1. Reporting Mental Health Records to the NICS Index
Denise Crates, Deputy Director
Office of Program Development and Funding
Good morning, I’m Denise Crates from the NYS Division of Criminal Justice Services.
I’m pleased to share with you the story of New York’s efforts to improve reporting of mental health records to the NICS Index.
I’d like to start by saying New York State views achievement of the objectives of the Brady and the NICS Improvement Act as fundamental in protecting the safety of our citizens.
NCJA National Forum
Mental Health Information in the National Instant Criminal Background Check System (NICS)
August 9, 2016

2. Starting Points for New York State
Establishment of a program for relief from a Federal Mental Health firearm disability determination:
New York State’s three relief programs were approved by the Bureau of Alcohol, Tobacco, Firearms and Explosives on July 31, 2009
These programs enabled by statutory and administrative enactments of the Legislative, Executive and Judicial branches of State government
Starting points…. New York was pretty early to the party in establishing a program for relief from federal firearms disabilities. In fact we established three programs, one for each state agency handling firearm prohibitor records.
One of the first efforts of the NICS Task Force was putting forth the legislative package of bills needed to enact the Relief from Disability program. This was an important first step. Not just because it enabled us to receive NARIP funding, but because it provides citizens with due process. Our objective may be to add records to NICS, but we must also protect the rights of individuals who should not be prohibited from purchasing a gun. We want the right people in the database.
Consequently, we were able to certify to the Attorney General on July 31, 2009.

3. Starting Points for New York State
State estimates of available records information collection – estimate of 339,558
Establishment of a NICS Record Improvement Task Force
Assessment of the completeness and availability of NICS Records
Another requirement of receiving NARIP funding was to provide an estimate of the number of qualifying mental health prohibitor records that existed at state and local hospitals. The NYS Office of Mental Health surveyed state psychiatric hospitals; general hospitals with psychiatric units; and for-profit psychiatric hospitals. The survey estimated the number of electronically available records at 339,558.
NARIP also requires the establishment of a NICS Record Improvement Task Force. New York had an existing Task Force, but with the receipt of NARIP funding the Task Force became a more formal body. The New York State NICS Task Force is comprised of representatives from five state agencies and two branches of government. It operates under the direction of the Division of Criminal Justice Services’ Deputy Commissioner for the Office of Public Safety.
Task Force members used the record estimates to evaluate the availability, completeness and accuracy of NICS related records under each agency’s control.

4. Starting Points for New York State
Identification of reasons for incomplete and/or unavailable records
Development of a NICS record improvement plan
This led to an expansion of the scope of the Task Force’s analysis and the identification of additional areas for improvement.
The Task Force focused on identifying state and local files and systems that contained the data for NICS related events. It evaluated the retention of qualifying records. Determined the best methods of transfer, Noted the accessibility of the data. Next they evaluated possibilities for disclosure, capture and transmission of the data to NICS.
Out of this exercise, plans emerged to address the obstacles limiting the State's ability to provide complete and accurate reporting of NICS records.  
These plans included the design of infrastructures to facilitate the collection of information at local sources such as private hospitals and civil courts. That information would then be communicated to state repositories and then to the NICS Index.

5. Formula for NICS Record Improvement
Federal Dollars
Planning and Oversight
Improved
Data Reporting Infrastructure
Continuous Improvement and Training
Complete NICS Records
New York’s NICS record improvement plan is displayed here as a formula for success:
First, New York has been fortunate to receive a substantial investment of federal dollars under the NARIP. To date we have received five awards totaling $14.3 million, and we hope to be awarded an additional $2.4 million soon.
You add planning and oversight to the federal dollars. This planning and oversight was done by the NICS Task Force. A multi-agency partnership, comprised of five state agencies that all participated, contributed and received grant resources for the project.
Next you add an improved data reporting infrastructure. It was determined the best option for addressing missing mental health records was a centrally managed technology solution that would transmit data from participating agencies to the NICS Index.
Last you add continuous improvement and training. The Task Force recognized monitoring the submission of mental health records and on-going training would be needed over a long period of time.
I will speak in more detail about each of these.

6. Investment of Federal Dollars
NARIP Awards to New York
FY 2009 – $ 937,411
FY 2010 – $ 5,994,588
FY 2011 – $ 3,198,502
FY 2014 – $ 1,254,127
FY 2015 – $ 2,936,045
FY 2016 – $ 2,481,605 (amount of application)
TOTAL = $16,802,278
Through our State's record of progress, ongoing work and detailed plans we were able to demonstrate our commitment to becoming a full partner in NICS. For these reasons, New York has been successful in applying for and winning federal dollars.
We have received five awards totaling $14.3 million to date and are hopeful we will receive another award in 2016.

7. State Partner Agencies / Meet Quarterly
Planning & Oversight
NICS Record Improvement Task Force:
Brings together agencies to achieve a comprehensive approach to entering all eligible records in the NICS Index:
State Partner Agencies / Meet Quarterly
Division of Criminal Justice Services (DCJS), Lead Agency
Office of Court Administration
Office of Mental Health
Department of Health
Office for People with Developmental Disabilities
As you know, a requirement of receiving funding under NARIP is creation of a NICS Task Force.
In New York, the Division of Criminal Justice Services (DCJS) is the lead agency in this five agency effort. The Task Force is comprised of staff from DCJS, the Office of Court Administration, the Office of Mental Health, the Department of Health, and the Office for People with Developmental Disabilities.
DCJS hosts quarterly meetings of the NICS Task Force and representatives of all participating agencies attend either in person or by telephone.
Participating agencies also attend regular status meetings and have frequent conference calls.
This Task Force is an effective group. It focused simultaneously on short and long-term planning. In the short-term, they addressed obvious issues where clear and immediate changes were needed. For example, getting necessary legislation written and signed into law. The long-term work addressed the development of a technology solution to improve the transmission of mental health commitment records from psychiatric hospitals to NICS.

8. Planning & Oversight Challenges
Mental health reporting fell short, due in part to the state’s extensive and complex human services infrastructure
Sixty two percent (62%) of state licensed inpatient psychiatric facilities did not maintain involuntary admission records in an electronic format and no local hospitals submitted such records to any state or national database
No mental health adjudication reporting process was in place
Challenges…obtaining mental health patient records. A complex undertaking in New York. Mental health service providers are both public and private entities, and regulatory oversight is conducted by three different state agencies: the Office of Mental Health, the Department of Health, and the Office for People with Developmental Disabilities.
State and local inpatient mental health systems operate independently and do not formally share patient health information with the state. No method was in place for local hospitals to transmit NICS data to the state other than by secure or through some other labor-intensive solutions.
The Task Force identified the following obstacles to reporting mental health records to the NICS Index: 1) a lack of automation (many records were only available in paper format); 2) data was missing (some data elements were not collected at all); 3) and third, the inability of mental health service providers to determine which records were required to be submitted (they were confused about how state and federal laws intersected).

9. Improved Data Reporting Infrastructure
Strategy
Create a centrally managed technology solution that will transmit mental health data from participating agencies to the NICS Index
The Task Force clearly saw the data gathering and reporting technology infrastructure needed improvement.
Based on this realization, a strategy emerged – DCJS would collect and report all mental health disqualifying entries to NICS.
The creation a centrally managed technology solution provided a number of benefits.
Central management imposes quality control and eliminates the extensive time required by manual entry. The result was an increase in the number of records available to be transferred. We also saw a related improvement in the quality of records.

10. Improved Data Reporting Infrastructure
Obstacle - Lack of Automation
Solution “There’s a app for that” - enable mental health service providers to capture the data required by NICS and provide it to the state Office of Mental Health (OMH) who would in turn provide the data to the Division of Criminal Justice Services for submission to the NICS Index.
To address the lack of automation, the Office of Mental Health, the Department Health, and DCJS worked together to build an automated solution so that local inpatient mental health providers could forward a data file or single NICS entry to OMH. OMH in turn would securely transmit this data to DCJS.
Considerable time was spent mapping out the business process and structure of NICS-related information which was useful as a tool in identifying reporting gaps and barriers.
The infrastructure, software and processes to make these records immediately and automatically retrievable was all built with support from the NARIP grant.

11. Data Reporting Structure
Here is the reporting structure.
The build of the system occurred over several grant cycles.
The FY 2009 NARIP funds supported development of direct interfaces between DCJS and agencies with mental health records; and between DCJS and NICS. These interfaces made it possible to provide immediate updating of mental health record submissions to NICS.
The FY 2010 grant was used to expand the interfaces to include submissions from the Office of Persons With Developmental Disabilities (OPWDD).
So, a total of three distinct electronic processes and software were developed to permit hospitals to submit NICS records to OMH.
Local mental health providers (that is private and local public hospitals) transmit NICS records to the Department of Health (DOH) who in turn transmit the files to OMH. The Office of Mental Health reports to DCJS who submits the records for inclusion in the national NICS database.

12. Continuous Improvement & Training
Obstacle – No clear idea of what records need to be reported
Solution
Clarifying statutes were passed
Practitioner training conducted
Feedback loop established
Another obstacle addressed was the inability of mental health service providers to determine which records need to be submitted.
Legal clarification helped reduce duplicate and missing entries. While New York State had no existing laws that would affect the availability of mental health records for transmission to NICS, state law was specifically amended to permit disclosure of relevant mental health records for the purpose of submission to NICS.
Training really helped improve the completeness of records being made available. Mental health practitioners received training on the types of records that must be reported and what qualifies as a prohibiting mental health event.
The NICS Improvement Plan recognized that on-going monitoring was needed to ensure records were complete and accurate. To that end, a feedback loop was designed. A set of errors and exceptions reports were developed to provide feedback to reporting agencies.

13. Results
In excess of 228,150 historical mental health records have been submitted
State operated psychiatric facilities submit an estimated 4,489 mental health records per year
Public and private hospitals (133 in total) have submitted in excess of 180,000 mental health records
On June 5, 2012, DCJS implemented the NICS Transmission System and here are the results:
In excess of 228,000 historical mental health records have been submitted
About 4,400 mental health records per year are submitted from state operated psychiatric facilities
in excess of 180,000 mental health records have been submitted by public and private hospitals

14. Results
The NYS Office of Court Administration has submitted in excess of 35,000 historical Civil Guardianships
Approximately 290 new Civil Guardianships and 105 modified Civil Guardianships are reported per month
OPWDD submits approximately 2.5 mental health records per month
the courts have reported over 35,000 historical Civil Guardianships to NICS and approximately 290 new guardianships are reported per month
OPWDD is a very small contributor, submitting approximately two and a half records per month

15. Summary Success comes from: Continued availability of federal funds
An engaged and active task force
Centrally managed technology solution
Continuous improvement through use of management reports and on-going training
New York is committed to continually improving the records we maintain and contribute to the NICS database. More importantly though, we are committed to protecting the safety of our citizens and the rights of individuals lawfully purchasing a weapon. Success in achieving complete and accurate records has resulted from:
The continued availability of federal dollars.
Our NICS Task Force has been a very effective body. Staff of Task Force member agencies have been very engaged and dedicated. Task Force meetings emphasize the importance of interagency communication and knowledge transfer. In addition, the Task Force has acted as an important resource for policymakers. Much of reason the Certificate of Relief from Disabilities program got off to a quick start was because this group advanced it to the Governor and the Legislature as a priority.
A centrally-managed process that automates record transfer works well where mental health records are not centrally maintained. This strategy will work for states that have had difficulty getting the records to NICS from the originating agency.
This last bullet is important and should not be overlooked. Continuous tracking of record submissions, outreach and on-going training have greatly improved the number and quality of New York’s NICS record submissions.

16. Questions?