The New York State Office of Mental Health today announced the progress achieved during the first eight months of Governor Kathy Hochul’s landmark $1 billion plan to strengthen New York State’s continuum of mental health care and outlined the next steps toward its full implementation. To date, the plan has resulted in awarding funding to dramatically increase outpatient community-based programs –including 137 new school-based mental health clinic satellites and 13 new Certified Community Behavioral Health Clinics, expanding inpatient care by 700 beds statewide; and discharge guidance for patients leaving hospital and emergency department settings.

“These historic and unprecedented investments into our mental healthcare system are laying the foundation for a robust continuum of care that is truly responsive to the needs of all New Yorkers,” Commissioner Dr. Ann Sullivan said. “We are funding early intervention for youth in schools and at pediatricians’ offices to vastly increase the availability of counseling and treatment services, while also providing the intensive and complex services for individuals with serious mental illness so they can live and thrive successfully in the community. As we watch this forward-thinking plan come to fruition, I commend Governor Hochul for identifying existing gaps in our system and then taking swift and ambitious measures to meaningfully address them."

Adopted as part of the FY 2024 State Budget in May, the $1 billion plan provides the funding needed to open new programs, expand effective initiatives, and develop thousands of units of specialized housing to serve individuals living with mental illness. To date, the state Office of Mental Health has released roughly $861 million in procurements associated with this plan, which is resulting in unprecedented growth.

The agency is on-track to issue the plan’s remaining procurements by March, helping to build early intervention and youth programs; expand access to clinics and housing; and provide employment incentives for mental healthcare workers. The plan is also improving insurance coverage, and adding hospital capacity so that the most seriously ill can receive the care they require.

Addressing Youth Mental Health

The plan has provided robust funding to establish or expand critical mental health services for children and youth, including school and home-based initiatives aimed at allowing them to receive care within the community. More than $5.1 million was awarded last month to support 137 school-based mental health clinic satellites, with an additional $3.2 million to establish other locations in 2024.

Operated by OMH-licensed service providers, the clinics establish satellite locations staffed by mental health practitioners at each school, so they can work alongside educators to achieve optimal treatment outcomes for youth. Once the new sites are established, more than 1,200 school-based clinics will be operating throughout the state.

OMH also awarded $17.7 million to dramatically expand HealthySteps, an evidence-based program to provide early childhood mental health care in pediatric settings. The funding will establish 46 new sites at pediatric healthcare settings in 19 counties and expand 51 existing sites, with a goal of growing the program to serve roughly 354,000 children at 224 sites statewide by 2027. 

OMH is issuing $11.9 million to greatly increase the statewide footprint of Home-based Crisis Intervention, an intensive individualized service that helps families maintain young people at home. The agency issued $5 million to establish nine new teams in regions throughout upstate, including two that will serve dully diagnosed individuals.  

These teams help enhance crisis intervention skills among families with children or young people between the ages of 5 and 20 who are at risk of needing inpatient psychiatric or residential treatment. Procurements for an additional 30 teams –including three serving individuals with intellectual or developmental disabilities –are expected to be released shortly. 

The plan is also investing $5 million for High Fidelity Wraparound services, an evidence-based care management intervention designed to work with those having complex mental health needs and who intersect with multiple systems. OMH has also solicited proposals for $10 million in suicide prevention programming and $3.1 million to further support the services offered by Comprehensive Care Centers for Eating Disorders, which are initiatives funded under Governor Hochul’s plan.

Closing Gaps in Outpatient Care

This fall, New York State issued new guidance for evaluation and discharge practices at comprehensive psychiatric emergency programs and emergency departments; and for Article 28 and private Article 31 inpatient facilities. Now being codified, this guidance sets the expected standard of care for assessing, evaluating, and discharging individuals with behavioral health conditions to ensure they leave with appropriate community support.

In the coming months, OMH will issue a procurement for $23.1 million to establish the first 18 of 50 new Critical Time Intervention teams to aid with discharge planning outlined in this guidance and to provide coordination services to help individuals adjust to a transition in care. These teams will include professionals and peers dedicated to helping clients develop skills and supports to live successfully in their community after leaving inpatient treatment or going from experiencing homelessness to specialized housing. 

OMH has issued $35.8 million in procurements to establish the first 23 of 42 new Assertive Community Treatment teams, including three for young adults, 10 for children, one for older adults, four forensic teams and five serving rural areas of the state. These multidisciplinary, evidence-based teams provide comprehensive and flexible treatment, support, and rehabilitation services to individuals in their community.

The plan is also dramatically expanding outpatient and community-based initiatives aimed at helping New Yorkers with mental illness live successfully in their community. Earlier this month, OMH awarded $3.5 million in funding to establish 13 new Certified Community Behavioral Health Clinics –seven in New York City and six in other regions of the state –to provide comprehensive services and coordinate care across behavioral, physical health, and social service systems care.

An additional 13 clinics will be funded in 2024, effectively tripling the number operating throughout the state and with a combined capacity to treat up to 200,000 individuals throughout the state. Open to any individual needing assistance without regard to their ability to pay, these clinics link to or directly provide mental health services, including 24-hour mobile crisis teams, emergency crisis intervention, and crisis stabilization; screening and assessments; patient-centered treatment planning; and outpatient mental health and substance use services.

Developing Specialized Housing

The plan will also dramatically expand the housing available for New Yorkers with mental illness, providing $890 million in capital and $120 million in operating funds to establish and operate 3,500 new residential units. Specifically, the plan will create 500 community residence-single room occupancy units, 900 transitional step-down units, 600 licensed apartment units, and 1,500 supportive housing units.

To date, OMH has issued procurements of more than $533 million to develop and operate up to 1,250 new units of housing for people with living with mental illness. This includes 750 units of single room occupancy apartments of supportive housing to serve individuals with mental illness and less acute needs; and 500 community residence single-room occupancy units to provide housing and intensive services to individuals with serious mental illness who are at the highest risk of homelessness.

Instituting Insurance Reforms

Under the plan, Governor Hochul enacted key insurance reforms as part of her plan, including a provision preventing individuals from being denied access to medically necessary inpatient services or for outpatient coordination of care. These changes will also require commercial insurance plans to cover life-saving care coordination services and to adopt appointment availability and geographic accessibility standards for behavioral health services.

Commercial plans in the state will be required to cover school-based mental health services for youth, with reimbursement rates at least equivalent to Medicaid rate, and reimburse for outpatient care provided by school-based mental health clinics –regardless of whether the clinic is a participating provider for those services. These changes will take effect when policies renew, which is Jan. 1 for most individual plans.

New regulations will be promulgated in 2024 to require commercial plans to have adequate networks by adopting appointment availability and geographic accessibility standards for behavioral health services. Additionally, a provision expanding commercial coverage for high-intensity discharge services –such as Critical Time Intervention or Assertive Community Treatment Teams –will go into effect on Jan. 1, 2025, ensuring New Yorkers leaving inpatient settings have adequate care when released.

Building Tomorrow’s Workforce

To address ongoing and future staffing shortages, the plan also expanded eligibility for the Community Mental Health Loan Repayment Program and provided an additional $5 million to extend eligibility to licensed mental health professionals, including master and clinical social workers; mental health counselors; marriage and family therapists; creative arts therapists, psychoanalysts, and psychologists.

In total, the program now has $14 million dedicated to recruiting and retaining skilled mental health professionals, providing up to $120,000 for psychiatrists and $30,000 for other mental health professionals to repay qualified education loans and student debt if they remain employed by licensed community mental health programs for three years. To date, the program has provided more than $2.3 million for 73 psychiatrists and more than $1.1 million for 129 nurse practitioners to help recruit and retain staff.

Helping New Yorkers Experiencing Homelessness

The plan is also expanding the Safe Option Supports initiative, building on the 14 teams now operating in New York City and seven teams in development in other regions across the state. These outreach and referral-based teams work with individuals experiencing homelessness to help them build life skills and strengthen their support network so they can successfully transition to community-based providers and supports.

The New York City teams are now assisting 630 individuals and have successfully placed 250 others into long-term or permanent housing since their inception in April 2022. OMH recently awarded $2.8 million to establish two new teams in New York City and $3.9 million to build four new teams outside of the metropolitan area.

In October, the agency provided $12 million to establish three new Intensive and Sustained Engagement Teams to serve communities in New York City, the Hudson River region and on Long Island. Staffed and lead by certified peers, these multidisciplinary teams will provide intensive community support services for New Yorkers with complex needs who have difficulty connecting with traditional forms of mental health care.

Expanding Inpatient Capacity

OMH has facilitated the return of nearly 500 inpatient psychiatric beds taken offline during the COVID-19 pandemic after issuing a directive to community-based hospitals earlier this year. OMH continues to work with hospitals to reopen offline beds and is holding accountable those facilities that lack a viable plan to restore their inpatient capacity. 

The agency also opened 150 new beds at state psychiatric centers this year, marking the largest expansion at of state psychiatric inpatient capacity in decades. Complementing this expansion, OMH established the first two Transition to Home units in New York City, creating a specialized program at Manhattan Psychiatric Center to help stabilize individuals struggling with chronic homelessness.

Staffed by a multidisciplinary team of doctors, nurses, social workers, occupational therapists, and other clinical and non-clinical personnel, these two 25-bed units provide recovery-focused treatment. As part of this initiative, OMH is developing a Community Residential Step-Down Program to provide a transitional space to house individuals stabilized at these units.