Informational Briefings and Public Hearings on Statewide Comprehensive Plan Scheduled

June 11, 2007

Dear Colleague:

Commissioner Hogan and I, in collaboration with the Mental Health Services Council, are pleased to announce the schedule and format for the 2007 regional Statewide Comprehensive Plan for Mental Health Services forums. I encourage you to review the 2007 Update and Interim Report to the 2006–2010 New York Statewide Comprehensive Plan for Mental Health Services prior to these events. The Update can be found on the OMH website at: http://www.omh.state.ny.us/omhweb/Statewideplan/2006/interim_report/update/.

As has been the case in recent years, there will be interactive discussions and more formal hearings to accomplish two goals. The first will be to provide stakeholders and the public with the opportunity to share their perspectives, priorities and experiences regarding the mental health system. The second will provide stakeholders with the opportunity to submit formal written and verbal testimony for the record.

Accompanying this letter is a schedule listing the dates, times, locations and contact information for these events. This year we will once again utilize a one-day combined format for each event, to minimize travel time and expense for individuals interested in attending both the interactive dialog and the hearing. Should there be any special accommodations that are needed, please let the Field Office contact person know. The content for the briefings and public hearings is as follows:

Discussion with Commissioner Hogan

The Commissioner will provide his perspectives on New York State’s public mental health system and emerging themes and priorities he has been hearing, and have a discussion with you to gain an understanding of your views. Underlying the discussion, the Commissioner would like to keep in focus the following questions:

• Are services consumer and family centered and consumer and family driven?
• How do we do better in this regard?

In addition to having discussion take place within the context of the vision and values of the public mental health system, the Commissioner would like to concentrate the discussion in three areas that have been identified by stakeholders as important:

1. Mental health services for children and families
   As OMH works on the development of a children’s mental health plan, in line with the Children’s Mental Health Act of 2006 (see Appendix 1), OMH would appreciate hearing about adaptations that may be needed to achieve outcomes desired by children and their families. Recommendations for developing a comprehensive strategic planning process for children and families are being sought. Additionally, Commissioner Hogan would like to learn more about how the implementation of Clinic Plus is proceeding and steps necessary to attain shared goals.
2. Housing priorities
   The 2007 Update emphasized strengthening housing and supports for persons with serious mental illness. OMH continues to invest very large amounts of resources into expanding housing capacity and assuring the ongoing viability of the existing capacity. Yet, we must face up to reality. There is simply no way that the state of New York is going to build a new home for everyone with a mental illness. Pretending that the impossible will happen blinds us to many things that need to be done. These include:
• Developing all the currently authorized mental health housing and advocating for more
• Working to make mainstream affordable housing accessible to people recovering from a mental illness, and advocating for affordable housing
• Reforming OMH housing programs so they are available when needed for people who need them most, including persons clinically ready to leave State hospitals
• Making housing a high priority concern of treatment providers, so they support consumers' needs for decent, safe and affordable housing.
• Providing support to consumers and families to sustain the housing that they have
• to provide persons with serious mental illness living in inappropriate settings or experiencing homelessness and desiring new housing opportunities

Fundamental to each of these approaches is the understanding that OMH is committed to supporting changes that will help communities and consumers achieve housing independence. Guiding principles for the Redesign of the Office of Mental Health Housing and Community Support Policies, which were released in mid-May, are attached as Appendix 2.

3. Coordinated care
   The Commissioners of Health, Mental Health, Alcoholism and Substance Abuse Services and Mental Retardation and Developmental Disabilities have been crisscrossing the State to talk with stakeholders about the integration of care across the service systems. OMH is very interested in hearing more about strategies for better integrating care, within the fiscal realities facing New York, which would help people achieve recovery, promote resilience and live, learn, work and participate fully in their communities.

Commissioner Hogan also welcomes the opportunity to discuss other local issues and to obtain a deeper understanding of regional and local needs.

Public Hearings
Formal hearings will also be held and interested individuals are invited to present verbal and written testimony. OMH is particularly interested in obtaining input in the three areas outlined above and in relation to any aspect of planning that persons wish to address.

Individuals wishing to attend the hearings to listen to the verbal testimony are welcome and are not required to pre-register. The public hearing format does not include questions or comments related to testimony presented.

OMH encourages the presentation of testimony and asks individuals interested in presenting testimony verbally to pre-register with the appropriate contact person in each region (see attached). Presenters are also asked to provide two printed copies of their testimony at the hearing. OMH encourages you to consider presenting testimony. If preferred, you may provide just your written testimony at the hearing or send it directly to Keith Simons, Deputy Commissioner/Chief Planning Officer, New York State Office of Mental Health, 44 Holland Avenue, Albany, New York 12229.

We welcome your attendance and participation at the briefings and public hearings.

Enclosures

cc:        Michael F. Hogan, PhD

Statewide Comprehensive Plan for Mental Health Services
2007 Informational Briefings and Public Hearings 

*OMH policy precludes using or carrying cellular phones in any area of OMH psychiatric centers accessible to patients.

Should there by any special accommodations (e.g., interpreters) needed, please let the Field Office contact person (listed above) know in advance.

Appendix 1
Children’s Mental Health Act

S T A T E O F N E W Y O R K

 6931--A
 Cal. No. 325

 2007-2008 Regular Sessions

 I N A S S E M B L Y

 March 22, 2007

Introduced by M. of A. P. RIVERA, ALFANO -- read once and referred to the Committee on Mental Health, Mental Retardation and Developmental Disabilities -- amended on the special order of third reading, ordered reprinted as amended, retaining its place on the special order of third reading.

AN ACT to amend chapter 667 of the laws of 2006 relating to providing for the establishment of a children`s mental health plan, in relation to the development and submission of a children`s mental health plan by the commissioner of mental health.

 THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:

1. Section 1. Section 3 of chapter 667 of the laws of 2006 relating to
2. providing for the establishment of a children`s mental health plan, is
3. amended to read as follows:
4. S 3. Children`s mental health plan. 1. The commissioner of mental
5. health shall develop and monitor the implementation of a children`s
6. mental health plan {, as approved by the governor} IN A MANNER CONSISTENT
7. WITH THE REQUIREMENTS OF SUBDIVISION (B) OF SECTION 5.07 OF THE MENTAL
8. HYGIENE LAW.
9. The children`s mental health plan shall BE FORMULATED FROM LOCAL
10. COMPREHENSIVE PLANS DEVELOPED BY EACH LOCAL GOVERNMENTAL UNIT, AS
11. DEFINED IN SUBDIVISION 6 OF SECTION 41.03 OF THE MENTAL HYGIENE LAW,
12. WITH PARTICIPATION OF CONSUMERS, CONSUMER GROUPS, PROVIDERS OF SERVICES
13. AND DEPARTMENTAL FACILITIES FURNISHING SERVICES IN THE LOCAL GEOGRAPHIC
14. AREA TO PERSONS WITH MENTAL ILLNESS. LOCAL GOVERNMENTAL UNITS MAY SUBMIT
15. MATERIALS ON LOCALLY DETERMINED NEEDS AND PRIORITIES TO THE COMMISSIONER
16. OF MENTAL HEALTH FOR REFERENCE IN THE PRELIMINARY AND FINAL CHILDREN`S
17. MENTAL HEALTH PLAN AND FOR ANY RECOMMENDATIONS AND REPORTS THEREON.
18. THE CHILDREN`S MENTAL HEALTH PLAN SHALL BE IN ADDITION TO AND SHALL NOT
19. SUBSTITUTE FOR OR REPLACE THE MENTAL HEALTH PLANNING PROCESS PROVIDED
20. FOR IN ARTICLE 41 OF THE MENTAL HYGIENE LAW.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
 { } is old law to be omitted.
 LBD10661-04-7
 A. 6931--A 2

1. THE CHILDREN`S MENTAL HEALTH PLAN SHALL contain short-term and long-
2. term recommendations to provide CULTURALLY AND LINGUISTICALLY COMPETENT
3. comprehensive, coordinated mental health assessments, early intervention
4. and treatment services for children from birth until age 18. Such plan
5. shall include, but not be limited to:
6. (a) coordinated provider services and interagency referral networks
7. for children from birth through age 18 to maximize resources and mini-
8. mize duplication of services;
9. (b) guidelines for incorporating social and emotional development into
10. elementary and secondary school educational programs, developed in coop-
11. eration with the commissioner of education, pursuant to subdivision 35
12. of section 305 of the education law;
13. (c) recommendations regarding appropriations for children`s mental
14. health assessments, early intervention and treatment to state and local
15. agencies;
16. (d) recommendations for state and local methodologies for integrating
17. and coordinating federal, state and local funding sources for children`s
18. mental health care;
19. (e) recommendations for building a qualified and adequately trained
20. workforce prepared to recognize, diagnose and provide mental health
21. services for children from birth through age 18 and their families;
22. (f) recommendations for facilitating research on best practices and
23. model programs, and dissemination of such information to the state`s
24. policymakers, practitioners and general public through training, techni-
25. cal assistance and educational materials; and
26. (g) recommendations for creating a quality-driven children`s mental
27. health system with shared accountability among state agencies and
28. programs that conducts ongoing needs assessments, uses outcome indica-
29. tors and benchmarks to measure progress, and implements quality data
30. tracking reporting systems.
31. 2. On or before {June} OCTOBER 1, 2007, the commissioner of mental
32. health shall submit a preliminary children`s mental health plan to the
33. governor and the legislature, and shall submit a final children`s mental
34. health plan on or before {June} OCTOBER 1, 2008. Thereafter, A CHIL-
35. DREN`S MENTAL HEALTH PLAN SHALL BE DEVELOPED AND SUBMITTED TO THE GOVER-
36. NOR AND THE LEGISLATURE BY THE COMMISSIONER OF MENTAL HEALTH CONSISTENT
37. WITH THE REQUIREMENTS OF SUBDIVISION (B) OF SECTION 5.07 OF THE MENTAL
38. HYGIENE LAW, EITHER AS A DISCRETE PART OF THE STATEWIDE COMPREHENSIVE
39. FIVE-YEAR PLAN FOR THE PROVISION OF STATE AND LOCAL SERVICES FOR PERSONS
40. WITH MENTAL ILLNESS REQUIRED UNDER THAT SECTION, OR AS A SEPARATE DOCU-
41. MENT, AT THE DISCRETION OF SUCH COMMISSIONER. CONSISTENT WITH SUCH
42. REQUIREMENTS, COMMENCING ON OR BEFORE FEBRUARY 15, 2009 AND annually
43. THEREAFTER on or before {June 1} FEBRUARY 15, the commissioner of mental
44. health shall submit {a} TO THE GOVERNOR AND THE LEGISLATURE AN INTERIM
45. report on the progress of the children`s mental health plan and recom-
46. mendations for revisions thereof.
47. S 2. This act shall take effect immediately.

Appendix 2
Guiding Principles for the Redesign
of the Office of Mental Health Housing and Community Support Policies

Revised May 16, 2007

Introduction: Safe, decent and affordable housing is a cornerstone of recovery from mental illness, as well as a mainstay of "the American Dream." Stable access to good housing is a fundamental problem for many people with mental illness because of their poverty, the limited supply of very-low-income housing, the rising cost of rental market housing and discrimination. Given this context any approach to reforming housing for people with a mental illness must stress:

• Expansion of low income housing in general
• Flexible supports that do not condition housing on services
• Expansion of specialty "supported housing" developed for people with a mental illness

Additionally, to reduce stigma, assuage "community resistance" and provide opportunities for recovery and rehabilitation, housing in normal/mixed neighborhoods and settings is preferable.

Unmet Needs: The unmet need for decent, safe and affordable housing--often with supports--is very substantial for people with mental illness. As a consequence of poor access to community housing, inadequate levels of mental health housing, and clinical programs that do not support people in getting/keeping housing successfully, many people with a mental illness are poorly housed or institutionalized. Thus, many people with a mental illness are "stuck" in:

• Homelessness and the shelter system
• Institutional settings (nursing homes, state psychiatric centers)
• Family-supported housing that cannot be sustained (e.g., with aging parents)
• Staffed residential programs (instead of homes)
• Adult homes

Reform must balance improved access to housing for all of these individuals with the need to improve "old" models of residential care, to move toward local systems of care that can arrange, provide, and support people in housing that is appropriate to their needs and preferences at any level of recovery.

Current Services: The New York State Office of Mental Health funds and oversees a large array of housing resources and residential rehabilitation programs. These resources include:

27,285 of these units are operated by not-for-profit agencies and 1,204 are State operated. In addition, 8,843 units are in development including 1,825 units of supported housing, 6,738 SRO units and 280 children’s units.

These are valuable and also expensive resources that are assets for the local mental health systems throughout the State. Many of these units were developed using approaches put in place in the 1980s and early 1990s, which emphasized a "residential treatment" strategy with services and supports provided in and sometimes as a condition of housing.

The New York State community-based mental health system has expanded dramatically during this time. Treatment, rehabilitation and pharmacological interventions have made great strides forward and the consumer empowerment movement has taken hold. Recovery is truly possible with the proper access to these resources.

Guiding Principles: It is time, then, to revisit the structures that govern the mental health housing assets in New York. Additional flexibility is needed for this housing to be responsive to individual recipient wishes and needs, system goals and to work effectively as a tool in the creation of local systems of care that reduce institutionalization, homelessness, people stuck in acute care settings, and waste. To achieve this, it is appropriate to outline guiding principles which can be used as a compass to focus these restructuring efforts. These principles include the following:

• Housing is a basic need and necessary for recovery. Most people want permanent, integrated housing that is not bundled with support services (housing as housing).
• Within an accountable system of care, there is also a finite need for staffed specialty housing and time-limited residential treatment programs.
• The primary goal of housing reform will focus on the individual and emphasize expanding access to supported housing. Person-centered principles of recovery will guide the work.
• On the community systems level, the local mental health housing resources will be viewed as an asset to expand access to supported housing and to facilitate broader reforms (i.e., accountability, recovery focus).
• As restructuring progresses, recipient satisfaction and recovery outcomes will be monitored.
• The new resource commitments in the 2007-08 budget will be used to facilitate restructuring.
• OMH will partner with affordable housing agencies to develop integrated, permanent housing.

OMH will work with stakeholders (local government, consumers, family advocates, providers) to incorporate flexibility into housing funding, regulation and oversight to introduce the above stated principles into OMH funded housing.

Action Implications:

• Continue development of additional housing units:
• in/via mainstream housing programs
• via OMH resources
• Emphasize supported housing models and integrated mixed settings.
• Explore conversion of staffed housing programs to:
• neighborhood-based supported housing
• more specialized staffed housing
• Blend new OMH housing resources with existing OMH housing/residential programs to achieve reform.
• Balance these development goals with meeting needs of identified populations.
• Increase the supply/focus on treatment/support programs that help individuals with a mental illness choose, get and keep housing.

We welcome comments and feedback on these principles and look forward to working with all stakeholders in this ambitious and timely effort. Feedback or suggestions may also be sent to: Robert W. Myers, PhD, Senior Deputy Commissioner, NYS Office of Mental Health, 8^th Floor – Adult Services, 44 Holland Avenue, Albany, New York 12229. Email at rmyers@omh.state.ny.us.