Tkaczyk Calls for Strengthening of Community Mental Health Reinvestment Act

Cecilia Tkaczyk

March 13, 2013

State Senator Cecilia Tkaczyk, Ranking Member of the Senate Committee on Mental Health and Developmental Disabilities, called on the Senate leadership to strengthen and provide adequate funding for the for the Community Mental Health Reinvestment Act. Tkaczyk noted that community-based services are less expensive for taxpayers and more effective for recipients than is institutional care.

Joined by Senate colleagues and noted mental health advocates, Senator Tkaczyk (D-Duanesburg) said, “This year marks the 20th Anniversary of the Reinvestment Act, which has been acclaimed by mental health service providers, advocates, recipients, and administrators. The basic principle behind this landmark legislation is that savings realized from closing and downsizing state facilities were to be reinvested into building and maintaining community-based services, which are far less costly for taxpayers, and far more effective than providing services in an institutional setting, emergency room or jail cell.”

Unfortunately, there has been a reduced commitment to Reinvestment in at least ten of the 20 years since passage of the Act, including 2002, when Governor Pataki vetoed the bill extending  Reinvestment and the funds associated with those savings.

In the 2013-2014 budget, both Governor Cuomo and the Assembly have identified $25 million in savings to the State’s Office of Mental Health hospital system, and proposed using $5 million of that money for Reinvestment.

The Senate Republican Conference, unfortunately, has chosen to completely eliminate those funds.

Senator Tkaczyk and her colleagues said at the very least they would like to see the $5 million proposed by the Governor and the Assembly included in the budget, but would prefer to have more of the anticipated $25 million in savings reinvested into community services.

They also cited the need to update the figure used to determine savings realized through downsizing and closure. We currently use $70,000 per bed per year, an out-of-date figure established over a decade ago. Experts agree that actual cost savings are more than $375,000 per bed per year.

Tkaczyk also advocated strengthening the Reinvestment Act by ensuring that savings realized from all aspects of downsizing the mental healthcare system --  including bed, ward and facility closure are considered for reinvestment into community-based services.

Senator Tkaczyk said, “Simply put, community-based organizations are being asked to provide more services, to more people with more challenging needs, in a system that is not fulfilling the commitment the State made to the providers who must meet those needs.  We have been asking them to do more with less. Now we are asking them to do more with nothing.”

Senator Liz Krueger (D-Manhattan) said, "Community-based service providers are crucial to the future of mental health services in our state," said "This new model can help us simultaneously rein in costs while achieving better patient outcomes, but not if we pull the rug out from under it. Sen. Tkaczyk is right: that would be a textbook case of penny-wise, pound-foolish. We should have learned from decades of de-institutionalization that you need to fund quality services in the communities where people live."

Senator Gustavo Rivera, Ranking Member of the Senate Health Committee, said,  "Fulfilling the commitment made by the State to reinvest in community-based organization would allow these nonprofit agencies to provide more direct and efficient care to people facing mental illnesses in our state. Quite simply, if we do not reinvest in these services we will deny our communities the resources necessary to effectively diagnose and treat mental health conditions."

Douglas Cooper, associate executive director of the Association for Community Living, said, “Community-based programs provide cost-effective rehabilitative services to the most severely disabled individuals living in the community. The Reinvestment Act is a promise made by New York State to fund community based services for people with mental illness when state-operated hospitals are downsized.  Reinvestment is an opportunity to provide increases to existing programs to ensure quality services are maintained and available, along with a funding source for new services that can meet the needs of individuals who  no longer rely on state hospitals.   People with mental illnesses can recover and are best served in the community."

Paige Pierce, executive director of Families Together in NYS, representing families of children who are in one or more of our state systems, said, “We know that our children can be served better in cost-effective, community-based programs.  But in order to realize this, we must invest in these programs or they will not be available as an alternative to institutional settings.  The lack of Community-based services leaves families with no other choice than the costly residential settings that we are trying to reduce.” 

Harvey Rosenthal, executive director of the New York Association of Psychiatric Rehabilitation Services (NYAPRS) said, “Reinvestment has represented New York’s promise to spend public mental health dollars where New Yorkers need them most in the community. New York spends more money on more hospitals serving less people than the next 2-3 states combined. Downsizing state hospitals and creating Centers of Excellence and reinvesting into community systems will allow New Yorkers to keep the promise of recovery for hundreds of thousands of New Yorkers with psychiatric disabilities.”