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Q&A
Council Member Linda Lee questions DOHMH on mental health programs and school-based services
1:53:59
·
9 min
Council Member Linda Lee engages in a detailed Q&A session with officials from the Department of Health and Mental Hygiene, focusing on various mental health initiatives, school-based mental health services, and funding for these programs. The discussion covers topics such as crisis respite centers, community connection centers, school-based mental health clinics, and clubhouses.
- Lee inquires about the differences between crisis respite centers and community connection centers, emphasizing the need for more beds in mental health facilities.
- Questions are raised about funding and expansion of school-based mental health clinics, including challenges with startup costs and reimbursement rates.
- The conversation touches on the Mental Health Continuum program and its potential for expansion, as well as the possibility of allowing DOE to bill for ABA services.
Linda Lee
1:53:59
Okay.
1:54:00
I'm just gonna ask a few follow-up questions and then we'll move on.
1:54:06
Actually okay.
1:54:07
So a quick question actually going back to the bronch support location that you were talking about, the $5,000,000.
1:54:14
That how is that different from what is the crisis respite centers?
1:54:20
And I know that we had come up with a local law to increase the number of crisis respite centers and I just was thinking when you guys were talking about it, is that a possible you know place where we could maybe increase in a different program that we really need those beds for?
1:54:36
So I just wanted to ask that out of curiosity.
Michelle Morse
1:54:38
I'll pass to Doctor.
1:54:39
Wright to share a little bit about the difference between the community connection centers and the respite Thank
Jean Wright
1:54:47
you commissioner.
1:54:48
So as you indicated, the crisis residents which were formerly the respite provide an alternative to hospitalization.
1:54:55
So individuals that tend to go to those places tend to stay about three weeks on average, but it could be less.
1:55:04
And these are not individuals that are homeless from the traditional sense of word, but they have places to live, but they don't meet the necessity to go to a hospital.
1:55:13
So it's as a syndicated a place where people can get support.
1:55:17
It's an open door setting they can continue their daily activities.
1:55:21
It's trained peers and non peers that help and work with individuals to help them successfully overcome this emotional stress that is temporary, and so this is a temporary setup that they have.
1:55:33
And in terms of the connection center, I think that is something that Assistant Commissioner Jamie Nichols talked about earlier in terms of step down from the standpoint of if you don't necessarily meet the criteria for IMT or FACT to continue or ACT to continue then that connection center is another alternative for individuals who are in between care that they need.
1:55:55
And so I don't know Jamie if you want to elaborate on anything more, but that would be how I see the difference.
Linda Lee
1:55:59
Okay.
1:56:00
I think the thing that made me think of both of them was when you said the brief stay because in my mind I'm thinking CRCs as well as the connection centers would be brief stays and so I just wanted to I'm always trying to think of how we expand the beds.
Jamie Neckles
1:56:14
Yeah, and I think they are increasing.
1:56:16
So support and connection center people are staying about three days, much more brief.
1:56:19
Crisis residences about three weeks.
1:56:22
And there's an expansion of crisis residences.
1:56:25
We really appreciate the council's support and advocacy on behalf of the service.
1:56:29
We started out with four ten years ago in the city that crept up to eight.
1:56:32
We're at 11 crisis residences citywide.
1:56:36
So we're headed in the right direction.
Linda Lee
1:56:37
Okay.
1:56:39
But still whenever I hear 11 I'm like, in a city of our size it kills me a little bit, but yes it is an improvement.
Jamie Neckles
1:56:46
Those are sites, not beds.
Linda Lee
1:56:48
Okay, sites, okay good.
1:56:50
Because I know previously when we talked about beds there were such a low number in the city, so hopefully that has got what are the total beds now?
Jamie Neckles
1:56:57
I walked into that question didn't I?
1:57:01
I think it's about 60 we can get back and confirm with you on that.
Linda Lee
1:57:05
Oh 60?
1:57:06
Yeah.
1:57:06
Okay.
1:57:11
Thank you.
1:57:12
Okay I'm just gonna skip around really quickly to the school based mental health clinics.
1:57:16
So I know that you said there's 26 new Article 31s and seven pending.
1:57:20
So having run an Article 31 or started one myself, I know it's a very painful process and so essentially if you look at it from the standpoint of an Article 31 clinic, if I'm running the clinic, it's essentially another satellite location and there's definitely startup costs to that and I know one of the things that the providers were having issues with was the low amount of startup costs to their sites and I think that was actually one of the big barriers that they were facing along with you know the reimbursement rates and the staffing and everything.
1:57:49
So I just wanted to know have there been any changes to that, have there been any discussions to potentially increasing that portion or other supportive services for the school based mental health clinics?
Michelle Morse
1:58:03
Yeah thank you for the question.
1:58:04
The school based mental health clinic both licensing process as well as the startup funds, is run by the Office of Mental Health at the state and we are always in conversation with them.
1:58:15
We have also heard the concern about the $25,000 that school based mental health clinics are automatically eligible for when they start a new clinic is not being adequate.
1:58:27
However, again, this is really an office of mental health decision at the state level about potentially changing some of those funds.
1:58:36
We also are aware that some of the high need schools where more than half of the students are coming from economically marginalized households, they're eligible for an additional $20,000 in startup costs.
1:58:50
So that's kind of focused again specifically on schools where the needs are at a higher level.
Linda Lee
1:58:57
Okay, mental health continuum, I ask this question every year.
1:59:01
It's such a great program and there are 16 school based mental health clinics covered under the current funding for 5,000,000.
1:59:09
So this is definitely one of I think of the impactful programs that I hear very positive things about and just wanted to know what the likelihood is in terms of baselining this, and if there are any plans to increase the funding levels currently, as well as maybe expand on how many centers there are?
Michelle Morse
1:59:34
Yes, the Mental Health Continuum Program funds both NYC public schools, H and H, and ourselves, so kind of the triad of agencies to work together to expand school based mental health clinics.
1:59:47
As you mentioned there are 16 that open this year.
1:59:50
But we in the health department, out of that 5,000,000 we receive about $470,000 of those funds.
1:59:57
Our role really is mostly focused on the technical assistance, ensuring the quality of the care at the school, based mental health clinics, and partnering with the providers that are running the clinics at the schools.
2:00:10
So our role or lane within the school based, within the mental health continuum is very narrow in that way.
Linda Lee
2:00:19
Is there an appetite to get more involved in that?
Michelle Morse
2:00:23
I would encourage you to talk with Health and Hospitals.
2:00:28
They've been leading the development of additional clinics as a part of the mental health continuum.
Linda Lee
2:00:34
Okay because I would imagine there's definitely a need for it so I'm just trying to figure out what the level of engagement should be but yes.
2:00:41
Okay and then oh this is a question I don't know how much oversight you have because this is more of a state issue but I'm just curious to know if you've heard anything about the ABAs.
2:00:56
I know that the state allows and maps out Medicaid billing right now.
2:01:01
DOE currently, I know this is more of a DOE thing but I'm just curious if there's any overlap, is not permitted to bill for ABA services and do you think that ABA services are an effective tool in school based mental health services and if so would you advocate for the state to permit DOE to bill for that?
Michelle Morse
2:01:22
I think we'd have to get back to you on that question.
Linda Lee
2:01:24
Okay yeah I'm just curious because I think the more support we can get to actually get this money to New York City schools would be great because currently they can't bill for it.
2:01:32
So maybe that's a conversation we could have more offline, but of course Gail has asked a lot of my questions and you know concerns around the clubhouses which you know we feel very strongly about in terms of the smaller clubhouses to make sure that they're funded, so that is something that we will continue to advocate for.
2:01:53
And just currently I know that the new clubhouses and the new RFP that was given out for the current contractors, pretty much all of them on track to opening and following the timeline or are there still hiccups with finding new locations if they need new locations?
2:02:12
If you could give us a status update on the current ones.
Michelle Morse
2:02:15
Absolutely yes, 12 of the 13 clubhouses are open and running, so we are seeing great progress in our new clubhouses.
Linda Lee
2:02:25
Okay 12 out of 13, and what's the reason for the last one not being able to open?
Michelle Morse
2:02:30
We can get back to you on that.
Linda Lee
2:02:31
Okay, alright thank you.
Sarah Sears
2:02:35
That's it for me, yeah.
Justin Brannan
2:02:37
Okay, thank you all very much.
2:02:39
Appreciate your testimony.
2:02:40
We will get started with the second portion very, very shortly.
Linda Lee
2:02:44
Yeah, was like, wait, don't leave.
2:02:46
Don't leave.
2:02:46
Don't And just for all the advocates here for the mental health piece and the community leaders, I just wanted to personally say I'm sorry I can't stay for the public portion, IU.
2:02:55
That's actually usually my favorite part, but I'm trying not to get disowned by my family because there's an obligation I need to go to, so just wanted to put that out there for the record.
2:03:04
Thank you.