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���ϲ����� Note: ���ϲ����� and other advocates continue to call for the 8.5% COLA to be enacted with this year’s final budget. We must keep the pressure up to guarantee we have funding to save our staff and services! You can send emails to legislators asking them to support the COLA by clicking . We will continue to send updates on the process of negotiations and how you can continue to advocate for this desperately needed investment.

���ϲ����� State Advocates Push for Increased Workforce Investments
By   Mental Health Weekly March 31, 2023

As ���ϲ����� state legislators and the governor negotiate the 2024 executive state budget, mental health advocates, providers, and the state’s entire health services sector continue to ramp up efforts to push for additional workforce funding and enact an 8.5% cost-of-living adjustment (COLA) increase in the final budget agreement.

Gov. Kathy Hochul’s proposed FY 2024 budget includes a $1 billion investment to transform ���ϲ�����’s continuum of mental health care, which includes allocating increased investments to develop new residential units, increasing capacity for inpatient psychiatric treatment, expanding mental health services in schools, and an expansion of outpatient services, according to a ���ϲ����� State Division of the Budget news release.

Advocates and providers are seeking an 8.5% COLA in the state budget for community-based mental hygiene and human services providers. The governor is proposing a 2.5% COLA, which advocates say is not enough. Meanwhile, the state’s Assembly and Senate lawmakers have added their support, along with mental health and health care organizations, for an 8.5% COLA.

Increased Advocacy
On Feb. 16, several advocacy groups from around the state descended on the state capital, Albany, ���ϲ�����, to rally for changes in the mental health delivery system and call for the increased COLA funding.

A billboard strategically placed on highways around the ���ϲ����� State Capitol building and its legislative office building read: “8.5% COLA for Human Services,” “Retain Staff and Keep the Lights On.”

The use of a billboard as an advocacy tool might represent the first time that one has been used, noted Glenn Liebman, CEO of the Mental Health Association in ���ϲ����� State (MHANYS). Additionally, letters and, last week over a 24-hour period, a push for 1,000 phone calls to be sent to legislators and representatives in order to keep the 8.5% COLA in the final budget.

The community has asked for a COLA increase for many years, even as it was mandated in law, said Liebman. Legislation was introduced 17 years ago to provide a COLA to the human services workforce, he said. “While it was funded for the first year, almost every year since then, the governor has chosen to ‘not withstand’ the language in the budget, explained Liebman. “Notwithstanding essentially means that the governor does not have to allocate COLA funding in a given year. Much of those 17 years, either there was no COLA, or a limited COLA.”

“Over the past 17 years, we have lost $600 million to our behavioral health system by not having the COLA annually,” said Liebman. If the system had been well-funded, more staff could have aided in people’s recovery and there would be less death and despair, he said.

Instead of including the entire 8.5%, despite our advocacy, the governor put in 2.5%, said Liebman. “We’re at a negotiating point now between the legislature and the governor to determine how much COLA will be this year,” he said.

The governor’s proposed budget is a “tremendous” one, serving important programs and services. However, you need a workforce to make this a success, he said. “If you don’t have a workforce to run [programs and services], then what’s the point?” Liebman noted.

“We worked with the legislature,” said Liebman. The ���ϲ����� state Senate and Assembly have agreed on what’s being dubbed a one-house bill and added in the 8.5% COLA. “We’re excited,” said Liebman. It’s not just the mental health community pushing for the increase, but the entire human services sector, he said. A budget resolution was expected last week, but it might be extended, Liebman noted.

The first priority is the 8.5%, he added. “The next step is to continue all [the] work we have done over the last several months to raise awareness and to raise visibility [about the issue].”

Mission-driven
“People come into our field because they’re mission-driven,” Liebman noted. “However being on a mission doesn’t pay the rent or put food on the table. We’ve had so many vacancies and turnovers,” he said. “It’s been very difficult to recruit and retain qualified staff.”

“As an entire behavioral health community, we’re struggling with our workforce,” said Liebman. “It’s difficult to retain the workforce when they can get other jobs with different pay in different fields,” he said.

It’s a very difficult job at times and dealing with individuals with complex needs, he noted. “Why would [health sector staff] stay if they could get much easier jobs,” he said. They believe in their jobs, but they can’t afford to stay, he said. “It’s a very sad commentary on society as a whole,” Liebman noted.
“People are so important in our community, oftentimes, people who are the least paid. These people are changing lives every day in the trenches.”

‘Historic’ Investment
“The governor’s investment of $1 billion in new services is historic, but unless we address the crisis in our existing services and staffing, we will only be building on sand,” Harvey Rosenthal, CEO of the ���ϲ����� Association of Psychiatric Rehabilitation Services, told MHW. “In the context, an 8.5% across-the-board COLA is critically necessary to allow agencies to try to hold onto their existing service capacity and staffing in advance of systemic expansion.”

The joint mental health budget committee is supposed to be done April 1, said Rosenthal. However, it may be another week or so before negotiations are finalized. “It’s still an accelerated pace,” said Rosenthal. “We’re continuing to lobby from all sides — at the committee level, the chair level and executive legislative staff,” he said. “The entire human services sector is behind this.”

“I’m always looking at this from the point of view of the people being served,” added Rosenthal. There are high turnover rates, long waiting lists, or services are suspended, he said. “We can’t take in more people,” Rosenthal said. They’re the ultimate victim — the people waiting for service. They’re looking to make relationships with staff who are less and less available.”

Rosenthal added, “It’s a crisis for the system, but ultimately for the people as well.” It’s becoming harder for providers to deliver existing services, he noted, especially when rising costs are not dealt with. We need a more dramatic contribution.”

Last year, Gov. Hochul’s 2023-2023 executive budget included a 5.4% COLA which was helpful, said Rosenthal (see “���ϲ����� MH advocates laud investments in proposed budget” MHW, Jan. 32, 2022; ).

While the governor has currently provided the “best budget,” with investments up and down the system, including expanded housing, rehabilitation services, and the addition of 3,500 beds over the next five years, without being able to pay staff and expenses, or add new services, it doesn’t bode well for success, Rosenthal said.

“We’re in such a crisis now,” said Rosenthal, adding that the proposed 2.5% COLA is nowhere near enough. COLA impacts across mental health, addiction, social services, and child welfare. “This is a human services issue. This is a crushing crisis for us all,” he said.

BH Provider Input
The executive director at the ���ϲ����� State Council for Community Behavioral Healthcare said behavioral health providers are concerned over staff vacancies and waiting lists. “Our sector, and specifically mental health and substance use disorder community-based agencies, are suffering with staff vacancy rates that approach 40% in some areas of the state,” Lauri Cole, L.M.S.W., told MHW. As a result, there are long waiting lists for services across the public mental hygiene system, she said. “It is in the state’s best interest to ensure ���ϲ�����ers experiencing mental health and/or substance use disorder challenges get the care they need quickly, and certainly before the need for more acute services becomes necessary,” Cole stated.

She added, “Our inability to compete with just about every other business on salaries, coupled with reimbursement rates that are relatively flat, is a one-two punch our sector cannot maintain. We implore state leaders to respond to this crisis by enacting an 8.5% COLA in the final state budget agreement, and by addressing reimbursement rates that do not reflect significantly increased expenses associated with operating our programs and services.”