Objective

To assess the extent of implementation of the three recommendations included in our initial audit report, Reporting of Community-Based Services Under the Transformation Reinvestment Plan (Report 2021-S-15).

About the Program

OMH’s mission 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. OMH operates psychiatric centers across the State and regulates, certifies, and oversees more than 4,600 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 expanded 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. The monthly reports present a variety of data on where funds are reinvested geographically and for what services. Examples of CBS supported 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 December 2023, the State has allocated more than $104.5 million in CBS from reinvestment funds, serving more than 146,500 individuals. Nearly $19 million in additional reinvestment funds have also been directed across the State.

The objective of our initial audit report, issued October 26, 2022, was to determine whether OMH provided adequate reporting of CBS reinvestment funds under the Plan. The audit covered the period from April 2018 through February 2022. The audit identified certain inconsistencies with how the NIS data is collected—including how providers reported NIS for different services, the timing of reporting for certain services, and variations in the process used for reporting—which could impact the accuracy of the information included in the reports. While we generally determined OMH had developed processes to report on the funds reinvested in CBS under the Plan, we also identified opportunities for OMH to improve its communication and data collection to ensure greater accuracy of its reports documenting its oversight of Plan reinvestments. We also determined that OMH could improve its reporting to show progress toward achieving targets supported through Plan reinvestments.

Key Findings

OMH officials have made some progress in addressing the problems identified in our initial audit report. Of the initial report’s three audit recommendations, one has been fully implemented, one has been partially implemented, and one has not been implemented.

Key Recommendation

Officials are requested, but not required, to provide information about any actions planned to address the unresolved issues discussed in this follow-up within 30 days of the report’s issuance.