Meet the New Deputy
Executive Commissioner
By Dan Frey, Editor in Chief
Crucial Issues to the Mental Health
Community Discussed
On January 20th at Fountain
House clubhouse in Hell's Kitchen, members of New York City's mental
health community met the new Executive Deputy Commissioner for the
New York City Department of Health and Mental Hygiene (DOHMH),
Division of Mental Hygiene: Gary Belkin, MD, PhD, MPH. The event was
organized by the DOHMH Office of Consumer Affairs whose mission is to
ensure that the consumer perspective is heard and integrated at all
levels of government. Carlton Whitmore is the director of this office
and Teena Brooks, LMSW, assistant director.
Dr. Belkin responded to questions from
a planning committee whose members were: Wendy Brennan, Lynnae Brown,
Angela Hebner, Carla Rabinowitz, Samene Reid, Rachel Saloman and
Moneer Zarou. Topics ranged from housing and criminal justice to
employment and managed care. Some topics listed in the evening's
program such as cultural competence and the assisted outpatient
treatment program were barely touched upon.
Housing
On housing, Dr. Belkin said that
governor Cuomo might approve funding for around 5,000 units of
housing for New York State's homeless, mental health, HIV/AIDS,
substance abuse, and domestic violence populations, including
families and youth. The campaign for supportive housing, known as
NY/NY 4, requested 30,000 units for these disadvantaged groups in New
York City over ten years.
Criminal Justice
On criminal justice, Dr. Belkin said
that, in response to the unnecessary death of a mentally ill Rikers'
inmate, mayor de Blasio's criminal justice taskforce will address
issues of mental illness and substance abuse at every stage of the
criminal justice system, including proper discharge planning from
jail to the community. He said “drop-off centers” will be created
as alternatives to incarceration for people with mental illness, with
the first one to roll out in the fall of 2015 in upper Manhattan.
These drop-off centers should offer an array of services to help keep
our peers out of the justice system. As part of a comprehensive plan,
corrections officers and police officers will receive training on
“deescalation” and understanding behavioral health issues similar
to what other states have been doing with good results.
Employment
The unemployment rate among people with
serious mental illness is a staggering 90%. Dr. Belkin said his
department funds 15 different employment programs and continues to
advocate for more peer hiring. He said that in the future managed
care environment, providers will be held accountable for improved
employment outcomes and that peer services will be Medicaid
reimbursable. He said an “RPC” or regional planning consortium
will be created that brings advocates and stakeholder groups together
to discuss issues of standardization, performance, service planning,
and resource allocation.
Medicaid Managed Care
On the future of service delivery in a
Medicaid, managed care environment (see “Medicaid Managed Care:
Rising to the Challenge” by Briana Gilmore, Winter 2015 edition),
Dr. Belkin said “HCBS” (home and community-based services) will
be offered through the “HARP” (health and recovery plans) for
individuals with significant health and behavioral health needs.
Fully integrated dual advantage plans (FIDA)will be available for
people with both Medicaid and Medicare who use community-based
long-term care services.
Peer Jobs
There was a concern among those in
attendance that peer workers who lacked a GED or high school diploma,
which is currently required to become a certified peer specialist,
would lose their jobs in this new billing environment, but Dr. Belkin
assured us that not all services will be billable to Medicaid and
some will continue to receive funding from the city. The smaller
provider organizations will receive technical support to help them
make the transition to Medicaid billing. He said he was unsure how
many city contracts, if any, will be displaced by the shift to
Medicaid billing.
Conclusion
Although Dr. Belkin and his senior
staff were weary from a long day at the office, we were glad that
they made it to the forum that evening. His liberal use of acronyms
was a bit off-putting, but he did his best to explain some difficult
concepts. The crowd seemed pleased with the event, but I was left
wondering how much influence we would have on future policies that
will affect our lives. Most of us don't even know how to speak the
language that large bureaucracies use, let alone how to affect change
within them. For those of us who do, I hope you step up to the plate
and get involved. We desperately need representation with
sensitivity, intelligence and strength.
