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Central NY Regional Centers of Excellence Team highlights kinks in OMH centralization plan that need to be worked out

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SYRACUSE — As the state Office of Mental Health moves forward with plans to centralize mental health care in New York, including a call to close inpatient facilities at the St. Lawrence Psychiatric Center in the process, experts are making recommendations to help guide the undertaking.

Nearly 30 stakeholders, including county officials and industry leaders, gathered last week at Hutchings Psychiatric Center for the second of three meetings of the Central New York Regional Centers of Excellence Team that is helping formulate the statewide shift away from inpatient care.

OMH Co-Chair Linda Nelson, representing the Central New York Field Office, said, “Our purpose is solely a planning discussion, a priority discussion about what it’s going to take to assist these recipients [of mental health care] when they are not inpatient because they won’t be inpatient as often or as much in the new model.”

Taking top priority in the latest meeting was the need to bolster outpatient care if inpatient facilities like the St. Lawrence Psychiatric Center are to close.

The current plan will see the children’s inpatient care facility relocated to Utica with adults being sent to Syracuse.

“We’re reinventing an entire domain,” Mrs. Nelson said. “What an exciting time to be in the mental health business. I find it energizing.”

St. Lawrence County Community Services Director Angela M. Doe said, “If I’m on board with this change in our structure and our move to more community based services, which I’m an advocate for, I’ll openly say that, but how is it that I’ll take care of the expenses that are incurred by my hospital?”

Ms. Doe also expressed concern over the ability of county governments to implement the services they feel will be necessary to fill the vacuum in mental health care left by the closure of inpatient facilities.

“As much as I understand the importance of community based services and how they serve as barriers for folks who may not have needed to be hospitalized, I still am struggling with figuring out what it is that I can do in rural, upstate New York and St. Lawrence County if spaces for children in particular are not available,” she said. “What I’m the most concerned about is losing that level of care and replacing it with the ‘potential’ of community based services.”

Art Johnson, director of Community Services in Broome County, said caution needs to be exercised as the state attempts to rely more heavily on community based care.

“In Broome County, the county jail is the largest mental health provider in the county,” Mr. Johnson said. “One hundred fifty beds every day of the week are occupied by mentally ill individuals who are being prescribed medication by their psychiatrist.”

Mr. Johnson said, unless the state wants more mental health patients to end up in jail, proper levels of funding will need to be established to support outpatient and community based care facilities.

Clinical Services Vice President and Chief Operating Officer Vicki Perrine, who is acting as community co-chair for the Central New York RCE Team, said local hospitals will be impacted by the shift to outpatient care unless new services are put into place quickly.

“I think that once you pull out the children’s inpatient services, from a hospital perspective, one of our main concerns is that we’re going to see more children in the [emergency room],” Ms. Perrine said. “It’s difficult to find beds when they do need services and they stay there for days. We’ve had some for weeks. But again, I’m onboard with what we’re doing here and am hopeful that we are going to get some services out in the community that will prevent folks from needing hospitalization.”

The RCE Team will meet one more time before delivering its recommendations to the Regional Centers of Excellence Steering Committee in late fall. The recommendations will eventually make their way to the OMH commissioner as part of the final plan to restructure mental health care in the state.

“I think the thing that I want to be sure that I say publicly is that, while we’ve been creative – we have a number of [community based] services – it doesn’t even skim the surface when we’re talking about an increased amount of [mentally ill] individuals in the community,” Ms. Doe said.

Charles “Chuck” W. Kelly, chair of the St. Lawrence Psychiatric Center Task Force working to prevent the closure of inpatient care facilities in Ogdensburg, said the meeting isn’t ruffling their feathers.

“They’ve got three or four months of meeting, then they come up with a game plan and present it to the higher ups,” Mr. Kelly said. “Then it becomes a real issue.”

Mr. Kelly said the task force is focusing on a meeting with Gov. Cuomo’s executive staff in December, where they hope to present a compelling case for keeping the St. Lawrence Psychiatric Center open with inpatient care facilities. “We’re going a step higher [than the RCE Team],” he said.

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