At GNYHA's request, the NYS Office of Mental Health (OMH) met with GNYHA's members to hear providers' responses and recommendations regarding Governor George Pataki's proposed budget for mental health for 2000-2001. The Executive budget earmarks close to $200 million for spending on mental health services, and GNYHA requested the briefing to provide members with a forum for making recommendations to OMH regarding the allocation of these funds. Over 80 GNYHA members attended the briefing at GNYHA's offices on February 23, 2000. Sharon Carpinello, R.N., Ph.D., Executive Deputy Commissioner, led a delegation of five OMH staff members in presenting an overview of the budget proposal, a report on children's service needs, and a status report on the special needs plans.

OMH's Priorities: OMH identified three budget-planning priorities -- accountability, best practices, and coordination of services. Much of the spending is targeted for case management and assertive community treatment teams. Additional funds are directed at supported housing, transitional residences, home and community-based services, family-based treatment, family support services, and mobile mental health teams. Ten million dollars has been budgeted for the development of outcome measures and best practices, which are integral to OMH's oversight plans to monitor access to services and appropriateness of services. OMH clarified that the $32 million budgeted to implement assisted outpatient treatment (AOT) and other aspects of Kendra's Law could be directed to services for people who meet the criteria for AOT but who voluntarily accept treatment.

GNYHA Members' Comments: GNYHA members noted that the bulk of spending was directed to support services, which, although important, are not a substitute for treatment. Providers expressed frustration over the lack of mental health services for children, evidenced by long waiting lists for treatment and extended inpatient stays of several months. GNYHA recommended that the State eliminate its requirement that all proposed outpatient mental health programs be Medicaid-neutral, as a means to increase treatment capacity. Members recommended the development of school-based services and day treatment programs for children, as well as integrated programs to address both substance abuse and mental illness. Hospital members with State-funded positions, known as "shared staff," spoke about the impact that the Governor's plan to eliminate most of these positions would have on mobile crisis services in their communities. The issues of Medicaid neutrality and shared staff are part of GNYHA's legislative agenda. Joseph English, M.D., Chair of GNYHA's Mental Health and Substance Abuse Services Committee, facilitated the meeting, and expressed concern that many hospital psychiatric services operate at a deficit and face a real risk of closing.

Future Meeting with OMH: OMH has accepted an invitation to pursue the discussion of GNYHA's recommendations on mental health services at the next GNYHA Mental Health Committee meeting. For a copy of OMH's highlights of the Executive budget proposal, call Anita Wall at GNYHA.