Despite initial reports of a January 29 release, the Governors 2020 Executive Budget Proposal, also known as his “Social Justice Agenda” was released on Tuesday, January 15 in a State of the State / Budget Presentation in front of members of the Legislature and various stakeholders.
The $175 billion proposal includes a 3.6 percent increase in spending on both healthcare and education, and a $1.8 billion middle class tax cut, but cuts certain aid to municipalities.
While a number of promises were indeed kept, such as full reimbursement to counties for the implementation of Raise the Age, a number of big-ticket items new members were hoping to see such as rent regulations and universal healthcare were not funded. In addition, dollars to localities to support early voting were absent as well.
Mental Health – While overall spending on mental health increased by 2.4 percent, some advocates are crying foul, given his one-year deferment of a 2.9 cost of living boost for Direct Support Professionals, a parallel measure to the Social Work Investment Initiative.
Mental Health proposals do include:
A $10 million increase in existing and new housing capacity,
A $10 million increase for peer support services to engage high need individuals,
$100 million to replace the 100-year-old Mid-Hudson Forensic Psychiatric Center
$850,000 to assist up to two county jails in making infrastructure improvements to provide mental health services to inmates in jail awaiting trial,
$60 million to maintain and preserve community-based residential facilities that allow people with mental illness to live in the most integrated settings possible, and
Re-Appropriation of $150,000 to both NASW-NYS and the New York State Psychiatric Association for the Veteran’s Mental Health Training Institute.
MH/SUD Parity – Executive budget includes a comprehensive set of behavioral health insurance parity reforms aimed at aligning and codifying the standards protections provided under and federal and state MH/SUD parity laws, which would be supported by a $1.07 million appropriation to the Department of Financial Services and $1.05 million to the Department of Health to allow for enhanced monitoring and enforcement We are reviewing the language of the proposal (68 pages) any potential impact of the continuous reference to standards that are at “minimum and consistent” with the federal parity law. Among the reforms included:
Prohibits preauthorization and concurrent utilization review of SUD services during the initial 21 days of treatment (This would be an expansion from current law, which prohibits preauthorization and concurrent utilization review of SUD services during the first fourteen days).
Prohibits preauthorization and concurrent utilization review of inpatient mental health services for youth (18 years of age and under) during the first fourteen days.
Requires mental health utilization review staff to have appropriate expertise.
Prohibits insurers and health plans from retaliating against providers who file reports regarding violations of the insurance law with State agencies (Department of Financial Services, Department of Health).
Requires insurers and health plans to post additional information regarding their in-network providers of MH/SUD, including whether provider is accepting new patients and affiliations with participating facilities certified or authorized by OMH or OASAS.
Children’s Behavioral Health Services - The Executive proposal allocates $10.5 million in state Medicaid dollars for provider reimbursement for the transition of the children’s behavioral health programs to Medicaid Managed Care. Family Peer Support Services will come online in July, while Youth Peer Services, and Crisis Intervention will be implemented in January of 2020.
Medicaid Services for Children with Autism - The Executive Budget provides for an expansion of Medicaid dollars to cover applied behavioral health analysis to treat 4,000 children with autism.
Substance Use Disorder – The Executive proposal calls for an additional $26 million increase (4.1 percent) in operating and capital support for OASAS to “enhance prevention, treatment and recovery programs targeted toward chemical dependency, residential service opportunities, and public awareness and education activities” and $200 million to “fight the scourge of the opioid crisis” but again, some advocates suggest funding doesn’t go far enough to combat the 200 percent increase in fatal opioid related overdoses in less than a decade.
OASAS proposal does include:
200 bed increase for residential treatment beds,
1200 new opioid treatment beds,
$3.75 million in funding to support ongoing medication-assisted treatment (MAT) in local jails and leverages federal funds to expand MAT to three additional DOCCS facilities,
Appropriates $1.5 million to make the Substance Use Disorder and Mental Health Ombudsman program permanent, a joint OASAS and OMH program that assists families in their navigation of the behavioral health system.
Developmental Disabilities - The Executive budget proposal includes a 2.7 percent increase in funding to support:
Increasing community housing supports,
Expanding access to individual subsidies for independent living opportunities,
Increasing day programming and employment opportunities,
Increasing access to respite services, and
$15 million in capital funding to expand independent living opportunities.
Public Protection - While there was no growth in the public protection spending the Executive’s proposal is policy heavy, including measures to:
Enact the Child Victims Act, a measure seeking to increase the amount of time victims of abuse can hold perpetrators responsible for a crime,
Invest $13 million in programs to engage at risk youth and deter gang recruitment,
End cash bail,
Reform the discovery process (requiring prosecutors and defense to share evidence throughout the litigation process,
Create mechanisms to ensure speedy trial,
Remove barriers to re-entry (such as removing suspension bans on drivers’ licenses,
Create opportunities for compassionate release,
Decrease the number of consecutive days an inmate may be remanded to solitary confinement cell,
Establish the Domestic Violence Survivors Justice Act (allowing judges sentencing discretion for survivors of domestic violence whose abuse is determined to be a significant contributing factor),
Legalize recreational use of cannabis and establish Office of Cannabis Management to centralize licensing enforcement and economic development related to its legalization
Includes a “restorative justice initiative” to correct past harms to individuals and communities disproportionately impacted by the “war on drugs’’ by reviewing and sealing cannabis convictions, eliminating collateral consequences such as parole violations, crafting and rolling out a public education campaign.
Human Services - A slight reduction in spending but policy heavy section of the Executive proposal is in Human Services and includes initiatives such as:
Enacting the Women’s Justice Agenda
Constitutional amendment to protect against discrimination on the “basis of sex” (Editorial note: Should be named after RBG),
Provide equal pay for equal work, and
Enact workplace breast feeding rights
Two measures the legislature beat the Governor to: banning conversion therapy and enacting the Gender Non-Discrimination Act. Each were passed by both houses the morning of the budget release.
Expansion of Kinship and Foster Care Capacity, vis a vis, a Transition Fund to help counties move away from congregate care and toward familial placements,
Reformation of PINS (persons in need of supervision) program through the advancement of legislation that prohibits the detention and placement of most youth who are alleged to be PINS, and
Reformation of Residential Domestic Violence Shelter Requirements (eliminating requirements that domestic violence victims must apply for Public Assistance in order to access to vital emergency services).
Higher Education- The Executive’s Higher Education proposal increases spending by $143 million and primarily focuses expanding access to higher education through:
Enacting the DREAM Act (recently renamed the Senator Jose Peralta DREAM Act), which allows undocumented students to access the Excelsior Scholarship, TAP and other state administered scholarships ($27 million price tag),
Increasing the Excelsior Scholarship annual family income threshold to $125,000,
Enacting regulations to protect student loan borrowers,
Maintains full funding (1.78 million) for Social Work Student Loan Forgiveness Program
Health Care - A 3.6 percent increase in spending to support initiatives such as:
“Enshrining components of the Affordable Care Act” such as pre-existing conditions and requiring products sold in New York State to continue to include the ten essential healthcare benefits provided for in the federal mandate,
Creation of a Commission to be supported by the Department of Health and Department of Financial Services to “develop options for achieving universal access to care.” The report is due to the Governor on December 1, 2019,
Codification of Roe vs. Wade,
Conducting a Safe Staffing Study to analyze how staffing enhancements and other initiatives can be used to improve patient safety while simultaneously, examining the potential fiscal impacts such regulations could impose,
Providing for comprehensive access to contraception, including emergency contraception.
The Executive proposal includes $400,000 re-appropriation or services and expenses of Youth Build programs located in New York,
Executive proposal includes a comprehensive update to the Workers Compensation Program; adding a number of professions as providers such as Licensed Clinical Social Workers, Nurse Practitioners, Physician Assistants and Acupuncturists.
The Executive proposal includes an initiative to expand criminal penalties for wage theft and proposes amending the state’s labor law and establishing an expanded range of violations, for wage theft. In addition, it seeks to grant authority to the State Department of Labor to refer cases for criminal prosecution.
In an effort to engage youth, the Executive proposal includes an initiative to create a Youth Council, consisting of up of 62 young people ( one from each county in the state), between the ages of 13 and 21. The council is meant to operate for two years, meeting at least three times a year, to inform the state government’s policies on education, employment, the environment, civic engagement, and juvenile justice.
Building upon last year’s Apprenticeship program through:
Increasing opportunities for apprenticeships in high-demand fields such as high-tech, health care, clean energy, and advanced manufacturing by 2025.
Doubling the number of women in all apprenticeships by 2025,
Prioritizing the expansion of apprenticeships through the State’s new Office of Workforce Development,
Enhancing collaboration between State agencies, SUNY, CUNY, workforce training providers, and the private sector to increase the number of apprenticeships in New York State.
Expanding the Apprenticeship Council to include additional growth sectors,
Simplifying the registration process of apprenticeship programs in New York State.
The budget re-appropriates 2019 funding for Youth Build Programs throughout the state.
The next phase in the Budget process will commence next week when Joint Sub Committee Hearings begin to hear testimony from stakeholders. A schedule was sent under separate cover. Should you wish to view the specific budget bills, you may do so by logging onto https://www.budget.ny.gov/pubs/archive/fy20/exec/fy20bills.html