Photo Credit: Wikimedia / Eden, Janine and Jim
Bellevue Hospital in New York City, December 2009

Lawmakers in New York State have passed a $1 billion multi-year plan to overhaul the state’s badly broken system of mental health care.

As part of the FY 2024 budget, the plan is aimed at expanding access, reducing wait times, and ensuring appropriate levels of care for those struggling with mental health issues in the state.

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As part of that process, the budget funds new residential units, increased inpatient capacity and outpatient services, supports peer-based outreach programs, expands school-based mental health services, and closes gaps in insurance coverage for behavioral health services.

“Decades of chronic underinvestment has allowed far too many New Yorkers to fall through the cracks in our state’s mental health care system,” Hochul said.

“The plan to fix our state’s continuum of mental health care marks a monumental shift in our approach … to ensure that everyone in our state has access to the high-quality care they deserve,” she added.

Here’s what the plan provides.

The Budget provides $890 million in capital and $120 million in operating funding to establish and operate 3,500 new residential units. The additional units include:
• 500 community residence-single room occupancy units to provide housing and intensive services to individuals with serious mental illness and are at the highest risk of homelessness;
• 900 transitional step-down units and 600 licensed apartment units serving individuals who require an intermediate level of services; and
• 1,500 supportive housing units serving individuals with a serious mental illness who have less acute needs but still require support to live in the community.

Also included is:
• $25 million in capital and $7.3 million in operating costs for 60 community step-down housing units in New York City, which will serve formerly unhoused individuals transitioning from inpatient care; and
• $18 million capital and $30 million operating funding to expand inpatient psychiatric beds, including opening 150 new adult beds in State-operated psychiatric hospitals.

In addition, the Budget provides the State Office of Mental Health with increased authority to sanction Article 28 community hospitals for failing to comply with the number of psychiatric beds outlined in their operating certificate.

To expand outpatient services, the budget provides $60 million in capital and $121.6 million operating funding for:
• 12 new comprehensive psychiatric emergency programs providing hospital-level crisis care;
• tripling the number of state-funded Certified Community Behavioral Health Clinics statewide from 13 to 39. These facilities offer walk-in, immediate integrated mental health and substance use disorder services for New Yorkers of all ages and insurance status;
• 42 additional Assertive Community Treatment teams to provide mobile, high intensity services to children and adults;
• eight additional Safe Options Support teams — five in New York City and three in the rest of state — to provide outreach and connection to services for homeless populations with mental illness and substance use disorders; and
• expansion of capacity at 20 Article 31 clinics to provide core mental health services.

Funding in the amount of $28 million will be used to create 50 new Critical Time Intervention care coordination teams to provide wrap-around services, from housing to job supports, for individuals needing transition assistance, including children and adults discharged from hospitals and emergency rooms.

This funding is aimed at helping hospitals “responsibly admit and discharge patients” and includes new standards for evaluation, with increased state-level oversight, the governor’s office said.

Another $2.8 million will be used to expand the Intensive and Sustained Engagement Treatment program to offer peer-based outreach and engagement for adults with serious mental illness.

An additional $3.3 million will be used to expand the Individual Placement and Supports program, an evidence-based model of supported employment for adults with mental illness.

The budget also provides $30 million to expand mental health services for school-aged children throughout the state, including $20 million for school-based mental health services and $10 million to implement wraparound services training.

Additionally, the budget includes $10 million to strengthen suicide prevention programs for high-risk youth.

Another $18 million is to be allocated over two years to reimburse providers for family preventive mental health services for parents and their children.

An additional $24 million will be provided over a two year period to reimburse providers for adverse childhood experience screenings.

The FY 2024 Budget also includes $12 million for HealthySteps and home-based crisis intervention programs to promote early childhood development and treatment for children and teens; plus $3.1 million to bolster treatment for individuals with eating disorders.

The budget also provides an additional $60 million to support the 988 Suicide and Crisis Lifeline – an increase of $25 million from the prior budget.

Also included is a four percent cost of living adjustment and an additional $5 million for the Office of Mental Health’s Community Mental Health Loan Repayment Program, expanding the eligibility for the program to include licensed mental health professionals.

Closing Gaps in Insurance Coverage
According to the governor’s office, the budget also closes gaps in insurance coverage that have blocked New Yorkers from accessing needing mental health care and substance use disorder services.

Under the changes outlined in the budget, commercial insurance plans must:
• adopt network adequacy standards for behavioral health services;
• cover mobile crisis, crisis intervention, and post-discharge services, including those provided in school-based mental health clinics, and addiction medication treatments and overdose reversal medications that are available over the counter; and
• follow utilization review standards that prohibit preauthorization or concurrent reviews for the first 30 days of mental health treatment for adults in an in-network inpatient hospital or crisis residence.

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Hana Levi Julian is a Middle East news analyst with a degree in Mass Communication and Journalism from Southern Connecticut State University. A past columnist with The Jewish Press and senior editor at Arutz 7, Ms. Julian has written for Babble.com, Chabad.org and other media outlets, in addition to her years working in broadcast journalism.