Objective

To determine whether the Office of Mental Health provides adequate reporting of community-based service reinvestment funds under the Transformation Reinvestment Plan. The audit covered the period from April 2018 through February 2022.

About the Program

The mission of the Office of Mental Health (OMH) is to promote the mental health of all New Yorkers, with a particular focus on providing hope and recovery for adults with serious mental illness and children with serious emotional disturbances. To carry out its mission, OMH operates psychiatric centers across the State and regulates, certifies, and oversees more than 4,500 programs operated by local governments and non-profit agencies. OMH has sought to reduce the capacity at its inpatient facilities and provide services in lower-cost, more accessible community-based settings. To accomplish this, OMH developed the Transformation Reinvestment Plan (Plan) in 2014. The Plan aims to rebalance the agency’s institutional resources by further developing and enhancing community-based services (CBS) in the State. Under the Plan, OMH reinvests funds realized through the closure of inpatient State beds (about $110,000 per closed bed) into CBS. To document its oversight of reinvestments and services provided under the Plan, OMH prepares monthly reports compiled from data submitted by voluntary providers that received the funds. Information on State-provided services is retrieved from OMH’s internal systems. The monthly reports present a variety of data on where funds are reinvested geographically and for what services. Examples of CBS-supported services via the reinvestment funds include supported housing, mobile integration teams, various crisis services, and clinic expansion. One key piece of data on the monthly reports is known as “New Individual Served” (NIS). Measuring NIS helps demonstrate the expansion of services with the reinvested funds. According to OMH, since 2014 and continuing through State fiscal year 2020-21, the State has allocated more than $82.5 million in CBS from reinvestment funds realized through the reduction of State-operated inpatient beds under the Plan and served more than 111,000 individuals. Nearly $19 million in additional reinvestment funds have also been directed across the State as the result of community inpatient bed reductions.

Key Findings

• Generally, we determined OMH has developed processes to report on the funds reinvested in CBS under the Plan. However, we also determined there are opportunities for OMH to improve its communication and data collection to ensure better accuracy of its reports used to document its oversight of the Plan reinvestments.
• We identified certain inconsistencies with how the NIS data is collected, which could impact the accuracy of the information included in the reports. These included how providers reported NIS for different services, the timing of reporting for certain services, and variations in the process used for reporting.
• We also determined that OMH could improve its reporting on the overall 11 reinvestment areas that it established for the Plan.

Key Recommendations

• Issue updated guidance to providers and State facilities on how to identify and count a NIS.
• Provide guidance or notes on the monthly reports indicating which services and counties report quarterly versus monthly and the associated impact to provide better context to users of the reports.
• Include information on the monthly reports to clearly show progress toward achieving targets supported through Plan reinvestments.