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December 16, 2008

Mental Health Budget Review (2009-2010)

In response to the State’s Fiscal Crisis, Governor Paterson introduced his Executive Budget a month early this year in the hopes that the legislature will have ample time to review the executive budget and that a state budget will be passed on time or even earlier then the April 1 deadline. For further information, you can go into the Division of Budget Website.

The major proposed budget cuts in mental health were:

• Mental Health (as well as all Human Services) COLA is delayed for a Year. In addition, the administration has also proposed eliminating 1.2% of the 3.2% increases in future years as well as a 1 percent cut for the last quarter of the 2008—2009 budget.
• Continuing Day Treatment Reimbursement Rates Lowered
• Community Residential and Family Treatment COLA Delayed
• Freeze Community Beds Outside of NY/NY 3 Agreement
• Eliminate the Funding for Unified Services
• Efficiencies in Funding of State Psychiatric Hospitals (not closures)
• Reduction of 450 beds in the state psychiatric hospitals (150 beds to be eliminated and an additional 300 beds to become transitional beds with reduced staffing)
• Delay Implementation of Some of the SHU Reform Funding
• Cuts to Sex Offender Program (Credit to the Administration for following up on recommendations of MHANYS and our colleagues in the community)
• Delaying the COLA for the State Workforce (Across the Board)

Cuts in the Health Budget include:

• Elimination of the Mental Health Carve Out for Anti-Depressants from the Preferred Drug List
• Major cuts to hospital reimbursements rates that will certainly impact length of stays in the psychiatric units of Article 28 hospitals for individuals with psychiatric disabilities
• Cuts to Funding Streams for Adult Home Residents

Some Additions in Mental Health include:

• Continue funding for 1500 Supported Housing Beds
• Medicaid Infrastructure Grant Approved (federal dollars). Providing $6 million in employment services (this is an excellent initiative)
• Enhancements to Criminal Justice NYC/NYS Task Force
• Children’s Mental Health Gets Small Funding Increase to help in implementation of children’s mental health plan
• Increase for Peer Support and Group Training

Overall Summary:

We have long maintained that in difficult economic times, more people are desperately in need of mental health services. We have also said time and time again that the worst economic strategy is to cut community based services when the alternatives are increased hospitalization, homelessness and incarceration.

Delaying a desperately needed COLA for the mental health community will make implementation of exiting programs more difficult and will certainly greatly impact the ability for the mental health community to keep a robust, well trained work force. The MHANYS vision of a well compensated work force with consistent COLA’s and health care enhancements should not have to be delayed, but the reality of our economy, has forced these delays.

Given the circumstances, Governor Paterson has responded to the needs of the mental health community by minimizing cuts to existing programs and services. Our greatest fear is that many of our programs would have taken major cuts. Instead, given the worst economy in many years, Governor Paterson and his administration should be credited for attempting to do the right thing in the mental health community in minimizing cuts to core community services.

Strategies:

The Mental Health Community is working together and will be identifying our priorities over the next few weeks in anticipation of the return of the Legislature in early January.

Given the bleak financial picture, it will be very difficult to get much additional funding from the legislature to restore cuts. However, we will continue to advocate strongly that you cannot delay funding to the COLA without the expectation that it will have a major impact on recruitment and retention for community providers even in bad economic times. We will also be working hard to not cut the funding by a third in future years.

We will also work with the Legislature to make sure that if there are major areas in the state budget that are restored, it will not be at the expense of cutting more mental health funding.

In summary, the administration listened to MHANYS and others when we called for continuing to cut funding to the civil confinement program. They also listened to us when we advocated strongly that core mental health services should not be cut. Given an enormous budget deficit and what has happened to other sectors in the community, Governor Paterson, his staff, the Office of Mental Health and The Division of Budget, have attempted to minimize the pain in our community.

That said, there are cuts and implementation delays that will undoubtedly have an impact to many of our programs. These are real lives that will be affected and not numbers on spread sheets. Please provide us with specific examples in which programs are closed and waiting lists are dramatically increased because of budget cuts.

This is the first in what will likely be many updates on the 2009—2110 Budget. We will provide a more detailed review in the coming days.