Capital Tonight: Mental health advocates face worker shortage

BY NICK REISMAN CITY OF ALBANY

UPDATED 6:30 PM ET JUN. 28, 2021 PUBLISHED 4:58 PM ET JUN. 28, 2021

The COVID-19 pandemic put a focus on mental health needs, but now service providers in New York say they are struggling to meet demand amid concerns over funding and a lack of staff. 

But now, service providers are being asked to do more as people emerge from more than a year of isolation and social distancing and grapple with the subsequent mental health strain of the crisis.  

"The pandemic, we saw the mental health needs have increased. Unfortunately, our workforce has shrunk," Association for Community Living Executive Director Sebrina Barrett said.

The programs that provide mental health services played a key role during the pandemic, but from housing to vacant staffing and the new 988 suicide prevention hotline that will soon be available has placed a strain on providers. 

It's a workforce that providers will have to retain to provide life-saving services for people who are struggling with mental health. But many jobs in the field are vacant, just as New York state officials are asking them to do more. 

At issue is funding for these jobs that for years has not kept pace with a rising minimum wage. 

"The problem is we don't have the workforce infrastructure to support the growing need in mental health," Barrett said. "What needs to happen is we need to invest in our workforce. We need to make these jobs attractive. Right now, our direct care workforce is making minimum wage. These are not minimum wage jobs."

New York is creating a new suicide prevention hotline called 988, an alternative to dialing 911. The move is being hailed by advocates for mental health. But Jeff Rovitz, of the Mental Health Association of Columbia and Greene Counties, said that's an example of services being expanded without the necessary staff in place. Coupled with the needs for housing programs, and providers are facing sharp challenges. 

"There's going to be significant questions related to funding for these services," Rovitz said. "There's going to be a snowfall effect. It's a great thing to happen, but there needs to be additional resources in the community."

Watch the video on Spectrum News 1

Spectrum News 1: Mental health agencies report workforce crisis in New York

By Spencer Conlin
Schenectady

PUBLISHED 5:23 PM ET Jun. 15, 2021

Mental health advocates across New York are celebrating a new resource for people living with mental illnesses. It’s called 988.

“We’ve seen all too often what happens in communities when the response to a mental health crisis is a 911 response,” said Sebrina Barrett, executive director of the Association for Community Living (ACL).

The number 988 will serve as a hotline for people experiencing a mental health crisis and help transform how the state responds to the emergencies.

But advocates say the new tool is highlighting another crisis.

“It’s not going to be helpful to have 988 if there is nobody there to answer the call,” said Barrett.

What You Need To Know

- The Association for Community Living (ACL) provides housing and rehabilitation services to more than 40,000 New Yorkers battling serious and persistent mental illness

- The ACL reports a 20% job vacancy statewide
988 will serve as a hotline for people experiencing a mental health crisis and will help transform how the state responds to such emergencies

The ACL is an organization of nonprofit agencies that provide housing and rehabilitation services to more than 40,000 New Yorkers battling serious and persistent mental illness like schizophrenia and bipolar disorder.

Barrett says right now, one in five jobs are vacant, and as a state-funded organization, filling that gap is tough.

“There is a limit to that funding,” she said. “Unlike corporations that can raise hourly wages in order to compete for employees, our members can’t do that.”

Delores Woodson works in the human resources office at Mohawk Opportunities, an ACL member based in Schenectady.

“Our talent pool has shifted in the fact that we’re not only getting less applicants, but the number of qualified candidates (has) shrunk,” she said.

Woodson says at the start of the pandemic, applicants were concerned about child care.

“Now, it's more so that the pay isn’t always what they’re looking for,” she said.

The lack of workers and turnover is also proving to be counterproductive in their work with clients.

“So, sometimes they have a hard time establishing trusting relationships to begin with,” said Kelley Nutter, human resources director at Mohawk Opportunities. “When they do establish that trusting relationship, it's really important for their recovery.”

Nutter has worked with Mohawk for more than 30 years and can’t recall a time quite like this.

“People once looked at nonprofits for their benefits, their time off and the experience and education,” she said. “Now, that is not a pull for applicants anymore.”

Their work continues, but Nutter, Woodson and Barrett are concerned staff could become too overwhelmed.

“We’ve got supervisors that are working overnight shifts at this point,” said Barrett.

She says if you’re interested in human services and are looking for a rewarding experience, a job like this could be the perfect fit.

“To come to work every day and see someone go from having to have 24/7 care to being able to live independently in their own apartment, to get a job or to get married, these are rewarding jobs.”

Watch the Video on Spectrum News 1

Register-Star/Hudson Valley 360 - Statewide advocates call on elected leaders to support the state’s most vulnerable New Yorkers

ALBANY — Advocates from across New York State joined forces on Feb. 9 to amplify their voices on behalf of one of the most vulnerable populations. The Association for Community Living (ACL) held a Virtual Mental Health Housing Forum and were joined by leaders across the state to call for support of mental health housing in the Empire State. The forum can be seen in full at https://aclnys.org/education-and-events/mental-health-housing-forum/

The Forum’s featured speakers included the New York State Office of Mental Health (OMH) Commissioner, Dr. Ann Marie Sullivan, Assemblywoman Aileen Gunther, Senator Samra Brouk, and ACL Executive Director Sebrina Barrett. Others who spoke were advocates, residents, housing staff, and family members who all shared perspectives on why mental house housing is more vital than ever before to providing a path to recovery for individuals with severe mental illness.

In the State of the State Address last month, Governor Cuomo included the conversion of vacant commercial property into affordable and supportive housing, and his proposed budget includes $250 million for new supportive housing; advocates agree that mental health housing is healthcare, and needed more now than ever before. By creating new supportive housing, Governor Cuomo is keeping his commitment to house some of New York’s most vulnerable populations. However, it is imperative that the supportive housing currently in operation see increased funding as well, if not first.

Before the pandemic, and before the state’s fiscal crisis materialized — which was just one year ago — mental health housing faced a $180 million shortfall. This is because the funding model that was created decades ago, has not kept pace with inflation. For example, employee health insurance premiums have risen 740% since 1984. The monthly premium rose from $183 in 1999 to more than $600 a month, or $7,000 a year. Current reimbursement rates for all fringe costs aren’t enough to cover just health insurance, let alone workers’ comp, federal payroll taxes, and unemployment benefits.

“Mental health housing is not only the right thing to do; it is fiscally smart,” said Sebrina Barrett, Executive Director of the Association for Community Living. “It is much less expensive than hospitals, prisons, jails, and homeless shelters. We have the ability to save lives, while saving the state money.”

“Adequate funding for supportive and mental health housing will help our neighbors and community members succeed,” said Senator Samra Brouk, New York State Senate Chair of the Committee on Mental Health. “These facilities are essential for recovery, and they provide vital, stable services for people in need of support. However, the staff providing that direct care need to make a living wage so that they can support their own families, too. Staff can’t focus on their jobs if they’re worried about putting food on the table.”

“Mental Health housing programs have been dealing with funding issues for many years,” said Aileen Gunther, Assembly Chair of the Committee on Mental Health. “It’s unacceptable and it needs to change. Direct-care staff in these programs have put their own lives at risk to ensure residential programs remained open throughout this pandemic. We need to do everything we can at a state level to ensure they receive a living wage.”

“I think we all recognize that this past year has proven to be a strain on everyone,” said Barrett. “The direct care staff and organizations that provide housing and support services have been instrumental in ensuring recovery from mental illness, and have enabled recovery to remain possible as the pandemic has changed all of our lives.”

ACL is a statewide membership organization of not-for-profit agencies that provide housing and rehabilitation services to about 40,000 people diagnosed with serious and persistent mental illness.

View the Article on Hudson Valley 360

Albany Times Union: Mental health providers join call for federal pandemic aid

Mental health providers join call for federal pandemic aid

Amanda Fries

Aug. 6, 2020 - Updated: Aug. 6, 2020 1:07 p.m.

ALBANY - Mental health and substance abuse service providers have joined the chorus of calls to federal lawmakers to provide financial relief to state and local governments in light of millions of dollars in state payments being withheld.

Service providers were alerted in late June that their third-quarter payments from the state would be reduced by 20 percent as New York grapples with a multi-billion-dollar deficit caused by the response and ramifications of the coronavirus pandemic. They argued the community-based programs provide stable housing and support for individuals at a lower cost than other options, thus funding them adequately saves money in the long run.

U.S. Rep. Paul Tonko joined industry leaders Thursday for a virtual news conference calling for more federal assistance, which service providers say are necessary to ensure the withholdings do not become permanent resulting in layoffs of essential workers, service cuts and the evictions of hundreds of vulnerable New Yorkers.

The Democratic congressman championed the Heroes Act, passed by the House in May, as the stimulus package that provides a “wholesome” response to the devastation brought upon localities from COVID-19 while ensuring dignity to those who rely on the essential services facing cuts.

“I find this so fundamentally flawed that they are rejecting this assistance, this rescue package that we have offered that will bring assistance and sensitivity to our state and local governments,” he said of some U.S. senators who have sought to block any relief package from including financial assistance to state and local governments. “Since we passed the Heroes Act, 70,000 people have died. I don’t know what more expression of crisis is required to get these people to move.”

The Heroes Act proposes a $3 trillion stimulus package, which includes a second round of $1,200 checks for individuals, hazard pay for essential workers, more funding for COVID-19 testing, contact tracing and other funds for state and local governments.

Senate Republican leaders have been steadfast in their refusal to offer state and local assistance, suggesting it amounts to a “bailout” for Democratic-led states, and recently released their stimulus package void of additional funding for state and local governments.

The $1.1 trillion HEALS Act, or Help, Economic Assistance, Liability Protection and Schools Act, would also provide another round of $1,200 stimulus checks for individuals plus over $100 billion to help schools and child care facilities reopen, and more financial support for hospitals, health centers and coronavirus research. It also extends liability protections to businesses, schools and health care providers, offers another round of funds for businesses through the Paycheck Protection Program and cuts the federal unemployment insurance to $200.

Bill DeVita, executive director of Rehabilitation Support Services - which provides supportive services and housing to adults with severe mental illnesses, said if the cuts turn permanent, it could result in nearly 300 people being evicted.

“The money withheld is the money that goes to pay those rental stipends,” he said. “Should the withholds become a cut, then we estimate that there will be hundreds of people who will eventually be evicted from their apartments.”

Spectrum News: Advocates Want Boost in Mental Health Housing

Spectrum News - Advocates Want Boost in Mental Health Housing

By Nick Reisman City of Albany
PUBLISHED 5:24 PM ET Dec. 18, 2019 UPDATED 6:00 PM ET Dec. 18, 2019

Mental health care advocates and family members are urging Governor Cuomo and state lawmakers to commit more money to housing for people with severe mental illnesses.

Family members of those with mental illnesses worry the state's efforts to provide housing to the most vulnerable have fallen short. Matthew Shapiro's mother is one of the tens of thousands of New Yorkers who have used special housing for people with mental illnesses. 

Shapiro tells us finding the right place is a challenge for families who need extra care for a loved one.  

"Families struggle so hard to even locate housing services for their loved ones. In most cases, family members would love to have a loved one living in the home with us," Shapiro said. 

New York state spends a significant portion of its budget, about $4 billion on mental health services, but advocates and family members contend the money hasn't kept pace with inflation. Shapiro says a major challenge for housing has been the churn of direct care workers, making the lives of mentally ill people all the more difficult. 

As family members, we know how hard it is to build up trust in a relationship that's so important in driving recovery and you can't build those types of relationships when you have a constant turnover in staff. 

But advocates this year are banding together, forming a coalition of groups to push the issue of housing forward. Toni Lasicki of the Association for Community Living says state officials need to pay attention. 

"It's much more difficult to serve the people we're seeing today," Lasicki said. "Our staff turnover is through the roof — 50, 60, 70 percent depending on what agency you are in. So the challenges are great." 

Advocates had hoped Governor Andrew Cuomo would approve a bill forming a commission to study the housing issue. Cuomo vetoed it, so they released a report on their own. 

"I think it would have backed up what we were saying and I think it would have raised the profile of the issue," Lasicki said. 

In a statement, the governor's budget office pointed salary increases approved for direct care workers that will help bolster recruitment. 

“New York state has made substantial investments in our direct care workforce, funding $355 million to support more than nine percent in salary increases since 2015 — including a two percent increase slated for January and another two percent in April," said spokesman Freeman Klopott.

Klopott continued, "These workers are the backbone of a strong service delivery system, and these investments are not only increasing salaries, but improving services by bolstering recruitment.”

Read the Spectrum News Article on their website.

Politico NY Pro: Cuomo vetoes studies on mental health housing needs and municipal broadband

Cuomo vetoes studies on mental health housing needs and municipal broadband

By Bill Mahoney

12/06/2019 08:05 PM EST

ALBANY — Gov. Andrew Cuomo’s late-year rush of vetoes continued apace on Friday evening, with the governor nixing 23 bills. He also signed 38.

Cuomo had not vetoed any bills in their entirety in the first 10 months of the year; he has since vetoed 69.

As is often the case, the justification for vetoing many of the bills is that they incur costs and would better be dealt with in the budget.

A measure that would let winners of Masters in Education Teacher Incentive Scholarship Program awards attend private schools instead of just public schools “could increase program costs by an estimated $10 million dollars,” Cuomo wrote. Another that would have the state study the feasibility of a municipal broadband program “would require a significant expenditure of funds.” And one to have a commission study spending needs in the state’s mental health housing system does not come with “a source of funding” to cover the commission’s technical needs.

Supporters of some of these measures grumbled that the costs of the bills are minimal and said Cuomo used that as an excuse to block bills he simply doesn’t like.

“The only result of this bill being signed into law would be an honest and impartial assessment of the dire fiscal condition of our housing system, and our fear is that this is the real reason why the governor decided to veto it,” said Bring it Home Coalition chair Antonia Lasicki, who supported the mental health study measure.

Cuomo also vetoed a bill that would have allowed taxi medallion owners to authorize agents to handle paying any congestion surcharges they incur. That measure lacks clarity for determining who’s responsible if neither party pays, the governor wrote, and “would undermine the ability of the Tax Department to administer and enforce the congestion surcharge.”

The bills Cuomo signed include a measure that would raise the annual cap on the amount of money a public sector retiree can earn without having their pension reduced from $30,000 to $35,000. That was advertised as a way to increase the number of retirees working as substitute teachers.

View Cuomo’s veto messages here and his chapter messages here.

Times Herald Record - Housing in short supply for mentally ill

By Chris McKenna
Times Herald-Record
Posted Jul 9, 2019 at 6:17 PM
Updated Jul 9, 2019 at 6:17 PM

Orange County residents suffering from mental illness and eligible for state-subsidized housing currently have about 525 apartments and places in group homes with varying degrees of supervision that the state is funding in the county.

But an even greater number of people - 718 - were on a county waiting list for housing as of March 1. And mental-health advocates say New York’s longstanding under-funding for those housing types has meant not only a shortage of available slots but staff reductions and low pay for the workers who care for that vulnerable population.

A bill sponsored by Assemblywoman Aileen Gunther and unanimously approved by both legislative chambers last month seeks to correct those problems by forming a commission to study the housing needs of New Yorkers with mental illness and recommend appropriate funding increases for the next budget.

Though a study commission might seem a way to skirt the funding shortfall, advocates and Gunther supported the solution and are hopeful it will make the problems too glaring to ignore.

“I hate ‘study bills,’” Gunther, a Forestburgh Democrat and chairwoman of the Assembly Mental Health Committee, said Tuesday. “But maybe if there’s a study bill, it will be addressed sooner.”

The state Office of Mental Health now funds about 40,000 mental-health beds but needs roughly another 35,000, said Antonia Lasicki, executive director of the Association for Community Living New York State, which represents nonprofits that provide housing and rehabilitation for the mentally ill.

Locally, the state is funding 525 beds in Orange County, 283 in Ulster County and 143 in Sullivan County - a total of 951 apartments and group-home slots in the three counties, according to figures that advocates provided.

The state boosted its annual housing budget by about $10 million each of the last five years, allocating around $920 million this year for all five types of mental-health housing, Lasicki said. What lawmakers and Gov. Andrew Cuomo must do now to overcome decades of underfunding, she argued, is bump spending by as much as $170 million - an amount she said most likely would be spread out over five years.

Advocates say one pitfall of the funding shortfall is high turnover among direct-care workers, who earn low salaries for increasingly complex jobs.

The state gives housing providers roughly minimum-wage amounts to pay their workers, and the providers must “find ways to pay more or they would have no staff,” Lasicki said. Some workers assigned to group homes must single-handedly supervise anywhere from eight to 48 clients, dispensing medication, writing service plans and goals for each client, serving meals and handling Medicare and Medicaid paper work.

If signed by Cuomo, the bill sponsored by Gunther and Sen. David Carlucci of Rockland County would create a nine-member appointed commission that would deliver its funding recommendations by October 2020. Advocates hope the work could be done sooner to influence the budget that will be adopted in the spring of 2020.

Nadia Allen, executive director of the Mental Health Association of Orange County, said Tuesday that clients who are waiting for housing slots now are either homeless or living with family members or in some precarious situation, in need of housing to give their lives stability. She said she hopes the study, if it comes to fruition, will get the attention it deserves.

“If you have a heart, in my opinion, once you see it you can’t unsee it,” she said.

Read the article on the Times Herald Record’s website here: https://www.recordonline.com/news/20190709/housing-in-short-supply-for-mentally-ill

Behavioral Health News: Mental Health Housing Workforce Left Short in State Budget

Mental Health Housing Workforce Left
Short in State Budget

By Jim Mutton, LMSW
Director of NYC Operations
Concern for Independent Living, Inc.

Thousands of non-profit employees working in mental health supportive housing programs across the state were left shorthanded again in the 2019-20 State budget this April, despite a year-long advocacy effort with the Bring It Home Campaign (www.bringithomenys.org), a coalition of over 1,000 mental health housing organizations, faith leaders and individuals. A 2.9% Human Service COLA for state funded community programs was deferred for a tenth year and $13 million in hard fought additional funding from the Assembly and Senate to enhance supported housing and SRO programs was removed in final budget negotiations, leaving only a $10 million increase to these programs to help address a cumulative funding shortfall of $162 million. While the $10 million is appreciated, it is not sufficient to solve the crisis that exists in the mental health housing system. The Times Union also reported that millions in funding for agriculture, healthcare, veterans and youth employment programs included in previous state budgets was reduced, shifted to other priorities or eliminated in the first budget since Democrats took over the state Senate.

As the Director of NYC Operations at a 45-year old non-profit which operates numerous mental health supportive housing programs in Brooklyn, the Bronx and on Long Island, I found myself reflecting on how such a momentous effort could go belly up yet again after months of campaigning, hundreds of legislative visits and six weeks of continuous protests in Albany. How could our state government have failed us again, when a mental health supportive housing stock of over 40,000 units now stood with a crumbling infrastructure 40-70% behind the cost of inflation? How could our agency continue to attract a skilled and competent workforce, when direct care positions now paralleled in salary with entry level jobs in the fast food industry or private car for-hire ride sharing services. How could I turn to our dedicated workforce who work 2-3 jobs to stay afloat and battle cycles of burnout and vicarious trauma week in and week out and convince them to stick with this career and not jump ship to hospital and union jobs? To put it in perspective, the $10 million increase in the state supported housing and SRO budget would translate to about $500 per bed and do little but add a few dollars to the biweekly pay checks of case managers and supervisors.

Despite the budget crisis, the housing pipeline hasn’t slowed down. Quite the reverse. The need has never been greater for supportive housing in our city and state and government funders have released a record number of RFP’s. In the past five years, our agency has almost doubled its housing stock to help thousands of individuals and families find a pathway out of poverty, illness and hardship to successful community reintegration and recovery. We were part of the effort to end chronic homelessness for veterans recovering from mental health and substance use challenges on Long Island and now intend to do the same in NYC. 

New capital and operating funding opportunities are needed to address record levels of homelessness and growing institutionalization of mentally ill individuals. In addition, more sensible funding rates to build attractive housing and hopefully reengage and re-energize a new workforce. However, unless these rates are adjusted for the entire mental health housing workforce, it will not be enough to resolve the longstanding erosion that has taken place over the last 30 years. To quote the Bring It Home Campaign website, “Integration works so much better than institutionalization, we know that. We also know that institutionalization is very expensive...” It’s time to recognize that community reinvestment also means workforce preservation and investment.

Read the article in the summer issue of Behavioral Health News here.

Albany Times Union Editorial: A matter of mental health

Editorial: A matter of mental health

June 27, 2019

THE ISSUE:
State lawmakers want a commission to look at whether certain programs for mentally ill people are adequately funded.

THE STAKES:
Shortchanging these programs affects not just clients, but all New Yorkers.


Since the 1950s, New York has been moving people with serious mental illness out of institutions. The effort had two commendable goals: to integrate these people as much as possible into society, and to reduce the huge cost of institutionalization.

There's every indication, though, that in the state's view, it's no longer enough to save money on institutionalization. There seems to be a new threshold: saving money on deinstitutionalization.

Where that has left the mental health system depends on whom you ask. Gov. Andrew Cuomo's administration no doubt wants the public to believe it's doing a good job of managing care while working within the governor's spending caps. And mental health advocates say care is suffering.

We all need to know who's right.

The numbers suggest the system is under increasing strain. Over the past decade, state spending on mental health has declined from just under $2 billion to $1.3 billion. If spending had kept up with inflation, it would need to be $2.4 billion today. And that doesn't factor in the growth in the population in the mental health system — more than 770,000, compared with 717,000 in 2011, according to the state's own estimates.

Mental health advocates note that the needs of people entering the system have changed. They're no longer formerly institutionalized patients somewhat used to rules and routines, who were taking only a couple of medications to control their illnesses. Now they tend to come off the streets, require more intensive management and rely on a whole range of drugs. All this is run largely by workers who earn around minimum wage — which, incidentally, is rising under state law, even as state funding doesn't keep up.

Seeking a window onto this situation, the Legislature this year passed a bill — unanimously in both chambers — to have a commission examine one piece of the system: housing for people with mental illness. The state Office of Mental Health contracts with local governments and nonprofits to provide about 40,000 units of supportive housing and services for adults with severe psychiatric disabilities.

Now advocates worry that the governor will veto the bill. Much as he may be reluctant to have an impartial look at consequences of his budget choices, though, Mr. Cuomo should sign it. This is an issue that could affect all New Yorkers, with all sorts of fiscal and social implications — pressure on local governments and taxpayers to make up for state funding cuts, greater pressure on institutions, hospitals, jails, shelters, police and courts, and the danger posed by having severely mentally ill people untreated and on the streets.

It's a matter of human dignity to allow and enable mentally ill people to live in the least restrictive environment possible. And it's a matter of public interest and safety that it be done right, which includes adequate funding. A half-century into this experiment, it's worth knowing if New York is still on that noble track.

Read the editorial on the Albany Times Union's website.