FINANCE

NEW YORK STATE SENATE FINANCE COMMITTEE — The state's three mental hygiene agencies presented a combined budget proposal exceeding $3.3 billion for fiscal year 2023-2024 during a joint legislative hearing on February 16, with agency commissioners highlighting historic investments in mental health services, substance abuse treatment, and developmental disability support. The Office of Mental Health's proposed budget of more than $1 billion represents what Commissioner Dr. Ann Marie Sullivan called "a historic budget, aiming for the first time to support the implementation of a truly comprehensive mental health system." The plan includes reopening 850 psychiatric beds at community hospitals, opening 150 new state-operated beds, establishing 26 new Certified Community Behavioral Health Centers to serve an additional 200,000 New Yorkers, and investing $890 million in capital funding plus $25 million in operational costs for 3,500 new housing units for people with serious mental illness. The Office of Addiction Services and Supports presented a budget of more than $1.2 billion, including nearly $175 million for state operations and over $968 million for Aid to Localities. Commissioner Dr. Chinazo Cunningham reported that $120 million in opioid settlement funds have been made available thus far, with $64 million directed to municipalities and $56 million supporting priority initiatives identified by the opioid settlement fund advisory board. The Office for People With Developmental Disabilities highlighted a 2.5 percent cost-of-living adjustment for nonprofit providers—the first back-to-back COLA in over a decade—with combined investments totaling more than $700 million toward increased costs including staff wages. Commissioner Kerri Neifeld noted the agency serves 131,000 people with developmental disabilities and has invested $125 million in capital resources for independent housing since 2016. Sen. Samra Brouk, chair of the Senate Committee on Mental Health, raised pointed questions about workforce retention, noting that the 2.5 percent COLA falls short of the 6.4 percent inflation rate and advocating for indexing workforce salaries to inflation. She also pressed Commissioner Sullivan on standardizing mental health crisis response teams across counties to ensure equitable service delivery, noting disparities where some areas have 15-20 minute response times while others face longer waits. The hearing was the ninth of 13 joint fiscal committee hearings on the Governor's proposed 2023-2024 budget, conducted pursuant to New York State Constitution and Legislative Law. Additional testimony from advocacy organizations and service providers is scheduled for later panels. NEW YORK STATE SENATE FINANCE COMMITTEE — Mental hygiene commissioners faced intense scrutiny over the 2023-2024 Executive Budget during a joint legislative hearing on Feb. 16, with lawmakers across both chambers demanding larger cost-of-living adjustments and faster action on psychiatric bed restoration. The central tension: a proposed 2.5 percent cost-of-living adjustment (COLA) that legislators said falls far short of the 8.5 percent increase needed to match inflation and address a deepening workforce crisis. Assemblywoman Gunther, chair of the Mental Health Committee, delivered pointed testimony, saying psychiatric bed closures were driven by "cash and profit, not people," and describing parents sitting with children 24 hours a day with no place to go. Office of Mental Health Commissioner Sullivan announced a 27.9 percent Medicaid reimbursement rate increase for inpatient psychiatric beds—a significant incentive to restore 1,000 beds (850 psychiatric, 150 state-operated) through ongoing hospital negotiations. She also outlined a new Qualified Mental Health Associate credential, modeled on addiction counselor certifications, to expand the mental health workforce by recruiting from community colleges and high schools. The workforce crisis dominated questioning. Assemblywoman Seawright cited alarming vacancy data: nearly 20 percent of direct-support positions unfilled statewide, up 42.5 percent since pre-pandemic, with 30 percent annual turnover. OPWDD Commissioner Neifeld defended the 2.5 percent COLA as building on last year's 5.4 percent increase, totaling $700 million over two years, and described extensive recruitment initiatives with SUNY, BOCES, and Georgetown University. OASAS Commissioner Cunningham addressed apparent funding decreases by explaining that the $200 million Opioid Stewardship Fund was appropriated for five-year spending, and the Opioid Settlement Fund ($123.6 million this year) was delayed pending the Advisory Board's November recommendations. She emphasized harm reduction strategies—naloxone expansion, fentanyl test strips, drug-checking machines—as central to addressing the overdose crisis. Sen. Fernandez, new chair of the Alcohol and Substance Use Disorders Committee, raised a pointed concern: scheduling drugs while encouraging testing could criminalize users. She indicated plans to propose protective legislation. The hearing revealed deep regional disparities. Assemblywoman Gunther described Sullivan County families unable to access mental health services due to lack of transportation and a five-month waiting list for children's psychiatrists, illustrating how wraparound services—touted by commissioners—remain unavailable in many counties. Lawmakers signaled they will push for larger COLA increases and faster bed restoration in budget negotiations ahead. NEW YORK STATE MENTAL HYGIENE BUDGET HEARING HIGHLIGHTS WORKFORCE CRISIS, YOUTH MENTAL HEALTH EXPANSION Albany — State mental health officials testified before the Legislature on February 16 that they are investing heavily in workforce recruitment and youth mental health services as part of the 2023-2024 executive budget, though significant challenges remain in residential placements and substance abuse treatment. The Office for People with Developmental Disabilities reported approximately 1,350 certified residential vacancies across its system, with about 1,200 individuals on an emergency need list awaiting placement. OPWDD Commissioner Neifeld defended the agency's person-centered placement approach, explaining that matching individuals with appropriate housing and housemates takes time and cannot be rushed despite available beds. The state is proposing a 2.5 percent cost-of-living adjustment (COLA) for not-for-profit providers, building on last year's 5.4 percent increase, representing a $700 million investment over two years. OPWDD is also launching a $10 million marketing campaign to recruit Direct Support Professionals and exploring partnerships with SUNY, Georgetown University, and potentially CUNY to create microcredentialing programs that translate DSP training into college credits. On mental health services for youth, the Office of Mental Health reported approximately 1,000 school-based clinics currently operating statewide, with plans to expand by several hundred annually. The budget includes $25 million to expand the 988 suicide and crisis hotline, which has seen growing call volume since its launch in July 2022. The state also plans to establish 3,500 new residential units for individuals with mental illness, with supported apartments potentially ready within 6-9 months and capital construction projects taking 1-2 years. Sen. Canzoneri-Fitzpatrick raised concerns that 4201 schools cannot access mental health funding despite facing a $2 million budget cut, requesting follow-up information. She also questioned whether last year's 5.4 percent COLA has been fully distributed to all providers. The Office of Addiction Services and Supports reported $123 million in Opioid Settlement funds appropriated for the fiscal year, with $5.8 million from adult-use cannabis legalization dedicated to youth prevention and education programs. However, Sen. Rivera directly challenged Commissioner Cunningham on the legal basis for refusing to fund overdose prevention centers, noting that two OPCs are currently operating in New York and have saved over 700 lives. Commissioner Cunningham maintained that state law prohibits the state from authorizing, regulating, or funding such centers, though he could not specify which statutes apply. Sen. Oberacker advocated for renaming mental health clinics to "mental wellness" clinics to reduce stigma and requested details on rural mobile services and the potential repurposing of two facilities in his district. He also expressed strong support for veteran mental health programs, noting that 21 veterans die by suicide daily and 30 die from substance use disorders daily. Assemblyman Gandolfo raised concerns about long waitlists for youth mental health services outside schools and requested that at least 40 percent of psychiatric recruitment funding focus on child and adolescent specialists. Sen. Gonzalez questioned whether the state is addressing the impact of telehealth and digital mental health companies targeting youth through influencers and requested information on cultural competency and language access as services expand. New York State mental hygiene commissioners faced pointed questions from legislators on Wednesday about the adequacy of the Governor's 2023-2024 budget proposal, with particular skepticism focused on workforce funding and the strategy for reopening psychiatric beds closed during the pandemic. The hearing before the joint Senate Finance and Assembly Health committees revealed significant concerns about implementation details of the $1.1 billion mental health investment. While commissioners outlined plans to reopen 850 community psychiatric beds closed during the pandemic and add 150 new state facility beds, Sen. O'Mara (R) challenged the allocation, noting the state is investing far more in community beds than state facilities despite Governor Cuomo's closure of 3,000-4,000 beds in previous years. The most contentious exchange centered on workforce compensation. Sen. O'Mara pointed out that the proposed 2.5 percent cost-of-living adjustment (COLA) for community-based providers represents a sharp decline from last year's 5.4 percent and falls far short of the 7.6 percent minimum wage increase taking effect upstate. "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 acknowledged the challenge but cited other funding mechanisms, including rate increases of up to 27 percent for hospitals and loan forgiveness programs. Sen. Hinchey (D) raised concerns about service access in rural and semi-rural areas, citing a constituent with a severe traumatic brain injury who was allocated $250,000 but could access only a fraction due to lack of available services. The constituent eventually relocated to Long Island and is now seeking services in Oklahoma. OPWDD Commissioner Neifeld acknowledged the access problem but offered limited specifics on solutions. Sen. Borrello (R) expressed skepticism about whether the state has the political will to address the crisis, emphasizing the need for proper discharge planning standards and adequate hospital funding. "Money's great, but what are we going to do to ensure that we have the will to help people when they need it most?" he asked. On the positive side, Sen. Rolison (D) presented a successful community model—the Echo team in Poughkeepsie—which conducted 427 contacts with individuals in crisis in 2022, resulting in 242 individuals being linked to services 1,835 times. She asked about funding mechanisms for municipalities to replicate the model. 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. Assemblyman Maher cited a constituent who was required to have a dirty urine sample to enter a short-term treatment facility, highlighting barriers to care that the commissioner said the agency is working to eliminate. Chairwoman Krueger requested written follow-up information on the locations of existing psychiatric beds, where the 850 community beds are being reopened, and where the 150 new state facility beds will be located. The commissioners agreed to provide detailed implementation timelines and plans. NEW YORK STATE MENTAL HYGIENE BUDGET HEARING HIGHLIGHTS SUPPORTIVE HOUSING EXPANSION, PSYCHIATRIC BED GAPS Albany — State mental hygiene officials testified before the Joint Legislative Committee on Finance on February 16 regarding the 2023-2024 Executive Budget, defending major initiatives while facing skeptical questioning from lawmakers about implementation timelines and provider capacity. The Office of Mental Health is proposing $890 million for supportive housing expansion targeting 3,500 new beds, with Commissioner Sullivan indicating most would be operational within 18 months to two years, though long-term capital construction projects could take longer. The budget also includes funding to bring 850 community-based psychiatric beds back online, representing a significant portion of the 6,000 total beds in the system, with a 27 percent rate increase intended to incentivize providers. Chairwoman Krueger expressed skepticism about whether rate increases alone would convince providers to reopen psychiatric beds, noting that many facilities have taken beds offline and questioning whether the state has accurately tracked which beds remain unavailable. She requested detailed written documentation of bed locations and the specific "carrot-and-stick" incentive mechanisms beyond the rate increase. The Office for People with Developmental Disabilities reported over $700 million in combined funding from current and proposed cost-of-living adjustments for the not-for-profit sector, though lawmakers raised concerns about whether wage increases are reaching direct support professionals. Commissioner Neifeld noted 1,200 people on the emergency needs list for residential opportunities and announced the agency's first chief diversity officer and a $10 million contract with Georgetown University for diversity, equity and inclusion initiatives. Senator Brouk 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 pregnant people. Commissioner Sullivan responded that the Office of Mental Health has established Project TEACH, providing statewide consultation lines for providers on antidepressant medication safety during pregnancy. The Office of Addiction Services and Supports discussed expansion of drug-checking machines through 38 community-based providers, with Commissioner Cunningham addressing concerns about new higher-dose naloxone products, noting that data do not show improved efficacy over existing formulations. Senator Fernandez introduced S4880 to create a formal drug-testing machine program with safety protections. Multiple legislators raised concerns about workforce shortages and wage adequacy, with Assemblyman Manktelow noting that some frontline workers are working double and triple shifts. Commissioners committed to follow-up discussions on wage implementation timelines and enforcement mechanisms for cost-of-living adjustments. NEW YORK STATE SENATE FINANCE COMMITTEE — Mental health advocates and state officials testified before a joint legislative committee on Feb. 16 regarding Governor Hochul's 2023-2024 mental hygiene budget, with a central dispute emerging over workforce compensation that threatens to undermine the administration's ambitious service expansion plans. The hearing revealed sharp disagreement between the Governor's proposed 2.5 percent cost-of-living adjustment for human services workers and the 8.5 percent increase demanded by providers, advocates, and county officials. Glenn Liebman, CEO of the Mental Health Association in New York State, warned that the workforce has endured 15 years of wage stagnation, losing over $600 million in purchasing power relative to inflation, and that without adequate compensation, the Governor's vision for expanded psychiatric beds and crisis services cannot be realized. "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 the budget's proposed $240 million cut to local assistance during an overdose crisis, calling it "grossly inadequate." The hearing also highlighted progress in protecting vulnerable populations. Denise Miranda, executive director of the New York State Justice Center for the Protection of People with Special Needs, reported that the agency has barred 870 individuals from the service system through its Staff Exclusion List and substantiates approximately 10,000 to 11,000 abuse and neglect cases annually from roughly 90,000 calls received. The Justice Center, marking its 10th anniversary in June, has expanded prevention work through virtual reality investigator training and targeted toolkits addressing trends in abuse. Sharon Horton of the National Alliance on Mental Illness praised the Governor's commitment to reverse the loss of 1,849 psychiatric beds since 2014 by returning 1,000 beds and improving hospital discharge practices. However, she described personal experiences with inadequate mental health emergency protocols, calling for comprehensive guidelines comparable to those for cardiac and stroke care. Courtney David, representing the state's 57 county mental hygiene directors, raised concerns about the competency restoration process under Criminal Procedure Law Section 730, noting that counties bear 100 percent of costs exceeding $1,100 per day, with some individuals languishing in the system for years despite most cases resolving within 90 to 150 days. The committee heard testimony that the state's $24 billion Rainy Day Fund could accommodate the additional $500 million needed to increase the COLA from 2.5 to 8.5 percent, setting up a potential budget negotiation over workforce investment as the Legislature considers the Governor's proposal. NEW YORK — Mental health and substance abuse advocates testified before a joint legislative committee on the 2023-2024 Executive Budget on Thursday, calling for significantly higher funding increases than the Governor proposed, particularly for workforce compensation and service expansion. The most contentious issue centered on cost-of-living adjustments (COLA) for mental health and substance abuse workers. Assemblywoman Gunther called the Governor's proposed 2.5% increase "absolutely an insult," demanding 8.5% instead. Testifiers emphasized that workers—predominantly women and people of color—are forced to work multiple jobs and deserve living wages. "Mission-driven does not put food on the table," said Mr. Liebman, an advocacy representative. Advocates cited a consensus figure of $500 million needed for increased reimbursement rates to address workforce shortages and service gaps. Mr. Liebman proposed a long-term pension system for the 800,000 people in the human service sector, similar to systems for state workers, police, and teachers. Sen. O'Mara questioned a $240 million decrease in the OASAS local assistance budget, which testifiers attributed to the Opioid Stewardship Fund being spread over five years. Sen. O'Mara expressed frustration that the state can fund migrant services but not mental health programs. Harvey Rosenthal, a person in long-term recovery, criticized the focus on hospitalization, arguing that "change doesn't happen in a hospital" and advocating instead for community-based services including peer support, 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 bill, which expands Medicaid reimbursement for other mental health practitioners licensed in 2005. She argued that creative arts therapists have specialized skills effective for populations where talk therapy may not work. Maria Cristalli, representing 40 provider organizations, noted that her organization Hillside has several hundred openings out of 1,800 staff and cannot deliver current services without workforce solutions. Sen. Fernandez asked pointed questions about whether criminalizing fentanyl and penalizing drug users helps combat addiction, signaling skepticism toward punitive approaches. Mr. Coppola responded that addiction should be treated as a public health issue, emphasizing medication-assisted treatment and harm reduction over incarceration. The hearing underscored deep concerns about chronic underinvestment in mental health and substance abuse services despite the Governor's proposed increases, with testifiers emphasizing that workforce compensation and service expansion remain inadequate to address the crisis. NEW YORK STATE SENATE FINANCE COMMITTEE HEARS TESTIMONY ON MENTAL HYGIENE BUDGET; ADVOCATES PUSH FOR EXPANDED TREATMENT, PEER SERVICES, AND INSURANCE REFORM Albany — Mental health advocates, service providers, and criminal justice reform advocates testified before the New York State Senate Finance Committee on Thursday regarding the Governor's 2023-2024 mental hygiene budget proposal, calling for significant expansions in treatment services, workforce support, and alternatives to incarceration. The hearing revealed stark disparities in the opioid crisis, with testimony showing that overdose death rates have increased fivefold for Black New Yorkers and quadrupled for Latino New Yorkers, compared to a threefold increase for white New Yorkers. Allegra Schorr, president of the Coalition of Medication-Assisted Treatment Providers and Advocates, warned that New York has exceeded the national average for overdose deaths and called for an 8.5 percent cost-of-living adjustment and $500 million in reimbursement increases to maintain and expand medication-assisted treatment access. Multiple testifiers emphasized the need for upstream investment in community-based services rather than emergency responses. Ms. Bufkin advocated for at least half of the proposed $1 billion in behavioral health funding to be directed to children and families, citing a "never-ending cycle" where inadequate funding forces families to choose between therapy and basic needs. Assemblywoman Gunther criticized the current approach, stating: "I'd rather invest our taxpayer money in the health and safety of people, rather than see them in jail because they're combative when someone goes after them and they're paranoid." Criminal justice reform advocates highlighted the cost-effectiveness of treatment over incarceration. Katherine Bajuk, a public defender with New York County Defender Services, cited data showing that for every dollar invested in treatment, the state yields $2 in savings. She advocated for the Treatment Not Jail Act and $60 million in funding to expand treatment courts, noting that one out of five people and over half the incarcerated population have mental illness. Nadia Chait of the Center for Alternative Sentencing and Alternative Services presented striking outcomes from the Nathaniel Assertive Community Treatment program, the only OMH-licensed alternative to incarceration in the state. The program showed a 70 percent decrease in recidivism, less than 5 percent new violent felony arrests among those entering on violent charges, a 70 percent decrease in homelessness, and a 225 percent increase in employment. However, Chait noted the program only serves Manhattan and Brooklyn and called for at least two additional teams. Several testifiers highlighted insurance network adequacy issues. Ms. Schorr described a scenario where individuals with commercial insurance coverage for methadone treatment cannot access it because providers are not in-network. Ms. Fagen of New York Creative Arts Therapists described a patchwork where only one Medicaid plan accepts licensed creative arts therapists, forcing clients to lose coverage when they change jobs. Senators engaged substantively on workforce issues, school funding parity, and emerging therapies. Sen. Mannion questioned witnesses about his Narcan accessibility bill, while Sen. Brouk focused on expanding peer services and mental health loan repayment programs. Ms. Cristalli of Hillside testified that the organization operates 853 schools serving children with complex needs but cannot serve all children due to inadequate resources and outdated rate methodologies. The hearing underscored a consensus among advocates and providers that the state's mental health system is underfunded and fragmented, with particular gaps in services for children, people of color, and those involved in the criminal justice system. NEW YORK STATE SENATE FINANCE COMMITTEE — Disability rights advocates and mental health service providers testified before the Joint Legislative Committee on Finance on Thursday, February 16, calling for significantly higher funding increases than the Governor's proposed 2.5 percent cost-of-living adjustment in the 2023-2024 executive budget. Testifiers unanimously requested an 8.5 percent COLA—matching current inflation—plus a $4,000 wage increase for direct support professionals (DSPs) to address a workforce crisis threatening service delivery across the state. Mike Alvaro of the New York Disability Advocates coalition, representing 85 percent of I/DD service providers serving 115,000 people, detailed the scope of the crisis: a 17 percent vacancy rate and 31 percent turnover among nonprofit-employed DSPs, costing the field $100 million annually. State-employed DSPs earn an average of $24 per hour while nonprofit DSPs earn $16—a 50 percent wage gap for essentially identical work, Alvaro said. Erik Geizer, CEO of The Arc New York, presented case studies of individuals unable to access services due to staffing shortages. "Cole aged out of his school program in June 2020. He has been waiting for an opportunity to continue his life," Geizer testified, describing a young adult confined to his apartment. "Imagine being confined in your apartment waiting for someone to help you explore your future." Veronica Crawford, a self-advocate with disabilities, testified about isolation caused by staff shortages. "People with disabilities need and rely on them for help. There are just not enough direct support professionals to support people," she said. Sebrina Barrett of the Association for Community Living reported that mental health housing providers serve over 40,000 New Yorkers with severe mental illness but face a $96 million shortfall and 25 percent staff vacancy rate. She noted that more than 42 percent of residents are age 55 and older with complex medical conditions, and called for a task force on aging in place. Jim Karpe, a parent of two young adults with I/DD, testified against extending the state's decade-long managed care investigation, citing unreleased studies showing managed care increases costs without improving quality or access. A Deloitte study concluded managed care would cost $200 million extra per year in administrative expenses, Karpe said. Sen. John Mannion stated he had requested 8.5 percent COLA and $4,000 DSP wage increases in his budget priority letter and encouraged colleagues to do the same. Sen. O'Mara expressed frustration with the Executive's proposal, saying he was "astounded" and questioning whether it represents negotiating strategy or being "out of tune" with I/DD community needs. Alvaro calculated that the 8.5 percent COLA would cost $235 million in state share, while the $4,000 wage increase would cost $126 million—amounts he said are proportional to the $50 million the state found for 15 percent of its workforce. The hearing was the latest in a series of budget hearings examining the Governor's mental hygiene proposal.