2003 Yellow Book | |||||
Backward | Forward | Cover | Overview | Agency Summaries | Agency Details |
Office of Mental Health (Summary) View Details |
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Adjusted Appropriation 2002-03 |
Executive Request 2003-04 |
Change |
Percent Change |
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AGENCY SUMMARY | |||||
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General Fund | 1,378,879,500 | 1,235,774,000 | (143,105,500) | -10.4% | |
Special Revenue-Federal | 39,493,000 | 41,401,000 | 1,908,000 | 4.8% | |
Special Revenue-Other | 559,982,000 | 670,516,000 | 110,534,000 | 19.7% | |
Capital Projects Fund | 37,700,000 | 42,000,000 | 4,300,000 | 11.4% | |
Mental Hygiene Capital Improvement | |||||
Fund-389 | 125,180,000 | 173,482,000 | 48,302,000 | 38.6% | |
Fiduciary | 570,000 | 570,000 | 0 | 0.0% | |
Enterprise | 8,277,000 | 8,284,000 | 7,000 | 0.1% | |
Internal Service Fund | 2,292,000 | 2,304,000 | 12,000 | 0.5% | |
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Total for AGENCY SUMMARY: | 2,152,373,500 | 2,174,331,000 | 21,957,500 | 1.0% |
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ALL FUNDS PERSONNEL BUDGETED FILL LEVELS |
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Fund |
Current 2002-03 |
Requested 2003-04 |
Change |
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General Fund: | 16,787 | 15,837 | (950) |
All Other Funds: | 523 | 523 | 0 |
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TOTAL: | 17,310 | 16,360 | (950) |
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Budget Highlights |
The Office of Mental Health (OMH) administers an extensive statewide mental health network, including community based mental health services, 17 State-operated psychiatric centers for adults, six State-operated psychiatric centers for children, three forensic psychiatric centers and two research institutes. The State-operated inpatient mental health system serves approximately 7,600 persons annually. Outpatient services are provided to an additional 37,000 patients each year. In addition to serving outpatients, OMH provides other community-based services, including community residences, residential care centers for adults and children, intensive and supportive case management, and supportive employment. There are more than 2,500 not-for-profit, municipal and proprietary mental health service providers in the community, meeting the needs of over 500,000 persons annually. All community-based providers are licensed by OMH. The Executive is requesting funding to support a workforce of 16,360 Full-Time-Equivalent (FTE) in State Fiscal Year (SFY) 2003-04, a decrease of 950 positions from SFY 2002-03 levels. The Executive proposes downsizing the State operated system by eliminating 90 beds, closing four adult psychiatric centers (PC) and one children's PC and consolidating the two mental health research institutes. Three PC's are proposed for closure in SFY 2003-04, Elmira PC, Hutchings PC, and Mohawk Valley PC. Patients at these facilities would be transferred to other State facilities as follows: from Elmira PC to Rochester PC, from Hutchings PC to Mohawk Valley PC, and from Middletown PC to Rockland PC. The closures would be effective July 1, 2003. The three facilities currently employ 1,323 FTE staff. Of those, 361 would remain at the facility to continue providing outpatient services, 619 staff would transfer to the facilities receiving the relocated patients, and 343 positions would be eliminated. The closure of both Bronx adult and childrens psychiatric centers would be accomplished by July 1, 2005. The Executive also proposes to abolish the Nathan Kline Institute, which is located on the grounds of the Rockland PC, effective April 1, 2003, and to consolidate its functions with the New York Psychiatric Institute in Manhattan. As a result of the closure, 113 FTE positions would be eliminated. The landmark Community Mental Health Reinvestment Act expired on September 30, 2001. A legislative proposal to create a new Reinvestment program to use bed-closure savings to strengthen base funding for voluntary agencies was vetoed by the Governor on December 20, 2002. The Governor's budget proposal for SFY 2003-04 includes Article VII legislation for a new Community Mental Health Support and Workforce Reinvestment Program to reinvest savings from State system downsizing into the community. However, the Executive proposes to delay the effective date of this legislation to April 1, 2004 and to utilize savings derived from bed and facility closures in SFY 2003-04 to fund the annualized cost of the Medicaid fee increases and cost of living adjustment (COLA) enacted in 2002. For many years, certain State employees from State-operated psychiatric centers were out-stationed at community based programs through the Shared Staffing Program and Community Reinvestment Program in order to provide some relief to local governments for the impact of deinstitutionalization on local services. The Executive believes that newer mental health initiatives make it no longer necessary for State staff to remain at local agencies, thereby allowing these positions to be returned to the psychiatric centers where they originated. The Executive proposes compensating local agencies for the loss of the State funded positions through an increase in their rates of reimbursement, thus providing the agency with the resources to hire replacement staff. The State employee would have the option of returning to the psychiatric center or staying with the local agency as its employee. A total of 315 FTE positions would be affected. The Executive proposes a new bed development initiative that would add 2,000 beds to the already existing pipeline over the next six years. In Phase I, a $65 million State appropriation would leverage another $52 million in local matching funds to pay for construction of 1,000 beds. The Adult Care Facilities Workgroup, formed as a response to revelations about the inadequate and dangerous conditions existing at certain Adult Homes housing persons with mental illness, made recommendations for change in its recent report. The Executive has proposed that OMH, the Commission on Quality of Care for the Mentally Disabled (CQC), and the State Office for the Aging (SOFA), together with the Department of Health (DOH) as the lead agency because of its role as regulator of the Adult Homes, work cooperatively to implement the Workgroup's recommendations. The Office of Mental Health would be involved in oversight of the client assessment process, medication management and coordination of mental health services and other rehabilitation services. This agency is found in the Health and Mental Hygiene appropriation bill. State Operations The Executive recommends All Funds State Operations appropriations of $1,114,126,000, a net decrease of $51,317,500 or 4.4 percent. The decrease is primarily the result of various cost-saving measures detailed below, offset by an increase in certain Special Revenue and Federal Funds. The General Fund decreases by $161,885,000 as programmatic cost savings are combined with an increase in Special Revenue Other offset funds of $95,403,000 from the Patient Income Account (PIA). The decrease in State Operations funding is the net result of the following actions:
Aid To Localities The Executive proposes an All Funds appropriation of $844,723,000, a net increase of $20,673,000, or 2.51 percent. The change results from the following actions:
Capital Projects The Executive requests All Funds appropriations of $215,482,000, a net increase of $52,602,000 or 32.29 percent. The primary source of the increase is a request for $65,000,000 to fund Phase I of a new community bed development program. Localities would be required to provide matching funds for up to 80 percent of the appropriation. While the ultimate goal is to add 2,000 beds, Phase I would provide for 1,000 beds. The increase in funding for community-based beds is offset by a decrease in support for capital projects at State-operated facilities. Article VII The Executive proposes to:
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