2016 Legislative Session Recap:

A very productive session but still much more to do…

This year’s legislative session featured the same bifurcation as takes
place every year in recent times. The budget is introduced in January and
from early January, through April 1, MHANYS advocacy is specifically geared
towards funding of services and other fiscal priorities. Then April 1—June
20th, MHANYS advocates for specific legislation such as the Mental Health
Education in Schools Bill.

Before discussion of the budget, we want to highlight the significance of
the passage of the Mental Health Education in Schools Bills. The idea of
health classes now teaching about mental health in schools in New York is
landmark legislation that will hopefully allow for generations of New
Yorkers to be well educated and aware of mental health. The net result will
be a future community of people who are much more responsive, understanding
and knowledgeable about mental health. If Governor Cuomo signs this into
law, it will be a great victory for all New Yorkers and will hopefully send
a message to the rest of the country about the importance of prevention and
early education in regard to mental health. We discuss the issue in greater
detail in the Legislative Section.

Budget Section (January – April 1)

Funding for Community Services and Supports in Mental Health

In this year’s budget, MHANYS advocated for an across the board increase in
community mental health funding. Much of this funding would have gone to
enhanced support through a rate adjustment. The Mental Health Community
has gone close to a decade without much increased funding for the mental
health workforce and the impact has been dramatic for MHA’s and other
community providers.

Along with our colleagues at NYAPRS and Kevin Cleary Associates, we
advocated for this specific funding increase for mental health. While not
reaching our target goal, this advocacy spurred on support for reinvestment
funding that had originally been cut from the state budget.

The State budget initially called for $5 million in reinvestment to go
towards transitioning 100 older individual with mental health issues in
State Psychiatric facilities to nursing homes. This policy, while well
intentioned, did not account for $5 million that would have been lost for
community reinvestment. These community dollars are part of the funding
system that drives recovery in the community for housing, peer support,
supported employment, family engagement and other recovery programs that
support the work of many of the MHAs.

Through the combined advocacy of our organizations, we were able to work
with the State and Legislature to add the $5 million back into community
reinvestment while continuing to insure that the 100 individuals with
proper outreach and support would transition to settings that would be most
appropriate to their needs.

Prison and Jail Reform

Another area of the budget that was very impactful to the mental health
community was in regard to jail and prison reintegration for people with
behavioral health needs. Along with our colleagues at The Legal Action
Center and NYAPRS, we pushed for bill language originally introduced by
Assemblymember O’Donnell that would provide a waiver to individuals in
correctional setting to be able to be approved for Medicaid up to thirty
days before release.

This common sense approach would reduce recidivism by insuring that post
release, an individual would automatically be able to engage in services
without having to wait for Medicaid approval. Through strong internal
advocacy by the Administration and support of the Legislature, this
language was passed in the New York State budget pending federal approval
by CMS.

When the waiver is approved, it will dramatically help individuals being
released from jails and prisons.

Minimum Wage

This was a major topic of discussion through this year’s budget. The
biggest concern that arose out of the not for profit sector was the
difficulty of being able to pay for increased salaries because of minimum
wage enhancement. The issue is not about supporting the increase, it is
about the commitment to help not for profits pay for the enhanced salaries
of those making minimum wage.

There is a potential two fold impact that has to be addressed as part of
minimum wage discussion. First is specific to existing workforce. Mental
health has always been a difficult area to recruit and retain quality
staff. As the minimum wage increase is implemented, there is likely to be
an increased impact in losing quality staff to other sectors.

The other concern is known as compression. Compression takes into account
the impact when someone making minimum wage, gets an increase and now makes
as much if not more than their supervisor or someone with years of more
experience. The Supervisor should get an increase in line with that of the
increase to the worker whose minimum wage has increased.

For example if the supervisor makes twelve dollars an hour and the staff
person makes ten dollars hour but the minimum wage is now twelve dollars an
hour, it is not equitable that the staff person is making as much as the
supervisor. The supervisor should get a similar increase in salary
consistent with what the person making minimum wage is now receiving.

While there was funding in the budget for not for profits being impacted by
minimum wage, there was no funding put aside for issues of compression
which will likely be of great significance in the future.

It is something not for profits like MHANYS will have to be working on in
the future to insure quality recruitment and retention.

Joseph Dwyer Veterans Peer to Peer Funding

Through the advocacy of the State Senate, there was over one million
dollars in a funding increase for the successful peer to peer veterans
mental health support models. Many of these programs are embedded in MHA’s
across New York State. It is a great privilege to work with veterans and
one that our members take very seriously. To date, there are over eleven
counties that have Dwyer Center Funding and this increase will help to
expand to additional counties while insuring enhanced services in each of
the existing Centers.

Crisis Intervention Teams

Recognizing, the importance of Crisis Intervention Teams in responding to
crisis that involve people with mental health issues, MHANYS and our
colleagues continued our advocacy on development of Crisis Intervention
Teams across New York State. The New York Assembly added one million
dollars to this year budget and the State Senate added five hundred
thousand dollars. This million and a half dollars will be spread across
several counties across New York that will be able to get CIT training for
their police force and for engagement with stakeholders.

At the request of the Assembly, MHANYS presented a forum on the Assembly
Disabilities Day featuring State and national experts discussing CIT
training.

Mental Health First Aid

MHANYS has long been proponents of Mental Health First Aid (MHFA) as both a
tool to educate the public about mental health but also as a response to a
mental health crisis. In this year’s budget, the State Senate added
$100,000 in the budget for MHANYS to continue to provide MHFA training to
members. In addition, as part of CIT training, there is funding made
available to provide MHFA training for law enforcement.

This is part of a campaign on the importance of mental health literacy
which comprises Mental Health First Aid, Suicide Prevention, Mental Health
Education in Schools and anti-stigma efforts.

Prescriber Prevails

This year’s budget proposed the elimination of prescriber prevails language
in Medicaid for various medication classes. To the credit of the Executive,
this list did not include mental health medications but it did include
medications that might well impact someone with a mental health issue.

A coalition of advocates including MHANYS work with the legislature to
restore this program.

*Legislative Highlights (April 1—June 20):*

*Passage of Mental Health Education Bill *

This landmark legislation, if signed by Governor Cuomo, would insure that
mental health education would have to be taught as part of health
curriculums in middle schools and high schools. We know that many schools
across New York already do that and do it well, but there are areas of the
State in which middle schools and high schools do not address mental health
issues.

The percentage of youth impacted either directly or indirectly by mental
health issues is incredibly high. By being able to offer mental health
education in schools, it will help provide youth with additional resources
and facts about mental health related issues and suicide prevention. This
can help dramatically decrease stigma while increasing prevention.

With the leadership of Assembly Education Chair Nolan and Senate Education
Chair Marcellino and all the MHA chapters and grassroots organization, this
bill passed this year. This was the top legislative priority of MHANYS and
we were pleased to see it passed. We look forward to Governor Cuomo signing
this bill. Special thanks also to MHANYS Board Member Sylvia Lask, MHANYS
Director of Public Policy, John Richter and Kevin Cleary Associates for
their great work in helping to get the legislation passed. It would never
have happened without them.

On a personal note, though we have been advocating for mental health in
schools for several years, the genesis of this movement started over twenty
five years ago when mental health lesson plans were first developed at
NAMI-Queens/Nassau. As the statewide director of NAMI at that time, I was
honored to be a small part of that by helping with statewide and nationwide
distribution. Their Breaking the Silence Lesson Plans have contributed
mightily to helping end stigma in schools.

Step Therapy

Step Therapy is an intervention in which an individual can ‘fail first’ on
medication in a plan’s formulary before being provided with another more
appropriate medication. Step Therapy impacts clinical judgement in that a
clinician’s medication choice (in consultation with the individual) may not
be approved by a plan if it is not in their existing formulary.

This can be very impactful with mental illness. For some people it can take
several painstaking months before they receive the appropriate medication.
And if that medication does not work for the individual than it can take
weeks or even months before they are weaned off and can try another
medication. You have to get it right the first time and that is why you
need as much choice and information as possible and not have to go through
tortuous months of medications that might not work. As a family member,
this is an experience we have had that no one should have to go through.

This legislation, if signed by the Governor, would allow for much more
rapid time line appeals for physicians as well as providing additional
consumer and physician safeguards.

Passage of this legislation was a priority for MHANYS in this year’s
session. Special thanks go to the bill’s sponsors—Senator Cathy Young and
Assemblyman Matthew Titone as well as all the grass roots organizations
involved in this successful campaign.

Summary and Other Considerations

There have been some landmark victories this year in Mental Health. For
the last two years in a row, the priority legislative agenda of MHANYS-last
year’s Mental Health Tax Check Off and this year’s Mental Health Education
Bill have passed the Legislature and the Check off Bill has been signed
into law. The impact of the Mental Health Education Bill could be positive
for years to come.

Passage of the Step Therapy bill will be helpful to individuals desperately
in need who have been denied access to their appropriate medications

Budget items like adding $5 million back to the budget for mental health
reinvestment, allowing for a federal waiver to insure that incarcerated
individuals are able to apply for Medicaid benefits thirty days before
being released from a facility; funding for veterans mental health, mental
health first aid and CIT are all significant victories that the mental
health community should feel good about.

That said, none of us are naïve to the challenges we still face on a daily
basis. Our community work force has seen one small COLA increase in eight
years, the cost of running programs continues to raise, preparation for
managed care raises a series of new challenges and existing housing
programs have not seen a real increase in several years. The end result is
less resources and services to help support the 800,000 people in New
York’s community mental health system.

Regarding, criminal justice reform, we are also angry that New York
continues to be one of two states that has not ‘Raised the Age’ to 18 in
which youth are charged as adults.

In regard to new housing, we are in agreement with the leaders in our
housing advocacy community including the Association for Community Living
and the other members of Campaign 4 NY/NY Housing who strongly urge
Governor Cuomo and the legislature to sign an MOU that includes $1.9
billion for the creation of 6000 new supportive housing units. To date the
Governor has announced that only $150 million of the new money will be
released to fund a one-year plan to build 1200 units of new supportive
housing.

Media and Events

In the world of mental health advocacy, one of the most significant tools
in the arsenal is involvement with the media. There were several
opportunities this session for MHANYS to provide expertise on budget and
mental health education issues. MHANYS was featured several times during
the course of this year’s Legislative Session on Capitol Pressroom with
Susan Arbetter and Capitol Tonight with Liz Benjamin.

In addition, articles in statewide media outlets about mental health
education in schools and the mental health budget from MHANYS perspective
were highlighted throughout this legislative session.

This year’s MHANYS Legislative Conference featured over two hundred people
including our members, fellow mental health advocates, high school
students, veterans, and advocates for individuals with eating disorders.

Through Assemblymember Marcus Crespo, MHANYS had an opportunity to present
about mental health education in schools and other mental health
initiatives to the Assembly Latino Caucus

Our two legislative chairs—Assemblymember Gunther and Senator Ortt continue
to be great friends and allies of MHANYS and we worked with them throughout
this year’s legislative session.

Next Year

Budget

It is all about enhancing funding for community services and workforce. Not
another year can go by without additional funding in place despite
challenges that lie ahead.

Legislation

With the new found momentum around the Mental Health Tax Check Off and
Mental Health Education in Schools Bill, next year we will continue to
advocate for mental health education in schools through a bill sponsored by
Senator Hamilton and Assemblyman Crespo that will add Mental Health First
Aid as part of the teacher certification process. In regard to fighting
stigma, we will advocate for a mental health public awareness to be added
to the list of licenses in New York State with the added funding going to
the State’s existing Mental Health Anti Stigma efforts.

Join Us:

If you feel strongly about these issues and want to join our statewide
advocacy, please contact MHANYS Public Policy Director, John Richter at
jrichter@mhanys.org

Please follow us on twitter @MHAacrossNYS

Thank you for all your great work this year but we know we can never rest
on our laurels and will continue the fight for community resources and to
end the stigma and discrimination of mental illness.

Glenn Liebman, CEO
Mental Health Association in New York State, Inc.
194 Washington Avenue Suite 415
Albany, NY 12210
gliebman@mhanys.org

(518)434-0439 x 220

 

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