January 17, 2024

See below for a look at executive budget Aid to Localities Approps.
Note:  The yellow highlighted approps in the OMH and OASAS sections (below) are the result of focused NYS Council advocacy that compelled NYS to begin enforcing an important expenditure target requirement in MCO contracts.  Many MCOs were being overpaid (as if they had hit their targets) despite missing them, and the state was not recouping the funds.

NYS Council advocacy resulted in the state beginning to enforce the targets two years ago, to the tune of $222M.  Since then additional recoupments have added another $220M to the recoupment bucket.   OMH and OASAS have used these funds to increase provider rates for a broad range of OMH and OASAS Programs including the Outpatient Clinics, the OASAS Part 820, children’s mental health services and more.  The recoupments continue.

For new members of our Association, the important part of this story is that the expenditure targets were in the MCO contracts to ensure the plans spent the vast majority of money they were paid by the state, on actual care for Medicaid beneficiaries.  We knew they were there and we knew they were not being enforced by the state.  We are grateful to Governor Hochul for her decisive action to address this problem.

The NYS Council is laser focused on increasing access to care for the individuals who need our services.  Count on it.

January 17, 2024
SFY 2025 Executive Budget Update Aid to Localities Appropriations of Interest
NYS Department of Health

• $7.785 million for services and expenses of an opioid addiction, prevention and treatment program (same as level provided in SFY 2024 final budget)
• $272,000 for services and expenses of an opioid overdose prevention program for schools (same as level provided in SFY 2024 final budget)
• Restructuring Health Homes to save $125 million in SFY 2026 (per Medicaid scorecard)
• $22.5 million for eligible certified community behavioral health clinics under the certified community behavioral health clinics indigent care program (reduced from SFY 2024 final budget)
• $465.5 million for new appropriation services and expenses related to the NYS Medicaid section 1115 demonstration waiver
• $7.6 million for new appropriation for continuous eligibility for children enrolled in NY Medicaid up to age 6 as proposed in SFY 2025 budget

Office of Addiction Services and Supports

• $8.86 million for OASAS provider cost of living adjustment of 1.5% (reduced from SFY 2024 final budget)
• $2.9 million to support direct salary costs and related fringe benefits from minimum wage increase (same level as SFY 2024 final budget)
• Appropriations of $1.5 million and $8.5 million for SUD and MH Ombudsman (same level as SFY 2024 final budget)
• $37 million for reinvestment in behavioral health services from the savings realized through the transition from Medicaid FFS to managed care (same level as SFY 2024 final budget)
• $63.7 million from the Opioid Settlement Account (down by $148.5 million from $212.2 million in the SFY 2024 final budget)
• $52.525 million for services and expenses related to recovery services, including housing and recovery centers (increase of $5 million from SFY 2024 final budget)

Office of Mental Health

• $4 million in new funding for recruitment and retention of psychiatrists, psychiatric nurse practitioners and other licensed clinicians in mental health programs for children licensed by OMH or OCFS
• $74 million for reinvestment in behavioral health services from the savings realized through the transition from Medicaid FFS to managed care (same level as SFY 2024 final budget)
• $34.985 million for OMH provider cost of living adjustment of 1.5% (reduced from SFY 2024 final budget)
• $8.22 million to support direct salary costs and related fringe benefits from minimum wage increase (increased from SFY 2024 final budget)
• $2 million in new funding for services and expenses related to suicide prevention, peer to peer training, and other mental health supports and services for veterans, first responders, including disaster relief workers

Please let us know if you have any questions.  More updates to follow.