Mental hygiene services now

Now what? That’s the question mental health providers are asking as the fallout of Gov. Andrew Cuomo’s state budget is felt in Dutchess County and throughout the state.

Cuomo’s budget severely reduced the state Office of Mental Health, which until recently managed mental health care through county departments of mental hygiene. Instead, under the budget, coordination of care will be turned over during the next two years to private BMOs (behavioral management organizations), who for a profit will determine levels of care. The role of county mental hygiene departments will be reduced merely to “consultation” status, after an earlier plan to eliminate the county role altogether was defeated.

As the privatization of the mental health field goes ahead, county leadership will need to address how the reduced county mental hygiene department will look. Certainly grievance boards will need to be created as a mechanism for checking and reviewing the decisions of BMOs when necessary care is denied. Beyond that, in all likelihood we can anticipate the eventual merger of the mental hygiene and health departments as the two become synthesized under President Obama’s healthcare model.

The larger question is what happens to access to care. Under Cuomo’s Medicaid redesign, New York state will be moving Medicaid recipients into the Health Home model championed by President Obama’s health-care reform. These virtual “homes” will function through the Department of Health to manage comprehensive health concerns of Medicaid patients — physical as well as mental.

The intent is to detect health risks early in the Medicaid population (mostly the indigent) and treat them now so as to avoid costly hospitalizations in later years. The short-term costs will be high because there will be case findings, and the expectations are that the costs will be much higher than traditional services today.

There is also concern that with limited dollars, that BHOs will prioritize physical health needs at the expense of mental health services. Already the shift toward health homes is moving away from mental health care to a more comprehensive model with existing “mental health case managers” given enlarged responsibilities and renamed “care coordinators.”

 At present there are no safeguards to ensure acceptable levels of mental health treatment for patients. Last week Medicaid recipients were notified by mail that some prescriptions would be discontinued when the changes are fully implemented.

There is also fear that change is taking place too fast. The Medicaid Redesign Team was hurrying to have the health home model implemented by Tuesday,  Nov. 1 (this deadline has since been extended), in keeping with state budget projections to take advantage of favorable federal reimbursement. Under the Obama health-care plan, the federal government will cover 90 percent of health-care costs associated with health homes for two years. It is unclear what happens when the two years are up.

The sum result at present is chaos, with the future of mental health services in New York state best described at a recent provider meeting as a thick bucket of fog. The only clarity is that the driving force is not quality of care, but the dollar.

Michael Kelsey represents Amenia, Washington, Stanford, Pleasant Valley and Millbrook in the County Legislature. Write him at KelseyESQ@yahoo.com.

Latest News

The artistic life of Joelle Sander

"Flowers" by the late artist and writer Joelle Sander.

Cornwall Library

The Cornwall Library unveiled its latest art exhibition, “Live It Up!,” showcasing the work of the late West Cornwall resident Joelle Sander on Saturday, April 13. The twenty works on canvas on display were curated in partnership with the library with the help of her son, Jason Sander, from the collection of paintings she left behind to him. Clearly enamored with nature in all its seasons, Sander, who split time between her home in New York City and her country house in Litchfield County, took inspiration from the distinctive white bark trunks of the area’s many birch trees, the swirling snow of Connecticut’s wintery woods, and even the scenic view of the Audubon in Sharon. The sole painting to depict fauna is a melancholy near-abstract outline of a cow, rootless in a miasma haze of plum and Persian blue paint. Her most prominently displayed painting, “Flowers,” effectively builds up layers of paint so that her flurry of petals takes on a three-dimensional texture in their rough application, reminiscent of another Cornwall artist, Don Bracken.

Keep ReadingShow less
A Seder to savor in Sheffield

Rabbi Zach Fredman

Zivar Amrami

On April 23, Race Brook Lodge in Sheffield will host “Feast of Mystics,” a Passover Seder that promises to provide ecstasy for the senses.

“’The Feast of Mystics’ was a title we used for events back when I was running The New Shul,” said Rabbi Zach Fredman of his time at the independent creative community in the West Village in New York City.

Keep ReadingShow less
Art scholarship now honors HVRHS teacher Warren Prindle

Warren Prindle

Patrick L. Sullivan

Legendary American artist Jasper Johns, perhaps best known for his encaustic depictions of the U.S. flag, formed the Foundation for Contemporary Arts in 1963, operating the volunteer-run foundation in his New York City artist studio with the help of his co-founder, the late American composer and music theorist John Cage. Although Johns stepped down from his chair position in 2015, today the Foundation for Community Arts continues its pledge to sponsor emerging artists, with one of its exemplary honors being an $80 thousand dollar scholarship given to a graduating senior from Housatonic Valley Regional High School who is continuing his or her visual arts education on a college level. The award, first established in 2004, is distributed in annual amounts of $20,000 for four years of university education.

In 2024, the Contemporary Visual Arts Scholarship was renamed the Warren Prindle Arts Scholarship. A longtime art educator and mentor to young artists at HVRHS, Prindle announced that he will be retiring from teaching at the end of the 2023-24 school year. Recently in 2022, Prindle helped establish the school’s new Kearcher-Monsell Gallery in the library and recruited a team of student interns to help curate and exhibit shows of both student and community-based professional artists. One of Kearcher-Monsell’s early exhibitions featured the work of Theda Galvin, who was later announced as the 2023 winner of the foundation’s $80,000 scholarship. Prindle has also championed the continuation of the annual Blue and Gold juried student art show, which invites the public to both view and purchase student work in multiple mediums, including painting, photography, and sculpture.

Keep ReadingShow less