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OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES


                                   Adjusted    Executive  Legislative                       
                                    Approp.      Request      Approp.
                                    2000-01      2001-02      2001-02      Change

STATE OPERATIONS
  General Fund                   49,444,000   46,941,000   47,148,000     207,000 
  Special Rev.-Fed.               5,922,000    5,663,000    5,663,000           0 
  Special Rev.-Other             17,221,000   17,828,000   17,828,000           0 
  Total for STATE OPERATIONS:    72,587,000   70,432,000   70,639,000     207,000 

AID TO LOCALITIES
  General Fund                  257,136,781  254,730,000  299,902,000  45,172,000 
  Special Rev.-Fed.             132,168,000  131,767,000  131,767,000           0 
  Special Rev.-Other              8,000,000    8,000,000    8,000,000           0 
  Total for AID TO LOCALITIES:  397,304,781  394,497,000  439,669,000  45,172,000 

  Capital Projects Fund          35,186,000   32,140,000   60,140,000  28,000,000 
  Total for CAPITAL PROJECTS:    35,186,000   32,140,000   60,140,000  28,000,000  

Agency Mission

The Office of Alcoholism and Substance Abuse Services (OASAS) administers a seven region statewide system of chemical abuse prevention, early intervention, and treatment services, provided in a variety of settings. The agency has a staff of 1,001, providing direct care in Addiction Treatment Centers (ATC) and oversight of community-based service providers. Prevention, early intervention, and treatment services are delivered across the State in both school and community locations. More than 1,300 providers, licensed and regulated by OASAS, serve approximately 120,000 persons each day, providing alcohol and substance abuse treatment.

The Executive is completing the last phase of consolidating what had been two disparate systems for treating alcoholism and substance abuse into a unified Community Treatment Services Program with a more equitable funding structure. Regulations to implement the consolidation are being promulgated by OASAS. Negotiations are continuing to establish consolidated Medicaid rates for the system. Integration at the State level increases efficiency and effectiveness at the local level by eliminating duplicative functions and reporting requirements. The creation of a single treatment system reflects the reality facing providers who serve a growing population of poly-abusers. OASAS operates 13 ATCs that provide inpatient services to approximately 7,000 persons annually. Nearly 600 staff provide intermediate-term care to patients, usually as follow-up to a more intensive acute care phase of treatment. The ATCs are viewed as important and valued partners by the community-based institutions that provide the more intensive, acute care phases of treatment.

Year-to-Year Change

The Executive recommends an All Funds budget of $497,069,000, a decrease of $8,008,781 or 1.59 percent. The All Funds State Operations budget decreases by $2,155,000, or 2.97 percent. The Aid to Localities budget is decreased by $2,807,781, or 0.71 percent. The Capital Projects budget is decreased by $3,046,000, or 8.66 percent.

Legislative Proposals

The Assembly proposes a General Fund appropriation of $207,000 to restore seven administrative planning positions to maintain the experienced, capable staff needed to oversee the implementation of an expanded, comprehensive and effective treatment program. The Assembly proposes $5,000,000 for expanded prevention and treatment services directed to children and adolescents: $2,000,000 for community and school-based prevention services, and $3,000,000 for treatment services. Enhancing support for community-based prevention programs as well as school-based programs, ensures that children and adolescents who have left school will not be deprived of needed services. When a child abuses alcohol or other substances, each day holds the potential for tragedy; treatment should not be delayed because there are not enough placements available, thus the Assembly proposal seeks to assure that young people seeking treatment will not have to be placed on waiting lists, by proposing additional funds for treatment services. The Assembly also proposes $20,000,000 for residential and outpatient services, substance abuse assessments and drug testing for monitoring and treatment of certain non-violent drug offenders.

The one resource essential to providing alcohol and substance abuse prevention and treatment services is competent, caring staff. Yet not-for-profit providers of chemical abuse prevention and treatment services are finding it increasingly difficult to recruit and to retain staff. In some cases, the staff turnover rate is as high as 35 percent. Furthermore, as the costs of operation go up, many not-for-profit agencies face growing deficits. While the Executive has proposed cost of living adjustments for all other not-for-profit providers in the mental hygiene system, chemical abuse prevention and treatment providers are denied an increase. The Assembly proposes a General Fund addition of $12,672,000 to support a 3.52 percent cost of living adjustment for chemical abuse prevention and treatment providers.

Chemical abuse service providers face growing deficits that result from receiving reimbursement for services at rates that are too low and serving an increasing number of clients who have no health insurance at all. Many of those clients have left the welfare rolls and joined the ranks of the working poor. Their wages are low and their employers do not provide health insurance, yet providers do not abandon them. Therefore, the Assembly proposes an addition of $4,000,000 to eliminate operating base deficits for chemical abuse prevention and treatment providers. Further, the Assembly proposes an appropriation of $1,000,000 for an Indigent Care Pool to be used to offset future costs to providers from serving persons who are uninsured. The Assembly also proposes $2,000,000 in additional funding for community-based service providers.

The Assembly proposes an appropriation of $500,000 for expansion of a demonstration program that improves coordination of services between chemical abuse service providers and mental health service providers at the county level. The use of Mentally Ill/Chemical Abuser (MICA) services coordinators has proven very effective in New York City and in the 8 counties where this program is in place: Columbia, Erie, Suffolk, Warren-Washington and Genesee-Orleans-Wyoming. Therefore, the Assembly proposes expansion of this program to 10 additional counties: Albany, Cortland, Monroe, Nassau, Oneida, Onondaga, Rockland, Schenectady, Tompkins and Westchester.

Accurate and complete record keeping is critical to managing treatment services effectively and efficiently, as well as to avoiding funding losses through audit disallowances. The Assembly proposes an addition of $3,000,000 in capital funding to assist providers with computerization efforts.

The Assembly notes with concern the continued deterioration of not-for-profit provider infrastructure (buildings and equipment). Repair and maintenance of facilities is far less costly than replacement. Therefore, the Assembly urges the Executive to use more than $31,000,000 in already existing capital reappropriations to halt the deterioration of these community facilities.

The Assembly also provides a capital appropriation of $25,000,000 to support the construction or rehabilitation of drug treatment beds. No such beds shall be occupied by violent or sex offenders.


RESIDENTIAL TREATMENT BED DEVELOPMENT.
RESIDENTIAL & OUTPATIENT SUBSTANCE ABUSE TREATMENT SERVICES.
PREVENTION AND TREATMENT PROGRAMS - COLA.
PREVENTION AND TREATMENT SERVICES FOR YOUTH.
TREATMENT PROGRAM BASE SUPPORT INCREASE.
TREATMENT PROVIDERS - TECHNOLOGY UPDATE.
SUPPORT FOR COMMUNITY BASED SERVICE PROVIDERS.
UNCOMPENSATED CARE POOL.
MICA COORDINATORS-EXPANSION.
PLANNING STAFF - RESTORATIONS.
$25,000,000
$20,000,000
$12,672,000
$5,000,000
$4,000,000
$3,000,000
$2,000,000
$1,000,000
$500,000
$207,000
CAPITAL
ATL/GEN
ATL/GEN
ATL/GEN
ATL/GEN
CAPITAL
ATL/GEN
ATL/GEN
ATL/GEN
ST/GEN