Mental health advocates back budget proposals that reinvest state hospital, Medicaid savings to grow community supports

More than 600 New Yorkers with psychiatric disabilities and community mental health providers braved the bitter weather today to urge state legislators in Albany to support what they called one of the largest single increases in community-based mental health services in state history.

This year's executive budget proposes to infuse local service systems with more than $200 million of community-based treatment, rehabilitation, housing and crisis, peer and family support services. Additional funds will also be available to stabilize inpatient psychiatric capacity in local hospitals.

A majority of the funds are derived from state savings achieved via reductions in the use of state and Medicaid hospitals. The advocates rallied in the cold outside the Capital to hail what they called a reversal of past practices that took savings out of the systems, and saw hospital beds close without appropriate increases in community capacity. Their rally cry was "Reinvest in my Recovery!".

"We've come out today to voice our strong support for the budget's commitment, to move public health care dollars to where they're needed the most by investing in more robust and responsive community-based systems of care," said Harvey Rosenthal, executive director of the New York Association of Psychiatric Rehabilitation Services, the organization that planned the rally.

The advocates lauded the budget's plan to transfer $25 million in state psychiatric hospital resources associated with an expected reduction in upward of 400 inpatient beds. "Gov. Cuomo's plan expands community services by both preserving and redeploying state jobs and by reinvesting savings to expand local nonprofit capacity," Rosenthal said.

The state and additional nonprofit workers associated with this initiative will work in an array of settings that were identified by regional planning bodies that are expected to include urgent care walk -n centers, mobile engagement teams, crisis beds, supported housing, peer and family supports, suicide prevention, forensic diversion and transportation.

The budget redirects $120 million in Medicaid funding to ramp-up local community recovery services in advance of plans to integrate behavioral health and medical care, and to turn it over to the coordination of managed care plans in 2015, in keeping with the governor's Medicaid redesign plan.

$30 million of these funds will be used to expand community rehabilitation, employment, family and peer supports, and transportation services through New York's pioneering use of new federal Medicaid flexibility provisions.

The advocates viewed the proposals as a multiple win for New Yorkers.

"These community investments will maximize the use of public mental health service dollars to help fill the cracks and modernize our community systems. At the same time, it helps New York to meet its legal obligation to serve people with disabilities in the most integrated community settings," said Maura Kelley, executive director of Buffalo's Mental Health Peer Connection, and NYAPRS co-president.

The budget adds another $20 million of Medicaid redesign funds ($105 million more over the next two years) for new supportive housing beds for repeat users of costly local hospital services, and includes a long-sought increase to keep up with ever-rising housing costs in downstate areas.

"Stable housing provides the foundation for recovery," said Steve Coe, executive director of Community Access and NYAPRS co-president. "This budget takes bold steps to grow new housing units while stabilizing existing supported apartment arrangements."

The budget also provides community housing and supports for more than 2,500 individuals who currently reside in state psychiatric hospitals and adult and nursing homes over the next two years.

By doing so, advocates said it ends a decade of broken promises to adult home residents with psychiatric disabilities, in compliance with a court settlement that had been stalemated for the past three years.

"Gov. Cuomo is bringing long-sought justice to our community," said Geoff Lieberman, executive director of CIAD, an advocacy group comprised of adult home residents. "We hope to see community housing offered to thousands of more residents who await the realization of their long-held dreams."

The advocates continued their call for a long deferred cost of living increase for nonprofit workers and for increases in New York City-based housing for homeless individuals.

Ralliers came in buses and cars from communities across New York, including Long Island, New York City, Western and Central New York, the Southern Tier and North Country, the Hudson River Valley and Westchester County.

"There is very strong support for these historic advances from every corner of the state," said NYAPRS Public Policy Director Briana Gilmore, who held late fall regional forums in Hempstead, Brooklyn, White Plains, Newburgh, Saranac Lake, Syracuse, Batavia and Binghamton.