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Friday Fax from Albany

Date: January 19, 2005
To: Board Members, Affiliate Executive Directors, Interested Parties
From: Glenn D. Liebman, CEO
Phone: (518) 434-0439 ext. 20
Fax#: (518) 427-8676
E-Mail Address: gliebman@mhanys.org

SAVE THE DATE

March 7, 2005
MHANYS’ Legislative Conference and Lobby Day
711-A Legislative Office Building, Albany

Special Edition

Governor Releases 2005-2006 Executive Budget Proposal: As advocates left the Office of Mental Health Tuesday evening, a relatively clear picture of Governor Pataki’s 2005-06 Executive budget proposal was taking shape – not as bad as expected. Nearly the entire mental health community had been bracing for what could have been the worst budget in years, in the face of a multi billion dollar state deficit.

In sum, there are several parts of the budget that we are pleased with including the recognition of housing through initiatives that will provide $6.5 million for supported housing stipend increases as well as continuing to fund the ‘pipeline’ for residential beds in the community. Funding increases for Article 31 clinics are also significant as is expansion of the Home and Community Based Waiver Program for Children (245 additional home and community based waiver slots).

Of greatest concern to us is the $3.9 million cut to Local Assistance. Combined with last year’s cut of $7.7 million, this will have a great impact on community providers, including many MHA’s. We are continuing to get clarification about the specific administrative impact of this cut including exact amounts (cuts may be less than the projected $3.9 million). At yesterday’s OMH briefing, we brought this issue up to the leadership at OMH and expressed our concern. As soon as we get clarification, we will share with all of you.

Of concern to us as well in the Medicaid budget is the elimination of mental health services for Family Health Plus, the Medicaid Cuts for psychological services and the Preferred Drug List (PDL).

Regarding a psychiatric facility closure commission, like that which was proposed last year, there has been no mention in the budget about such a Commission, yet we have had positive conversations with the Administration about the proposed creation of such a Commission. We will continue to advocate for a Commission with strong stakeholder participation.

On all these issues, we will provide greater information in the coming weeks.

We would like to acknowledge that putting this material together was a collaborative effort between MHANYS, Michael Friedman representing the NYC and Westchester MHA and Harvey Rosenthal and Dick Jaros from NYAPRS.

 

Following is a snapshot of Governor Pataki’s 2005-06 Executive budget proposal as it relates to individuals with mental illness. In addition to the budget, OMH is expected to release the Statewide Comprehensive Plan for Mental Health Services 2005-09 sometime today.

  • Proposed closure of Middletown Psychiatric Center (PC), with beds to be consolidated at Rockland Psychiatric Center, to take place April 1, 2006. As part of this proposal, the Governor recommends that 100% of the $7M in operating costs associated with Middletown PC be Reinvested to expand state-operated community services within Orange and Sullivan counties, which are currently served by Middletown PC.

  • On top of last year’s $7.7M cut in Local Assistance for mental health in 2004-05, the Governor proposes an additional $3.9M cut for 2005-06 for Local Assistance. While details have yet to be worked out, it appears that such savings will be achieved “by reducing or eliminating funding to local mental health providers that are underperforming, delivering less cost effective services, or whose agency administration and overhead costs are higher than system-wide averages.”

  • Savings realized by eliminating inefficiencies in Local Assistance funding and savings resulting from Federal Medicaid maximization would be redirected to provide $6.5M for an increase in the stipends for community providers for the operation of supported housing beds.

  • Changes are proposed to the Family Health Plus program, which provides access to comprehensive health coverage for eligible low-income adults who do not have insurance through their employers, yet have incomes that do not qualify them for other publicly financed health programs. Such changes would include “making the benefit package consistent with that offered through Healthy New York.” It appears that this would include dropping coverage of mental health services from Family Health Plus, altogether.

  • Responding to the calls for Medicaid relief coming from counties throughout the state, the Governor proposes a series of changes to reduce costs associated with Medicaid. Included in these reforms is a cap on the county share of Medicaid costs up to the amount they will have spent in 2005 and a proposed state takeover of local Medicaid costs effective in 2008.

  • As in previous years, the Governor proposes the creation of a Preferred Drug Program (PDP) to achieve savings in Medicaid for prescription drugs. Atypical anti-psychotics, anti-depressants, anti-retrovirals used for treatment of HIV/AIDS, and anti-rejection drugs used for organ transplants are exempted.

  • The Governor proposes elimination of coverage under Medicaid for psychological, dental and podiatric services. In addition, modifications will be made to the reimbursements provided for transportation under Medicaid.

  • Merges the Commission on Quality of Care for the Mentally Disabled (CQC) with the Office of Advocate for Persons with Disabilities (APD) to create the Commission on Quality of Care and Advocacy for Persons with Disabilities.

  • $24M for freestanding Article 31 mental health clinic programs to provide for workforce enhancements and to improve quality of care.

  • ; $32M for court ordered Assisted Outpatient Treatment (Kendra’s Law), case management and the Medication Grants Program. With Kendra’s Law due to expire on June 30th, extension of the law will be considered by the legislature this session.

  • In conjunction with the Office of Children and Family Services, OMH will establish a demonstration project to create 245 new waiver slots through the Home and Community Based Waiver program.

  • In collaboration with the Department of Corrections, OMH proposes $7M in continued funding to expand mental health treatment capacity and clinical staffing for prisoners with mental illness.

  • $10M in continued funding for adult home residents, including an additional 3500 case management slots for adult home residents living with mental illness.

  • Continued funding for research at the NY Psychiatric Institute in Manhattan and the Nathan S. Kline Institute at Rockland PC.

  • Continued funding for the New York/New York II housing agreement.

  • $1M to for the eating disorders centers of excellence legislation passed in 2004.

  • $2M to comply with the fingerprinting legislation passed in 2004 for mental health direct care staff.

 

Committee Chairs Chosen in Both Assembly and Senate: Late last week and early this week, the mental health community received notice from the legislature as to who the respective Committee Chairs would be in both houses.

We are very pleased to receive word that Assemblymember Peter Rivera will remain Chair of the Assembly Committee on Mental Health, Mental Retardation and Developmental Disabilities. We look forward to at least another two years of work with Chairman Rivera.

And in the Senate, mental health advocates are providing a warm welcome to Senator Thomas Morahan (Rockland County and part of Orange County) in his new role as Chair of the Senate Committee on Mental Health and Developmental Disabilities. Welcome, Senator Morahan!

Following is a NYS Senate press release on Senator Morahan’s new committee assignment. Additional information on Senator Morahan can be obtained at http://senatormorahan.com.

SENATOR MORAHAN APPOINTED CHAIRMAN OF
SENATE MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES COMMITTEE

Majority Leader Lauds Senator's Dedication and Leadership

Tuesday, January 18, 2005

Senator Tom Morahan was appointed to chair the prestigious Senate Mental Health and Developmental Disabilities Committee.

"I'm honored that Senator Bruno has appointed me to help oversee a significant part of our State's mental health and developmental disabilities responsibilities. I look forward to working with the State Office of Mental Health, State Office of Mental Retardation and Developmental Disabilities, the Commission on the Quality of Care, and the Developmental Disabilities Planning Council to ensure that all patients get the best possible care," Senator Morahan said.

"Mental health issues are critically important to the people of New York State, and Tom Morahan's understanding and commitment to this issue make him highly qualified to serve as chair and leader of the committee," Senate Majority Leader Joseph L. Bruno said. "Senator Morahan has always demonstrated his dedication and leadership, both to his local constituents and the entire state, and I'm confident that he will do an outstanding job leading the Mental Health Committee."

 

Timothy's Law Campaign criticizes Pataki for cutting mental health benefits from Family Health Plus: Text of Jan. 18 Timothy's Law Campaign press release.

Mental Health Advocates Gravely Concerned about
Governor’s Proposed Cuts to Family Health Plus Benefits

“Members of the Timothy’s Law Campaign have spent the last several years fighting an uphill battle to secure mental health parity legislation in New York State (now known as Timothy’s Law); today that crusade was dealt a severe blow when Governor George E. Pataki released his 2005-06 Budget proposal in which he recommended cutting mental health benefits from Family Health Plus” stated Paige MacDonald, Co-chair of the Timothy’s Law Campaign and Executive Director of Families Together in New York State.

Timothy’s Law is a bill in New York State, named in memory of Timothy O’Clair, a 12 year old boy who completed suicide in March 2001 following a 5 year struggle with mental illness. If enacted, this legislation would amend the Insurance Law to require health insurers and health maintenance organizations (HMO’s) in New York State to provide coverage for mental illness and chemical dependency equal to that which is provided for other medical conditions by such insurers and HMO’s.

Family Health Plus is a publicly funded health insurance program for adults between the ages of 19 and 64 who do not have health insurance but have incomes too high to qualify for Medicaid. Since its inception, the program has been proudly touted by the Governor as providing comprehensive health insurance coverage to New York’s lower income working families. Should the Governor’s recommendations come to fruition, mental health benefits would no longer be encompassed in that “comprehensive” package.

Mental Health Advocates are outraged and view this latest development in the fight for equitable insurance practices as a giant step backwards. “However slow, the issue of mental health parity appeared to be gaining ground; during the 2004 legislative session the Assembly overwhelmingly passed Timothy’s Law and while in the end, the two houses could not come to terms on a compromise bill, the Senate, for the first time in New York’s history passed its own version of mental health parity legislation” stated Glenn Liebman, Executive Director of the Mental Health Association of New York State.

Tom O’Clair, Timothy’s father and Co-chair of the Timothy’s Law Campaign also felt the sting of the Governor’s proposal “I can only pray the Legislature recognizes the error in the Governor’s proposal to cut mental health benefits from Family Health Plus.” Referring to the Governor’s statement about the need to keep New York State the best state in the nation with regard to health care, O’Clair commented “First, we need to make it the best – taking mental health coverage out of Family Health Plus doesn’t make New Yorkers any healthier nor does it make New York’s health care any better. In fact, it makes them both worse.”

 

In the News: Following is a New York Times article on the Governor’s budget release that also details the fight that will likely ensue over the budget this year.

 

The Governor's Three-Pronged Plan to Meet His $105 Billion Budget. By Michael Cooper
The New York Times, January 19, 2005

ALBANY, Jan. 18 - Faced with enormous bills coming due for health care, transportation and education, and limited resources even in a $105.5 billion budget, Gov. George E. Pataki hit on a trio of different strategies in the spending plan he unveiled on Tuesday: service cuts, heavy borrowing and playing for time.

The governor tried to meet the state's rising health care costs head-on, taking the politically risky step of calling for nearly $1 billion in Medicaid cuts and setting the stage for a battle royal with the state's powerful health care industry. By offering to cap local Medicaid costs, Mr. Pataki hopes to win county governments as allies in the fight.

To shore up the state's mass transit systems and roadways, Mr. Pataki proposed a $36.6 billion five-year plan that calls for borrowing billions, backed in part by higher fees on drivers and higher mortgage recording taxes. But the plan falls far short of providing the money that the Metropolitan Transportation Authority wants even for routine maintenance, not to mention some costly expansion projects.

And with a politically explosive court order hanging over his head requiring the state to fix New York City's schools, the governor essentially stalled. He released a proposal that mirrored the one he made, and failed to win support for, last year. It calls for increasing aid to city schools by $280 million, a fraction of the $1.4 billion increase that a court-appointed panel recommended for each of the next four years.

As lawmakers and lobbyists grasped in vain to read hints about the governor's political future into his spending plan - some thought it sounded like the budget of a man who plans to step down in two years; others said it sounded like the plan of a man running again - several said it could be his last chance to push big changes. Next year, they observed, Mr. Pataki will either be a lame duck or opening a re-election campaign.

The proposed budget came after the State Legislature passed its latest budget in history last year as lawmakers fought over Mr. Pataki's education spending proposal. With the governor's new spending plan budging so little from last year's proposal, and with the Legislature's power to amend the budget sharply curtailed by the courts, some lawmakers grumbled privately that they could break the late budget record this year, too.

As he tried to sell the plan to the Legislature - standing before a backdrop of slide projections with messages like "Ensuring Fiscal Integrity," "Helping Local Governments" and "Advancing Economic Freedom" - Mr. Pataki urged lawmakers to "build on our momentum by sticking to the proven formula of fiscal discipline and tax cuts."

But while the proposal does contain some tax cuts - Mr. Pataki challenged the Legislature to speed the reduction of a $190 million income tax surcharge on the state's highest earners - it also contains roughly $700 million in new taxes and fees. The governor wants the Legislature to extend a $455 million sales tax on clothing, which was supposed to end this May, as well as to raise the tax on wine. And he authorized higher camping fees and higher tuition fees at state and city university systems.

None of the proposals are likely to be adopted without a fight. Minutes after the governor left the theater where he outlined the spending plan, Assembly Speaker Sheldon Silver, a Democrat, was attacking Mr. Pataki, saying he had included too little in his budget for New York City and complaining that the governor's tax proposals and higher fees would favor the wealthy at the expense of the poor and the working class.

Soon afterward, Joseph L. Bruno, the Senate's majority leader and a Republican, was complaining that the governor's education proposal did not raise enough money and sent too much of what it did raise to New York City.

But the rules of engagement this year are unclear. The state's highest court, the Court of Appeals, ruled last month that most of the budget-making power in New York State rests with the governor and that the Legislature is limited in how far it can go in changing his proposals. So lawmakers in both parties were unsure of their next step.

The effect could be felt widely. For years Mr. Pataki's budgets have proposed withholding some financial aid from the state's poorest college students until they graduate, and for years the Legislature has killed the proposal, arguing that it would put another hurdle in front of poor New Yorkers.

But this year, Assembly Democrats said, the proposal was written into the bill that the governor plans to submit establishing the aid program, the Tuition Assistance Program. So lawmakers fear that unless they can negotiate with the governor and persuade him to abandon the proposal, they may be faced with a dilemma when it comes time to vote on the budget: accept his change in the program or cut the program altogether.

Mr. Silver, who unsuccessfully challenged the governor's budget-making powers in court, said Mr. Pataki was flexing his newly affirmed powers by trying to change state policy in budget bills that the Legislature has little leeway to change.

 

Until next time, we remain,
Working to ensure available and accessible
mental health services for all New Yorkers