Listed below is the testimony that MHANYS provided at the recent Assembly
Mental Health and Developmental Disabilities Committee. In addition to our
testimony, we also referenced the importance of suicide prevention and
highlighted our concerns about adult home reform which we will discuss in a
future Mental Health update. We were very appreciative of Assembly member
Gunther and the other members of the committee for holding this hearing.

Testimony to the Assembly Standing Committee on
Mental Health and Developmental Disabilities

Subject: Access to Mental Health and Developmental Disability Services and
Supports

December 6, 2018

Glenn Liebman, CEO

Thank you to Assemblymember Gunther and the other members of the committee
for holding this hearing. We are very appreciative of all your support and
hard work on behalf of MHANYS and on behalf of the entire mental health
community.

My name is Glenn Liebman and I am the CEO of the Mental Health Association
in New York State, Inc. (MHANYS). We represent 26 member agencies in 52
counties, serving thousands of individuals with mental health related
issues. What brings our organization together is our collective advocacy
that focuses on the greater good of the entire community, including
fighting to end the discrimination of mental illness.

Through the leadership of Assemblymember Gunther and the entire committee,
there has been much that has changed in recent years in regard to mental
health public awareness and prevention. The mental health income tax check
of, the license plate bill highlighting mental health awareness and, the
most important of all, the initiatives. The mental health education bill
would never have come about without your leadership.

While New York State and the NYS Office of Mental Health should be
recognized and acknowledged for their innovative work in mental health,
there are still some significant gaps in our system that need to be
responded to through enhanced funding and community partnerships.

Workforce

In recent years, we have highlighted workforce issues as our number one
budget item. Later today, I will be attending a workforce summit dedicated
to providing solutions to the myriad of workforce issues sponsored by the
Executive Chamber. We are appreciative of the State holding this forum and
look forward to sharing our insight on tuition reimbursements, career
ladders, and other programs that will help New York recruit and retain a
quality workforce.

This will be an important discussion, but another part of the discussion is
paying a livable wage to the entire human services workforce.

Through the Legislature and Governor Cuomo’s leadership, there was a
funding increase for direct care staff in the mental hygiene agencies. This
6.5 percent increase for direct care staff and 3.25 percent increase for
staff such as social workers, psychologist, peers, and psychiatrists was
very important and much appreciated.

However, to support a livable wage for the entire sector, we need an across
the board COLA increase based on the CPI which is 2.9%.

For the last 11 years, there was a COLA built into the State budget but
every year it has been not withstood by the Executive, leaving the human
services sector with virtually no new funding during this period.

How can we ask the human services not-for-profits to work with our most
vulnerable New Yorkers to insure their safety, security, and recovery
without providing suitable funding to recruit the quality staff necessary
to achieve those ends? We are clearly concerned how to keep people
protected and safe in a nurturing environment.

These jobs are incredibly rewarding and powerful and the people in the
sector are driven by the need to help others, but they still need a place
to live, a car to drive, funding for their education and, most importantly,
to pay for the lives of their children. There is a high percentage of the
human services workforce that are single parents and one in four immigrants
in NYS are working in direct care services.

Those of us in mental health also know that raising funding for an entire
sector impacts behavioral health in a dramatically positive way. All ships
rise when funding becomes available.

Separate from any COLAs, there should be an infrastructure developed for
workforce so agencies can apply to get funding for things like tuition
reimbursements, career ladders, and educational scholarships.

Recommendation:

We need the Assembly and the entire Legislature to continue to embrace our
workforce and urge support for a 2.9% COLA in this year’s executive budget.
If it is not in the budget, we urge your support for the funding to be in
the final budget.

We also urge funding for a non-profit workforce funding project. We have
certainly witnessed other sectors in health care receiving these kinds of
incentives, it is only fair that those of us in the non-profit sector get
parity with other health care workers. The Centene funding for hospital
workforce was not something that we were opposed to – we just wanted to
ensure that the not-for-profit sector would have been provided with parity
with the hospital-based programs.

All of us in the behavioral health space are currently doing a survey of
our members to find out issues with recruitment and retention. We are all
speaking with one voice in calling for a 2.9 COLA and funding for an
infrastructure funding opportunity. In addition, our colleagues at Strong
Non-Profits, representing over 350 agencies, have made the COLA ask their
number one priority for the 2019 Legislative Session.

Mental Health Education in Schools

With New York State becoming the first State in the nation to mandate
education in schools, there is a lot of attention being payed to the law
and frankly, it has been in a very positive way. I was in Boston last week
talking to their advocates about the law. We have talked about it with many
States and have received interest from as far away as Ethiopia.

Since the actual implementation of the law began in September, there has
been a lot of positive news to share. We are pleased that school districts
across New York State have been complying with the law and, in many cases,
they are not only implementing the law but they are helping to change the
school climate to make the environment much more conducive to mental health
and mental wellness.

Last month, Assemblywoman Nolan held a hearing about mental and physical
health in schools and we were pleased to hear from Education Commissioner
Elia that she had not heard one word critical of this new initiative.

Through the leadership of Assemblywoman Gunther, MHANYS was able to get
funding in the budget to help create a School Mental Health and Training
Resource Center.

This funding has helped to spread the word about mental health in schools.
We were able to help fund regional representatives in the field to work
with our affiliates in talking to schools about the law. To date, we have
had successful engagement with over 40 percent of the schools in New York.

Our new website www.mentalhealthednys.org has generated thousands of
engagements through resources dedicated to educators, families, students,
and community providers.

Over the first three months of this school year, we have presented to over
five thousand educators, administrators, and families. We strongly believe
that the information we have put forward is helping to insure
implementation of the law and responding to needs around school culture.

The net result is that through this prevention lens, we are better able to
help normalize mental health in schools and treat it no differently than
you would treat physical health. Stigma and discrimination against those
with mental health related issues will be reduced and byproducts of that
discrimination like bullying and punitive measures like school detention
will also be reduced.

We are heading in that positive direction and the funding and legislative
support have a lot to do with that. We want to again thank you and the
Assembly for the funding support.

We also would like to acknowledge Commissioner Sullivan at the NYS Office
of Mental Health and Commissioner Elia at the Department of Education for
really supporting this initiative and insuring the long-term success of the
project. We are also appreciative of many of our peers in the education
community like the Schools Boards, Teachers, Administrators, Principals,
and PTAs for embracing these changes.

Recommendation:

We urge continued funding of one million dollars in the 2019-20 budget to
continue the School Mental Health and Training Resource Center

Housing

MHANYS is a member of the Bring It Home campaign comprised of over 950
community-based mental health providers who support increased funding for
housing in the budget.

You will be hearing shortly from my colleague Douglas Cooper, Associate
Executive Director of the Association for Community Living, which serves as
the lead organization in this campaign.

As in so many things, New York is a national model for housing. We have
more residential options in New York for people with mental health concerns
than any other State.

Despite that impact, the sad reality is that there has been very little new
funding to keep these existing units in line with cost increases that we
face in other sectors.

The minimal rate increase combined with a lack of a COLA has depleted
housing programs in New York State. Providers are forced to have people
work long shifts with not a lot of supports. Staffing standards have been
impacted, regulatory obligations are difficult to meet, and property values
continue to increase.

Long waiting lists, safety concerns, and staff shortages should not be a
legacy for the legal and moral obligation for housing of our most
vulnerable New Yorkers.

Recommendation:

We support a one-time increase in funding to support a rate increase for
mental health housing.

Criminal Justice

The largest state psychiatric facility in New York is Rikers Island. This
is an unfortunate byproduct of the transinstiutionalization of people with
mental health related issues.

There are several State and Federal initiatives that help respond to that
reform.

Recommendations:

1) Continue to fund Crisis Intervention Training Teams (CIT) in New
York State. CIT training has been a best practice in working with the
police and individuals in crisis to help better respond to emergency
situations. Through the State Senate, there has been increased funding for
CIT in recent years. We hope that this will continue to be a priority.

2) Mental Health First Aid Funding – In many corners of the State, law
enforcement has been unable to take advantage of CIT training for many
reasons including the 35 hours necessary to complete the training.

Mental Health First Aid is training that provides an eight-hour program
that responds to the needs of individuals while in crisis. For individuals
that are unable to complete CIT training, Mental Health First Aid has been
a good supplement to provide a basic knowledge of mental health to law
enforcement

3) We support our colleagues in the legislature and advocacy community
in sponsoring HALT legislation. No longer should individuals with mental
health concerns and other *issues be forced to spend time in solitary
confinement. It is both inhumane and* traumatic for someone who is already
facing mental health related issues.

4) We applaud the inroads being made by the State to support the
Federal Waiver that allows for individuals released from jails and prisons
to be presumed eligible for Medicaid thirty days before release. We believe
having services, housing, and medications in place before release will have
a great impact in cutting down on recidivism.

Geriatric Mental Health

As the population continues to age, there is a greater population of
individuals who are older that have mental health related issues. Over a
decade ago, the Legislature created the Geriatric Mental Health Act, which
provided demonstration projects across New York with a focus on best
practices in communities across the State. There have been several
successful models developed during this time but unfortunately there has
been little funding to replicate these models.

Recommendation:

Double the amount of funding for the Geriatric Mental Health Demonstration
Projects. In over the decade of this program, funding has remained stagnant
at two million dollars. We are urging support to double to four million in
the upcoming budget year. It is time to develop increased awareness of
individuals who are aging and have mental health related needs.

Other Issues of Concern

There is a litany of gaps in the care of individuals with mental health
needs – all of which need time, funding, and attention given to it in
response to our crisis of care.

Issues like adult home reform, HARP services through Medicaid Managed Care,
Links to Addiction Services, Health Homes, Family Engagement, Medication
Access, Veterans Mental Health, Mobil Crisis, Children’s Mental Health,
Reinvestment, Behavioral Health Parity, and Anti-Discrimination efforts are
all priority areas in mental hygiene and should continue to be discussed
and responded in a comprehensive manner.

Summary

At MHANYS, our mission is to end the discrimination and stigma of mental
illness. All the issues we have addressed have an impact through that lens.

You have been wonderful friends to our cause and that is greatly
appreciated. Of greatest need right now is the workforce crisis. Without a
quality workforce, we are going to continue to impact the safety, support,
and recovery of people in our community mental health system. In addition,
as we know, behavioral health impacts every area in the not-for-profit
sector from maternal health to juvenile justice and to all the social
determinants of health. The entire human services community is in need of a
COLA for 2019-2020.

New York leads the nation in the continued growth of mental health in
schools. This is a model that other States and countries are looking at as
the face of change for prevention of mental health issues and for the
normalizing of mental health and physical health. New York must continue to
lead the way and we urge continued support for funding the School Mental
Health Resource and Training Center.

Housing rates continue to be inadequate. Through the work of the Bring It
Home campaign, we also urge your support for a one-time infusion of funding
for residential rates.

There is so much work to do in behavioral health in so many issue areas and
we are very appreciative of all you do to help respond to those needs.

Thank you for all your hard work and dedicated leadership and I look
forward to any questions from the committee members.

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