N.Y. Advocates Pleased About Reinvestment Plans in Community
Mental Health Weekly; Volume 23, Number 48, 12/23/13
Editor’s note: As MHW went to press we learned that Gov. Andrew Cuomo has revised the state’s recon- figuration plans. Under the new plan, announced Dec. 19, three of the nine state psychiatric hospitals slated for closure will remain open along with the expansion of community services, including the establishment of a Children’s Behavioral Health Center of Excellence. Advocates will resume their push for community reinvestments. MHW will continue to follow these developments.
New York state’s mental health community is pleased that Gov. Andrew Cuomo’s administration has committed up to $25 million in its upcoming budget as part of the state’s sweeping plan to consolidate its inpatient psychiatric care facilities and reinvest savings from planned hospital closures into the community. Advocates expressed support for the state’s financial commitment during a news conference Dec. 16.
In July, the state announced plans to reduce its 24 psychiatric hospital systems to 15 to create regional centers of excellence (RCEs). An RCE model will be regionally based networks of inpatient and community- based services, each with a specialized inpatient hospital program located at its center, with geographically dispersed community services “hubs” overseeing community-based services (see MHW, July 22).
If implemented, the plan will re-invest up to $73 million over the next three years that will be used to improve current services and to extend help to an estimated 7,000 more individuals and families in need. Additionally, the proposal to reconfigure state mental health services would redeploy state staff to critically needed outpatient roles.
Advocates say they are pleased by a commitment from state officials to include $25 million in its upcoming budget to boost community services in advance of the state hospital closures.
The $25 million in funding for pre-investment is a good idea, said Glenn Liebman, CEO of the Mental Health Association in New York State (MHANYS). “The most important part, besides the reconfiguration, is to make sure that money is in place for the closures,” Liebman told MHW. “We’re pleased to see the state commitment to ensure there is going to be money following individuals when they leave the facilities.”
Gov. Andrew Cuomo is planning to introduce his state budget in late January, said Liebman. While the $25 million will be impactful, advocates intend to work with the legislature and the administration for increased funding to pay for other mental health commitments not related to facility closures, he said.
“We have made another step in the process toward the state mental health reconfiguration,” Harvey Rosenthal, executive director of the New York Association of Psychiatric Rehabilitation Services (NYAPRS), told MHW. “We learned that the state is making a substantial commitment to this [effort].”
Rosenthal added, “They’re increasing services even before state officials start closing hospital beds. That’s really critical to everything. This is a very progressive plan and long overdue.”
The services, based on the recommendations by the steering committee, would include 24-hour family support services, walk-in urgent care, crisis respite services, peer support and housing, said Rosenthal.
Other services would include:
• Establishment of mobile engagement teams to respond to calls and to provide assessment, consultation, first-line treatment and referral to services.
• Expansion of first-episode psychosis teams to address the unique needs of young adults experiencing the critical early stages of schizophrenia or other psychotic illnesses.
• Expansion of forensic diversion services to reduce incarceration and pressures on jails, and transportation to improve access to services in rural areas.
• Expansion of evidence-based family support services, including Multi-Systemic Therapy (MST), and other modalities to improve children’s recovery outcomes.
The state’s new community funding would commit about $110,000 for every hospital bed closed for com- munity services, an increase from the current statutory level of $70,000 per bed, he said.
It’s important to know that under the RCE plan there will be no staff layoffs, said Rosenthal. “This proposal increases jobs,” he said. Hospital staff will be transferred to community jobs, and many will be retrained for jobs in the community, said Rosenthal.
“If the community sees a dramatic array and diversity of services, you will see the need for hospital services decrease dramatically,” Rosenthal said. The plan is expected to be implemented in 2014 and completed by 2017.
Family resource center
While the state plans to downsize some hospitals, all hospital hubs would still exist, said Liebman. “We’re trying to push the idea for a family resource center in the hub,” he said. The center would assist families visiting loved ones in psychiatric facilities with lodging in the community, transportation and other supports, Liebman said.
“We want to make sure the state responds to the needs of family members as well,” he said. MHANYS has already talked to the state about the center, said Liebman. “They recognize that families are strong constituents,” he said.