Mental Health Update

“Mental Health Issues are the Defining Challenges of Our Time”

Governor Kathy Hochul

With this in mind, below is a breakdown of the ‘top of the trees’ mental health issues.   Few caveats:  The Article 7 language which provides specificity to the budget has not yet been reviewed. We will have a clearer picture at that time. Also, MHANYS policy team of John Tauriello and John Richter will be doing a deeper dive on the budget over the next few days.

 Human Services COLA:

This has been MHANYS top policy issue for several years.

The Governor’s budget includes a 1.5% COLA for the Human Services Not for Profits.  This year’s CPI is at 3.2%   We appreciate the continued commitment and we will work with the Executive and the Legislature to provide a 1.7% increase to make it whole at 3.2%     This is the one issue that crystalizes our entire community workforce.

Commentary on COLA:

 The Governor’s commitment to COLA has been far more than any other Governor in New York’s history and it is very significant .  The work to create change in commercial parity benefits is also a significant driver of funding for our sector, but the reality is we need a lot more.  We need a full executive and legislative commitment to the 3.2 percent COLA, we need a $500 million investment to behavioral health for all the years we did not receive any or minimal increases, we need long term strategies such as pension benefits for not for profits and we need funding to incentivize young people for careers in mental health through career ladders and Qualified Mental Health Associate titles.

Behavioral Health Parity including Commercial Insurance Reimbursement Rate Proposed Changes and Greater Enforcement to Plans that are not providing full behavioral health parity.

The reality is that many commercial plans do not compensate providers for costs incurred to deliver services.  The Governor is proposing legislation that requires commercial insurance companies to pay for State licensed outpatient mental health and substance use services at least at the Medicaid Rate

MHANYS Note:  We completely support the Governor in the movement to enhance commercial insurance rates.

Existing Residential Programs:

$43 million for 17,000 housing supports.

 MHANYS Note: This was part of last year’s state commitment to residential programs. 

988

$100,000 to provide specialized maternal mental health training programs for providers that work on 988

 MHANYS Note:  We have to work on legislation that will create self-sustaining funding for 988

Expansion of Project Teach of 1.5 Million

This will expand to create specialized support for individuals during pregnancy and postpartum

MHANYS Note: Governor Hochul and Commissioner Sullivan deserve a great deal of credit for their recent work on maternal metnal health. Senate Mental Hygiene Chair Samra Brouck has helped lead that charge and we are very appreciative.

Establishment of Loan Forgiveness Program for Mental Health Clinicians Serving Children—$4 million

MHANYS Note:  This is worthwhile idea and we have to continue to increase loan forgiveness programs for the entire mental health workforce

Youth ACT Team–$9.6 million to create 12 new Youth Act Teams

Youth Mental Health First Aid and Peer to Peer Programs—$2 million 

MHANYS Note:  We were very pleased to see reference to Youth Mental Health First Aid.  We have been doing this training for many years and the education of the workforce that works with children has been greatly enhanced by this training.

Workforce Incentives:

The Office of Mental Health is proposing five new initiatives that address incentives for careers in mental health. These ideas include a job bank, Behavioral Health Fellowship Program, Credentialing Paraprofessionals and a focus on rural communities. 

MHANYS Note:  This has been a major agenda item for MHANYS and we are pleased to see it proposed in the State Budget.  We continue to advocate for the Qualified Mental Health Associate title for paraprofessionals with career ladders that do not infringe on scope of practice issues.

Improve Mental Health Admissions and Discharge–$7 million to expand regulatory compliance activities with OMH licensed and unlicensed programs including inpatient hospitals and CPEPS

Mental Health Courts

$6.2 million including establishing a team in OMH that will work with mental health courts and providers to ensure individuals are connected to servives that they need

Crisis Intervention Teams (CIT)

$187,000 to increase CIT teams.

MHANYS Note:  We have long supported CIT as an evidence based best practice

Mental Health Capital Investments:

The Executive Budget continues to build on the Governor’s investments in expanding capacity to care for people with mental illness by funding an additional 200 new psychiatric inpatient beds. The funding covers 125 State-operated inpatient beds, including 15 for children and adolescents, 85 for adults, and 25 forensic; and 75 Transition to Home beds.

MHANYS Note: We have long supported the Governor’s commitment to increasing the reimbursement in community hospitals for mental health beds in line with medical/surgical beds. In regard to State Psychiatric Hospitals, we have concerns that while the state hospital census across the country is declining, we are seeing an increase. We are already the largest psychiatric inpatient system in the country with 23 hospitals (no other State has more than 10).  We should develop a Commission to review the State Hospital Facilities with a focus on alternative uses as is being done in Creedmoor as a housing facility for new immigrants.

$42.2 million to increase reimbursement for services provided in DOH-licensed facilities and private practices treating mental health conditions.

• Invests $10.4 million to increase reimbursement rates for healthcare providers serving individuals with physical, intellectual, or developmental disabilities.
• New York will also submit a new 1115 waiver amendment to allow children to remain continuously enrolled in Medicaid and Child Health Plus up to age six, with the goal of preventing gaps in coverage during important developmental years and improving outcomes for long-term health and well-being.
• Improve Access to Primary Care. The Budget builds upon the historic primary care investments in the FY 2024 Budget, continuing to invest in access to preventive care, including increased reimbursement rates for adult and children’s mental health services provided in a hospital setting or private physician practice.
• Expand Early Childhood Mental Health Consultations. The Budget increases funding to double the amount of early childhood mental health consultations across the State. Currently, there are Infant Toddler Mental Health Consultants located at seven regional infant and toddler resource centers. The additional funding will go to these resource centers to expand mental health consultants to providers across the State. The Budget provides $1.7 million for this purpose.

Proposed actions for the Mental Hygiene agencies build on prior investments in mental health, targeted efforts to address the opioid crisis, and continued support for community-based services including residential programs. The Executive Budget proposals result in Mental Hygiene system spending of $10.9 billion in FY 2025, reflecting annual spending growth of $814 million (8.0 percent).