Mental Health Budget Update: 2011-2012

 On the heels of what will be one of the largest advocacy fights in many years (the fight to insure that large MCO’s don’t take over mental health services in New York), we are also faced with a difficult budget.

 This year’s proposed budget is very general and it is hard to decipher specific targeted areas, but here is a very brief top of the trees analysis:

 A) Community Budget:

 We are in the process of finding out specifically where cuts will occur. The budget narrative does not define specific cuts, but does say, “Funding reductions in certain community supported programs including children’s clinic plus, non-direct services such as training and education, as well as local administration.”

 The narrative does reference restructuring of non-residential OMH programs including CDT. At the same time the language also references support for PROS program.

 All told, the administration proposes a total cut of $27 million to the community budget. Given the already increasing pressure on community providers, this will only make things even more difficult in this environment. This will be a major budget advocacy priority over the next several months.

 COLA’s

 For the third year in a row, there are no new COLA’s in the budget for the human services workforce. In the budget narrative, there is the intention by the administration to extend the COLA through state fiscal year 2014-15. My understanding is that means that though there is language not to provide the COLA for this year, there is a state commitment to continue the COLA in fiscal year—2012-2013 and 2014-15

 Housing:

 The budget proposes freezing the development of all new community residential programs for one year. The budget also calls for the maintenance of existing rates for OMH residential facilities and community residential/family based treatment.

  B) State Operations:

 The Governor has called for ten percent decreases in General Fund spending for the Office of Mental Health. They intend to meet that target by the rightsizing of government, increasing efficiencies and reducing workforce spending. The are no specifics attached to how this ten percent cut will be achieved. 

 There is also proposed language in the budget that allows for the administration to waive the one year notification for the closing of state psychiatric facilities. Also, in the language of the budget, is reference to the list of all the state psychiatric facilities. This language is obviously very broad and does not specify any facility for closure. Given the target number of the administration, it is likely that there could be several facilities proposed to be closed.

 C) New Mental Health Funding

 The only new funding in mental health this year is in response to the adult home lawsuit settlement. Based on the court ruling, there will be 4500 new supporting housing beds over the next three years for adult home residents as well as support services for those individuals. The cost for the next fiscal year is estimated at $41.3 million

 D) Medicaid

 We will be sending out separate material on the Medicaid budget in the next several days.

Analysis:

 We know there will be a lot of heartache in this budget, and hopefully, this will be the worst budget we will have to face for many years. There are a lot of challenges that lie ahead for us this year. There has been a cut of $27 million to community mental health services that will greatly impact non Medicaid services in New York State. We will work to preserve what we have, but also to work during the thirty day amendment process and with the legislature, to try and restore additional community funding.

 However, the reality in mental health right now, is not the budget battle. It is the battle to insure that the large MCO’s do not take over mental health care in New York State. We must continue our advocacy on this front. More information will be forthcoming.