Mental Health Association in New York State, Inc.
(Publication Archives)

Friday Fax from Albany

CORRECTION: MIDDLETOWN PC TO CLOSE 4/06: Contrary to what was reported in last week’s edition of the Friday Fax from Albany, it has come to our attention that after the Legislature’s Joint Conference Committee on Mental Hygiene agreed to wait for additional details from the Office of Mental Health on the proposed closure of Middletown Psychiatric Center, the General Conference Committee (‘mother ship’) subsequently came to an agreement with the Governor to move ahead with the planned closure of the facility, slated for April of next year. With the closure of Middletown PC, the Office of Mental Health will work to create and enhance state-operated services in the Orange/Sullivan County area, including the establishment of a Transitional Residential Unit, State Operated Community Residences (SOCR), an Assertive Community Treatment (ACT) team, a Crisis Residence to provide diversion from hospitalization, a Mobile Crisis Service, a Forensic Clinical Services Team, a Mentally Ill Chemical Abuser (MICA) service coordinator, and a Housing Case Manager/Advocate.

TUESDAY - ADULT HOME RESIDENTS ‘SPEAK OUT’ FOR REFORM: Tuesday was a truly inspiring day for many mental health advocates, as approximately 100 residents of adult homes came to Albany from all over the state to call for improvements in the quality of care provided in adult homes. Residents, themselves, held a press conference at which designated spokespeople conveyed the message that the Legislature’s agreed to budget is a good first step, while much work remains to be done to provide additional housing alternatives, a clothing allowance, and greatly needed air-conditioning. In addition, residents called upon Governor Pataki to sign the Legislature’s budget proposal into law, including an increase in the SSI rate, which would provide residents with additional ‘Personal Needs Allowance’ money each month.

There have been several good ideas that have come out of the Governor’s budget regarding adult homes, including the ENABLE program, which would provide grants to adult homes that will be used to foster the independent growth of residents. There are adult homes residents who are very capable of living in more independent settings. The ENABLE program would be used to help in development of activities of daily living skills, vocational and educational programs.

Later, at the ‘Speak Out,’ residents raised their voices to describe the current conditions in some adult homes and call for changes to improve the lives of all residents. Several legislators, including Senators Morahan and Golden, and Assemblymembers Gottfried, Cohen, and Peter Rivera, spoke to the gathered residents, answering questions as they were posed.

Then, residents broke out into 14 teams to go meet with individuals legislators. At one meeting with a staff person from Senator Skelos’ office, residents described how an increase in the Personal Needs Allowance would allow them to purchase desperately needed clothing to replace poorly fitting or worn our clothes. One resident expressed his simply desire to be able to purchase more additional pineapple juice, rather than rationing out 6 over an entire month.

All in all, the day proved to be an exceptionally empowering experience for the residents who traveled to Albany. Following is a Coalition of Institutionalized Aged and Disabled press release:

ADULT HOME RESIDENTS SPEAK OUT
IN SUPPORT OF BUDGET

RESIDENTS URGE GOVERNOR PATAKI NOT TO VETO
FUNDING TO IMPROVE LIFE IN ADULT HOMES

A group of 100 residents from adult homes in eight New York counties convened in Albany today to express their support for the Legislative budget, urging Governor Pataki to fund an increase in their personal needs allowance and independent case management/peer specialist services.

The Legislative budget funds an increased personal needs allowance for residents as part of an SSI rate increase. Residents would receive an increase of $14 in 2006 and $15 in 2007, which would enable them to pay for such essentials as toiletries, transportation, and food. The budget also includes $5 million in funding for independent case management and peer services.

Woody Wilson, a resident of Palisade Gardens Home for Adults in Yonkers, NY and President of the Coalition of Institutionalized Aged and Disabled (CIAD) said of the personal needs allowance increase: "It's been a long time coming. It's not here yet, but we have our hopes up."

Residents thanked the Legislature for passing the budget. At the same time, they reminded lawmakers and the Governor that many of the reforms they have been promised over the years still urgently need to be addressed.

"This budget is a good start," said Gary Levin, a resident of Ocean House in Far Rockaway, NY. "We still need funding for independent housing and we need reform legislation passed. This is not the end, it's the beginning, but it's a very good beginning."

The group traveled to the War Room in the Capital Building to dramatically deliver their message to the Governor in the form of a newspaper, the Adult Home Daily News, with the headline, "Residents Urge Governor Not to Veto!" Afterwards the group held a Speak-out where they proclaimed support for the budget, as well as funding for other urgent needs: air-conditioning for resident rooms, alternative housing, and an annual clothing allowance. In addition to six resident leaders, Senators Golden, Morahan and Assemblyman Rivera spoke at the Speak-out.

Ginger Stephenson, the President of the resident council at Hedgewood Home in Beacon, NY voiced her concern that no community housing has been funded or designated for adult home residents: "It's discouraging to live in an adult home when I know I am capable of living independently. I moved here from another adult home that closed because there was no alternative housing available to me."

For thirty years, the problems in adult homes have been documented in government reports and media exposes. There are about 35,000 residents living in adult homes in New York State. 12,000 of those residents have psychiatric disabilities. Originally intended as housing for the elderly, many adult homes now house people with mental illness due to the shortage of community mental health housing. The problems in the homes plague elderly and mentally ill residents alike: poor conditions and services, weak regulations, lack of air-conditioning in resident rooms, a dearth of housing alternatives, and the indignity of receiving only $130 or $150 per month for all personal needs expenses. After so many years, the time has come for real reform so that residents finally can live with dignity, respect and choice.

The Coalition of Institutionalized Aged and Disabled is a non-profit organization of nursing home and adult home resident councils. CIAD is governed by a Board of Directors of residents from facilities throughout the New York City area. Formed in 1973, CIAD is dedicated to protecting the rights of residents and improving the quality of their life and care.

WEDNESDAY – MEDICAID MATTERS DECENDS ON ALBANY: As active members of the coalition of Medicaid consumer organizations called Medicaid Matters New York, MHANYS joined with many members of this coalition in hastily scheduled meetings with members and staff from the Senate and Assembly to voice our grave concerns over the Governor’s continued attempts to cut Medicaid as part of this year’s budget. The Governor has publicly expressed his desire to see additional ‘reform’ of Medicaid this year, and has been pushing the Legislature to agree to additional cuts to programs like Family Health Plus before the April 12th deadline, at which point he must approve or veto the Legislature’s agreed to budget.

Medicaid Matters New York continues to be concerned that the Governor’s proposed Family Health Plus benefit elimination (including mental health) and increased co-payments are areas that the Governor is pushing the Legislature to make changes. In the Legislature’s budget agreement, many of these changes were rejected. Medicaid Matters New York’s message has been to reject any additional cuts in these areas. Following is Medicaid Matter’s Press Release:

MEDICAID MATTERS CALLS UPON GOVERNOR TO STOP ASSAULT ON FAMILY HEALTH PLUS AND MEDICAID

Statewide coalition asks Legislature to stand firm
against Governor’s request for additional cuts

Medicaid Matters New York, a statewide coalition of over 100 community-based organizations committed to speaking up for Medicaid consumers, is calling upon the Governor to stop pressuring the Legislature to make additional cuts to Family Health Plus and Medicaid that would directly impact hundreds of thousands of low-income and disabled New Yorkers. In the final hours of negotiations before the April 1 budget deadline, Family Health Plus, a program that provides health coverage to low-income, working New Yorkers, is being used as a bargaining chip by the Governor, who wants to cut the program instead of promoting cost-containment proposals that will hold consumers harmless.

“Family Health Plus is crucial to the health and well-being of low-income New Yorkers and fills in critical gaps in our state’s health care system” said Laura Caruso, Coordinator of Medicaid Matters New York. “Cuts to Family Health Plus target vulnerable New Yorkers while doing little to address the state’s budget gap. In fact, the savings ascribed to Family Health Plus cuts represent only 0.4 percent of the estimated budget gap. We can find a healthier way to balance the budget.”

Medicaid Matters New York (MMNY) has and continues to believe that positive Medicaid reform must be achieved in New York State – but not on the backs of consumers. We support leveraging New York’s prescription drug purchasing power to bring down the price of drugs, simplifying and streamlining of administrative enrollment processes, advocating for increased federal Medicaid funding and a full federal assumption of dual-eligible costs, proposals to make managed care really work at coordinating and improving access and quality of care without mandatory enrollment of currently exempt/voluntary populations, and transitioning New Yorkers in long term care to home and community-based settings where appropriate.

Family Health Plus is a New York success story. Since the program began, over 450,000 low-income New Yorkers have enrolled in FHPlus and are now able to receive the health care services they need without fear of economic devastation. The Pataki administration took great pride in having expanded health coverage for lower income families in New York. But his proposed cuts to the program renege on that promise. While the budget aims to contain the growing costs of Medicaid, and relieve local governments of their expenses, low-income families will bear the brunt of the cost reductions.

THURSDAY – RALLY TO PREVENT ADDITIONAL BUDGET CUTS: In an effort organized primarily by SEIU 1199, hundreds of people gathered on the steps of the Capitol to call upon the Governor to cease his continued attempts to find state budget ‘savings’ through additional healthcare cuts, including Family Health Plus. Additional rallies took place in Buffalo, Corning, Long Island, Rochester, Syracuse and Watertown. MHANYS joined those who gathered in Albany to call upon the Governor not to veto the Legislature’s healthcare budget agreement. Following is a New York Times article on these statewide rallies.

ASSEMBLY ANNOUNCES ADDITIONAL KENDRA’S LAW HEARING – APRIL 21 IN BUFFALO: NYS Assembly Press Release:

Silver announces that Assembly will hold hearings on
Kendra's Law on April 8 and 21.

Forums Will Review Law's Efficacy and Consider Possible Improvements

Assembly Speaker Sheldon Silver today announced that the Assembly Codes Committee, chaired by Joseph Lentol and the Mental Health Committee, chaired by Peter Rivera, will conduct a series of public hearings to consider the implementation, status and efficacy of Kendra's Law. The Assembly hearings are scheduled for Friday, April 8, in New York City and Thursday April 21, in Buffalo.

The 1999 statute, named for Kendra Webdale who was killed after being pushed in front of a New York City subway train by a diagnosed schizophrenic, is aimed at ensuring individuals with mental illness follow prescribed medical treatment plans. The statute is set to expire on June 30.

"As I said in 1999, this legislation is about compassion and public safety. It was our hope that the law would be an effective tool for families and caregivers who struggle to ensure that individuals with mental illness do not become a threat to themselves or others," said Silver. "Now, as we consider extending the law, it is appropriate for us to examine how it is working and whether any additional legislative improvements are necessary."

"These hearings will provide the Assembly with a good opportunity to gauge the law's effectiveness. I expect these public sessions will provide insight into how the statute has been implemented and whether the goals of the legislation have been met," said Lentol.

"This law was intended to ensure that individuals with mental illness receive proper care, while also providing some peace to their families and strengthening necessary public protection," said Rivera. "I am anxious to hear an update from the mental health community before we determine how we will go about renewing the statute."

Among those expected to testify are numerous family members, including Patricia Webdale, Kendra's mother, and representatives from the state attorney general's office, the mental health care community and local government officials.

According to Silver, the law provides a framework for providing court-ordered Assisted Outpatient Treatment (AOT) to persons with mental illness who, in view of their treatment history and circumstances, may be unlikely to survive safely in the community without appropriate services and support. In enacting this law, the Legislature found that in order for AOT to achieve its goals, court-ordered treatment must be linked to a system of comprehensive care in which the state and local authorities work together to ensure access to treatment services.

Since the implementation of Kendra's Law, more than 10,000 individuals have been referred to local AOT coordinators for the purpose of determining their potential eligibility for court-ordered treatment. A total of more than 3,700 court orders requiring treatment for referred individuals have been issued statewide since the law's enactment.

CARTER CENTER’S MENTAL HEALTH FORUM FEATURING TOM O’CLAIR TO BE WEBCAST APRIL 14TH: Carter Center Media Advisory.

LIVE WEBCAST TO EXAMINE MENTAL HEALTH CARE SYSTEM FOR CHILDREN

ATLANTA, April 7 (AScribe Newswire) -- "Children's Mental Health: Navigating the System," the final event in the 2004-2005 Conversations at The Carter Center series, will be webcast live Thursday, April 14, 2005, from 7 to 8:30 p.m. on http://www.cartercenter.org/. Panelists include mental health legislative activist Tom O'Clair and award-winning journalist Paul Raeburn -- men whose lives have been impacted by the realities of obtaining adequate mental health care for their own children.

Former First Lady Rosalynn Carter, a longtime advocate of mental health care for children and co-founder of The Carter Center, will make opening remarks.

Dr. Thomas Bornemann, director of the Carter Center's Mental Health Program, will lead the discussion about the well-being of children in light of recommendations from the President's New Freedom Commission on Mental Health. Panelists will also provide insight into systems of care that emphasize treatment of and recovery from mental illnesses.

Tom O'Clair of Schenectady, N.Y., lost his 12-year-old son, Timothy, to suicide in 2001. As a result of his son's mental health issues, and lack of parity in mental health insurance, O'Clair spearheaded "Timothy's Law Campaign," an organization known by various names over the past 10 years, that has mental health parity as its goal.

"It was through the loss of Timothy and the prior four to five years of pursuing access to his needed care -- and finding shortcomings in the system -- that prompted my involvement in the movement for mental health parity in New York State," he said.

A mechanic for the NYS Thruway Authority, O'Clair is a member of the board of directors of the Mental Health Association in New York State and is a volunteer for the Samaritans Suicide Prevention Center of the Capital Region of New York State. He is an active lobbyist for the passage of "Timothy's Law," a mental health parity bill, currently before the New York State legislature.

O'Clair is also the father of John and Christopher, Timothy's older brothers.

Paul Raeburn is the author of the memoir, "Acquainted with the Night: A Parent's Quest to Understand Depression and Bipolar Disorder in His Children." From 1996-2003, he was the science editor and a senior writer at Business Week, and prior to that was science editor and chief science correspondent at The Associated Press. Raeburn is a commentator for National Public Radio's Morning Edition, and occasional guest host of NPR's Talk of the Nation: Science Friday. He has written for The New York Times Sunday Magazine, Psychology Today, The Washington Post, Discover, Popular Science, Child, Self, Technology Review, and many other newspapers and magazines.

Raeburn was a 1999-2000 Rosalynn Carter Fellow for Mental Health Journalism. His project focused on the scientific and social aspects of mental illnesses in children and how schools cope.

Raeburn is a graduate of the Massachusetts Institute of Technology, where he received a bachelor's degree in physics. He also studied composition at the Berklee School of Music in Boston, and he plays piano and guitar. A native of Detroit, Raeburn now lives and works in New York City with his wife, the writer Elizabeth DeVita-Raeburn.

Conversations at The Carter Center is an annual series of evening programs designed to increase public awareness on issues of national and global importance. The 2005-2006 Conversations season will be announced summer 2005.

The live webcast will be archived on the Carter Center Web site (http://www.cartercenter.org/) following the event. Questions to panelists may be submitted in advance by e-mailing to: carterweb@emory.edu

May is Mental Health Awareness Month

Second Annual Walk for Mental Health

Week of May 14 – May 20, 2005

In November of 2004, several advocates from across the state walked 122 miles in support of Timothy's Law. The walk went from Warwick, NY to Albany, NY and culminated in a rally of more than than 600 individuals gathered for Mental Health Parity.

This year, two advocates involved in the Walk for Timothy’s Law in Memory of Robin Jane Desrats, Ann Berardinelli of Families with Bi-Polar Children, and Ali Zimmerman, an employee of Independent Living, Inc., are planning an annual Walk for Mental Heath during May is Mental Health Month.

During the week of May 1st through the 20th, they will be getting walkers from each county to participate in a relay-type walk from the four corners of the state, converging on Albany on the 20th.

If you are interested in participating, please contact Ann or Alexandra - e-mail the Walk Committee at mentalhealth_walkers@yahoo.com, or call Ann at (845) 566-0810 or Ali at (845) 703-1042 and they will connect you with the agency coordinating the walk in your region.

SAMARITANS SUICIDE PREVENTION CENTER'S
7th Annual HOPE Candlelight Vigil

Thursday, May 19, 2005, 6:00-9:00 P.M.

When you are sorrowful look again in your heart,
and you shall see that in truth you are weeping
for that which has been your delight. ~Kahlil Gibran

On May 19th, Samaritans Suicide Prevention Center will hold its 7th annual candlelight vigil on the steps of the NYS Capitol in Albany.

This event not only memorializes the lives that have been tragically lost to suicide (through the faces on the NYS 1998 - 2005 LifeKeeper Memory Quilts), but will also work to save future lives through sharing, courage, and the commitment to the prevention of suicide. In addition, the Vigil serves to recognize those individuals dedicated to the prevention of suicide through the Annual LifeKeeper Memory Award. This year’s LifeKeeper Awards will be presented to NYS Office of Mental Health Commissioner Sharon Carpinello and Associate Director of Clinical Operations for the Albany County Department of Mental Health, Bill Dickson.

For more information, go to http://www.timesunion.com/communities/samaritans/, e-mail sams@fcscapitalregion.org, or call (518) 689-0080.

SAVE THE DATE – MAY 3rd, SPECIAL SCREENING OF MAANGAMIZI

Join the Mental Health Association in New York State (MHANYS) at the Spectrum 8 Theatres on 290 Delaware Ave. in Albany at 7:00 p.m. on May 3 for the Capital District premiere of Maangamizi. Producer/Director Ron Mulvihill will speak about the film at the reception to follow.

Proceeds from this special screening go to support MHANYS. For more information about this event, or to purchase tickets, call (518) 434-0439 ext. 20. Tickets are $35 for regular admission (includes $25 charitable contribution to MHANYS), $10 students/seniors, and free for mental health consumers.

For full details about the event, including a brief synopsis of the film, see the Maamgamizi flyer.

IN THE NEWS:

Psych center closure plan embraced by unions. By John Milgrim, Ottaway News Service
Middletown Times Herald Record, March 30, 2005

Albany – State lawmakers and two key unions have agreed to a new Pataki administration plan to close Middletown Psychiatric Center in April 2006.

The plan includes a promise of 50 new jobs, two new community residential psychiatric treatment centers in Orange and Sullivan counties and a new 48-bed transitional treatment facility to be located on the current center's grounds.

Gov. George Pataki included no such plan when he called for closing the center in his Jan. 18 budget.

When Pataki proposed the closure, he promised that $7 million in annual savings would be reinvested in community mental-health services.

More recently, state Sen. John Bonacic, R-C-Mount Hope, whose district includes the center, and Assemblywoman Aileen Gunther, D-Forestburgh, opposed the closure because no detailed reinvestment plan had been provided. The Public Employees Federation and the Civil Service Employees Association, which represent workers at the center, also opposed closure without a detailed plan.

"It's a really good deal," Gunther said. "It beefs up the quality of care in Sullivan and Orange counties. It really does."

Under the plan:

- Orange and Sullivan counties would each get a 12-bed community residence operated by the state.

- The state would create an Assertive Community Treatment team in Orange to provide services for "treatment resistant" patients.

- Staffing at existing programs, like the Middletown Mental Health Clinic, Pathways and the Friendship Club, would be increased, though exact numbers were unavailable.

- The state would also create a new 24-hour psychiatric crisis service to work with patients in Sullivan County, a service coordinator for chemical abusers with mental illnesses, a team to work with the severely mentally ill in county jails and a housing case manger to help people with mental illness find affordable housing.

Voice of the Consumer: Adult Home Residents Speak Out
New York Nonprofit Press, April 2005

In 2002, when Clifford Levy of the New York Times wrote his Pulitzer Prizewinning expose of the Adult Home system, the general public was shocked. Politicians reacted with outrage and calls for reform.

One group, however, was not shocked at all, because it knew all too well the plight of 12,000 New Yorkers with mental disabilities living in Adult Homes. Residents, themselves, had long been struggling to improve their care, both systemically and in their own individual Adult Homes.

The Coalition of Institutionalized Aged and Disabled (CIAD) is the primary vehicle through which Adult Home residents advocate on their own behalf.Founded in 1973 to be a voice for nursing home residents, CIAD has increasingly turned its attention to Adult Homes over the years.

CIAD members point to many types of problems within the Adult Home system. However it is the underlying issues of isolation, hopelessness and sustained dependence which are most devastating to residents. Too often, it is this sense of helplessness that allows operators to offer only inadequate medical and mental health care, bad food and poor housing.

"We are very much unknown and ghettoized," says Irene Kaplan, a CIAD board member and resident of the Surf Manor Home in Brooklyn. "Once you come into an adult home, for the most part you are not encouraged to move forward. In many cases it is discouraged. Intimidation is often used."

CIAD works to assist residents find their own voice with which to advocate for their needs and services, on both a micro and macro level.

"In individual adult homes, Resident Councils have developed as a means of helping residents maintain as much control over their lives as possible," says Geoff Lieberman, CIAD's Executive Director. "They provide a democratic vehicle for resolving complaints and a means for people to get together and talk about their concerns and issues."

However, developing a successful Resident Council is not always easy, particularly in adult homes where some owner operators either openly resist or subvert the process. "In some cases they are quite effective," says Kaplan. "In others, the residents are so intimidated or so ignorant that they won't support it. In many cases, the Resident Councils are operated by the owners."

CIAD provides technical assistance to the individual Resident Councils in the various homes. "We help people to organize and strengthen their Resident Council so they can be as effective as we think they can be," says Lieberman.

Residents point to cases where Resident Councils have been able to address concerns and issues at individual adult homes, ranging from food to telephone access. At Madison-York Adult Home in Rego Park, a Resident Council got 56 signatures on a petition complaining about stale bread, says CIAD member Dorothy Harle.

In some cases, individual Resident Councils have undertaken projects with systemwide implications. The Resident Council at Sanford Home in Flushing Queens, led by Ray Harris advocated to obtain MTA Half-Fare cards for disabled residents. The effort was so successful that CIAD picked it up as a project and worked with Resident Councils across the City to help more than 450 residents apply for halffare cards.

CIAD partners with MFY Legal Service's Adult Home Advocacy Project in monitoring adult homes that house large numbers of mentally disabled adults. "We provide training to residents on their rights and meet with them at the homes to discuss and address complaints and legal issues," says Lycette Nelson, a MFY Staff Attorney with the project.

CIAD handles complaints that do not require legal expertise, while MFY works with the residents who have legal issues, providing advice and counsel, brief services, and full representation as needed. "Over the past year we have handled over 200 individual cases of adult home residents," says Nelson. "These cases involved the withholding or misuse of resident funds; refusal to re-admit a resident after a hospitalization; and violation of residents' civil rights."

"For many years, CIAD and MFY Legal Services have been the only organizations regularly walking through the doors of adult homes," says Lieberman. Last year, CIAD's three-member staff made 327 visits to 35 adult homes in New York City.

On a system-wide basis, CIAD members have taken their case to Albany to advocate for a variety of causes. Last year, they held a CIAD Speak-Out to remind politicians that Adult Homes are still a system which needs fixing. Another Speak Out is scheduled this month. The issues, unfortunately, haven't changed.

Last year, Governor Pataki vetoed an $11 increase in the SSI Personal Needs Allowance. " Right now it is $130 per month or $150 for those with SSI-D," says Gerard Heller, a resident at Surf Manor. "Is that money to live on? When we go up to Albany, we are going to tell legislators to amend bill A-238 so we can have an increase in our allowance."

Heller and the other CIAD members are also seeking a separate temporary clothing allowance.

CIAD also wants improved health and mental health care and air conditioning in rooms. Levy's Times series cited cases of residents literally dying from the stifling heat in Adult Home bedrooms. "I have told our operators that air conditioning would be cheaper for the public rather than having residents going to hospital emergency rooms," says Kerry O'Day.

Most importantly, CIAD wants alternatives to the Adult Home system itself.

"Adult homes were originally supposed to be a solution for the elderly; those who needed daily assistance rather than serious mental health care," says Kaplan. "What has happened over time is that adult homes have become catch-alls for anyone and everyone with any kind of disability, whether it be psychological or physiological."

"One size fits all," is how CIAD characterizes this fundamental problem. "Not everyone living in an adult home should be there," says Gary Levin, a resident of Ocean House in Far Rockaway and a member of CIAD's Policy Committee. "It is a dead end for some people and dead ends are not good."

MFY Legal Services has taken this position to court by working to file Disability Advocates v. Pataki et al, which argues that placing mentally ill adults in large adult homes is a form of re-institutionalization prohibited by the federal Americans with Disabilities Act.

Advocating for themselves is already a success for many CIAD members. "The system leaves a lot to be desired, but if you are active and speak out, they will make changes," says Robin Stigliano, a resident of Bay View Manor in Bensonhurst. "That is what CIAD taught me. Before, I was just part of the flock. Now, I help out."

For information go to www.ciadny.org or call 212-481-7572.

Budget Talks Continue Behind the Scenes. By Karen DeWitt
New York Public Radio, April 6, 2005

The state legislature's budget, passed March 31, left some gaps. Negotiations are taking place to try to reach agreement on those items before Governor Pataki's veto deadline of next Tuesday.

When lawmakers passed their budget on March 31, they left out some parts, after they were unable to reach agreement with Governor Pataki.

The largest chunk of the budget left undone is how to distribute $1.1 billion dollars in federal money for welfare programs and other services for the poorest New Yorkers.

That's left groups like the Coalition for the Homeless in limbo. The Coalition's Shelly Nortz says her group relies on $325,000 a year from that fund, to help people who are facing eviction keep their apartments.

This is the second year in a row that the Coalition for the Homeless and some other not- for- profit social services groups have faced uncertainty. Their grant money was left out of last year's budget, after Governor Pataki vetoed the items from the legislature's budget. The Assembly was never able to muster the votes for an override.

Governor Pataki had wanted the federal funds to be distributed in the form of block grants to county social services departments, to spend as they chose. The legislature wanted to continue to earmark the money for a number of not for profits that they believed filled gaps in the state's social service safety net.

The Senate and Assembly offered the governor a compromise, half of the money would go to block grants, half to service contracts with not for profits. The governor rejected the idea. Nortz says her group and the other not for profits have been caught the middle of a fight over a December court decision that limits the changes the legislature can make to the governor's budget. Unless Pataki resubmits budget language, the legislature can't make the changes it wants to.

"I'm disappointed that the governor chose this particular aid to needy families as a way to test what that court decision allows ," she said. "He wants to make a point, but it really throws all of this funding into question."

Other disputed areas left out of the budget include a $150 million dollar Environmental Protection Fund, and a multi-million dollar plan for capital improvement projects for colleges and universities.

Some other items that were already settled in the legislature's budget are now back on the negotiating table. Tuition hikes at public colleges, rejected by the legislature, are once again being discussed. Governor Pataki had sought a one-time $500 increase this fall, followed by gradual tuition increases each year. The Senate and Assembly said no to both ideas. But Assembly Speaker Sheldon Silver says his house has offered a counter proposal to the governor, which would include some tuition increases.

"A modest amount...would be acceptable if it went to improve the conditions at the university ," he said.

Silver said acceptable spending would include the hiring of more full time faculty so that more students could graduate in four years. The Speaker says so far, the governor has not accepted the proposal.

Arguments also continue over the Medicaid portion of the budget. Governor Pataki is still seeking deeper benefit cuts to recipients. Speaker Silver says the Assembly will not go along with the cuts.

Governor Pataki has until April 12th to decide whether to veto parts of the legislature's spending plan. The deadline may put pressure on both sides to come to agreement on all of the outstanding issues in the budget.

The governor left for Rome Wednesday, to attend the Pope's funeral, and won't be back until Sunday.

Planned Budget Protests Turn Into Big, Loud Thank-Yous. By Al Baker
The New York Times, April 8, 2005

ALBANY, April 7 - Anyone wondering how two of the most politically potent interest groups in New York, health care workers and hospitals, made out in the state's budget wars need only to turn on a television and catch one of their ads.

"Call your state legislator and thank them," the ads, broadcast this week, said.

It was a message repeated on the Internet, outside the State Capitol here Thursday and amid the throngs of unionized workers in Times Square and in six cities around the state where 1199/S.E.I.U., the health care workers' union, and the Greater New York Hospital Association rallied with noisemakers, drums and whistles.

The day's coordinated rallies were originally planned as a war cry against cuts to the state's health care system and taxes on it: more than a $1 billion burden on Medicaid, health insurance for the working poor, hospitals and nursing homes.

Then the State Legislature actually passed the budget before its April 1 deadline, a punctual finish for the first time in nearly a quarter-century, and rejected most of the health care cuts.

So the rallies became victory dances, thanking the Legislature for rejecting most of the proposed cuts and some of the taxes, and a bit of a warning shot aimed at Gov. George E. Pataki, who has until Tuesday to decide whether to veto parts of the Legislature's budget, including the health care spending.

"We're saying to him today, 'Do the right thing, you know it's the right thing,' that regardless of where he goes in his political life, there's going to be sick people, and patients, and he does not want to leave a legacy behind of hurting sick people," Mike Rifkin, a union official, said on Thursday at a noisy rally here. "That's the wrong legacy to leave."

The health care industry is a formidable force in Albany. Blair Horner of the New York Public Interest Research Group said the health workers' union and the hospitals were usually "in the top 10" in spending on lobbying and campaign contributions.

"They are in the 800-pound-gorilla category of Albany politics, both of them," he said. "They are widely considered to be among the most influential interest groups at the State Capitol."

Three-quarters of the union's 250,000 members choose to make a $5-per-month contribution for "political action." The union spent "well over a million" dollars during the week that the ads began to run, said Jennifer Cunningham, the union's executive vice president.

But its members also mobilized the public, she said, knocking on 146,789 doors since Feb. 7, getting 4,600 people to write notes opposing the cuts and encouraging 236,254 others to blitz state officials with phone calls, postcards and e-mail messages.

If Thursday's display of public gratitude was meant to thank lawmakers for listening, it was also meant to work against a possible veto-and-override showdown with the governor.

"It's like if our immune system is wiped out and here comes an infection," said Kenneth E. Raske, president of the hospital association, referring to the specter of vetoes by the governor. "We're on a vigil at this point."

Mr. Raske attended the Times Square rally, where thousands of health care workers lined Broadway from 42nd to 34th Street. Dennis Rivera, the union leader, and Sheldon Silver, the Democratic speaker of the State Assembly, spoke to the crowd, and Ms. Cunningham read a letter from Joseph L. Bruno, the Senate's Republican majority leader.

One speaker at the rally, Bruce McIver, president of the League of Voluntary Hospitals and Homes, summed up the paradox of the day. He called the budget "a terrific budget," but said the hospitals were working with the unions to prevent cuts.

"We're still in this fight," he said. "The struggle will continue."

Rally targets Medicaid cuts - Labor, health care, political representatives decry severity of Pataki's reform proposals. By Joy Davia
Rochester Democrat & Chronicle, April 8, 2005

Rita Lewis' hands flailed and her tiny frame shook as she talked about why she and at least 400 others were rallying at the Riverside Convention Center on Thursday morning.

"We're tired of Pataki's cuts," said Lewis, straining her soft voice above the whistles and shouts. "And those Medicaid cutbacks — they're just absurd!"

Lewis helps run the shelter at the House of Mercy and works with people who rely on Medicaid programs, which is health insurance for the poor. She and others at the rally fear that Gov. George Pataki's proposed Medicaid cuts might become a reality.

The state Legislature approved a budget last week — the first on-time budget in two decades — that restored about $700 million of Pataki's $1.1 billion in proposed Medicaid cuts. But the Legislature and Pataki's office are still negotiating parts of the budget. Pataki, who is in Rome for the funeral of Pope John Paul II, until Sunday, has until Tuesday to accept the budget or veto parts of it.

Overall, local reaction to the Medicaid part of the budget has been mixed. And the hundreds of union workers, labor leaders and political and health care officials at the rally became the latest local group to vocalize their Medicaid reform position.

Those who streamed through the convention center Thursday had a unified theme. "Pataki should approve the budget and put his veto pen away," said Bruce Popper, vice president of Service Employees International Union Local 1199 Upstate.

About a dozen local officials — including Assembly and state Senate members — also spoke at the rally, which was sponsored by 1199 SEIU and a coalition of health care and consumer advocacy groups.

They lamented the proposed taxes on health care providers, which they said might prompt them to cut services and staff. They voiced opposition to cuts in Medicaid or Family Health Plus, which is free health insurance for the working poor.

But Pataki has said that New York must enact his Medicaid reforms if the state is to remain financially viable.

The Legislature did adopt in its budget some proposals endorsed by Pataki, along with some reforms promoted in the last few weeks by unions, health care groups and a local coalition, Common Sense Medicaid Reform for All New Yorkers.

A cap on what counties pay for Medicaid was included in the budget. But as the Legislature and Pataki hash out budget compromises, that locally endorsed reform is open to negotiation.

Pataki, since unveiling his executive budget, has consistently said that the cap "is contingent on the enactment of long-term cost containment measures that will reform Medicaid and contain the program's growth," said Scott Reif, a Pataki spokesman. Chief among those reforms, he added, was a commission that would "right-size the health care system" by suggesting which health care facilities to close or reduce in size.

Overall, Jean Kase, vice president of government and public affairs for the Rochester Business Alliance, said she was pleased the Legislature's budget included reforms proposed by the Common Sense group, such as the cap and a preferred drug list that would encourage Medicaid enrollees to use cheaper drugs. But Kase said she wished the budget included more items that would save more money in the long term, such as disease management programs.

Strong Health, which operates Strong Memorial and Highland hospitals, also didn't see in the Legislature's budget the extensive cuts initially proposed by Pataki. Instead of the hospitals losing about $16 million annually, they'll have to deal with $3.2 million in cuts, said Len Shute, Strong Health's chief financial officer.

"I wouldn't classify it as a win, but it's not the disaster that was initially proposed," he said.

Others wonder how the poor will pay for health care if the final budget includes drastic Medicaid cuts.

Eloris Putmon, 59, is on Medicaid. Her son, Timothy Emanuel Putmon, 20, just got Family Health Plus coverage. They live together in a city apartment. Timothy, who is a temporary factory worker, helps his mom, who is a widow and on Social Security, pay the bills.

Now that Timothy has Family Health Plus, he can get the reading glasses he's needed for the last year and a half, Eloris Putmon said. Timothy, who will receive a discount on the glasses, hopes to get them by September, when he starts classes at Monroe Community College.

"There's a lot of books to read at MCC," she said. "It's such a good program, it would be terrible if these cuts do happen."

Racial Disproportion Seen in Applying 'Kendra's Law'. By Michael Cooper
The New York Times, April 7, 2005

After Kendra Webdale was killed in 1999 by a schizophrenic young man who pushed her into the path of an approaching subway train, the state passed a law giving judges the power to force the mentally ill to comply with treatment.

State officials say the statute, known as Kendra's Law, has been a great success, and Gov. George E. Pataki wants to make it permanent when it comes up for renewal in June. But an analysis of state data by a group that opposes its compulsory-treatment provision found that the law has been disproportionately applied to black New Yorkers.

The group, New York Lawyers for the Public Interest, concluded that blacks were nearly five times as likely as whites to be the subject of court orders stemming from Kendra's Law. Examining court orders for treatment that have been issued since the law took effect, the group found that 42 percent of the 3,958 orders for treatment were invoked against blacks, who make up 16 percent of the state's population, while 34 percent of the orders applied to whites, who make up 62 percent.

"It's important to know if our mental health policy is disproportionately taking away the freedom of groups of people who have historically been oppressed," said John A. Gresham, the senior litigation counsel for the group, a research and advocacy organization.

Jill Daniels, a spokeswoman for the state's Office of Mental Health, said that it was misleading to compare the race and ethnicity of those being treated under Kendra's Law with the race and ethnicity of those in the general population, and that the proportions were similar to those for adults receiving intensive care in urban areas.

Mr. Gresham's group is releasing the report this week because the State Assembly is planning to hold its first hearing on the law on Friday.

Under Kendra's Law, the courts can order mentally ill adults to receive outpatient treatment if nonadherence to past treatments resulted in hospitalizations or in violence toward themselves or others. If the court-ordered course of treatment is not followed, the patient can be involuntarily hospitalized.

A report issued last month by the Office of Mental Health cited reports by case managers that patients ordered into outpatient treatment under Kendra's Law were less likely to try to harm themselves or others, destroy property or create disturbances at the end of their treatments.

The concept of compulsory treatment has long been controversial. Last year the state's highest court, the Court of Appeals, upheld the law in a 6-to-0 vote. "The state's interest in immediately removing from the streets noncompliant patients previously found to be, as a result of their noncompliance, at risk of a relapse or deterioration likely to result in serious harm to themselves or others is quite strong," Chief Judge Judith S. Kaye wrote.

Mr. Gresham said that given the inequalities shown in his data, the parts of the law allowing the courts to compel treatment should be eliminated, while those providing greater access to mental health services should be kept. But other advocates warned against eliminating the forced treatment.

"That would gut the law," said J. David Seay, the executive director of the National Alliance for the Mentally Ill of New York State, an advocacy group that wants Kendra's Law to be extended permanently, and strengthened to make it easier for families to petition the courts to issue orders.

Mr. Seay added that his group would like to see the law applied more evenly throughout the state.

The question of what the numbers meant was the subject of debate on Wednesday.

Mr. Gresham pointed to state data showing that, even compared with demographics of who is served by the public mental health system, blacks are disproportionately subjected to court orders under Kendra's Law. But state mental health officials noted that those figures included children, who are not covered by Kendra's Law, and that the figures were comparable to recent studies of adults served by the system.

Mental health advocates and city and state officials cited possible explanations for the disparity. Some noted that more than three-quarters of the court orders had been issued in New York City, which has a large black population. But Mr. Gresham said that even within New York City, blacks were the subject of a disproportionate number of court orders.

Others suggested that blacks and Latinos with mental illness might not have access to needed mental health care early on, making them more likely to find themselves in the kinds of crises that lead to interventions.

Whatever the reason, officials said it merited study. "It's very troubling," said Councilwoman Margarita Lopez, chairwoman of the Council's Committee on Mental Health.

Panel Offers Plan to Help Mentally Ill in New Jersey. By Tina Kelley
The New York Times, April 1, 2005

A special task force appointed by Acting Gov. Richard J. Codey to examine mental health services in New Jersey has found a fragmented, uncoordinated system that relies too heavily on expensive institutional care, provides inadequate rehabilitation, and often houses people with serious mental illness in jails and juvenile detention centers.

Yesterday the governor, who has made mental health his signature issue, welcomed the report and its lengthy series of recommendations to provide better care, improve access to services, and to make available more community-based treatment.

"By implementing these recommendations, we will move from the current 'take your meds, go to a program' approach to treatment to an approach that supports long-term recovery and wellness," Mr. Codey said.

The report by the Mental Health Task Force, which Mr. Codey created as his first official act when he became acting governor in November, endorsed $40 million in new spending for mental health next year as proposed in his budget plan.

The money would go in part to pay for a student loan forgiveness program to attract and retain quality social service workers, for the screening of new mothers for postpartum depression, which afflicted Mr. Codey's wife, Mary Jo, and for better access to care to reduce, for instance, the average six-week wait for people to see a state psychiatrist.

Kelley Heck, the governor's spokeswoman, said he would like to see the Legislature pass his initiatives as soon as possible.

The deadline for the Legislature to approve next year's budget is June 30.

The task force, led by Robert N. Davison, executive director of the Mental Health Association of Essex County, called for increasing the number of beds at Greystone Park Psychiatric Hospital to 510 from 460, and at a transitional housing program, Care and Hope at Morris Plains, to 25 from 10. It also called for all state-regulated health insurance plans to cover mental disorders the same way they cover physical disorders.

The report warned that the state's heavy reliance on institutional care was not sustainable. It now costs $146,000 a year to care for a person in a psychiatric hospital, and half of the current 2,000 patients are ready to be discharged but have nowhere else to go. Given population trends, if less expensive and frequently more appropriate community-based services are not provided for mentally ill people, another 400 beds will be needed, the task force said.

The report called such institutional care inappropriate. "The lost potential in human terms is incalculable," the task force wrote. "Lives have been lost, spirits broken and families devastated."

Improving services to mentally ill children was a priority for the governor and the task force, and its recommendations included moving low and midlevel offenders with mental illness from juvenile detention centers into treatment, and providing housing and community-based services to young people leaving detention.

The report noted that up to 70 percent of juvenile offenders are believed to be mentally ill. Nationally, according to Carolyn Beauchamp, president of the Mental Health Association in New Jersey, 5.4 percent of the general population suffers from mental illness. In New Jersey, that would translate to more than 460,000 residents.

Kevin M. Ryan, the state's child advocate, said one mentally ill young person has been in a North Jersey detention center since August waiting for an appropriate place. Mr. Ryan's office released a report in November criticizing the state for warehousing mentally ill young people behind bars.

"Whether we are implementing the reform, supporting it or monitoring it, we must all redouble our efforts to end the illegal detention of children with mental illness quickly," Mr. Ryan said in a statement yesterday.

Ms. Beauchamp called the task force's report courageous, and praised it for including the views of so many consumers of the state's mental health services. She said she was optimistic that the proposed reforms would take hold.

"Too frequently these reports are done and nothing happens, but we can tell by the $40 million already in the budget that action will be taken on many of these recommendations," she said.

Until next time, we remain,
Working to ensure available and accessible
mental health services for all New Yorkers