NYAPRS Note: Several NYS Democratic state legislators and mental health advocates held a news conference a few hours ago in Albany calling on Republican Senators to join them, the Assembly and Governor Cuomo in keeping the promise of Community Reinvestment that was included in this year’s Executive budget proposal.
The Community Reinvestment Act was passed 20 years ago to provide for the downsizing of New York’s largest-in-the-nation state psychiatric hospital system and the redirection of a portion of the savings in to ramping up community recovery supports, including peer support, employment, housing, crisis and children’s’ services. It funneled over $200 million of public dollars to where the vast majority of people with ongoing mental health conditions want to live, recover and be a part of their communities.
But in recent years, savings from the ongoing closure of state hospitals and wards have been largely been lost to mental health services, having been gobbled up for state savings.In his 2013-4 budget proposal, Governor Cuomo has proposed a plan to close more facilities and wards and to create a smaller number of regional Centers of Excellence and to bring back a small version of Reinvestment, $5 of the $25 million that's projected to be saved.
However, state legislators appear to be rejecting the Governor’s specific proposal to downsize a system that spends more money for more facilities serving less people than the next few states combined! They apparently see the state hospital system as a jobs program not a treatment program. Further, Republic Senate leaders have taken all of the reinvestment dollars out, in contrast to the Assembly.
It appears that some form of downsizing other than the regional Centers plan may be still on the table. So, please join your fellow advocates from across New York to call Albany today and every day this week, as follows below!
MAKE 3 PHONE CALLS TO KEEP THE PROMISE OF FOR REINVESTMENT!
Make 2 calls to the NYS Senate, calling
Senate leaders Skelos at 518-455-3171 and Klein at 518-455-3595
and call Assembly Speaker Silver at 518-455-4911
and leave the following message:
“I’m a registered voter from (your locality) calling to urge you to downsize state psychiatric hospitals & reinvest savings into community recovery services!
Pushing To Restore Community Mental Health Services
byRick Karlin Albany Times Union March 13, 2013
The push torestore$120 million in local disabilityservices has been one of the emerging themes in this year’s buget-building drama and now another lower-key narrative is developing, at least today, about the $5 million the governor and Democrats want for local mental health supports but which Senate Republicans are zeroing out.
Democratic Senators Liz Krueger, Cecilia Tkaczyk and Terry Gipson just held a brief press conference calling for funding restorations to organizations that provide housing and other locally based services for those with mental illnesses.
The money for these services is supposed to come from the ongoing, decades-long de-institutionalization, or closures of massive state operated psychiatric hospitals in favor of close- to-home treatment.
In New York more than 90,000 people resided in psychiatric hospitals in the 1950s compared to about 3,000 today. At the same time, a variety of state and local non-profits are providing more than 30,000 beds for outpatients today, said Doug Cooper of the Association for Community Living.
As these hospitals continue to close, the enormous savings were supposed to go in part toward local services. But that hasn’t happened said Cooper and others who noted one of the major expenses here consist of rent for this outpatient housing.
“Rents go up every year. Their budgets have not gone up,” he said.
“We don’t want to shortchange mental health services,” added Tkaczyk, who like Gipson, serves on the mental health committee.
Tkaczyk Calls for Strengthening of Community Mental Health Reinvestment Act
News Release March 13, 2013
State Senator Cecilia Tkaczyk, Ranking Member of the Senate Committee on Mental Health and Developmental Disabilities, called on the Senate leadership to strengthen and provide adequate funding for the for the Community Mental Health Reinvestment Act. Tkaczyk noted that community-based services are less expensive for taxpayers and more effective for recipients than is institutional care.
Joined by Senate colleagues and noted mental health advocates, Senator Tkaczyk, who was appointed to serve on the Mental Hygiene Budget Conference Committee, said, "This year marks the 20th Anniversary of the Reinvestment Act, which has been acclaimed by mental health service providers, advocates, recipients, and administrators. The basic principle behind this landmark legislation is that savings realized from closing and downsizing state facilities were to be reinvested into building and maintaining community-based services, which are far less costly for taxpayers, and far more effective than providing services in an institutional setting, emergency room or jail cell."
Unfortunately, there has been a reduced commitment to Reinvestment in at least ten of the 20 years since passage of the Act, including 2002, when Governor Pataki vetoed the bill extending Reinvestment and the funds associated with those savings.
In the 2013-2014 budget, both Governor Cuomo and the Assembly have identified $25 million in savings to the State's Office of Mental Health hospital system, and proposed using $5 million of that money for Reinvestment. The Senate Republican Conference, unfortunately, has chosen to completely eliminate those funds.
Senator Tkaczyk and her colleagues said at the very least they would like to see the $5 million proposed by the Governor and the Assembly included in the budget, but would prefer to have more of the anticipated $25 million in savings reinvested into community services.
They also cited the need to update the figure used to determine savings realized through downsizing and closure. We currently use $70,000 per bed per year, an out-of-date figure established over a decade ago. Experts agree that actual cost savings are more than $375,000 per bed per year.
Tkaczyk also advocated strengthening the Reinvestment Act to include savings realized from all aspects of downsizing the mental healthcare system - including bed, ward and facility closure.
Senator Tkaczyk said, "Simply put, community-based organizations are being asked to provide more services, to more people with more challenging needs, in a system that is not fulfilling the commitment the State made to the providers who must meet those needs. We have been asking them to do more with less. Now we are asking them to do more with nothing."
Senator Liz Krueger (D-Manhattan) said, "Community-based service providers are crucial to the future of mental health services in our state," said "This new model can help us simultaneously rein in costs while achieving better patient outcomes, but not ifwe pull the rug out from under it. Sen. Tkaczyk is right: that would be a textbook case of penny-wise, pound-foolish. We should have learned from decades of deinstitutionalization that you need to fund quality services in the communities where people live."
Senator Gustavo Rivera, Ranking Member ofthe Senate Health Committee, said, "Fulfilling the commitment made by the State to reinvest in community-based organization would allow these nonprofit agencies to provide more direct and efficient care to people facing mental illnesses in our state. Quite simply, if we do not reinvest in these services we will deny our communities the resources necessary to effectively diagnose and treat mental health conditions."
Douglas Cooper, associate executive director of the Association for Community Living, said, "Community-based programs provide cost-effective rehabilitative services to the most severely disabled individuals living in the community. The Reinvestment Act is a promise made by New York State to fund community based services for people with mental illness when state-operated hospitals are downsized. Reinvestment is an opportunity to provide increases to existing programs to ensure quality services are maintained and available, along with a funding source for new services that can meet the needs of individuals who no longer rely on state hospitals. People with mental illnesses can recover and are best served in the community."
Paige Pierce, executive director of Families Together in NYS, representing families of children who are in one or more of our state systems, said, "We know that our children can be served better in cost-effective, community-based programs. But in order to realize this, we must invest in these programs or they will not be available as an alternative to institutional settings. The lack of Community-based services leaves families with no other choice than the costly residential settings that we are trying to reduce."
Harvey Rosenthal, executive director of the New York Association of Psychiatric Rehabilitation Services (NYAPRS) said, "Reinvestment has represented New York's promise to spend public mental health dollars where New Yorkers need them most in the community. New York spends more money on more hospitals serving less people than the next 2-3 states combined. Downsizing state hospitals and creating Centers of Excellence and reinvesting into community systems will allow New Yorkers to keep the promise of recovery for hundreds of thousands of New Yorkers with psychiatric disabilities."