Mental Health, Office of

Note: Most recent estimates as of 01/22/08.

Mission

The Office of Mental Health's (OMH) mission is to promote the mental health of all New Yorkers, with a particular focus on providing hope and recovery for adults with serious mental illness and children with serious emotional disturbances.

Budget Highlights

The Executive Budget recommends $3.7 billion All Funds ($564 million General Fund; $3.1 billion Other funds) for the Office of Mental Health (OMH). This is a net increase of $1.4 billion ($67 million General Fund) over 2007-08 which is largely attributable to technical adjustments associated with a major restructuring of Medicaid resources designed to improve transparency in the budget. Excluding such technical adjustments and changes in Capital Projects, the increase over 2007-08 appropriations is $628 million, of which $498 million is due to employee fringe benefits now budgeted in OMH. The remaining net change primarily reflects community residential pipeline expansion, the annualization of prior year initiatives, inflationary increases, State Operations savings associated with program efficiencies, and targeted investments, as outlined below.

The Executive Budget recommends a staffing level of 18,034 FTEs for the Office of Mental Health, an increase of 415 from the 2007-08 Budget. This increase primarily reflects the annualization of prior year initiatives and positions added to OMH's fill level to comply with new and anticipated statutory changes. Most of the agency’s workforce provides direct care services to patients.

OMH continues to improve the efficiency and cost-effectiveness of its operations and the network of non-profit providers it supports. Major budget actions to promote cost efficiency and rationalize reimbursement include:

• Rationalizing Provider Reimbursement: OMH will renew efforts to ensure that all appropriate third-party revenue standards for non-profit providers are maintained, saving an estimated $7.5 million from 2008-09 projected costs;

• Other Aid to Localities Efficiencies: Increased emphasis on managing Local Assistance spending - including achieving audit recoupments and managing new program development - will result in an estimated $34 million savings from projected 2008-09 costs without any impact on service delivery;

• State Operations Program Efficiencies: OMH will work to re-align staff resources to decrease the usage of overtime and consultant contracts, control the implementation of prior year initiatives, and will also implement best practices to reduce energy and pharmaceutical spending. These actions will save approximately $19 million from projected 2008-09 costs; and

• Maximizing Third-Party Revenues: Through due diligence analysis, OMH will generate an additional $32 million in third-party revenues to offset General Fund spending.

These savings actions as well as others proposed in the Budget will permit targeted investments to support the Commissioner's priorities for 2008-09 to strengthen community mental health care and provide the highest quality of care for people requiring inpatient services, with the ultimate goal of helping individuals to live full, productive lives in their communities. Recommendations include:

• Workforce Strategies for Recruitment, Retention and Training: For State Operations, targeted salary enhancements will be provided to ensure that OMH can recruit and retain a qualified clinical workforce, especially in areas of the State that are traditionally underserved, and the Rural Tele-psychiatry program will be expanded to allow for increased education and training. This initiative will cost $2.3 million in 2008-09 eventually annualizing to $12 million over three years. On the non-profit workforce side, the Budget supports $30.1 million for the final year of the current three-year Cost of Living Adjustment (COLA) for these employees commenced in 2006-07 and extends the COLA for another three years through 2011-12;

• Sustaining and Expanding the Ambulatory Care System: Consistent with the Governor's philosophy of improving access to ambulatory care to reduce reliance on costly inpatient and emergency services, and based on the results of the 2007 study of outpatient provider reimbursement, the Budget advances $5 million in new resources that will annualize to $10 million to take the first steps in rationalizing clinic funding. This initiative will provide fiscal relief to mental health clinics by: establishing minimum comprehensive outpatient provider rates for clinics licensed solely under Mental Hygiene Law; rebasing clinic providers who have exceeded their Comprehensive Outpatient Programs (COPS) threshold using prior year service volume; eliminating volume adjustments on COPS clinic services; limiting certain payments made for services provided to managed care enrollees; and removing the Medicaid neutrality cap for mental health clinic services. In the children's mental health area, this Budget recommends removing barriers to specialty mental health treatment for children by allowing for the designation of more clinics that serve children enrolled in managed care. Additionally, new resources that will annualize to $5 million will permit Family Services to be added to the portfolio of covered services under the Clinic Plus program. Furthermore, employment services in the Personalized Recovery Oriented Services program will be enhanced by new resources that will annualize to $1.3 million;

• Managing the Care of High Cost Populations: OMH, in concert with OASAS and the Department of Health and consistent with the priorities of the Task Force on Co-Occurring Disorders, will engage in demonstration programs to address the treatment needs of persons who are both mentally ill and chemically dependent, with $1.0 million included in OMH's budget for this purpose, which will annualize to $2.5 million. An additional $1.5 million - annualizing to $2.0 million - will support two managed care demonstration programs (one in Western New York and one in New York City) that will help coordinate both the health and the behavioral health needs of high cost populations, resulting in more effective and cost efficient coordinated care; and

• New Community Bed Initiatives: In order to meet the continuing need for housing of persons moving into less restrictive settings, the recommendation commits new capital and operating resources that will permit OMH to develop 1,500 Supported Housing Beds targeted to specific mentally ill populations; develop 500 integrated Single Room Occupancy (SRO) beds for priority populations; and, in concert with the Department of Health and the Commission on Quality of Care and Advocacy for Persons with Disabilities, provide capital funds to purchase Adult Homes and convert them into OMH housing. Additionally, the Executive Budget provides increased flexibility for Mental Hygiene agencies to establish integrated housing projects, which will increase access to housing, while also helping to reduce the negative stigma attached to housing for the mentally ill.

The 2008-09 recommendation also supports key investments commenced in 2007-08 to strengthen the infrastructure of OMH's community-based system of care, including $12 million in new resources for the second of a three-year effort to enhance the critical Community Residence housing model.

2008-09 Executive Budget — Agency Presentation
Mental Health, Office of (PDF)