January
25, 2007
1800 DESCEND ON ALBANY FOR CAMPAIGN FOR
MENTAL HEALTH HOUSING RALLY
On
Tuesday, January 23rd, 2007 the Campaign for Mental Health Housing
and the Association for Community Living (ACL) sponsored a Rally
to preserve, reform and develop housing for people with mental
illness in New York State. Approximately 1800 people came to Albany
to participate in the rally and lobby day. This was the largest
mental health rally ever held in New York.
For
more information on the Campaign for Mental Health Housing, visit
our website at www.campaign4housing.org.
MHANYS
SEEKS PROJECT COORDINATOR: 21 hrs. per wk. for private
nonprofit agency. Experienced self-starter to promote, sustain,
and enhance efforts to improve services and living conditions
for parents living with mental illness. Excellent oral and written
communication skills and training experience are crucial. Some
travel required. Master’s Degree in mental health field,
knowledge off Microsoft Office Suite. Great work environment and
good benefits. Equal Opportunity Employer. E-mail cover letter
and resume to hdavis@mhanys.org or fax to (518) 427-8676
IN
THE NEWS:
Governor
Mulls Budget Cuts To Trim Growth in Medicaid
The New York Sun, January 24, 2007
By Jacob Gershman
ALBANY
— New York's health care industry is bracing for Governor
Spitzer's first budget proposal, which is expected to trim about
$1 billion out of projected growth in Medicaid, sources said.
Mr.
Spitzer and his budget director, Paul Francis, are wrapping up
the governor's spending plan for the 2007–2008 fiscal year,
which the governor is due to present to the Legislature by the
end of the month.
Perhaps
the most closely watched element of the budget is in the area
of Medicaid, whose growth the governor has pledged to curtail
to pay for high-profile priorities, such as Mr. Spitzer's plan
to give homeowners a $1.5 billion property tax break and a campaign
promise to settle a multibillion-dollar lawsuit brought by the
Campaign for Fiscal Equity that concerns funding for New York
City public schools.
Sources
say Mr. Spitzer will propose a Medicaid package that slows down
built-in inflationary growth in the health care industry by reducing
what is known as the trend factor, an automatic adjustment in
reimbursement rates that helps hospitals, nursing homes, and doctors
keep up with the rising costs of doing business.
The
reductions won't translate into an overall lowering of Medicaid
spending in absolute terms year to year. State budget officials
had predicted that the state would be spending roughly $1.5 billion
more out of its operating fund on Medicaid in the upcoming budget.
Mr. Spitzer could be scaling back that growth to about $500 million.
Taking into account this year's $2 billion surplus, budget officials
have estimated that the governor would need to trim $2 billion
from the budget to deliver on his big-ticket campaign promises
and balance the books.
A
major portion of the budget is mandated spending in which the
governor has little power to change. Traditionally, in times of
deficits, there are two fatty areas in the budget that New York
governors have relied on for emergency trimming: education and
Medicaid. In this year's case, Mr. Spitzer has pledged to increase
education spending, which leaves Medicaid on the chopping block.
The
state's major hospital associations, which are already absorbing
the probable loss of nine hospitals slated for closure by Mr.
Pataki's health care commission, are aware of the reality. "We
know we're going to fight a battle," a hospital source told
The New York Sun.
Mr.
Spitzer has indicated that he would put to rest a lawsuit and
complaints from city officials that the state is under-funding
the city's public school system by proposing in his budget a plan
to increase school aid by at least $4 billion over the next four
years. One education source said Mr. Spitzer is sticking with
that figure, even though the state's highest court ruled last
year that the state owed the city less than $2 billion. Mr. Spitzer,
however, is still counting on the Bloomberg administration to
share the burden of the $4-billion plan and is in talks with the
mayor's office to reach a deal.
To
pay for extra statewide school funding, Mr. Spitzer may change
how education funding is distributed among upstate New York, Long
Island, and the city. The city, which traditionally receives 38.86%
of state education funding, and less wealthy districts in upstate
areas could wind up with a greater share than usual. The changes
could upset what is known as the "shares" system, leaving
Long Island with a smaller slice of the pie.
For
weeks, Mr. Spitzer has been foreshadowing cuts in the health industry.
In his State of the State address that he delivered early this
month, Mr. Spitzer made particular note of Medicaid's explosive
growth, saying, "In just the last 15 years, state spending
on Medicaid as a share of the budget's General Fund has increased
from 14% to 35%. These are dollars we have made an affirmative
decision not to spend on education, tax cuts, infrastructure or
the kind of health care investments that are so desperately needed."
On
the campaign trail, Mr. Spitzer said he would find $1 billion
in savings from Medicaid, but offered less controversial belt-tightening
measures, like added fraud prevention mechanisms and efficiencies
through electronic billing.
While
Mr. Spitzer will propose other cost-saving measures, it's likely
that any changes to the trend factor will provoke the most uproar
in the health-care industry, an influential interest group in
Albany that was highly successful in lobbying the Legislature
to reverse the bulk of Medicaid cuts that Mr. Pataki proposed
in his budgets.
In
last year's executive budget, Mr. Pataki called for a slightly
larger reduction in Medicaid. But his threats vanished after hospital
groups orchestrated a massive advertising campaign that accused
the governor of risking the lives of babies. In the end last year,
Mr. Pataki backed down and agreed to restore most of his cuts.
This
year, the political equation has changed. With a new, popular
governor having supplanted a lame duck executive, hospital sources
say they have less power to demand that lawmakers come to their
rescue.
Meanwhile,
sources say Mr. Spitzer won't be addressing charter schools or
civil confinement in his budget and plans to separately negotiate
deals on those two issues. That would represent a change in tactics
from the Pataki administration, which sometimes embedded less
popular measures in the budget to gain leverage over them.
Mental-Health Law on the Books, but State and Insurers
Play Catch-Up
The Ithaca Journal, January 20, 2007
By Cara Matthews, Gannett News Service
ALBANY
-- New Year's brought a law mandating equal coverage for mental
and physical illnesses, along with scrambling by insurers to comply
and many unanswered questions about a special small-business benefit
that could cost the state nearly $100 million annually.
It
all comes down to timing. Or better yet, a lack of time.
The
Assembly didn't approve the legislation, often called Timothy's
Law, until Dec. 13, with a provision that it become effective
Jan. 1. Then-Gov. George Pataki signed it Dec. 22, voicing clear
doubts it could be implemented in 10 days. Gov. Eliot Spitzer
took over on New Year's Day, and a leadership change in many state
agencies, including the Insurance Department, has followed.
The
short time frame was not enough for insurers to make all the changes
ordered in the legislation, which prohibits higher co-payments,
deductibles and other restrictions on care for mental illness
that don't apply to physical ailments.
Insurance
industry representatives said they're doing the best they can
to comply. There are "thousands of man hours" involved
in changing computer systems and training staff, said Jim Redmond,
a spokesman for Excellus Blue Cross Blue Shield, Rochester region,
which has about 2 million members upstate.
Normally,
insurers would get six months to a year to put such a complex
mandate into effect, Redmond said.
"It's
a little like trying to tune the motor on a car while the engine's
running," he said.
In
fact, various health insurance companies, including Excellus BCBS,
want to push back the effective date four to six months, Redmond
said.
The
industry has not received a response to the request and is moving
forward with implementation, said Leslie Moran of the New York
Health Plan Association, which represents managed-care plans.
Moran
said her group needs many questions answered, particularly about
small-business benefits.
"There's
a tremendous consumer expectation in terms of coverage and plans
haven't been told what rules they're playing by," she said.
As
for consumers, they become entitled to the new level of care when
their insurance plan is renewed with the state -- a number are
renewed in January but there isn't one universal date for all
companies -- even if their insurers or companies don't yet have
all the updated paperwork, technology and staff expertise that
usually coincides with such changes.
Under
the legislation, insurance plans have to allow at least 30 inpatient
treatment days and 20 outpatient visits for mental illness each
year. The state will cover the extra cost for businesses with
fewer than 50 employees. Larger businesses have to provide a higher
base level of care and additional coverage for children. People
with coverage are supposed to receive written notice of the change
before it becomes available, the law states.
The
law is named for the late Timothy O'Clair of Schenectady, who
took his own life in 2001 at age 12. His family had limited mental-health
coverage and had to give up custody of him so he would qualify
for state-paid treatment. Timothy's father, Tom O'Clair, lobbied
extensively for the new law.
It
is unclear exactly how many people the law will apply to, but
activists claim it could be up to 5 million people or more. It
does not cover companies that are self-insured, which are exempt
under federal law. It excludes about 900,000 low-income residents
in Family Health Plus and Child Health Plus, extensions of the
federal Medicaid program for the poor. Healthy New York, a low-cost,
low-benefit insurance product employers buy into, is not included
either.
The
approximately 1 million government employees, retirees and family
members who are in the state's Empire Plan are now eligible for
the higher level of care, and about 1 million people in plans
for small businesses will be covered too.
The
state's superintendent of insurance is charged with developing
a mechanism to cover the cost of additional premiums for small
businesses. That has yet to be completed. Advocates for Timothy's
Law said they learned in talks with the Pataki administration
that the small-business benefit would cost the state an estimated
$90 million a year. The price tag for extended coverage for the
Empire Plan employees could be several million dollars annually.
The
Insurance Department, which has primary responsibility for implementing
the law, does not know yet when new regulations will be in place,
spokesman Chapin Fay said.
"Really
everything's up in the air and small businesses are still awaiting
word of how the mechanics of this benefit will work," said
Chris Koetzle, a vice president with Support Services Alliance
for small businesses, which has about 14,000 members in the state.
The
state should consider putting some money into a public education
campaign, said Shelly Nortz of the Coalition for the Homeless,
which pushed for the law.
"This
is massive change in public policy," she said.
It
will be a "bumpy ride" at first, she said. "There's
all kinds of complexity to this that I think is worth taking your
time on," she said.
Held by Pataki, Sex Offenders Are Released
The New York Sun, January 23, 2007
By Joseph Goldstein
Two
sex offenders were released this month from the mental hospitals
where they have been involuntarily held since their prison sentences
ended.
They
are the first sex offenders to be released since the state's highest
court ruled that prison officials acted illegally by transferring
more than 100 sex offenders to mental hospitals without a court
order. Governor Pataki ordered the transfers in 2005.
The
releases this month were not ordered by a court but came after
state psychologists for the Office of Mental Health decided the
two did not require civil confinement, an official there told
The New York Sun.
The
decision to release the men moots a court hearing that was expected
to take place in the coming weeks regarding their confinement.
At that hearing, lawyers for Attorney General Cuomo were expected
to argue that the men should remain confined. A spokesman for
Mr. Cuomo said the Office of Mental Health, not the attorney general,
makes decisions regarding releases.
"It
is their call," the spokesman, John Milgrim, said.
One
of the men released was convicted more than 15 years ago of 2nd
degree assault, a lawyer with knowledge of the case said. The
lawyer, who spoke on the condition of anonymity, said the conviction
was connected to charges that the man had committed a rape in
Queens. The convict is not listed in either the online or telephone
directory of registered sex offenders in New York. The second
man who was released is a registered sex offender; no additional
information about him was available.
Both
were released within the last two weeks — one from the Manhattan
Psychiatric Center and the other from the Kirby Forensic Psychiatric
Center — the lawyer said.
In
the past two years, psychologists for the Office of Mental Health
approved transferring about 120 sex offenders, including the two
just released, to psychiatric institutions in order to prevent
their release from state custody. One state judge, Jacqueline
Silbermann, has called into question whether the psychological
assessments by state doctors showed the need for civil confinement
in each case.
Although
New York has no law for confining sex offenders at the end of
their prison sentences, Mr. Pataki used a civil law not intended
for inmates to detain the men in mental hospitals. Last November,
the Court of Appeals in Albany ruled that this policy denied sex
offenders the due process to which they were entitled. The court
did not order their release but did order "immediate"
hearings to be held.
The
official in the Office of Mental Health Services said hearings
for about 50 of the offenders are pending.
The
two sex offenders released this month are not the first to be
released since Mr. Pataki initiated his policy. Prior to the Court
of Appeals decision, five other sex offenders being held in psychiatric
institutions were also released, the mental health official said.
"There
have been a number of people who have been released, including
individuals who never belonged in the system to begin with,"
the deputy director of Mental Hygiene Legal Service, which represents
the men, Stephen Harkavy, told the Sun. Mr. Pataki's policy, Mr.
Harkavy said, "ignored due process protections that would
have prevented erroneous hospitalization."
A
spokesman for Mr. Pataki, David Catalfamo, said the release of
the men was "of great concern."
