ALBANY — Members of the Assembly accused legislative leaders Monday of failing to prioritize New York’s available mental health and addiction services in the state budget as the primary reason inefficiencies and inequities persist in the system, they said.
The Assembly Alcoholism and Drug Abuse and Mental Health committees held a hearing for several hours Monday to examine how the state Office of Addiction Services and Supports and Office of Mental Health work to integrate services for New Yorkers who need treatment or programs from both agencies.
About 1.4 million New Yorkers have co-occurring mental health and substance abuse disorders, with higher rates of homelessness, suicide, incarceration or early death if left untreated.
“An integrated OMH and OASS would have been a lifesaver for my son,” said Stephanie Marquesano, founder and president of The Harris Project, named for her 19-year-old son who died of an accidental overdose in 2013.
The current state system failed her son, she said during Monday’s hearing, with its redundancies and lacking the correct mental health and addiction prevention treatments.
Efforts to treat co-occurring disorders cannot seamlessly fit in one state agency.
“So it’s difficult for them to be funded in the budget,” Marquesano said. “Having two separate systems treat individuals with (co-occurring disorders) is not practical from a clinical or financial perspective. ... Individuals are being forced to access service in two places.”
Disparities with the two systems working together to get New Yorkers the help they need exist for a myriad of reasons, but inadequate funding is the main factor inadequacies and redundancies persist, said Alcoholism and Drug Abuse Committee Chair Assemblyman Phil Steck, D-Colonie.
“I certainly could think of things I could take it from to fund this particular area and would be happy to do so, but unfortunately, that is not the majority’s viewpoint and it is, quite frankly, not the view of the governor,” Steck said in response to frustrated witnesses that improving integrated services will likely need to be done with existing resources.
“The issue of funding is problematic unless the governor would be willing to give up some of his pet programs, which I don’t see happening,” Steck added. “The governor is the biggest player at the budget table.”
Gov. Andrew Cuomo budgeted $4.5 billion in his executive 2021-22 budget proposal for the Office of Mental Health, an increase of $50 million, or 1.1%. Assemblywoman Aileen Gunther, who chairs the Mental Health Committee, argued Assembly Speaker Carl Heastie, D-Bronx, and Senate Majority Leader Andrea Stewart-Cousins, D-Yonkers, also do not prioritize addressing mental health and addiction programs with lawmakers until after most of the budget is spoken for.
That leaves lawmakers rushing to fight to get funding for their specific issues, making it impossible for programs to meet the increased need for mental health and addiction services, said Gunther, D-Forestburgh.
“You have to see it as it is: There’s control from Andrea and Carl Heastie,” Gunther said. “A leader is a leader is a leader, and you know what? Supposedly, you’re representing the entire state of New York whether you’re in the Assembly or the Senate, and the important thing is when (legislative leaders) begin the process, not the staff.
“We get it when it’s almost like the die is cast,” she added, “and they say to us, ‘There’s X amount of money left over.’”
Legislative leaders have most of the state budget, which deadlines April 1 each year, planned by late fall, Gunther said. Negotiations and funding continue to change until the spending plan is passed, usually within a week of the deadline.
“Every year, we’re in a panic at the end,” the assemblywoman said. “The fact is, it should be worked on all summer. If it were my world, it would be different.”
Witnesses requested lawmakers focus on increasing funding to develop integrated care for youth and in rural upstate communities.
Representatives with Stewart-Cousins and the Senate Minority Conference on Monday declined to comment on Gunther’s statements, the leader’s position on increasing funding for services or how senators’ budget requests are considered.
Representatives with the Assembly Speaker’s Office in the majority conference did not respond to requests for comment Monday.
New Yorkers in poor, minority, rural or small communities struggle to find transportation to access state services. Lack of treatment also leads to higher-cost medical care and increased state disability rates.
Child psychiatrists, or in-patient and detox care are often minimal in counties outside New York City. But people who lack money or transportation will not complete addiction programs or other needed services.
State Office of Mental Health Commissioner Dr. Ann Marie Sullivan said the department is working to improve telehealth capacity for these programs, but lawmakers argued many New Yorkers, especially upstate, lack sufficient broadband or high-speed internet connection to help.
Sullivan expressed the need to expand programs and clinics in schools across the state to further prevent alcohol and drug abuse and addiction.
Other panelists echoed the idea, encouraging the increased ability to spot or treat mental health from an early age.
“It’s a fabulous idea, but the investments haven’t been there,” Gunther said.
Statutory barriers have made integrating services difficult, including reimbursement shortfalls, reporting requirements and contracting and funding issues.
“As much as we have accomplished, there is still more we need to do,” Gonzalez-Sanchez said. “I don’t want to make any excuses ... Are we perfect, do we have everything we need throughout the state? The answer is no, but if you look at where we were and where we’re going and how quickly we’re getting to where we’re going, you’ll see there’s a lot of efforts being done.”
OASS and OMH collaborate with the state Health Department to integrate and improve services, and have certified several Community Behavioral Health Clinics across the state to expand same-day access, case management, rehabilitation, eliminating wait lists and reducing emergency department and in-patient hospital visits in those communities.
Improving the state’s ability for integrated service is needed more than ever, witnesses and lawmakers said, after a significant increase in mental health issues, substance abuse and emergency incident calls since the coronavirus pandemic began in March 2020.
“How do we do this? I don’t have the answer today,” Steck said. “How do we maximize the resources we are likely to have available to us?”
Witnesses on Monday also noted the new universal behavioral health hotline, or “988,” that will launch in July to help people report suicide or behavioral health crisis calls.
Similar to dialing 911, anyone who dials 988 on a telephone will be connected to officials equipped to handle mental health or addiction-related incidents.
Congress passed the law designating the number for behavioral health crises in September.
The state Legislature passed a measure this month requiring funds from settlements against opioid manufacturers, distributors, dispensers, consultants or resellers will be used for statewide addiction and treatment services to further combat the opioid epidemic.
Witnesses pushed for the millions in settlement funds be used to help with integration and bolster other related programs.
The new mandate will require substantial vigilance, Steck said, adding a figurative legal “lockbox” is impossible, regardless of state law.
“Two things are clear: We need more money for children’s behavioral health, and siloed services,” Steck said. “We’re going to do the best we can to address those two things.”