MHANYS’ 2016 Legislative Agenda continues to emphasize the association’s top public policy priorities including critical funding elements of this year’s State Executive Budget. New York needs a healthy and sustainable mental health treatment and housing infrastructure staffed by a stable and capable workforce. We are also committed to fostering a citizenry informed and aware enough to successfully access needed services in a timely manner. Therefore, MHANYS will continue its enduring commitment to improving mental health literacy for all New Yorkers with a special focus on youth. Promoting mental health literacy facilitates early intervention, treatment and prevention while reducing stigma. Finally, MHANYS believes reforms are needed in the way our justice system responds to the needs of people with mental illness; specifically, youth with mental illnesses who become justice involved and a need for better continuity of care for individuals with mental illness upon release from jails and prisons. Several additional initiatives round out this year’s agenda.
Executive Budget-Related Initiatives
Mental Health Workforce Investment: The historic under-funding of mental health workers employed by non-profit agencies has caused significant recruitment and retention challenges over the years. Last year’s Executive Budget provided a 2% across the board cost of living adjustment for direct care workers, which represents the only increase in wages for these workers in nearly 8 years. As a result, the wage disparity has continued to grow larger and larger over time between workers employed by the state and those employed by not-for-profit agencies in similar jobs. Minimum wage proposals for state workers and select sectors of the private labor market without commensurate wage increases for workers employed by non-profit agencies will further compound this disparity and jeopardize the viability of community-based mental health agencies. MHANYS, therefore, is proposing a two-tiered approach to addressing both the historic wage disparity and the compounding of this differential from minimum wage increases. This proposal will help to secure the health and viability of the non-profit mental health system of care.
Specifically, MHANYS is urging the Governor and the Legislature to provide:
- An immediate 7 percent Mental Health Worker COLA in this year’s Executive Budget ($91 million) to address the historic lack of inflationary adjustments and to bring the existing workforce into closer wage alignment with the current state mental health workforce, and;
- A commitment from the state to provide mental health workers employed by not-for-profit agencies with a minimum wage increase commensurate with wage increases being proposed for state workers and various workers in the private sector.
It should also be noted that an immediate 7 percent across the board COLA for direct care workers and supervisors will help address the problem of “compression” that occurs when a minimum wage increase is applied to direct care staff in the absence of wage increases for immediate supervisors.
Housing: Over the past several decades the funding for the various housing models in New York that are home to people with mental illness and those in recovery has not kept pace with inflation, rising administrative costs and the increasing demands of serving people with co-occurring conditions and the management of complicated medications regimens. This trend of under-funding has put our valuable housing assets in jeopardy. In response, MHANYS is advocating for targeted Executive Budget funding to sustain New York’s housing infrastructure including Community Residence-Single Room Occupancy (CR-SRO) housing, Supported Housing, Community Residences and SP-SROs (permanent housing with supports). ($92.9 million)
Managed Care Readiness: The transition in New York State from a primarily fee-for-service Medicaid payment system to managed care presents significant challenges for community-based non-profit providers. While collectively these providers account for a substantial portion of the mental health services available at the community level, many lack experience in Medicaid billing or operating within a managed care environment. These providers are an indispensable asset to the mental health system of care and will need financial assistance with start-up costs, technology assistance and expert consultation. MHANYS believes it is in New York’s best interest to help these providers survive and thrive in the transition to Medicaid managed care and urges the Governor and Legislature to make funding available for this purpose.
Community Investment: Continued reduction in state psychiatric hospital beds, which includes the reduction of census and possible long-term facility closures, is expected to result in $16 million in State savings. In 2013 MHANYS played a lead role in working with the state to secure commensurate funding for community-based mental health services such as supported housing, peer support, crisis intervention, and family engagement services. MHANYS supports this funding in the Executive Budget and urges continued support for community investment.
Post-release Continuity of Care: When individuals with a mental health diagnosis are released from jails and prisons successful re-entry into society begins with proper continuity of care. Under current law, the Mental Health Grant Program provides grants for the cost of medications and other services needed to prescribe and administer medication for individuals with a mental illness who leave the local jails, state prisons or hospitals and have applied for Medicaid. MHANYS is advocating this year for an expansion of this program to include mental health treatment in addition to the medication currently covered in the program ($5 million).
Medication Access: While MHANYS is pleased that mental health medications will continue to have the protection of “prescriber prevails”, we also believe that this protection should extend to all medications in a plan’s formulary due to the complexities of treating people with multiple, and often comorbid diagnoses.
Crisis Intervention Teams: Advocate for additional funding for statewide Crisis Intervention Teams (CIT) including the expansion of programs beyond counties that have CIT. This could be its own initiative or be included more broadly under funding for mental health literacy.
Veterans and Military Families: Advocate for renewed funding to continue the Joseph Dwyer Peer to Peer Project and expand the program to include additional counties. We would also advocate for greater involvement of families within the funding model.
Suicide Prevention: Support legislation to create and support a NYS Suicide Prevention Council under OMH leadership, this Council would: work with OMH to develop a NYS suicide prevention plan that aligns with the National Strategy for Suicide Prevention. Expand the Suicide Prevention Center of New York (SPCNY) by creating Satellite Offices in each of the 5 OMH regions. ($1.5 million).
Geriatric Mental Health: Building on the Geriatric Mental Health Act of 2005, MHANYS supports continued and expanded funding for the Geriatric Mental Health Services Demonstrations Grants Program and the Interagency Geriatric Mental Health Planning Council ($3 million).
Enhanced School-based Mental Health Services: Advocate for the funding of several enhancements for schools to support more school social workers and therapeutic after-school mental health services.
Mental Health Literacy Initiatives
Mental Health Education in Schools: Advocate for the inclusion of mental health education as part of the health education curriculum in schools. MHANYS staff will work with allies and grass roots advocates to increase support in the Legislature for A.3887-A and S.6046 and to increase the number of bill sponsors.
Mental Health Education for Teachers: Teachers are on the front line of educating our youth every day but often lack basic resources or knowledge about the signs, symptoms and available treatments for mental health disorders, or how to respond to a mental health crisis. Teachers should be better equipped to recognize and respond appropriately to these signs and to have the knowledge necessary to also teach students about mental health. MHANYS believes that educating teachers in public mental health compliments our proposal that students also need to learn about mental health. We urge the Legislature to pass S.6234-A.
Funding Mental Health Literacy: Advocate for additional funding for training in Mental Health First Aid, Youth Mental Health First Aid and other versions of MHFA tailored for special populations such as older adults.
Justice & Forensic Mental Health Initiatives
Juvenile Justice: Too often, youth who fail to get help become justice involved, further complicating their prospects for needed treatment. This is why MHANYS supports “raise the age” legislation and why we seek special provisions for youth with mental health challenges who get into legal trouble.
Discrimination Against Parents with Psychiatric Disabilities: Advocate for the elimination of NYS Social Services Law (SSL), subdivision 4 of §384-b which discriminates against parents diagnosed with a psychiatric or developmental disability and can result in the termination of parental rights.
Justice Center Statute Amendment: Advocate that Adult Care Facilities (including adult Homes) that serve individuals with psychiatric disabilities and have licensed capacity less than 80 beds be subject to the powers, authority and protection of the Justice Center. Currently they are exempt.
Step Therapy Legislation: MHANYS supports legislation (A.2834/S.3419) which would ensure that prescribers of medication have a clear and convenient process to override step therapy under specific conditions when medically in the best interest of the patient.