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FINAL HEALTH/MENTAL HYGIENE ARTICLE VII BUDGET BILL INCLUDES TARGETED INFLATIONARY INCREASE

The final Health/Mental Hygiene Article VII budget bill has been passed by both houses.  One component included in the bill was a 2.6% Targeted Inflationary Increase (TII). While the NYS Council and many other associations advocated for a greater increase, this TII is vital to help stabilize our system of care, particularly as we face significant uncertainty and potential funding challenges from the Federal Government.  The TII will increase rates for 4/1/25-3/31/26 for programs under OMH, OASAS, OPWDD, OTDA, OCFS and SOFA.

The increase is unrestricted but providers will need to submit a written certification attesting how funding will be used to first promote the recruitment and retention of support staff, direct care staff, clinical staff and non-executive admin staff or to respond to other critical non-personal service costs prior to supporting salary or other compensation for executive level job title.

FINAL BUDGET DOES NOT INCLUDE NYS COUNCIL
OMIG AUDIT REFORM LANGUAGE

Unfortunately, the final SFY26 State Budget did not include our OMIG Audit Reform language so we will aggressively pursue passage of our standalone bill, S4955A (Harckham) / A1069A (Paulin), along with passage of our new carve out bill that would remove most outpatient mental health and substance use disorder services from the state’s Medicaid managed care program, A8055  (Simon).  (We are still waiting for the Senate version, sponsored by Senator Samra Brouk to come out with a bill number.)

For too long, Medicaid audits conducted by the NYS OMIG have relied on tactics that are unnecessarily punitive. Providers who have operated in good faith and delivered high quality care live in fear of these OMIG audits because they can be punished severely for technical and/or human errors that are not material to whether the Medicaid recipient received the service, or the quality of care provided to the individual. Current OMIG audit practices include application of extrapolation to clerical errors, which has resulted in disproportionate findings and enormous fines that can shut down the entire program, or impact a Medicaid providers’ ability to continue to provide critical services to their communities. This practice is crippling and risks the continued viability of New York’s safety net system.

GOVERNOR ANNOUNCES $4.5 MILLION TO FUND SERVICES FOR CHILDREN AND YOUTH LIVING WITH MENTAL ILLNESS

Governor Kathy Hochul announced that $4.5 million in state funding was awarded to establish 10 new Youth Assertive Community Treatment teams, including five in New York City, two on Long Island and three in areas north of the metropolitan area.

Administered by the state Office of Mental Health, the new multidisciplinary teams will support 360 additional youth with serious emotional disturbances who are either at risk of entering, or are returning home from high intensity services, such as inpatient settings or residential services.

Congratulations to NYS Council members who were among the list of award recipients.  The full list of recipients include:

  • Access Supports for Living Inc., serving Westchester County
  • The Charles Evans Center, serving Nassau County
  • Central Nassau Guidance and Counseling, serving Suffolk County
  • Children’s Home of Wyoming Conference, serving Chenango County
  • Interborough Developmental & Consultation Center, serving Brooklyn
  • The Child Center of NY, two teams serving Manhattan and Queens
  • Jewish Child Care Association of NY, serving the Bronx
  • Child and Family Services of Erie County, serving Erie County
  • Richmond University Medical Center, serving Staten Island
COMMERCIAL INSURANCE COVERAGE FOR CHILDREN’S MENTAL HEALTH AND SUD SERVICES MUST BE CONSISTENT WITH COVERAGE UNDER THE NYS MEDICAID PROGRAM

There is a disparate availability of critical services to address the youth mental health crisis in New York.  This has resulted in persistent waiting lists for outpatient and home-based care that range from several weeks to many months with some children and youth forced to live in hospital emergency rooms while awaiting an appropriate referral for follow-up care upon discharge from the hospital.  The NYS Council urges the state to require regulated commercial insurance and child health plus to provide coverage for children’s mental health and SUD services consistent with coverage under the NY Medicaid Program. Examples of mental health services currently available to Medicaid beneficiaries but not mandated to be covered by commercial insurance include HCBS and CFTSS services. 

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