FINANCE

NEW YORK STATE SENATE FINANCE COMMITTEE HEARS MENTAL HYGIENE BUDGET TESTIMONY — Commissioners of three major mental health agencies presented Governor Hochul's proposed 2023-2024 budget to joint legislative committees on February 16, highlighting historic investments totaling more than $3 billion across mental health, addiction services, and developmental disabilities programs. The hearing, the ninth of 13 budget review sessions, featured testimony from the Office of Mental Health, Office of Addiction Services and Supports, and Office for People With Developmental Disabilities, along with advocacy organizations and service providers. OMH Commissioner Dr. Ann Marie Sullivan described the budget as historic, proposing more than $1 billion for a comprehensive mental health system. Key initiatives include reopening 850 psychiatric beds at community hospitals, opening 150 new state-operated beds with a $15 million investment, establishing 50 new Critical Time Intervention teams with nearly $14 million, and investing $890 million in capital and $25 million in operational funding for 3,500 new housing units. The budget also allocates more than $85 million to expand outpatient services, $40 million for children's mental health including school-based clinics, and $10 million for suicide prevention in underserved communities. Sullivan also announced 26 new Certified Community Behavioral Health Centers that will serve an additional 200,000 New Yorkers. OASAS Commissioner Dr. Chinazo Cunningham presented a proposed budget of more than $1.2 billion, including nearly $175 million for state operations and over $968 million for Aid to Localities. She announced that $120 million in opioid settlement funds have been made available, with $64 million directed to municipalities and $56 million supporting priority initiatives identified by the opioid settlement fund advisory board. OPWDD Commissioner Kerri Neifeld highlighted the budget's focus on workforce retention, noting that the proposed 2.5 percent cost-of-living adjustment combined with the prior year's 5.4 percent COLA represents the first back-to-back COLA investments in more than a decade, totaling more than $700 million toward increased costs and staff wages. She also outlined continued $15 million annual capital investments in community-based housing, bringing total housing investments to $125 million since 2016. During questioning, Sen. Samra Brouk, chair of the Senate Mental Health Committee, raised concerns about workforce retention, noting that the 2.5 percent COLA does not keep pace with inflation rates of approximately 6.4 percent. She advocated for indexing workforce salaries and COLAs to inflation and pressed Commissioner Sullivan on standardizing crisis response teams across the state, noting inequities in response capabilities between counties. Sullivan acknowledged that mobile crisis teams exist in all but two counties but indicated the focus is on standardizing response times and staffing across the state. The hearing included testimony from multiple advocacy organizations representing mental health providers, people with disabilities, and individuals in recovery, though their testimony was not included in the transcript excerpt provided. NEW YORK STATE SENATE FINANCE COMMITTEE — Lawmakers sharply questioned the adequacy of the Hochul administration's 2023-2024 mental hygiene budget during a joint legislative hearing Thursday, with particular focus on a 2.5 percent cost-of-living adjustment that legislators said falls far short of addressing inflation and a deepening workforce crisis across mental health and addiction services. Assemblywoman Gunther, chair of the Mental Health Committee, delivered pointed criticism of the budget's approach to psychiatric bed restoration and regional disparities in mental health services. She highlighted that families in Sullivan County lack transportation to access mental health care, with some children being sent to facilities in Westchester County. "This is the United States of America. This is not what we do," Gunther said, calling for faster action on bringing 1,000 psychiatric beds back online. Assemblywoman Seawright, chair of the Committee on People with Disabilities, cited alarming workforce data: a 20 percent vacancy rate for direct-support positions statewide, a 42.5 percent increase in vacancies since pre-pandemic levels, and a 30 percent annual turnover rate. She questioned how agencies can operate effectively under these conditions and emphasized that workers—predominantly women of color—deserve fair compensation. Sen. Mannion, chair of the Committee on People with Developmental Disabilities, pressed OPWDD Commissioner Neifeld on whether the 2.5 percent COLA is sufficient given competitive workforce pressures. Neifeld defended the increase as part of a cumulative 5.4 percent adjustment when combined with prior-year investments, and highlighted over $700 million in two-year funding for the not-for-profit system. She also described extensive recruitment initiatives including partnerships with SUNY, BOCES, and Georgetown University. OMH Commissioner Sullivan testified that a 27.9 percent Medicaid reimbursement rate increase for inpatient psychiatric beds should incentivize hospitals to restore capacity. She also outlined a new Qualified Mental Health Associate (QMHA) role, modeled after addiction counselors, to expand the workforce under licensed professional supervision. OASAS Commissioner Cunningham addressed apparent funding decreases by explaining that $200 million in Opioid Stewardship funds were appropriated for five-year spending, and $120 million of Opioid Settlement funds have been made available following the Advisory Board's November recommendations. She emphasized harm reduction strategies including naloxone expansion, fentanyl test strips, and drug-checking machines. Sen. Fernandez, new chair of the Alcohol and Substance Use Disorders Committee, raised concerns about the tension between scheduling new drugs and encouraging drug testing, indicating intent to propose legislation protecting individuals from criminal penalties for testing drugs. The hearing underscored legislative frustration that budget proposals, while containing targeted investments, do not adequately address systemic workforce shortages and inflation pressures across mental hygiene agencies. New York's mental hygiene agencies outlined ambitious plans to expand mental health services and address workforce shortages during a joint legislative budget hearing on February 16, with commissioners detailing hundreds of millions in new investments while facing pointed questions about service integration and controversial harm reduction policies. The Office for People with Developmental Disabilities (OPWDD) and Office of Mental Health (OMH) announced significant workforce investments, with OPWDD proposing a 2.5% cost-of-living adjustment (COLA) building on the current year's 5.4% increase—totaling $700 million over two years. OPWDD Commissioner Neifeld reported workforce stabilization for the first time in recent months and outlined a $10 million marketing campaign to recruit direct support professionals, along with partnerships with SUNY, BOCES, and Georgetown University. OMH Commissioner Sullivan reported approximately 1,000 school-based mental health clinics currently operating statewide, with plans to expand by several hundred annually. The agency is investing $25 million to expand the 988 suicide prevention hotline, which has seen growing call volume since its July 2022 launch. Sullivan also clarified that 3,500 (not 35,000) new residential units are planned for individuals with mental illness, with some supported apartments potentially available within six to nine months and capital construction projects taking one to two years. The Office of Addiction Services and Supports (OASAS) detailed $1.9 million in medical cannabis funding and $5.8 million from adult-use cannabis legalization for youth prevention and treatment programs. Commissioner Cunningham reported $123 million in Opioid Settlement Fund appropriations for the fiscal year. Legislators pressed commissioners on service integration, with Assemblyman Eachus highlighting the challenge of serving individuals with co-occurring developmental and mental disabilities. Assemblyman Keith Brown criticized the CHAMP study as weak on recommendations and called for comprehensive multi-agency coordination. Sen. Gustavo Rivera engaged in contentious questioning about overdose prevention centers, pressing OASAS Commissioner Cunningham on the specific state laws prohibiting their operation and funding—despite two centers currently operating in New York that have saved over 700 lives. Cunningham maintained that state law prohibits the agency from authorizing, regulating, or funding such centers. Sen. Canzoneri-Fitzpatrick raised concerns about 4201 schools' access to mental health funding and a reported $2 million budget cut, while Sen. Oberacker advocated for renaming school clinics as "mental wellness" clinics to reduce stigma and highlighted two ready-to-use facilities in his rural district that could be repurposed for mental health housing. New York State mental hygiene commissioners defended the Governor's 2023-2024 budget proposal during a joint legislative hearing on February 16, facing pointed questions from lawmakers about the adequacy of funding increases and the state's commitment to reopening psychiatric beds closed during the pandemic. The hearing, held before the Senate Finance Committee and Assembly Health Committee, centered on a proposed $1.1 billion increase for mental health services, including plans to reopen 850 community psychiatric beds and add 150 new state facility beds. However, commissioners acknowledged that none of the 850 community beds have yet reopened, though some hospitals have begun submitting reopening plans following a February 10 deadline. A central point of contention was the 2.5 percent cost-of-living adjustment (COLA) for community-based providers, down from 5.4 percent the prior year. Sen. O'Mara challenged the adequacy of the increase, noting that minimum wage is rising 7.6 percent upstate and questioning how direct care providers can compete with fast food workers offering higher wages. "How are they supposed to keep pace in recruitment and retention of employees when a fast food worker is getting three times the raise?" he asked. OMH Commissioner Sullivan outlined plans for critical time intervention teams—composed of nurses, social workers, and peers—that would follow individuals for up to 10 months after discharge from emergency rooms or inpatient units. The budget allocates $28 million for expanding these teams. Sullivan also described new discharge planning standards and resources to prevent the "revolving door" of repeated emergency room visits. Sen. Hinchey raised concerns about service gaps in rural areas, citing a constituent with traumatic brain injury who received a $250,000 budget allocation but could access only a fraction of services and waited three years for a service dog approval that was never formally denied or approved. The constituent eventually relocated to Long Island and is now seeking services in Oklahoma. Sen. Rolison described a successful local model from Poughkeepsie—the Echo team—that conducted 427 contacts with individuals in crisis, initiated 126 follow-ups, and linked 242 individuals to services 1,835 times in one year. He asked about funding for municipalities to create similar street outreach teams. OASAS Commissioner Cunningham noted that medication-assisted treatment reduces overdose death risk by 50 percent and discussed the agency's shift toward harm reduction approaches. The budget allocates $7 million for cannabis prevention and support services. OPWDD Commissioner Neifeld highlighted $12 million in capital funding for a Finger Lakes facility expansion expected to yield 170 additional full-time positions, and noted that additional dollars beyond the COLA are invested to keep pace with minimum wage increases. Sen. Krueger requested written documentation of where the 850 community beds have reopened, where the 150 new state facility beds will be located, and the location of the existing 6,000 community-based inpatient psychiatric beds across the state. NEW YORK STATE SENATE FINANCE COMMITTEE — State mental hygiene officials defended their 2023-2024 budget proposals during a joint legislative hearing on Feb. 16, facing pointed questions from lawmakers about implementation timelines, provider participation, and whether funding increases will actually reach frontline workers. The Office of Mental Health is requesting $890 million for supportive housing expansion targeting 3,500 new beds, with Commissioner Sullivan acknowledging that most beds will take 1.5 to 2 years to become operational, while new construction projects could take several years longer. The agency is also proposing a 27% Medicaid rate increase for community-based psychiatric beds, bringing the total from 5,150 currently online to 6,000 beds. Chairwoman Liz Krueger (D-Manhattan) expressed skepticism about whether the rate increase alone will convince providers to reopen psychiatric beds, requesting a detailed list of which facilities have offline beds and what enforcement mechanisms exist to ensure the "carrot-and-stick" incentive model actually works. "I'm not even convinced there aren't a lot more than 850 that they took offline," Krueger said. Sen. Diane Brouk (D-Westchester) raised maternal mental health as a critical gap, noting that maternal mental health conditions are the third leading cause of pregnancy-related deaths in New York and affect one in five birthing people. She referenced her bill—vetoed by the Governor last year—to create a maternal mental health workgroup. OMH Commissioner Sullivan responded that the agency has established Project TEACH, a statewide consultation line for medical providers to discuss antidepressant medication safety during pregnancy. The Office for People with Developmental Disabilities reported that 1,200 people are on its emergency needs list for residential opportunities and highlighted a $10 million contract with Georgetown University for diversity, equity and inclusion initiatives. However, Assemblywoman Seawright pressed Commissioner Neifeld on quality-of-life concerns in residences, citing reports of deteriorating physical conditions and inadequate staffing. The Office of Addiction Services and Supports discussed expansion of drug-checking machines to 38 community-based providers, with Sen. Fernandez introducing bill S4880 to formalize the program. Commissioner Cunningham acknowledged that new higher-dose naloxone products (8-milligram) are available but said data show no better efficacy than existing products, attributing reduced naloxone effectiveness to poly-substance overdoses involving xylazine. Multiple legislators raised concerns about whether cost-of-living adjustments (COLAs)—5.4% in the current budget and 2.5% proposed—are reaching direct support professionals and whether they keep pace with inflation. Assemblywoman Kelles noted that some facilities report 25-40% staff shortages, with directors performing direct care work. Commissioner Neifeld said OPWDD has issued attestations to providers to track how COLA funds are being used but acknowledged the complexity of operational costs. NEW YORK — Mental health advocates and state officials testified before a joint legislative committee on Wednesday that Governor Hochul's 2023-2024 budget proposal, while historic in its commitment to mental health services, falls short on critical workforce compensation and local funding needs during an ongoing overdose crisis. The hearing before the Senate and Assembly Finance committees featured testimony from the state Justice Center for the Protection of People with Special Needs, which reported handling approximately 10,000 to 11,000 abuse and neglect cases annually across the mental hygiene system. Executive Director Denise Miranda highlighted the agency's Staff Exclusion List, which has barred 870 individuals from the service system, and noted that 280 people have attempted to reenter the workforce after being excluded. However, advocacy organizations expressed frustration with the budget's workforce provisions. The Governor proposed a 2.5 percent cost-of-living adjustment for mental health and addiction service workers, falling short of the requested 8.5 percent increase. Glenn Liebman, CEO of the Mental Health Association in New York State, noted that the human services workforce has endured 15 years of essentially no cost-of-living adjustments, resulting in a $600 million loss to the system relative to inflation. "The Governor's laid out a great vision, but if you don't have the workforce to operate within that vision, then there's a lot of things that are failing," Liebman testified. John Coppola of the New York Association of Alcoholism and Substance Abuse Providers criticized a $240 million reduction in local assistance funding, calling it unacceptable during an overdose pandemic. "The number 'minus 240 million' should not be in this budget next to local assistance," he said. On a positive note, Sharon Horton of the National Alliance on Mental Illness praised the Governor's proposal to return 1,000 psychiatric beds, reversing a loss of 1,849 beds since 2014. She also applauded planned improvements to hospital admission and discharge practices, sharing a personal account of inadequate discharge planning for her son with serious mental illness. Courtney David, representing the Conference of Local Mental Hygiene Directors, raised concerns about the state's competency restoration process, noting that individuals charged with crimes can languish in the system for years at a cost exceeding $1,100 per day, with counties bearing the full expense. Senators Mannion and Brouk pressed officials on specific operational details and staffing challenges, while Chair Liz Krueger asked whether the Justice Center's decade-long combination of investigation and prevention work has measurably improved service quality across the state's mental hygiene system. NEW YORK — Mental health and substance abuse advocates clashed with state budget priorities on Thursday, demanding an 8.5% cost-of-living adjustment for workers instead of the Governor's proposed 2.5%, while also highlighting critical gaps in service delivery across the state. At a joint legislative hearing on the 2023-2024 Executive Budget for mental hygiene, testifiers painted a picture of a workforce crisis in the nonprofit sector, where employees—predominantly women and people of color—earn as little as $15 per hour and often work multiple jobs. "Mission-driven does not put food on the table," said Glenn Liebman, representing advocacy organizations. Assemblywoman Gunther was blunt in her criticism: "Eight-point-five is what we need," she said, arguing that the 2.5% increase was "absolutely an insult." She emphasized that adequate compensation would prevent workers from burning out and help reduce incarceration by ensuring people receive mental health care before they enter the criminal justice system. Testifiers also raised concerns about the $240 million reduction in the Office of Alcohol and Substance Abuse Services (OASAS) local assistance budget. John Coppola, representing advocacy organizations, said the reduction should be reconsidered and that a consensus of providers had identified a need for $500 million in additional reimbursement rates to address workforce and service gaps. Sen. O'Mara expressed frustration that the state found $1 billion for migrant services but was cutting mental health funding. "We can find a billion dollars to support migrants in a sanctuary city that invited them, but we're not funding mental health programs," he said. Other concerns raised included the exclusion of licensed creative arts therapists from a Medicaid reimbursement expansion, inadequate housing support for people experiencing homelessness, and the need for better data on overdoses. Sen. Oberacker, an EMS volunteer, noted that overdoses are only counted if they result in death, making it impossible to assess the true scope of the crisis. Harvey Rosenthal, a person in long-term recovery, criticized the state's focus on hospitalization as a solution, arguing that "change doesn't happen in a hospital" and advocating instead for community-based services including peer support, housing-first models, and crisis stabilization centers. The hearing, held by the Senate Finance Committee and Assembly Ways and Means Committee, revealed deep concerns about whether the budget's mental health investments can be effectively implemented without addressing the underlying workforce crisis. NEW YORK STATE SENATE FINANCE COMMITTEE HEARS TESTIMONY ON MENTAL HYGIENE BUDGET; ADVOCATES PUSH FOR EXPANDED TREATMENT, WORKFORCE FUNDING Albany — The New York State Senate Finance Committee held a joint legislative hearing on the 2023-2024 executive budget for mental hygiene services on Thursday, hearing testimony from providers, advocates, and public defenders who warned of critical shortages in mental health services and called for substantial increases in funding and reimbursement rates. Testifiers emphasized that New York faces a public health crisis driven by provider shortages, inadequate Medicaid reimbursement rates, and insufficient access to community-based services. Ms. Bufkin, testifying on behalf of children and families' mental health advocates, called for at least half of the proposed $1 billion in behavioral health funding to be directed to children and families, noting that historically this population receives a disproportionately small share when funding amounts are unspecified. The hearing revealed stark racial disparities in the opioid crisis. Allegra Schorr, president of the Coalition of Medication-Assisted Treatment Providers and Advocates (COMPA), reported that while overdose deaths tripled for white New Yorkers, they increased fivefold for Black New Yorkers and quadrupled for Latino New Yorkers. She called for an 8.5 percent cost-of-living adjustment (COLA) and a $500 million reimbursement increase to maintain and expand access to medication-assisted treatment. Multiple testifiers advocated for the Treatment Not Jail Act and expanded alternatives to incarceration. Katherine Bajuk, a public defender and crime victim, testified that for every dollar invested in treatment, the state yields $2 in savings, and that 75 percent of crime victims support treatment for people charged with violence. Nadia Chait of CASES described the Nathaniel Assertive Community Treatment (NACT) program, the only OMH-licensed alternative to incarceration in the state, which shows a 70 percent decrease in recidivism and a 225 percent increase in employment among participants. She called for expansion of at least two additional NACT teams to serve people in the Bronx and additional Brooklyn locations. Assemblywoman Gunther made pointed remarks about investing in upstream prevention and community-based services rather than emergency room and jail responses. She criticized police-first response to mental health crises and referenced international models in Denmark, Spain, and Germany that handle mental health differently. She also referenced Daniel's Law, which would send mental health workers and EMTs rather than police to mental health crises. Senator Mannion expressed strong support for parity between 853 schools (operated by providers like Hillside) and public schools, and advocated for his Narcan bill requiring naloxone availability in all public settings with automated external defibrillators. Both COMPA and CASES testified in support of the bill. Testifiers also highlighted insurance network adequacy issues. Ms. Fagen of New York Creative Arts Therapists described how only one Medicaid managed care plan accepts licensed creative arts therapists in-network, creating a patchwork that disrupts patient care when families change insurance. Ms. Schorr noted that people with commercial insurance coverage for methadone treatment often cannot access it because insurance plans have not contracted with opioid treatment providers. The hearing underscored the need for workforce investment, with multiple testifiers calling for the 8.5 percent COLA, reimbursement rate increases matching the cost of care, and expanded loan repayment programs for mental health practitioners. Testifiers also emphasized the importance of peer-run programs, intermediate housing options, and community-based alternatives to hospitalization and incarceration. NEW YORK — Disability rights advocates and mental health service providers testified before the Joint Legislative Committee on Finance on Thursday, delivering a stark assessment of the state's mental hygiene and intellectual and developmental disability systems, calling the Governor's proposed 2023-2024 budget inadequate to address a deepening workforce crisis. The hearing, held February 16, featured emotional testimony from service providers and people with disabilities describing how staff shortages are preventing individuals from accessing community programs, leaving them isolated and worsening their mental health. Erik Geizer, CEO of The Arc New York, presented case studies of individuals harmed by the shortage, including a young man who has been waiting since 2020 to transition from school to community supports, and a woman who refuses to bathe because she is uncomfortable with substitute staff. The central dispute centered on the Governor's proposed 2.5 percent cost-of-living adjustment (COLA) for disability and mental health services. Advocates unanimously requested an 8.5 percent COLA—matching current inflation—plus a $4,000 wage increase for direct support professionals (DSPs). Michael Seereiter of the New York Alliance for Inclusion and Innovation called the 2.5 percent proposal "frankly embarrassing" in an 8.5 percent inflation environment. The wage disparity between state and nonprofit workers emerged as a key concern. State-employed DSPs earn approximately $24 per hour, while nonprofit-employed DSPs earn $16 per hour for the same work—a 50 percent gap. Seereiter argued this disparity perpetuates racial and gender inequities, since nonprofit DSPs are disproportionately Black, Latinx, and female. The nonprofit sector provides 85 percent of I/DD services but was excluded from recent state wage increases. Data presented painted a dire picture: a 17 percent vacancy rate and 30 percent turnover rate among nonprofit DSPs; 20,000 total DSP vacancies statewide; and $100 million in annual costs from turnover alone. Mike Alvaro of New York Disability Advocates noted that over 11 years, the I/DD field received only 1.2 percent total COLA investment—$1 billion less than if services had been included in Medicaid. Jim Karpe, a parent of two adults with I/DD, testified against extending the state's decade-long managed care investigation, citing studies showing managed care increases costs without improving quality or access. A Deloitte study, he said, projected $200 million in additional annual administrative costs. Sebrina Barrett of the Association for Community Living highlighted an emerging crisis: over 40 percent of residents in mental health housing are age 55 and older, with complex medical conditions including dementia and COPD. Nursing homes refuse to admit people with mental illness, forcing aging residents into costly hospital stays. She requested a task force on aging in place. Sen. John Mannion stated he had requested an 8.5 percent COLA and $4,000 wage increase in his budget priority letter and encouraged colleagues to do the same. Sen. Pat O'Mara expressed skepticism about the Executive's budget, saying he was "astounded" and questioning whether it represented negotiating strategy or being "out of tune" with community needs. The hearing concluded with Assemblywoman Aileen Gunther sharing a personal anecdote about a young woman with disabilities in her district who lacks the staff support to work or participate in meaningful activities, underscoring advocates' argument that the issue is fundamentally about human dignity and quality of life.