Tkaczyk Mental Health Reinvestment Measure Moves Through Committee

Cecilia Tkaczyk

February 13, 2014

State Senator Cecilia Tkaczyk’s legislation to strengthen the State’s community-based mental health services has been reported from the Senate Committee on Mental Health and Developmental Disabilities.

Senator Tkaczyk last year introduced the “Communities of Excellence Mental Health Reinvestment Act,” which would take money saved from consolidation of the State’s psychiatric hospital system and use it to ensure that our community-based services are appropriately funded.

Similar legislation was introduced this year by Senator David Carlucci, Chairman of the Committee on Mental Health and Developmental Disabilities, together with Senator Tkaczyk, Ranking Democratic member on the committee, and Senator Thomas Libous, the former chair of the committee.

Senator Tkaczyk said, “As the Office of Mental Health moves to close unused or under-utilized bricks and mortar psychiatric hospital facilities, it is critical that we take at least a portion of the savings and reinvest it into mental health services. This will allow us to reach people in the communities where they live, and take advantage of more effective -- and less-costly -- community-based mental health services.”

Senator Tkaczyk’s measure was widely supported by mental health experts and advocates, and was introduced in the Assembly by Assemblywoman Aileen Gunther, chair of the Assembly Mental Health Committee. Gunther has also introduced the new Carlucci/Tkaczyk/Libous measure in the Assembly.

The legislation is meant to complement the NYS Office of Mental Health’s proposed “Regional Centers of Excellence,” which will greatly reduce the number of psychiatric centers. Their measure would ensure the transition to regional hospital centers is accompanied by an appropriate plan, with proper funding, to provide the necessary community-based services.

Deinstitutionalization began in the NYS psychiatric hospital system in the early 1960s. At the time, there were 90,000 people making up the in-patient psychiatric hospital system in our state.

By 1978, the inpatient population had been reduced to just 30,000.

However, community-based services were not developed, and funding did not follow the 60,000 or so patients from the hospital into the community to meet their needs. Another 15 years passed, and another 12,000 to 15,000 people returned to the community before the Legislature acted.

In 1993, New York enacted the Community Mental Health Reinvestment Act, which was the most significant reform in the state's mental health care system in decades. It has been acclaimed by mental health advocates, recipients, employees, providers, and administrators alike.

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.

 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 all funds associated with those savings. In all, hundreds of millions of dollars have been lost from community-based services through “notwithstanding language” which allowed the money saved to be swept into the general fund, and diverted from mental health services.