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Hochul announces 'comprehensive plan' to 'fix New York state's continuum of mental health care'


Tue, Jan 10th 2023 10:50 am

‘Transformative plan’ will increase capacity for inpatient psychiatric treatment by 1,000 beds and add 3,500 housing units serving individuals with mental illness

√ Governor calls for systemic accountability for mental health admissions and discharges; dramatic expansion of outpatient services and insurance coverage

Gov. Kathy Hochul has announced, as part of the 2023 State of the State, a “comprehensive plan to overhaul New York's continuum of mental health care and drastically reduce the number of individuals with unmet mental health needs throughout the state.”

A press release said, “The multiyear plan includes increasing operational capacity by 1,000 beds for inpatient psychiatric treatment, creating 3,500 units of housing to serve New Yorkers with mental illness, increasing insurance coverage for mental health services, dramatically expanding outpatient services, and creating systemic accountability for hospital admissions and discharges to better address the needs of individuals suffering with mental illness. These proposals, over time, will reflect more than $1 billion in investment in mental health.”

"When it comes to protecting New Yorkers' well-being, strengthening our mental health care system is essential and long overdue," Hochul said. "We have underinvested in mental health care for so long, and allowed the situation to become so dire, that it has become a public safety crisis, as well. This proposal marks a monumental shift to make sure no one falls through the cracks, and to finally and fully meet the mental health needs of all New Yorkers."

Hochul’s team said she “will realign the state's approach toward mental health with a comprehensive package of investments and policy changes aimed at transforming all parts of the mental health care continuum – from prevention to treatment to recovery.”

Per the governor’s office, this includes:

•Increasing operational capacity for inpatient psychiatric treatment by 1,000 beds: During the COVID-19 public health emergency, the state allowed hospitals to make operational decisions that resulted in taking inpatient psychiatric beds offline, even while the operating certificate for the beds remained in place. Gov. Hochul's plan will direct Article 28 community hospitals to immediately bring 850 currently offline inpatient psychiatric beds online. New legislation will allow the state Office of Mental Health to fine Article 28 community hospitals up to $2,000 per violation per day for failing to comply with the number of psychiatric beds outlined in their operating certificate. The state will also open 150 new adult beds in state-operated psychiatric hospitals, including 100 in New York City alone, which are in addition to the 50 beds that the governor announced last November.

•Creating 3,500 new housing units for individuals with mental illness: Gov. Hochul will make a capital investment and provide the necessary operating funds for 3,500 new residential units serving New Yorkers with mental illness. Specifically, the plan calls for:

√ 500 community residence-single room occupancy units to provide housing and intensive services to individuals with serious mental illness and at the highest risk of homelessness.

√ 900 transitional stepdown units to help individuals transitioning from various levels of care to community-based living.

√ 600 licensed apartment units to serve individuals requiring an intermediate level of services to be able to live in the community.

√ 1,500 supportive housing units serving individuals with serious mental illness, split between scattered-site rental units that can be opened quickly and new construction or renovated facilities completed over the next five years.

Improving Admissions and Discharge Planning and Establish Systemic Accountability

Hochul is proposing a combination of policy changes and investments to create systemic accountability for admissions and discharges, including requirements that hospitals responsibly admit patients in need of care, with new comprehensive standards for evaluation and increased state-level oversight to ensure new protocols are being used effectively; emergency departments and inpatient providers discharge high-risk, high-need individuals into immediately available wraparound services; and outpatient programs to provide immediate and ongoing appointments for high-risk individuals during the discharge process. The plan also calls for the creation of 50 new critical time intervention teams to provide wrap-around services for discharged patients – from housing to job supports.

•Dramatically expanding outpatient services: Hochul's plan will expand a wide range of outpatient services to expand mental health care access, reduce wait times, and ensure appropriate levels of care. Specifically, the plan includes adding:

√ 12 comprehensive psychiatric emergency programs, providing hospital-level crisis care across New York state.

√ 42 assertive community treatment teams to provide mobile, high-intensity services to the most at-risk New Yorkers, with 22 new teams in New York City and 20 in the rest of the state.

√ 26 certified community behavioral health clinics to provide walk-in, immediate integrated behavioral health care, providing both mental health and substance use disorder services for New Yorkers of all ages and insurance status, supplemented by an indigent care pool to ensure access regardless of one's ability to pay. This will triple the number of certified community behavioral health clinics in New York state from 13 to 39, serving approximately 200,000 New Yorkers.

√ Eight safe options support teams to provide outreach and connection to services for homeless populations with mental illness and substance use disorders, with five new teams in New York City and three in the rest of the state. This will build on the safe options support teams introduced by Hochul in last year's State of the State that are currently in operation in New York City.

√ 20 expanded-capacity Article 31 mental health clinics providing care to the most vulnerable New Yorkers, which often serve as a front-door mental health service in communities across the state.

√ Health Home Plus care management to provide assistance as individuals with mental illness seek to access the services they need, hiring dozens of new care managers to serve individuals with serious mental illness.

•Expanding insurance coverage for mental health services: The plan will close critical gaps in insurance coverage for mental health services. This includes prohibiting insurance companies from denying access to medically necessary, high-need, acute and crisis mental health services for both adults and children, expanding commercial and Medicaid coverage of mental health services to improve the well-being and success of individuals once they leave hospitals or emergency departments. The plan will also set appointment availability and geographic accessibility standards for behavioral health services to ensure New Yorkers have access to treatment from in-network providers, and ensure access to behavioral health services whether it is delivered in-person or via telehealth.

Expanding Mental Health Services for School-aged Children

Hochul proposes expanding access to mental health services in schools by increasing Medicaid payment rates for school-based satellite clinics and school-based wraparound services, to incentivize further development of this critical care. In addition, the governor will introduce legislation requiring commercial insurance providers to pay for school-based services at a level equal to the higher paying Medicaid rate, to ensure timely access for all children. The plan also outlines an annual investment to provide the start-up funding necessary to get new and expanded school services in operation quickly.

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