2000 SESSION REPORT ASSEMBLY COMMITTEE ON

MENTALHEALTH

MENTAL RETARDATION AND DEVELOPMENTAL DISABILITIES

Sheldon Silver, Assembly Speaker Martin A. Luster, Committee Chair January 2001

THE ASSEMBLY STATE OF NEW YORK ALBANY JAMES F. BRENNAN During the 2000 Legislative Session, the Assembly Majority advanced a comprehensive plan to improve services for persons with mental disabilities. Much remains to be done, however, and the Committeewill surely be working with the Senate and the Executive during the 2001 legislative session to address the needs of New York’s mental hygiene system. I am proud of the accomplishments made by the Committee during my 6-year tenure as Chairman, and would like to thank the many members of the mental health and mental retardation communities whom I have had the pleasure of working with over the years, and who have done so much to support and advance the goals of the Committee. Yours truly, James F. Brennan Member of Assembly

New Chairman Appointed In the opening days of the 2001 Legislative Session, Assemblyman Martin Luster was named the new chair of the Assembly Committee on Mental Health, Mental Retardation and Developmental Disabilities. First elected to represent the 125th Assembly District in 1988, Assemblyman Luster has previously chaired the committees on Libraries and Education Technology and Real Property Taxation, as well as the Legislative Commission on Government Administration. During his tenure as a Legislator, Assemblyman Luster has had 142 bills signed into law. They include the Rural Education Research Act, which focuses attention on the needs of students in rural schools and the Tech-Prep Bill, which establishes programs of worker preparation for youth at risk. Mr. Luster’s Practitioner Placement Law is intended to encourage primary care physicians to establish practices in under-served areas.

Assembly Advances Key Legislation in 2000

Priorities for 2001: Work and Wellness, Presumptive Eligibility, Insurance Parity

Work and Wellness Act

In June of this year, the Assembly Majority passed The Work and Wellness Act of 2000 to enable persons with disabilities to buy into the Medicaid program by paying premiums on a sliding scale based on income.

People earning less than $26,000 would pay nothing and still retain their Medicaid benefits. People earning $30,000 would pay $275, and those earning more than $30,000 would pay between $275 and approximately $5,500 depending on their income.

This important measure would benefit both people with disabilities and New York State as a whole, allowing individuals to pursue work opportunities in the community while ensuring that their special health care needs are covered by comprehensive insurance.

Currently, many people with disabilities are discouraged from seeking employment by the knowledge that an increased income would make them ineligible for Medicaid, and that the insurance products available commercially do not cover the exceptional health care needs of individuals with severe disabilities.

The Work and Wellness Act of 2000 takes advantage of the option created by the federal Ticket to Work and Work Incentives Improvement Act of 1999 to receive federal financial participation in the costs associated with an expansion of Medicaid coverage for severely disabled workers.

New York lost the opportunity this year to be the first state to take advantage of the new federal legislation when the Senate and the Executive did not follow the Assembly’s lead by supporting The Work and Wellness Act. However, the Assembly Majority plans to make this important initiative a top priority for passage this year.

Presumptive Medicaid Eligibility

Continuity of care is a key element in the effective treatment of mental illness. Unfortunately, mentally ill individuals returning to the community from stays in hospitals, jails and prisons are often denied immediate care if they do not have Medicaid coverage.

Because it takes between 45 and 90 days for the Department of Social Services to determine Medicaid eligibility according to State Social Services law, many individuals in this position must wait at least a month and a half to begin receiving the benefits they desperately need –– instead of receiving continuous care as a means of easing their transition back into the community. In other cases, an individual is simply unable to access services.

Presumptive Medicaid Eligibility would eliminate the waiting period that occurs while Medicaid eligibility is verified, and replace it with a 90-day assumed eligibility period. The cost would be funded in part by Federal subsidies, and Medicaid will reimburse the state for sevices up to three-and-a-half months prior to the date of application.

This measure did not receive the support of the Senate and the Executive in 2000. However, it will continue to be a priority for the Assembly Committee on Mental Health during 2001.

Mental Health Insurance Parity

For the fourth consecutive year, the Assembly Majority has passed a Mental Health Insurance Parity bill (A.6235) that would require insurance companies to provide the same level of coverage for the diagnosis and treatment of mental illness that they routinely provide for physical health needs.

Unfortunately, Mental Health Insurance Parity –– like The Work and Wellness Act and Presumptive Medicaid Eligibility –– was stymied by a lack of support in the Senate and the Executive’s office.

This measure is an essential component of the Assembly Majority’s efforts to ensure that mentally ill New Yorkers receive the treatment they need. Existing laws do nothing to curb insurance companies that discriminate against individuals with mental illness by placing limits on the number of days or visits permitted for diagnosis and treatment, and charging mentally ill individuals higher deductibles or co-payments.

Thirty-two states now mandate some form of mental health insurance parity. The Assembly Majority is committed to ensuring that in 2001, New York will join those states and make insurance parity a reality for those suffering from mental illness.

Other Committee Initiatives...

Signed into Law

Article 15 Amendment
(Chapter 78 Laws of 2000) Provides that any references in article 15 to mentally retarded persons shall be deemed to apply to persons who are developmentally disabled, as well; thus ensuring that developmentally disabled individuals have access to mental hygiene facilities. This measure addresses an oversight in the original law.

Comprehensive Psychiatric Emergency Program (CPEP)
(Chapter 93 Laws of 2000) Extends the Comprehensive Psychiatric Emergency Program for four years, to integrate hospital-based psychiatric services with local mental health and social services, providing comprehensive local systems of emergency care.

Surrogate Decision Making Program
(Chapter 94 Laws of 2000) Extends for five years the operation of the Surrogate Decision Making Program, which makes necessary major medical treatment available to residents of OMH or OMRDD facilities who lack the capacity to provide informed consent for such treatment.

Passed Assembly

Several important initiatives passed the State Assembly but were not enacted by the State Senate:

Children’s Bill of Rights
(A.1809-B) Establishes a bill of rights for children in residential care, setting up a clear and consistent set of principles to guide the care and treatment of all children placed in out-of-home settings.

Legal Services
(A.8430) Expands the authority of the Mental Hygiene Legal Service (MHLS), making it available to mentally disabled individuals in matters pertaining to their care and treatment, even if they do reside in a traditional facility.

Waiting Lists for Services
(A.3222-A) Requires the commissioners of Mental Health and the Office of Mental Retardation and Developmental Disabilities to prepare reports regarding waiting lists for services, allowing voluntary agencies and the Legislature to determine how best to establish or expand services for individuals with mental illness or developmental disabilities.

Children’s Coordinated Services Initiative (CCSI)
(A.4391-B) Directs localities to create a procedure to examine the needs of seriously emotionally disturbed children who are at risk of residential placements.

Special Needs Plans (SNPs)
(A.11213-A) Provides for the appointment of independent actuaries to review the reimbursement rates proposed by the OMH for mental health SNPs, and extends authorization for one year.

Files Sealed
(A.7407-B) Supports the right of former outpatients of mental health care facilities to have files removed after ten years.

Sign Language Interpreters
(A.9701-A) Requires psychiatric centers to provide deaf or hearing-impaired patients with a sign language interpreter.

Medicaid Neutrality Cap
(A.9536-A) Prohibits the Commissioner of Mental Health from basing the licensing or expansion of services on availability of State Medicaid funds.

Asset Sales
(A.5949) Requires that, upon the sale of Mental Hygiene assets (i.e. inpatient psychiatric or developmental centers), any money left over after paying off state bonds on the sold property be appropriated for capital projects and annual debt service savings for community-based mental hygiene programs.

2000-01 Budget Highlights...

The following appropriations for the Office of Mental Health were included in the final 2000-01 State budget:

$7.6 million to complete restoration of the County Shared Staffing Program with a full 215 positions funded;

$6.8 million for a one-and-a-half percent Cost of Living Adjustment for not-for-profit providers of non-residential mental health services;

$2.85 million for children’s community-based treatment services, including but not limited to: clinic services, crisis services, suicide prevention, and school-based mental health services;

$2.5 million for an added payment to certain freestanding mental health providers of outpatient services;

$1.3 million for adult mental health rehabilitation and peer services, including but not limited to club houses, peer support and crisis services;

$850,000 for a total of 12 positions at the two mental health research facilities –– eight positions at the Nathan Kline Institute and four positions at the New York Psychiatric Institute, and;

$775,000 for various community mental health organizations.

The following appropriations were made for the Office of Mental Retardation and Developmental Disabilities:

$53.5 million for the New York State CARES initiative;

$1.73 million for various community organizations providing services to mentally retarded and developmentally disabled consumers, and;

a 5% COLA for providers which was included in the Executive’s budget proposal was approved.

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