Mental Health Update

MHANYS is part of a coalition with ten other statewide behavioral health organizations. As part of the Senate/Assembly Budget Hearing for Mental Hygiene on Monday, our group is committed to working together around the agenda items listed below.We will share MHANYS testimony on Monday.

Go Giants. Really like their chances on Sunday.

BLUEPRINT FOR REVIVING NEW YORK’S COMMUNITY-BASED

MENTAL HEALTH AND SUBSTANCE USE DISORDER SYSTEMS OF CARE

New Yorkers lack appropriate access to mental health and substance use disorder (SUD) care today because the State has repeatedly failed to provide adequate funding for these essential services in the past. For more than a decade, the Administration reneged on an over $700 million commitment that was due to support the mental health and substance use disorder provider systems of care.

We are pleased with the many priorities Governor Hochul has included in her SFY 2023 proposed Budget for mental health and substance use disorder services. We ask that they remain in the enacted budget. While a priority area such as the 5.4% Cost-of-Living-Adjustment is critically important and long overdue, it is insufficient to meet the current crisis. Below are additional items that we respectfully request the Legislature’s support for New York’s Behavioral Health system.

5.4% COST-OF-LIVING-ADJUSTMENT (COLA) MUST BE ENACTED TO INCLUDE THE FOLLOWING RECOMMENDATIONS:

In 2006, a law was enacted to provide a statutory COLA for human service providers (Chapter 57 of the Laws of 2006), including behavioral health providers. The COLA for each fiscal year is to be based upon the previous July’s annual Consumer Price Index – Urban (CPI-U). While the original law has been extended for every year through this current fiscal year, unfortunately, most years since 2006, COLAs were not included in the state budgets. This resulted in a cumulative, compounded financial deficit of approximately 30% to providers.

WE REQUEST THAT THE LEGISLATURE INCLUDE THESE NEW REQUESTS IN THE FINAL ENACTED SFY 2023 BUDGET:

1. Amend the Governor’s proposed 5.4% COLA language to include Health Home Care Management (HHCM) in the Part DD Amendment.

2. Amend the Governor’s proposed 5.4% COLA language to include the Office of Temporary and Disability Assistance (OTDA) NYS Supportive Housing Program in the Part DD Amendment.

3. Remove the “sunset” provision in the Part DD Amendment as included in the Executive’s proposed SFY budget and include HHCM and OTDA Supportive Housing, to help ensure that COLAs will be included in all future budgets.

THE LEGISLATURE MUST INVEST $500 MILLION TO:

1 SUPPORT RATE INCREASES FOR LICENSED AND UNLICENSED BEHAVIORAL HEALTH SERVICES AND PROGRAMS

· Focus on building a sustainable workforce through investments in all adult and children licensed and unlicensed behavioral health programs.

· Address the access to care crisis caused by a minimum 25% staff vacancy rate across all our adult housing, children’s residential, crisis residential, clinics, care management, outpatient and residential SUD treatment, peer, and other community-based and behavioral health care services.

· Implement rate adjustments that will begin to address the significant disparity between cost of care and current reimbursement of the same

2 BUILD THE JOB PIPELINE AND RESUSCITATE THE BEHAVIORAL HEALTH WORKFORCE

Tuition Reimbursement: Full scholarships available to individuals at SUNY and CUNY schools who commit to working in the public mental health and substance use field for five years following graduation.

Loan Forgiveness: Loan repayments to staff working in eligible programs as determined by underserved populations. A partial loan payment should be provided at the end of each year of eligible service.

Ensure that behavioral health programs are included in the proposed Nurses Across New York Program.

Establish an academic fellowship in Addiction medicine in each of New York State’s public medical schools.

Support Internships and Field Placement Stipends:  Field experiences and internships are expected to contribute to the mastery of behavioral health competencies, with a focus on balancing the educational and practice needs of the student with the needs of the community. Funding is needed to attract students to the field by offering stipends while they are learning the skills needed for their career.

Heal the Healers: Ensure the development of broad-based wellness programs for all employees of behavioral health care providers through direct funds and tax credits for employers.

3 INVEST IN DIVERSITY, EQUITY & INCLUSION

The behavioral health workforce is diverse and, consequently, has been disproportionately impacted by racial and social justice inequities. While raising salaries and providing funding for education will help to sustain our diverse the workforce, additional targeted actions must be taken.

· Targeted scholarships for BIPOC

· BIPOC Leadership Development program

· Conscious and unconscious bias training in the workplace

4 BUILD CAREER LADDERS FOR ADULT, YOUTH AND FAMILY PEERS

Investments must be made to develop career pathways for adult and youth peers, and families.

Peers (people with lived experience and training) are a critical part of the behavioral health workforce. However, peers are often unable to move up in agencies or to access non-peer positions.

We must make investments to develop career pathways for adult, youth and family peers that recognize the critical personal experience they bring to complement traditional clinical approaches. Families and caregivers with lived experience also provide unique expertise in navigating the behavioral health system and with addressing the needs of their loved ones.

5 ESTABLISH A REFUNDABLE PERSONAL INCOME TAX CREDIT FOR DIRECT CARE/SUPPORT
WORKERS IN THE OMH, OASAS AND OPWDD SYSTEMS

To recognize the vital work that our mental health and substance use treatment disorder Direct Care Workers and I/DD Direct Support Professionals perform on a daily basis to support individuals with disabilities and behavioral health challenges to live enriched, fulfilling and safe lives, we are asking that the legislature include language to establish a Refundable Personal Income Tax Credit for Direct Support Professionals in the OMH, OASAS and OPWDD systems.’

This proposal would be a well-earned recognition of their work and provide crucial recruitment and retention incentives to curb the workforce crisis by adding up to $5,000 to direct care worker and direct support worker salaries.

6 SUPPORT THE EXPANSION OF CHILD HEALTH PLUS (CHP) TO INCLUDE BEHAVIORAL HEALTH

For many young people, mental health and substance use concerns arise at a young age. This has expanded exponentially since the start of the pandemic.

· Support the expansion of behavioral health services under the state’s Child Health Plus (CHP) insurance plan for children and families.

· Support the alignment of Child Health Plus benefits with other Medicaid benefits.

7 SUPPORT HMH, ARTICLE VII, PART P THAT WOULD REQUIRE NEW YORK STATE TO USE  COMPETITIVE BID PROCESS WHEN IDENTIFYING MANAGED CARE ORGANIZATIONS (MCOS) TO PARTICIPATE IN THE ADMINISTRATION OF BEHAVIORAL HEALTH SERVICES CARVED INTO MEDICAID MANAGED CARE

· Behavioral health benefits for Medicaid recipients with serious mental health and/or substance use conditions have been carved into Medicaid managed care since 2015. During this time, many Managed Care Organizations (MCOs) have proven to be unfit to manage these benefits.

· The state has issued over 150 citations to MCOs that manage behavioral health benefits for a variety of deficiencies including failure to comply with federal and state parity laws, and inappropriate claims denials. New Yorkers with behavioral health conditions deserve more!

· Use of a competitive procurement process will have the effect of forcing interested vendors to intensify their commitments and increase their quality outcomes so they can continue to manage these benefits.

· New York should utilize a competitive procurement process to identify MCOs and require these companies to re-bid for inclusion on a regular basis. Participation in our carve-in is a privilege, not an entitlement.