As of this writing, this is what we know about the budget as it relates to
mental health. We will provide more specifics in the coming weeks.

Our friends at NYAPRS are also sending their update out simultaneously. We
both have our different perspectives highlighting the budget, but between
our two agencies, we hope you are able to get a comprehensive view of the
budget as it relates to mental health.

We also want to acknowledge the work of our members, our fellow advocates
in the community who did an outstanding job this budget season, our
colleague in the Legislature and Executive who were very responsive to
several of our priorities and our lobbyist Kevin Cleary who did a wonderful
job in advocating for MHANYS priority areas.

School Mental Health Resource and Training Center

(1 Million Dollars)

This year’s Executive Budget includes funding to create the School Mental
Health and Resource Center. This Center is created in
response to the new law that will require all New York State schools to
include mental health as part of their K-12 health curricula.

The Center will provide phone and web-based information, referral services,
consultation with school districts, regional summits, webinars and
professional development.

We thank the Executive and the Legislature for their support and we want to
extend a special thanks to Assemblymember Gunther who led the charge on
this funding as well as to Assembly Speaker Heastie.

It also would have never happened without all your support. Thank you for
your grassroots efforts. First it was tax checkoff, and then it was mental
health in schools, then license plates and now a Resource Center. None of
that happens without your taking the time to call, write letters send
e-mail blasts or whatever else you did to help support these initiatives.

Workforce Language

Unfortunately, there was no language added in the budget for the mental
hygiene workforce that called for future annual increases of funding for
direct care and clinical staff. The good news is that this budget as of
April 1 will include a three and a quarter percent increase for direct care
staff and clinical staff.

We will continue off budget to build a larger coalition in support for
workforce funding commitments for next year’s budget. Simultaneously, we
will also engage in conversation with other stakeholders regarding career
ladders, enhanced training opportunities, educational scholarships and
other mechanisms to retain and recruit quality staff.

We need to provide a living wage for our workforce. Our sector should be
more significantly valued for the work they do on a daily basis.

Housing

This year’s budget includes ten million dollars to fund existing housing
providers. This was the original proposal in the Executive Budget.
Unfortunately, despite tireless efforts from the Bring It Home campaign,
there was no new funding added to this year budget for housing.

Existing housing providers have continued to provide quality services while
virtually never refusing services to those that are hardest to serve. Most
of the providers are barely making ends meets between the burden of
administration and salaries with minimal increases compared to other
sectors.

Largely because most people in our field are driven by helping and
supporting people, many providers have accepted contracts that were loss
leaders in order to insure people have a place to live. Providers should be
rewarded for the work that they do to help peers recover in residential
programs that provide a substantial savings to State Government.

Crisis Intervention Teams

The State Senate has continued to show support for CIT through funding of
$925 in the budget. These teams will now expand into other areas of the
State. Over the last several years, New York State has gone from being a
limited trainer of CIT to among the nation’s leader in this area. Great
credit is due to Senate Mental Hygiene Chair, Robert Ortt for leading the
charge on this issue

$425 thousand of this funding has been set aside for mobile apps for law
enforcement to connect to clinicians working with individuals with serious
mental illness. We are very excited to hear more about this program as it
rolls out.

Reinvestment

The budget includes the closure of 100 psychiatric hospital beds that will
be reinvested into community services. This will bring $11 million more to
the community for many of the services that the MHAs have long advocated
for around peer support, housing, crisis intervention, diversion and family
engagement. We are pleased that it is included in this year’s budget for
the continuation of community support services.

Health Home Funding

One of the more controversial parts of this year’s budget was in regard to
the proposal to cut one hundred million dollars from Health Homes. Over
the last several years, Health Homes have been the new version of
traditional care management that was largely funded through a favorable
Medicaid Match at the Federal Level. In recent years, there have been
concerns voiced about the efficacy of Health Homes.

MHANYS position has been that this should be an off-budget discussion
regarding the primacy of Health Homes. Cutting existing health home dollars
with no plans to reinvest back into behavioral health amounts to a cut to
our sector that serves no purpose.

This year’s budget includes stronger language around accountability of the
Homes. The language allows for the Health Commissioner to establish
reasonable targets for implementation and encourages health homes and
managed care providers to work collaboratively. Penalties may be assessed
for those health homes that don’t meet existing targets. We still have
not seen any language regarding a specific cut.

Prescriber Prevails

What we are hearing is that the Legislature is planning to restore the
Prescriber Prevails language that that Executive sought to eliminate in the
budget. We are very supportive of the legislature in adding back this
language. As we have said time and time again, prescribers in consultation
with the individual should have final say on their appropriate medications.
It should not be driven by a health plan formulary.

As a family member myself, I know the importance of medication for my loved
one. Not having the appropriate medication can be devastating for many New
Yorkers with mental health-related issues. We hope to get confirmation soon
about this.

Mental Health First Aid

As we continue the movement to increased mental health literacy for the
entire community, we thank the Senate for adding money to the budget this
year to continue our member-driven work around Mental Health First Aid.
There are over one hundred individuals within the Mental Health Association
trained to provide MHFA to the community. This training has been utilized
by individuals in all sectors.

Social Work Licensure

This language has long been one of the most debated topics in our field.
This is framed largely as a workforce issue. The discussion was focused on
the role of social workers in regard to their supervisory role in clinical
care. There has to continue to be a pivotal role for others in the
professions. The final compromise strikes a balance between the sectors
while providing safeguard that the existing nonsocial work license
workforce will continue their essential role. Great credit is due to the
coalition that was developed in immediate response to this concern.

Language will be forthcoming.

Veterans Mental Health

The Senate has continued to make it a priority to fund the Joseph Dwyer
Peer to Peer Mental Health Veterans project. These programs help to support
veterans with mental health needs in their communities through peer support
in a non-stigmatizing environment. We are pleased to see this year that
there is an expansion of the funding to include additional counties. Many
of these programs are run through our MHAs in those communities. There is
total funding of $3.735 million for this project.

Adult Home Update

As the proposed increase in SSI for adult homes has moved through the
budget process, advocates continue our call for an equivalent increase for
residents PNA. We are not adverse to adult home getting increased funding,
but what we are opposed to the individuals in the home not receiving any
increase to their fifty dollars week PNA.

This funding ended up not being included in the budget but we were pleased
that there was five million dollars added to provide greater engagement
with peers and adult home residents. The work of our colleagues at NYARPS
was instrumental to that add. In addition, there was funding in the budget
of $225,000 for our colleagues at CIAD who do incredible grassroots
advocacy in the community with residents and former residents of adult
homes.

Children’s Mental Health Waiver

This year’s proposed budget added a two-year timeframe to implementation
of the Children’s Mental Health Waiver. As part of the final budget
agreement, the legislature rejected the time frame and has added language
to begin the process of implementation. Children’s advocates played a large
part in framing this issue and working with the legislature to eliminate
the two-year time frame

Ombuds Program for Behavioral Health

Due largely to the advocacy of our colleagues at the Legal Action Center,
there is $1.5 million in the budget for an ombuds activities for substance
abuse and mental health access to care and treatment concerns. More
details to come.

Suicide Prevention

The Senate added five hundred thousand dollars to the Sources of Strength
initiative that provides prevention and awareness about suicide prevention
in several school districts in New York State. This year’s funding will
increase their ability to provide the training in additional schools. They
are doing very innovative work and it is very positive that they are
receiving this funding.

Jail Based Restoration

The Legislature rejected proposed budget language that would add a jail
based restoration initiative. Counties and advocacy groups had raised some
concerns about this issue and they were able to work with the Legislature
to reject this initiative.

SUMMARY

Like most other years, this year’s budget was a mixed bag for mental
health. While we are very pleased that the legislature recognized the
importance of mental health in schools by funding a Resource Center, we are
disappointed that there was no money added to housing in the budget beyond
the original ten million dollars and we also remain concerned that there
was no language added to provide salary increases for direct care and
clinical staff for next year through workforce enhancements.

We were pleased to see funding added again this year for CIT, Mental Health
First Aid and Veterans Mental Health as well as Legislative support for the
rejection of Prescriber Prevails.

As we move now from budget to legislation, we pivot from financial pieces
to legislative fixes such as supporting the HALT legislation to insure that
people with mental health issues and other individuals such a pregnant
woman and individuals in the LBGTQ community are excluded from solitary
confinement.

We will also continue our work to enhance mental health literacy through
other public awareness campaigns and raising visibility of the new mental
health in schools legislation. We will also be working with the workforce
sector to help incent people to stay in the behavioral health workforce.

We have come far in the last several years but unfortunately we have a long
way to go. We appreciate all of you who called in about the mental health
training and resource center. Your work is instrumental to any reforms in
recent years. Please keep doing everything you are doing to raise
visibility and end stigma.

Glenn Liebman, CEO