Gov. Hochul talks mental health care (photo: Darren McGee/Governor's Office)
Governor Kathy Hochul is touting the inclusion of over $1 billion for mental health care in the new $229 billion budget deal recently struck with legislative leaders.
"When it comes to keeping people safe, there are commonsense places we can start as well. One of them has to do with fixing our mental health system because it is broken, the rates of mental illness have been on the rise, and the pandemic only made matters far worse," Hochul said Thursday evening when she announced the framework of a budget deal.
"Too many people can't get the care they need, and for too long we've underinvested in mental health," she said.
While the funding has broad applications for the governor's "continuum of mental health care" vision, part of it relates to ongoing challenges to her goal of reinstating over 1,000 psychiatric beds in hospitals across the state to directly deal with the most serious mental illness.
The new budget allocation includes $14 million for mental health care workforce recruitment and retention at a time when hospitals have been unable to open psychiatric beds, and in some cases shuttered more units, in part due to severe staffing shortages exacerbated by the pandemic.
Hochul has been pushing hospitals to reopen psychiatric units closed during the pandemic using a mix of incentives, punishment, and workforce development spending. Those efforts have largely been frustrated by the scarcity of needed clinical and support staff and the costs of renovations for financially strapped facilities.
More than 600 beds, out of an initial 1,050, remained offline this spring, including more than half in New York City. While New York City Health + Hospitals, the city’s public hospital system and largest inpatient provider, plans to restore most of its shuttered beds by the end of this year, most facilities throughout the state continue to struggle to do so.
This week, state lawmakers voted through the budget bills negotiated among Hochul, Senate Majority Leader Andrea Stewart-Cousins, and Assembly Speaker Carl Heastie, all Democrats, after weeks of logjam over bail, housing, charter schools, and other contentious policy issues. Less fuss was made over the governor's mental health agenda, which went largely uncontested in each chamber's one-house budget response.
Last year, Hochul and the State Legislature allocated $55 million in state and federal funds to increase Medicaid reimbursement rates for psychiatric beds in general hospitals to bring them closer to regular medical bed rates. They also included $9 million for loan forgiveness for psychiatrists and psychiatric nurse practitioners to help fill needed positions.
Earlier this year, the state Office of Mental Health and state Health Department issued an ultimatum to hospitals requiring them to bring all licensed beds back into service by April 1 or face fines and other sanctions. In the state budget this year,
Hochul successfully pushed for legislation to allow OMH to impose penalties of up to $2,000 per violation per day (up to $25,000) on hospitals operating below the psychiatric bed capacity listed on their license agreement. The move is a bitter pill for some hospitals that have been operating below capacity for years, often as part of plans developed with OMH.
In the new budget for the fiscal year that began April 1, loan forgiveness funding increased from $9 million to $14 million. The language was expanded to include "other licensed clinicians" in facilities with "critical capacity shortages," after hospital officials pushed for aid to other important roles like social workers and technicians.
Another $3 million from the state's General Fund is available for loan forgiveness for psychiatrists who agree to work for three years in hospitals or outpatient services in underserved areas. That funding was included in last year's budget as well. The budget also includes a 4% cost of living adjustment for some mental health workers.
On Wednesday, the governor's office issued a series of press releases touting elements of the new state budget, including one highlighting over $1.4 billion in mental health spending.
"Decades of chronic underinvestment has allowed far too many New Yorkers to fall through the cracks in our State's mental health care system," Hochul said in an accompanying statement. "The plan to fix our State's continuum of mental health care marks a monumental shift in our approach, reversing years of neglect to our system and bringing bold investments to ensure that everyone in our state has access to the high-quality care they deserve."
Also Wednesday, the governor touted the funding when asked about a man in apparent psychological distress who was killed in the subway by a fellow passenger. "One element we have not talked about is the billion dollars investment in mental health services so we don't have people who are homeless in our subways, many of them in the throes of mental health episodes, and that's what I believe were some of the factors involved here," Hochul told reporters when asked whether she thought the individual should be charged in the death, adding she needed more facts about the case and calling it "deeply disturbing."
Hochul's mental health care agenda is focused on expanding inpatient and outpatient services, and insurance coverage of mental health and telehealth care.
It includes $48 million to add 150 long-term beds in some of New York's 24 state-run psychiatric institutions.
Hochul secured $182 million for outpatient mental health services, including new psychiatric emergency programs in hospitals, a dramatic increase in the number of Certified Community Behavioral Health Clinics from 13 to 39, and new mobile treatment teams. It also pays to expand capacity at 20 private behavioral health clinics.
Close to $3 million will go to peer-based outreach programs and $28 million will support the creation of 50 Critical Time Intervention teams, a care coordination model touted by Hochul and Mayor Eric Adams.
Another $30 million will go towards mental health services in schools, Hochul said last week.
That money "will help meet the needs of our children and hopefully cut the demand for services by half over the next five years," she said last week. "They need services now. You give them the services now, you keep them from needing more serious services in the future."
It also uses $42 million over two years to reimburse family and children providers for preventative mental health services. It also requires insurance companies to cover a range of mental health services including crisis intervention and post-discharge.
The 988 suicide and crisis hotline will receive an additional $60 million, a $25 million increase from last year's budget.
The bulk of the funding is for capital and operating expenses needed to create and sustain supportive housing units, including 3,500 units for people at risk of homelessness.
Outside the $1 billion for mental health care, the final budget agreement also includes $500 million for distressed safety-net hospitals and increased rates for enrollees in Medicaid and the state's Essential Plan for low-income New Yorkers.
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by Ethan Geringer-Sameth, reporter, Gotham Gazette
@GeringerSameth @GothamGazette
In the Legislature (photo: NYS Senate Media Services)
State lawmakers this week approved Governor Kathy Hochul's proposed $39.5 million allocation to New York's new campaign finance system, including base funding for a small-dollar public match.
The funding includes $25 million for public matching funds that will be available to participating candidates running for statewide and legislative offices beginning in 2024. It also includes the full $14.5 million sought by administrators to run the program.
The new system, passed by Democrats in 2020, lowered individual contributions limits and will multiply small, in-state or in-district donations starting at a 6-to-1 match for contributions below $250. Modeled on New York City's decades-old system and the Campaign Finance Board that runs it, good government groups say the new state system will make outsider candidates more competitive, help increase diversity among state-level elected officials, and incentivize candidates to engage with more voters.
"Governor Hochul is committed to restoring trust in government, and that includes ensuring the Public Campaign Finance Board has the resources it needs to fulfill its obligations under the law," wrote spokesperson Hazel Crampton-Hays in an email to Gotham Gazette.
Lawmakers passed and Hochul signed the $229 billion budget this week, almost a month after the April 1 start of the fiscal year, following weeks of debate among Hochul and legislative leaders over bail reform, housing policy, and other issues.
The new campaign finance funding comes after uncertainty during budget negotiations about implementing the program – including potentially postponing it. As late as March, Senate Majority Leader Andrea Stewart-Cousins would not rule out the possibility of delaying the small-dollar match until after the 2024 elections, when all 213 seats of the State Legislature will be on the ballot. Doing so would give incumbents seeking reelection one more chance to go before voters under the rules that last got them elected.
Advocates waged a campaign in the weeks leading up to the final budget agreement to preserve the system as lawmakers had passed it three years ago and provide it the funding requested by the new Public Campaign Finance Board. The final budget contains no delays nor does it otherwise tinker with the program.
"Public financing has made New York City elections more accessible and fair, and that's exactly the goal for statewide public campaign financing," said Senator Zellnor Myrie, a Brooklyn Democrat and chair of the Senate’s elections committee, in a statement to Gotham Gazette. "I'm really pleased we secured funding to expand the program in this year's budget because our democracy is stronger when the playing field is level."
"I am excited that lawmakers have taken the next step by funding the program in the state budget," said Assembly Member Latrice Walker, also a Brooklyn Democrat and the Assembly's elections chair, in a statement. Walker voted against the budget over opposition to rollbacks of bail reforms she championed in 2019.
"The seats of government should be open to people like me who grew up in public housing developments in Brownsville. Seats should be open to people who are not beholden to hedge funds and mega-donors. This is good for democracy,” Walker added.
Earlier this year, Democratic supermajorities in the State Senate and Assembly each approved one-house budget resolutions in response to Hochul's executive budget proposal that included the $39.5 million for public campaign financing. Spokespeople for Stewart-Cousins and Assembly Speaker Carl Heastie did not respond to requests for comment on the funding.
Republicans denounced the funding, arguing it will spend tax dollars with few returns for New Yorkers.
“The public deserved a budget that made New York safer and more affordable," wrote Senate Minority Leader Robert Ortt in a statement to Gotham Gazette. "Instead they got billions in additional spending and higher taxes to help fund welfare for politicians.”
"I've said from the beginning, taxpayer dollars and political campaigns don't belong anywhere near each other,” said Assembly Minority Leader William Barclay in a statement to Gotham Gazette. “It's that simple. Democrats' willingness to dole out public money never wavers, and that's a persistent problem in New York.”
"There's a huge disparity in resources between what the financing board requested and what actually made it in the budget," Barclay added. "A $100 million request was ludicrous, it will be interesting to see how the program runs with 60 percent less than what the board said it needed."
Ultimately, the Public Campaign Finance Board, an arm of the State Board of Elections responsible for implementing the system, estimates it will need $100 million for matching funds for the 2024 election cycle when hundreds of legislative candidates will be seeking office across the state.
Supporters of the system were concerned that not including the full funding portended potential delays or clawbacks of the hard fought victory. Hochul has maintained that her inclusion of the $25 million demonstrates her commitment to the new program. It builds on $20.6 included in last year's budget. The remaining funding will need to be included in next year's budget in order to reach the Board’s target.
"The agreed-upon funding for the Public Campaign Finance Program and the small donor matching system is a big and important step in giving everyday New Yorkers a stronger voice in their democracy following a frustrating budget process," reads a statement from Fair Elections NY, a coalition of advocacy and labor groups pushing for the funding. "This financial commitment to New York State's landmark program will be invaluable to its first year and affirms what a majority of voters have long demanded."
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by Ethan Geringer-Sameth, reporter, Gotham Gazette
@GeringerSameth @GothamGazette
Gov. Hochul talks clean energy (photo: Darren McGee/Governor's Office)
Climate activists are cheering New York’s $229 billion budget for the 2024 fiscal year, which was approved Tuesday night, celebrating three major policy victories and a series of additional funding allocations. The changes, seen as monumental by supporters and critics alike, include passage of legislation that will ban gas hookups in new construction, allow the state power authority to build and own renewable energy facilities, and create a “cap and invest” system with decreasing caps on greenhouse gas emissions, fees on those emissions, and funding for a variety of related purposes including consumers’ energy bills.
While some disappointment remains among activists and progressive elected officials as several other measures were left on the cutting room floor, there is widespread celebration as New York takes major steps toward a renewable energy future. There is also significant skepticism among conservatives and some moderates around whether New York can and should be taking such aggressive steps.
Climate legislation was one of the areas where there appeared to be broad agreement between Governor Kathy Hochul and the State Legislature, even as they clashed on other contentious issues that delayed the budget one month past the April 1 start of the new fiscal year. Both sides agreed that urgent and ambitious action is necessary to meet emissions targets set by the state’s landmark Climate Leadership and Community Protection Act (CLCPA) of 2019. The act requires a 40% reduction in statewide emissions by 2030 and an 85% reduction by 2050 compared to 1990 emissions levels. It also requires that 70% of the state’s electricity should come from renewable sources by 2030 and that 100% of the state’s electricity should be emissions free by 2040.
Much of the climate, energy, and environmental policy agenda for the year was set by long-running efforts by climate activists and the mandated Scoping Plan from the state Climate Action Council, established in the CLCPA and released in December. In January and February, Hochul then offered her agenda, informed by that Scoping Plan, setting the stage for negotiations with the Legislature.
“New York is committed to building a clean economy and protecting our environment for future generations," Hochul said in a statement on Wednesday. “This Budget shows an unprecedented commitment to green infrastructure, reducing emissions from the building sector, and protecting clean water. I thank my colleagues in the Legislature for their collaboration on a transformational Budget that represents one of the most ambitious packages our state has advanced as we continue the fight against climate change.”
The governor’s marquee climate-related achievement is the cap-and-invest program that will impose a cap on greenhouse gas emissions, to be reduced every year, and require the state’s major emitters and fuel distributors to buy allowances for their emissions. The revenue raised from the program is meant to be directed towards renewable energy, green jobs, and environmental justice communities, with at least $1 billion set aside for rebates to help consumers with higher energy bills.
The final budget sets the foundation for the cap-and-invest program, including labor and investment provisions, and the overall program will now have to be crafted by the state Department of Environmental Conservation (DEC) and the New York State Energy Research and Development Authority (NYSERDA) over the next year.
Two other major bills that have been longtime priorities for climate advocates also made it into the budget – the All-Electric Buildings Act, which prohibits fossil fuel hookups for heating equipment in new construction starting in 2025 for buildings of seven stories or fewer, and 2028 for almost all new buildings; and the Build Public Renewables Act (BPRA), which will allow the New York Power Authority (NYPA) to build and operate its own renewable energy projects.
Assemblymember Robert Carroll, a Brooklyn Democrat who sponsored the BPRA, called it the “most important Green New Deal legislation to ever pass” in Albany. “This will ensure New York is a nationwide leader in the just and sustainable transition from fossil fuels to renewable energy. It will transform NYPA from a moribund agency to the most dynamic builder and owner of public renewables in the nation,” he said in a statement.
“New Yorkers have won the most transformational climate and green jobs bill in the nation,” said the Public Power NY Coalition, which was a major proponent behind the legislation, in a statement. The BPRA is expected to create tens of thousands of union jobs in the renewable energy sector, with prevailing wage requirements and Project Labor Agreements to ensure worker protections. The coalition did, however, criticize the exclusion of stronger mandates in the legislation, such as a proposed requirement to build new projects after 2035.
The state currently does have billions invested in renewable energy projects that have been completed or are underway including wind, solar, and hydroelectric infrastructure. Just last year, the governor signed off on the largest transmission projects in the state in 50 years, approving two renewable energy pipelines that will power New York City.
The budget also requires that state facilities and campuses be entirely decarbonized by 2040, allocating $30 million to NYPA to create decarbonization plans for 15 state facilities and another $30 million to SUNY Albany for a Thermal Energy Network. And it authorizes Suffolk County to carry out a ballot referendum on creating a recurring funding source for wastewater infrastructure.
Besides legislation, there are also several climate-related funding streams in the budget including $200 million to provide relief to New Yorkers with high energy bills, $200 million to help low-income households electrify and retrofit their homes, $500 million in clean water infrastructure funding, $400 million for the Environmental Protection Fund, and $200 million to improve state parks.
Those investments will complement the implementation of the $4.2 billion Environmental Bond Act which was approved by voters in November and the state has now begun to implement.
“I think overall we're happy with [the state budget],” said Pat McClellan, policy director of New York League of Conservation Voters (NYLCV), in a phone interview. “There's definitely still work to do.” All-electric buildings and cap-and-invest were among NYLCV’s top priorities.
A crucial measure that advocates also celebrated was additional state funding for the MTA. A well-functioning mass transit system, they say, is an essential component to reduce a reliance on polluting personal vehicles. “Boosting service frequency and reliability is one of the single best things you can do to get more people out of cars,” McClellan said.
The budget did not advance another climate-crossover policy pushed by Hochul: denser housing, especially around mass transit stops throughout the MTA region — a policy at the nexus of climate, housing, and transit. It was part of Hochul’s larger Housing Compact plan that the Legislature rejected.
Several other proposals that activists and legislators wanted did not make it into the final deal. That includes the New York HEAT (Home Energy Affordable Transition) Act, which aligns gas utility regulation and planning with the goals of the CLCPA and ensures that low- and moderate-income families don’t spend more than 6% of their income on energy bills. McClellan said the bill is essential to cut emissions from existing buildings, which are the biggest polluters in the state.
The budget also did not include a proposed phased-in ban on new fossil-fuel heating equipment that Hochul had proposed. The idea sparked a misleading narrative that the governor wanted to require the removal of gas stoves from people’s homes, and she later backed away from the proposal.
Another exclusion from the budget was the Waste Reduction & Recycling Act, a bill aimed at reducing packaging production and increasing recycling. “Those were both things that we were disappointed by because we’ve been pushing hard for them and we're certainly going to be revisiting them post-budget,” McClellan said.
Legislators and advocates who hailed the passage of the cap-and-invest program say both the executive and legislative branches must now ensure smart design of the program and make sure that there are adequate safeguards in place for the money that it raises. “There's a lot of work left to do on the program design,” said McClellan. “We would have liked to have seen some more detail in the budget bills in terms of what types of spending will happen with those revenues and what types of guardrails will be in place to make sure that we're getting serious reductions in disadvantaged communities.”
That point isn’t lost on lawmakers. Senator Pete Harckham, a Westchester Democrat who chairs the Senate’s Committee on Environmental Conservation, said in a phone interview that he and his colleagues will continue to push for mandates on how investments are funneled from the program. Harckham has sponsored the Climate and Community Protection Fund bill, which would ensure that cap-and-invest proceeds go towards accomplishing the goals of the CLCPA including building efficiency retrofits, green energy infrastructure, mass transit, affordability rebates, and more. “We’ll try and move that bill this year,” he said. Legislators have about a month of session left this year.
“While we didn’t get everything we wanted on the invest side, we got important principles in there,” Harckham added, pointing to union labor provisions with prevailing wage standards for new renewable projects that were included in the budget. “We established the principle that the governor will come back to the Legislature before spending the funds. That’s really an important separation-of-powers victory, and we put our flag in the ground about disadvantaged communities.”
He also intends to prioritize waste reduction legislation in the post-budget session. “I'm optimistic that we can get there on waste,” he said.
In a phone interview, Katherine Nadeau, deputy director of environmental group Catskill Mountainkeeper, praised the Legislature for removing a proposal in the cap-and-invest program, backed by the governor, which would have given certain businesses free allowances for emissions and for putting the revenues from the program into the budget, making it “subject to appropriation, and that is going to be a democratic process for moving those billions of dollars. out across the state to support climate solutions.”
The governor also backed away from another proposal opposed by Democratic legislators that would have changed the way that the state accounts for methane emissions.
Nadeau said the state should now move to pass the NY HEAT Act, which would also eliminate the so-called “100-foot rule” that requires utilities to install gas lines for new consumers for free if they live within 100 feet of an existing main gas line. Existing utility customers pay increased costs, effectively subsidizing fossil fuel infrastructure.
“The budget is a big, complex document and this is a great example where in some places we have definitely gained on the climate solutions front and on meeting the need that the climate crisis presents to New Yorkers, and there are other places where there's so much work to be done,” Nadeau said.
Conor Bambrick, director of policy for Environmental Advocates NY, praised the budget for taking “a significant stride towards tackling the climate crisis and protecting our most vulnerable communities.” But he expressed some disappointment that it did not dedicate funding to replace lead lines around the state. “With an estimated 500,000 of these pipes continuing to expose low-income New Yorkers and communities of color to a dangerous neurotoxin, state leaders must prioritize getting the lead out before the end of session by passing the Lead Pipe Right to Know Act,” he said. “We need decisive action to put our state on track to meet the Biden administration’s goal of 100% lead service line replacement in the next 10 years.”
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by Samar Khurshid, senior reporter, Gotham Gazette
@samarkhurshid @GothamGazette