Gov. Kathy Hochul announced that $5.1 million would be awarded to 137 school-based mental health clinics in New York — including 82 at high-needs schools. This round of funding is part of the governor’s $1 billion plan to fortify New York’s mental health care system.
“The number of young people contemplating suicide, the number of young people feeling depression: the numbers are astronomical,” Hochul said on Thursday, Nov. 30. “We have an obligation to try to return these young people to some semblance of normalcy, even three years after the impact of the global pandemic.”
However, advocates say this isn’t enough to deal with the system’s faults.
Faith Beaty, who is on the leadership council of Healthy Minds Healthy Kids — a statewide coalition of behavioral health providers, advocates and families — said she has dealt with the challenges of navigating New York’s mental health system for her child who is currently in a residential treatment facility.
“It’s the hardest thing for me to have to go through,” Beaty said, who also works in Rochester schools. “I’ve done everything that I can because of my daughter, I do the work that I do because of my child. She has opened my eyes and impacted me in a way that nobody else ever could.”
Beaty became tearful when describing the hoops she jumped through to get her child adequate care. She is one of many parents dealing with endless waitlists, affording basic needs, like housing and food and a lack of facilities and providers for their children.
A CDC report released Nov. 29 showed that death by suicide has risen by 3% nationwide in 2022. In New York, death by suicide is the third leading cause of death for kids ages 15 to 19.
“The mental health challenges in our state are deep-rooted and systemic,” said Alice Bufkin, the associate executive director for policy & advocacy at Citizens’ Committee for Children of New York. “What we know is that children throughout the state are sitting on waitlists for months, for six months, for a year or longer to get services.”
In New York, only 24 psychiatric facilities, totaling 3,800 beds, are directly operated by the state. The state Office of Mental Health runs around 80 outpatient clinics — roughly 1,300 residential beds — and a range of community programs in state prison settings. However, up to 29% of teen boys and up to 57% of teen girls reported feeling sad or hopeless between 2011 to 2021.
The lack of access to state-funded facilities means that many parents are forced to pay out of pocket for private treatment facilities.
“Parents' entire lives are consumed by trying to get their children the care they need,” Bufkin said. “What we know is we don’t have the workforce necessary to meet the needs of young people. As a result, we have children who are cycling in and out of emergency rooms and hospitals and then they’re becoming adults with even more complex challenges. It doesn’t need to be this way.”
One of the factors contributing to New York’s complex mental health system is the lack of providers, according to advocates, meaning the existing practices cannot meet the needs for services for kids and families.
John Kastan, chief strategy and innovation officer at The Jewish Board, said the lack of providers is exacerbated; rates of reimbursement in the Medicaid system are inadequate and have not kept up with the cost of hiring workers, inflation and the cost of living. Kastan, alongside a workgroup, has been working on a rate request for the state.
“When we work with children and their families or caregivers in mental health, were not just working with the children and family but a number of systems that they interact with,” Kastan said. “Whether that’s the school system, pediatric health system, children welfare system, shelters or juvenile justice, that requires a tremendous amount of work that is not accounted for in the way in which were reimbursed as providers.”
One of the rate proposals for the fiscal 2024 state budget is a 3.2% increase in Medicaid reimbursements for children’s behavioral health clinics and two specialized programs including Children’s Home and Community Based Services (HBCS) and Children and Family Treatment Support Service (CTFSS) — which provides flexible interventions including family and peer support workers.
The rate proposal asks for other increases in Medicaid reimbursement including a $7.50 per month payment for children and families being served in the system for care coordination efforts, a 35% rate adjustment for reimbursement rates and a volume adjustment to account for the fact that the number of children using HBCS and CFTSS, has not come close to what the state utilized in developing it’s rate structure for these two programs.
In total, the rate proposal for the next state budget would be around $195 million to help compensate providers for outpatient work, improve rates of reimbursement from the Medicaid system and adjust the way funding is distributed to schools with mental health clinics.
“I know these numbers sound big but remember, New York state has a $70 billion Medicaid program,” Kastan said. “If you compare this to that, these amounts are actually not that large”
Kastan said the implementation of this proposal will help create a stable and robust service system that’ll be able to meet the needs of New York’s youth and intervene at the right time to avoid a critical, and more expensive, outcome.
For parents like Beaty, the governor’s recent funding provides some relief that the state is committed to solving the youth mental health crisis. However, the state’s goal of transforming its mental health care system will have to dig deeper to address the complex issues that prevent providers from being able to address the high demand for services.
“The system has failed our children but we as educators, parents and communities will fight until New York state does the right thing,” Beaty said.
