FINANCE

NEW YORK STATE SENATE FINANCE COMMITTEE HEARS MENTAL HYGIENE BUDGET PROPOSAL EMPHASIZING WORKFORCE CRISIS AND SYSTEM EXPANSION Albany — The New York State Senate and Assembly joint fiscal committees heard testimony on Governor Hochul's 2023-2024 mental hygiene budget on Thursday, with three state agency commissioners presenting a combined $3.2 billion proposal aimed at expanding mental health and addiction services while addressing a critical workforce shortage. The Office of Mental Health's proposed $1 billion-plus budget represents what Commissioner Dr. Ann Marie Sullivan called "a historic budget" for implementing a comprehensive mental health system. The plan includes reopening 850 psychiatric beds at community hospitals that were converted during the COVID-19 pandemic, opening 150 new state-operated beds, and developing 3,500 new housing units with $890 million in capital investment. OMH also proposes $85 million to expand outpatient services, $40 million for children's mental health including school-based clinics, and continued funding for the 988 crisis line. The Office of Addiction Services and Supports presented a $1.2 billion budget that allocates $120 million in opioid settlement funds, with $64 million directed to municipalities and $56 million for board-identified priorities including harm reduction, treatment, and recovery services. Commissioner Dr. Chinazo Cunningham emphasized the expansion of Certified Community Behavioral Health Centers and Crisis Stabilization Centers to provide integrated care for substance use and mental health conditions. The Office for People With Developmental Disabilities highlighted workforce retention as its highest priority, with Commissioner Kerri Neifeld noting that back-to-back cost-of-living adjustments—5.4 percent in the current year plus a proposed 2.5 percent—will provide more than $700 million toward increased staff wages. The budget also includes $120 million in new state resources (leveraged with federal funds) and a statewide ombudsman program. However, Sen. Samra G. Brouk, chair of the Senate Mental Health Committee, raised pointed questions about workforce retention, noting that the 2.5 percent COLA falls short of the 6.4 percent inflation rate and questioning whether it will adequately compete with rising costs for housing, food, and childcare. She advocated for indexing workforce salaries to inflation annually. Brouk also pressed Commissioner Sullivan on standardizing crisis response teams across counties, noting disparities in response times and team composition that she compared to unequal firefighting services. Commissioner Sullivan responded that rate increases across the system—including 10 percent for clinic rates and 27.9 percent for inpatient beds—provide additional resources for salary increases beyond the COLA. She also noted that mobile crisis teams are licensed and regulated with uniform clinical standards, though response times vary by region. The hearing was the ninth of 13 joint fiscal committee hearings on the Governor's proposed budget. Additional testimony from advocacy organizations and service providers is expected in subsequent panels. NEW YORK STATE SENATE FINANCE COMMITTEE — Legislators sharply questioned state mental hygiene officials on February 16 over a proposed 2.5 percent cost-of-living adjustment they said falls far short of addressing inflation, with multiple lawmakers calling for an 8.5 percent increase instead. At a joint Senate-Assembly hearing on the 2023-2024 Executive Budget for mental health, developmental disabilities, and addiction services, lawmakers focused heavily on a workforce crisis threatening service delivery across three state agencies. Assemblywoman Gunther, chair of the Mental Health Committee, cited specific regional shortages, noting that Sullivan County has lost psychiatric beds and families must transport children hours away for treatment. "This is the United States of America. This is not what we do," she said, pressing officials on plans to restore 1,000 psychiatric beds. Assemblywoman Seawright, chair of the Committee on People with Disabilities, cited alarming workforce data: a 20 percent vacancy rate for direct-support staff statewide, a 42.5 percent increase in vacancies since pre-pandemic levels, and a 30 percent annual turnover rate. She emphasized the workforce is predominantly women of color deserving fair compensation. Office of Mental Health Commissioner Sullivan defended the agency's plan to create a new paraprofessional credential—Qualified Mental Health Associates—modeled on addiction counselors, saying they would be recruited from community colleges and high schools to expand the workforce. She also cited a 27.9 percent Medicaid reimbursement rate increase for inpatient psychiatric beds to incentivize hospitals to restore closed beds. Office for People with Developmental Disabilities Commissioner Neifeld defended the 2.5 percent COLA as part of a two-year $700 million investment, detailing extensive recruitment partnerships with SUNY, BOCES, and Georgetown University. She said state operations are seeing increased retention, though she acknowledged not having current turnover data. Office of Addiction Services and Supports Commissioner Cunningham explained that apparent budget decreases were due to reappropriation of multi-year opioid settlement and stewardship funds. She said $120 million in Opioid Settlement funds have been made available following November 2022 recommendations, with $123.6 million appropriated for the current year. She detailed harm reduction initiatives including naloxone expansion and drug-checking machines. Sen. Fernandez, new chair of the Alcohol and Substance Use Disorders Committee, raised concerns about Article 7 proposals to schedule new drugs, questioning whether encouraging drug testing while criminalizing possession creates a legal trap for users. She indicated intent to propose protective legislation. The hearing revealed deep legislative skepticism about whether proposed investments adequately address workforce shortages and service gaps, particularly in rural and underserved regions. NEW YORK STATE SENATE FINANCE COMMITTEE — State mental hygiene officials defended their 2023-2024 budget proposals during a joint legislative hearing Thursday, emphasizing workforce development and expanded services for youth while facing pointed questions about harm reduction strategies and access equity. The hearing featured testimony from three agency commissioners: Office of Mental Health Commissioner Dr. Kristine Sullivan, Office for People with Developmental Disabilities Commissioner James Neifeld, and Office of Addiction Services and Supports Commissioner Dr. Arlene Cunningham. Commissioner Neifeld outlined a $700 million investment in OPWDD's not-for-profit system over two years through a 2.5% cost-of-living adjustment building on the current fiscal year's 5.4% increase. He reported approximately 980 vacancies in the voluntary residential system and 370 in state-operated facilities, with about 1,200 people on the emergency need list for residential placement. The agency is pursuing partnerships with SUNY and CUNY for workforce training and launching a $10 million marketing campaign to attract direct support professionals. Commissioner Sullivan announced plans to expand school-based mental health clinics from approximately 1,000 currently operating across the state by several hundred annually, with the goal of placing clinics in every school. The budget includes $25 million to expand the 988 suicide and crisis hotline to handle increased call volume and establish two new call centers, and $3,500 new residential units for individuals with mental illness, with at least half expected operational within 18 months. Commissioner Cunningham detailed $123 million in Opioid Settlement Fund appropriations and $5.8 million from adult-use cannabis legalization for youth prevention and treatment programs. However, she faced sharp questioning from Sen. Gustavo Rivera over the agency's refusal to fund overdose prevention centers, which he noted are already operating in New York and have saved over 700 lives. Cunningham maintained that state and federal law prohibit the state from authorizing, regulating, or funding such centers, though she could not specify which statutes apply. Sen. Canzoneri-Fitzpatrick raised concerns about 4201 schools' access to mental health funding and a $2 million budget cut they face. Sen. Oberacker advocated for rural service expansion and suggested rebranding school clinics as "mental wellness" clinics to reduce stigma. Assemblyman Keith Brown called for a comprehensive, multi-agency approach to co-occurring disorders rather than "Band-Aid" solutions. Commissioners committed to follow-up responses on several metrics, including average vacancy duration, average time on emergency residential need lists, and details on CUNY partnership development. New York State mental hygiene agencies 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 pace of service expansion in a state grappling with a severe mental health crisis. The hearing, held before the Senate Finance Committee and Assembly Health Committee, centered on the proposed $1.1 billion increase for mental health services, including plans to reopen 850 psychiatric beds closed during the pandemic and add 150 new state facility beds. However, lawmakers expressed skepticism about whether these investments would be sufficient to address years of service cuts and current shortages. Sen. O'Mara raised the most pointed criticism, arguing that the 2.5 percent cost-of-living adjustment (COLA) for community-based providers is inadequate compared to the 7.6 percent minimum wage increase upstate and the prior year's 5.4 percent COLA. "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. OPWDD Commissioner Neifeld clarified that additional dollars are invested to keep pace with minimum wage increases, but O'Mara remained unconvinced. Sen. Borrello questioned whether the state has the political will to implement necessary changes, noting that more than 1,000 mental health beds were closed under previous administrations. OMH Commissioner Sullivan assured lawmakers that the Governor is committed to reopening beds and implementing discharge planning standards to prevent "revolving door" emergency room visits. Sen. Hinchey raised concerns about service gaps in rural and semi-rural communities, citing a constituent with traumatic brain injury who was allocated $250,000 but could not access services in Ulster County and eventually moved to Long Island to seek care. She criticized coordination failures between state agencies. The agencies outlined several new initiatives, including $28 million for critical time intervention teams that will follow individuals for up to nine months after discharge, and expansion of street outreach teams. OASAS Commissioner Cunningham emphasized that medication-assisted treatment reduces overdose death risk by 50 percent and discussed the agency's shift toward harm reduction approaches. Sen. Rolison described a successful municipal crisis intervention model in Poughkeepsie that made 427 contacts with individuals in crisis and linked 242 people to services 1,835 times in one year, asking whether funding would be available for similar programs in other municipalities. The hearing revealed significant tensions between lawmakers' desire for rapid service expansion and agencies' acknowledgment that implementation will take time, particularly given workforce shortages and the need to recruit and retain direct care workers in a competitive labor market. NEW YORK STATE SENATE FINANCE COMMITTEE — State mental hygiene officials faced pointed questioning from legislators on Wednesday about whether proposed budget increases would actually translate into expanded services, particularly regarding psychiatric bed capacity and workforce wages. At a joint legislative hearing on the 2023-2024 Executive Budget, Senate Chair Liz Krueger pressed Office of Mental Health Commissioner Ann Sullivan on the state's plan to bring 850 community-based psychiatric beds back online, expressing skepticism that a 27 percent Medicaid rate increase alone would convince providers to reopen facilities. "I'm not even convinced, with all due respect, that there aren't a lot more than 850 that they took offline and haven't brought back," Krueger said, demanding a detailed list of bed locations. Sullivan outlined an ambitious supportive housing initiative: $890 million in capital funding to create 3,500 new beds, with most operational within 18 months to two years. However, she acknowledged that new construction projects could take several years. The commissioner also detailed efforts to address college mental health crises, including expansion of the 988 suicide prevention line and a Text5U texting service for college students across SUNY and other institutions. Senator Jessica Brouk raised maternal mental health as an urgent crisis, noting that maternal mental health conditions are the third leading cause of pregnancy-related deaths in New York and affect one in five pregnant people. She referenced her vetoed bill to create a maternal mental health workgroup and asked Sullivan to provide written details on the state's Project TEACH consultation line for providers. Office for People with Developmental Disabilities Commissioner Kerri Neifeld reported that 1,200 people are on the emergency needs list for residential opportunities and highlighted a $10 million contract with Georgetown University for diversity, equity and inclusion initiatives. However, multiple legislators raised concerns about staffing shortages and whether proposed COLA increases—5.4 percent this year plus a proposed 2.5 percent—would adequately address wage gaps and staff turnover. OASAS Commissioner Ira Cunningham discussed harm reduction initiatives, including expansion of drug-checking machines to 38 community-based providers and clarification that new higher-dose naloxone products, while available, have not demonstrated superior efficacy to existing formulations. Senator Fernandez introduced bill S4880 to establish a drug-testing machine program, urging careful implementation to protect participants. Multiple legislators requested written follow-ups on enforcement mechanisms for wage increases, specific timelines for service expansion, and data on service quality and outcomes. NEW YORK — Mental health and addiction service advocates urged state lawmakers on Thursday to increase workforce compensation and psychiatric bed capacity, warning that inadequate funding threatens to undermine Governor Hochul's ambitious mental health agenda outlined in her 2023-2024 budget proposal. During a joint Senate-Assembly hearing on the executive budget, representatives from four advocacy organizations criticized the Governor's proposed 2.5 percent cost-of-living adjustment for the mental health workforce as "grossly inadequate," arguing that a 8.5 percent increase is desperately needed to address a decade-long staffing crisis. "We requested an 8.5 percent increase for the workforce. We got 2.5 percent. That is grossly inadequate," said John Coppola of the New York Association of Alcoholism and Substance Abuse Providers, highlighting a $240 million reduction in local assistance in the budget proposal. Glenn Liebman, CEO of the Mental Health Association in New York State, warned that without adequate workforce investment, the Governor's vision cannot be realized. He noted the state has a $24 billion Rainy Day Fund and that moving from 2.5 to 8.5 percent would cost less than $500 million. "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 said. Sharon Horton of the National Alliance on Mental Illness-New York State praised the Governor's commitment to mental health, particularly the proposal to return 1,000 psychiatric beds lost since 2014. However, she criticized hospital admission and discharge practices, citing her personal experience with her son's traumatic discharge and subsequent police encounter. Denise Miranda, executive director of the New York State Justice Center for the Protection of People with Special Needs, testified on the agency's decade of operations. She reported that the Justice Center investigates approximately 10,000 to 11,000 abuse and neglect cases annually from its 24/7 call center, which receives 90,000 calls per year. The agency's Staff Exclusion List has barred 870 individuals from the service system, with approximately 280 attempting to reenter the workforce. Courtney David, executive director of the New York State Conference of Local Mental Hygiene Directors, advocated for reforms to the state's competency restoration process, noting that some cases last 3 to 10 years at a cost exceeding $1,100 per day, with counties bearing 100 percent of costs. Senators Mannion and Brouk engaged substantively with both the Justice Center director and advocacy panelists, seeking data on service gaps and workforce challenges to support their advocacy for increased investment. NEW YORK — Mental health and substance abuse advocates clashed with state budget priorities on Thursday, testifying that a proposed 2.5% cost-of-living adjustment for workers is inadequate and that the state is underfunding critical services despite record investments in behavioral health. At a joint Senate-Assembly hearing on the 2023-2024 Executive Budget for mental hygiene, advocates and provider organizations called for an 8.5% COLA increase, arguing that workers—predominantly women and people of color—cannot sustain themselves on current wages and many work multiple jobs. "Mission-driven does not put food on the table," said Glenn Liebman, representing advocacy organizations. Assemblywoman Gunther criticized the Governor's proposal as "absolutely an insult," noting that the state has a $24 million Rainy Day Fund that could be deployed. She argued that investing in mental health and substance abuse services prevents incarceration and saves lives. John Coppola, representing advocacy organizations, cited a $500 million funding gap needed for reimbursement rate increases to address co-occurring substance use and mental health disorders. He also questioned a $240 million decrease in the OASAS local assistance budget, asking whether those funds could be redirected to addiction services before being allocated elsewhere. Senator O'Mara expressed frustration that the state allocated $1 billion to support migrants in sanctuary cities while underfunding mental health programs. He noted his budget notes show approximately $200 million in reappropriated funds. Senator Oberacker raised concerns about the lack of standardized overdose data collection across counties, noting that overdoses are only counted if they result in death, missing cases where Narcan is used in the field. He proposed working with testifiers to develop legislation standardizing reporting. Harvey Rosenthal, a person in long-term recovery and advocate for 30 years, criticized the focus on hospitalization as a solution, arguing that "change doesn't happen in a hospital" and that the revolving-door problem of repeated admissions demonstrates the failure of discharge planning. He advocated for community-based solutions including peer bridgers, crisis stabilization centers, and housing-first models. Drena Fagen, a licensed creative arts therapist, testified that her profession was excluded from Part Q of the budget bill, which expands Medicaid reimbursement for other mental health practitioners licensed in 2005. She argued that creative arts therapists have proven effectiveness, particularly for children and trauma survivors. Provider organizations praised the Governor's mental health investments but emphasized workforce shortages. Maria Cristalli, CEO of Hillside, reported several hundred job openings out of 1,800 staff and called for expanded COLA to include more disciplines, loan forgiveness, and scholarship programs. The hearing revealed tensions between the Legislature's desire to expand services and the practical constraints of workforce capacity and funding adequacy. NEW YORK — Mental health advocates, treatment providers, and criminal justice reform advocates urged the New York State Legislature on Thursday to significantly expand funding and services for behavioral health, substance use disorder treatment, and alternatives to incarceration in the 2023-2024 budget, citing alarming disparities in overdose deaths and persistent gaps in access to care. Testimony at the joint legislative hearing on the mental hygiene budget revealed stark racial disparities in the opioid crisis: overdose deaths have quadrupled for Latino New Yorkers and increased fivefold for Black New Yorkers, while tripling for white New Yorkers, according to Allegra Schorr, president of the Coalition of Medication-Assisted Treatment Providers and Advocates. New York's overdose death rate now exceeds the national average. Advocates called for at least half of the Governor's proposed $1 billion in behavioral health funding to be directed to children and families, arguing that historical underfunding of youth services perpetuates a cycle where young people cycle through emergency rooms and hospitals without receiving adequate mental health support. They also requested an 8.5 percent cost-of-living adjustment for human services workers and $500 million in additional reimbursement to address workforce shortages and operating costs. Criminal justice reform advocates highlighted the success of treatment-based alternatives to incarceration. Katherine Bajuk, a public defender with New York County Defender Services, testified that for every dollar invested in treatment, the state saves $2, citing data from the Office of Court Administration. She advocated for passage of the Treatment Not Jail Act and $60 million to expand treatment courts. Nadia Chait of the Center for Alternative Sentencing and Alternative Services presented data on the Nathaniel Assertive Community Treatment program, the only OMH-licensed alternative to incarceration in the state. The program achieved a 70 percent decrease in recidivism, a 70 percent decrease in homelessness, and a 225 percent increase in employment among participants. However, the program only operates in Manhattan and Brooklyn, serving individuals facing felony charges. Chait called for at least two additional ACT teams to serve the Bronx and other areas of the state. Senators pressed witnesses on implementation details. Sen. John Mannion asked about his bill requiring naloxone (Narcan) to be available in all public settings where automated external defibrillators are required. Witnesses supported the measure, with Schorr noting that Narcan is simple to administer and that increased access could save lives. Sen. Mannion also advocated for parity in school funding, noting that children served by private schools like Hillside have complex needs and deserve funding equivalent to public school students. Witnesses also highlighted insurance barriers to care. Schorr testified that people with commercial insurance coverage for methadone treatment often cannot access it because insurance plans have not contracted with opioid treatment providers. She called on the Legislature to require commercial insurers to contract with all medication-assisted treatment providers in their service areas. The hearing underscored persistent workforce shortages, inadequate reimbursement rates, and gaps in peer support services, with advocates urging the Legislature to invest in upstream, community-based services rather than relying on emergency rooms, hospitals, and incarceration to address mental health and substance use crises. NEW YORK STATE SENATE FINANCE COMMITTEE — Advocates and service providers testified before the Joint Legislative Committee on Finance on February 16 that the Governor's proposed 2023-2024 budget for mental hygiene and disability services falls dangerously short of addressing a workforce crisis threatening vulnerable populations across New York. The hearing, which examined the Executive Budget's mental hygiene provisions, revealed stark disparities in funding and wage support between state and nonprofit providers, with testimony centering on inadequate cost-of-living adjustments and direct support professional (DSP) compensation. Michael Seereiter of the New York Alliance for Inclusion and Innovation criticized the proposed 2.5 percent COLA as "frankly embarrassing" in an 8.5 percent inflation environment, noting that nonprofit-employed DSPs face a 17 percent vacancy rate and 30 percent turnover rate. He highlighted that the Governor provided wage increases of $4,000 to $6,000 for state-employed DSPs while leaving nonprofit workers—who provide 85 percent of I/DD services—without comparable raises. Erik Geizer, CEO of The Arc New York, presented case studies of individuals unable to access services due to staffing shortages, including a young adult who has been waiting since June 2020 to transition from school to community supports. He stated that turnover costs the field approximately $100 million annually and called the situation "unconscionable." Advocates requested an 8.5 percent COLA and a $4,000 wage increase for nonprofit DSPs, with Mike Alvaro of New York Disability Advocates calculating the state share cost at $235 million for the COLA and $126 million for wage increases. He noted that over 11 years, the I/DD field received only 1.2 percent total COLA investment, compared to the $1 billion it would have received if included in Medicaid increases. Sebrina Barrett of the Association for Community Living testified that mental health housing providers serve over 40,000 New Yorkers but face a $96 million shortfall and 25 percent staff vacancy rate. She highlighted an emerging crisis: more than 42 percent of residents are age 55 and older with complex medical conditions, yet housing models from the 1980s and 1990s lack appropriate staffing and nursing support. Veronica Crawford, a self-advocate with disabilities, provided powerful testimony about how staff shortages leave people with disabilities isolated and unable to participate in community programs, increasing anxiety and behavioral issues. Jim Karpe, a parent of two young adults with I/DD, testified against extending the managed care investigation, citing Texas studies and a Deloitte report showing managed care increases costs without consistent quality or access improvements. He called for ending the decade-long investigation to allow OPWDD to focus on direct service improvements. Sen. John Mannion stated he had requested an 8.5 percent COLA and $4,000 salary increase in his budget priority letter and encouraged colleagues to do the same. Sen. O'Mara expressed frustration with the Executive's budget, noting that ARCs in his rural district face home closures due to staffing shortages, questioning whether the proposal represents genuine priorities or negotiating strategy. The hearing underscored deep concerns among legislators and advocates that current funding levels will continue to deteriorate services for New York's most vulnerable populations.