1999 Outpatient Assisted Treatment Legislation in New York
In 1999, the NYS Legislature will most likely consider a bill to start statewide Outpatient Assisted Treatment. Outpatient Assisted Treatment is a court order requiring an individual to do certain things (such as stay in treatment) as a condition for staying in the community.
Governor Pataki has announced that he will introduce a bill and Senator Libous has also indicated his intent to introduce a bill. As of April 1999, these bills have not yet been introduced. NYC Dept. of Mental Health is also circulating an unintroduced bill.
There are currently (5/1999) at least 5 bills that have been introduced in New York. The first three are based on a pilot program that has been going on at Bellevue Hospital in New York, while the second two are based on a proposal put forward by Attorney General Eliot Spitzer. Those based on the Bellevue pilot are vastly inferior to those based on the Attorney General’s proposal.
In 1995, the state legislature authorized the start of a pilot outpatient assisted treatment program at Bellevue Hospital. At the end of the pilot, the legislation required New York City to issue a report on the efficacy of the program and make a suggestion to the legislature as to whether the program should be extended, ended, modified, and/or expanded to rest of state.
New York City commissioned Policy Research Associates in Delmar, NY (Henry Steadman) to do a study of the Bellevue pilot. The studies findings were discussed at a public Hearing on December 16, 1998. Unfortunately, the PRA report had so many flaws that few conclusions could be drawn from it, and many of those PRA attempted to draw from it, were not supported by the study. Advocates noted that similar flaws were found in another PRA Study they conducted on behalf of the McArthur Foundation. The flaws in the PRA study and discussion of conclusions that can be drawn from it is presented elsewhere on this site.
The NYC Department of Mental Health, Mental Retardation and Alcoholism Services (DMHMRAS) held legislatively mandated public hearings on December 16, 1998 in conjunction with the NYC Health and Hospitals Corp. Many families, providers, doctors and others testified in favor of expanding the program statewide.
On April 1, 1999, NYC publicly announced a plan to expand the program statewide. The bill is exceedingly weak and contains numerous provisions to make sure that it is rarely used.
The disadvantages of the Bellevue Program are
1. You have to be currently in the hospital in order to get into it.
2. Only the hospital (not families and others) can petition the court for outpatient assisted treatment
3. You have to have an extensive history of prior hospitalizations to be eligible for the program.
4. It is not statewide.
On March 1, 1999, Assembly woman Elizabeth Connelly, who bravely introduced the legislation creating a model at Bellevue introduced a bill to authorize the commissioner of mental health to designate other hospitals to set up similar programs to Bellevue. Unfortunately, the bill has all the limitations of the original.
In late April, 1999, Assemblyman James Brennan who chairs the mental health commitee, proposed a bill that would establish four more pilots throughout the state based on the Bellevue Model.
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Attorney General Eliot Spitzer’s Proposal
In reaction to a long history of incidents of violence involving individuals with brain disorders (culminating in the alleged pushing onto a subway track of Kendra Webdale by Andrew Goldstein in early January 1999), Attorney General Eliot Spitzer started reaching out to families, consumers, the public and others to see if some proposal could be crafted that balanced the various interests. The Attorney General announced his proposal at a press conference in early February 1999. The Attorney General gave credit to the Treatment Advocacy Center for the work they did in educating him to some of the issues. NY-TAC believes that the Attorney General’s bill does a good job of balancing all the conflicting interests to achieve the most benefit for the person with a brain disorder and the community they live in.
The Outpatient Assisted Treatment Act is expected to be introduced into the legislature. It is in most ways similar to the Bellevue Pilot, but with many significant improvements. The proposal is discussed elsewhere on this site.
Other Proposals
Assemblyman John Ravitz introduced a bill that is based on the proposals put forward by the Attorney General. Like the Attorney Generals bill, John Ravitz’s is very good.
Other legislators (Libous/Padataki) have indicated plans to come forward with proposals, but have not yet provided anything for the NY Treatment Advocacy Coalition to respond to. Likewise, NYC has a proposal circulating
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(Posted 2/1999) (Update 4/20/1999)
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