This year we are sending out the MHANYS budget update in conjunction with our friends at NYAPRS. Between our two organizations, we have identified a lot of priority budget areas as well as provided our own unique individual spin on the budget impact.

MHANYS 2016-17 Budget Analysis: Mental Health

As we have said every year, this is a top of the tree’s analysis of the budget. We will spend the next several days reviewing the budget and undoubtedly find things that we were unaware of especially in the Medicaid Budget.

As a personal narrative, I was very moved when the Governor talked about his partner Sandra Lee and her battle with breast cancer, highlighting the importance of early intervention and prevention. I was struck by how you can make that analogy with mental health. Both from family experience and from science, we know that if we detect early through screenings and assessments, our ability to stop mental illness increases dramatically. This is also true with the enhancement of education and prevention and wellness support and services.

Also, when the Governor talked about investing 100 million dollar for comprehensive community schools, I couldn’t help but think about how significant it would be to insure that mental health education would be a prominent part of any curriculum and that all teachers and school personnel should have Mental Health First Aid Training. Many MHA’s across New York State are embedded in school settings either in outpatient services or in clinics. They would be ideal partners in development of community schools supports.

Mixed Bag Budget

This is a mixed bag budget with several highlights but also several MHANYS priorities that were underfunded or not funded. The budget has set the tone for what we hope will be a very productive discussions about our priorities around community mental health funding, housing, corrections and mental health literacy.

Housing Ads/Homeless Housing

We are appreciative of the Governor for addressing issues of homelessness by creating an impressive response through more beds, greater enforcement and a common sense approach to oversight. The idea of an independent review for the shelter system is a worthy goal.

We are pleased to see the long term commitment of $20 billion dollars over five years for housing. The breakdown includes ten billion for five years for a Housing New York 2020 project that will create or preserve one hundred thousand units of housing across New  York State.

The other ten billion dollars, also implemented over five years, will be dedicated to 6000 new supported beds, 1000 emergency shelter beds and 20,000 new supported housing bed across the State. 7.8 of the Ten Billion dollars will be dedicated to supporting 44,000 existing supportive housing units, 77,000 shelter beds and other homeless related services. The specifics of the plan will be highlighted over the next several weeks.

From our perspective, this could be a very strong policy change that can have enormous effects for people with mental illness who are homeless. It could very well be significant to other individuals with mental illness as well. Over the next several weeks, we will work with our expert colleagues in the housing field to see how this will impact mental health housing.

It is important that the Governor has highlighted the homeless population as a major priority and we look forward to working to assist in mental health training and support for the workforce and for outreach and engagement services.

Continued Transition of Hospital Bed Closures into the Community

We are also pleased that there is the continued commitment of funding from bed closures to community services of 16 million dollars. MHANYS, NYAPRS and other community organizations fought hard for that funding several years ago and we are appreciative that the commitment from the State continues with the emphasis on housing, crisis services and peer and family support.

Children’s Mental Health Services

We have also long advocated for children’s mental health services especially around prevention. MHANYS has dedicated much of our recent advocacy efforts around this area especially as it relates to mental health in schools.

We were pleased that this year’s budget proposes six new State Plan Medicaid Services for Children. The services are crisis intervention, community psychiatric support and treatment, psycho social rehab services, family peer support services, youth peer training and support services and service from other licensed practitioners.

There is 7.5 million added to the budget for this initiative with an expectation that it will go up to $30 million by 2018.

Funding for Community Based Services

Our largest priority this year has been around a commitment to community based mental health services and workforce. Community mental health services have long been underfunded and the lack of any cost enhancement in recent years has even put us further behind in ability to provide services. Adding in the impact of the minimum wage increase to community based providers makes cost enhancements even more significant. Recently the Governor agreed to raise the minimum wage for the state workforce. True equality would be providing that level of funding for not for profits licensed by New York State

The budget includes a COLA increase based on the CPI of approximately $2.4 million dollars in mental health .While this begins to open the door a little, we must have a broad and planful discussion about funding for community based services. We will work with the Legislature and Governor to advocate for a large expansion in the future.  MHA’s and other community providers are hard pressed to retain quality staff and to also provide the essential safety net services that keep people in the community. Without a robust enhancement to the base of services, there will be continued diminishment of programs and supports.

Corrections

In the area of corrections and mental health, the Governor’s budget proposes adding a million dollars to the Raise the Age campaign in the Mental Health budget. MHANYS has been strongly supportive of this initiative and we hope that all sides will work together to get legislation passed to insure that 16 and 17 year olds who are incarcerated will not be tried as adults.

Other Initiatives of Note in Mental Health

The Governor has also called for independent office to review cases of police involved civilian deaths. As we know, several of these deaths involve people with mental health related issues. We will get greater detail on this initiative.

The Governor has also recommended 12 weeks of paid family leave that includes ‘caring for a sick family member’. This was an important initiative to our colleagues at NAMI as many family members serve as care members for their loved ones. This was also a very important issue as we were advocating for Timothy’s Law as many individuals had to miss weeks of work due to their loved one’s mental health related issues. We are very pleased that this initiative is included in the budget.

The Governor has proposed in the budget to include mental health supports for OMH long term care patients moving to skilled nursing facilities or managed long term care programs. Approximately 100 people will be impacted.

Unaddressed Priorities

What was left unaddressed in the budget were several priority areas of MHANYS including geriatric mental health, veterans mental health, suicide prevention, Mental Health First Aid, funding for CIT and resources for individuals on Medicaid to be provided with mental health services upon release from jail and prisons. Also, we continue to advocate for statewide advocacy for adult home residents.

We are also frustrated that year after year the budget has language that eliminates prescriber prevails for Mental Health Medications in Plan Formularies.  As we ask every year, who better to identify and provide appropriate medication for an individual more than the Prescriber and the individual? The legislature has been a great friend on this issue and we will work with them to restore this cut.

Time to Invest in Mental Health

We are pleased that the Governor has highlighted some areas that have long been priority to MHANYS including reinvestment of services, children’s’ mental health and additional housing and supports. This is an important acknowledgement. However much more needs to be done.

In recent days, we have seen all the investments that are being made throughout New York State from everything from funding to update upstate airports to reconstruction of Penn Station and the Jacob Javits Centers. Millions and millions of dollars are at the table for these worthy projects.

Now is also the time to invest in mental health. Yes, there are DSRIP dollars and managed care funding that will hopefully shape the system in a positive way for years to come, but that still does not transform mental health services overnight.

We still have a public system of care with over 800,000 people that needs help and support now. MHANYS legislative agenda calls for a large investment in the mental health workforce and funding to insure the base of existing housing (we support our colleagues at ACL who have tirelessly researched the impact of what it means for providers to not get housing subsidies on an annual basis).

For many years, the community mental health system has been the backbone of innovative services and support that has kept people out of the hospital and in the community. It is time for that work and that innovation to be broadly recognized. At MHANYS, we always have a large array of advocacy agendas, but we will be highlighting the importance of workforce investment and housing throughout the budget process.

Most Important Part of What I Am Saying

I am repeating myself from yesterday but the only way we will get anywhere is through the sweat equity of all of you. Take the time to meet with your legislators, make the calls and blast out e-mail and twitter alerts and highlight the importance of workforce and housing. Tell your friends and colleagues to get involved and come to our legislative day on March 9th and let your voice be heard.

Those hundreds of people who filled out Senator Carlucci’s petition for the Tax Checkoff Bill and thousands who participated in our movement for the bill are representative of hundreds of thousands of New Yorker impacted by mental illness. If everyone who is impacted by mental illness rises up and raise their voices, we will be the loudest constituency in Albany.

Get Involved

Over the coming weeks and months, we will be sending out a lot of updates about priority area with specific information on how you can help us make sure that there is a true investment in mental health this year and in the future.

As always, you can contact me at gliebman@mhanys.org or John Richter at jrichter@mhanys.org with any questions.

 

Glenn Liebman, CEO

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