Office of Mental Health

The Enacted Budget passed by the Legislature on May 1, 2003 makes the following changes to the Executive Budget:

·        Fully restores$9.9 million in funding for “the full and continued independent operation” of Elmira, Hutchings, and Middletown psychiatric centers.

·        Adds $7,825,000 to fully restore funding for “full and continued independent operation of the New York state psychiatric institute and the Nathan S. Kline institute for psychiatric research, with no diminution of research or service levels or activities at either institution” 

·        Rejects the executive proposals for a single statewide appointing authority and to change the one year notification requirements under Section 7.17 of the Mental Hygiene Law for targeted psychiatric and research centers. 

·        Reduces the Administration and Executive Direction Program by $2.5 million in nonpersonal services. DOB claims that this reduction will lead to an estimated 55 layoffs; there is no indication that any of this reduced appropriation is currently used to fund state employee positions. 

·        Maintains the Executive Budget recommendation for Shared Staff.  While the $15.25 million for this program is a state operations appropriation, the Executive Budget moved the funding into a “Contract Recovery Account” and indicated that the funding would be transferred to counties if the employee was hired by the county to continue their current shared staffing assignment.  All other employees would be reassigned back to the payroll facility.  There is no language to indicate that the Executive’s proposal was rejected or amended by the legislature.

·        New Reinvestment language requires the Commissioner of OMH to report to the Governor and the Legislature by October 1, 2004 and annually thereafter, with a long- term capital plan for future uses of all mental health facilities, including any proposed closures or consolidations.  OMH must also report a long-term plan for state employee utilization and their role in the provision of an integrated and comprehensive system of treatment and rehabilitation for persons with mental illness.

The thirty day amendments recommend (revised March 7, 2003):

• The 30 day amendments do not include any changes to the transfer of function provisions in the Article VII bill.  The original Article VII bill provided for a transfer of function upon enactment only from Nathan Kline to the New York Psychiatric Institute.  Similar provisions have not been added for any of the psychiatric centers for which closure has been proposed (Elmira PC, Middletown PC, and Hutchings PC).  Without such a provision in legislation, any transfer of function would require an Executive Order.  This administration has never used an Executive Order for such purpose, and to date PEF has no indication that such action is being planned.  PEF is in the process of clarifying the intent of the administration in this regard.

The Executive Budget recommends (revised February 5, 2003):

• The net loss of 1,221 FTEs, 950 of which occur in SFY 2003-04 including 611 position abolitions.  This includes a decrease of 1,089 FTEs in Adult Services, including the 277 reductions in the current fiscal year.  An additional 113 positions will be eliminated in the Research Program, and 25 in the Administration and Finance Program. The estimated workforce will be 16,360 FTEs on March 31, 2004. 

• Closure of the following psychiatric centers on July 1, 2003:

-         Hutchings PC, to be consolidated with Mohawk Valley PC.

-         Middletown PC, to be consolidated with Rockland PC.

-         Elmira PC, to be consolidated with Rochester PC.

According to the Assembly, of the 1,323 FTE staff currently employed at Hutchings, Middletown and Elmira PCs 361 would remain at the facility to continue providing outpatient services, 619 staff would transfer to the facilities receiving the relocated patients, and 343 positions would be eliminated.

• A provision in the Article VII bill for OMH overrides the 12-month notification provision of Section 7.17 of the Mental Hygiene Law, allowing all of these facilities to be closed by July. Closure of the following psychiatric centers on October 1, 2005:

-         Bronx PC, to be consolidated with Pilgrim and Creedmoor PCs.

-         Bronx Children’s PC, to be consolidated with other downstate children’s PCs .

·        Consolidation of the Nathan S. Kline Institute into the New York Psychiatric Institute (NYPI), for a savings of $8.2 million.  Both campuses will remain in operation under the direction of NYPI.

·        Creation of a single appointing authority pursuant to Article VII legislation. This would allow OMH to reassign people from one psychiatric center to another.

·        Elimination of the Shared Staff Program. According to the Assembly budget analysis, the budget proposes compensating local agencies for the loss of the State funded positions through an increase in their rates of reimbursement, thus providing the agency with the resources to hire replacement staff. The State employee would have the option of returning to the psychiatric center or staying with the local agency as its employee. A total of 315 FTE positions would be affected, a combination of 185 Shared Staff and 130 Reinvestment positions. This issue needs to be clarified at Labor/Management.

·        Elimination of salary enhancements for psychiatrists and nurses.  Details of this proposal are not yet available, but may include geographic differentials, shift differentials, increased minimum salary for impracticability to recruit and/or increased minimum salary for advanced qualifications. This issue needs to be clarified at Labor/Management.

·        Further reduction of “unnecessary inpatient capacity.”  Details are not yet available on the number of bed reductions.

·        Elimination of non-essential funded vacancies.  Details are not yet available on the number of vacancy reductions.

·        Savings from closures and bed reductions to fund a new Community Reinvestment Act.  The Act will be used to support the 2002-2003 COLA and fee increase to address workforce issues and improve recruitment and retention in voluntary-operated programs ($30 million is provided for this purpose in the Aid to Localities budget).  Funding from bed reductions will also fund 600 new supported housing beds.  Future savings from bed closures at Bronx Children’s PC will be used for children’s crisis intervention beds, home-based crisis intervention teams, and home and community-based services waiver slots.

• Maintenance of the $19.6 million appropriation in the Enhanced Community Services Program supported through the Health Care Reform Act (HCRA).  This supports Transitional Residences on the grounds of state psychiatric centers, Children’s Mobile Mental Health Teams at Office of Children and Family Service facilities, and monitoring and oversight of community mental health programs.
• A net decrease of $46.1 million in the Adult Services program from the 2002-03 enacted budget.  This includes a decrease of $61.2 million in personal services and an increase of $15 million in Special Revenue-Other “Contract Recovery” account, which appears to be for shared staff.   The budget narrative refers to a conversion of funding of shared staff in order to maximize Federal Medicaid reimbursement, suggesting that OMH has devised a method to recoup Medicaid funding for these positions.
• An increase in the Children and Youth program of $3.5 million in personal services, and a decrease of $1.9 million in nonpersonal services from the enacted budget.
• An increase in the Forensic program of $2.8 million in personal services.
• A reduction of $6 million in personal services and $2.2 million in nonpersonal services in the Research in Mental Illness Program, reflecting the consolidation of Nathan S. Kline and NYSPI.
• A reduction of $1.7 million in personal services in the Administration and Finance Program, corresponding to a reduction of 25 FTEs.
• Development of 2,000 community-based privately operated beds for individuals leaving State facilities and adult homes and for the homeless mentally ill.  A $65 million capital appropriation will support the first 1,000 beds.

• A $4.6 million appropriation in the Department of Health, Office of Continuing Care, to fund initiatives in collaboration with OMH, the Commission on Quality of Care for the Mentally Disabled, and the State Office for the Aging to undertake a statewide effort to conduct client assessments, improve medication management, initiate enhanced service coordination and other advocacy services, and expand social and recreational activities. The budget indicates that Federal Medicaid matching funds will bring the funding for this purpose to $8 million.