Mental Health Update

For probably the first time in New York’s history, mental health is front and center in the State of the State. The number one symbolic issue we have faced for many years is the stigma of mental health challenges. The fact that Governor Hochul choose to address these issues in the State of the State is a very positive step forward for our community.

We are very appreciative of Governor Hochul leading with an innovative discussion of mental health resources.  Creating new services through increases of 42 ACT teams, 50 Time Critical Intervention teams, 5 SOS Teams,  26 CCBHC clinics and a dozen CPEPS is unprecedented  and will help provide needed resources to an underfunded system of care.

In addition, 3500 residential beds in New York through a variety of SRO, Transitional Step Down beds, licensed apartments and supported housing units will help respond to the overwhelming need for more housing.  The key is to make sure that these beds are out the door appropriately and rapidly. Capital construction can take several years to build but this is clearly a priority.

In addition, there is a proposal to increase hospital beds by 1000– 850 beds through community hospitals and 150 for State Psychiatric hospital beds.    We strongly support the Governor in vesting OMH with ability to ensure that they will better able to support the policy of converting beds that went go to medical/surgical beds to transition to mental health beds.   These beds will be monitored to insure that individuals are getting appropriate services.

We do have concerns about the 150 new inpatient psychiatric beds.  There will be overall greater scrutiny around those beds which is obviously a good thing but the movement back to state psychiatric hospital beds is not a positive trend.  People recover with community support and not state psychiatric beds.

While we applaud Governor Hochul’s innovative movement around mental health transformation (outside of opening 150 more psychiatric hospital beds), the biggest concern we have is who will we have to run and engineer this innovative programming. If you talk to any of our members, the refrain is always the same—-‘great programs, but we don’t have the staff to run these programs’.

What will greatly help is support for an 8.5% COLA. We await the budget in a few weeks to see if the bold plan will be able to meet expectations through appropriate funding for our mental health and human services workforce.

As leaders in the fight for mental health education in schools, we were very pleased that the Governor referenced the importance of school mental health. Increases around Medicaid for school based mental health clinics is a great step forward.  We also have to increase the presence in school settings themselves through additional counselors, social workers and other clinical staff. And most importantly is the importance of working with schools to help create an atmosphere of mental wellness and connections to careers in mental health which is consistent with

We also applaud the Governor for her work in supporting behavioral health parity.  No one should be denied coverage because they are paying a premium not equivalent to what they would pay for physical health care—it is sad in this day and age we still have to say it but that is the reality of some plans continuing to reject mental health benefit claims

Glenn Liebman
he/him/his
CEO, MHANYS

(518) 434-0439 | MHANYS.org

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Facebook: @MHAacrossNYS
Twitter: @MHAacrossNYS

GOVERNOR HOCHUL ANNOUNCES COMPREHENSIVE PLAN TO FIX NEW YORK STATE’S CONTINUUM OF MENTAL HEALTH CARE 

Transformative Plan will Increase Capacity for Inpatient Psychiatric Treatment by 1,000 Beds and Add 3,500 Housing Units Serving Individuals with Mental Illness 

Governor Calls for Systemic Accountability for Mental Health Admissions and Discharges; Dramatic Expansion of Outpatient Services and Insurance Coverage

Governor Kathy Hochul today announced, as part of the 2023 State of the State, a comprehensive plan to overhaul New York’s continuum of mental health care and drastically reduce the number of individuals with unmet mental health needs throughout the state. The multi-year plan includes increasing operational capacity by 1,000 beds for inpatient psychiatric treatment, creating 3,500 units of housing to serve New Yorkers with mental illness, increasing insurance coverage for mental health services, dramatically expanding outpatient services, and creating systemic accountability for hospital admissions and discharges to better address the needs of individuals suffering with mental illness. These proposals, over time, will reflect more than $1 billion in investment in mental health.

“When it comes to protecting New Yorkers’ well-being, strengthening our mental health care system is essential and long overdue,” Governor Hochul said. “We have underinvested in mental health care for so long, and allowed the situation to become so dire, that it has become a public safety crisis, as well. This proposal marks a monumental shift to make sure no one falls through the cracks and to finally and fully meet the mental health needs of all New Yorkers.”

Governor Hochul will realign the state’s approach toward mental health with a comprehensive package of investments and policy changes aimed at transforming all parts of the mental health care continuum -from prevention to treatment to recovery. This includes:

• Increasing operational capacity for inpatient psychiatric treatment by 1,000 beds: During the COVID-19 public health emergency, the State allowed hospitals to make operational decisions that resulted in taking inpatient psychiatric beds offline, even while the operating certificate for the beds remained in place. Governor Hochul’s plan will direct Article 28 community hospitals to immediately bring 850 currently offline inpatient psychiatric beds online. New legislation will allow the state Office of Mental Health to fine Article 28 community hospitals up to $2,000 per violation per day for failing to comply with the number of psychiatric beds outlined in their operating certificate. The State will also open 150 new adult beds in state-operated psychiatric hospitals, including 100 in New York City alone, which are in addition to the 50 beds that the Governor announced last November.
• Creating 3,500 new housing units for individuals with mental illness: Governor Hochul will make a massive capital investment and provide the necessary operating funds for 3,500 new residential units serving New Yorkers with mental illness. Specifically, the plan calls for:

• • 500 community residence-single room occupancy units to provide housing and intensive services to individuals with serious mental illness and at the highest risk of homelessness.

• • • 900 transitional stepdown units to help individuals transitioning from various levels of care to community-based living.

• • • • 600 licensed apartment units to serve individuals requiring an intermediate level of services to be able to live in the community.

• • • • • 1,500 supportive housing units serving individuals with serious mental illness, split between scattered-site rental units that can be opened quickly and new construction or renovated facilities completed over the next five years.

Improving Admissions and Discharge Planning and Establish Systemic Accountability 

• Governor Hochul is proposing a combination of policy changes and investments to create systemic accountability for admissions and discharges, including requirements that hospitals responsibly admit patients in need of care, with new comprehensive standards for evaluation and increased state-level oversight to ensure new protocols are being used effectively; emergency departments and inpatient providers discharge high-risk, high-need individuals into immediately available wraparound services; and outpatient programs to provide immediate and ongoing appointments for high-risk individuals during the discharge process. The plan also calls for the creation of 50 new Critical Time Intervention teams to provide wrap-around services for discharged patients – from housing to job supports.

• Dramatically expanding outpatient services: Governor Hochul’s plan will substantially expand a wide range of outpatient services to expand mental health care access, reduce wait times, and ensure appropriate levels of care. Specifically, the plan includes adding:

• • 12 comprehensive psychiatric emergency programs, providing hospital-level crisis care across New York State.
  • 42 Assertive Community Treatment teams to provide mobile, high intensity services to the most at-risk New Yorkers, with 22 new teams in New York City and 20 in the rest of the state.
  • 26 Certified Community Behavioral Health Clinics to provide walk-in, immediate integrated behavioral health care, providing both mental health and substance use disorder services for New Yorkers of all ages and insurance status, supplemented by an indigent care pool to ensure access regardless of one’s ability to pay. This will triple the number of Certified Community Behavioral Health Clinics in New York State from 13 to 39, serving approximately 200,000 New Yorkers.
  • Eight Safe Options Support teams to provide outreach and connection to services for homeless populations with mental illness and substance use disorders, with five new teams in New York City and three in the rest of the state. This will build on the Safe Options Support teams introduced by Governor Hochul in last year’s State of the State that are currently in operation in New York City.
  • 20 expanded-capacity Article 31 mental health clinics providing care to the most vulnerable New Yorkers, which often serve as a front-door mental health service in communities across the state
  • Health Home Plus care management to provide assistance as individuals with mental illness seek to access the services they need, hiring dozens of new care managers to serve individuals with serious mental illness.

• Expanding insurance coverage for mental health services: The plan will close critical gaps in insurance coverage for mental health services. This includes prohibiting insurance companies from denying access to medically necessary, high-need, acute and crisis mental health services for both adults and children, expanding commercial and Medicaid coverage of mental health services to improve the well-being and success of individuals once they leave hospitals or emergency departments. The plan will also set appointment availability and geographic accessibility standards for behavioral health services to ensure New Yorkers have access to treatment from in-network providers, and ensure access to behavioral health services whether it is delivered in-person or via telehealth.

Expanding Mental Health Services for School-aged Children  

• Governor Hochul proposes expanding access to mental health services in schools by increasing Medicaid payment rates for school-based satellite clinics and school-based wraparound services, to incentivize further development of this critical care. In addition, the Governor will introduce legislation requiring commercial insurance providers to pay for school-based services at a level equal to the higher paying Medicaid rate, to ensure timely access for all children. The plan also outlines an annual investment to provide the start-up funding necessary to get new and expanded school services in operation quickly.

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Additional news available at www.governor.ny.gov
New York State | Executive Chamber |press.office@exec.ny.gov | 518.474.8418

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