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NYS Division of the Budget: Andrew M. Cuomo, Governor; Robert L. Megna, Budget Director Division of the Budget Home Page

NYS Division of Budget

Andrew M. Cuomo, Governor
Robert L. Megna, Budget Director

2010-2011 Executive Budget – Briefing Book


Mental Hygiene

  • Commission on Quality of Care and Advocacy for Persons with Disabilities (CQCAPD)
  • Department of Mental Hygiene (DMH)
  • Developmental Disabilities Planning Council (DDPC)
  • Office of Alcoholism and Substance Abuse Services (OASAS)
  • Office of Mental Health (OMH)
  • Office of Mental Retardation and Developmental Disabilities (OMRDD)

I. Overview

The mental hygiene agencies provide services to individuals with mental illnesses, developmental disabilities, chemical dependencies, and problem gambling. These agencies — OMH, OMRDD, OASAS, DDPC, and one oversight agency, CQCAPD — are expected to serve nearly one million individuals in 2010-11, including more than 600,000 persons with mental illness, 260,000 persons with chemical dependencies or gambling problems, and 125,000 persons with developmental disabilities.

II. History/Context

The mental hygiene system currently operates 47 institutional facilities serving a State-operated inpatient residential capacity of 7,200 individuals. The State also provides funding to support approximately 86,000 community residential housing options. Additionally, the State supports numerous outpatient, employment, clinic, habilitative, and treatment programs in partnership with 4,300 not-for-profit provider agencies. There are three facilities dedicated to conducting state-of-the-art research into the causes of and appropriate treatments for serving adults and children with psychiatric and developmental disabilities.

The proposed Executive Budget for the mental hygiene system would total approximately $8.5 billion in 2010-11.

III. Proposed 2010-11 Budget Actions

The 2010-11 Executive Budget recommends $134 million in net savings actions for the mental hygiene agencies in addition to those ongoing actions reflected in the 2009-10 Deficit Reduction Plan and proposed via collective bargaining. Savings would be achieved by placing aggressive cost controls on agency operations; maximizing payments from third-party payers; reforming and restructuring State and local programs and administrative practices; reducing adult inpatient psychiatric center capacity; and delaying community bed development. In addition to these savings actions, the budget does not include any funding for a previously planned human services cost-of-living increase, but does propose legislation to forestall a 2.1 percent reduction that would otherwise occur, driven by the Consumer Price Index-based methodology in current law.

The Executive Budget recommendations support the development of approximately 2,600 new residential beds in 2010-11, including:

  • 1,111 OMH beds, already in the pipeline, that provide both supported housing and congregate housing options;
  • 256 OMH beds for New York/New York III;
  • 992 OMRDD beds, including 510 associated with OMRDD’s NYS-CARES initiative; and
  • 272 chemical dependence treatment beds, including 183 associated with drug law reform.

The budget includes funding to divert individuals from prison to treatment programs, consistent with recent reforms to the State’s drug laws, increases support for mental health services to adult home residents, and provides a Medicaid trend increase for OMRDD in 2009 and 2010.

IV. Summary of Spending (All Funds)

Category 2009-10
($ in millions)
2010-11
($ in millions)
Change
Dollar
(in millions)
Percent
Total Mental Hygiene Spending 8,070 8,499 429 5.3
OMH 3,212 3,414 202 6.3
OMRDD 4,270 4,465 195 4.6
OASAS 565 597 32 5.7
CQCAPD 17 17 0 0.0
DDPC 4 4 0 0.0
DMH 2 2 0 0.0

The majority of the spending increase is attributable to increased Federal support of $223 million for a variety of ongoing State and local operated programs. General State Charges costs are projected to increase by $129 million.

V. Major Initiatives

Gap Closing Actions

Proposal 2010-11
($ in millions)
2011-12
($ in millions)
OMRDD State Operations Efficiencies 25 28
OMRDD Local Restructuring 24 43
OMH State Operations Efficiencies 44 38
OMH Inpatient Restructuring 9 18
OMH Forensic/SOMTA Reforms 10 11
OMH Local Restructuring 18 13
OASAS Restructuring 3 3
CQCAPD Restructuring 1 1
Total 134 155
  • OMRDD Local Restructuring. The major savings actions include:

    • Achieving an overall 18 percent reduction in targeted case management services through reform of Medicaid Service Coordination. Reforms include increasing staff caseloads, reassessing the number of individuals requiring service, and developing different levels of service that are more closely tailored to individual needs;
    • Implementing a three percent overall rate reduction in the financing of residential habilitation services delivered in supervised Individualized Residential Alternative programs effective October 1, 2010. This reduction would be partially offset by trend increases provided in 2009 and 2010;
    • Delaying the development of certain residential opportunities for individuals aging-out of the school system and children’s residential placements; and
    • Reforming the administration and oversight of the Family Care program over a multiyear period beginning in 2010-11. (2009-10 Savings: $24 million; 2010-11 Savings: $43 million)
  • OMH State Operations Efficiencies. Key actions include reducing non-critical staff via attrition; converting certain information technology consultant staff to less costly State employees; reducing overtime and the use of stand-by/on-call shifts; increasing the use of alternative work schedules; eliminating redundant reports; and eliminating all nonessential non-personal service spending. (2010-11 Savings: $44 million; 2011-12 Savings: $38 million)
  • OMH Inpatient Reforms. Eight psychiatric center wards would be closed at various facilities, reducing State-operated inpatient capacity by approximately five percent. The resources associated with closing six wards would be used to support less costly and more appropriate community programs, and two wards would be replaced with Transitional Placement Program beds, a less staff-intensive outpatient model designed to support the transition of patients to community care. (2010-11 Savings: $9 million; 2011-12 Savings: $18 million)
  • OMH Forensic/SOMTA Reforms. The census for civilly confined sexual offenders is projected to increase, but not to exceed 230 individuals in SFY 2010-11. Additional inpatient capacity is scheduled to open at St. Lawrence Psychiatric Center; therefore, inpatient capacity for sexual offenders at Manhattan Psychiatric Center would no longer be required. The budget also reflects efforts to encourage courts to use videoconferencing to reduce costly transportation and security services. (2010-11 Savings: $10 million; 2011-12 Savings: $11 million)
  • OMH Local Restructuring. OMH would continue to restructure a variety of programs to focus resources on emerging priorities. OMH would maximize payments from recoveries through enhanced audit efforts, including recovery of payments from third party payers and exempt income revenue in excess of operating costs. Savings would also result from a change in billing practices by carving out Medicaid prescription drug costs from the operating costs of residential treatment facilities. A portion of the savings would be reinvested in a proposed multi-year remedial plan for adult home residents with mental illness, described in further detail below. (2010-11 Net Savings: $18 million; 2011-12 Net Savings: $13 million)
  • OASAS Restructuring. This proposed restructuring reflects approximately $1 million in operational savings by using e-technology for communications, training and procurement; controlling travel, food and pharmaceutical costs; streamlining administrative functions while limiting the use of cell phones and other electronic devices; and by deferring the development of new gambling prevention programs. (2010-11 Savings: $3 million; 2011-12 Savings: $3 million)
  • CQCAPD Efficiencies. CQCAPD would achieve savings through elimination of all non-critical, non-personal service costs; increased use of alternative work schedules; elimination of two staff positions associated with the Interagency Coordinating Council for Services to Persons who are Deaf, Deaf-Blind, or Hard of Hearing and oversight of Special Housing Units; and increased use of Federal funding for certain local aid payments. (2010-11 Savings: $1 million; 2011-12 Savings: $1 million)

Other Budget Actions

  • Adult Homes Reinvestment. A portion of savings from delays in bed development begun in 2009-10, as well as proposed actions in this year’s budget, are being reinvested pursuant to a proposed multi-year remedial plan in response to a Federal district court decision. This remedial plan would provide additional OMH supported housing for individuals leaving adult homes. The remedial plan would provide additional funding of $1 million in 2010-11 to begin assessments of current residents, with funding of $20 million annually in five years to be used for 1,000 additional supported housing units, education, skills development, and ongoing reviews of remaining adult home residents. (2010-11 Investment: $1 million; 2011-12 Investment: $4 million)
  • Paterson Drug Law Reform. The Executive Budget reflects funding to support the operating costs for new residential treatment beds and outpatient treatment slots for addiction treatment services associated with drug law reform enacted in 2009-10. The OASAS budget includes $13 million of funding for this effort.
  • OMRDD Residential Opportunities. While the Executive Budget reflects a slowdown in funding for new bed development, funding for nearly 1,000 new residential opportunities in 2010-11 is still recommended. This includes support for over 500 NYS-CARES opportunities, as well as for individuals leaving institutional settings (including nursing homes) and aging-out of educational environments, representing an investment of $46 million in 2010-11 and $53 million in 2011-12.

 

    Briefing Book Table of Contents    |    Entire Briefing Book (PDF)

 

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