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November 5, 2007

Mental Health Weekly Article on Health Care Enhancements
for Direct Care Staff

We have been working with Mental Health Weekly on this attached story on Health Care Enhancements. I think the article does a good job in talking about the disparity in health care enhancement for direct care staff in developmental disabilities and direct care staff in mental health.

The principal point I was trying to make was that developmental disability workers should get health care enhancements but how can you leave behind direct care staff in mental health. The disparity right now is close to $77 million dedicated in developmental disabilities for enhancements as opposed to nothing for the program in mental health. 77 to 0. It is time to address that disparity and provide mental health workers with enhanced health care. If you want to sign on to support this change, please send me an e-mail at gliebman@mhanys.org

Please note that in the article, I should have made it clear that this enhancement would not be limited to just direct care staff in licensed programs. We need a broad health care enhancement for the entire spectrum of direct care staff in all mental health programs.

N.Y. Advocates Push For Compensation for Direct Care Workers
Mental Health Weekly
November 5, 2007

Citing health care workforce concerns in the mental health community, New York advocates are calling for increased health care enhancements for direct care staff in the state’s mental health programs.

The Mental Health Association in New York State (MHANYS), the New York Association of Psychiatric Rehabilitation Services (NYAPRS) and several other groups are requesting $10 million, which in actual dollars, would mean a $325 per person health insurance stipend for 31,000 direct care workers in programs licensed by the New York State Office of Mental Health (OMH).

Currently, the Office of Mental Retardation and Developmental Disabilities (OMRDD) provides healthcare initiatives for its direct care workers known as Health Care Enhancement I and II, which calls for the agency to distribute $17 million to voluntary provider agencies.

Additionally, OMRDD was able to draw down more than $13 million from Medicaid. The requested $325 stipend for OMH direct care workers would provide equitable coverage for both groups.

Officials have indicated that the $325 per person will be used to reimburse out of pocket expenses paid by employees; to reduce premiums paid by employees; to set up flexible spending accounts; and to set up health related reimbursement arrangements.

“The health care enhancements provided to OMRDD workers should also be provided to direct care workers with the state OMH,” Glenn Liebman, MHANYS chief executive, told MHW. “By offering a $325 health care incentive for direct care staff, it provides individuals with a greater incentive for staying in their position.” Liebman noted that the health care incentives are also consistent with New York Gov. Eliot Spitzer’s call for universal health care for all New Yorkers.

Invaluable Services

“We strongly agree that direct care staff in OMRDD deserve to have health care enhancements, but there has to be equity with mental health,” said Liebman. “New York State will have expended over $70 million, including Medicaid, for health care enhancements for OMRDD licensed workers and they have not spent one penny for health care enhancements for OMH licensed workers.”

Liebman added, “It makes no sense when both groups are performing invaluable services in the community. We are asking for $325 as a starting point but with a call for increased funding in the future.” The retention of direct care staff is an important issue, said Liebman.

“The great concern we have is the rate of direct care staff who are leaving the field,” said Liebman. Some agencies have reported about 30 to 40 percent, he noted. “The state is being responsive to the concerns of the turnover rate for people working in direct care,” said Liebman.

OMH’s priorities for 2008-2009 include securing the third year cost-of-living for direct care workers, the Journal News reported. Liebman said that while advocates think it is important to support the third year of the Cost-of-Living Allowance (COLA), they think its equally imperative that COLA be combined with health care enhancements to retain quality staff.

“If you combine COLA with a health care incentive, you’re sending a strong message to the workforce in mental health: ‘We’re a population that is invaluable,’” noted Liebman.

According to MHANYS, many agencies in the state run both mental health and developmental disabilities programs. They note that it creates an inequitable work place when there are health incentives for the developmental disabilities staff and not the mental health staff.

Existing Roadmap

“There’s already an existing roadmap in place,” with the efforts of OMRDD, he said, adding that OMH should follow OMRDD’s successful model.

Advocates, meanwhile, have met with the state OMH, the governor and the division of the budget, said Liebman. “All of the meetings have been positive,” he noted.

“We’ve been told it’s a very tough budget year,” he said. “We’ll continue to get the word out and send the message to policymakers. This is a very important initiative for the mental health community.”

Raymond Schwartz, co-chair of public policy for NYAPRS, said that Commissioner Michael Hogan stated that direct care worker health enhancement would likely be provided in the state budget. “Hogan acknowledged the importance of providing something to help providers keep staff,” Schwartz told MHW. (NYAPRS Note clarification: Commissioner Hogan listed the 3rd year of the CPI-adjusted workforce COLA as a priority).

“The whole issue boils down to equity,” he noted. ‘It’s about treating people fairly and providing them with a meaningful packet of benefits to show you really care about them,” said Schwartz. “Turnover is not good for anybody and it’s not good for the people being served."

Issues of Veterans and Mental Health

Last week, I had the opportunity to present in forums at Nassau Community College and at Syracuse University on issues of returning veterans and mental health needs.

At both forums the number one issue I heard regarding services was the stigma associated with acknowledging mental health problems in the military. During the Nassau forum, a Vietnam Veteran spoke to the stigma associated with seeking services during Vietnam and noted that the culture has not changed dramatically with the current war in Iraq and Afghanistan. It is no wonder that less than 30% of veterans with mental health issues seek treatment.

MHANYS, through Deputy Director Helena Davis, is working with NASW to develop a statewide conference on veterans needs especially around issues of PTST and TBI. Listed below is a 12 point action plan around veterans issues and how we can help respond to their needs. We will be advocating with the Spitzer administration and the legislature to implement these recommendations.

Recommendations

  • Allocate funds to train public and private nonprofit mental health agencies in treatment of trauma-related issues and the special needs of returning soldier and their families
  • Provide funding for these agencies to do outreach to returning soldiers and their families in order to provide individual and group counseling as well as social support programs
  • Allocate funds to create effective treatment protocols for post traumatic stress disorder including peer support programs and self-help techniques and evidence based best practices
  • Development of core curriculums on training trauma for all military personnel who are mental health professionals
  • Train and deploy mental health personnel who are experts in the areas of depression and combat stress
  • Military wives should be informed of the risk and be screened for depression during the postpartum medical exams
  • Allocate respite funding for single parents who are struggling with psychiatric symptoms that impede their ability to parent when they are in crisis
  • In New York, we must create more responsive systems of care among the mental health and addiction disorders communities. Many individuals coming back from war have both a co-occurring mental illness and addiction disorders. Programs that provide integrated treatment for these disorders should be incentivized to work with veterans
  • In New York, veterans with psychiatric disabilities in the public mental health system should be among the priority population of people who should have access to Single Point of Entry (SPOE) for housing and case management.
  • Increased suicide prevention efforts geared specifically to the needs of veterans. Also, there should be educational efforts in place for family members when veterans return from war. They are the gatekeepers and should be trained about suicide prevention awareness.
  • In New York, we have to have strong cross collaboration efforts between the New York State Office of Mental Health, The New York State Office of Alcoholism and Substance Abuse Services and The New York State Office of Veteran’s Affairs.
  • We must develop a strong public awareness campaign in New York dedicated to ending the stigma of mental illness. Whether you are a veteran, a child, an adolescent or an adult---the number one issue that precludes someone from seeking mental health treatment is the stigma that exists for people with mental illness. Resources are needed to let the public know that one in five individuals in this country have a mental illness and that most of them live lives of courage and resiliency as productive members of society.

 

MHANYS Albany PWPD Conference Moved to December 4th

Please note that we have moved our PWPD conference in Albany to December 4th.

Parents with Psychiatric Disabilities Initiative Training Meeting
December 4th in Albany, NY

The Parents with Psychiatric Disabilities Initiative Training has been rescheduled from November 1st to Tuesday, December 4th. This training will be held at the Best Western Sovereign Hotel in Albany. A continental breakfast will be served from 8:00 – 8:30 am.

Meeting sessions will include:

Parenting, Recovery, Stigma, and Discrimination
Legal Realities
Successful Parenting Strategies
New Mothers Wellness Toolkit, and
Legislative Strategies

Please join parents, mental health and service providers, and advocates from across New York State at this meeting on December 4th.

* The registration fee will be waived for any parents with limited income upon completion of a registration form.

* Sliding scale registration fees are also available to agencies with limited training funds.

The registration deadline is Friday, November 23rd.

Registration forms are available at www.mhanys.org. Please contact Lorraine McMullin at 518-434-0439, ext. 211 or lmcmullin@mhanys.org with any questions.