In January 2001, I was appointed by Assembly Speaker Sheldon Silver to chair the Assembly Committee on Mental Health, Mental Retardation and Developmental Disabilities. This appointment has been an enormous, but interesting challenge. I have had to learn the intricacies of a complex mental hygiene system, including funding mechanisms, methods of providing services, treatment and service philosophies, and the day-to-day needs of recipients of mental hygiene services in New York. I have also had the extraordinary opportunity to meet and begin to work closely with over 100 groups representing mental health care recipients, families, providers, funders and advocates. Together, we crafted a mental health legislative program which, when fully enacted, will provide for the immediate needs of New Yorkers with mental illness, developmental disabilities or mental retardation, and serve as a foundation for a long-term structure of services that will help meet these needs for years to come.

Below are brief outlines of some of the pieces of legislation I have introduced, as we begin to move into the second half of the 2001-2002 legislative session.

A.8466-b — Health Care Decisions Act for Individuals with Mental Retardation — This measure delineates the scope of medical decisions that court-appointed guardians may make on behalf of an individual who lacks the capacity to make such decisions for him or herself. The bill includes a carefully-controlled legal and medical process to make such decisions, including decisions regarding the withdrawal or withholding of life-sustaining treatment. This bill was passed by the Assembly on June 26th, but was not acted upon by the Senate.

A.4506 — Fair Insurance Treatment Act of 2001 — This bill requires that all insurance companies and HMOs that offer health insurance must also provide coverage for mental health and substance abuse services. Furthermore, the bill mandates that such coverage must be provided on the same basis as all other coverage, including costs to the insured. Thirty-two other states have enacted similar parity legislation that prohibits discrimination against those suffering with mental illness and/or substance abuse problems. A.4506 was passed in the Assembly on July 17th and awaits action in the Senate.

A.5971-c — Waiver of State’s Sovereign Immunity Under the Americans with Disabilities Act — In February of this year, the U. S. Supreme Court ruled that the Americans with Disabilities Act (ADA) does not permit lawsuits to be brought by state employees against the state in federal court. Upon hearing of this decision, I immediately introduced this bill to restore the right of individuals employed by the state to sue the state for failing to provide "reasonable accommodation and access" in the workplace under the ADA. A.5971-c passed the Assembly on June 25th, but was not acted upon by the Senate.

A.8994-a — Medicaid Access for Individuals Coming Out of Jails and Prisons — Often, when inmates are released from jails and prisons, they have no means of paying for necessary health, mental health and related services and medications. This is especially problematic for those facing mental illness or substance abuse issues. This bill would require correctional facilities to file applications for Medicaid on behalf of inmates expected to be released from a state prison or county correctional facility. Providing eligible individuals with access to such services and medications when they are discharged will help end the ‘revolving door’ effect so common with released inmates. This bill has been referred to the Assembly Committee on Correction.

A.3162 — Children’s Bill of Rights — This bill will protect children placed in residential programs who are often moved to different facilities and programs across service systems. This will establish a clear and consistent set of principles to guide the care and treatment of all children placed out-of-home. The Assembly passed A.3162 on April 2nd, but the Senate failed to take action.

A.9081, A.9082, A.9083,A.9084 — Electroconvulsive Therapy — The committee has also focused on Electroconvulsive Therapy (ECT), a procedure used to treat certain mental illnesses by directing electrical current through the brain. These four bills have been introduced to gain more knowledge about ECT administration throughout the state, to ensure that ECT is practiced safely and proper notification has been provided to the patient. All four of these bills have been introduced and reported to the Committee on Mental Health, Mental Retardation and Developmental Disabilities, where we are continuing to examine the issue and make amendments to the bills.

Planning goals and objectives — While no legislation has been introduced as of yet, the committee — in conjunction with the Committee on Alcoholism and Drug Abuse — has convened public hearings in Albany and Buffalo regarding the need for state-wide planning goals and objectives, and the effectiveness of services to those with multiple disabilities. As presently written, the Mental Hygiene law requires the offices of Mental Health (OMH), Mental Retardation and Developmental Disabilities (OMRDD), and Alcohol and Substance Abuse Services (OASAS) to establish goals and objectives, with input from all who would be affected, for the provision of services for the disabled, including individuals with multiple disabilities. The committees conducted a third and final hearing in New York City on January 24, 2002.

I look forward to continuing with this agenda to ensure that New York State properly serves those vulnerable New Yorkers suffering from mental illnesses, developmental disabilities and mental retardation.

"The tragic events of September 11th had a profound impact on New York State’s financial outlook. However, I am doing everything in my power to ensure that a fair share of the state’s available resources will go to agencies that provide services to individuals with mental illnesses, mental retardation and developmental disabilities." Assemblyman Martin A. Luster Chair For further information on Mental Health issues, contact the Committee at: Room 826 LOB Albany, New York 12248 (518) 455-5444 or see the ‘Mental Health’ link of the "Committees, Commissions, and Task Forces" section

On March 21st, 2001, the Assembly passed, as part of its overall budget resolution, the committee’s fiscal plan in the areas of mental health, mental retardation and developmental disabilities. This plan was issued in response to Governor Pataki’s 2001-2002 state budget proposal released in January. This included proposals to close two state adult psychiatric hospitals, consolidate four children’s psychiatric centers, and use the savings to fund a cost-of-living adjustment (COLA) and Medicaid fee increase for mental health service providers. The plan to close and consolidate these facilities was a surprise to the entire state mental health community, including residents, families and those in nearby communities.

In an attempt to formulate the Assembly’s mental health budget proposal, the committee held a public hearing on February 14th to gain input from one of the communities most affected by the proposal – the Greater Syracuse/Central New York region covered by the Richard H. Hutchings Psychiatric Center in downtown Syracuse. Nearly everyone who testified at the hearing and wrote or called the committee expressed their opposition to the Governor’s proposal to close Hutchings and Middletown Psychiatric Centers.

The committee also hosted a roundtable discussion on March 8, 2001, to discuss the Governor’s proposed consolidation of four children’s psychiatric centers. Under Governor Pataki’s proposal, the Queens Children’s Psychiatric Center, the Rockland Children’s Psychiatric Center, the Sagamore Children’s Psychiatric Center and the Western New York Children’s Psychiatric Center would be relocated onto the grounds of existing adult psychiatric centers in the vicinity. The committee’s roundtable discussion included families, advocates and professionals in the field of children’s mental health, as well as many other interested parties. The overwhelming majority of those who attended the roundtable stated that the consolidation of these four children’s psychiatric centers with adult facilities were completely unacceptable.

As a result of the February 14th hearing and the March 8th roundtable discussion, the Assembly crafted a state budget proposal that rejected the Governor’s plan to close and consolidate state psychiatric facilities. While the Assembly recognizes that the in-patient psychiatric hospital census continues to decline, the Assembly was forced to reject the Governor’s proposal due to the total lack of planning and consultation with people who would be most affected by these closures and consolidations, as required by law.

To ensure such consultation, the Assembly budget resolution required that a formal, detailed plan for the future use of all state-operated mental health facilities, including the required consultation, be submitted to the legislature by October 1, 2001, and annually thereafter. The plan must document that the families of children and adults who would be affected by a particular proposal have been included in the decision-making process. Also, if state-owned mental health facilities were to be closed, the Assembly’s plan would require that all of the net proceeds from the sale of OMH property be used for capital projects by community-based providers.

In addition, the Assembly’s mental health proposal included a 10% increase in Medicaid fees for community-based, mental health outpatient service providers and also a minimum 2.5% COLA for 3 years to residential and non-residential community service providers. Our plan would finance these increases through the state’s reduction of the adult in-patient psychiatric center beds by 625 over the next three years. While both the Governor and the Assembly proposed funding increases to service providers, the Assembly did so without tying those increases to any particular closings or agency consolidations. The Assembly’s budget proposal also appropriated $3 million for an adolescent mental health demonstration project intended to develop innovative residential and treatment programs to address the unique needs of mentally-ill adolescents up to age 21. Also, to begin to address the extraordinarily high staff turnover rates experienced by community-based voluntary providers, the Assembly proposed $100,000 to be allocated to each of two state offices, OMH and OMRDD, to identify strategies that can assist voluntary providers in recruiting and retaining skilled staff.

Additionally, the Assembly’s budget resolution included continued funding for the NYS-CARES program, operated by OMRDD, and an additional $1.6 million which would be fully matched with federal funds to support innovative workforce recruitment and retention initiatives. The Assembly approved the Governor’s 3.52% COLA for Medicaid-funded, community-based, not-for-profit providers, but extended that adjustment to include Medicaid-service coordinators who were excluded from the Governor’s plan — an increase of $1.6 million.

On August 2, 2001, after months of attempts to negotiate a budget, the legislature grew weary of the Governor’s unwillingness to negotiate and passed a ‘base-line’ budget, with the intention of returning to Albany to address any shortfalls. Funding for the 10% Medicaid fee increase, the 2.5% COLA, and all other initiatives included in the Assembly budget proposal were not included in the ‘base-line’ budget. Before the legislature returned to Albany to attempt to negotiate a ‘supplemental’ budget with the Governor, the tragic events of September 11th occurred. With the attack on the World Trade Center came an entirely different financial outlook for the state.

After a careful assessment of the financial resources the state has lost and the resources remaining, the legislature passed, and the Governor signed, supplemental budget legislation to allocate $200 million for non-profit organizations that provide health services and emergency relief services. This small allocation of money will assist providers to meet the increased demand on their services. We acknowledge that the sum is inadequate and we hope that the 2002-03 budget will realistically recognize this deficiency. At this time, determinations are still being made about the amount of funding the different areas within the health and human services field will receive. However, I can assure you that I am doing everything in my power to ensure that a fair share of that money will go to those agencies that provide services to those individuals with mental illnesses, mental retardation and developmental disabilities.