Office of Mental Health
The enacted budget makes the following changes to the Executive Budget (analysis as of March 30, 2006):
- Adds $150,000 to the Administration and Finance Program for a study to review the financing and reimbursement of mental health services provided by Article 31 clinic, continuing day treatment and day treatment programs.
- Adds $500,000 to the Research in Mental Illness Program for 4 additional research scientist positions at the NYS Psychiatric Institute for schizophrenia research.
- Adds $500,000 to the Research in Mental Illness Program for 5 additional research scientist or research psychiatrist positions at the Nathan Kline Institute for Psychiatric Research for dementia, schizophrenia and mental health services research programs.
- Adds $5 million in capital funding for St Lawrence Psychiatric Center, presumably related to the treatment of sexually violent offenders.
- Eliminates $130 million in capital funding for the conversion of DOCS Camp Pharsalia to a secure treatment facility for persons civilly committed as sexually violent offenders. Funding for improvements to existing OMH facilities ($85.5 million) for civilly committed sexually violent offenders was approved.
- Gives the Dormitory Authority the authority to sell part of the land at Creedmoor Psychiatric Center to the Indian Cultural and Community Center.
The Senate and Assembly made the following changes to the Executive Budget (analysis as of March 15, 2006):
Senate:
- Added $500,000 to the Research in Mental Illness program for 5 FTE research scientist or research psychiatrist positions for Nathan Kline Institute.
Assembly:
- Reduced the capital appropriation by $130 million dollars reflecting the expenses for the development of secure treatment facilities for sexually violent offenders, including DOCS Camp Pharsalia.
- Denied the Executive Budget proposal to transfer Camp Pharsalia to OMH as the site of a 500 bed hospital for sexually violent predators.
- Approved the adaptation of 641 beds for violent sexual offenders, but did not allow bed expansions for violent sexual offenders at St. Lawrence and Rochester Psychiatric Centers.
The Executive Budget recommends (analysis as of January 25, 2006):
- An increase of 459 FTEs over the adjusted SFY 2005-06 FTE level. The adjusted level includes an increase of 340 FTEs in SFY 2005-06. The proposed increases include 5 FTEs in Administration and Finance; 441 FTEs in Adult Services (in addition to the 256 added in 2005-06); 5 FTEs in the Children and Youth Services Program (in addition to the 52 FTEs added in 2005-06; 8 FTEs in Forensic Services; and 4 FTEs in Research. While the budget documents indicate a year end FTE level of 17,506 (authorized fill), the actual year end level according to DOB will be 16,981. We expect the actual year end fill level to be the lower number.
- An overall budget of $1.3 billion, an increase of $99.2 million over SFY 2004-05 (8.2%).
- An increase of $72 million in Adult Services (8.9%), including $32.2 million in personal service (4.9%) and $39.8 million in nonpersonal service (27.1%). The additional 441 FTEs in this program will apparently not come on line until the end of SFY 2006-07.
- Contractual services increases include $13.6 million in Adult Services Program and $4.7 million in Administration and Finance, the purpose of which should be explored in labor/management.
- An unspecified reduction of $33.4 million for “various State Operations and Local Assistance efficiencies including overtime management savings and provider audit recoveries”. The budget refers to control of overtime through deployment of an expanded workforce. According to the Assembly, a savings of $1.55 million is taken for control of overtime, yet the budget shows that Holiday/Overtime pay is still projected to increase by $1.28 million in SFY2006-07, all in the Adult Services program. An explanation should be sought in statewide labor/management.
- Additional funding for the care and treatment of violent sexual predator programs following civil commitment:
- A new 500 bed facility for violent sexual predators on the grounds of DOCS Camp Pharsalia in Chenango County which will open in 2009 ($135 million in capital funding).
- $26.8 million for operational needs for the care and treatment of sexual predators. The OMH budget analysis indicates that this will support 697 FTEs (25 in SFY2005-06, 441 in 2006-07). This funding is included in the Adult Services Program.
- $35 million in capital appropriations for short term renovations related to sexual predators. This will include renovations at Central NY PC and conversion of a vacant building at St Lawrence PC. If the need arises, space at the Rochester PC and Manhattan PC will be used.
Despite frequent references to civil commitment, there is no accompanying Article VII legislation that would provide for a civil commitment process for these offenders.
- No closures or consolidations due to “the leveling off of previously declining demand for inpatient services, utilization of current inpatient capacity, and the need to evaluate future inpatient capacity needs.”
- $68 million in capital funds for Phase I of construction of new facilities for Bronx Adult and Children’s psychiatric centers (total $226 million project).
- $28 million for a re-location of Kirby psychiatric center in the Dunlop Building to avoid $25 million in net capital costs and increase the number of forensic inpatient beds.
- Provides $600,000 for a NYS Evidence-Based Treatment Dissemination Center which will train clinicians in new treatment models (5 FTEs). In 2006-07 up to 400 clinicians will be trained in evidence based practices for the treatment of depression and trauma in children and adolescents.
- Large nonpersonal services increases in the Adult Services ($39.8 million, 27.1%), Children and Youth ($3.2 million, 23.9%) and Forensic Programs (2.8 million, 25.5%).
- Reinvestment of $7 million in savings from the closure of Middletown PC into State operated community based services.
- $4 million to build necessary infrastructure to implement Medicare Part D (full pharmacy coverage at no cost for Medicare-eligible clients served by OMH facilities).
- $1.5 million (plus $500,000 in the OASAS budget) for start-up of State-sponsored managed care demonstration programs for individuals with co-occurring mental illness and substance abuse disorders.
- Expansion of DOCS treatment capacity for inmates with mental illness (8 FTEs, $290,000, annualized to $588,000).
- $2 million increase in the Special Revenue-Other Cook/Chill Account related to increased reimbursements.
- According to the Assembly Ways and Means Committee analysis, $2.9 million will be appropriated for initiatives intended to improve coordination and delivery of services by community based providers. Management should provide details of this initiative at statewide labor/management.
- A three year COLA for human services voluntary providers (2.5% in 2006-07, $10.6 million).
- OMH is one of three pilot agencies in 2005 that participated in an initiative to incorporate performance based planning into the budget process. This includes development of a strategic overview and multi-year “business plans”. To our knowledge PEF members who will assumedly implement these plans has had no role in the process and has not had access to these plans. The implications of this pilot program should be raised at labor/management.
- OMH is going to collaborate with the newly created Office of State Medicaid Inspector General in investigating Medicaid fraud.
Program Details-State Operations
Enacted
Proposed
Enacted
Change in
Percent
Program
2005-06 Budget
2006-07 Budget
2006-07 Budget
Appropriation
Change
All Funds
$1,202,936,000
$1,302,099,000
$1,303,249,000
$100,313,000
8.3%
General Fund
$586,610,000
$771,407,000
$772,557,000
$185,947,000
31.7%
Special Revenue-Federal
$1,272,000
$1,358,000
$1,358,000
$86,000
6.8%
Special Revenue-Other
$604,196,000
$518,476,000
$518,476,000
($85,720,000)
-14.2%
Enterprise Fund
$8,349,000
$8,349,000
$8,349,000
$0
0.0%
Internal Service
$2,509,000
$2,509,000
$2,509,000
$0
0.0%
Administration & Finance
$72,382,000
$82,033,000
$82,183,000
$9,801,000
13.5%
Personal Service
$39,189,000
$40,895,000
$40,895,000
$1,706,000
4.4%
Nonpersonal Service
$19,193,000
$25,052,000
$25,052,000
$5,859,000
30.5%
Svcs & Exp Art 31 Study
$0
$0
$150,000
Special Revenue-Federal (SRF)
$1,272,000
$1,358,000
$1,358,000
$86,000
6.8%
Special Revenue-Other (SRO)
$1,870,000
$3,870,000
$3,870,000
$2,000,000
107.0%
Internal Service (ISF)
$2,509,000
$2,509,000
$2,509,000
$0
0.0%
Enterprise Fund (Ent)
$8,349,000
$8,349,000
$8,349,000
$0
0.0%
Federal Block Grant Fund (SRF)
$1,272,000
$1,358,000
$1,358,000
$86,000
6.8%
Personal Service
$790,000
$814,000
$814,000
$24,000
3.0%
Nonpersonal Service
$164,000
$178,000
$178,000
$14,000
8.5%
Fringe benefits
$318,000
$366,000
$366,000
$48,000
15.1%
OMH Gifts & Donations - (SRO)
$500,000
$500,000
$500,000
$0
0.0%
OMH Grants & Bequests - (SRO)
$70,000
$70,000
$70,000
$0
0.0%
Cook/Chill Acct (SRO)
$1,300,000
$3,300,000
$3,300,000
$2,000,000
153.8%
MH Sheltered Workshop Acct - (Ent)
$5,753,000
$5,753,000
$5,753,000
$0
0.0%
Personal Service
$2,045,000
$2,045,000
$2,045,000
$0
0.0%
Nonpersonal Service
$3,708,000
$3,708,000
$3,708,000
$0
0.0%
MH Community Stores Acct - (Ent)
$2,596,000
$2,596,000
$2,596,000
$0
0.0%
Personal Service
$551,000
$551,000
$551,000
$0
0.0%
Nonpersonal Service
$1,793,000
$1,793,000
$1,793,000
$0
0.0%
Fringe benefites
$252,000
$252,000
$252,000
$0
0.0%
MH Revolving Acct - (ISF)
$2,509,000
$2,509,000
$2,509,000
$0
0.0%
Personal service
$993,000
$993,000
$993,000
$0
0.0%
Nonpersonal service
$1,068,000
$1,068,000
$1,068,000
$0
0.0%
Fringe benefits
$448,000
$448,000
$448,000
$0
0.0%
Adult Services
$804,378,000
$876,361,000
$876,361,000
$71,983,000
8.9%
Personal Service
$654,409,000
$686,587,000
$686,587,000
$32,178,000
4.9%
Nonpersonal Service
$146,804,000
$186,609,000
$186,609,000
$39,805,000
27.1%
Maintenance Undist.
$3,165,000
$3,165,000
$3,165,000
$0
0.0%
Children and Youth
$127,165,000
$136,755,000
$136,755,000
$9,590,000
7.5%
Personal Service
$113,870,000
$120,284,000
$120,284,000
$6,414,000
5.6%
Nonpersonal Service
$13,295,000
$16,471,000
$16,471,000
$3,176,000
23.9%
Enhanced Community Services
$19,600,000
$19,600,000
$19,600,000
$0
0.0%
Forensic
$129,975,000
$136,012,000
$136,012,000
$6,037,000
4.6%
Personal Service
$119,132,000
$122,401,000
$122,401,000
$3,269,000
2.7%
Nonpersonal Service
$10,843,000
$13,611,000
$13,611,000
$2,768,000
25.5%
Maintenance Undist.
$0
$0
$0
$0
Offset
($595,201,000)
($507,481,000)
($507,481,000)
$87,720,000
-14.7%
Special Revenue-Other (SRO)
$595,201,000
$507,481,000
$507,481,000
($87,720,000)
-14.7%
HCRA Transfer Fund - (SRO)
$19,600,000
$19,600,000
$19,600,000
$0
0.0%
MH Patient Income Acct - (SRO)
$575,601,000
$487,881,000
$487,881,000
($87,720,000)
-15.2%
Research in MI
$49,436,000
$51,338,000
$52,338,000
$2,902,000
5.9%
Personal Service
$37,568,000
$39,148,000
$39,148,000
$1,580,000
4.2%
Nonpersonal Service
$4,343,000
$5,065,000
$5,065,000
$722,000
16.6%
Extra Research Scientists
$400,000
$0
$1,000,000
$600,000
150.0%
Special Revenue-Other
$7,125,000
$7,125,000
$7,125,000
$0
0.0%
OMH Research Recovery Acct - (SRO)
$7,125,000
$7,125,000
$7,125,000
$0
0.0%
Personal Service
$1,915,000
$1,915,000
$1,915,000
$0
0.0%
Nonpersonal Service
$4,560,000
$4,560,000
$4,560,000
$0
0.0%
Fringe Benefits
$650,000
$650,000
$650,000
$0
0.0%