MHW: New York State Campaign Launches to Seek Better Funding for MH Housing

NYAPRS Note: More great coverage of last week’s campaign launch aimed at raising housing rates here in NY.

New York State Campaign Launches to Seek Better Funding for MH Housing
Mental Health Weekly October 16, 2017

While New York state mental health advocates and providers are grateful for the state’s sweeping new $2 billion plan to fund new supportive housing units, they say funding is sorely needed to fund existing community-based mental health housing programs before the state’s housing system reaches a financial breaking point.

New York State leads the country, say advocates, with 40,000 com- munity-based mental health housing units; however, the system has been stretched untenably thin by decades of inconsistent and unreliable state funding. Those concerns prompted the official launch Oct. 10 of the “Bring It Home: Better Funding for Better Care” campaign at the state capitol.

One day following the campaign launch, Gov. Andrew M. Cuomo announced 169 conditional awards to agencies in 47 counties across New York that will provide support services and operating funding for at least 1,200 units of supportive housing for homeless persons with special needs, conditions or other challenges. The awards, totaling up to $30 million, are part of the governor’s $2.6 billion, five-year plan to develop 6,000 units of supportive housing, according to a release from the governor’s office.

The Bring it Home includes the Association for Community Living; the New York Association of Psychiatric Rehabilitation Services (NYAPRS); the Mental Health Association of New York State; the NYS Conference of Local Mental Hygiene Directors; and other advocates, providers and individuals.

“New York state has a pretty robust housing system for people with serious and persistent mental illness and functional impairment,” Toni Lasicki, executive director of the Association for Community Living, told MHW. The facilities across the state include community residences, treatment apartments and supported housing units, she said. No other state provides an amount of housing remotely like this, said Lasicki.

“It’s pretty extraordinary,” she said. The only problem is these programs are not funded adequately. The state has not provided any cost-of-living adjustment increases,” she said. “We’ve had flat funding for years.”

Every year a statute involving a cost-of-living increase is presented to the governor and the legislature, and every year it’s put on hold, Lasicki said. “They waive it every year; they’re not bound by it,” she said.

Funding needs
The state pays a provider per year per person, said Lasicki. This has to cover the majority of the rent, the majority of the utilities, staff, supplies, equipment (phones, computers, paper, copy machine, etc.) and administration, she said. The New York Office of Mental Health pays $16,656 in New York City. That amount “is barely enough to cover the rent,” she said. Other rates, which are lower in other parts of the state, vary, she noted.

The New York State Office of Alcoholism and Substance Abuse Services have a similar program that pays the providers $25,000 per year per person in New York City, said Lasicki.

“We’re now at the point where providers are losing money on the programs,” she said. “We need the state to infuse money to provider rates. The state has not provided a regular increase to continue what we need to do under our contract.”

What set the stage for New York State to become a national leader in providing supportive housing for consumers with mental illness? At one time, the state had more psychiatric hospitals than any other state, said Lasicki. There were 24 such facilities back in the 1950s that served about 93,000 people, she said. In the 1970s, when medications were helping patients become stable, they were pretty much institutionalized, had no income and weren’t able to make it on their own, explained Lasicki.

She added, “The late Governor Mario Cuomo made a big investment in housing units to provide much of the housing. He kept adding units every single year.”

Existing beds ‘at risk’
NYAPRS is a coalition member of the Bring It Home campaign. “The campaign is looking to fill in along the continuum of community mental health housing in New York,” Harvey Rosenthal, executive director of NYAPRS, told MHW. “We’re very grateful for the administration’s commitment to add new beds, but at the same time existing beds are now at risk.”

Rosenthal said that a number of agencies and programs are at a breaking point around their ability to maintain existing programs at rates that have not risen appropriately for some time.

“While money is being made available for new beds, there needs to be funding for the old beds as well,” he noted. “Providers are increasingly reluctant to agree to operate housing [at current provider] rates,” he said. “Some providers might close programs.”

Rosenthal added, “We want to make sure existing housing is financed at the necessary level to ensure continued housing for people with psychiatric disabilities. We have to make sure as we add new housing to make sure the current housing is stable as well.”

National perspective
“Housing is so fundamental to a person’s mental health,” Kevin Martone, executive director of the Technical Assistance Collaborative, a national nonprofit organization that advances proven solutions to the housing and community support services needs of low-income people with disabilities and people who are homeless, told MHW.

He added, “State budget officers and legislators should be reminded that modest investments in housing and mental health services help contain runaway spending in emergency departments, psychiatric hospitals and correctional systems.”

Providers not receiving adequate rates for service delivery may find they’re serving fewer individuals at a time when people are under- served in the mental health system and need additional services to meet their needs, he said. “New York and other states make the case that additional funding will meet the service needs of people with mental illness,” he said. The problem is that when states are struggling financially, history shows that the mental health system takes cuts when it needs growth, he said.

Martone noted that, nationally, there is an overwhelming need for new housing, but states need to preserve the existing affordable housing supply for people with disabilities and those who are chronically homeless. “I would encourage states like New York to ensure that housing options are evidence-based, safe, and decent and integrated into the community,” Martone said.