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PUBLIC TESTIMONY
Testimony by Chelsea Rose, Policy and Advocacy Manager at Care for the Homeless
1:32:42
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Chelsea Rose from Care for the Homeless testified about challenges in providing healthcare to homeless individuals with disabilities. She highlighted issues with telemedicine reimbursement, an aging shelter population, and long-term psychiatric disabilities.
- Telemedicine has become crucial, but Medicaid reimbursement rates are insufficient
- Shelters are struggling to accommodate older adults with serious mental illness or dementia
- There's a lack of coordinated care and housing for individuals with long-term psychiatric disabilities
Chelsea Rose
1:32:42
Good afternoon.
1:32:43
My name is Chelsea Rose and I'm the policy and advocacy manager at Care for the Homeless.
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Thank you to the members of the committee for the opportunity to testify today.
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Care for the Homeless has been providing medical and behavioral health services exclusively to people experiencing homelessness in New York City for over forty years.
1:33:01
We operate 23 federally qualified health centers across all five boroughs and they're co located in shelters, soup kitchens and drop in centers.
1:33:09
Nearly forty percent of the over twelve thousand patients we served last year are living with chronic health conditions that qualifies disabilities.
1:33:17
Our model of care is built around accessibility, bringing care directly to where people are and removing barriers in a system that is often too complex to navigate, especially for people with co occurring chronic conditions, psychiatric disabilities, and cognitive impairments.
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Today I want to highlight three challenges.
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First, telemedicine, which has become a lifeline for many of our patients, particularly those who are older or managing chronic conditions.
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Last year twenty eight percent of our visits were done via telehealth, half of which were for behavioral health.
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Yet Medicaid only reimburses a fraction of the in person rate.
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This places an enormous strain on our providers.
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We urge the council to support payment parity at the state level so we can sustain this essential care model.
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Second, an aging shelter population.
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We're seeing older adults with serious mental illness and or dementia in shelters.
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Long term care facilities often turn them away, leaving people stuck in shelters that aren't equipped to meet their needs.
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This leads to fragmented care and a significant strain on an already overburdened system.
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Third, long term psychiatric disability.
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Many of our clients have cycled through hospitals, shelters, and the streets for decades without successfully accessing coordinated care services or stable housing.
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Hospitals frequently discharge patients with known histories of homelessness and mental illness without a clear path to housing or continuing treatment.
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Shelters are left to fill the gap, but they are not equipped to manage complex psychiatric needs.
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These are systemic issues that require systemic solutions.
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We need telehealth to be fully funded, long term care options to be expanded, and real pathways disability for people with chronic mental illness.
1:35:02
Thank you for your time and your commitment to health and dignity of all New Yorkers.
1:35:07
Thank you.