Fax from Albany
March 28, 2003
Board Members, Affiliate Executive Directors, Interested Parties
Joseph A. Glazer, Esq., President/CEO
(518) 434-0439 ext. 20
Any time an organization tries to site a new program, particularly residential,
for people living with mental illnesses, NIMBY (Not In My
Back Yard) rears its head. People from throughout the community,
usually lacking sufficient understanding of the program, understanding
of those to be served or other attributes of the planned service will
rally against the proposed site, making the argument that they don’t
want it in their community. Largely founded in misguided fear and ignorance,
NIMBY has untracked many a worthy program or residence.
is a much lesser known phenomenon. An acronym for Not Out
of My Back Yard, NOMBY is a similar, albeit more
educated and compassionate response to proposed dismantling of services
or facilities. This year, as in 2001, Governor Pataki has proposed the
closure of state run psychiatric centers around our state. And in the
communities that fear new and greater gaps in the mental health services
available, NOMBY is the first and most visceral reaction.
demarcation line in the MHA movement around proposed closures is best
explained in terms of NOMBY. Virtually all of our MHAs, as well as MHANYS,
believe that the size of the infrastructure of the state run psychiatric
hospital system exceeds the demand and required capacity. Downsizing is
warranted, and utilizing the funds saved to improve (dare we even say
develop) the system of community-based care is universally supported.
Where we divide is the question of which community is going to lose their
the years, the role of psychiatric hospitals has evolved. Although the
residential buildings remain large, each facility actually serves many
times more people on an outpatient basis than inpatient. They have become
the core of intensive mental health services for their communities, as
well as their large catchment areas. Communities fear that the closing
of the facility will lead to a drop in access to inpatient beds, outpatient
services, and continuity of care. And, in the absence of a plan, history
continually bears out those fears as justified.
and foremost, it is important to note that Deinstitutionalization, long
a rallying cry for mental health advocates, has never included a plan.
That, at least in part explains how the same percentage of the population
that occupied state hospitals in the 1950s is numerically equivalent to
the percentage living with mental illnesses caught in the criminal justice
system today – 0.3%.
recently, we need look no further than the closing of Gowanda psychiatric
center a decade ago. Today, people in that community will tell you that
the county jail is the largest psychiatric hospital in the county, there
are substantial gaps in housing and services, and that Buffalo is too
far for many people to go to see, and advocate for, their loved ones who
are hospitalized with critical mental health care needs.
NOMBY is what has brought MHANYS to its position regarding the proposed
closures Governor Pataki has put forward. We agree that the infrastructure
is too large, and that services can be provided more effectively and cooperatively
in the community. But we cannot support closures in the absence of an
overarching plan, for what happened in Gowanda will happen elsewhere unless
the planning and systems change is completed.
NMHA Legislative Alerts:
Senate Health Panel Must Take Up Parity Bill
Grassroots: Urge Committee Members to Press for "Markup"
To win passage of parity legislation this year, it is critical that the
US Senate Committee on Health, Education, Labor, and Pensions (the "Health
committee") take early action on the Senator Paul Wellstone Mental
Health Equitable Treatment Act, S. 486. Advocates must press their senators,
and particularly those who are members of the Health Committee, to push
the chairman to "mark up" the parity bill very soon.
members of the US Senate Health Committee must hear from constituents
urging them to press the chairman to “mark-up” the Wellstone
parity bill. For us in New York, Senator Hillary Clinton should be contacted,
thanked for cosponsoring the parity legislation, and urged to push for
a ‘mark up’ of the Wellstone mental health parity bill (S.486).
call Senator Clinton in both her New York offices and Washington office,
using the Parity Hotline 1-866 PARITY4 (1-866-727-4894). The message is:
"I'm a constituent, calling to urge Senator Clinton to push for
a 'markup' of the Wellstone mental health parity bill (S. 486). It's really
vital to pass this bill to end insurance discrimination against people
who have mental disorders."
Considering Deep Medicaid and Mental Health Cuts
Contact Members of Congress Now to Avoid a Funding Crisis Ahead!
House and Senate are completing work on a budget plan that lays the groundwork
for what could lead to deep, long-term cuts in federal mental health funding.
The House of Representatives has already passed a plan that would slash
Medicaid spending by some $93 billion over the next ten years, and, next
year alone, would cut $53 million in mental health funding from the Substance
Abuse and Mental Health Services Administration as part of a $1.4 billion
across-the-board program reduction. The House proposed these deep cuts
to offset the huge revenue loss its adoption of the President's tax-cut
proposal would trigger. Although the Senate has yet to complete work on
its version of a budget resolution, it has adopted a number of helpful
amendments, including temporary fiscal relief for the states and their
Medicaid programs, and increased funding for public health programs.
development of the budget resolution on a very fast track, and the risk
that major cuts proposed by the House could be adopted soon, it is critical
to voice concerns immediately. Grassroots advocates must register immediate,
profound concern to head off a real crisis.
modify the following letter as you see fit and fax it to your senators'
and representatives' offices at the earliest opportunity:
(Senator or Representative, as pertinent] ________:
behalf of the Mental Health Association of _________, I am writing to
raise our deep concerns about the House-passed fiscal year 2004 budget
resolution, and to urge you to oppose any cuts to the Medicaid program
as part of that budget resolution. We also ask you to prevent cuts to
any other federal programs that provide supports and services to people
who have or are at risk of developing mental illnesses or substance
its very troublesome provisions, the House-passed budget resolution
requires that Medicaid be cut by more than $90 billion over the next
decade. The impact of such cuts must be understood in light of a mental
health system that the President's mental health commission has already
described as being in crisis, and in light of the growing dimensions
of that crisis, as states grapple with record budget deficits. Cuts
in Medicaid would take a particularly heavy toll on people with mental
illnesses because that vital safety net program currently funds approximately
50 percent of state and local spending on mental health care. Cutting
Medicaid, and "block granting" it, as the resolution proposes,
would put millions of people who have mental illnesses and depend on
Medicaid at increased risk of becoming homeless, institutionalized,
involved with the criminal justice system, or perhaps of taking their
own lives. It is vital that the final budget resolution plan provide
for increased federal support for the states and their Medicaid programs,
as is called for in the Senate budget plan.
also urge you o to oppose across-the-board cuts in the House budget
plan, which would slash mental health funding by $53 million, and shrink
funding for the supports and services people who have mental illness
or substance use disorders desperately need. Please ensure that the
final budget resolution provides the higher funding allocations provided
for in the Senate budget resolution.
What the budget debate has clearly highlighted is the fact that this
country simply cannot afford the more than $1 trillion in tax reduction
proposed in the House budget plan. Deep sustained tax cuts would profoundly
reduce the federal government's capacity to meet pressing mental health,
social service and public health needs. These must remain a national
We urge you to inform conferees of our views, and to oppose the final
budget resolution if it requires cuts in Medicaid or other mental health
To Host Events on PROS for NYAPRS’ Members:
Special 'PROS' Edition
NYAPRS Members March 21, 2003
Harvey Rosenthal Executive Director
OMH's PROS Proposal Continues to Take Shape;
Come to Special NYAPRS' Member Meeting with OMH in Albany on April 11;
NYAPRS to Host Biweekly Member Teleconferences on PROS;
NYAPRS Launches Series of Local PROS Forums;
NYAPRS' Annual Conference to Feature Special Day, Track on PROS
In response to the growing interest and controversy over OMH's new Medicaid
outpatient license, termed "PROS' (Personalized Recovery Oriented
Services), NYAPRS has planned a number of ways for our members and friends
to stay informed, have input and prepare for the broad array of changes
required by the proposal.
According to the NYS Office of Mental Health, PROS is a "comprehensive
(new) recovery model that integrates treatment, support and rehabilitation".
PROS as proposed will replace IPRT, existing vocational programs, clubs,
and on-site rehabilitation programs with a new license option for providers
of these services. PROS providers will bill Medicaid for rehabilitation
and recovery oriented services. In addition, there is an option to include
Continuing Day treatment programs under the license.
the next few weeks, NYAPRS will be offering the following:
- April 11 Members Meeting with OMH in Albany (Save the Date!)
NYAPRS members are strongly encouraged to attend a day-long meeting
in Albany on April 11 at the Quality Inn in Albany that will feature
a new revised morning presentation by OMH staff and afternoon discussion
amongst our membership and staff that will particularly focus on a
number of developments in the model we have been pursuing. Look for
more details early next week…
- Bi-weekly Member Teleconferences NYAPSRS' Kelly Adams is finalizing
efforts to set up a biweekly hour-long teleconferences (likely on
Fridays) that will be designed to help our members stay current on
all new developments and to provide input and help inform our advocacy
with OMH on PROS.
- Local NYAPRS Special PROS forums Starting next week, NYAPRS Executive
Director Harvey Rosenthal and Consultant Dick Jaros will be making
a series of local presentations on PROS at NYAPRS Regional meetings.
Currently scheduled forums, to be held between 10 am and Noon, include:
- March 26 Long Island South Oaks Hospital Amityville
- March 28 Syracuse Onondaga Public Library
- More being scheduled....
- PROS Institute Day, Workshops at this year's Annual Conference
Look for a broad array of in-depth institutes and workshops at this
- Special NYAPRS PROS Summary Look for a special summary of PROS
chief components and implications for both recipients and providers
of community rehabilitation services in next week's Recovery Report.
Bottom line: plan riles. Dozens speak against shutting Hutchings, other
centers. By Amy Hsuan
The Syracuse Post-Standard, March 21, 2003
Of the 51 people who spoke Thursday at an Assembly hearing on Gov. George
Pataki's plan to close Hutchings Psychiatric Center, just a few - including
one state Office of Mental Health official - voiced support for the idea.
official's testimony was greeted by jeers.
than 200 people attended the Assembly Mental Health Committee hearing
in the Onondaga County Legislature chambers at the county courthouse.
Most of those who attended oppose the plan to shut Hutchings, which the
Pataki administration says would save the financially strapped state $6.6
million. The governor also plans to close Elmira Psychiatric Center and
three other centers Downstate.
state employees' union won a court order Wednesday temporarily halting
the state's preparations to shut down the centers. A hearing will be held
on the issue April 2.
proponent of the shutdown was Al Holmes, deputy commissioner of the state's
Office of Mental Health.
acknowledged that the closing of Hutchings was "strictly a bottom-line"
decision that calculated the number of empty beds and the cost of services
into a savings for the state. He cited new drugs as having decreased the
number of inpatients over the years, making for more beds than patients.
he was unable to give specific answers to some questions posed by the
When asked how many child psychiatrists were employed at Mohawk Valley
Psychiatric Center in Utica, where Hutchings patients would be treated,
Holmes said he didn't know, but that he expected there was at least one.
asked how the state was planning to assist with the costs of transporting
family members from Syracuse to Utica, Holmes said that while the state
had done so in the past, the option had not been considered in this case.
William Magnarelli, D-Syracuse, said he was disappointed that the Mental
Health Office appeared to focus more on money than on quality of care.
"There is no real plan for getting patients back into the community.
I don't feel like I'm getting that," Magnarelli said. "I'm hearing
a lot about how we're going to save money."
of the testimony and crowd response came from patients, employees, union
leaders and medical professionals from both the Elmira and Hutchings centers.
The hearing started at 10:30 a.m. and went well into the afternoon.
cited concerns over the loss of proximity to quality health care, the
dangers of separating patients from family and friends and the costs of
commuting to a distant center.
neglect of the population in need of mental health care is the result
of "views (that) have made us appear to be an expendable population,"
said Eon West, who has been in the mental health care system in Onondaga
County for 10 years.
things are in jeopardy if the centers close, from transitional living
services, outreach to residential," West said.
of the Hutchings closure talked of the loss of more than 350 jobs and
millions of dollars of annual payroll. Others spoke of Syracuse's inability
to establish itself as a viable medical center without a mental health
care unit, thus losing investments from outside resources.
order to create a medical health care powerhouse ... it is very important
to us have a mental health care center," said David Mankiewicz, executive
vice president of the University Hill Corp., a business development group.
members Magnarelli; Joan Christensen, D-Syracuse; Jeff Brown, R-Manlius;
Will Barclay, R-Pulaski; and chairman Peter Rivera, D-Bronx, demonstrated
an overwhelming support for keeping Hutchings open.
talking about human lives. We're talking about people," Rivera said.
hearing is the second in a series being held across the state on the proposed
closing of five mental health care facilities statewide.
Pataki administration says the closing of three centers - Hutchings, Elmira
and Middletown - will save the state $18.2 million a year in the midst
of a fiscal crisis.
MH Parity Proposal in N.Y. Stems from Publicized Failure
Mental Health Weekly (Reprinted from NYAPRS), March 24, 2003
coalition of New York state mental health and substance abuse advocates
expects as early as this week to see introduction of legislation that
could yield behavioral health parity protections that are among the strongest
in the country. Perhaps more so than with other parity bills that have
been introduced around the country, this legislation will put a human
face on the fight to end discrimination in health insurance benefits.
outcome of the planned legislation, which is expected to cover chemical
dependency as well as mental health and which will go beyond a “serious
mental illness” approach to its mental health protections, may depend
in part on efforts of the Timothy Law’s Campaign (TLC) Coalition.
newly formed coalition has urged New York legislators to end discriminatory
behavioral health coverage by adopting a law named in the memory of Timothy
O’Clair, a 12-year-old Schenectady resident who committed suicide
two years ago this month.
27-member coalition includes groups such as the Coalition of Voluntary
Mental Health Agencies Inc., the National Alliance for the Mentally Ill
(NAMI) of New York State, the Association for Community Living,
the New York State Psychiatric Association, physician representatives,
and consumer and family groups. The advocates were joined at a news conference
last week by Timothy O’Clair’s parents, Tom and Donna O’Clair,
who reportedly are playing an active role in the advocacy effort.
had been diagnosed over the years with depression, attention-deficit/hyperactivity
disorder, and oppositional defiant disorder. His family had difficulty
accessing services for their son after they reached
inpatient and outpatient coverage limits in their family health insurance
to information released by the Mental Health Association in New York State
(MHANYS), the family faced high copayments for mental health care, and
said mental health treatment for their son was of a high quality but sporadic.
the end of the fourth grade, Timothy had begun to refuse attending school.
His first hospitalization occurred in 1998 after an incident in which
he threw rags into the furnace of his family’s home. But according
to those active in the Timothy’s Law Campaign, Timothy was hospitalized
for only eight
days because his family’s insurance company would not cover a longer
the hospitalization, the O’Clairs often pursued outpatient treatment
for their son, but couldn’t access the residential care they felt
Timothy’s parents decided to relinquish custody of their son when
he required more care than their insurance would cover. He was placed
in foster care in order for him to become Medicaid-eligible.
was the only way they could give him the services he needed,” Joe
Glazer, MHANYS’s president and chief executive, whose organization
hosted last week’s press conference, told MHW. “With parity
you don’t have to relinquish custody for your child to get the services
committed suicide seven weeks before his 13th birthday by hanging himself
in his bedroom closet.
O’Clair family feels if their [health insurance] coverage was not
limited, Timothy would be here today,” Mathew Mathai, deputy director
of the New York Association of Psychiatric Rehabilitation Services, told
MHW. “They expressed that with great courage at the press conference.”
discussion of parity is heating up again on the federal side as well,
with last month’s introduction in both houses of Congress of comprehensive
mental health parity legislation bearing the name of the late Sen. Paul
Wellstone (see MHW, March 3).
York advocates say they are encouraged by the legislative support they
have received so far in both the state Assembly and Senate.
proponents of the legislation are expected to include Assemblyman Paul
D. Tonko, who represents the O’Clair family’s district, and
Sen. Hugh T. Farley. Advocates also expect support from Senate Mental
Health Committee Chairman Tom Libous and Assembly Mental Health Committee
Chairman Peter M. Rivera. It was uncertain at press time as to what the
formal sponsor list for
the bill would look like.
and other state lawmakers who are working on the parity bill say they
intend to build significantly on the parity protections afforded in the
current limited federal parity law for mental health, which prohibits
nondiscriminatory mental health coverage only in the areas of lifetime
and annual coverage limits.
language in the legislation states, “Every policy delivered or issued
for delivery in this state which provides coverage for medical or hospital
care shall provide coverage for the treatment and diagnosis of mental,
nervous or emotional disorders or ailments, and disorders of alcoholism,
alcohol abuse, substance abuse, substance dependence or chemical dependence,
however defined in such contract. Such policy shall not impose any greater
limitations on such coverage than it does for physical health benefits.”
year since we’ve put Timothy’s name and face with it, we’re
farther along than they’ve ever been able to get in previous years.”
Advocates say bills will be introduced in both chambers and will be identical
in each. Lawmakers are currently reviewing the legislation, which advocates
hope will be introduced this week.
McDonald, executive director of Families Together in New York State, Inc.,
and chair of the Timothy’s Law Campaign Coalition, told MHW, “It’s
a phenomenal coup to have the same bill in the Assembly and the Senate.
All of us have worked really hard in developing the language and are really
pleased with it.”
added, “New York’s legislation is very broad. It has one important
piece: It’s got a person’s face. That is a real illustration
of what can happen when we don’t have parity.”
O’Clair told MHW that he hopes the legislation will end the stigma
many families experience in the form of their unmet mental health insurance
needs. “I’ve heard through members of the coalition that
it’s been roughly seven years trying to get a parity law passed,”
he said. “This year since we’ve put Timothy’s name and
face with it, we’re farther along than they’ve ever been able
to get in previous years. That gives me hope.”
New York advocates point to two recent studies to support their parity
efforts. The first, an actuarial study by PriceWaterhouseCoopers, estimates
that passage of Timothy’s Law would increase health insurance
premiums by only $1.26 per employee per month.
Actuarial Analysis of Comprehensive Mental Health and Substance Abuse
Benefits for the State of New York indicates that the proposed parity
bill would not add significant overall costs for companies whose health
plans include mental health and substance abuse benefits.
to Glazer, in a survey by the Utica, N.Y.-based Zogby International Poll,
81 percent of New Yorkers said they were willing to pay the estimated
$1.26 more per month to ensure full insurance coverage for mental and
chemical dependency needs. “Insurance parity is cost-effective;
studies support that,” he said.
added that the O’Clair family paid over $3,000 in child support
to the state when Timothy was placed in foster care. “The family
could have paid $8 over six months at $1.26 per month to get Timothy the
help he needed,” he said.
have a great deal of hope that this is the year,” Glazer added.
workers protest plan to close hospital. By John-Henry Doucette
Times Herald Record, March 26, 2003
Middletown – Middletown Psychiatric Center employees gathered along
Monhagen Avenue yesterday to protest the Pataki administration's plan
to shut down the hospital, ship them out and send their patients away.
is the biggest sin of all," said Lucille Sorrentino, a Scotchtown
nurse who has worked 19 years at the center. "My roots are here.
I bought a home. My life is here, helping these patients."
hospital has cared for mentally ill people in Orange and Sullivan counties
for over a century. Its shuttering in July would kill off a large employer
here and leave a hole in the system of care for some of the region's most
could force 370 employees to work outside Orange, and that's if those
state workers remained in jobs at all, union leaders said.
and city officials have opposed closing the center.
such a step has been considered for years as a belt-tightening move. Gov.
George Pataki announced the closure, among others in the state mental
health system, in January.
the state planning to shift workers to other state facilities, court action
has stayed Pataki's hand. The Public Employees Federation filed suit because
Pataki began closing the center without approval by lawmakers.
100 people at nearby state facilities may be displaced to make room for
MPC workers, union officials said yesterday.
than 100 patients, mostly from the general area, might be shipped to Orangeburg,
about an hour's drive from Middletown.
next time, we remain,
Working to ensure available and accessible mental health services for
all New Yorkers