Fax from Albany
November 27, 2002
Board Members, Affiliate Executive Directors, Interested Parties
Joseph A. Glazer, Esq., President/CEO
(518) 434-0439 ext. 20
Early Thanksgiving Edition
Calls on Leaders to Exempt OMH
from 5% State Agency Budget Cuts
would be a truly callous government, indeed, that cut funding for mental
health services in the face of what we all know,” says MHANYS President/CEO
The Mental Health Association in New York State, Inc. (MHANYS) today called
on state government leaders to exempt the NYS Office of Mental Health
from the 5% across the board agency budget cut called for by Budget Director
Carole Stone late last week.
a letter to Governor Pataki, Senate Majority Leader Bruno and Assembly
Speaker Silver, the organization pointed to eight months of continuous
revelations regarding the terrible state of New York’s mental health
system. The letter stressed the New York Times’ articles
that added the inappropriate settings of adult homes and nursing homes
here and out of state to the existing list of prisons, jails and homelessness.
sum, it is painfully evident that tens of thousands of people with serious
mental health needs are facing poor or insufficient care, improper treatment
settings and unwarranted incarceration, hazards and dangers,” the
organization says that dual problems are at the root of New York’s
mental health care morass --- historic under-funding of mental health
programs, and 25 years of failure to create the comprehensive system of
community-based mental health care promised by Governor Hugh L. Carey.
recognizes that our state faces tough financial times. But the continued
failure to fund and coordinate our mental health programs (they really
can’t be called a system) cannot be ignored. The reality is that
we must, both morally and legally, provide quality services in the community
for people with mental illnesses. We urge you to protect and improve what
we already have, and not knowingly and willingly add to the quagmire,”
is a 501(c)(3) not-for-profit corporation, made up of consumers, advocates,
providers and family members involved in mental health. The organization
provides education, training, outreach, information and advocacy for its
33 affiliates serving 54 counties across the state.
Health in the News: For being such a short week, it was a very active
week where several articles of interest to the mental health community
found their way to the pages of newspapers across the state.
prominently, the state’s interagency adult home initiative announced
the actions the state plans to take to address the unacceptable conditions
in adult homes as they were reported by the New York Times earlier
this year. An Associated Press and New York Times article are attached
to this Friday Fax from Albany.
addition, this week also brought editorial pages in major newspapers calling
for the development and implementation of a comprehensive plan for mental
health services, similar to that which MHANYS’ has called for in
its report, The Unfinished Promise
of Willowbrook. Editorials from the Journal News and Syracuse
Newspapers are attached to this Friday Fax from Albany.
talk about the upcoming budgetary situation the state is likely to face
next year, has once again raised fears that psychiatric hospital closures
and consolidations will again be options the state will consider. The
editorial found in the Syracuse Newspapers makes reference to this
as well as the article in the Middletown Times Herald Record, both
are attached to this Friday Fax from Albany.
to Improve Care in Adult Homes.
Associated Press, November 26, 2002
found November 27, 2002 in multiple newspapers, including the Albany
Times Union, The Ithaca Journal, the Rochester Democrat
and Chronicle, the Poughkeepsie Journal)
N.Y. (AP) - The state will assess the medical conditions and needs of
the 32,000 residents of adult homes as part of an effort to protect patients
from abuse and neglect, the Pataki administration said Tuesday.
will also be deployed to private adult homes statewide to make sure needed
medications are available and properly administered. Independent case
managers will help coordinate care and improve treatment for the 12,000
mentally ill residents at the homes, according to Harvey Rosenthal of
the state Association of Psychiatric Rehabilitation Services.
infusion of outside skilled professionals is critical to properly enhancing
and assuring the quality, integrity and effectiveness of the care adult
home residents have a right to receive," Rosenthal said.
group was among the advocates for the mentally disabled who worked with
the administration to devise the new initiatives.
state, which is facing multibillion-dollar shortfalls, did not say Tuesday
how it would pay for the changes, however. That concerned advocates for
the 12,000 mentally disabled residents living in 450 adult homes throughout
think it depends on how much of it is funded out," Rosenthal said.
"In principle, what's being offered here is, I think, a fairly substantial
Glazer, president of the Mental Health Association in New York State,
said the state's response without funding commitments amounts to simply
amazing," said Glazer, who provided input but wasn't part of the
state's working group of advocates. "The residential component of
our mental health system is a car wreck and the plan now is for government
to slow down and look as it drives by."
need a top-to-bottom revamping that will result in a plan and a system
for care, none of which exists in New York state right now," Glazer
Pataki administration proposed reforms beginning in April, when The
New York Times reported on dangerous adult home conditions. The newspaper
found unhealthy and even deadly conditions in mostly New York City-area
facilities from unnecessary surgery to dangerously hot bedrooms.
policies announced Tuesday include:
- Clinical, psychiatric and functional assessments of all residents
by highly qualified and trained personnel.
- Improved case management and coordination to make sure appropriate
care is provided.
- Improved management of medications by qualified personnel.
- Better social and recreational services.
- Increased advocacy and legal support for patients.
actions further ensure that residents of adult homes will receive appropriate
services and, when appropriate, high quality mental health care in a safe,
clean environment," said state Mental Health Commissioner James Stone.
Times reported that patients and advocates were critical of the state
Health Department's oversight of the homes. The Times found that
workers at the homes falsified patient records to cover up inadequate
care and coerced residents into unneeded surgery.
1995 and 2001, 946 residents at 26 major homes died, the Times
found. Some died of heat-related illnesses in rooms with no air conditioning;
others died of routine illnesses that were not promptly treated, or they
Millions for Homes for the Mentally Ill
New York Times November 27, 2002
Robert F. Worth
administration panel released a report yesterday calling for hundreds
of millions of dollars of spending on new services and housing to overhaul
New York's decades-old system of adult homes for the mentally ill.
health officials embraced the report at a panel meeting and described
their efforts to fulfillits recommendations. But they did not say how
they would pay to implement them, and they provided no specifics about
how to create new housing for the mentally ill, one of the panel's central
state has begun to implement some of the recommendations, including assessing
the medical condition and needs of group home residents, deploying nurses
to ensure that medications are administered properly and providing better
advocacy and legal support, the health officials said yesterday.
initiatives set forth today represent another in a series of important
actions to improve the quality of life and services in the adult homes,"
the state health commissioner, Antonia C. Novello, said yesterday.
Ms. Novello did not specifically address the panel's recommendation to
create about 6,000 units of new housing for mentally ill people currently
living in group homes, an effort that is expected to take many years and
cost hundreds of millions of dollars. For now, Gov. George E. Pataki has
appointed an interagency working group to look at the housing needs of
the mentally ill and other populations, officials said.
indicated our willingness to proceed with these initiatives," said
John F. Signor, a spokesman for the State Department of Health. "But
until we go further along in this process, it is impossible to come up
with a realistic price tag."
panel was established in May by Ms. Novello after The New York Times
published a series of articles describing poor conditions and malfeasance
at the largest group homes in New York City.
members of the panel said yesterday that state officials had told them
to expect more details about financing for housing and other recommendations
in the governor's State of the State Message in January and in the executive
Pataki declined to comment on the recommendations yesterday. Robert R.
Hinckley, his spokesman, said the panel's recommendations "provide
an important road map for ensuring that residents in group homes get good
quality care they're entitled to."
on mentally ill warranted - Editorial
The Journal News, November 25, 2002
are these people? Where are these people?
ill New Yorkers appear to be missing in action. Certainly, they have been
missing from action, given the Pataki administration's unwillingness to
present clear answers to questions about their treatment and housing.
after months of scandal and accusations, Gov. George Pataki is supposed
to outline a plan tomorrow to begin addressing New York's mental-health
crisis, starting with the plight of those in adult homes, Gannett News
Service reported over the weekend. Media reports and subsequent investigations
apparently spurred the state's response.
is about time. But any short-term plan must only be considered a first
step toward the desperately needed goal of providing New Yorkers a comprehensive,
fact-filled, no-nonsense status report on the care of mentally ill people
during Pataki's tenure.
must be accompanied by realistic estimates of what it will cost to reform,
and sufficiently fund, a responsible, and responsive, system — followed
by the governor's commitment to do just that.
problem is not just the 12,000 adult-home residents here in New York.
Jersey Gov. James McGreevey announced last week that he had ordered his
health commissioner and attorney general to investigate why the Pataki
administration has sent hundreds of patients from New York psychiatric
wards and hospitals to nursing homes and adult homes in his state that
do not have mental-health credentials. McGreevey was reacting to a New
York Times story that detailed how Pataki's administration has sent
severely ill — and therefore costly to treat — psychiatric
patients out of New York state.
York, apparently, is saving millions of dollars by sending the mentally
ill from its psychiatric wards, hospitals and programs outside its borders,
where the federal government picks up a portion of the cost of caring
for them through Medicaid subsidies.
practice, if documented, violates acceptable notions of decency, as well
as legal and moral standards for patient health care," McGreevey
told the Times. "New Jersey clearly was not briefed as to the significance
nor the intent of these transfers."
New Jersey's outrage, its investigation must also examine the thoroughness
of its own oversight of nursing homes there. Two of the New Jersey homes
alone have been paid $82 million by Medicaid to care for hundreds of New
Yorkers since 1995, the Times reported. More than 725 psychiatric
patients have been sent to the two sites since 1995, according to Medicaid
records. Yet the homes have been criticized in reports by their own state.
Jersey's examination comes on the heels of several others into New York's
treatment of the mentally ill, a constitutionally required state responsibility.
Other probes have been triggered by the Times and other published
reports. United States attorneys in Brooklyn and Manhattan, for example,
are looking into adult homes there used by the state.
responding to articles, the U.S. Justice Department is specifically reviewing
possible civil rights violations of mentally ill people put in locked
units in New York nursing homes — a practice the Pataki administration
adopted in 1996 and then suspended this year after published reports.
the recent gubernatorial campaign, Pataki repeatedly insisted that, in
fact, his administration has brought back 5,000 mentally ill patients
from out of state. But his aides and a Health Department official could
not offer evidence of that, the Times reported, and refused to answer
other questions or supply details about New York's mentally ill people.
How has the state's psychiatric hospital system managed to go from more
than 9,000 patients in 1995 to about 4,300 right now? Where are these
people? Certainly, they have not been welcomed home to their communities
or others, where group homes and programs for the mentally ill are anathemas.
Where is the evidence that state requirements for discharge planning of
these patients, which include stable housing and consistent services,
have been met? When New York has sent patients out of state, what efforts
are made to welcome them back? Many allege that they are not even allowed
back in to New York.
Why hasn't Pataki made his signature on legislation renewing funding for
the Community Reinvestment Act a priority? The Legislature passed the
2002 act in June, which was supposed to help fund mental-health services.
Originally passed in 1994, the act expired in 2001. Advocates, patients
and service providers complain bitterly that it never delivered on its
intent of using money saved from downsizing state psychiatric facilities
to fund local programs. Certainly, without the governor's signature, it
can't this year, either.
a scathing report issued at the height of Pataki's recent re-election
campaign, the Assembly Committee on Mental Health, Mental Retardation
and Developmental Disabilities called New York's mental-health system
"broken." It forcefully blamed the Republican governor: ".
. . The administration has hamstrung (the Legislature's) efforts with
bureaucratic delays, under-funding and regulations that have blocked effective
use of the programs," it said.
Oct. 31 report accuses the governor and the state Health and Mental Health
departments of ignoring legal and oversight requirements regarding the
mentally ill. It calls the system "a top-down planning process that
is inefficient, facilitating wasteful use of public resources. As a result,
thousands of mentally ill persons have suffered indignities and abuse.
Hundreds of other have suffered untimely deaths . . ."
concluded by saying, "The Committee regrets that, with regard to
the care and treatment of mentally ill residents of adult homes, it has
had to rely, to some extent, on investigative reports of the media . .
late as Thursday, the committee's chair, Assemblyman Martin Luster, D-Ithaca,
told the Editorial Board, the administration had not supplied all the
information requested by the panel since the adult-home scandal broke
earlier this year — nor had it met a deadline for a report due the
Assembly committee the previous week related to an important section of
the Mental Hygiene Law.
dispute could be attributed to partisan squabbling between the Republican
governor and Democratic-controlled Assembly. It could be, except for the
media reports. Except for the investigation called for by New Jersey.
Except for the investigations called for by the federal government.
Pataki administration apparently realizes that it now must answer sooner,
rather than later, where New York's mentally ill people are, how they
are faring and why.
Syracuse Newspapers November 25, 2002
No one chooses to be mentally ill. Just as no one would choose to get
cancer or contract diabetes, no one wants their brain to betray them.
People with mental illness are victims just as those with any other chronic
illness. They need medical attention.
ill people who are too sick to care for themselves or those who are so
affected that they could be dangerous are rightly the state's responsibility.
For generations, people with mental illnesses were confined to locked
hospitals. Some languished in wards for decades, having little contact
with the outside world. As science learned more about the problems of
the mentally ill, and as different forms of therapy developed, experts
recommended that many individuals could lead better and happier lives
in community-based programs.
York, like many other states in the 1960s, began shutting down the hospitals.
Some of them well deserved to close. They were horrible places - dark
and dank. Unspeakable things happened in those old wards. Patients were
abused every way possible. Their closure ended a grim era in this state's
the state never fulfilled the other half of the promise. Patients were
chucked out of the hospitals, but there simply were not enough places
for them to safely land. Instead of community-based homes with lots of
supervision and the proper kind of care, thousands of mentally ill people
were left to fend for themselves or they were sent to locked nursing home
wards - trading one nightmare for a new set of terrors.
this year, The New York Times uncovered records that proved hundreds
of mentally ill people were prisoners in nursing homes, never allowed
outside, living in wards and rooms with little or nothing to help them
month, the Times exposed another outrage. Hundreds more of these
patients were sent to nursing homes in New Jersey and Massachusetts -
homes that were already in trouble with their own state governments for
being substandard. They are places without the expertise or staff to care
for people who are mentally ill. Yet, according to state records, just
two nursing homes in New Jersey have collected more than $82 million in
New York Medicaid payments since 1995.
Massachusetts, the Sun Bridge nursing homes, known to be substandard in
every important way, were paid $260 million to care for mentally ill New
Yorkers, according to the Times, which cited Medicaid records.
This is how bad some Massachusetts homes are: One patient gouged out the
eye of another with his bare hands.
regulators say the Sun Bridge facilities have deteriorated markedly in
recent years, repeatedly criticizing them for mismanagement, shoddy care,
sexual assaults and other violence among residents, including the resident's
eye gouging last year," said a Times report.
Mental illness, like physical illness, often requires carefully calibrated
care. Medications have to be prescribed and delivered with precision.
Talk therapy has to be consistent. Neither of those things that can be
provided by people qualified only to look after aged people. Are any of
the people sent out of state ever seen by doctors? How does that work?
all of this, Gov. George Pataki has insisted the decisions to move patients
to nursing homes were made on a medical basis. He told the Times
during his campaign that more than 5,000 patients were brought back to
New York, but no records could be found to substantiate that. John Signor,
a spokesman for the state Health Department, told the Times the
administration had sent fewer than 50 people annually to facilities outside
New York. In fact, Medicaid records show that since 1995, more than 725
New Yorkers have gone to the Lincoln Park and Andover nursing homes (in
New Jersey) alone, an average of more than 90 a year.
the lies? Perhaps it's because the mentally ill don't have big campaign
contributors writing checks on their behalf. Perhaps it's because Pataki
knows it's wrong to victimize mentally ill New Yorkers this way.
in Syracuse, Hutchings Psychiatric Hospital was targeted by Pataki for
closure. It still could be, and God knows where the patients would end
up. This administration must be more forthcoming about its plans for caring
for the mentally ill.
Psych Center may be shut by state budget crunch
Middletown Times Herald Record, November 25, 2002
Ottaway News Service
Albany – Is Middletown Psychiatric Center on the state's chopping
With New York facing a budget gap that could run as high as $10 billion
next year, the state's largest labor union fears the Pataki administration
– in an effort to control costs – is once again eyeing the
shut down of the Monhagen Avenue hospital and others like it across the
very, very concerned and this is a large reason why we've been banging
the drum," said Steve Madarasz, spokesman for the 77,000-member Civil
Service Employees Association, which has long been critical of the Pataki
administration's mental-health policies.
State Office of Mental Health spokesman Roger Klingman would not say whether
hospital closures were being considered to help the state close its looming
deficit, saying it would be premature to comment on cost-cutting measures
prior to the release of Gov. George Pataki's proposed executive budget.
Harvey Rosenthal, executive director of the New York Association of Psychiatric
Rehabilitative Services, said he expects the administration to call for
the shutdown of some of its state-run psychiatric centers.
can't imagine that in a difficult budget year, when they're looking to
cut costs and close the budget gap, that state mental hospital closures
aren't on the table," Rosenthal said. "And I'd think Middletown
and Hutchings would be the ones you'd have to look at first since they
were targeted last time around."
Two years ago, Pataki proposed the closure of the Middletown center as
part of a plan to save the state $64 million.
Under that plan, which also included the shutdown of Hutchings Psychiatric
Center in Syracuse, part of the savings would have been diverted to community-based
mental health programs and pay for raises of direct-care workers.
At the time, most mental-health advocates supported the shutdowns, claiming
local programs were too cash-strapped to adequately provide services.
But lawmakers and the CSEA ultimately killed Pataki's proposal, arguing
the closures would leave gaping holes in the state's mental-health system
and cost too many good-paying jobs.
are some so-called advocacy groups that have these delusions that if the
state closes these hospitals there will be more money for their operations,"
Madarasz said. "But, they have been played. The fact of the matter
is, the state has walked away from that concept."
Nonetheless, the closure of state-run mental hospitals is nothing new.
With advances in psychiatric medicine and the proliferation of outpatient-treatment
programs, more than 80,000 state-run psychiatric beds have been lost over
the last 50 years.
Middletown has not been immune to those cutbacks. In 1981, for instance,
the hospital had 1,800 beds. Today, there are just 118, Klingman said.
In arguing for Middletown's closure two years ago, state Mental Health
Commissioner James Stone said one of the main reasons the hospital was
targeted was because $34 million in upgrades are needed to bring the center
up to accreditation standards.
then, there really has been no spending per se," Klingman said of
Steward DeGroat, president of the hospital's CSEA Local 415, said the
state's claim the center needs multimillion-dollar upgrades is little
more than an excuse to shut the facility down.
place is in great shape," he said.
Kate Abdoo, spokeswoman for Forestburgh Democratic Assemblyman Jake Gunther,
said the assemblyman "wouldn't be surprised" if the hospital
is targeted for closure again. But if that's the case, she said, Gunther
will fight as aggressively as he did two years ago to ensure that the
center remains open.
In recent months, the governor has been under intense fire from activists
and the CSEA for discharging mentally ill patients from state psychiatric
hospitals and placing then in ill-suited nursing homes and adult homes.
Other patients, meanwhile, have literally been shipped out of state.
next time, we remain, Working to ensure available and accessible mental
health services for all New Yorkers