NYS Budget Process and Executive Proposal Overview Jeremy Darman Director of Governmental Relations NYS Conference of Local Mental Hygiene Directors, inc. February 8, 2013 DCS Mentoring session – Syracuse, NY

The NYS Budget Process Late Summer: “Call letters” go out to agencies- with Governor’s broad guidelines, priorities 2013 SFY letters ask flat budgets, continuing back-office efficiencies Fall: Agencies send budget requests to Division of Budget, hearings for agency heads. Quick start meetings (not held this past year) Late Fall: Division of Budget begins crafting general budget narrative Winter: DOB, 2nd Floor draw up Executive Budget The NYS budget is the single most important document and process at the state level for LGUs. This is the typical process- only the timing for release of budget is constitutionally mandated.

Budget Process Continued Early January: State of the State Address, first clues for budget come out Late January/Early February: Executive Budget is released. 21-day/30-day amendment period starts Feb-March: Joint Legislature Budget hearings March: “One-house” budget bills released March: Subject-based Conference Committees meet publicly, report to leadership group (“Mothership”) April 1: Begins State Fiscal Year, final budget due. This year, budget session ending a week before April. DOB Website “Citizen’s Guide” to the budget is very helpful

Budget Construction “The Budget” is actually a series of bills Appropriation Bills: Dollar amounts to each agency, by program area. Divided by State Ops/Local Aid Article VII Bills: Bill language to support the appropriations. Looks more like a regular bill. Other: Revenue, deficiency, financial plans Final bills are the multiply amended versions of the Executive Bills (e.g.: S.2606-E/A.3006-E/Chapter 59 is the Health & Mental Hygiene Article VII Bill)

Implementing the Enacted Budget After Budget is passed, CLMHD distributes enacted budget briefing broken down by agency. Budget process returns to agencies for implementation Agencies work directly with LGUs and CLMHD in communicating and implementing health and mental hygiene budget policies and changes to funding

2013-14 SFY Executive Budget Overview $142/136 bn all-funds with/without one-time aid Mental hygiene flat-funded But…additional MRT funds available to mental hygiene: health home, housing High profile items this year: Minimum wage increase Local govt pension contribution stabilization NY SAFE Act funding? Caveat: potential $800m-$1bn hole if DD facility rate and MRT waiver negotiations founder

General Health & Mental Hygiene Items Human Services COLA (1.4%) deferred again Permanent exemption from SW/MHP and corporate practice registry Medicaid Managed Care conforming language OASAS APG equivalency proposed; sunset date for OMH APG equivalency (both to sunset in 2015) Health home plus, and HH infrastructure funds Atypical antipsychotics slight return

General Government Items Pension contribution “smoothing”- setting and locking into a fixed contribution rate Elimination of local reports that are not Required by federal govt Necessary for the protection of health, safety, and welfare Necessary for “critical state purposes” Ethics ban exemption for privatized employees serving same individuals from public/private job

OASAS Items SAFA “fix” amendments State methadone registry to include dosage info Hospital-based detox/withdrawal DRGs eliminated from statutes; DOH to set administratively Temporary operator protocol

OMH Items Closure, consolidation, merger, reduction of OMH psychiatric hospitals 45 day notice to Legislature & website for ward closure/conversion to TPP 75 day notice to Legislature, county CEO, website for closure, merger, consolidation of facility Community reinvestment 41.55 “notwithstood” OMH committing $5 million community MH funds Regional Centers of Excellence, OMH listening tour Mental health incident review panels

OPWDD Items Final closure of Taconic and Finger Lakes DCs, 300 residents returning to communities from January 2013 to April 2014 Staff reductions and conversions 150 staff converting to crisis service teams regionally 2,000 state FTEs reducing over 2 years Managed care enabling legislation: FIDAs, DISCOs, HMO “comprehensive health service plans” WARNING: Ongoing DD IP rate negotiations with CMS may open hole in budget this year

Over to Rob!

Now What??!! Robert York, LCSW, MPA Director of Community Services Warren and Washington Counties February 8, 2013

Jeremy is AWESOME isn’t he??

Jeremy is AWESOME isn’t he?? Use this information locally Effective tool for educating local stakeholders and partners Read it, follow the updated versions, and USE it locally!! How, you say?

Make HAY!!! (or Lemonade!!!)

Haymaker: One who makes hay Haymaker (slang): A powerful punch Calling all Haymakers Haymaker: One who makes hay Haymaker (slang): A powerful punch

Take advantage of this opportunity...

Making Local Hay (or Lemonade!) Stakeholder Education Planning Budgeting Policy Making Advocacy

Education Forward CLMHD documents to appropriate local stakeholders. Use the CLMHD documents to develop your own document to use locally, tailored to specific groups.

Education Consider providing budget analysis documents to: Staff Local Legislative Committee BOS/County Legislature Provider and Peer Community CSB and Subcommittees Other County Department Heads Other local stakeholders

Education: Become a resource! Stakeholders and partners are looking for this information

Planning Once stakeholders are educated, information can be incorporated into your local planning process. Information can be used with other planning partners who may not be regular subcommittee attendees. Areas of concern or mediation can be addressed through the planning process.

Planning The more stakeholders are well educated about current realities/challenges being faced, this brings focus to the planning process and contributes to stakeholder buy-in.

Budgeting Know your departmental budget---what portions/amounts are local tax $? What does this fund, specifically? What portions are state funded? Outside of your departmental budget, what other portions of the county budget may be impacted? Outside of your department, what services/providers in the community may be impacted?

Budgeting Many counties are now doing multi-year budgeting or at least are starting their budget discussions earlier in the year. Develop positive relationships with your Field Office staff at all levels. Dialogue with Field office staff regarding potential impacts to your specific SAL funding authorization.

Budgeting Gather analyses from other sources as well. Statewide trade associations, advocacy groups, the Senate and Assembly all produce budget analysis documents tailored for their constituents. Most of this is easily accessed through web searches. Rely on Conference Staff and their knowledge of potential impacts. Send e-mail inquiries if you have questions.

Budgeting You will get a sense if anything will potentially impact your current year budget, in which case you will have to develop remedial measures and alert appropriate local stakeholders. In terms of preparing next years budget, you now have a good sense of areas that may need attention. If you issue guidance to contract providers, you may incorporate information learned.

Policy Making Local and Statewide Policy can be influenced based on information learned and shared. If Legislators and CSB members are educated early on and are aware of areas of concern, opportunities for policy change are greatly enhanced.

Policy Making Use this information to make your case!

Advocacy Don’t like it?? Then, advocate for change!! If Legislators and CSB members are educated early on and are aware of areas of concern, opportunities for policy change are greatly enhanced.

Advocacy Opportunities exist for coordination of multi-stakeholder advocacy efforts. Engage and empower CSB, Subcommittees, providers, families/peers.

Advocacy Advocate with your Statewide Association. Provide feedback to CLMHD staff. Raise issues of concern/local impact.

So, Now What??!!

Go out there and make some… Hay… Or Lemonade…

Regardless of the metaphor, Make a Difference!!!