The NYS Council has released its 2025-26 Budget/Legislative Priorities document.  Below is a quick synopsis of the specific areas of focus.

The full Priorities document is available online here.

OVERDOSE CRISIS
The NYS Council calls on the Hochul Administration to make a $1B investment in prevention, treatment, recovery and harm reduction services in the OASAS system of care similar to the investment of $1B enacted several years ago to expand and address the needs of New Yorkers with serious mental health conditions.

WORKFORCE
The NYS Council requests a Cost of Living Adjustment (COLA) of 7.8% on all Medicaid reimbursable rates and contracts for mental health and substance use disorder services provided by eligible OASAS and OMH licensed, certified, or registered agencies. Note: This 7.8% request is embraced by the entire NYS Human Services sector.

The NYS Council requests a 25% set aside of the anticipated $4B revenue from the MCO Tax for community-based behavioral health (mental health and substance use disorders). These funds must not be used exclusively to assist institutional healthcare settings that rely on a viable community-based system of care to receive discharged New Yorkers who need access to continuing care services through the public mental health and substance use disorder system.

The NYS Council requests additional job titles be added to the NYS 1115 Waiver Career Pathways Initiative to help address job vacancies.  Currently there are only three eligible practitioner types (MSW, CASAC, LMHC) targeted for this new Initiative.

The NYS Council requests that New York State address barriers that are a result of the SED Scope of Practice changes that restrict valued practitioners from practicing at the top of their scope by making statutory or administrative changes.

ACCESS TO CARE

The NYS Council requests that any eligible OMH/OASAS clinic should be permitted to become a Demo Clinic as part of the CCBHC Demonstration Program.  In addition, there should be a permanent carve out of CCBHC Demo Clinic services and whatever comes next (if/when the federal demo expires) from Medicaid managed care.

The NYS Council calls on the Administration to carve out behavioral health services from state’s Medicaid Managed Care (MMC) Program.  We currently have a system of care in which third party vendors driven by profit erect barriers to access to care and severely constrict provider ability to serve clients in need by failing to reimburse in a timely manner for services rendered sometimes years ago.  Carving out BH services would yield over $400M/minimum in savings to the state that could be reinvested in OMH and OASAS systems of care to address workforce crisis and rate inadequacy.

CHILDREN AND YOUTH

The NYS Council calls on the Hochul administration to continue its historic track record of implementing groundbreaking policy reforms on behalf of our children and youth (including the soon-to-be-enacted commercial insurance rate mandate) by mandating that all of the OMH and OASAS services available to children/youth and their families in the Medicaid Program are also available to children/youth/families with commercial insurance.

REGULATORY REFORM

The NYS Council requests that the telehealth law must be made permanent to preserve access to care and to address barriers to care (travel costs, time away from work, childcare responsibilities, cultural taboos associated with visiting a community-based clinic for care) that limit so many New Yorkers from receiving the services they need and deserve.

Access to Primary Care/BH Care (Integrated Care)
● Establish adequate rates for physical health services provided in Article 31/32 settings.
● Streamline regulatory process for eligible providers to acquire an Integrated Licensed.
● Simplify and streamline physical plant requirements required of agencies seeking to provide integrated care.

Prompt Payment Statute Reform
● Implement mandatory sanctions on state and MCOs for missing timely payment and related laws/regulations.
● Implementation of commercial rate mandate must include robust state surveillance, monitoring and enforcement.
● Mandatory financial sanctions on MCOs and commercial insurance plans that fail to pay on time and in full.
● Prompt Payment Statute reform.
● Prohibit pre-payment reviews by plans.
● Prohibit retroactive payment reviews and takebacks after 1 year has elapsed.

OMIG Audit Reform
● Legislation has been perfected; providers are still being forced to not appeal due to potential punishment associated with losing appeal. Human beings make mistakes and providers are entitled to correct technical errors, and the state should establish a 50% or more threshold for errors to trigger extrapolation. Protocols are not complete and now cover COVID period.

Regulatory Flexibility
● Regulatory Flexibility: OASAS and OMH intake standards should conform with federal standards which are far less aggressive than NYS requirements.
● OMH Part 551 draft regs – there should be no requirements for providers in good standing to be required to notify state re: census changes and seek approval prior to expanding access to care.

For more information about the NYS Council, please contact Lauri Cole, Executive Director at 518-461-8200 or lauri@nyscouncil.org.