February 12, 2024
We envision a future where no child is on a waitlist to receive behavioral health services, and where every child receives the level of care they need when they need it. Achieving this vision requires sustained, multi-year investments and policy reforms from the State. To put New York on the right path, we urge state leaders to make the following investments and reforms in the Fiscal Year 2025 Budget:
1. Invest $195 million in the children’s behavioral health outpatient system to address the severe reimbursement rate challenges that have undermined the ability of children to access timely, high-quality services.
The Campaign for Healthy Minds, Healthy Kids (HMHK) developed a first-of-its-kind study of reforms needed to address rate inadequacy and workforce shortages in programs including Outpatient Clinics (Article 31 and 32s), Child and Family Treatment and Support Services (CFTSS), and Home and Community-based Services (HCBS). These rigorously-developed recommendations include adjusting outpatient rates to keep pace with inflation, enabling the children’s clinic rates to reflect the complexity of serving children and families, increasing pay for providers who coordinate with a growing array of care managers, and increasing funding for CFTSS and HCBS to address the gap between anticipated volume and actual number of children served. Without this targeted investment in outpatient behavioral health services, the behavioral health workforce will continue to disappear, the capacity to care for children will continue to shrink, and New York’s children will sit on longer wait lists or go entirely without urgently needed services. If these reforms are enacted, community behavioral health providers could hire over 1,300 additional clinicians and New York’s outpatient mental health system could serve over 26,000 additional children.
2. Require commercial health plans to pay in network providers of outpatient behavioral health services at or above the Medicaid rate.
The HMHK Campaign strongly supports Governor Hochul’s proposal in the Executive Budget (Article VII, HMH, Part AA) which would mandate that commercial insurers reimburse in- network outpatient providers (at a minimum) at the same level as the State mandated Medicaid rate. Commercial insurers continue to operate with impunity, maintaining deeply inadequate rates at a fraction of what Medicaid pays. This has contributed to the workforce capacity crisis, ultimately increasing the number of families on waitlists and children sent to emergency rooms and hospitals because their families cannot find or cannot afford providers who take their insurance. A recent report by the NYS Attorney General demonstrated that New York’s health insurance companies are failing to offer adequate mental health care, highlighting the central role inadequate reimbursement rates play in this failure. It is critically important that State leaders support efforts to require insurers to increase their rates, and that the costs of this increases are not passed on to patients.