November 22, 2023
In follow up to the OASAS Restructure Addiction Services Financing Project (RASFP) Town Hall Webinar, the Office has posted a Frequently Asked Questions (FAQs) document here: https://oasas.ny.gov/rasfp-faqs. Providers can continue to submit questions to RASFP@oasas.ny.gov.
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Class Action Status Sought on Behalf of Medicaid Eligible Children Across New York
On November 16, 2023, a motion for class action was filed on behalf of 4 NYS Medicaid eligible children and many thousands of additional children who have not been able to secure mental health services New York State is required to make available under the Medicaid Act, the Americans with Disabilities Act and the Rehabilitation Act. The services at issue are a well-defined set of mental health treatment supports known as intensive home and community-based mental health services (IHCB-EPSDT Services) and HCBS Waiver services. The common program names for the services in question are CFTSS and HSCBs Waiver services.
On behalf of the children, Children’s Rights, Inc, Disability Rights New York, Proskauer Rose LLP and the National Health Law Program argue that systemic deficiencies, created by statewide policies, practices and procedures have gone uncorrected for years.
Plaintiffs seek to certify two classes of children impacted, including all current or future Medicaid-eligible children in New York State under the age of 21:
(a) who have been diagnosed with a mental health or behavioral condition, not attributable to an intellectual or developmental disability, and
(b) for whom a licensed practitioner of the healing arts has recommended IHCB-EPSDT Services to correct or ameliorate their conditions.
Plaintiffs allege that Defendants violate the Medicaid Act by not arranging for these services as the Act requires, and by not ensuring that the services are provided with reasonable promptness. The action claims that state officials have repeatedly recognized that the limited services offered by Health Homes are not meeting the needs of children who need intensive care coordination.
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Attached, please find a November 2023 Report from SAMHSA regarding VBP and SUD Treatment. You will note that several of the contributors to the Report are representatives from Third Horizon Strategies, the national consulting firm OASAS has engaged to work with the Office on its recently announced OASAS Addiction Funding Restructuring Initiative.
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Last month the Governor announced the creation and first meeting of a new commission that will ultimately make recommendations to the Executive regarding the future of healthcare in New York State. The NYS Council covered the announcement and shared additional information on the new Commission with our members.
Below is a recently published Crain’s Health Pulse interview with Dr. Sherry Glied, chair of the new Commission:
Q&A With The Chair Of The Commission on the Future of Health Care
An article in Crain’s Health Plus, written by Amanda D’Ambrosio, this week centered around a Q&A with the chair of governor’s health commission on diagnosing New York’s challenges. Governor Hochul’s Commission on the Future of Health Care is a 13-member commission that has been tasked to advise the governor on transforming New York’s health care system. The group consists of hospital executives, former state and federal health officials, and private equity investors and is focused on health care delivery and costs.
Dr. Sherry Glied, the chair of the commission and dean of the NYU Wagner Graduate School of Public Service, spoke to Crain’s about the commission’s long-term strategy.
Question: The commission has a goal of making recommendations to transform New York’s health system. Where do you start?
Answer: We do not want to start by talking about immediate problems, like what to do about Medicaid reimbursement in some place tomorrow. If you look at the people who are on the commission, that’s not what we do. That’s the challenge but also the potential of this: If we’re going to make the New York state health system work better for people, we have to figure out what the underlying big problems are.
Question: So developing a long-term strategy to improve health care delivery?
Answer: But not the minutia. When you’re in government, the thing that is most compelling to you is the piece of paper that is in front of you on the desk right now. The phone call that’s happening now, the tweet that just went out saying this hospital is about to close because they don’t have enough money. The governor doesn’t need a commission to do that; that’s her job. She needs a commission so she can step back and say, “OK, I have to deal with this hospital. Where am I going five years from now?” If we just keep doing this with band-Aids and duct tape, in the end we’re not going to have much of a health system.
Question: The governor said she expects the commission to advise on Medicaid, a top cost driver here. What is your approach?
Answer: My understanding is that the Medicaid budget is largely baked, right? The amount of money going to Medicaid has been negotiated with the federal government. I certainly think Medicaid is an important lever of state policy. So thinking about what Medicaid pays for and how much Medicaid pays surely falls within the jurisdiction of the governor. But the total spend on Medicaid and trying to cut the cost of Medicaid is not a goal of the commission. Medicaid is sort of a lever; it’s not an objective.
Question: The group’s first subcommittees will focus on hospitals and long-term care. Why did you choose to start there?
Answer: Willie Sutton said, “Why do I rob banks? Because that’s where money is,” right? Those are two natural places to start. It’s not because we think that’s where we have to make the biggest [changes]—we haven’t looked yet. We will surely have behavioral health as a group, primary care, and social determinants of health.
Question: The commission’s first set of recommendations is due at the end of 2024. Where do you see things a year from now?
Answer: Since we’ve only had one meeting, which was introductory, it’s a little premature for me to say. But I’d like us to be able to articulate, in at least a couple of areas, a realistic vision of what systems in New York need to look like, and how that differs from what they look like now. I don’t want us to be making political decisions. We’re not experts in the politics of New York state. I don’t want to have conversations where people say, “Well, that’s a great idea, but this interest group and that interest group …”—not what this is for. I want us to say, “Looking at the data, this looks like a problem, and this looks like it’s a solution.”
In closing the chair stated I’m hoping I can persuade my fellow commissioners to not even try to think of any solutions for at least the first three or four months—try to do as much diagnostic work, run MRIs and CT scans on the health system, and really understand what we are looking at before we jump in.
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Online therapy company Talkspace will provide free virtual mental health services to more than 400,000 adolescents and teens in New York City. The New York City-based digital mental health company inked a partnership with the NYC Department of Health and Mental Hygiene to operate a new program called TeenSpace to offer tele-mental health services to teenagers between the ages of 13 and 17 years old at no cost. Launching this month, the service enables NYC teenagers to connect with a licensed therapist through phone, video, and text. (Article here)
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