Bring It Home: The Facts
NYS Office of Mental Health Program Funding
The green and dark red lines show all increases in funding that these four programs received since 1991 compared to inflation (bright red line). Green reflects increases in funding for OMH licensed community residences and licensed treatment apartments, which provide very high levels of care. The dark red line reflects increases in funding for large congregate licensed programs with a high level of care (CR-SRO) and large unlicensed programs (SP-SRO) with a lower level of care. Funding has eroded 40 – 70% due to inflation.
40% - 70%
of funding in New York State mental health housing is lost to inflation.
Mental health units in jeopardy.
NYS Office of Mental Health Supported Housing - 2017 Adequate Rate for a 1-Bedroom Apartment by County
The following explains the Chart Below. It computes an adequate SH rate in each county in NYS.
A. Rent: Based on HUD Fiscal-Year 2017 Fair Year Market Rents for a One Bedroom apartment.
B. Rent Paid By Residents: Residents pay 30% of income, typically the SSI living alone rate of $822/month, which is $247 per month or $2,964 per year.
C. TOTAL PROPERTY COST TO AGENCY: Column A minus column B.
D. CONTINGENCY FUNDING: $500. Based on current OMH minimum of $500 per recipient annually to resolve housing situations that put the resident at risk of losing his/her housing including non-collectable rent payments due to various reasons, minor maintenance not the responsibility of the landlord, furniture storage, and any other housing related emergency problems that, if not addressed, could cause loss of housing. This number has not changed since 1991.
E. OTHER THAN PERSONAL SERVICES (OTPS): $1500 per Supportive Housing slot - Based upon a realistic estimate of costs that includes travel, insurance, office supplies, telephone, office rent, etc.
F. CASE MANAGER: $39,000 = $30,000 salary plus $9,000 for fringe benefits (30%) for a case manager with a caseload of 20. A 15% differential is included for downstate counties: $44,850 = $34,500 salary plus $10,350 for fringe benefits (30%).
G. SUPERVISOR: $52,000 = $40,000 salary plus $12,000 for fringe benefits (30%) for a supervisor with a caseload of 100 consumers or 5 case managers. A 15% differential is added for downstate counties: $59,800 = $46,000 salary plus $13,800 for fringe benefits (30%).
H. ADMINISTRATION and OVERHEAD (A&OH); at 12% on columns D through G – well under the mandated 15% required under Executive Order #38. I. ADEQUATE SUPPORTED HOUSING RATE: Total of cost columns C - H.
J. CURRENT SUPPORTED HOUSING RATE: This is the rate SOMH currently pays by county for each supported housing unit in each county.
K. SHORTFALL: This number is the difference between column I and column J, per bed, and represents the discrepancy between the current rate and an adequate rate. All assumptions in the calculation above are modest.
ADEQUATELY FUNDED MENTAL HEALTH HOUSING
It's 40% - 94% less expensive, depending on housing model & institution, to use community housing versus psychiatric institutions, other hospitals, nursing homes, shelters, jails and prisons.
NYS Department of Health's Medicaid Redesign Team's Special Needs Housing Pilots show a:
15% reduction in Medicaid spending
40% reduction in inpatient admissions
26% reduction in ER use
44% reduction in inpatient rehab
27% reduction in psychiatric inpatient admissions
Housing as Health Care — New York's Boundary-Crossing Experiment
Kelly M. Doran, M.D., M.H.S., Elizabeth J. Misa, M.P.A., and Nirav R. Shah, M.D., M.P.H.
N Engl J Med 2013; 369:2374-2377 December 19, 2013
Excerpt: “[T]he United States ranks first in health care spending but 25th in spending on social services.1 These are not two unrelated statistics: high spending on the former may result from low spending on the latter. Studies have shown the powerful effects that “social determinants” such as safe housing, healthful food, and opportunities for education and employment have on health. In fact, experts estimate that medical care accounts for only 10% of overall health, with social, environmental, and behavioral factors accounting for the rest. 2
Full Article Here