With technically only a few days till the April 1 budget deadline (the
possibility exists that it is likely to close down even sooner given that
March 30th is Good Friday and the first night of Passover), the Legislature
and Executive have been working furiously on the budget. Some of the
overriding issues on the mental health table that we are advocating for in
the budget include:

Mental Health Education

We support creation of a School Mental Health Resource and Training Center
to respond to the new legislation that allows for the teaching of mental
health in schools. This has been a major priority for MHANYS during this
budget season given the need for resources and support for schools driven
by the legislation.

Status:

This is still being negotiated as part of the budget process. At MHANYS we
feel strongly that this Center needs to be funded to get schools the jump
start they need to effectively provide appropriate instruction and
resources to students.

Workforce

Language that came from the Senate would require the State to provide a
three and a quarter percent increase for direct care and clinical staff in
mental hygiene settings starting on April 2019 and running through April
2022. There is not any funding in the budget for this given that the start
date is April 2019 (as there was for this year) but the advocacy in future
years would be driven by the State’s commitment to this funding stream.

Status:

This is still being negotiated. It is somewhat controversial and likely to
get push back from some quarters. At MHANYS, we feel strongly that there
should be language and a full future funding commitment to create a living
wage to recruit and retain quality staffs. As proven this year by
behavioral health advocates and the BFair campaign, this is an issue that
will continue to be front and center for the Legislature and the Governor.

Mental Health Housing

Bring It Home campaign members are continuing their push to enhance the
existing proposed ten million dollar increase in the budget. The Senate has
proposed adding funding of five million dollars. Advocates hope that number
will increase during negotations.

Status:

Still part of the budget negotiation. The need for increased rates has
been evidenced by the long waiting lists to get into residential placement
and the frustration of quality staff forced to work extraordinary hours
with limited resources (see also workforce)

Proposed One Hundred Million Cut to Health Homes (Two Million with
Medicaid Match)

Though this proposal technically is at the Health Table and not at the
Mental Hygiene Table, it still greatly impacts many individuals in
behavioral health who have their care management services through Health
Homes. Cutting this large amount from Health Homes without commensurate
reinvestment of community services just ends up being a cut to a care
management system that is largely populated by individuals in the
behavioral health sector.

Status:

Advocates have been weighing in with the Senate about this proposed cut and
looking at strategies for keeping the Health Home dollars in place while at
the same time discussing language changes and outcome measures. This is
still being negotiated in the Health Budget Table.

Crisis Intervention Teams

While funding has not been officially added, it is clear that both the
Senate and Assembly support continued funding for CIT, recognized as an
evidenced based model for police interaction with individuals with mental
health issues. Over the last several years, county mental health providers,
peers, families and law enforcement officials have embraced CIT making New
York State a national leader in this area.

Status: 

If the past years are predictive of the future then it is likely that there
will be increased funding for CIT and that additional counties will be able
to take advantage through their local law enforcement agencies and mental
health providers.

Mental Health First Aid

Over the last several years, the Senate has provided funding for MHANYS to
train our members statewide on Mental Health First Aid (MHAF). MHFA is an
eight hour training designed to show how individuals can respond to a
mental health crisis and to be better educated about mental health and
their own wellness. This has paid off through the increased number of
people both statewide and nationwide who are being taught Mental Health
First Aid Instruction through our membership and other groups. Recently it
was announced that over one million people have been trained nationwide on
MHFA.

Status:

MHANYS will continue to advocate for funding for this essential training.
It has proven to be a very successful public awareness tool that has been
embraced by many community stakeholders.

Prescriber Prevails

In this year’s proposed budget, the Executive eliminated prescriber
prevails language for Mental Health medications and other medications in
Health Plans formulary. Medicaid recipients should be able to get their
appropriate medication based on the doctors recommendation and not just
what exists in a plan’s formulary. For many people with mental health
related concerns, appropriate medication is an essential part of the
recovery process.

Status:

This is at the Health Budget Table. Both the Assembly and Senate have
supported the mental heath community’s request for adding back language
allowing for Prescriber Prevails to be reinstated back in the budget. We
will continue to raise our voices on this issue.

Adult Home Residents Personal Needs Allowance

There is a proposed SSI increase for adult homes as part of the three way
negotiation. We are not opposed to increases for adult homes operators. Our
advocacy as part of the NYSCAHR coalition is to insure that if there is an
SSI increase, that there be a commiserate increase in Personal Needs
Allowances (PNA) for the residents. Most residents receive only fifty
dollars a week as part of their PNA. There is a desperate need for an
increase for the residents PNA and if there is an increase to operators, it
is only fair and equitable that residents get an increase as well.

Status:

This issue is being negotiated at the Health Table.

Veterans Mental Health Funding through the Joseph Dwyer Mental Health Peer
to Peer Program

The Senate has long been supportive of adding funding to the Dwyer program
and expanding the number of counties that receive the funding. Many MHAs
run the programs in their counties. This model has proven successful in
many counties throughout New York State in creating an environment for
veterans that is non-stigmatizing and driven by strong principles of
engagement and education.

Status:

Though this is currently being negotiated in the budget, we are hopeful
that there will continue to be funding in place for the Dwyer Program. We
remain optimistic about this funding.

Social Work Licensure

This issue has consumed a lot of time and effort during this budget season.
We are supportive of the continuation of the existing practice exemption.

Status:

MHANYS is part of a large cadre of mental health advocates and providers
that are supporting the continuation of the practice exemption. In an era
of a mental health workforce crisis, this is not a time to put more
constraints on existing providers of services.

Delay in Expansion of Children’s Behavioral Health Services

The proposed budget called for a two year delay in the expansion of
Children’s Behavioral Health Serivces in Managed Care.

Status:

Advocates have been pushing on this issue to eliminate the two year delay.
There has been positive feedback from Legislatures but nothing definitive
has been announced.

POST BUDGET

Assuming the budget is passed in the next several days, MHANYS will
continue our advocacy through legislation for the rest of this legislative
session including work around the HALT Bill, Mental Health Public Awareness
and Workforce.

 

Glenn Liebman, CEO
Mental Health Association in New York State, Inc.