Mental Health Update

As we continue to scour the State budget, there are several more initiatives that impact behavioral health.  Caveat to all this is that the Governor’s Executive Budget includes $6 billion dollars from a future federal stimulus.  The State is hoping to receive up to $15 billion. If neither of these benchmarks are achieved than this year’s budget could be the worst in recent memory.

20% Withhold Information Becomes More Clear

As we interpret the budget language, our understanding is that counties/behavioral health agencies will get back 15% of the 20% that they lost as of July 1, 2020. However the 5% will no longer be a withhold but a permanent cut. Moving forward for the 2021-22 fiscal year, the funding to counties that transition to the providers will have a permanent cut of 5%.  This is all subject to New York receiving $6 billion in aid from the federal government. However, if New York receives the full $15 billion than there will be no cuts to behavioral health services.

Bottom Line:

MHANYS and our colleagues will certainly advocate for the elimination of this 5% cut to an already overburdened community system.

Not Withstanding Reinvestment:

This year the proposed Executive Budget includes language that would not withstand reinvestment for this year.  There are 200 proposed bed closures this year that would result in savings of $22 million for New York State. This funding would end up in the State’s general fund instead of being included in community mental health services. This $22 million dollars would not be added to the funding base of over $100 million that already exists.  It is not clear from the budget if reinvestment will continue as in the past if there is full restoration of the $15 billion.

Bottom Line:

MHANYS has fought for the new reinvestment funding since it begin six years ago. We will continue to advocate for this restoration. This funding has been appropriately lauded by the State and providers for helping to create innovative programs including peer respite, jail diversion, housing, crisis intervention and other important programs.

Crisis Stabilization Centers:

The OMH and OASAS Commissioners can jointly license 26 crisis stabilization centers statewide. The Center shall serve as an emergency service for a person with a mental health or substance use disorder. The Centers will include the ability to provide engagement, observation, detoxification, telemedicine, peer support, Medication Assistance Therapy and therapeutic interventions.

Bottom Line:

There are several Crisis Stabilization Centers in existence across the State—several of them run by MHA’s. They have been critical in providing alternatives to emergency rooms for those in greatest need and it is a welcome alternative.  We are having some conversations to ascertain the success and the challenges of the Centers including issues of billing and case rates

Mental Health Education in Schools:

We are very pleased that the Governor has included $500,000 in the budget for MHANYS School Mental Health Resource and Training Center. New York continues to be the national leader in the inclusion of mental health education in schools. This is a continued affirmation of the work of the Center and the State’s commitment to our project

Bottom Line:

The Pandemic and Issues surrounding Social Justice have made it clear more than ever that there is a need for additional mental health funding for schools. Levels of anxiety, depression, substance use and suicide are at all-time high levels. The work of the Resource Center needs to be amplified by having the ability to reach more schools across New York State. We will be advocating with the Legislature and Executive this session for additional funding.

Housing:

This year’s budget provides the unspent $20 million in funding from last year that was allocated to housing providers to support rate increases for housing providers.

Bottom Line:

We will continue to advocate that the spending be utilized in this year’s budget and that there is additional funding for housing as capacity increases

Workforce:

This year’s executive budget includes funding to defray the increase in minimum wage cost to not for profits in OMH, OASAS and OPWDD.  This is a long term state commitment to increase the minimum wage statewide to $15

Bottom Line:

The funding to not for profits around the minimum wage is appreciated but more needs to be done. Last year’s #3for#5 campaign was gaining traction until COVID hit. If New York receives $15 billion from the Federal Government than the Executive and the Legislature should work together to provide increase of three percent a year for the next five years to the not for profit human services sector.

Crisis Intervention Teams and Mental Health First Aid

There are very few evidenced based tools that provide mental health education and crisis training to law enforcement than CIT and Mental Health First Aid.  CIT is a 35 hour training for law enforcement official and the community that emphasis the role of families and peers in helping to mitigate a mental health crisis. Mental Health First Aid is an eight hour training that has been used as a supplement for educating law enforcement about mental health and how to respond to a crisis.  Given all the grave concern about law enforcement and mental health, these two tools are very significant in helping to support a peaceful resolution to a crisis situation.

Bottom Line:

We will need the Executive to work with the Legislature to insure funding in the final budget for both CIT and MHFA

Prescriber Prevails

As we have said for the last decade, one of the most significant concerns we face is that individuals in need of medication for their mental health issues are denied the appropriate medication because their appropriate medication is not available on a plan’s formulary. In all fairness, what could me more effective than an individual in discussion with their psychiatrist determines the most appropriate medication. Makes completes sense and yet every year the Executive calls to eliminate this useful protection.

Bottom Line:

Restore the protection of Prescriber Prevails in Medicaid Plans

Funding for Joseph Dwyer Veterans Peer to Peer Mental Health

The funding for the Dwyer program has been essential for peer support among veterans. For the almost decade that the Dwyer program has been in existence, it has helped hundreds of veterans with mental health concerns provide support for each other as well as necessary clinical help.

Bottom Line:

Unfortunately, there is no proposed money in the budget for this program. Work with the Executive and the Legislature to insure funding for the Dwyer program

Final Analysis:

In the most untraditional of years, we have the most untraditional of challenges that lie ahead.  The Governor’s budget assumes $6 billion in Federal stimulus funding. What happens if we get less than the $6 billion. Well he already laid out that six billion would be a disaster and that New York needs $15 billion to be made whole. Well what happens if we receive more than $6 billion but less than $15 billion. Would it be enough to limit the 5% cut or will some sectors get more restoration than other sectors?

What is the role of the Legislature in this year’s budget?  Will they have any money to help defray the impact of the budget cuts?  Will they use the supermajority to add tax revenues even if they are opposed by the Governor?  Will other options become available as well?

I think it is safe to say that we are agnostic when it comes to decision making—all we care about is not cutting fundamental mental health services. We just laid out our concerns in the budget whether the 5% cut, the notwithstanding of reinvestment and a host of other issues. The only thing we care about is restoring any cuts to behavioral health.  The world has changed dramatically in the last year between racial unrest and COVID and the mental health impact is seen at every level of society.  We will do whatever we can to insure that this essential mental health funding is not cut in this year’s Executive Budget.

What you can do

If you believe in what we are saying than come join your voice with us on the week of March 8^th for our Mental Health Matters Days.  Look out for registration coming soon.  Also, if you know of someone that is interested in mental health advocacy, please share our update list with them and have them sign on to get this information.

Glenn Liebman
CEO, MHANYS
194 Washington Avenue, Suite 415
Albany, N.Y. 12210

Support MHANYS Mental Health Matters Week
March 8^th—12^th