NYAPRS Note: Here’s a copy of testimony we gave this morning at a NYS Assembly Hearing on the crisis in our sector and workforce. Please note the attached handout detailing our ask for a permanent COLA (this year’s share amounts to a 5.4% hike) and a $500 million investment to resuscitate our workforce and community based behavioral health agencies that have been on life support for man years and at states of crushing crisis at the current time.
Great thanks to our members who sent in over 10 pages of quotes yesterday afternoon that offered a powerful demonstration of the crisis in very personal terms, testimony that all 3 Committee members found very powerful. Great thanks are due to Assembly Mental Health Committee chair Aileen Gunther for her longstanding determination to hold state government accountable to address the crisis and her work in setting up and chairing today’s hearing.
Stay tuned for a series of actions we will be asking you to take to press the Administration and Legislature to make this an historic year for our sector, workforce and most of all, the people we serve and support across the state.
Testimony Before the
NYS Assembly Mental Health Committee
on the Mental Health Workforce Crisis
November 9, 2021
Presented by
Harvey Rosenthal CEO
New York Association of Psychiatric Rehabilitation Services
harveyr@nyaprs.org 518-527-0564
The New York Association of Psychiatric Rehabilitation Services serves as a state and national change agent dedicated to improving services, public policies and social conditions for people with mental health, substance use and trauma-related challenges, by promoting health, wellness, rights and recovery, with full community inclusion, so that all may achieve maximum potential in communities of choice.
www.nyaprs.org
Good morning. On behalf of the board and members of the New York Association of Psychiatric Rehabilitation Services (NYAPRS), I wish to extend our great thanks to Chairwoman Gunther and the members of the committee for focusing us all on the single greatest crisis that I’ve seen in my 47 years in the field: a battered, heavily underfinanced and overwhelmed community behavioral health system’s inability to provide appropriate support to New Yorkers in need at a time when that support has never been needed more.
My name is Harvey Rosenthal and I have served as NYAPRS CEO over the past 30 years. Since 1981, NYAPRS has represented a partnership of tens of thousands of New Yorkers with psychiatric disabilities and the community service providers who support them across the state. Our aim has always been to improve services, public policies and social conditions for people with mental health, substance use and trauma-related challenges, by promoting their health, wellness, rights and recovery and full community inclusion.
Our commitment is very personal: I am in long term mental health recovery as are most of our Board and staff and many leaders who head up many of our member agencies.
As we all know all too well, we have been dealing with 3 intertwined crises caused by
-
the impact of COVID-19
-
the dramatic increase in demand for behavioral health services relating to trauma, anxiety, depression, overdoses and youth suicide connected to the virus and
-
our state’s inability to respond to this demand due to a long history of underfunding its behavioral health workforce and sector.
While some sectors of the healthcare system have seen some increases over the past decade, our agencies have long experienced the reverse: costs and demand have steadily gone up year after year while the state has reneged on statutory commitments to fund a Cost-of-Living Adjustment over 9 of the last 11 years.
As a result, we have seen a steady stream of workers leaving or not applying for community-based behavioral health positions or failing to show up for an interview. The result is many jobs are going unfilled, leading to staffing shortages that have reached emergency levels.
While the State Legislature has attempted to help as evidenced by last year’s 1% COLA it simply does not have the ability on its own to make the level of investments that New Yorkers in need require without having a full partner in the Administration.
We have recently received some encouragement in the form of the $21 million of workforce related funding released a few weeks ago by Governor Hochul and OMH Commissioner Sullivan. We are grateful to see that some additional relief is coming over the next few months and in a few instances some of these funds will be used to fund sustainable rate hikes to several program areas. Nonetheless, most of it are issued on a one time only basis, will not reach a large percentage of unmet needs and cannot be used to increase workers’ wages and agency expenses that are at the heart of this crisis.
I’d like to close by setting the stage for the remarks that my colleagues will offer throughout the day by presenting you with direct comments from the people this is all ultimately about, courageous New Yorkers in mental health and addiction recovery and the dedicated workers on the front line who support them every day.
I reached out to NYAPRS members yesterday at around 2:30 and received the following responses within the next two hours. Given that our Governor comes from Western New York, it was especially fitting that many of the first responses came from groups in that part of the state.
Restoration Society Buffalo
-
It’s too painful to even think about. I feel like I lost relationships that I had built over a number of years with staff who up and quit or were let go, burned out or over worked.
-
I worked to assist one gentleman who was homeless for many months as his housing workers changed or quit–He at one point contemplated suicide and getting arrested to get out of his homeless situation.
-
I literally feel like COVID has ruined me. I was in counseling at Horizons but when COVID hit, I had to switch to telehealth. I don’t have a computer…I have a phone but I barely know how to work it and I can’t afford the minutes. It was really hard for me to keep my appointments and they ended up discharging me.
-
I feel that there is a dire need for more one-on-one peer staff interacting, assisting, checking up on, and letting people like me know that there is someone there for them, that they are not alone in the struggle of mental health and overall life’s general, battles, trials and tribulations.
-
Every time I get a new counselor, I have to start my story over the from beginning instead of continuing to move forward. I don’t trust people very easily so it takes even longer to get started again.
-
My counselor is brand new in the field. He is not very knowledgeable or helpful, although I know he is trying. I’d be much further along in my recovery if I had a more experienced counselor.
-
I called my counselors every day to try to move my medication adjustment up. I am severely depressed and losing hope.
-
I’d been pretty stable over the past few years, but the pandemic became very challenging on my mental health, and I tried to link up to counseling. I had to wait 2 months to get an appointment and then was told I could only been seen monthly instead of weekly or biweekly which is what I really need right now.
Mental Health Peer Connection, Buffalo
-
I lost my psychiatrist and counselor and then waited months to get hooked up with a prescriber, only to find myself on a 14-month waiting list for counseling. My depression has been unbearable. I feel so bad for those that are not even close to knowledgeable of the mental health system that I have. I know and I am struggling every day. It is devastating. What about my brothers and sisters?
Community Missions, Niagara Falls
-
We currently have 23 open positions that keep revolving in the agency. We fill one and then another person leaves; shifting work responsibilities in the vacancies are mostly to blame for this imbalance.
Recovery Options, 7 counties across Western NY including Erie, Monroe and Chautauqua Counties
-
We have experienced significant staff turnover, leaving participants with the feeling as though they need to “start at square one” when their regular staff person leaves. New staff has also found it more difficult to meaningfully engage with participants who are not interested in developing a rapport with a new staff member. In some instances, this has resulted in an increase in no show rates and reduced the consistency of service delivery.
Compeer Rochester
-
Individuals and families with mental health needs should not be subjected to the pain of sharing their stories over and over again while providers come and go. It is our shared responsibility to appropriately compensate people to do this important work for the long-haul, monetarily, as well as showing support for dedicated employees as they deal with their own life challenges.
Mental Health Empowerment Project Albany, Rensselaer, Rockland Counties
-
The Samaritan hospital crisis has a wait time of upwards of 2 days prior to being seen
-
CDPC has been on deferral/not taking admissions multiple times and individuals from Albany County have been sent out of county in a state of crisis
-
People have been waiting 4 to 6 weeks for an initial appointment for their local psychiatric rehabilitation program
-
A Troy provider has de-designated themselves as a provider of empowerment services, leaving a huge gap
-
Individuals leaving detox with an outpatient referral are waiting in excess of 4-6 weeks for an intake
-
There was no code blue housing in Rensselaer County last winter as none of the approved providers could staff the locations
-
We support an individual who is approved for 35 hours per week of a home health aid and he has been dropped from the county list because they cannot find anyone to provide the service. He is in a wheelchair and needs aid with hygiene, shopping, cooking and cleaning and often does these activities alone and has fallen from his wheelchair and not been able to get back up for hours before someone arrives to assist.
-
Many people on parole and probation community supervision went unseen or completely unsupervised during COVID and are now being violated through no fault of their own.
Mental Health Association in Putnam County
-
Our community outpatient mental health clinic (the only one in the county that serves children) is receiving 100 calls/referrals a week and because of the workforce crisis, this is forcing long wait times for intakes and triage for anyone in crisis.
-
Three weeks ago, it was a suicidal 38-year-old Marine who had to wait 2 weeks for an intake, last week it was a corrections officer whose family fell victim to a random act of violence that claimed the lives of several family members. This week it will be someone else in desperate need of care who after having the courage to reach out, will have to wait, or go unserved.
-
As co-chair of our suicide prevention task force, our suicide numbers are increasing, and we fear that that trend will continue. We are concerned about our clients as well as the remaining members of behavioral health care workforce/care teams that at some time will reach their breaking point, shouldering the heavy burden from increased demand for care without adequate resources.
-
Please value our workforce as we have been collectively working tirelessly since the onset of the pandemic. Many unsung heroes who need support to meet the demands of the next pandemic, the mental health crisis in America.
It’s critical to underscore that the ever-growing gaps in funding for the workforce and our agencies are taking the greatest toll on people of color who have long been among our most underserved. Future funding allocations must address this!
We join our colleagues in calling on the Administration and Legislature to join together and take decisive action to approve a 5.4% COLA and a $500 million investment to resuscitate both our workforce and the agencies in which they work. See the attached handout for details.
Now is the time to address this crushing workforce crisis during a time when we are awash in federal dollars and from huge surpluses derived from a very high level of tax receipts. Now is the time to commitment to make annual COLAs based on the CPI Rate permanent and to make a $500 million investment in our system to raise workforce pay and benefits across the board, to boost funding to both existing community housing, rehabilitation, peer support treatment and to create new capacity to keep pace with the ever-rising needs.
New York State government must not fail yet again to make a sustained commitment to aid our most vulnerable New Yorkers and its behavioral health sector.