Mental Health Budget Initiatives Overview 2022-2023

NYS OFFICE OF MENTAL HEALTH 2022/2023 ENACTED BUDGET OVERVIEW Office of Financial Management June 12, 2025

2 2022/23 OMH Enacted Budget Initiatives: 5.4% Cost of Living Adjustment (+$93.7M) and Minimum Wage ($5.4M): The Budget includes resources to fund the 5.4% Cost of Living Adjustment (COLA) for community mental health providers licensed, designated and/or funded by OMH; and the statutory minimum wage increases. Healthcare and Mental Hygiene Worker Retention Bonus ($38.7M): The Budget includes Article VII legislation authorizing Healthcare and Mental Hygiene Worker retention bonuses with up to $3,000. New Safe Options Support (SOS) teams for Homeless ($11.3M): The Budget includes $11.3M in 2022-23 and $21.5M full annual to develop 20 new SOS teams to reach thousands of homeless individuals using evidenced based Critical-Time-Intervention (CTI) model.

3 2022/23 OMH Enacted Budget Initiatives (cont.): New Investments to Expand and Strengthen Children s Services ($53M) - Expand school based mental health services in schools and other evidenced based mental health supports for students and school staff ($10M). - Expand HealthySteps for integration of mental health services into primary care settings ($10M). - Expand Home Based Crisis Intervention (HCBI) programs for children which provide short- term, intensive, in-home crisis intervention services to a family in crisis ($7.5M in 2022-23, $10M Full Annual) - Expand the Trauma-Informed Network to recognize and address the range of experiences that may be trauma-inducing for young children and their families ($10M). - Funds to increase rates for Residential Treatment Facilities (RTFs) to improve quality and strengthen/preserve capacity for the highest need children ($7.5M). - Funds for implementation of evidence-based treatments to improve access for children and families ($8M).

4 2022/23 Enacted Budget Initiatives (cont.): Residential Investments ($65M in 2022-23; $104M Full Annual): The Budget includes resources to support a two-year plan for investments to strengthen and preserve OMH Supported Housing, Single Room Occupancy and Community Residential programs. The plan is supported by Article VII legislation to authorize the property pass through of reasonable cost increases pursuant to MHL 41.38 for unlicensed housing. Supported Housing Reinvestment ($15M): The final Budget includes $15M for full reinvestment of resources for additional stipend increases for Supported Housing programs choosing to voluntarily participate in the implementation of Rehabilitative and Tenancy Supports.

5 2022/23 Enacted Budget Initiatives (cont.): Dwyer Veteran Peer Support Program ($7.7M): The Budget includes funding for the PFC Joseph P. Dwyer Veteran Peer Support Program to support statewide implementation of peer-to-peer mental health supports to veterans in New York. Mental Health Wellness Community Workforce Pilot ($2.5M): New resources to pilot a Mental Health Wellness program to equip a community corps of lay personnel trained in mental health care to engage communities with limited access to mental health care. Expand Psychiatric Rehabilitation Services and Enhance the New York Employment Services System (NYESS) ($2.5M): New resources to expand psychiatric rehabilitation services and enhance NYESS, a unique interagency partnership between OMH and DOL that exists to support the employment services system in its entirety to improve employment opportunities and supports for New Yorkers

6 2022/23 Enacted Budget Initiatives (cont.): 988 Implementation ($35M in 2022-23; $60M Full Annual): Resources for the expansion of call centers for 988 implementation starting July 1, 2022. These funds will increase call center capacity and expand functionality to include 24/7 call, text and chat capacity across the state and support linkages to New York s community-based crisis system including mobile crisis services, crisis stabilization and crisis residential programs. New Community Beds ($36.2M): The Budget includes support for ongoing community bed development including resources for 1,691 new beds coming on- line in 2022-23. Community Mental Health Reinvestment ($22M): The Budget annualizes $22M for reinvestment for the further expansion of community-based programs.

7 2022/23 Enacted Budget Initiatives (cont.): Investments to Improve Access to Psychiatric Care ($49M): The Budget also includes State investments announced by Governor Hochul on February 18, 2022 including: - $27.5M/$55M Gross to increase rates for inpatient psychiatric care; - $9M to recruit psychiatrists and psychiatric nurse practitioners; and - $12.5M for 500 additional supportive housing beds to house people experiencing homelessness in their communities (Note: Supported Housing bed are budgeted centrally in ESSHI).

8 2022/23 Enacted Budget Initiatives (continued): OMH Managed Care Reinvestment Savings for Recoupment of MLR and BHET - The Budget includes appropriations for the full reinvestment of $111M in State recoveries; OMH ($74M State share/$148M Gross) and OASAS ($37M State/$74M Gross). - Full reinvestment of Managed Care savings recovered from Managed Care plans pursuant to underspending of the Medical Loss Ratio (MLR) and Behavioral Health Expenditure Target (BHET) for two fiscal years. - Article VII clarifies the process and requires DOH and OMH to post information pursuant to the MLR and BHET.

9 Article Vll Legislation: Temporary Operator: Extends for three years, through March 31, 2025, the existing authorization for the Commissioners of OMH and OPWDD to appoint a temporary operator of a certified provider in certain extraordinary but time limited circumstances. DSRIP Waiver: Extends the authority through April 1, 2024 to waive licensure requirements to allow integrated programs established under DRSIP to continue operating. Extension of Government Rates: Extends the statutory requirements that managed care plans use government rates to reimburse outpatient behavioral health services through March 31, 2027 and clarify that this applies to the rates for newly licensed Article 36 crisis programs.

10 Article 31 Community Program Rate Increases Office of Financial Management June 12, 2025

11 5.4% Cost of Living Adjustment (COLA) Article VII Bills- Health and Mental Hygiene (HMH) (S8007- C/A9007-C) Eligible programs and services: OMH, OASAS and OPWDD community programs Certain other human services programs funded, licensed, or certified by DOH, OTDA, OCFS, and SOFA Effective on April 1, 2022

12 Rate Increases Mental Health Outpatient Treatment and Rehabilitative Services American Rescue Plan Act (ARPA) - time limited o Workforce Recruitment and Retention: 11.5% (eff. 2/1/22 - 9/30/22) o HCBS: 5.0% (eff. 2/1/22 - 3/31/23) Ongoing program investment: 5.0% (eff. 2/1/22) Cost of Living Adjustment: 5.4% (eff. 4/1/22)

13 Rate Increases Personalized Recovery Oriented Services (PROS) American Rescue Plan Act (ARPA) - time limited o Workforce Recruitment and Retention: 13.1% (eff. 10/14/21 - 3/31/22) o HCBS: 22.3% (eff. 10/14/21 - 3/31/22) Ongoing program investment: 10.3% (eff. 4/1/22) Cost of Living Adjustment: 5.4% (eff. 4/1/22)

14 Rate Increases Assertive Community Treatment (ACT) American Rescue Plan Act (ARPA) - time limited o Workforce Recruitment and Retention: 8.5% (eff. 10/7/21 - 3/31/22) o HCBS: 10.4% (eff. 10/14/21 - 3/31/22) Ongoing program investment: 5.0% (eff. 4/1/22) Cost of Living Adjustment: 5.4% (eff. 4/1/22)

15 Rate Increases Community Residence American Rescue Plan Act (ARPA) - time limited o Workforce Recruitment and Retention: 20.0% (eff. 10/1/21 - 3/31/22) o HCBS: 9.6% (eff. 10/14/21 - 3/31/22) Ongoing program investment 4.8% minimum increase (eff. 4/1/22) o Cost of Living Adjustment - permanent o 5.4% (eff. 4/1/22)

16 Rate Increases Day Treatment, Continuing Day Treatment and Partial Hospitalization Services Cost of Living Adjustment: 5.4% (eff. 4/1/22) Ongoing program investment permanent o 5% increase (eff. 7/1/22)

17 OMH Medicaid Reimbursement Rates All current OMH Medicaid rates and fee schedules are posted on-line: https://omh.ny.gov/omhweb/medicaid_reimbursement/

18 OMH Article 28 Rate Increases & Investments Office of Financial Management June 12, 2025

19 Rate Increases - Medicaid FFS Inpatient Psychiatric July 1, 2018 (SPA 18-59) Children s inpatient rates increased 25% adjustment factor from 1.0872 to 1.3597 October 1, 2018 (SPA 18-66) @ 5.22% base rate $676.21 August 1, 2021 (SPA 21-18) @ 9.86% base rate $742.68 January 1, 2022 (SPA 22-05) Expanded rural definition April 1, 2022 (SPA 22-47) @ 27.94% proposed $950.43 Restore 1.5% Budget cut from prior year Across the Board increase of Medicaid rates by 1%

20 Comprehensive Psychiatric Emergency Program (CPEP) Rate Increases CPEP Rate Increases (New rates for Triage and Referral Visits, Full Emergency Visits and Extended Observation Beds) planned for 7/1/2022 effective date FPN increase statewide CPEP Medicaid spending by $20M More details with revised fees to come in shortly with State Plan submission State Aid for CPEP Mobile Crisis Start-Up and Expansion $500K annual for two years; July 1, 2022 through June 30, 2024. Support for start-up, adding Peers and expansion of mobile crisis. Future reinvestment of 3-year eFMAP @ 85% for mobile crisis.

21 $9M Investment Recruitment and Retention of Psychiatrists and Psychiatric Nurse Practitioners OMH is developing a loan repayment program for Psychiatrists and Nurse Practitioners to assist with recruitment and retention in Article 28 inpatient, CPEP and community settings (ACT, Clinic, etc.) OMH also considering investment in Technical Assistance for providers accessing funds to assist in loan forgiveness. This investment will be made annually.

22 Questions? Office of Financial Management June 12, 2025