Office of Mental Health

Additional information (revised January 28, 2004):

·          According to the Assembly, the closure of Middletown PC will include the transfer of 186 positions to Rockland PC, 60 positions will be moved into outpatient programs for a total of 121, and 59 positions will be eliminated.

·          The $7,000,000 increase for the Forensic Services Program will add 66 nurses and psychiatrists to the number of clinical personnel stationed in Department of Correctional Services (DOCS) facilities. A total of 264 beds would be added to provide forensic services: 102 Behavioral Care Unit beds, 75 Special Treatment Program beds and 87 Intermediate Care Program beds. The Behavioral Care Unit (BCU) is a new, highly intensive treatment model, would serve as an alternative to DOCS Special Housing Units (SHU). The Executive proposes adding 38 BCU beds at Great Meadow and 64 BCU beds at Sullivan correctional facilities. Three new 25 bed Special Treatment Program (STP) beds at undesignated facilities will supplement the 43 Special Treatment Program (STP) beds, located at the Attica and Five Points correctional facilities. The STP provides specialized therapeutic services and support, including on-site 24-hour crisis services to inmates in SHUs. The Intermediate Care Program (ICP) will be increased by 87 beds, bringing the total number to 652. ICP is the “step-down” program that prepares mentally ill inmates for return to the general population. The ICPs are dedicated, residential units that provide enhanced rehabilitation, treatment and supports for inmates with serious mental illness. The costs for capital development and increased security would be borne by DOCS.

The Executive Budget recommends (revised January 21, 2004):

• The net loss of 109 FTEs in SFY 2004-05 from the adjusted 2003-04 FTEs which included over 350 restored FTEs.  This includes a decrease of 140 FTEs in Adult Services, 30 FTEs in the Research Program, and 5 in the Children and Youth Services Program. The Forensic Services program will be increased by 66 FTEs. The estimated workforce will be 16,707 FTEs on March 31, 2005. 

• Closure of Middletown PC on April 1, 2005 (in compliance with the one year notification law).  Remaining patients will be transferred to Rockland PC.  Fifty percent of savings all administrative, support and overhead cost from the closure ($3.4 million) will be reinvested in state-operated community-based programs.
• Elimination of 21 under-utilized child inpatient beds (locations not identified).  Full annual savings of $2.6 million will be reinvested into other children’s community services.
• Article VII legislation that will establish a bipartisan Blue Ribbon Commission for the Closure of State Psychiatric Centers to recommend facility closures through 2010 to report on 4/1/05.  The Commission will be composed of gubernatorial (4 members) and legislative representatives (4 members), with the Commissioner of Mental Health serving as the chairperson with the tiebreaking vote.  Unless both houses of the Legislature reject all recommendations in their entirety within 45 days of receipt of the recommended closure list the closures must be implemented.  Not less than 10% or more than 40% of the total excess inpatient capacity would be eliminated in any fiscal year.
• Legislation establishing the Commission will also extend the Community Mental Health Support and Workforce Reinvestment Act through 2010, providing reinvestment of 50% of all administrative, support and overhead cost savings into State-operated community-based services.
• An All Funds increase of $1.4 million (0.1%), including a General Fund increase of $85.5 million (16.4%) and a decrease of $83.7 million in Special Revenue-Other funding.
• Unexplained increases in personal services may reflect the additional pay period for the institutional payroll for SFY 2004-05
• A decrease in the Children and Youth program of $970,000 in personal services, which is greater than would be anticipated by the reduction of 5 FTEs, particularly when there is additional funding for the 27^th institutional payroll period.
• An increase in the Forensic program of $7.6 million in personal services, reflecting the increase of 66 FTEs and the additional pay period..
• A reduction of $1.9 million in the Research in Mental Illness Program.  As in the Adult Services Program, restorations for averted research center closures/consolidations in the 2003-04 budget were not broken out into personal and nonpersonal services, making a year to year comparison difficult.  The Executive budget the shows a reduction of $1.9 million in personal services.  The Division of Budget indicated that this reflects the elimination of funded vacancies in both Nathan Kline and New York Psychiatric Institute.
• An increase of $262,000 in personal services and $2.5 million in nonpersonal services in the Administration and Finance program.  There are no increases in FTEs to explain this increase.
• A decrease of $6.2 million in the Adult Services program from the 2003-04 enacted budget.  This includes elimination of the $15 million Special-Revenue Other appropriation for Shared Staff offset by increases in personal and nonpersonal services.   Restorations for averted facility closures in the 2003-04 budget were not broken out into personal and nonpersonal services, making a year to year comparison difficult.  The Executive budget the shows an increase of $5.6 million in personal services and $2.9 million in nonpersonal services.  Changes in nonpersonal service include an increase of $1.9 million in Contractual Services.  Holiday/Overtime pay is decreased by $1.8 million. The budget indicates there will be  further reduction of “unnecessary inpatient capacity” in Adult Services.  Details are not yet available on the number or location of bed reductions.
• All Fiduciary fund accounts have been transferred to Special Revenue-Other accounts
• Unexplained fringe benefits increases in Enterprise and Internal Service funds where there is no increase in personal services. 
• Savings of $7.9 million associated with further reduction of “unnecessary inpatient capacity”.  Details are not yet available on the number or location of bed reductions.

·        $7.6 million in additional funding for expanded mental health treatment capacity and clinical staffing for forensic DOCS inmates.  OMH will work with DOCS to establish a new Behavioral Health Unit program model, almost triple the number of beds for the Special Treatment Program; expand bed capacity for the Intermediate Care Program; and improve access to clinical staff for mental health services.

• Transfer of the Compulsive Gambling Education and Treatment Program to OASAS.
• An appropriation of $9 million in local assistance funding for OMH community residence providers to help them stabilize staffing levels.
• Closing the 2004-05 budget deficit of $5.1 million in part with $298 million in mental hygiene programs by increasing Federal aid and initiating additional cost-saving measures.  This proposal should be explored with management.
• Establishing a utilization and case management system in DOH for high cost Medicaid recipients who access substance abuse, mental health and developmental disability services.  The impact of this proposal should be explored with management.