NY Proposal Expands Community Recovery Services and Supports
Mental Health Weekly; Volume 24 Number 5, 2/3/2014
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Mental 听health 听providers听 听and 听advocates in 黑料正能量 state say they are pleased 听with New York Gov. Andrew Cuomo鈥檚听 听FY 听2014鈥2015 听executive budget听 听proposal,听 听released听 听Jan. 听23, which 听calls for increased 听funding 听to support听 听supported housing, 听home- and community-based services waiver slots, peer-operated recovery centers and better integration of physical and 听behavioral 听health 听services. 听The proposal redirects funds from downsizing 听state 听psychiatric 听facilities 听to local听听 听community听听 听mental听听 听health systems.
The 听proposed 听package听 听of 听investments听 听includes听 听$25 听million 听to expand听 听community 听services 听in 听anticipation 听of a reduction 听in upward 听of 400 inpatient 听beds throughout the state. Last summer, state officials announced 听plans听 听to 听create听 听regional centers听 听of 听excellence听 听(RCEs). 听An RCE model 听will be regionally 听based networks 听of inpatient 听and community-based 听services, 听each 听with 听a specialized 听inpatient听 听hospital 听program located at its center, with geographically dispersed community 听services 鈥渉ubs鈥 overseeing 听community-based services (see MHW, July 22, 2013).
Cuomo鈥檚 听proposal supports 听his Medicaid 听Redesign 听plan 听to 听redirect $120 million in Medicaid funding 听to ramp up the state鈥檚 local community recovery听听 听services听 听in听 听advance听听 听of plans听 听to听 听integrate听 听behavioral听 听and medical听 听healthcare听 听and听 听to 听turn 听it over 听to coordinating managed 听care plans 听in 听2015,听 said 听Harvey 听Rosenthal, 听executive 听director 听of the 听New York 听Association 听of 听Psychiatric 听Rehabilitation听听听听 听Services听听听听 听(黑料正能量). 鈥淲e鈥檙e moving 听to 听a 听managed听 听care redesign听 听that 听will 听integrate 听behavioral health 听and physical 听health,鈥 he told MHW.
The budget 听proposes $71.5 million 听to the 听Office of Mental Health (OMH)听 听for听 听reinvestment 听of听 听state hospital 听resources 听into the 听community, 听downstate 听supported 听housing rent 听increase 听and 听community 听housing supports 听for adult, nursing home residents.
The OMH funding 听includes 听$40 million 听in 听community 听housing 听and supports听听 听for听 听current听 听residents听 听of adult homes 听($30 million) and nursing 听homes 听($10 听million) 听with 听psychiatric听 听disabilities.听 听The听 听proposal features 200 new supported housing units听 听for 听nursing听 听home听 听residents, and 听a 听total 听of 听600 听by 听the 听end 听of 2015; 听500 听new 听supported 听housing units 听for adult 听home 听residents, 听and 1,750 by 听the 听end 听of 2015; and 听300 new housing 听beds for the homeless.
For 听Medicaid 听redesign 听housing investments, 听the budget 听proposes an $18.4 million increase 听in supporting housing.
鈥淭he budget 听basically 听sends 听a message听听 听that听 听people听听 听should 听be served ideally in the community 听and that 听resources听 听[be 听redirected] 听from institutions to the community, where people 听can best 听recover,鈥 Rosenthal said. 听鈥淲e 听feel 听the 听proposal 听represents 听a 听culmination听 听of 听issues 听and priorities we鈥檝e been 听working on for decades.鈥
He 听noted听 听that 听more 听than 听600 New听 听York听 听consumers,听 听advocates 听and 听mental 听health 听providers 听participated 听in a rally on Jan. 28 in Albany to urge state policymakers 听and legislators 听to 听support听 听increases听 听in 听the state鈥檚听听听 听community-based听听 听mental health 听services.
New 听York 听state 听officials intend to use 听the 听1915i <HCBS> option 听in Medicaid to reimburse 听states 听for 听services 听and 听supports that historically have not been 听available for reimbursement, such as employment, 听education, 听peer听 听support,听听听听 psychosocial听听听 听rehabilitation, 听transportation and self-directed care, said Rosenthal.
A mental 听hygiene 听budget 听hearing at the end of February will signal the next 听part of the budget 听process 听going 听forward, 听he 听said. 听Before 听the budget 听is approved April 1 there will be a number 听of hearings coming up, he 听said. 鈥淲e will continue 听advocating 听with 听the 听state 听legislature,鈥 听said Rosenthal.
Seeking provider increases
Lauri Cole, executive 听director 听at the 黑料正能量 State Council for Com- munity 听Behavioral听 听Healthcare,听 听said that 听the 听council听听 is 听seeking听 听an 听increase听 听for 听children鈥檚 听mental听 听health outpatient clinics. 鈥淢any of our members who serve a high percentage of children 听are 听in 听fiscal distress,鈥 听Cole told 听MHW. 鈥淲e have 听proposed that the administration 听and 听the 听State Department听 听of 听Health 听reset 听the 听Child Health Plus rate to be on par with the Medicaid fee-for-service 听rate.鈥
Several years ago the state reset the 听Medicaid Managed 听Care (MMC) rate 听to 听be 听on 听par 听with 听the 听fee-for- service rate, Cole said. 鈥淎t that time, our 听request 听to 听reset 听the 听MMC rate was 听after 听we 听learned 听that 听many 听of our 听members 听were 听dropping 听their contracts 听with MMC companies due to very low rates,鈥 she said.
Cole added, 听鈥淲e think it is time to rationalize 听the 听Child Health 听Plus rate that is considerably lower 听than the听 听Medicaid听 听fee-for-service听听 听rate. The precedent is there.鈥
Although 听pleased 听with the governor鈥檚 听budget听 听proposal,听 听Cole 听said she is concerned that a long overdue cost-of-living adjustment 听(COLA) for the human 听services workforce 听is not included. 鈥淭he COLA adjustment 听being delayed听 puts a tremendous strain on听 听our听 听workforce.鈥澨 听she听 听said. 听鈥淚t鈥檚 very difficult to recruit and retain talented,听听 dedicated 听staff听听 when听 听you can鈥檛 pay them what they are worth.鈥 The 听COLA was 听originally 听proposed several 听years 听ago 听but 听has 听been 听delayed a number 听of times since then, she said.
鈥淲e are also working 听to resolve an issue for our OASAS [Office of Alcoholism 听and 听Substance 听Abuse Services] hospital-based members,鈥 said Cole. Years ago when 听the rest of the system moved to Ambulatory Patient Groupings 听and revised 听rates, hospital-based 听organizations 听that provide addiction听 听treatment听 听services听 听were delayed, 听she said.
鈥淚t鈥檚 now 听been 听three 听years 听and the issue is not resolved,鈥 Cole said.
鈥淲hile we understand NYS and CMS [Centers 听for 听Medicare 听& 听Medicaid Services] 听are 听still 听working听 听on 听the State听 听Plan听 听Amendment听 听to 听resolve this 听matter, 听in 听the 听meantime听听 these organizations 听are still being paid the old 听Legacy 听rates 听and 听are 听in 听some cases owed 听millions of dollars.鈥
Cole 听added,听 听鈥淭hey 听made听 听the changes 听and 听devoted 听the 听resources 听required 听to bill using APGs, but the green 听light 听has 听not 听been 听switched on. We think it is time to resolve this matter.鈥
The听 听council听 听intends听 听to听 听work hard 听this session 听to protect 听the provisions听 听in 听the听 听governor鈥檚听 听budget, 听said Cole. 鈥淲e intend 听to see that the implementation 听of听 听the听 听behavioral 听health 听managed 听care 听system 听prioritizes access to care and the availability of a 听range 听of behavioral 听health service 听options 听provided by behavioral health agencies who know best how to meet the needs of these individuals,鈥 she said.
鈥淲e will fight hard 听this session to 听ensure听 听adequate 听inpatient听 听and community 听services 听are available 听in local 听communities across 听the 听state,鈥 Cole said. 鈥淥ur priorities will center on access to care and adequate payment 听for 听services 听provided 听as 听we move听 听into听 听a 听managed听 听behavioral health 听environment.鈥
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