Response to the 2016-17 Budget Agreement
(from NAMI-NYS Legislative Alert)
Action Agenda Victory: New York to Enact Paid Family Leave!!!
NAMI-NYS and our grassroots advocates scored a major victory as Governor Cuomo and the Legislature agreed to enact a Paid Family Leave program that meets the standards we had been calling for: mainly, twelve-weeks of paid leave at two-thirds of a normal salary. This benefit will be eligible to family members in order for them to care for a loved one in a medical (including psychiatric) emergency or when they are dealing with a chronic illness (such as psychiatric disorders). Increasing family involvement in the recovery process has always been central to NAMI-NYS's mission. We have continually advocated for removing all barriers preventing family participation and establishing true recovery teams, consisting of someone living with a mental illness, their service providers and their family members.
When someone is experiencing a psychiatric emergency or hospitalization due to a chronic illness, that individual's family members should not have to worry about losing their jobs and salaries in order to be by their loved one's side.
This is a major victory for NAMI-NYS and our families, many of whom have had to sacrifice their jobs and financial security to serve as caregivers for a loved one with mental illness. During this advocacy campaign, many of you have shared your stories about how having a paid family leave would have helped you during a time of crisis. We are so grateful to you for projecting your advocacy voice on this issue. It is because of you that our state now leads the nation in ensuring that working families have access to this essential and long-overdue benefit.
Of the inclusion Governor Cuomo said, "This will affect the quality of life of millions of people in this state and it's basic, it's simple," Cuomo said. "We don't live at work. We live with families and we should have the capacity to be there when the families need you."
Click here to read NAMI-NYS's full statement of the inclusion. We thank the Governor and the Legislature for caring for caregivers.
While we were thrilled to by this development, the reality is that positive features in the budget are still few and far between and we clearly have a lot of work to do. The mental health community saw some investments, but those fall why short of what NAMI-NYS has identified as what is needed to create a more mentally healthy New York State. We are glad that we have made some significant progress on criminal justice issues, but too many of our priorities were either underfunded or ignored.
Here is how the key issues of our Advocacy Agenda were addressed in the Executive Budget Proposal:
1-The Need for Safe and Affordable Housing for People With Mental Illness:
First and foremost, the budget still targets the closing of 200 in-patient psychiatric beds from the Office of Mental Health hospitals. Below, you will see that savings from this reduction will be used for community support services; however, there was no investment in supported housing for people with mental illness with wrap-around services.
While the Cuomo administration has committed to funding 20,000 new supportive housing beds over the next 15 years, much of this is old appropriated funds or bonded money that does not exist yet.
The bottom line is people living with a serious mental illness and those being removed from state psychiatric facilities need housing NOW. As we explained, the dedicated non-profit providers who offer supported housing with services simply do not have the capacity to meet the full needs of this population. The main factor contributing to this inability to house and support all of those living with serious mental illness is the lack of increases since 1990. This failure to keep up with the rates of inflation has forced these providers to operate at 43% of where they should be. NAMI-NYS and our advocacy partners ACLNYS, MHANYS and NYAPRS have identified that $92 million would be needed simply in order to get these programs operating at today's rates. Unfortunately, this much needed investment was not made.
Along with the lack of investments, housing providers now also have to face the daunting challenge of providing continuity of care with the new minimum wage rates. The increase of minimum wage has been a major concern for many direct service providers.
The budget contains a minuscule investment for OMH funded community based agencies, designed to get staff to the levels consistent with the budget agreement between the Governor and the Legislature: $900,000 increase for the last 3 months of the current fiscal year (January-March), $5 million for FY 2017-18 and $14.4 million for FY 2018-19.
While this investment appears to be positive, NAMI-NYS is still concerned that this will fall way short of what is necessary to keep and retain caring and qualified staff to help people receiving services, especially without the aforementioned funding necessary to bridge the gap caused by flat-funding.
2-Continued Reinvestment in Community Services
Another positive development is the budget calling for the full allocation of an annualized amount of $22 million in community reinvestment which represents a $110,000 per closed bed. This was the amount NAMI-NYS advocated for and this restores a possible $5.5 million cut.
The budget includes $30 million of funding for community based health care providers.
Again this is a small investment when you take into consideration how underfunded these valuable resources are. Remember as well that NAMI-NYS joined MHANYS and NYAPRS in calling for a $90 million investment for community services aside from the reinvestment in bed reductions.
3- Ensuring Access to Proper Medication
NAMI-NYS is grateful to our legislative leaders for once again restoring prescriber prevails for people receiving Medicaid in the budget.
As you will see below in the Take Action section we now must focus our attention on regulating the practice of fail first procedures by private insurance providers. (UPDATE: Governor has signed into law)
4-Mental Health Education in Schools
This issue was not a budget priority. However, NAMI-NYS will continue to push to create more mentally healthy schools by advocating for three bills that would address this glaring omission in education.
UPDATE: Mental Health in Schools- A3887B/S6046 was signed into law 9-30-16
5-Improving the Criminal Justice-Mental Illness Interface in New York State
The budget contained two positive inclusions which will improve the criminal justice-mental illness interface in New York State:
1-CIT Expansion-This is an area where our mental health chairs Senator Rob Ortt and Assemblywoman Aileen Gunther have really delivered. Senator Ortt is funding $500,000 and Assemblywoman Gunther is funding $1 million to expand CIT initiatives. This brings the total investment in CIT expansion to $3.4 million in the last three years. This is an important initiative that will help generate positive outcomes when police are called to intervene in situations involving someone in a psychiatric crisis and will help protect the safety of both individuals living with mental illness and police officers.
2-Presumptive Medicaid Eligibility and Medicaid Restoration 30 Days Pre-Jail/Prison Discharge-This is something NAMI-NYS has been advocating on behalf of for quite some time. We are grateful to the leadership of Assemblyman Daniel O'Donnell, chair of the Corrections Committee, who has really fought for this. These efforts have led the administration to seek federal approval to restore Medicaid benefits 30 days before discharge from a correctional facility to allow for discharge planning designed to make easier reintegration for 'high needs individuals."
6-Support the New York State Office of Mental Health's Research Institutes: New York State Psychiatric Institute and Nathan Kline Institute
It appears that the funding levels for New York State Psychiatric Institute and Nathan Kline Institute have been sustained.
7-Support Veteran's Mental Health
Our legislative leaders were able to include an additional $2.78 million to expand the O'Dwyer Veterans Peer-to-Peer program.
This budget was a true "mixed bag" containing victories and disappointments. While we rejoice that New York has made the right move to care for caregivers by enacting paid family leave, the reality is the continued reduction of hospital beds coupled with the shortfalls in housing and community service funding makes the family role more important than ever. We envision many families having to use the paid family leave benefit to keep their loved ones from falling through the ever enlarging cracks in the mental health care system. Clearly there is much work that still needs to be done and we must be diligent for the remainder of this legislative session to help pass bills that will help address the omissions from the budget. Together, we can get laws passed that will ensure people receive the proper medication, help identify mental illness and intervene as early as possible by incorporating mental health in schools and make sure that people with the most serious forms of mental illness receive the support they need to advance their recovery.
Three of NAMI-NYS' legislative priorities have been signed into law by the governor.
1-Ensuring Access to Proper Medication- S-3419C/A-2834D We need to make sure doctors have the final say about what medications are most appropriate when treating someone with a chronic illness (especially psychiatric disorders where medication are not interchangeable). All too often insurance providers refuse to cover a doctor's prescription and force their customers to fail first on a less expensive medication before allowing them to step up to the original prescription. This practice (Step Therapy) must be regulated.
Senate: Passed 06-14-16
Assembly: Passed 06-16-16
Governor signed into law January 3, 2017, effective January 1, 2017
2-Mental Health in Schools- A3887B/S6046 Early recognition and early intervention are keys to preventing the most serious symptoms caused by psychiatric disorders. Recognition and intervention needs to be taking place in schools. NAMI-NYS is supporting three bills that would improve mental health awareness in schools by incorporating mental health education into health education, requiring teachers to receive mental health awareness training and ensuring that schools have a social worker on staff.
Assembly: Passed 06-09-16
Senate: Passed 06-15-16
Governor signed into law 09/30/16
3-Paid Family Leave-see above