Support the International Association of Peer Supporters

NYAPRS Note: Since 2004, The International Association of Peer Supporters (iNAPS) has served at the only nation-wide organization to represent the interests of the peer support workforce that includes members from every state and several countries outside the US. Members of this network can come together to share their ideas and innovations, exchange resources and information based on real world application, and add their voice to others when concerns and issues affecting all of us require a global response from a global community. Please see below all of the benefits of iNAPS membership and consider joining today. Thanks!

Why Join iNAPS?

iNAPS—the International Association of Peer Supporters—is a 501(c)(3) non-profit which has been the only nation-wide organization to represent the interests of the peer support workforce and to have annual conferences since 2006.  Founded by Steve Harrington and an avid group of peer specialists in Michigan in 2004, our mission is to grow the profession by promoting the inclusion of peer supporters throughout healthcare systems worldwide, and our vision is that peer support become a viable option for anyone who wants the mutuality of a compassionate peer support relationship.  Membership is open to any peer supporter—voluntary or formally employed as a peer specialist—and to allies who support the concept and the real-world development of this unique kind of helping.  Dues for one year are $35; lifetime memberships are available for $350. 

By joining iNAPS, you are helping to advance the agenda of peer support by strengthening our voice and increasing the capacity of our communities to connect with each other, learning about current issues in the field, the latest research on peer support, and policy developments at the state and federal level which impact peer employment and reimbursement for services.  This is accomplished in part through our monthly newsletter, which reaches over 5000 people, and our Annual Conference, which this past year was held in Orlando, Florida, with keynote speakers Keris Jan Myrick, MBA, MS, Mark Salzer, PhD, and Azza Altaraifi.  Last year’s keynoters, in Phoenix, were Pat Deegan, PhD, Sally Zinman, and Chacku Mathai, CPRP.  Next year’s conference will be in San Diego from October 21-23, 2019.

iNAPS has broadcast and archived on our website over 30 webinars on topics of interest to peer support workers and supervisors, and although anyone can view these, official continuing education credit is available only to members.  Membership in iNAPS also allows you to attend our annual conference for a reduced rate, and to participate in a number of regular community networking and education events, such as a monthly peer specialist networking teleconference, and a monthly supervisors’ teleconference.  iNAPS publishes regular newsletters with perspectives from members and updates on the profession, and recently was chosen by the Copeland Center’s Doors to Wellbeing project to administer the National Peer Specialist Registry.  This database, scheduled to go live in early 2019, will allow peer support workers from anywhere in the U.S. to list their name, credentials, and any contact information and self-description that they want potential employers to see. 

We are very excited about what’s ahead in the field of peer support, as more and more healthcare settings are recognizing the power and value of peers in maximizing positive health outcomes.  With iNAPS uniquely positioned to represent the interests of peer supporters throughout the U.S., we are looking forward to having chapters in all 50 states. But we need YOU in order to accomplish that goal. Come join us as we shape the future of our profession!  

For more information and links to resources and a membership page, go to our website,

SAMHSA/APA Launch Clinical Support System Resource

NYAPRS Note: The American Psychiatric Association has launched a SAMHSA funded Clinical Support System-SMI Resource’s whose mission is “to advance the use of a person-centered approach to care that ensures people who have SMI find the treatment and support they need. For clinicians, we offer access to education, data, and consultations so you can make evidence-based treatment decisions. For patients, families, friends, people who have questions, or people who care for someone with SMI, we offer access to resources and answers from a national network of experts.

The Clinical Support System-SMI Resource has launched:

About This Initiative: SMI Adviser is funded by the Substance Abuse and Mental Health Services Administration (SAMHSA) and administered by the American Psychiatric Association (APA). The APA works closely on this project with a team of experts from 30 other mental health organizations. This team includes clinical experts, peers, patients, families, and policy makers.

This resource will be available to all that need assistance addressing SMI be they providers, families, or clients. Resources are not yet posted; however, individuals do have the ability to seek a consultation or ask a question.  Training resources which can be viewed on-demand will be added imminently. Please disseminate to your grantees and other relevant partners.  This is a publicly available resource which we want to be widely available and promoted beyond just our grantees. 

OMH Seeks Opioid Initiatives Project Manager

NYAPRS Note: OMH is looking to fill a new position aimed at improving rates of screening for and managing opioid use disorders in article 31 mental health clinics statewide.

 Research Scientist 2

The Office of Mental Health (OMH) is seeking a qualified candidate to fill a Research Scientist 2, Grade 22, position that will function as the Project Manager, Opioid Initiatives. The incumbent will oversee the implementation of a portfolio of initiatives designed to enhance identification and treatment of individuals with opioid use disorder within the public mental health system.

Specific duties to be performed may include, but are not limited to, the following:

• Review and disseminate data on rates of Opioid Use Disorders (OUD) among individuals receiving care in NYS OMH licensed and operated settings;

• Create summary reports and resource guides related to evidence-based practices for identification and management of OUDs;

• Participate in the formulation of plans to scale up OUD best practices in NYS OMH licensed and operated programs;

• Develop program guidelines including clinical pathways and reporting requirements;

• Arrange and partake in meetings with key stakeholders including State, hospital, outpatient, and housing provider representatives to present plans and implementation strategy;

• Convene periodic planning/oversight meetings;

• Work with key stakeholders including allied State agencies and OMH Field Offices to develop and manage learning collaboratives and/or other implementation support programs for providers within the mental health system;

• Review data analytic reports related to uptake of practices;

• Develop and implement evaluation plan to test effectiveness of implementation activities;

• Prepare summary reports for internal review and peer-reviewed publication;

• Assist the Bureau of Inspection and Certification in overseeing accountability efforts through licensing activities;

Minimum Qualifications:

This is a full-time non-competitive position.

The minimum qualifications for appointment to a Research Scientist 2 position are: A Bachelor’s degree and three years of professional research experience in an appropriate field; or a Master’s Degree and two years of such experience; or a Doctorate degree in an appropriate field. Appropriate fields include: Biostatistics, Economics, Epidemiology, Public Health, Psychology, Sociology, Social Work, or a related social science field.

Application Procedure: Interested candidates should submit a resume and cover letter via email to OMHHRM@OMH.NY.GOV, attention Sarah Mahar. Please reference Vacancy ID #62753B.

Notes: Candidates are advised that, should they accept a job with OMH, they will be required to be fingerprinted and pay a fingerprint fee. NYS Office of Mental Health is an Equal Opportunity/Affirmative Action Employer.

For complete vacancy details, please see the following link:

Jan 7 OMH Webinar on Employment: The Path to Recovery

Topic: Employment: The Path To Recovery

This web seminar, hosted by Christopher Coyle, Mental Health Program Specialist for the NYS Office Of Mental Health, will describe the various employment resources that are available to individuals on SSI/SSDI. In addition, various work incentives will be covered that can aid individuals in retaining their Medicaid while they work. We will also cover the benefits of utilizing the Ticket To Work program.

Date and Time: Monday, January 7, 2019 10:00 am, Eastern Standard Time

Event number: 649 961 956

Event password: nysomh123

Audio conference information

To receive a call back, provide your phone number when you join the event, or call the number below and enter the access code.

US Toll Free: 1-844-633-8697

Local: 1-518-549-0500

Toll-free dialing restrictions:

Access code: 649 961 956

Call for Applications: 2019 BRSS TACS Capacity Building TA Opportunity

The Substance Abuse and Mental Health Services Administration’s  (SAMHSA)  Bringing   Recovery   Supports   to Scale   Technical   Assistance   Center   Strategy    (  BRSS   TACS)  is pleased to announce the 2019 Capacity Building Opportunity, an intensive technical assistance opportunity for peer-run organizations, recovery community organizations, family-run organizations, and youth- and young adult-run organizations.

The Substance Abuse and Mental Health Services Administration’s (SAMHSA) Bringing Recovery Supports to Scale Technical Assistance Center Strategy (BRSS TACS) is pleased to announce the 2019 Capacity Building Opportunity, an intensive technical assistance opportunity for peer-run organizations, recovery community organizations, family-run organizations, and youth- and young adult-run organizations.

The 2019 Capacity Building Opportunity contributes to SAMHSA’s mission to reduce the impact of substance misuse and mental illness on American communities.  Applicants are encouraged to consider SAMHSA’s activities related to mental illness and substance use disorders in the Interdepartmental Serious Mental Illness Coordinating Committee and its report to Congress, the SAMHSA Strategic Plan FY2019-FY2023and Facing Addiction in America: The Surgeon General's Report on Alcohol, Drugs and Health.

The 2019 Capacity Building Opportunity will offer sustained individualized consultation, training, and peer-to-peer support up to 25 organizations in one of the five designated focus areas.

  1. Partnering With State Systems to Advance Recovery 

  2. Developing an Integrated Workforce 

  3. Building Infrastructure and Organizational Capacity

  4. Sustaining Access to Treatment and Recovery in Educational Settings 

  5. Supporting Reintegration

Please note that previous recipients of the 2018 SAMHSA BRSS TACS Capacity Building Opportunity are eligible to apply.

Applications are due by Thursday, January 31, 2019 at 8 p.m. EST. For more information on eligibility and how to apply, please review the overview and application online:

You may email BRSS TACS at with questions pertaining to this opportunity.

 Application Deadline: January 31, 2019

Click Here to View Application


BRSS TACS supports programs, systems, states, territories, and tribes as they implement effective recovery supports and services for children, youth, families, young adults, adults, seniors, and other diverse populations with behavioral health conditions. SAMHSA’s mission is to reduce the impact of substance abuse and mental illness on America’s communities.

Questions or comments about this e-mail? Let us know!

Disclaimer: This application was supported by contract number HHSS2832012000351/HHSS28342002T from the Substance Abuse and Mental Health Services Administration (SAMHSA). The views, opinions, and content of the newsletter are those of the writers and do not necessarily reflect the views, opinions, or policies of SAMHSA or the U.S. Department of Health and Human Services (HHS).


'The Costly Price of Benefits' for WNY/CNY Provider: Join the NeC-ATTC/NYAPRS Learning Collaborative

NYAPRS Note: The following comes from NYAPRS’ Len Statham: “Our friends at the Northeast & Caribbean Addiction Technology Transfer Center (NeC-ATTC) in partnership with NYAPRS will be offering a Learning Collaborative on the subject of poverty and employment.  This ATTC-NYAPRS “Costly Price of Benefits” Learning Collaborative will focus on employment as the “therapeutic intervention” in helping people recover from mental illness/substance use. Organizations from the Central and Western NY region are encouraged to apply for this free intensive training and Technical assistance.”

Join the NeC-ATTC/NYAPRS Learning Collaborative:

The Costly Price of Benefits

The Northeast & Caribbean Addiction Technology Transfer Center (NeC-ATTC) and the New York Association of Psychiatric Rehabilitation Services (NYAPRS) is pleased to announce the 2019 Costly Price of Benefits Learning Collaborative, a free, training and intensive technical assistance opportunity.  Up to eight (8) Behavioral health and Substance Use organizations located in Western/Central New York will be selected to receive face-to-face training, individual onsite consultation, and web-based implementation support.

Overview: The intersection between poverty and disability runs throughout all domains of one’s life. While the traditional course of action in treating mental illness and substance use has been medically-based, and more recently recovery-based, little attention has been paid to the effects that living on public benefits has on one’s mental health. This ATTC-NYAPRS “Costly Price of Benefits” Learning Collaborative will focus on employment as the “therapeutic intervention” in helping people recover from mental illness/substance use. Using this curriculum, organizations will learn how to effectively embed employment into the very fabric of their organizational culture.

Overall Objectives: Learning Collaborative participants will be able to:

  • Become familiar and adept at teaching the “Costly Price of Benefits” curriculum

  • Integrate curriculum into employment and  individualized recovery treatment plans

  • Identify action steps for implementation to support an employment-centric culture

  • Demonstrate your organization’s ability to support participants’ and measure their individual progress and outcomes in using the curriculum

  • Use the curriculum to change the narrative of the culture of your organization

Kick-off Training Sessions – January 28 & 30, 2019 (sessions to take place at the Buffalo Central Library)

This is organized as one-day, in-person, training sessions. This will introduce the “Costly Price of Benefits” curriculum to participants and provide the skills necessary to teach and use the curriculum effectively with clients. Providers need only attend one of these sessions and will be responsible for travel expenses incurred.

ECHO/Zoom Sessions - March – June 2019

ECHO webinars will be delivered via video-conference (i.e. Zoom software) in four parts and will be accessible to all who participate in the kick-off session. These ECHO webinars will adhere to the following agenda: 

  • Module 1 – Operationalizing the curriculum; case study

  • Module 2 – Case study on activating individuals toward employment

  • Module 3 – Case studies presented by organizations on barriers faced

  • Module 4 – Case study related to benefit issues effecting clients

On-Site Follow-up Technical Assistance - February – July 2019

NYAPRS will deliver individual on-site TA sessions twice a month for 1-2 hours each session that will focus on assisting agencies to operationalize and implement the curriculum into their respect treatment settings.

For more information and to learn how to formally apply to participate in this initiative contact:

Len Statham, NYAPRS at (585)490-3979 or

WSJ: Joint Commission Accredited More Than 100 Psychiatric Hospitals Despite Abuses

NYAPRS Note: The following investigative report raises very serious questions about the Joint Commission’s oversight of US private and public psychiatric hospitals after it continued to fully accredit hospitals linked to death, abuse and sexual assaults. Further, the report found that “state inspectors found about 16% of those hospitals each year, or about 140 institutions total, operated with such severe safety violations they could put federal funding at risk” and that “about three-fourths of the psychiatric hospitals found with violations in 2014 or 2016 went on to have later violations.”

These findings are especially disturbing and must result in greatly increased federal oversight, particularly given recent moves by CMS and some states to extend Medicaid reimbursement to private psychiatric hospitals that will result in thousands of new patient admissions to those facilities. According to the National Association of State Mental Health Program Directors, the number of people in private psychiatric hospitals has increased by 180% since 1970.

Psychiatric Hospitals With Safety Violations Still Get Accreditation

by Stephanie Armour  Wall Street Journal  December 26, 2018

More than 100 psychiatric hospitals have remained fully accredited by the nation’s major hospital watchdog despite serious safety violations that include lapses linked to the death, abuse or sexual assault of patients, a database investigation by The Wall Street Journal has found.

The Joint Commission, an Oakbrook Terrace, Ill., nonprofit that evaluates most of the nation’s hospitals, revoked or denied full accreditation to fewer than 1% of psychiatric hospitals it oversaw in fiscal 2014 and 2015, the latest date for which detailed federal data is available. State inspectors found about 16% of those hospitals each year, or about 140 institutions total, operated with such severe safety violations they could put federal funding at risk.

Troubled hospitals have promoted their continued accreditation to attract new patients, in some cases even after the federal government terminated their Medicare funding due to recurring safety risks.

Psychiatric hospitals kept their accreditation after patients said they were raped or assaulted; died by suicide; or slept on chairs due to crowding, among other incidents, according to a review of hundreds of pages of state inspection reports.

The Joint Commission, a private body authorized by the government to review hospital performance, has long held an accrediting monopoly. It inspects almost 90% of the nation’s psychiatric hospitals, and the federal government relies on its findings. The commission determines whether hospitals comply with federal safety-related regulations. Hospitals determined by the commission to be in compliance get accreditation.

A lot of money is at stake: Medicare payments to inpatient psychiatric facilities reached $4.5 billion in 2017, growing an average of 1% each year since 2006, according to federal data.

The Joint Commission is currently the only accrediting organization with a federally approved psychiatric-hospital accreditation program for Medicare. It also accredits nearly 1,900 behavioral-health organizations such as group homes and addiction-treatment centers.

The Journal previously reported that the Joint Commission continued to accredit a variety of hospitals despite safety violations. In the case of inpatient psychiatric hospitals, the patients and staff are especially vulnerable, because so many of the patients are suicidal and cared for in the absence of family members who often act as patient advocates.

Psychiatric centers, like other hospitals, pay the Joint Commission for its inspections, and some hire consultants from a commission subsidiary to help them pass those reviews, which many ethics experts consider a conflict of interest.

Commission officials said that their surveys of hospitals shouldn’t be considered regulatory inspections and that they work collaboratively with psychiatric hospitals to help them improve.

“It is important to acknowledge an uncomfortable reality: There are no perfect hospitals anywhere in the world,” the Joint Commission said.

Some mental-health experts say the current system features the wrong incentives.

“Accrediting bodies can’t make the standards too high or no one will ever pay for it,” said Benjamin Miller, chief strategy officer at Well Being Trust, an advocacy group on mental health and wellness. “Accreditors are all in the business to make money.”

The Journal found 141 psychiatric hospitals, out of roughly 490 across the country, that were accredited by the Joint Commission and cited by state officials from fiscal 2014 and 2015 for serious violations.

For most of the 141, those violations weren’t the first; they had an average of eight serious violations in the years going back to 2011, according to state inspection records and Some had dozens of previous violations.

“I am very concerned about the data. It’s showing us there is a disparity between their surveys and ours,” said Seema Verma, administrator of the Centers for Medicare and Medicaid Services. “You want to be sure accreditation means something.”

CMS checks accreditors’ work using a formula known as a disparity rate to gauge how often safety issues were overlooked. Its data shows the commission’s reviews of psychiatric hospitals had a 57% rate, which officials described as concerning and the highest of all types of hospitals.

Commission officials say they work closely with institutions to fix problems. But the psychiatric hospitals that kept their full accreditation after an incident had an average of nine major violations since then, with some having more than 30.

Those later violations include sexual assault, the alleged rape of a teenage patient, the administration of psychotropic medication without consent and failure to give insulin to diabetic patients, according to state inspection records. State inspectors said one patient sustained a skull fracture because the hospital failed to implement safety measures. Another hospital failed to adequately investigate when a staff member used a phone to take pictures of a patient’s breasts, inspectors said.

In 2016, Austin Skidmore resided at Laurel Heights Hospital, a psychiatric residential facility for autistic youth in Atlanta owned by Universal Health Services Inc. During an episode when the 19-year-old became agitated, according to a lawsuit filed by his family, an employee held him down and another held his legs.

Several minutes later, Mr. Skidmore’s face turned blue, and he choked on his own vomit in a death that the medical examiner classified as a homicide.

State inspectors in December issued a report saying that “the facility used a manual hold in a manner that would potentially impair the patient’s ability to breathe resulting in the death of the patient.”

Laurel Heights officials said in court filings their actions weren’t at fault in Mr. Skidmore’s death. “This was an unfortunate and isolated incident and is not representative of the compassionate care that our staff and clinicians provide,” Jane Crawford, a spokeswoman for UHS, said in an email.

The facility has kept its accreditation. “We are aware that Laurel Heights has remained fully accredited since Austin’s death, and are concerned,” said Austin’s father, Jack Skidmore. “Austin was a very special child, and we miss our son dearly.”

Rep. Greg Walden (R., Ore.), who chairs the House Energy and Commerce Committee, which oversees health issues, said the panel began an investigation into the accreditation process after the Journal’s initial story on hospital accreditation in September 2017.

“These findings are of great concern and underscore the need to critically evaluate the performance of accrediting organizations in all segments of the health-care sector,” Mr. Walden said of the new data findings on psychiatric hospitals.

When safety problems arise, the federal agency can terminate Medicare funding, but that is a move of last resort, since medical centers cut off from such funding are often forced to close.

Some industry leaders expressed disbelief that a hospital that was terminated from Medicare could keep its accreditation.

“If they’re terminated, they wouldn’t be accredited. I don’t see that. I’m not aware of that happening,” said Mark Covall, president and chief executive of the National Association for Behavioral Healthcare, which represents more than 1,000 behavioral facilities.

But that is what happened at Timberlawn Behavioral Health System, a psychiatric hospital in Dallas, which was cut off from Medicare in August 2015 for repeated and serious violations. It kept its accreditation and displayed the accompanying Joint Commission “Gold Seal of Approval” on its website to recruit potential patients. The hospital is now closed.

Timberlawn had received nearly $20 million in Medicare funding since 2014.

Eastern State Hospital, a psychiatric hospital in Williamsburg, Va., also kept its full Joint Commission accreditation after it was terminated in April 2016 from Medicare, which funded over $1 million in treatment from 2014 to 2016.

The accreditation industry is facing heightened scrutiny following the Journal’s initial report. The Trump administration said last week it was weighing whether to continue approving accrediting organizations that also have consulting arms, which would include the Joint Commission. CMS, a division of the Department of Health and Human Services, has announced increased oversight. Officials unveiled a pilot project to change how they evaluate accrediting organizations, and said they would provide the public with new information about the performance of accreditors and hospitals.

The Energy and Commerce Committee launched an investigation in March into accrediting organizations. And Sen. Chuck Grassley (R., Iowa) is working with CMS staff to determine what statutory changes are needed to make accreditors’ confidential inspection reports public.

The Joint Commission said most hospitals come into compliance once deficiencies are pointed out. “The goal of the private accreditation system is to identify deficiencies in care and have the hospitals correct those deficiencies—it is not to find as many deficiencies as possible to justify removing accreditation from those organizations,” the commission said.

About three-fourths of the psychiatric hospitals found with violations in 2014 or 2016 went on to have later violations, according to an analysis of the federal data.

CMS officials, who oversee the commission and grant it authority to inspect hospitals, have been concerned for years about the accreditation of psychiatric hospitals.

In December 2015, CMS cited “serious issues” regarding the commission’s performance. It later put its psychiatric-accreditation program under probation, which ended in December 2016. But CMS ultimately backed the program, saying it would closely monitor the commission’s work.

—Paul Overberg contributed to this article.

Cuomo 3rd Inaugural Address Underscores Efforts to End Cash Bail, Conversion Therapy

NYAPRS Note: Upon beginning his third term yesterday at an inaugural address on Ellis Island, NYS Governor Andrew Cuomo pledged a series of initiatives he wants to put into law that he outlined several weeks ago in an address to the NYC Bar Association. See below for details.

NYAPRS is particularly in strong support of the Governor’s push to end cash bail and stop countless avoidable arrests and entry in our criminal justice system (many by affecting New Yorkers with behavioral health conditions, and to put a legal end to conversion therapy designed to change an individual's sexual orientation.

Our 2019 legislative priorities include a substantive housing rate hike, a 2.9% Cost of Living Adjustment, passage of the HALT bill that will include an end to solitary confinement for people with mental health conditions and another round of Crisis Intervention Team initiatives.

Look for more details in the next few days about how to push for these issues at NYAPRS Annual Albany Legislative Day on February 26.

Three Takeaways: Gov. Andrew Cuomo's Inaugural Address on Ellis Island

By Joseph Spector Rochester Democrat & Chronicle  January 1, 2019

ALBANY - Gov. Andrew Cuomo took the oath of office for a third term Tuesday, vowing to fight federal policies and advance a broad agenda for New Yorkers.

The Democratic governor gave his remarks on Ellis Island, symbolizing his differences with President Donald Trump over immigration and other national issues.

"There is now a fundamental questioning of the viability of the American promise — a covenant that created our national founding 242 years ago and reached full flower right here in this great hall," Cuomo said in his speech.

The Democratic governor was first elected in 2010, and he has promised to implement a sweeping platform with his party fully in control of the state Legislature for the first time during his tenure.

Cuomo, 61, has been speculated as a potential presidential candidate in 2020, but he has repeatedly stressed he will not run.

He urged New York would lead the nation by coming together, not through division…..


In the roughly half-hour speech, Cuomo pledged a series of initiatives he wants to put into law that he outlined during his successful campaign last year and more specifically in recent weeks.

They include stronger abortion rights, tighter gun-control laws, the legalization of recreational marijuana and the end of cash bail so low-level criminals are not kept in jail unnecessarily.

He challenged his fellow Democrats to make sure the agenda is passed as the six-month legislative session starts Jan. 9.

Democrats won the Senate majority for the first time in a decade in last November's election.

"We either perform by delivering real solutions that restore hope and progress in people's lives or we fail," Cuomo said. 

"And failure is not an option for New Yorkers."

Andrew Cuomo's Agenda: 10 Laws He Wants To Change In New York

by Jon Campbell, Rochester Democrat & Chronicle  December 17, 2018

Here's a look at 10 things Cuomo vowed to pursue in the early part of the new year:

1) Make The Property-Tax Cap Permanent

Cuomo was first elected in 2010 on a promise to cap local property taxes, which he and lawmakers did in 2011.

But the state's cap — set at the lower of 2 percent or the rate of inflation — is set to expire in 2020.

Cuomo wants to make it permanent.

He also wants to extend a higher tax on the state's top earners, something that is a consistent topic of debate at the Capitol.

"We must maintain our millionaire's tax, also make permanent our 2 percent cap on the regressive local property taxes, something that FDR fought against for decades," Cuomo said.

2) Bolster Abortion Rights

Gov. Andrew Cuomo announced new steps Monday, July 9, 2018, to strengthen abortion rights in New York. 

Federal abortion protections through the Roe v. Wade case go further than the protections in New York law.

Abortion also remains in the state's penal code, which outlines crimes and the punishment they carry.

For years, pro-choice advocates and Democratic lawmakers had pushed to install Roe v. Wade rights into state law to protect against the decision being overturned by a conservative Supreme Court.

With a fully Democratic Legislature in place, Cuomo has vowed to approve that measure within the first 30 days of 2019.

3) DREAM Act

Republicans who led the state Senate since 2010 had opposed efforts to implement a state-level DREAM Act, which would allow those in the country without documentation to qualify for state-level tuition assistance for college.

With Democrats in charge, Cuomo said he believes the DREAM Act will become reality.

In his speech, Cuomo said the state must "pass the DREAM Act to open the door of education to all our dreamers."

4) Legalize Marijuana

Recreational marijuana became legal in Vermont on July 1, 2018. 

For much of his first two terms, Cuomo was opposed to allowing marijuana for recreational use in New York.

No longer. Cuomo offered his most forceful support to date for legalizing marijuana, calling on the state to take the issue up early next year.

The governor's shift — he called marijuana a "gateway drug" as recently as last year —comes as neighboring Massachusetts, Vermont and Canada have legalized small amounts of the drug.

5) Congestion Pricing In NYC

Cuomo has been facing plenty of heat for the condition of the New York City subway system, which is aging and is often in disrepair.

The governor has vowed to push for congestion pricing to help fund a plan to improve the subways.

Essentially, vehicle traffic that enters certain zones of Manhattan would be hit with a toll, with much of the revenue going toward improving public transit.

6) Child Victims Act

For years, victims have pushed a measure that would extend the statute of limitations for child sexual abuse crimes and open up a one-year window to revive previously timed-out claims.

This year, Cuomo expressed optimism that the Child Victims Act would become law. 

Senate Democrats, who will take over control of their chamber in January, have also signaled support. The one-year window, in particular, had Republicans wary when they were in control.

7) LGBT Protections

The governor vowed to pass the Gender Expression Non-Discrimination Act, which would provide protections for those who are transgender and add gender identity to the state's hate crime and human rights laws.

He also vowed to put a legal end to conversion therapy in New York.

Previously, Cuomo's administration had approved regulations that implemented both of those goals. A law would make it harder for future administrations to undo.

8) Gun Control

With Democrats in control, Cuomo has vowed to bolster the state's gun-control laws.

Specifically, Cuomo has pointed to three different measures he'd like to see become law.

One would officially ban bump stocks, the type of equipment used by a mass shooter in Las Vegas to make a semi-automatic weapon simulate an automatic weapon.

The second would expand the wait period for gun-seekers flagged by the national background check database. Currently, the wait period is three days. Cuomo wants to expand it to 10.

The third bill, known as the Red Flag Bill, would allow family members or school officials to petition a judge to block someone from owning a gun if the person is deemed to be a danger to themselves or others.

9) Ending Cash Bail:

Cuomo said he will push to enact reforms in the state's criminal-justice system.

One way he wants to do it: Ending cash bail.

By requiring defendants to put up money or bond to get out of jail while awaiting trial, it discriminates against lower-income defendants, who often come from minority communities, Cuomo has argued.

"A judge should determine the individual's risk of release rather than the individual's access to wealth," Cuomo said.

10) Make Election Day A State Holiday

Cuomo said he's going to push for a number of reforms to make it easier to vote in New York, claiming the state has to "address the cynicism and skepticism that people feel."

One reform he's looking for? Cuomo wants to make Election Day a state holiday.

That would mean many workers — including state and local employees and others whose employers recognize state holidays — would get the day off, making it easier for them to vote.

Cuomo also vowed to push for automatic voter registration, early and mail-in voting and aligning the state and federal primaries, which are currently held on different days.