Executive Budget Proposals: Snippets from the Budget Briefing Book

February 1, 2023

Executive budget proposal includes a COLA at $500M = 2.5% increase for OMH and OASAS, OPWDD, OCFS, OTDA, SOFA agencies.  Includes OCFS and OTDA programs, including Foster Care, Adoption, NY/NY III Supportive Housing Agreement, and the Nutrition Outreach and Education Program. 

Cost Of Living Adjustment (COLA). The Executive Budget includes a 2.5 percent COLA to human services providers in FY 2024. The COLA applies to voluntary operated providers of services for OPWDD, OMH, OASAS, Office of Children and Family Services (OCFS), Office of Temporary and Disability Assistance (OTDA), and the State Office for the Aging (SOFA). For the Mental Hygiene agencies, this amounts to $188.6 million ($314.1 million including federal matching funds) for OPWDD, OMH, and OASAS voluntary operated programs, and will provide fiscal relief to providers, enabling them to offer more competitive wages to their staff to address workforce recruitment and retention issues and better support the individuals they serve.

OASAS Proposals

Strengthen Supportive Housing Programs. The Executive Budget includes $6.5 million to maintain over 1,500 OASAS residential recovery units. This investment will fully fund current rental and supportive services costs for existing units.

Address the Opioid Epidemic Using a Public Health Approach. OASAS will continue to oversee one of the nation’s largest substance use disorder systems of care with approximately 1,700 prevention, treatment, harm reduction and recovery programs serving over 731,000 individuals per year. As the State’s opioid treatment authority, OASAS will continue to coordinate State-federal relations in addiction services and implement a statewide harm reduction strategy, in collaboration with the Department of Health (DOH), which is designed to meet people where they are and prevent overdoses.  At Governor Hochul’s direction, OASAS established a new Division of Harm Reduction to coordinate the implementation of low-threshold, patient-centered approaches in communities around the State.

Community Health Access to Addiction and Mental Healthcare Project (CHAMP) Ombudsman Program. CHAMP is the New York State independent health insurance ombudsman program for substance use disorder and mental health care that, through a joint program with OASAS and OMH, partners with community-based organizations to educate and assist New Yorkers in maximizing insurance coverage for substance use and mental health. 

The Executive Budget continues funding for CHAMP to be available statewide, and increases funding for OASAS and OMH parity enforcement activities by $3.5 million.

Opioid Settlement Fund Investments. Since 2021, the State of New York has reached settlement agreements with several of the pharmaceutical companies responsible for the opioid epidemic which are expected to provide more than $2 billion to the State and to municipal governments through 2040. Through the end of FY 2024, over $320 million in payments related to those settlement agreements will be deposited in the State’s Opioid Settlement Fund, which will be used to support addiction services throughout the State. OASAS is working with other State agencies including DOH and OMH to implement a range of initiatives to address the opioid crisis guided by recommendations issued by the Opioid Settlement Fund Advisory Board, in a manner consistent with the terms of the opioid settlement agreements. Board members issued their first recommendations on November 1, 2022, identifying the expansion of harm reduction services, treatment, and investments across the service continuum as top priorities.

Opioid Stewardship Investments. The FY 2023 Enacted Budget appropriated $200 million to invest monies owed to the State retroactive to 2017 and 2018, after the Opioid  Stewardship Act was upheld by the U.S. Supreme Court. The Executive Budget reappropriates these funds to support a variety of initiatives overseen by both OASAS and DOH. During FY 2024, OASAS will utilize Opioid Stewardship Funds to pursue a number of harm reduction initiatives, including equipping street outreach teams with cutting-edge equipment which will allow individuals to test their drugs for fentanyl, a grant program to establish 15 community-based harm reduction programs throughout the State, and the development of a training program designed to help police departments, jails, and other elements of the criminal justice system implement harm reduction strategies designed to save lives. 

Minimum Wage. The Executive Budget leverages an additional $38 million in State funds to support minimum wage increases, including indexing minimum wage to inflation, for staff at programs licensed, certified, or otherwise authorized by OPWDD, OMH, and OASAS.

Certified Community Behavioral Health Clinic (CCBHC) Expansion. 

CCBHCs are an effective model for delivering integrated physical and behavioral healthcare for people with mental illness and/or substance use disorder and are an important part
of the Governor’s plan to ensure access to care.  The Budget will establish joint licensure by OMHand OASAS for these programs, and create an Indigent Care Program to protect providers from uncompensated care. The Budget also includes resources to create 26 new Certified Community Behavioral Health Clinics (CCBHCs), tripling capacity to 39 programs statewide. 

Includes a 5% Medicaid rate increase for hospitals, nursing homes and assisted living.

Expand Inpatient Bed Capacity. 
The FY 2024 Executive Budget includes funding for the opening of 1,000 inpatient psychiatric beds which is part of
a multi-year plan to increase operational capacity at mental health facilities. These beds will help to meet the increased need for mental health services across the State. Added beds include 850 currently offline, inpatient psychiatric beds at public hospitals licensed under Article 28; and 150 new State-operated inpatient psychiatric beds. 

Create a Qualified Mental Health Associate Title.

The establishment of this title will provide a career ladder and additional training for paraprofessionals to provide services more independently and improve the quality and access to care in OMH funded and licensed settings. 

-Enhance Children’s Mental Health Programs. The Executive Budget will expand mental health services for children and families by investing an additional $12 million in the HealthySteps program and Home-Based Crisis Intervention (HBCI) teams, $5 million for High Fidelity wrap around supports, and $10 million to develop school-based clinics, building on the Governor’s State of the State initiative from 2022. 

-$2.4B for Healthcare Capitol Infrastructure grants

-Increase in overall reimbursement for Primary Care and School-Based Clinics including expansion of coverage provided by Community Health Workers, primary prevention services, and primary and urgent care shelters

-The Budget also makes the following managed care reforms:

  • Requiring plans to pay a claim as billed by a provider and limit the reviews of scope in good faith medical necessity disputes. When a payer questions the medical necessity of the services, the claim will be reviewed by a joint committee composed of clinicians representing both the payer and the general hospital and if the dispute prevails, then ultimately the claim will be determined by an independent third party. This proposal will cost $7.7million in FY 2024 and $31.8 million in FY 2025.
  • Requiring plans to spend more on patient care.
  • Discontinuing supplemental funding for managed care quality pools. This proposal will provide savings of $111.8 million State-share in FY 2024 and FY 2025. 

-Support Foster Care Agencies. The Budget includes $17 million in financial support to assist certain foster care providers with new Federal requirements as they relate to Institutions for Mental Disease (IMD). Funds will be used to hire necessary medical staff at foster care facilities, back-fill Medicaid reimbursement for voluntary agencies who provide medical care to Medicaid eligible youth, and assist voluntary agencies in transitioning to the Federal requirements.