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Capitolwire: Wolf Budget Proposal Spurs Debate on Mental Health Funding
By Robert Swift

HARRISBURG (Feb. 14) — A budget proposal by Gov. Tom Wolf is spurring a new debate about providing more state mental health services during this time of pandemic-related stress.

The governor proposes spending $36.6 million from the taxpayer-supported General Fund in Fiscal Year 2022-23 to restore much of a decade-old cut in state aid to county-run mental health programs.

He would also direct $75 million in federal American Rescue Plan funds for support payments to help keep and hire new employees for qualifying home and community service providers.

A 21-member Mental Health Safety Net Coalition sent a letter Monday to lawmakers asking them to consider the proposed $36.6 million increase as a starting point in budget negotiations.

“The governor’s proposed increase will help offset the loss in purchasing power due to a decade of level funding,” wrote the coalition that includes service providers, hospitals, treatment centers and professional groups. “This money is critical to help counties get back to the effective level of resources they had 10 years ago, but it does not even begin to address all the gaps in our mental health system or surging demand for mental health services as we enter the third year of the global pandemic.”

Not only has the pandemic increased demand for services, it has also led to significant health staff shortages and increases in suicides and opioid deaths, the coalition said.

Also the County Commissioners Association of Pennsylvania issued a statement Monday calling on lawmakers to support Wolf’s proposal. It would restore two-thirds of a 10 percent cut to the budget line item in 2012 if enacted.

“If the funding continues to be uneven with the growing demand, counties will continue to struggle to in meeting the needs of their residents,” said CCAP President and Bradford County Commissioner Daryl Miller.

A key feature of county mental health programs is they are available to the entire community regardless of income, said Brinda Penyak, CCAP deputy executive director.

CCAP made rebuilding a “crumbling” mental health system its top priority this year. For the past six decades, counties have carried the responsibility to provide and contract for a range of community-based mental health services, including crisis intervention, treatment, education and prevention.

“We would strongly support advance planning and (mental health funding) increases that are practical and sustainable to ensure increased system availability for the long term,” said Dr. Kathy Quick, executive director of the Pennsylvania Mental Health Consumer Association while voicing concern that the proposed funding hikes for this year can’t be sustained in the future.

The issue of pandemic-related mental health challenges facing the general population and students as well has been the subject of several legislative hearings during the past two years.

The Senate Agriculture and Rural Affairs Committee held a hearing last month focusing on mental health issues facing agricultural workers. Pennsylvania has received a $500,000 grant from the U.S. Department of Agriculture to provide more resources to support mental health programs in rural areas by linking to national hotline networks and providing education and training, said state Agriculture Secretary Russell Redding at that hearing.

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Thursday, February 17, 2022, 3:00 pm–4:30 pm EST

Hosted by the National Association of County Behavioral Health and Developmental Disability Directors (NACBHDD) and Optum

Efforts nationwide to promote diversity, equity, and inclusion (DEI) are critical to advancing a more just and equitable society. However, the strategies and approaches to promoting equity can be drastically different given the organizations leading these efforts as well as the regional and cultural contexts in which they occur. Please join NACBHDD and Optum as we explore DEI efforts nationwide from state, local, and corporate partners. Our expert panel will also highlight timely resources to help your organizations promote similar efforts.

REGISTER

Cost: FREE

Speakers include:

  • Introductory remarks by Dan Ohler, Vice President, Public Sector Growth at Optum Health; Former Board Chair, NACBHDD
  • Moderated by Ron Manderscheid, PhD, former President and CEO, NACBHDD; Adjunct Professor at the Bloomberg School of Public Health, Johns Hopkins University, and the Suzanne Dworak-Peck School of Social Work, University of Southern California
  • Michelle Cabrera, Executive Director, County Behavioral Health Directors of California
  • Gilbert Gonzalez, Director, Bexar County Department of Behavioral and Mental Health
  • Graham McLaughlin, Vice President of Social Responsibility, Optum
  • Debra L. Wentz, Ph.D., President and CEO, New Jersey Association of Mental Health and Addiction Agencies, Inc. (NJAMHAA)
  • Lynda Zeller, Senior Fellow, Behavioral Health, Michigan Health Endowment Fund; former Commissioner for Behavioral Health & Intellectual and Developmental Disabilities Administration, Michigan Department of Health and Human Services

Panel Bios

Dan Ohler
Dan has over 25 years of experience working with state and local government in the behavioral health space, including being a past President for NACBHDD. Since joining Optum in 2014, he has worked with state and county government clients in the behavioral space. Dan has a master’s degree in business administration from Xavier University and a Bachelor of Science in business administration from West Liberty State College.

Ron Manderscheid, PhD,
Ron Manderscheid, PhD, is the former Executive Director of the National Association of County Behavioral Health and Developmental Disability Directors. Concurrently, he was Executive Director of the National Association for Rural Mental Health, Adjunct Professor at the Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, and Adjunct Professor, School of Social Work, University of Southern California. Dr. Manderscheid serves on the boards of the Cosmos Club, the Employee Assistance Research Foundation, the Danya Institute, the Council on Quality and Leadership, the NASMHPD Research Institute, and the National Register of Health Service Psychologists. Previously, he served as the Director of Mental Health and Substance Use Programs at the Global Health Sector of SRA International and in several federal leadership roles at the U.S. Department of Health and Human Services. Throughout his career, he has emphasized and promoted peer and family concerns. He has also authored numerous scientific and professional publications on services to persons with mental illness and substance use conditions.

Michelle Cabrera
Michelle is the Executive Director of the County Behavioral Health Directors Association of California, a statewide association representing the behavioral health directors from California’s 58 counties, in addition to the Tri-City (Pomona, Claremont, and La Verne) and City of Berkeley Mental Health Authorities. In addition to her current work, Ms. Cabrera has been appointed to the California Disability and Aging Community Living Advisory Committee and served as an appointed member of Governor Newsom’s Council of Regional Homeless Advisors. She graduated from Georgetown University with a Bachelor of Science degree in foreign service.

Gilbert Gonzalez
Gilbert has more than 30 years of experience in the fields of substance abuse and mental health, crisis prevention, and treatment provision. He currently serves as Director of the Department of Behavioral Health for Bexar County. Born and raised in San Antonio, Texas, Mr. Gonzales received his bachelor’s degree in political science and a master’s degree in clinical psychology from Trinity University.

Graham McLaughlin
Graham leads the health equity-focused social responsibility program for Optum, a global health services organization with over 175,000 staff members across 150 global offices serving 124 million individuals, 4 out of 5 US hospitals, over 200 health plans, and over 100,000 healthcare facilities. Prior to Optum, Graham launched and led the corporate responsibility program at The Advisory Board Company, a publicly traded health services firm, and has also been a management consultant for Fortune 500 organizations and a wilderness therapy instructor.  Graham graduated Summa Cum Laude from UNC-Chapel Hill with a dual degree in psychology and management.

Debra L. Wentz, PhD.
Debra L. Wentz, PhD, is the President and Chief Executive Officer of NJAMHAA and Executive Director of the New Jersey Mental Health Institute. Dr. Wentz holds numerous board and committee positions and appointments on the state and national levels, including several at the National Council for Mental Wellbeing. She currently serves as the Chair of the New Jersey Governor’s Council on Mental Health Stigma. Dr. Wentz earned a doctoral degree from University of Paris, Paris, France; a second PhD and MA degree from the University of Connecticut; and an executive MBA from the Alternative Careers Program of the Wharton Business School, University of Pennsylvania. She completed undergraduate work at Goucher College, Maryland. She is bilingual in French and English.

Lynda Zeller
Lynda is the Senior Fellow, Behavioral Health for the Michigan Health Endowment Fund. Prior to this role, she served for seven years as the deputy director for the Behavioral Health and Developmental Disabilities at the Michigan Department of Health and Human Services. In this position, Lynda functioned as the State Authority for all community-based mental health, substance use disorder, and intellectual and developmental disabilities policies and services.

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The next Managed Long-Term Services and Supports (MLTSS) Subcommittee meeting will be held on March 1, 2022, as a webinar from 10:00 am–1:00 pm.

You can register for the meeting here. After registering, you will receive a confirmation email containing information about joining the webinar. Remote captioning and streaming services will be provided; if you require these services, please visit here. If you require another accommodation, including an alternative method for submitting questions or comments about meeting topics, please send an email no later than February 18, 2022, so other accommodations can be scheduled.

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ODP Announcement 22-017 is to announce that Residential ISP Staffing training sessions are now available to Administrative Entities (AEs), Supports Coordination Organizations (SCOs), and Providers of Residential Services in the Consolidated and Community Living Waivers from February through June 30, 2022. Residential ISP Staffing trainings described in ODP Announcement 21-057 have been completed, but additional training can be provided by agency professionals who have volunteered to provide training and participated in delivering training in the fall of 2021, referred to ODP Designated Trainers.

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Photo by Markus Winkler on Unsplash

RCPA staff reviewed the Governor’s proposed budget, and while many details still need to be sorted out, RCPA can provide some high-level facts about the proposed budget from the House Democrat Appropriations Committee 2022/23 Executive Budget Proposal At–A-Glance and the Governor’s 2022/23 Executive Budget Spreadsheet. Of note, please see pages 12–13 for the Department of Human Services line items and page 6 for the Department of Drug and Alcohol Programs.

The highlights of the Governor’s proposed budget include:

Education Funding

  • Spending $43.7 billion in state General Funds;
  • $1.55 billion, a 24% increase, in basic education funding;
  • $1.25 billion to be distributed through the fair funding formula;
  • $300 million in Level Up funding to the 100 most underfunded districts; and
  • $200 million, a 16% increase, in special education funding.

Economy

Proposed increase to state’s minimum wage to $12 per hour effective July 1, 2022, including tipped workers, with 50 cent annual increases up to $15 per hour ($74.6 million direct revenue increase).

Protecting the Most Vulnerable

  • $91.25 million ($190.1 million total funds) to increase MA rates for skilled nursing facilities, effective January 2023, to comply with regulatory changes planned for July 2023;
  • $50 million, or a 44% increase to state supplemental programs for aged, blind, and individuals with disabilities, to increase the personal care home state supplement from $439.30 to $1,351.80 per month;
  • $75 million in federal funds to recruit and retain behavioral health providers;
  • $36.6 million to invest in critical county behavioral health services;
  • $15 million in federal funds to stabilize payments to substance use disorder treatment providers and assist with pandemic related expenses;
  • NEW: $14.3 million to increase the monthly Supplemental Nutrition Assistance Program (SNAP) benefit from $20 to $35 for 75,000 to 95,000 seniors and individuals with disabilities;
  • NEW: $280,000 to implement Agency with Choice, preserving the ability for home and community-based waiver participants to choose their worker while allowing workers to obtain the support of an agency;
  • $18.8 million to serve an additional 832 individuals with intellectual disabilities and autism currently waiting for services;
  • $1 million to provide community placements for individuals residing in intermediate care facilities;
  • $1.25 million to discharge 20 individuals from state hospitals through the Community Hospital Integration Project Program (CHIPP);
  • $2.4 million for Department of Aging and Department of Human Services to strengthen older adult protective services (8 positions), create a child welfare crisis response team (4 positions), and support increased regulatory, licensing, budgetary, and administrative functions (30 positions) through increasing complement;
  • NEW: $8 million to extend postpartum coverage for birthing parents eligible for Medical Assistance to 12 months;
  • $15 million, a 77% increase, to implement additional evidence-based home visiting and family support services to 3,800 additional families;
  • $1.8 million to support court-appointed volunteer advocacy; and
  • NEW: $10 million for State Disaster Assistance, a new initiative to provide disaster assistance to individuals and to improve access to safe, secure, and weathertight homes.

In addition to the above proposed funding, the Governor and Democratic legislative leaders support allocating the unused American Rescue Plan funds from last year’s budget to various programs, which are outlined in the Democrat’s American Rescue Plan Act — State Fiscal Recovery plan, to help Pennsylvanians rather than letting the funds be transferred to the General Fund to sit in reserve.

The above information is a high-level overview of the Governor’s budget proposal. The specific line items contained in the Governor’s 2022/23 Executive Budget Spreadsheet are the overall dollars allocated for health and human services. The Department of Human Services (DHS) has not yet released their Budget Blue Book, which breaks down these line items and provides a detailed dollar amount allocated to specific human service programs. We are being told the DHS Blue Book should be available with this specific information at the end of February or the first week of March. Once RCPA obtains the Blue Book and reviews it, we will provide members with a more detailed summary and analysis.

As a reminder, the Governor’s Proposed Budget is just that: a proposal. The General Assembly will now hold budget hearings; a complete hearing list can be found here. The General Assembly and the Governor will conduct budget negotiations after the House and Senate budget hearings conclude to hopefully finalize the Commonwealth’s 2022/23 budget by June 30. If you have any questions, please contact Jack Phillips.

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The Pennsylvania Department of Drug and Alcohol Programs (DDAP) is now offering “Co-Occurring Conditions: Promising Practices and Approaches.”

Co-occurring conditions are no longer the exception but the expectation, requiring treatment programs to design services that address the interrelationship among complex physical, psychiatric, and substance use conditions. This curriculum will review up-to-date principles, terminology, screening, assessment, treatment considerations, and programming guidelines, and the interactive program will engage participants through discussion and small group exercise. This six-hour virtual course is divided into two parts in DDAP’s Training Management System.

Participants of this course will:

  • Describe the foundations of integrated treatment;
  • Highlight key treatment considerations;
  • Employ screening and assessment for COD; and
  • Critique integrated treatment plans.
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