphasized the importance of dealing with stigma.

Under the mental health services domain, they suggested attention to co-morbid physical and mental health issues, particularly chronic conditions related to medications necessary to maintain functioning, such as persistent dental cavities and gum disease, obesity, and diabetes. Their calls for improvement also indicated day-to-day challenges recipients face in working toward recovery and accessing the services and supports necessary to achieve it. Overall, having access to an array of housing needs was cited as primary and a number of recipients also asked for improvements in transportation to enable them to be fully participate in their working and living environments. In addition to emphasizing the importance of natural supports, peer-run services and a focus on wellness, recipients also noted the merit of having access to legal services to help them cope and to supportive mechanisms that keep people out of the criminal justice system.

Under the system management domain, recipients suggested an examination of the entitlement system, with an eye toward reducing disincentives to recovery.

Outcomes Domain

Public Mental Health Promotion

Mental Health Services Domain

Continuous Quality Improvement

Access to Services

Children and youth

Adults

Older adults

Housing

Forensic services

System Management Domain

Service System Capacity

Fiscal, policy and regulatory

Workforce issues

Trade Associations

In all, seven representatives of trade associations provided an extensive set of recommendations, which were concentrated primarily among the mental health services and system management domains.

Within the mental health services domain, discussion centered on the need to conduct more research into eliminating disparities and to continue disseminating research findings. A number of suggestions were also offered regarding the needs of older adults of Hispanic and Asian American heritage. With respect to housing, they suggested monitoring how well housing needs are being met using the Balanced Scorecard and developing short-term crisis intervention housing for persons seen in emergency departments.

The trade associations also offered multiple fiscal, policy and regulatory suggestions. Underlying these suggestions was concern for the increasing importance of Medicare and particularly Medicaid in financing mental health treatment and services and the desire to maintain non-Medicaid reimbursable supportive treatment approaches consistent with recovery via other funding streams. They also urged yearly provider COLAs tied to inflation.

Workforce issues were also cited by trade associations, with recommendations to increase cultural and linguistic competence among direct care staff, through training and centers of excellence, creating public-academic partnerships to draw able clinicians into care settings, and increasing the number of bilingual providers in mental health settings.

Recommendations were also offered to improve the coordination of care between OMH and the Office of Alcoholism and Substance Abuse Services, OMH and the Office of Mental Retardation and Developmental Disabilities, and primary care settings serving older adults and mental health settings.

While suggestions for the outcomes domain were fewer, trade association representatives did lend support to continuing efforts at suicide prevention and overall public education and prevention efforts.

Outcomes Domain

Mental Health Promotion

Mental Health Services Domain

Research to Practice

Continuous Quality Improvement

Access to Services

Children and youth

Older adults

Housing

System Management Domain

Service System Capacity

Fiscal, policy and regulatory

Workforce

Care Coordination

Strategic Planning at the County and Local Levels

Drawing upon its knowledge and expertise gained through overseeing local mental hygiene services, the Conference of Local Mental Hygiene Directors entered into a partnership with OMH in 2004 to create systematic planning processes that would result in comprehensive county plans capable of informing the yearly statewide mental health planning and budgeting processes. The Conference’s goal has been to foster local planning processes, in conjunction with the development of local comprehensive plans for mental health services, to inform mental health planning. An equally important goal of the Conference has also been to promote planning that reflects the input of the many stakeholders of the mental health and local communities under the direction of the County mental health agencies and Directors of Community Services.

During the first year of developing a foundation for local planning, the Conference established a Mental Health Planning Subcommittee, which, since its inception, has been chaired by Dr. Michael O’Leary, Director of Community Services for Columbia County. The Conference also created a Technical Assistance team to aid planning. The first task of this group was to develop and conduct a survey of county mental health services priorities. Results of the survey, which was completed by every county and analyzed by the Conference, appeared in Appendix 2 of the 2005 Statewide Comprehensive Plan. The Conference also launched preliminary work to ensure access to planning data to County planning staff and initiated regular planning meetings with OMH. In September 2004, at its twice yearly meeting, the Conference heard a report from its Planning Subcommittee and consultants on the survey results. Milestones for the next two years of the project were also discussed.

Year 2 of the initiative was devoted to refining and standardizing technical assistance tools and making them available to all Conference members. Based on extensive input from Conference members and feedback from OMH, the team finalized a Planning Template to permit County staff members to provide crucial data and information consistently and comprehensively. Next, OMH, the Conference, and Conference members worked together to design a web-based platform that enabled Conference members to identify available data sources and overcome technical barriers to accessing appropriate data sets for planning purposes. The result was the creation of a County Planning Menu, which consolidates key reports and data resources and offers information in a manner consistent with the Planning Template. In addition to these activities, the Conference made available model instruments for gathering stakeholder input. The biannual meetings also supported a forum to advance strategic planning and to set the stage for the last year of the three-year planning project.

The main area of activity for 2006, the last year of the planning initiative, has been the completion of county plans using the tools and structures developed under the planning framework. During this last year, the Conference developed a detailed time table in cooperation with OMH for completion, submission and review of the County plans. The schedule was developed to permit adequate time for review of the county plans and planning priorities to inform the Statewide Comprehensive strategic planning process for State Fiscal Year 2007.

The Conference’s primary focus for this last year has been on local mental health priorities, which are reflected in the plans submitted by the Counties. The Planning Template has served as the vehicle for gathering together the three most important mental health priorities for each County. The Conference has taken responsibility for synthesizing, analyzing and summarizing the results and for reporting them back to Conference members and OMH. A copy of the Conference’s report, which is attached as Appendix 2, is available online at http://www.clmhd.org/itemfiles/2007_Plan_rev060925.pdf.

During the fall meeting of the Conference in 2006, substantial time was devoted to reviewing the planning process, including the development of a strategic framework to guide the analysis of priority areas and results of the top County priorities by a number of perspectives. The Conference and its membership also discussed strengths of the schema used to categorize information and strategies for improving it as well as next steps in refining the framework and processes so they yield useful information to inform statewide mental health planning.

Next Steps

The Conference is moving forward with results from its priority-setting exercise and review of overall county plans. It is also examining the three-year process and modifications necessary to advance planning.

The collection and analysis of strategic priorities represents an important step in re-invigorating the local planning process. Currently, OMH is conducting an analysis of the County submissions and the Conference Report in the context of this year’s cycle for developing the OMH strategic plan and potential Executive Budget initiatives. OMH will also continue to work with the Conference to expand and refine local planning efforts. These efforts will be addressed more fully in the 2007–2011 Statewide Comprehensive Plan.

Performance and Outcomes Management: The Balanced Scorecard

In April 2006, OMH launched its web-based Balanced Scorecard to provide the public with information about the agency’s progress toward achieving the goals articulated in the Statewide Comprehensive Plan for Mental Health Services.

The Balanced Scorecard is an important method for improving accountability and promoting positive change within the public mental health system, whereby individuals and families are at its core, resilience and recovery are fostered, and individuals with mental illness are enabled to live, work, learn, and participate fully in their communities. It is a tool for engaging all stakeholders in working together to maintain and improve the quality of care.

Initiated in the spring of 2006, the Scorecard builds on years of progress in the area of performance management within OMH. The Scorecard measures and reports on outcomes experienced by individuals served in the public mental health system, results of public mental health efforts undertaken by OMH, and critical indicators of organizational performance. It provides viewers with opportunities to examine progress in strategic areas, monitor performance, and use data to inform decision making.

The initial version of the Balanced Scorecard, which included eight management objectives, was presented to stakeholders during the April and May 2006 statewide regional briefings and public hearings on the 2006–2010 Statewide Comprehensive Plan. Each presentation included a discussion of the Scorecard’s purpose, an overview of the OMH Performance Improvement Committee’s role in identifying and defining management objectives, an online demonstration of the Scorecard, a discussion of future enhancements, and a question-and-answer session. The Scorecard’s design and content received enthusiastic and favorable responses from stakeholders, who indicated they would like to see additional management objectives and more local data included in future editions.

This feedback complemented the OMH plan to seek input continuously as it regularly updates the Balanced Scorecard and increases the number of management objectives presented. In July 2006 OMH expanded the Scorecard content to include 16 management objectives, thereby broadening the ability of users to assess performance of the public mental health system. Additional enhancements to the Balanced Scorecard in July included enhanced functionality, such as the ability to sort management objectives by target population (e.g., adults, children), to identify initiatives implemented during the 2006–2007 Fiscal Year, and to link to more extensive program-specific information. Moreover, the Scorecard has been strengthened through the addition of more local-level data.

Balanced Scorecard data and management objectives will continue to be updated as OMH priorities and initiatives change and to provide a more comprehensive assessment of performance in our public mental health system.

Appendix 1

Listing of Testimony by Stakeholder Group for Analytic Purposes

Advocates/Advocacy Organizations

Counties

Parents/Families

Providers

Recipients/Concerned Citizens

Trade Associations

Appendix 2

Conference of Local Mental Hygiene Directors 2007 Plan for New York Mental Health Services: County and City Priorities

Comments or questions about the information on this page can be directed to the Office of Planning.