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Restructure Addiction Services Financing Project (RASFP)

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Restructure Addiction Services Financing Project (RASFP)

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Overview

OASAS provides funding support for addiction services to approximately 1,200 programs operated by more than 350 providers. In State Fiscal Year 2021/2022, OASAS provided nearly $500 million in net deficit funding to eligible providers for addiction services. Eligible providers are defined as not-for-profit entities known as voluntary agencies which are established for the purpose of providing addiction services, and local governmental units (LGU) which may include cities, towns, villages, and counties.

Currently, OASAS funds Net Operating Deficits:

OASAS currently funds approved net operating deficits for addiction services. The net operating cost of a program is determined as total operating expenses approved by OASAS, less all sources of revenue.  This operational deficit, or net deficit, is then funded by OASAS as State aid which consists of State General Fund, Federal Substance Use Prevention, Treatment and Recovery Services Block Grant (SUBG), or other Special Revenue Funds. OASAS may fund up to 100 percent of the net operating deficit of a provider. State aid is paid as an advance payment based on the approved program budget either quarterly for non-Federal funds or monthly for Federal funds.

The approved budget for an existing funded program is often based on historical funding patterns. As a result, the State aid funding for older programs may be inconsistent with the State aid funding provided to new programs which creates inequities for the same type of services, even within the same geographic area.

To address these inconsistencies, OASAS issued a Request for Information (RFI) to seek alternate funding approaches that will provide greater equity in funding addiction services while maintaining compliance with State and Federal statutes and rules, especially related to the SUBG expenditure rules.

Request for Information (RFI)

On November 4, 2022, OASAS issued an RFI. Following a review of all applications, OASAS selected Third Horizon Strategies (THS) as the consulting firm to assist us with this project.

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    RFI Restructuring Addiction Services Financing

    OASAS intends to request information about vendors that can review the current system of financing addiction services authorized under Articles 25 and 41 of New York State Mental Hygiene Law (NYS MHL); to make recommendations for changes designed to ensure the equitable reimbursement of substance use disorder (SUD) and gambling services consistent with State law and Federal regulations which is conducive to the provision of effective and high-quality services; and, to assist in the implementation of the selected methodology. 
     

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Third Horizon Strategies

Third Horizon Strategies specializes in providing a 360º view of complex challenges across three horizons – past, present, and future – to help stakeholders interpret signals and trends; design integrated system; and enact changes so that all communities, families, and individuals can thrive. The mission-driven firm understands that mental health, substance use prevention, harm reduction, treatment, recovery, and problem gambling services are critical to overall health. Third Horizon Strategies helps organizations and state governments identify innovative care models and form partnerships to promote community behavioral health and systems integration that can improve long-term outcomes.

Since 2018, the firm’s leadership has supported the work of the Alliance for Addiction Payment Reform – an alliance focused on developing strategies to establish a structure that promotes the development of integrated treatment and recovery networks. For the Restructure of Addiction Services Financing Project, Third Horizon Strategies has partnered with The Terry Group, a firm of consulting actuaries with deep experience in the areas of health care and data analytics. 

Collectively, the project team has decades of experience developing Recovery-Oriented Systems of Care and deep expertise in publicly funded substance use disorder and problem gambling services delivery systems, including the Substance Use Prevention, Treatment, and Recovery Services Block Grant (SUBG); State Opioid Response funding; and Medicaid Managed Care.

Project Timeline

We are working on a project with a flexible timeline that requires regular adjustments based on our research and engagement efforts. This is typical for projects as we uncover the need for more data and ways to fill the gaps. We're conducting research, engaging with stakeholders, and exploring potential frameworks for alternative funding. Following that, we'll refine our approaches based on feedback and eventually move towards implementation, understanding that this will be a lengthy process due to the amount of work involved in making any changes.

It will involve three repeatable project cycle timelines, as follows: 

Cycle One: October 2023 to May 2025

Cycle Two: August 2024 to March 2026

Cycle Three: June 2025 to July 2027

 

Community Input

OASAS will hold regular calls and meetings to inform community providers, associations, and Local Government Units (LGUs) on the status of the Restructure Addiction Services Financing Project. These Community Forums will be recorded and posted to this webpage, along with commonly asked questions and answers and any minutes that may result from focused stakeholder meetings.
 

Meeting Recordings

2024 
2023

*The November 2023 Town Hall for Providers webinar was held twice – once for the provider associations and once for the providers. 

Frequently Asked Questions

Over 60 provider questions and OASAS answers are available online from the Restructure Addiction Services Financing Project Town Hall Community Forums held on May 23, 2024, and November 1, 2023. 

Review Questions & Answers