Alliance Alert: We commend Governor Hochul and the New York State Office of Mental Health (OMH) for taking steps to reduce unnecessary administrative burdens and modernize outdated regulations that have slowed the expansion of mental health services across New York State.
These reforms are an important step toward allowing providers to focus more of their time and resources on what matters most: supporting people in their recovery. By reducing unnecessary paperwork and streamlining approval processes, providers can spend less staff time navigating administrative requirements and more time building relationships, engaging individuals, and delivering the services and supports people need. These changes can also help agencies expand services more quickly and reach more New Yorkers as demand for community-based mental health and substance use supports continues to grow.
However, reducing red tape alone will not address the significant funding and workforce challenges facing our service system. We must pair these reforms with substantial investments in community-based agencies, including a 3.4% Targeted Inflationary Increase (TII) to help providers keep pace with rising operating costs and dedicated, ongoing wage increases for frontline workers to improve recruitment and retention.
We applaud the Governor and state agencies for recognizing the need to make our system more efficient and responsive. By combining regulatory reforms with sustained investments in agencies and their workforce, New York can ensure that providers have both the flexibility and resources needed to expand access, meet growing demand, and deliver consistent, high-quality, recovery-oriented services to more people across the state.
Office of Mental Health to Relax Prior Approval Process for Changing Services
By Ethan Geringer-Sameth | Crain’s Healthcare | October 26, 2026
The state Office of Mental Health is easing restrictions on providers seeking to expand or modify services as part of a government-wide red-tape-cutting exercise that Gov. Kathy Hochul unveiled last week.
For the first time in more than 15 years, the agency is modifying its Prior Approval Review process, which governs a range of applications from address changes to major capital projects. Once finalized, the reforms are expected to apply to roughly 1,700 mental health and substance use providers licensed under the agency, according to OMH.
“That’s a really long time to rely on our processes and hold our licensed providers to the regulations that are in many aspects outdated,” said Gina Bae, associate commissioner for OMH’s Office of Quality Improvement. “So this is very much overdue, and we’re really excited to be in this repeal and replace process.”
New York’s mental health services are highly regulated by the state with multiple tiers of review and approval that vary in complexity and allowance. The regulations have been one of the key ways the office oversees service delivery, but they have also slowed major expansions. The proposed changes will be finalized some time after a public comment period closes on Nov. 15.
“We’re keeping up with the times and incorporating feedback from providers and the local government unit partners over the past several years,” Bae said. “So I really feel good about the changes.”
The changes are part of Hochul’s Express NY initiative, which includes 125 regulatory reforms across more than 20 state agencies and public authorities. Hochul announced the first round of 50 reforms in June, with the second batch unveiled last week.
The announcement comes in the final weeks of an election season in which both parties have focused on affordability. In public messaging around the program, the governor’s office has framed the initiatives as direct savings for New Yorkers. “The reforms will save New Yorkers tens of millions of dollars and an estimated 5 million hours in time previously wasted filling out unnecessary paperwork, waiting in line, navigating confusing instructions and websites,” read a Wednesday press release from her office announcing the changes.
New thresholds
One of the most significant reforms the office is proposing is to vastly reduce requirements for capital project approval by increasing the cost threshold for projects that will trigger the highest level of review from $600,000 — a vestige of earlier decades — to $30 million.
“Six-hundred thousand dollars these days cannot get you a lot,” Bae said. “And for hospitals to have to go through the most comprehensive level of … review in order for them to start the construction or the needed work, it just doesn’t work.”
The changes would also streamline the approval process for school-based mental health clinic satellites, allowing providers that operate at least one licensed satellite to establish others through a less rigorous approval process, known as an administrative action. Under that process, providers would need to notify OMH field offices of the change but would not require review and approval from the agency’s central office or county governments.
Providers looking to increase or decrease the number of people they serve would also no longer be required to seek approval from the Office of Mental Health as long as their new clients are part of the same population and in the same area of their current license. The office will continue to monitor clinic capacity through other means, such as a recently introduced survey that includes the number of individuals served.