NYAPRS Note: Reactions have poured in about yesterday’s release by the NYS Office of Mental Health of their plans to reconfigure state operated services and create a reduced number of state of the art regional Centers of Excellence (see below for a revised version of our NYAPRS First Look summary).
A number of prominent mental health advocacy groups have come out in strong support of the plan, and are calling for assurances that savings will be kept in the system and reinvested into boosting local mental health nonprofit systems.
Senate Mental Health Committee Chairman David Carlucci has praised the plan while a number of state legislators including the powerful Binghamton Senator Tom Libous have vowed to fight it.
The Auburn Citizen has cautioned state unions from using ‘scare tactics.’ Nonetheless, the Civil Services Employees Association has blasted the plan while the Public Employees Federation has held comment while it studies the plan.
One county mental health director offered appreciation for the concept but concerns about the details.
State mental health services are ultimately about the people who they serve. It is their voice that needs to be considered above all others. The state system is supposed to about treatment first and not jobs, jobs which the plan is fully preserving by redeploying state workers to where they’re needed most, which is in promoting recovery and not the custodial approaches of the past.
Stay tuned for more actions and details!
Nine State Psychiatric Centers To Close In Plan
Albany's CDPC To Expand In Plan To Shut Nine State-Run Psychiatric Hospitals
By Rick Karlin Albany Times Union July 10, 2013
The state Office of Mental Health on Wednesday unveiled a sweeping plan to consolidate and reduce the number of state-run psychiatric hospitals from 24 to 15 over the next three years.
"The time has come to fundamentally change the way we think about mental health in New York state," OMH Acting Commissioner Kristin Woodlock said in releasing the plan.
By the time it's concluded, though, New Yorkers with mental illnesses will be far less likely to be treated at a large state hospital. Instead, they'll seek help from one of the 15 regional centers or reside in a local community-based facility.
Mental health officials note that New York, with a population of roughly 19 million, may be the nation's sole holdout in terms of how many psychiatric hospitals it maintains. California, with approximately 38 million residents, has five such centers.
Under the "Regional Centers of Excellence" plan, large facilities such as those near Middletown, Elmira and Ogdensburg will close or merge, but hospitals including Albany's Capital District Psychiatric Center will expand to absorb clients from the closed sites.
CDPC also will serve as a regional hub offering a wider array of services and coordinating with smaller residential facilities.
Disclosure of the overhaul, which has been months in the making, was welcomed by those who provide mental health services, although they cautioned that they will be watching to ensure the savings go back into community services.
"Our organizations welcome these proposals," read a statement issued by seven organizations that provide non-hospital services such as treatment and housing to those with mental illness.
The groups "want to ensure that a significant portion of state savings from staff attrition and facility closures is reinvested into local communities to boost nonprofit services."
"I think this is really bold," added Harvey Rosenthal, executive director of the state Association of Psychiatric Rehabilitation Services and one of the letter's signatories.
He noted that Gov. Andrew Cuomo's administration appears to be trying to avoid conflict with politically powerful unions like the Civil Service Employees Association and the Public Employees Federation by offering assurances that the closures won't lead to layoffs except through attrition.
As part of "ensuring continuity of employment," OMH says it will redeploy unionized hospital employees to work in outpatient centers. The agency will also offer transfers to other state agencies and retraining as needed.
The Cuomo administration and its predecessors have for several years been downsizing the once-vast upstate system of adult and youth prisons. That scheme, however, has been met with resistance from lawmakers whose communities rely on the prisons for jobs.
At least one influential state senator was already speaking out against the OMH plan: Binghamton's Tom Libous, the chamber's Republican deputy leader, said the decision to close facilities in Binghamton and Elmira "destroys services in the Southern Tier."
Unions also remained wary, noting the plan, which won't begin in earnest for a year, is short on details about precisely where people leaving the existing centers will go, and how local communities will absorb and pay for them.
"Once again, the Cuomo administration is purposely misleading the public about the impact of his policies by packaging his proposal with a nice-sounding name without providing any real detail about how services will be provided or supported," CSEA President Danny Donohue said in a statement.
CSEA represents about 5,000 workers in OMH facilities.
Many workers are underutilized due to a steady decline in the number of people who live in psychiatric hospitals.
The trend is seen as the result of advances in treatment and medication, and the decades-old mandate against needlessly confining people with mental illnesses.
According to OMH, there are fewer than 5,000 people residing in its psychiatric centers, compared with roughly 93,000 during the 1950s.
State Wants To Close Inpatient Psych Services At Binghamton Health Center
By Jessica Bakeman Gannett News Service July 10, 2013 |
An inpatient psychiatric center in Binghamton is on the state’s list to be closed under a consolidation plan announced Wednesday by mental health officials in Albany.
The plan, which state officials claim will save millions of dollars and provide improved services to mental health patients, drew immediate opposition from Binghamton’s legislators in the Senate and Assembly.
Sen. Thomas W. Libous, R-Binghamton, said he will fight the state’s plan because locking the doors at the local psychiatric center will not only eliminate jobs, but also disrupt families and actually threaten the quality of mental health care.
“The entire Southern Tier region of the state no longer will have psychiatric services. That’s horrible,” said Libous, who is also the deputy majority leader in the Senate. “To look at this as a numbers game, to just say we are going to save money, is extremely insensitive.”
Assemblywoman Donna A. Lupardo, who has a professional background in mental healthcare, was also skeptical of the proposal to close what is known as the Greater Binghamton Health Center on Robinson Street.
“I am very disappointed to learn of the planned closure of both the adult and children’s inpatient units at GBHC,” said Lupardo, D-Endwell. “Given the community need and the intense effort that went into its creation, I will ask that the decision to discontinue children’s inpatient services be revisited.”
Lupardo said the closing would leave a “huge service gap” not only in the Binghamton area, but also throughout the Southern Tier.
On the positive side, she said there are no planned layoffs because the center will become an Office of Mental Health outpatient service hub. Under the plan, she said community services would be expanded.
The state hopes to protect jobs by shifting employees to the new regional centers or reassigning inpatient workers to community-based positions. Employees in Binghamton, for example, could opt to transfer to regional hospitals in Buffalo, Syracuse or Utica, or could be placed in outpatient clinics or other vacant mental health positions locally.
The state wants to consolidate its 24 psychiatric hospitals into 15 regional centers over three years, but officials do not expect layoffs.
Adult inpatient psychiatric centers in Binghamton and Elmira are set to close, starting in 2014, while a Rochester hospital will transform to a regional forensic facility, treating mentally ill people in the criminal justice system. Another forensic hospital in New Hampton, Orange County, will shut its doors, as will a children’s facility in West Seneca, Erie County.
Along with Rochester, regional centers will be established in Albany, Syracuse, Utica and Rockland County, as well as in New York City and Long Island. The state is expected to save $20 million in the consolidation.
There are currently 373 employees at the Binghamton hospital and 363 at Elmira, state records show. The Rochester hospital that’s closing has 542 employees. At the New Hampton facility, there are 553 employees, and in West Seneca, there are 169. State officials stressed that the employee counts include inpatient, outpatient, facilities, administration and residential staff, and not all positions would be impacted.
Another change in the consolidation plan will allow patients to choose where to seek treatment, eliminating requirements based on geographical area.
“Working together with communities, we can and will change the outdated and costly way we serve individuals with mental illness,” Acting Mental Health Commissioner Kristin Woodlock said in a statement Wednesday. “We are courageous and determined to take the lead in moving our behavioral health system towards excellence.”
The state’s largest public employee union knocked the plan in a statement Wednesday, calling it vague and irresponsible.
“There is nothing of excellence in Governor Cuomo’s proposal to close psychiatric centers, leave seriously ill people without the help they need and dump more unfunded mandates on local taxpayers,” said Danny Donohue, president of the state Civil Service Employees Association.
The state is required to announce any closures or consolidations a year before they begin, so hospitals will not be affected until July 2014.
The plan to reorganize the hospitals was included in Gov. Andrew Cuomo’s budget proposal in January. Lawmakers removed it from the budget but gave the mental health office the power to lead the consolidation without further legislative approval.
Where inpatient hospitals will close, the state will create community-based “hubs,” which will provide administrative support for outpatient service providers. Whether the “hubs” will be located in the existing hospital buildings or elsewhere will be determined on a case-by-case basis by teams of local mental-health professionals.
Five regional teams will flesh out the consolidation plan. The teams will each include a senior executive from the office of mental health, a county mental health director and a community representative, all to be appointed by the state mental health commissioner.
Existing psychiatric hospitals in Binghamton, Syracuse and Utica will merge to form the Empire Upstate Regional Center, with two inpatient campuses. An adult facility will house 185 beds in Syracuse, and a children’s facility will have 75 beds in Utica.
The adult psychiatric centers currently in Buffalo and Elmira, and the children’s treatment facility in West Seneca, will merge to create the Great Lakes Regional Center in Buffalo. The consolidated facility will house 208 beds by 2017, when the plan is fully implemented. Rochester’s adult inpatients will be transferred to regional centers in Buffalo or Syracuse. Under the plan, the existing mental hospital in Rochester will transform into the Western New York Regional Forensic Center by 2017, serving 155 people in the criminal justice system, such as those who were deemed mentally unfit to stand trial for a crime.
The adult and children’s psychiatric centers in Rockland County will merge to form the Lower Hudson Regional Center in Orangeburg, which will house 405 beds by 2017. A research-driven regional center will also be located in Rockland County at the Nathan Kline Institute, which collaborates with New York University on psychiatric research.
Outpatient “hubs” will be located in Buffalo, Rochester, Binghamton and Elmira, as well as Westchester County, Poughkeepsie and Middletown, Orange County.
Several hospitals in New York City, Long Island and the North Country will also close or merge to form regional centers.
The state Public Employees Federation, a union, said it was still reviewing the plan to determine how it would impact its members. The union estimates it has 9,500 members statewide working in facilities that will merge into regional centers.
“Our concerns are for our members’ continuity of employment and that the quality services that our members provide to this community are continued,” spokeswoman Jane Briggs said.
Mental health advocates lauded the plan in a statement Wednesday, although they said they hope to see the state reinvest savings into community-based programs.
“Our organizations welcome these proposals to reconfigure state dollars and staff in a way that maximizes state resources to meet our communities’ most pressing needs, while at the same time creating state-of-the art regional psychiatric facilities that are among the nation’s best,” said the state Association of Psychiatric Rehabilitation Services, the Mental Health Association and other groups.
Elmira Psychiatric Center Set To Close
Written by G. Jeffrey Aaron Ithaca Star-Gazette July 11, 2013
The Elmira Psychiatric Center is slated to lose its inpatient beds and be converted to a “regional hub” for outpatient and community services, according to proposal released Wednesday by the state Office of Mental Health.
The consolidation plan released by the Office of Mental Health calls for consolidating 24 inpatient hospitals statewide into 15 regional centers and establishing more than two dozen outpatient service hubs. The plan would begin in 2014 and is expected to save $20 million the first year. The state spends about $6.6 billion, including federal funds, annually on mental health treatment.
While some area mental health officials say the system is in need of an overhaul, they are anxiously awaiting the final version of the proposal. Hospital closures or consolidations require one-year notice to state legislators, so nothing will happen until next July. But between now and then, lawmakers in Albany and numerous advisory committees will meet to hammer out the final version of the proposal.
“The proposal is both good and bad,” said Brian Hart, director of Mental Hygiene Community Services in Chemung County. “Any effort to revamp the system is a good thing in general, but the devil is in the details. I can appreciate what the commissioner is trying to do. Revamping a system that needs it is a huge challenge in today’s environment, but it’s a start and the framework will be developed over the next 12 months.”
Hart also said it’s important to remember the proposal is just a plan and not the final document.
“The final result could be any number of modifications with local details added,” he said.
New York opened its first asylum 175 years ago, and it's time to fundamentally change the way the state thinks about mental health, according to Acting Commissioner Kristin Woodlock. About $1.3 billion, or 20 percent, is currently spent on inpatient care for about 1 percent of its patients, the agency reported. The psychiatric hospital census has dropped to about 4,000 down from 93,000 in the 1950s.
Meanwhile, the Elmira Psychiatric Center has led the state in a number of performance metrics and is the state’s top-ranked facility in terms of cost effectiveness, said state Sen. Tom O’Mara, R-Big Flats.
“Trying to revamp the whole system and shutting down inpatient services at the Elmira facility is like throwing the baby out with the bath water,” O’Mara said. “I’m very disappointed with the lack of inpatient services in the Finger Lakes region, particularly in the area of children’s beds. It would be problematic for youth or their families to have to travel to either Buffalo or Utica and I’m concerned about the loss of jobs associated with this over time.”
On Wednesday, state officials emphasized that jobs would not be cut but that employees will be giving the opportunity to transfer to open positions.
The 15 regional centers with inpatient hospitals are planned for Buffalo and Rochester; Syracuse and Utica; Albany and two in Orangeburg in the Hudson Valley; Brentwood on Long Island; and Brooklyn, Staten Island and Queens, with two in both the Bronx and Manhattan.
Other psychiatric hospitals in Buffalo, Binghamton, Orangeburg and on Long Island will close and consolidate with new centers in 2014, followed by closings and consolidations in Rochester, Ogdensburg and Manhattan the next year, and in Orange County in 2016, according to the plan.
"Working together with communities, we can and will change the outdated and costly way we serve individuals with mental illness," Woodlock said. The plan, which followed a statewide listening tour and more than 2,000 public comments, will expand community services and let individuals and families choose where to get treatment, eliminating current geographic restrictions, she wrote.
“There’s a commitment to not lay off workers but as beds are taken down there will be a need to bolster the outpatient system,” Hart said. “So, there will be lots of discussion at the state level to talk about what the bolstered outpatient plan will look like.”
New York has far more psychiatric hospitals than any other state and it's been difficult to close them because of legislative opposition over the jobs they provide, though recent authorization by lawmakers enabled the Cuomo administration to move ahead with the overhaul, said Harvey Rosenthal, executive director of the New York Association of Psychiatric Rehabilitation Services.
"This positions New York at long last to move away from the biggest hospital system in the country," he said, “and instead put those tax dollars into the best community system we can create."
But as presented, the proposal doesn’t take into consideration issues like travel and housing, said state Assemblyman Chris Friend, R-Big Flats.
Downstate communities have mass transit systems that make it easier for families to visit relatives staying in the inpatient regional centers. But the situation upstate is quite different, Friend said, and having to travel to Buffalo or Utica could be difficult for area families.
Locating affordable apartments for community-based housing programs for outpatients could also become a challenge, Friend said.
“The real impact will be on the children, the youngest and most vulnerable,” he said. “Families need to be involved in the treatment but having to get to other areas for inpatient service creates a real hardship. It would be nice to have the governor look at Elmira facility’s models within their 11-county district try (and) to duplicate them upstate rather trying to revamp everything.”
O’Mara agrees, saying he’s “truly angered and disheartened” that the administration has failed to heed repeated calls to save the Elmira Psychiatric Center.
“It’s a failure to recognize the fundamental importance of the Elmira Psychiatric Center to the 11-county region this dedicated, high quality and successful facility has served with distinction,” he said.
According to the Office of Mental Health, in any given year one in four New York adults has a diagnosable mental disorder, while one in 17 has serious mental illness. The Elmira facility employs about 360 full-time workers, with 143 of them providing inpatient services and 113 providing outpatient services plus administrative staff. In 2011, the facility admitted 268 inpatients.
Orangeburg Included Among State Mental Health Centers
By Ryan Buncher Pearl River Patch July 11, 2013
The New York State Office of Mental Health (OMH) announced a plan that would include OMH Regional Centers of Excellence in Rockland County.
State Senator David Carlucci (D-Rockland/Westchester), who is the chairman of the State Mental Health and Developmental Disabilities Committee, praised the plan, which is part of a restructuring of the existing bureaucracy with a goal of providing better community-based care. The state is consolidating 24 mental health facilities into 15
The Rockland Psychiatric Center and Rockland Children's Psychiatric Center, both in Orangeburg, are being consolidated to form the Lower Hudson Regional Center for Excellence. The Nathan S. Kline Institute at 140 Old Orangeburg Road in Orangeburg will be the Nathan Kline Research Center of Excellence.
"I am absolutely thrilled that OMH has decided to base part of its regional operations right here in Rockland County," Carlucci said. "This is also a huge win for the people of the Hudson Valley living with mental illness and their families, who depend upon quality care and treatment. I can think of no more fitting place better suited to meet the needs and the mission of the Regional Centers for Excellence."
The Regional Centers for Excellence will include community service hubs created to improve oversight of state operated outpatient service providers.
Our View: Taking Psychiatric Care Into New Era
Auburn Citizen July 11, 2013
It's too early to tell how this will all shake out, but a plan by the state to consolidate psychiatric services appears to be a move that's long overdue.
A few decades ago, New Yorkers by the thousands were stockpiled in so-called "insane asylums" because people simply didn't know what else to do. But advances in knowledge, treatment and medications mean that many people who once would have been institutionalized can get along fine with the appropriate care. So a plan by the state Office of Mental Health to close some of the state's inpatient hospitals and open new outpatient service facilities throughout the state makes a lot of sense. The changes would be phased in over time, with an expected savings the first year of $20 million.
At this point, we urge the state to move cautiously - and the critics to choose their words carefully.
The health and safety of people in need of psychiatric care is paramount, and great care must be taken to ensure that those requiring inpatient or outpatient treatment will still have access to those services. And great care must be taken to explain any upcoming changes to these vulnerable patients and their families to avoid any undue stress.
The scare tactics so often employed whenever there's talk about retooling the public workforce are out of place in this instance, but that didn't stop the CSEA from quickly predicating that the consolidation plan would "leave seriously ill people without the help they need."
There seems to be no question that the model the Office of Mental Health has been working within is out of date, and the state could be providing psychiatric services in a much more cost-effective manner and even get better results for those in need of care.
Balancing the need to provide adequate services with a need to cut costs will be tricky. The state needs to tread lightly as it implements these changes, and critics of the plan need to recognize that their rhetoric might do more harm than good.
Psychiatric Facilities For Children To Expand In Utica
By STEVE HUGHES Utica Observer-Dispatch July 10, 2013
It doesn’t look like the area will lose any more jobs under the state’s psychiatric hospital reorganization plan.
In fact, Mohawk Valley Psychiatric Center’s inpatient children’s unit could add a few jobs in the next two years when it consolidates with another state center.
That consolidation will add 90 beds to the 75-bed Utica facility as it becomes part of a 20-county regional center, according to a state plan released Wednesday that lays out the future for mental health care across the state.
The plan merges the state Office of Mental Health’s 24 inpatient hospitals into 15 regional for excellence centers and establishes more than two dozen outpatient service hubs over the next few years.
“This is an investment in the future of mental health care in New York state,” said Office of Mental Health spokesman Ben Rosen.
The Central New York region’s center, known as the Empire Upstate Regional Center for Excellence, will include Hutchings Psychiatric Center and the Mohawk Valley Psychiatric Center.
It will have two inpatient facilities - an adult ward with 185 beds in Syracuse, and wards for children and adolescents in Utica.
In addition, the children’s inpatient ward in St. Lawrence will be closed in 2015 and 90 beds will be moved to Utica. Nearly 60 people work in the Utica unit, according recent reports. It couldn’t be learned Wednesday how many jobs could be added here.
The plan was a relief to local officials and employees: Last July, the adult inpatient facilities were closed in Utica and sent to Hutchings. Nearly 140 jobs were affected.
“We advocated that (Mohawk Valley Psychiatric Center) was ideally positioned to be designated a Regional Center of Excellence, and Oneida County looks forward to realigning community based services to serve as a model to neighboring counties,” said Linda Nelson, Oneida County Mental Health commissioner, in a news release.
There will be four community hubs in the Central New York region, located in Ogdensburg, Utica, Syracuse and Binghamton, to provide outpatient community services to a 20-county region.
Separately, Marcy’s Central New York Psychiatric Center, which provides psychiatric care to inmates, will be renamed the Central New York Forensic Center.
A spokeswoman for the union representing state employees at the psych center could not be reached for comment.
Consolidation begins in 2014 and is expected to save $20 million the first year. The state spends about $6.6 billion, including federal funds, annually on mental health treatment and has the largest network of psychiatric hospitals in the country.
Glenn Liebman, CEO of the Mental Health Association in New York State, applauded the state for its approach to overhaul the mental health care system.
Some concerns remain though, including how or if the state will reinvest the money it saves from closing psychiatric hospitals.
“The devil is in the details,” he said. “We’d like to see more specifics. First there’s the notion of reinvestment, which is taking the money from the closing and moving it into community services. We want to make sure the money is kept in the system.”
State Plan Guts St. Lawrence Psychiatric Center Inpatient Services;
Full Impact On Jobs, Services Unclear
By ELIZABETH LYONS Watertown Times July 11, 2013
Local and state officials said they are preparing to fight to maintain jobs and services at the St. Lawrence Psychiatric Center following an announcement Wednesday that its inpatient services will be moved to other facilities by 2015.
As part of a three-year plan by the state Office of Mental Health to revamp how psychiatric care is delivered, the psychiatric center’s adult inpatient services will be moved to the Empire Upstate Regional Center of Excellence, Syracuse, starting next year. Children and youth services will be moved to the Empire State Regional Center of Excellence in Utica starting in 2015.
The St. Lawrence Psychiatric Center will maintain its secure sex offender treatment program.
OMH spokesman Benjamin Rosen said the psychiatric center’s patient census as of Tuesday was 68 adults, nine children and 90 sex offenders. He said most of the adults and children, excluding sex offenders, will be moved into community care by the time inpatient services are ended. He did not say what would happen to any patients admitted under inpatient care in the meantime.
“It’s OMH’s intention that nearly all individuals currently receiving inpatient care can successfully transition to community-based care with appropriate supports,” he said in an emailed response to questions.
The plan calls for an expansion of community-based services at Ogdensburg, which will be designated as a community service hub. Mr. Rosen said what community services will be offered remain to be seen, and will be based on recommendations by a regional center of excellence team yet to be formed. The St. Lawrence Psychiatric Center will be part of the Central New York Region.
OMH said in its Wednesday news release that the plan will provide for continuity of employment for OMH workers, but it was unclear what staffing level the Ogdensburg facility will maintain. The center employs 520 people.
Some positions associated with inpatient care will be shifted to community care positions. Inpatient positions that are maintained will be transferred to facilities that offer inpatient services. Employees also will be given the opportunity to transfer to vacant positions within the OMH system or to other state agencies with appropriate training.
Civil Service Employees Association spokesman Stephen A. Madarasz, Albany, said the plan’s lack of detail for what the future holds for employees is troubling.
“They make allusions to retraining people and moving them into community services, but without specifics, it’s impossible to be able to really assess what the impact will be for jobs, people, quality of services and availability of services,” he said. “Right now there are inadequate services in communities, and there is no indication of how this will improve services.”
The realignment of services throughout the state could mean that employees will have to take positions elsewhere to maintain employment, he said. Mr. Madarasz said some facilities, including Ogdensburg, will be designated as regional hubs for community services, but OMH has not said what that means.
“If you have 100 people at a facility now, and those jobs get reduced to 12 in the regional hub, that’s a lot of jobs that have gone elsewhere,” he said. “What does that mean for the rest of the employees? Do they have to take a job in Syracuse or somewhere else?”
Assemblywoman Addie J. Russell, D-Theresa, said the north country’s state lawmakers will need to work hard to mitigate job losses in Ogdensburg.
“There are jobs not directly related to treatment that I’m very concerned about,” she said. “That’s why I will be advocating vigorously to try to retain the services that are currently at the psychiatric center.”
State Sen. Patricia A. Ritchie, R-Heuvelton, said although the plan is being billed as a no-layoff plan, it’s likely that staffing levels in Ogdensburg will be affected.
“We’re waiting for the details and some reassurance that there won’t be any job losses,” she said. “That’s going to come out in the details of the plan, but the conversation I had was that maybe the jobs would be realigned a little differently so that if you were a maintenance worker at the psych center, for instance, you could be a maintenance worker at one of the community homes. But that’s really at the crux of the issue. We need more details to know what it means to be a community-based hub.”
IMPACT ON FAMILIES
Mrs. Russell said she worries about how moving inpatient services will affect families who will have to travel long distances to see loved ones, as well as what effect being far from home will have on patients.
“These few regional centers of excellence across the middle of the state are not sufficiently close to the populations that need them,” she said. “We should be maintaining the service levels there, if not expanding them.”
“We heard from a lot of people who had family members who were treated at the psych center and talked about how important being close to them was to their recovery,” Mrs. Ritchie said. “Being over two hours away is a real concern. If you’re in Franklin County, you have to tack another hour onto that.”
Asked whether any accommodations could be made for families for whom traveling to see loved ones in inpatient care would be a hardship, Mr. Rosen said the regional center of excellence team could recommend “hospitality housing, discounted hotel arrangements, and web-based video conferencing.”
PREPARED FOR BATTLE
The head of a task force that has been working to maintain the psychiatric center and secure a designation as a regional center of excellence said the group’s members aren’t taking the news lying down.
“It’s not a win situation,” St. Lawrence Psychiatric Center Task Force Chairman Charles W. Kelly said. “They’re talking about expanding community care, which is wonderful, but that’s something they should have done 50 years ago, that they said they were going to do 50 years ago, and didn’t. The question is whether they will do it now.”
Mr. Kelly said the task force has requested a meeting with acting OMH Commissioner Kristin M. Woodlock, and will meet this morning to figure out its next steps.
“We’re going to fight,” he said. “The win is they didn’t close the whole thing down. The loss is that they didn’t make us a regional center of excellence, and they should have.”
Mrs. Russell said the state has two more budget cycles before inpatient services are scheduled to move out of the St. Lawrence Psychiatric Center, which will hopefully give lawmakers enough time to undo potential job losses and service reductions.
She said money could be diverted directly to the St. Lawrence Psychiatric Center to preserve its services.
“There is time to try to make revisions to the plan,” she said. “OMH is making an assumption that the eastern side of the region is going to want to seek services in the capital district. I’m not sure that people who have been in a facility for an extended period of time are going to want to make that change.”
Mrs. Ritchie said the state Legislature’s biggest role could be in making sure money saved from a reduction in inpatient services is funneled directly to community-based care rather than spent elsewhere.
“There is always that option, depending on how this plan unfolds and what it means to the community and those receiving care,” she said. “I will do absolutely everything I can to protect the jobs and services in the area.”
Mr. Kelly said he is skeptical about the Legislature’s ability to turn the situation around. He said he has been disappointed at a lackluster response from state lawmakers to prevent the potentially disastrous impact the OMH plan holds for patients, their families and the region’s economy.
“To Senator Ritchie’s credit, she has worked with us and supported us, but the main work in this thing has come from the task force,” he said. “Frankly, I’m disappointed in where we are. I think we should have been treated better than this.”
NYAPRS FIRST LOOK AT OMH RECONFIGURATION PLAN
Here are initial details, as we understand them, from OMH’s plan to reconfigure state operated mental health services and to create a reduced number of Regional Centers of Excellence. We’ll send out corrections if and as needed.
- The plan reduces the number of adult, children’s and forensic inpatient facilities from 24 individual facilities to 15 Centers of Excellence.
- Our current understanding is that the following facilities that are closing their inpatient service as a whole are Binghamton, Elmira, MidHudson, Sagamore, and Western NY Children’s PCs; and St. Lawrence will only continue operating a SOMTA program after the completion of the plan. The plan does not include the reduction of any state-operated outpatient services in any location.
- Our current understanding is that, at the end of a 3 year transition process, OMH will operate 15 Regional Centers of Excellence (RCEs): 1) Great Lakes RCE in Buffalo (adult and kids); 2) Western NY Forensic Center of Excellence in Rochester; 3) Empire Upstate RCE in Syracuse (adult) and Utica (kids); 4) Central New York Forensic Center of Excellence in Marcy (which will oversee the Ogdensburg SOMTA program); 5) Capital District RCE in Albany (adults); 6) Lower Hudson RCE in Orangeburg (adults and kids); 7) Nathan Kline Research Center of Excellence in Orangeburg; 8) Greater New York Children’s RCE in Bronx and Queens; 9) Bronx RCE (adults); 10) Brooklyn RCE (adults); 11) South Beach RCE (adults and kids) in Staten Island; 12) Queens RCE (adults); 13) New York Psychiatric Institute Research Center of Excellence in Manhattan; 14) Manhattan Forensic Center of Excellence; 15) Island RCE (adults); RCEs 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 service “hubs” overseeing state-operated community-based services throughout the region.
- The plan removes geographic catchment areas, meaning people can choose the facility they believe is most specialized and best in meeting their needs.
- The focus will be on short intensive inpatient stays, with best practice discharge planning.
- State staff may be transition from inpatient duty to community innovations like “Community Support Teams, Wellness Centers, and integration of care with pediatricians and partnerships with local housing providers.”
- This may well occur through “voluntary reassignment” (“the ability to voluntarily take a position with another OMH facility without hiring freeze or Civil Service clearance restrictions”).
- State staff will also be able to pursue employment outside of OMH at other state agencies.
- “As OMH expands community-based services, we will assist employees in transitioning to positions in settings within a reasonable distance from employees’ existing workplace.”
- “OMH will explore opportunities to retrain our workforce, to transition into future roles which are significantly different from current ones.”
- The state is hereby giving its one year required legal notice to make these changes; it does not believe these changes require legislative approval.
- The 3 year transition period will allow for “community-level planning and priority setting, staff training as well as establishment of support services in the community. Predictability and future vision will help to align the resources needed to achieve the intended outcomes from Regional Centers.”
- There will be a statewide leadership team and an operations team in each of the five (5) OMH regions. Membership on each Regional Centers of Excellence Team (RCE Team) will be by invitation, including representation from peers and family, providers, labor unions, Regional Economic Development Councils, the Dormitory Authority of the State of New York, and stakeholders with a membership limit of 15 people. These teams, whose proceedings will be public, will be charged with overseeing the implementation of the Regional Centers of Excellence plan.
- The plan has an unspecified commitment to allow for “improved access to safe and affordable housing.”
- Reinvestment: there is no specified formula or clear mandate to reinvest a percentage of savings from attrition or facility closures to community based nonprofit services. Advocates are very concerned about this.