MHW: Changes to RCE Doesn't Alter Advocates Support

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.