[Rusty Weaver] 10:17:17 And that was in 2014, after which the rate of decline started to To flatten out a bit, but dip down farther than what we might expect by chance alone. And as Anne Marie mentioned in some of the background, and as you can read about in our report, that does coincide with some policy changes that's [Rusty Weaver] 10:17:31 More observable with the Cuomo administration. [Rusty Weaver] 10:17:37 This is a very complex graph. But the second question that we asked about the workforce is, number one, we can see that mental health is an industry in New York State from the last slide that is increasing in general. [Rusty Weaver] 10:17:48 However, that growth is really anchored in the private sector. We don't see the same level of growth in the public sector. [Rusty Weaver] 10:17:54 And so with that being said, we might want to look at the public sector specifically to think about the types of workers that are that are going to be impacted by those changes, by that decrease of employment in an industry that is otherwise growing throughout the state. [Rusty Weaver] 10:18:09 And so what this chart does is it breaks down, you can see three major rows. They almost look like steps descending down from the top of the chart to the bottom. [Rusty Weaver] 10:18:19 You can see those marks at the very end of the chart on your right hand side where you see solid lines and how they sort of begin to jut into the left of the chart. [Rusty Weaver] 10:18:27 Those three big blocks show the total size of the public sector mental health workforce from the US Census Bureau data that we're using. [Rusty Weaver] 10:18:34 And those steps to the left on the graph that you see in the big gray bars are indications that that workforce has been shrinking in number. Inside of each of those big steps, we then break down the workforce by race, ethnicity, and gender. [Rusty Weaver] 10:18:49 And so it's difficult to see maybe in absolute numbers how these changes are taking shape in the workforce overall. I just wanted to present the absolute numbers for you here first before If we can go to the next slide, Anne-Marie, we look at relative changes in these subpopulations in the mental health workforce. [Rusty Weaver] 10:19:09 The Census Bureau tracks roughly seven different ways of identifying race, ethnicity in a in their race ethnicity framework. And so we followed the groups that the Census Bureau data allow us to follow. [Rusty Weaver] 10:19:23 Persons who identify as Asian or Pacific Islander, Black or African American, Hispanic or Latino, Indigenous, some other race or multiple races. So if individuals identify with more than one race or ethnicity. [Rusty Weaver] 10:19:36 And then individuals to also identify as white. And so if we look at this chart, we try to mirror the colors that you've seen in other charts. So the dark. [Rusty Weaver] 10:19:45 Blue shade, if you can see that, is representing the public sector. The lighter orange shade is representing the private sector. [Rusty Weaver] 10:19:50 And what you can see on the right-hand side of the chart are a lot of bars sort of just racing toward the right-hand side that are colored orange, showing that in the private sector, all individuals or individuals from all of those racial ethnic groups that I just named saw an increase in their presence in the private sector portion of the mental health workforce. [Rusty Weaver] 10:20:13 All of that growth that we saw in the earlier line chart is being created by individuals from all races and ethnicities that are tracked by the Census Bureau. Whereas on the other side of the chart. [Rusty Weaver] 10:20:25 Those darker blue shades, we can see most of those bars are moving toward the left, indicating contraction or a decrease in their presence in the public sector side of the state's mental health workforce. [Rusty Weaver] 10:20:37 Individuals who identify as black or African-American, for example. Saw a decrease in their presence in the public sector side of the mental health workforce by about 27%. [Rusty Weaver] 10:20:46 Over the two most recent decades, whereas such persons saw growth in their presence in the private sector side of the mental health workforce. Now, the data that we have, I'll be clear, do not allow us to track mobility from public to private sectors. So we don't know who is moving or being displaced in the public sector and potentially taking a job in the private sector. We effectively just have these snapshots in time at each of these intervening decades. [Rusty Weaver] 10:21:13 And so we can't say that there's been a total displacement of persons from the industry as a whole, but we can see how the industry shifts. [Rusty Weaver] 10:21:21 Based on these relative patterns. So effectively, what we see is almost all racial or ethnic groups are decreasing their presence in the public sector side of the mental health workforce. It's not even, however, those rates of change aren't the same for all race ethnicities. [Rusty Weaver] 10:21:36 Whereas we see growth across the board in the private sector. [Rusty Weaver] 10:21:42 And some of the implications of that are that the workforce has changed in terms of its composition in both sides, both public and private. [Rusty Weaver] 10:21:51 But the changes maybe present some unique challenges when we start to dig in and look at how diversity has shifted. [Rusty Weaver] 10:21:59 And so those patterns that you just saw in the last chart, some bars moving to the left, some bars moving to the right. [Rusty Weaver] 10:22:06 We can use that in kind of a, for lack of a better term, a nerdy way to quantify the probability that any two workers, if we just pull two random workers out of this industry. [Rusty Weaver] 10:22:17 What is the probability that they identify as different races or ethnicities? [Rusty Weaver] 10:22:21 And so this diversity index that's being summarized in the table here that you can see on your right is doing just that. It's giving us a probability effectively from zero to 100 that if we just drew two workers out of either private or public sector side of the workforce that they would identify differently when it comes to their race, ethnicity. [Rusty Weaver] 10:22:38 And what you can see, there isn't a huge gap in 2000 or 2010, but there's a history and a precedent that the state government or the public sector side of the mental health workforce has been a bit more diverse than has the private sector side. [Rusty Weaver] 10:22:53 And that flipped in 2020. So all of those patterns of change that we saw, the growth in the private sector, which was really driven by persons of color especially. [Rusty Weaver] 10:23:01 And the shrinkage of workers in the public sector, which was driven by higher rates of decline among persons of color being represented in that workforce has now made the private sector side of the mental health workforce considerably more diverse than the public or than the private excuse me, than the public sector side. And so that again is telling us who is being impacted by austerity. If it is austerity that's causing this decline that we see. [Rusty Weaver] 10:23:25 In the public sector side of the mental health workforce, which I think that I don't think that's a big leap to make since we do see this industry just growing across the state at incredibly fast rates. [Rusty Weaver] 10:23:37 So if it's austerity that's responsible, it's also austerity that's responsible for making this workforce a little less diverse and persons of color being impacted a little bit more so than persons who identify as, say, white. [Rusty Weaver] 10:23:52 Next slide, please. Thank you. And so the next batch of questions that we ask then is, okay, so we now know the who of who is being impacted potentially by public sector austerity in the mental health workforce. [Rusty Weaver] 10:24:05 What are the potential consequences of that? And one way that we tried to trace out potential consequences is by looking at wages in the public versus private sector. [Rusty Weaver] 10:24:13 So does austerity in the public sector mean that we're getting lower wages, for example, or is there downward pressure on wages because of that? Or is there upward pressure? Is the competition from the private sector leading to bigger contracts and higher wages. These are the types of things that we're running through our minds when we answer or when we ask these questions. [Rusty Weaver] 10:24:32 So this is another data graph here. It's relatively easy to read once we crack the code. And so I'm going to try to help crack the code for us here. [Rusty Weaver] 10:24:43 What you can see in the graph are again two lines, blue and red, dark and somewhat light. The darker blue represents the public sector side of this workforce. The red or lighter shade represents the private sector. And you see three moments in time across the right-hand side or the horizontal axis of the graph. This is 2000, 2010, and 2020. [Rusty Weaver] 10:25:02 And on the vertical axis, we see median wages after adjusting for race, ethnicity, age, gender, and all of the normal sociodemographic constructs that we tend to try to adjust for when computing wages. [Rusty Weaver] 10:25:16 And so one thing that we can see is Somewhat surprisingly, way back in 2000, the median wage for a mental health worker in the private sector was significantly higher than it was for that same worker in the public sector. [Rusty Weaver] 10:25:31 But that might have been a bit of an aberration in 2000. Because if we look at the rest of the time horizon, we get to an outcome that we might expect based on the high union density that we tend to see in the public sector versus private sector. [Rusty Weaver] 10:25:43 And the volumes of literature that we have that suggest that unionized jobs tend to pay higher wages than their non-unionized counterparts. And so on the two steps on the right-hand side of this graph for 2010 and 2020, we can see that the median public sector worker out earned the median private sector worker by relatively [Rusty Weaver] 10:26:04 Relatively large gaps. What we can see over time in the change over time is that wage growth, and this is the little table down on the bottom left of the screen that you're looking at. [Rusty Weaver] 10:26:14 The very last row, the growth in these median wages from 2000 to 2020, The median private sector worker did see their wages increase by about $7,600 per year over this 20-year time horizon. [Rusty Weaver] 10:26:27 But on the state government side, the median wages increased by closer to $12,000. So again, we see this pattern where workers who are in these positions and being paid by New York State tend to have on average better compensation than their counterparts in the private sector. And what does that mean? [Rusty Weaver] 10:26:43 It means that if we see a decline in the public sector workforce, if we see fewer of these jobs. [Rusty Weaver] 10:26:48 That means we're having fewer good paying jobs and potentially union jobs in the New York state economy that are potentially being replaced by private sector jobs, which while they're still seeing increases in wages, are not seeing increases in wages at the same magnitude. [Rusty Weaver] 10:27:04 And so the result could be a potential net loss for workers in the economy. [Rusty Weaver] 10:27:11 These are just methods of triangulating some of the findings that we have from those micro level data points where we're using, again, individuals self-reported wages from their responses to a larger survey to compute median wages. These graphs are showing BLS data broken out by specific mental health [Rusty Weaver] 10:27:29 Sub-industry in the state government versus private sector side. There are some gaps in the data, so you'll notice some gaps in the charts. [Rusty Weaver] 10:27:36 But in general, on the left, you see wages in hospitals. On the right, you see wages in psychiatric and substance abuse hospitals specifically. And the overarching patterns that we see throughout time are that jobs in the public sector tend to be better compensated than their counterparts in the private sector. [Rusty Weaver] 10:27:53 If you're wondering about the anomalies toward the end of the graph, we don't have great explanations for them. [Rusty Weaver] 10:28:00 The guidance in the data sets don't recognize those anomalies in big spikes in state government wages. [Rusty Weaver] 10:28:07 However, one implication is that this is 2020. This is the height of the pandemic, and public health workers, especially those in the state, were working a lot more hours than they normally work and presumably were being compensated through overtime and the like. And so that's a potential reason that you see that uptick at the end. I would say, though, that you can safely ignore that. That's somewhat of an aberration. We would expect things to sort of come back down to normal. [Rusty Weaver] 10:28:32 This is a similar look at just another industry, residential intellectual and developmental disability mental health and substance abuse facilities, same pattern. [Rusty Weaver] 10:28:41 And so what we find in all of these aggregate patterns, I've been talking about how public sector workers tend to be better compensated but which workers. We did compare occupation by occupation, median wages across these two sectors and looked for statistically significant differences in them. [Rusty Weaver] 10:28:57 And one of the most interesting findings that we saw is that on the public sector side in this industry, it tended to be jobs that are more associated with working class or blue collar jobs, especially building cleaners or support staff. [Rusty Weaver] 10:29:12 Clerks and office workers that tend to significantly out earn their counterparts on the private sector. [Rusty Weaver] 10:29:17 In the private sector, higher um educational requirement positions like surgeons and physicians, for example, out earn their state government counterparts, which Again, if you buy into the story of private sector competition and how it's supposed to elevate wages, maybe they're [Rusty Weaver] 10:29:33 Is where we're seeing that play out a bit. But in general, the public sector is really good. [Rusty Weaver] 10:29:39 For working class New Yorkers in terms of the wage premiums that we saw in a lot of these occupations across the state. And so once again, that brings us back to this point. What does that mean if the state government side of the mental health the mental health workforce is declining. [Rusty Weaver] 10:29:54 It means that more working class New Yorkers, more New Yorkers of color are probably losing out on higher wages and better paying jobs and benefits. [Rusty Weaver] 10:30:05 Slide, please. And so we took all of that and then we tried to compare it to observable public health outcomes from the area health resources file put out by the Department of Health and Human Services. [Rusty Weaver] 10:30:16 And this is where I gave that precaution at the outset that it is kind of difficult to make causal connections here, but we can observe patterns of association and things that are probably not coincidental. [Rusty Weaver] 10:30:26 And so one thing that we looked at here is just the total number of healthcare professionals Providing psychiatric care in New York per 100,000 residents. So think of it as like a crime rate, but for a specific type of healthcare providers. [Rusty Weaver] 10:30:40 And in this case, the data spanned the period that we had access to spanned the period from 1995 to 2019. And what we saw is just, again, impacts of potential austerity. We saw a decrease in the number of psychiatric care professionals per 100,000 people at New York State as a whole, and mostly in every county as well. At the statewide rates. [Rusty Weaver] 10:31:00 In 1995, we started out at about 27.3 total healthcare providers per 100,000. [Rusty Weaver] 10:31:06 That dropped by almost five providers per 100,000 people by 2019. [Rusty Weaver] 10:31:13 Next slide, please. And if we break this out by county, if we look at the geography of those changes, it's not an urban or a rural problem. It's just a New York state issue. We saw these patterns of decline [Rusty Weaver] 10:31:29 Throughout the state, downstate as well as upstate. Some of the biggest changes, however, did occur in more rural and remote areas. [Rusty Weaver] 10:31:36 The implications of that, again, are more difficult because if you're in a rural or remote area, you already have a lot of travel time generally to get to destinations to consume the healthcare services that you need. And if facilities are closing and there are fewer providers, that means potentially even more deferred care. [Rusty Weaver] 10:31:56 Slide, please. And what that could look like could be very serious consequences. So here we did draw out the age adjusted suicide rates in New York State by county. [Rusty Weaver] 10:32:07 And again, you can't necessarily see a broad pattern here. This is where there's reason to approach some of these data with a full view and an open mind. But what we did see is an uptick generally. [Rusty Weaver] 10:32:20 Between 2010 and 2020 in age-adjusted suicide rates, it was just a minor up But the pattern that follows is, especially in areas you might notice over in the southern tier area in western New York and in some of central New York. [Rusty Weaver] 10:32:35 Darker orange and red shades where we saw bigger increases in suicide rates are the same types of counties where we saw bigger drops in the number of psychiatric care providers per 100,000 New Yorkers. [Rusty Weaver] 10:32:47 And so in this case, again, we're not necessarily asserting causality here, but there is a reason to believe that the pattern of loss that we see in this type of care is linking up with increases in age-adjusted suicide rates across the state. [Rusty Weaver] 10:33:05 And then the last thing we saw is the state does also track in its vital statistics things like self-harm injury hospitalization cases, which is another potential outcome of poor mental health or mental health crisis. [Rusty Weaver] 10:33:20 What we saw here is more happy news, I guess we could say, than the suicide rate, which has ticked up a bit. [Rusty Weaver] 10:33:26 There has been a drop almost across the board in the state in hospitalizations due to self-harm. [Rusty Weaver] 10:33:33 Types of injuries. But again, when we compare the patterns of these changes at the county level. [Rusty Weaver] 10:33:39 With patterns of decreases in mental health service providers, there is that same type of eyeball or visual correlation that we saw with suicide rates where there were lower drops or no drops or static rates of age adjusted self-harm rates in the counties that tended to see some of the biggest drops in the number of service providers per 100,000 residents. [Rusty Weaver] 10:34:00 And so again, these connections between what we can really document in the terms of the changing workforce and the austerity that appears to be there. [Rusty Weaver] 10:34:09 We can make some connections to these public health indicators that we can see and the connections that we can make are somewhat troubling. [Rusty Weaver] 10:34:14 And have policy implications, which I'll turn to Anne Marie to take us to that point. [Anne Marie Brady] 10:34:23 Thank you so much, Rusty. Sorry. [Anne Marie Brady] 10:34:32 And so I'm going to talk a bit about the implications of these findings. [Anne Marie Brady] 10:34:37 Why do these findings matter? What are the findings telling us? Well, first, what became clear is that in New York State, and like Rusty said, we know this public sector workers are five times more likely to belong to a union. [Anne Marie Brady] 10:34:51 Compared to a private sector employee. According to the US Department of Labor, workers with union representation enjoy a significant pay premium compared to non-union workers. And again, that became clear through the presentation of the findings. [Anne Marie Brady] 10:35:06 Our findings show that the trends toward privatization and state government austerity in New York State mental health workforce are costing New Yorkers good paying union jobs. [Anne Marie Brady] 10:35:15 And the good jobs being lost have been disproportionately held by women and workers of color, especially Black and African-American workers. [Anne Marie Brady] 10:35:23 And it is this point that I really want to zero in on for a second. [Anne Marie Brady] 10:35:27 So we know that in the United States, at every level of education and income, African Americans are paid less, have less assets than their white counterparts. [Anne Marie Brady] 10:35:37 Compared to white Americans, African Americans have higher rates of unemployment, accrue less wealth, and have lower rates of home ownership. [Anne Marie Brady] 10:35:43 So the driving force behind these patently unequal life chances and opportunities are the racial rules, the rules, regulations, policies, and practices that have their roots in enslavement and post-reconstruction. [Anne Marie Brady] 10:35:56 And that today still undergird the US economy. But interestingly enough, since reconstruction in the United States, the public sector has played a especially important role in countering these patently unequal life chances. [Anne Marie Brady] 10:36:10 Specifically in the labor market. And that is because historically the public sector's more regulated wage system, its commitment to equal opportunity policies, and its bureaucratic hiring and promotion practices have protected women and African-American workers from gender and race-based economic discrimination, pay and occupational attainment. [Anne Marie Brady] 10:36:31 It is for this reason that in the sociological literature, the public sector has been referred to as a sheltered labor market, a place of protection. [Anne Marie Brady] 10:36:39 For workers vulnerable to discrimination, such as women and African-American workers. [Anne Marie Brady] 10:36:45 Gender pay gaps, regardless of race and ethnicity, are lower in the public sector than in the private sector. [Anne Marie Brady] 10:36:51 While the wage premium associated with public sector employment is much higher for African Americans. [Anne Marie Brady] 10:36:57 African-american workers, especially African-American men, are more likely to achieve higher status jobs. [Anne Marie Brady] 10:37:03 Have higher paying earnings, low job insecurity in the public sector. [Anne Marie Brady] 10:37:07 Public sector jobs have defined universal benefits such as equitable and better health insurance cover coverage as well as access to more paid leave. [Anne Marie Brady] 10:37:17 Pensions with guaranteed lifetime benefits upon retirement. And of course, as has been discussed, public sector jobs have higher rates of unionization. And unions are especially beneficial to African-American workers because they compress pay disparities among workers with similar jobs. [Anne Marie Brady] 10:37:34 Unions give workers voice in their jobs results in reducing turnover. It increases job stability and provides better, more equitable and more useful workforce training across all jobs. [Anne Marie Brady] 10:37:46 Which results in more equitable hiring. For these reasons and more, the public sector has therefore been an important pathway to social and economic mobility for African American workers. [Anne Marie Brady] 10:37:57 And therefore, the bottom line and what I would argue is that this trend towards privatization and state government austerity in the New York State mental health care workforce are costing New Yorkers good paying union jobs and the good jobs being lost have been disproportionately held by African-American men and women, as the data shows. [Anne Marie Brady] 10:38:15 So our research demonstrates what happens when this essential pathway for African-American economic and social mobility runs up against austerity and the privatization of public sector jobs. [Anne Marie Brady] 10:38:27 The findings from this research therefore suggest, in my opinion, that the movement towards privatization and austerity in New York State puts downward pressure on this mobility, this otherwise essential pathway for mobility for African Americans in the public sector. And I would argue as such undermines a crucial source [Anne Marie Brady] 10:38:45 Of what we call in the economics literature quality of outcome for a group historically disadvantaged in the US labor market. [Anne Marie Brady] 10:38:53 So ultimately, without reinvestment into and meaningful job recreation within. The New York State mental health workforce, observable trends will continue to exacerbate patterns of racial, gender, and economic inequality in New York. [Anne Marie Brady] 10:39:09 I turn it over to you, Patricia. [Patricia Campos-Medina] 10:39:15 Thank you so much for the presentation of the key findings of this research study. [Patricia Campos-Medina] 10:39:22 I want to remind all the attendees that We at the Worker Institute and the Buffalo Local Lab are part of the School of Industrial and Labor Relations and part of the public impact mission of the ILR school at Cornell University. So we engaged in research [Patricia Campos-Medina] 10:39:40 That advances the public interest And we bring partners who are interested in advancing solutions to problems faced by workers both in the public and in the private sector. And it's in the spirit of that collaboration that we conducted this study, focusing on the public sector workforce. And given that the public sector workforce is huge and it's a big impact, we couldn't do everybody. So we focused this specific research on the public. [Patricia Campos-Medina] 10:40:12 Healthcare sector. With that in mind, one of the key stakeholders in this conversation to advance solutions to this workforce is the public Employees Federation. [Patricia Campos-Medina] 10:40:27 So they are here and they will give their reactions and their feedback on the study. We also have public sector partners who are interested in understanding what's happening in the workplace And they will also give us They're there. [Patricia Campos-Medina] 10:40:45 Their reactions to the study and the impact that they see from their standing as representing the public sector. And both are Senator Brook and Senator Jackson and the representative Timothy Holt from the commission at New York State Civil Service. But before we get to them, I want to open the floor [Patricia Campos-Medina] 10:41:05 For Wayne, President Wayne Spence to give a little remarks as to the impact on the study and how do you see this study advancing solutions for the sector that you represent in the public sector and randy you can Vice President Randy'Antonio. You can follow President Spence. And after that, I'll introduce our other speakers. [Wayne Spence] 10:41:30 Thank you. Thank you, Patricia. Again, I'm Wayne Spence, president of the Public Employees Federation. [Wayne Spence] 10:41:39 I was not surprised by some of the data. We had believed that we have seen a significant decrease in uh cuts, decrease in mental health workers that we represent in OMH. But it seems as if it was I'm biased. We are as a union, we're saying it. [Wayne Spence] 10:42:00 So the data did not surprise me when it came up. I knew as president from 2015 that under the Come administration, public sector jobs and mental health was drastically cut. [Wayne Spence] 10:42:14 And privatization had taken over. What was surprising to me was surprising to me was the impact on African-Americans. [Wayne Spence] 10:42:22 That I didn't expect. I didn't expect to see such a dramatic the impact on African-American workers. I thought it would have just been across the board. So that was an interesting thing that I did not expect to see. [Wayne Spence] 10:42:36 When the data was released. But we knew that we needed data. [Wayne Spence] 10:42:42 When I came in, my predecessor had run a campaign. I ran for election in 2015 and we actually talked about a strategy to highlight this by going to the United Nations and asking the un to put out a resolution calling out New York State saying that they were criminalizing mental health. [Wayne Spence] 10:43:03 The idea of talking about criminalizing mental health, nobody was really talking about that. [Wayne Spence] 10:43:08 In 2015. Those conversations started to become more so now coming out of COVID. [Wayne Spence] 10:43:15 So it's interesting. What this data shows. You know, we lost 1600 employees At the Office of Mental Health between 2013 and 2023. [Wayne Spence] 10:43:27 You know, Rikers Island. Is, you know, it's like a mental health facility now. It criminalizing mental health. [Wayne Spence] 10:43:37 And it's victimizing the mentally ill. But also at the same time, we do know the mentally ill who are not getting services because of the cuts and trying to recover from the cuts from the Cuomo administration. [Wayne Spence] 10:43:48 Is having a direct impact on safety in new york city especially we see it in the subway system. [Wayne Spence] 10:43:57 I'm glad to hear the study because I'm glad that Robert Jackson, Senator Jackson. [Wayne Spence] 10:44:03 Senator Brooks and the civil service commissioner is here Because again, recently when OMH asked to do an upgrade we challenge the upgrade in some of the social workers. And we felt that some of the social workers who were not going to be getting lifted up were [Wayne Spence] 10:44:18 Potentially people of color. But OMH fought us on it. And at the time, we didn't have this data. I hope that they see that what we suspected actually is not proven in the data. [Wayne Spence] 10:44:30 And so with that, I am going to turn this over to VP Randy, D. Antonio. But before I do that, I just want people to know that we fought hard as a union. [Wayne Spence] 10:44:41 To make sure that certain things that the Cuom administration wanted to do did not happen. He wanted to close Western New York Children's Psychiatric Center. [Wayne Spence] 10:44:48 He wanted to move it on the grounds of an adult psychiatric center. [Wayne Spence] 10:44:52 He wanted to close the Rockin Psychiatric Center. And if he had did close the rock and psychiatric center there would be no mental health treatment for ages 5 to 21 between the Bronx and Utica. [Wayne Spence] 10:45:05 These were things that the Cuomo administration wanted to do, and we fought. [Wayne Spence] 10:45:10 And those fights kind of led us to have a conversation for Cornell to do an unbiased study because we had our biases as to what's going on. So I'm grateful for this study. [Wayne Spence] 10:45:20 Randy, I'm going to let you run with it. [Randi DiAntonio] 10:45:22 Sure. So thank you, everyone, and good morning to all. First off, I just want to thank Cornell for the work they did for partnering with PEF. [Randi DiAntonio] 10:45:30 You know our fund our future campaign is actually Fund Our Future for a thriving new york that's the full title. [Randi DiAntonio] 10:45:37 And the purpose of this campaign was not just to focus on the jobs that we do, but on the services that were critical to New Yorkers, especially vulnerable New Yorkers. [Randi DiAntonio] 10:45:47 And when we looked at what we were seeing. This undercutting of the workforce we realized that it had ramifications that really magnified throughout the course of COVID. [Randi DiAntonio] 10:46:01 Everyone realized as mental health needs grew that there was an issue because the state workforce was, as President Spence said. [Randi DiAntonio] 10:46:09 1600 less than what it had been, you know, 10 or 15 years before. [Randi DiAntonio] 10:46:14 Now, to give you some perspective, I am a licensed social worker by trade. I have been for 35 years. [Randi DiAntonio] 10:46:20 I've worked in both the private sector as well as the public sector. So I have a unique perspective in that These are sectors that work well together in the majority of cases but the public sector is able to handle much more complex individuals [Randi DiAntonio] 10:46:38 People with more challenging needs And when we lost over 2,000 inpatient psychiatric beds. [Randi DiAntonio] 10:46:45 It affected the entire service system. Now, I lived through the transformation agenda as an employee at OPWD. [Randi DiAntonio] 10:46:55 What happened throughout those 10 years was a structural cut to almost every agency we have that serves vulnerable New Yorkers. [Randi DiAntonio] 10:47:04 You know, the plan was for people to be put into community settings to receive services. [Randi DiAntonio] 10:47:10 You know look closer to home But those services were not well funded on the private sector side. [Randi DiAntonio] 10:47:17 As well as having worked there, I know because the wages are less, because there's no benefits. [Randi DiAntonio] 10:47:23 In terms of retirement security, job security Those jobs typically people, there's a higher turnover rate So continuity of care is affected. I think it's really important to note that you know, the transformation agenda was couched as a very positive thing [Randi DiAntonio] 10:47:45 And in some cases, it did have positive impact. But this study shows that over the course of that time. [Randi DiAntonio] 10:47:53 Many communities were harmed by it. From from a just a civil service standpoint a lot and i'm sure Commissioner Hogue's will speak to this you know these are legs up into the middle class. Civil service jobs allow for advancement, merit in fitness [Randi DiAntonio] 10:48:09 They allow for people to have upward mobility where that's not quite as prevalent. [Randi DiAntonio] 10:48:15 I think it's really important to recognize that even now, and we have, I have to thank the governor and our partners in the legislature Even now, though, we have added about 350 beds And we are working towards adding staff [Randi DiAntonio] 10:48:31 That just started over the last few years. This data has helped us to make the case that these jobs are not just about the employees, but also about the impact on services. And let me talk a little bit about the impact on services. [Randi DiAntonio] 10:48:48 President Spence mentions that the mentally ill have been criminalized in many instances. And I want to say. [Randi DiAntonio] 10:48:55 The majority of people with mental illness that commit criminal acts are small, but they are often very very serious. [Randi DiAntonio] 10:49:04 There's many more that are exploited and vulnerable and left out on their own. And when all of our facility Beds started closing, people were moved into spaces where they were not getting what they needed. So where did they end up? They ended up in our hospitals. [Randi DiAntonio] 10:49:19 They ended up on the streets. They ended up in our emergency rooms, short-term placements. [Randi DiAntonio] 10:49:25 Or more likely in dealing with police in our jails and in our prison settings. [Randi DiAntonio] 10:49:31 And, you know, we know as secure units closed as jobs were being outsourced that the ability for people who are back out in the community to either get back into Inpatient care or to get the services they needed was just not happening. [Randi DiAntonio] 10:49:49 And it's frustrating as a social worker and as a representative for those who work in the mental health field You know, this is very frustrating to have to have people on waiting lists for much more extended periods of times. If you don't have enough beds and you don't have enough staff. [Randi DiAntonio] 10:50:08 The safety net breaks. And that's what we saw happen over the course of the last 10 years. [Randi DiAntonio] 10:50:14 I give credit to the legislature for recognizing this in the last few years. [Randi DiAntonio] 10:50:18 And I give credit to the governor, but there is a lot more to do. We are still severely understaffed. [Patricia Campos-Medina] 10:50:24 Yeah. [Randi DiAntonio] 10:50:27 We are still short. The number of secure beds that we need in our inpatient systems. [Randi DiAntonio] 10:50:33 And we are still vastly underrepresented in our community crisis teams. [Randi DiAntonio] 10:50:37 You know, there's a couple of things in the upcoming budget that we really want to flag because we think From a policy perspective and from a monetary perspective, these things need to be budgeted so that we can actually serve the people with the highest needs [Randi DiAntonio] 10:50:54 And that are falling through the cracks. We support adding additional forensic We support expanding mental health staffing But a lot of the trends in the last few years have been what this study showed. They've been to the private sector. [Randi DiAntonio] 10:51:10 And the private sector has bottom lines. The private sector have higher turnover. The private sector isn't always equipped with the security or environmental controls or the level of staff in terms of the you know psychiatry nurse practitioners, they don't always have the same resources [Patricia Campos-Medina] 10:51:17 Thank you. [Randi DiAntonio] 10:51:31 And oftentimes the most seriously mentally ill are not able to be served. [Randi DiAntonio] 10:51:36 So we are looking at a situation where there's a lot of proposals in this year's budget from involuntary commitment to adding acute care units, to adding forensic beds. But if we don't deal with the staffing issues. [Randi DiAntonio] 10:51:51 I think those beds may open But we spent $22 million. Our staff worked over 22 million hours in overtime just last year. [Randi DiAntonio] 10:52:02 In the mental health system. That first of all, the amount of money is astronomical. But think about the stress the burnout the ability to provide quality of care if you're working umpteen numbers of extra hours each week. [Randi DiAntonio] 10:52:16 It just is not sustainable. So we're looking at adding all these beds. We need to do more with staffing. And we're asking our legislative partners, we're asking the governor. [Patricia Campos-Medina] 10:52:20 Yeah. [Randi DiAntonio] 10:52:26 To do the things we've been asking for you know looking at tier six. [Randi DiAntonio] 10:52:32 Looking at salary enhancements. Funding our community outpatient programs Because we do need to do partnerships with our private sectors. But right now, I'll just give you an example of the 30 state operated facilities around the state. [Randi DiAntonio] 10:52:47 Only 12 of them have community crisis teams. That means Rochester doesn't have one. [Patricia Campos-Medina] 10:52:53 Yeah. [Randi DiAntonio] 10:52:56 Syracuse doesn't have one. Binghamton doesn't have one. [Randi DiAntonio] 10:53:00 Long Island doesn't have one. They are primarily in the city. [Randi DiAntonio] 10:53:05 And in Rockland County. So we know there's gaps. And it doesn't mean that because the governor put money in a few years ago for the private sector that they're getting filled. [Randi DiAntonio] 10:53:15 So we are looking forward to partnering. We believe this research helps us make the case that these jobs are not only good for the patients and clients we serve. [Randi DiAntonio] 10:53:25 They're good for the communities we live in. They're good for employees. So I'll turn it back to you and thank you. [Patricia Campos-Medina] 10:53:29 Thank you, Randy. Thank you, Randy, for… for the clear path for solutions that you had outlined to the findings and to to solve this. [Patricia Campos-Medina] 10:53:45 Not crisis, but these problems that we identified and the public sector and the mental health care sector. And there's part of the formula to finding solutions to this crisis is partnering up with our public sector and policymakers to understand the problem. [Patricia Campos-Medina] 10:54:04 Discuss the possible solutions and then figure out how to prioritize investment. [Patricia Campos-Medina] 10:54:11 On the solutions to the mental health care crisis in New York State. So to help us Give us some thoughts, some ideas, or to explain how this is crisis is being faced in their districts We are going to have senator [Patricia Campos-Medina] 10:54:28 Robert Jackson. From District 31 of New York State to share a little bit of his views and his reflections on this work and the work ahead to address some of these concerns. [Patricia Campos-Medina] 10:54:40 After you're done, Senator Sarma Brooke, you can jump in also and share your perspectives on the research on the proposed solutions. [Patricia Campos-Medina] 10:54:51 And how we're going to work together with the administration, Commissioner Timothy Hawks, after they speak, you can jump in and also share your reflections on the research and how we can move forward together. [Patricia Campos-Medina] 10:55:04 As advocates and as policymakers. To be able to move forward solutions that address the concerns of New York State's residents and its workers. So Senator Jackson. [Patricia Campos-Medina] 10:55:19 Please unmute yourself. [Senator Robert Jackson] 10:55:26 Thank you for the opportunity to be here and listen to the report. [Senator Robert Jackson] 10:55:30 To address this critical issue that is not just a crisis. [Senator Robert Jackson] 10:55:34 But a political failure for sure. One that is hurting our communities and not one community, but our communities all over the state. [Senator Robert Jackson] 10:55:44 Through New York State every single day. And as you know. [Senator Robert Jackson] 10:55:49 You watch the news, you watch the television, listen to the radio And you see this person is being pushed on the train tracks without any you know warning or anything and no dispute people are basically have some mental health issues and they are around the communities without the help that they actually need. [Senator Robert Jackson] 10:56:13 And this is not like it is not like in the 70s. [Senator Robert Jackson] 10:56:17 I mean, basically, we had most of all of the psychiatric centers open in order to provide the services. [Senator Robert Jackson] 10:56:28 And so, and that was seen. But now what we see is the results of the situation where people are out there, when I say out there, in my communities, I'm talking about New York City. [Senator Robert Jackson] 10:56:42 In the subway. The streets, all over the place. [Senator Robert Jackson] 10:56:48 And they need guidance. They need mental health services. And they're not getting it at the care that they rightfully deserve. [Senator Robert Jackson] 10:56:57 So let's be clear. Austerity is a choice Privatization is a choice. [Senator Robert Jackson] 10:57:02 And both are failing the people who need their services the most. [Senator Robert Jackson] 10:57:05 And I know that just in my area of Washington Heights, Inwood, Marble Hill. [Senator Robert Jackson] 10:57:12 The northwest bronx. That represent about 339,000 people. [Senator Robert Jackson] 10:57:17 And they need help. And they're part of Majority of them all the working class. [Senator Robert Jackson] 10:57:22 That do not have the resources of the middle class and those in the higher class as far as class. [Senator Robert Jackson] 10:57:30 We're only talking about money. That's what you're talking about, money, to provide the services they rightly need. [Senator Robert Jackson] 10:57:37 And so listening to you give your report. [Senator Robert Jackson] 10:57:42 Is basically saying is basically saying Hey, everyone. There's an issue of concern and we're not addressing it properly and we need to help everyone come in. [Senator Robert Jackson] 10:57:51 So Tim told the commissioner for civil service uh is here But what about the people that are running The psychiatric centers and what have you and so forth. [Senator Robert Jackson] 10:58:04 What about them? They need to be in this listening to it and so that they can go then turn to the governor And to the policymakers and say, you know one thing? They're right. [Senator Robert Jackson] 10:58:15 And we need to work together to make it happen. So over the last past decade, New York State has seen a significant reduction in public sector mental health job. [Senator Robert Jackson] 10:58:27 Positions in state psychiatric centers hospitals, community clinics, and crisis response teams have been cut and outsourced to private entity. And this shift has led to lower wages Demonition of benefits. [Senator Robert Jackson] 10:58:44 Precarious employment conditions for mental health professionals workers who once had job security and union representation now face temporary contracts. [Senator Robert Jackson] 10:58:54 Increased caseloads and burnout. And that this is not happening even across the city Black, brown, immigrant. [Senator Robert Jackson] 10:59:03 Working class communities are being hit hard all over the place. All over the place. [Senator Robert Jackson] 10:59:10 And the neighborhoods I represent, as I said earlier, northern Manhattan. [Senator Robert Jackson] 10:59:14 Then the Bronx, Washington, Inwood, Marble Hill, Morris Heights, Kingsbridge. They need help. [Senator Robert Jackson] 10:59:20 Not only at the state level. But at the city level also. [Senator Robert Jackson] 10:59:25 They need help and they don't have the means In order to provide services to family members that may have some issues and concerns about their mental health. [Senator Robert Jackson] 10:59:37 So who suffered? You know who suffers. The people who are out there are most vulnerable neighbors. [Senator Robert Jackson] 10:59:44 Seniors, low-income families people experiencing homelessness And our youth are left without the support that they need. And with fewer resources Residents face longer wait time, and I heard that in here. [Senator Robert Jackson] 10:59:59 And limited access to care. And this lack of support exacerbates issues such as homelessness. [Senator Robert Jackson] 11:00:06 I came to work here today. And there were two people sleeping on the train. [Senator Robert Jackson] 11:00:13 And know one thing, the average person that are going to work or wherever they're going with their kids to school, they're riding the subways and they're not bothering those individuals that are sleeping Because why? Because obviously they're sleeping there because they're sleeping [Senator Robert Jackson] 11:00:31 In my opinion, they need a place to sleep. And they find that in the subway system. [Senator Robert Jackson] 11:00:35 And you don't want to disturb them because you don't know what the reaction is going to be. [Senator Robert Jackson] 11:00:42 You want your safety and your children's safety and other people to be safe. [Senator Robert Jackson] 11:00:47 And we want all those individuals that need help to get the help that they rightfully need. [Senator Robert Jackson] 11:00:53 And that's the solution. And so I say that The evidence is clear. [Senator Robert Jackson] 11:01:00 Public operated mental health services are more effective at delivering care to those who need it the most. [Senator Robert Jackson] 11:01:06 You'd say, let's send it to Jackson. How do you know that? [Senator Robert Jackson] 11:01:09 I tell you that I've worked for PEPF for 23 years And I've been in the Rockland site Kingsbridge Psychiatric center you know psychiatric psychiatric Institute on 168th Street in Washington Heights. [Senator Robert Jackson] 11:01:26 I've been out to facilitate I've been in prison and jailed as a representative working for the union. [Senator Robert Jackson] 11:01:34 So I know it. And you know one thing I know? I know that we're not getting the type of services that we need in order to make sure that the people in our state are doing what they need to do in order to protect [Patricia Campos-Medina] 11:01:44 No. [Senator Robert Jackson] 11:01:50 The people that we both all represented. So with that i'm going to Executive Director Patricia Campos. Medina, thank you for having me. [Patricia Campos-Medina] 11:01:54 Thank you, Senator. Yeah. [Patricia Campos-Medina] 11:02:01 Thank you so much for your intervention. Senator Brooke. [Senator Samra G. Brouk] 11:02:07 Thank you, Patricia. And thank you to all the researchers and for this presentation and path for Today and hosting this conversation, but obviously the work that all of your members are doing every day. I'm Senator Sam Rabuk, proud to represent the Rochester area in the 55th Senate District. [Senator Samra G. Brouk] 11:02:27 But also for discussion the chair on the Senate Mental Health Committee. So this is something that I focus on a lot. And especially right now as we are in budget, I'd say most of my days are talking about what we need to do in the mental health budget. So, you know, just off the top, and I know I want to get to questions from everyone, and I know there's more folks to speak. So I'm not going to repeat [Senator Samra G. Brouk] 11:02:52 Everything that Senator Jackson, VP Randy and President Spence said. But I do want to say I couldn't agree more. [Senator Samra G. Brouk] 11:03:00 As I was listening to some of their reflections on this research. [Senator Samra G. Brouk] 11:03:06 I kept thinking, wow, that sounds like a speech I've given before because we have talked about these things. And, you know, while I think President Sven said it really well, you know, when you are in these spaces, when you are talking to employees, when you are talking to individuals who are seeking services. [Senator Samra G. Brouk] 11:03:24 It's hard not to have already seen that this was the case. But of course. [Senator Samra G. Brouk] 11:03:29 Anecdotes cannot change policy alone, right? And so seeing data, irrefutable data around the trends that have occurred because of the privatization, because of the divestment. [Senator Samra G. Brouk] 11:03:43 From our mental health sector, from our public sector here in New York State is absolutely crucial so that we can be thoughtful and deliberate about how we move forward when it comes to particularly as I'm looking at it, the mental health HMH part of the state budget. [Senator Samra G. Brouk] 11:03:59 So there's two things that I would add to the conversation in terms of major reflections I have. [Senator Samra G. Brouk] 11:04:08 I've shared with folks before I didn't know that coming in as the Senate Mental Health Committee chair meant that my first job in January 2021 was basically just to fight the governor on all of the cuts. [Senator Samra G. Brouk] 11:04:20 It seemed so contradictory to me to be cutting mental health budget in the midst of not just a COVID pandemic, but a mental health crisis. [Senator Samra G. Brouk] 11:04:33 And of course, only a year later, our own Surgeon General said, we do have a mental health crisis in so many ways all over the country. And so I guess, silly me, I thought government was logical, but I've learned otherwise. And now we're just fighting to make decisions that make sense for New Yorkers. But we can make light of it here, but we know that there's actually very serious implications of this. [Senator Samra G. Brouk] 11:04:56 We talked about closures of beds. We talked about how by closing beds in the mental health sector and opening up prisons, we've essentially moved so much of our mentally ill population into the carceral system where they are not being rehabilitated. They are not coming back out better than when they went in and in fact are compounding some of their illnesses and becoming even [Senator Samra G. Brouk] 11:05:22 Needing more services that again do not exist once again. And so, you know, I've been very focused on rebuilding our public sector because it's very clear Listen, I think it was brought up earlier. [Senator Samra G. Brouk] 11:05:36 The truth is government is there to serve. We are there to serve regardless of profit, regardless of margin. We are there to serve those who may not find help in other places. [Senator Samra G. Brouk] 11:05:49 When you take away those supports, when you close those facilities, when you don't invest in that workforce. [Senator Samra G. Brouk] 11:05:57 You end up with large groups of people who will not be served or simply can't be served by what exists in the private sector. We have both. [Senator Samra G. Brouk] 11:06:06 We need both, but by taking and taking and taking from one, it is a great disservice. [Senator Samra G. Brouk] 11:06:12 To individuals who need that care. And we find ourselves now with more and more individuals with severe mental illness, undiagnosed mental illness. [Senator Samra G. Brouk] 11:06:21 And also more individuals finding themselves in crisis. And so that's only going to make it even more challenging to meet those needs. And so I'm a huge proponent of really trying to make up for the divestment out of this sector. The second thing I want to bring up, though, is that I'd be remiss not to talk about the economic development side of this. [Senator Samra G. Brouk] 11:06:43 Right. You know, I think about what union membership did for my family where you had actually a father who was a former PAF member, immigrant from Ethiopia, came here with nothing, found himself early on in a union job, a mother who was a nice, still is a retired NYSIT member. [Senator Samra G. Brouk] 11:07:04 That's how my family went from grandparents who almost didn't graduate high school to parents who were able to graduate college were able to solidly live in the middle class and raise their three children on union jobs. And so we also know particularly [Senator Samra G. Brouk] 11:07:25 And I'm going to speak from my personal experience for Black families, particularly for Black women, as we heard in this presentation. [Senator Samra G. Brouk] 11:07:33 Having access to a union job, the stability it offers, the benefits it offers to not just keep you healthy, but your family healthy, right? These are the types of things that maintain a middle class. [Senator Samra G. Brouk] 11:07:46 And when we think I've got to talk about Rochester for a bit, when we think about the instability that we see in our neighborhoods. [Senator Samra G. Brouk] 11:07:54 Even if you think about crime and violence in communities, so often it is not just Black women, but women who are the stable figures of households of streets, of neighborhoods and communities. [Senator Samra G. Brouk] 11:08:09 When we have stable jobs with benefits and livable wages, that can make or break not just a household, but a community. And so it's very concerning to me. [Senator Samra G. Brouk] 11:08:21 To see some of those trends. And the last thing I'll say on the economic development piece is oftentimes when they are not union jobs, I'm not saying all jobs that aren't union jobs are bad, although if you're in a workplace, start a union. But what I will say is that Many times you do see in the private sector, there are individuals with low paying jobs. They are minimum wage, but they are low paying jobs [Senator Samra G. Brouk] 11:08:45 That still require them to need other subsidies and supports. But what you see oftentimes when someone is in a union job is it actually is a livable wage. [Senator Samra G. Brouk] 11:08:55 And those benefits that come with it mean that that person really can stand on their own with those benefits and wages, which actually helps If you want to talk about state budgets, bottom line, that does help the bottom line to have people who have those things. So those are some of the reflections that I had. Again, I'm really grateful to all the researchers in Cornell for putting so much into this. This is exactly what we need to make more thoughtful. [Senator Samra G. Brouk] 11:09:21 Evidence-based data backed decisions in the state government. So thank you. [Patricia Campos-Medina] 11:09:26 Thank you so much, Senator Brooke, for your thoughts and your idea and connecting union jobs and development, the need for mental health. [Patricia Campos-Medina] 11:09:34 Next. Commissioner Hawks, your reflections and specifically around what is the the the administration doing around civil service and what's their approach and your reflections on the study and how to move forward [Anne Marie Brady] 11:09:49 You're muted. [Patricia Campos-Medina] 11:09:51 Auda? Yes. And while you do that, all the participants We've seen your questions and answers. We will address them at the end of this section. And Anne-Marie will manage that discussion. [Patricia Campos-Medina] 11:10:11 Can you hear me? You can hear me? And so there was an issue with my broadband and it was freezing. So I dialed in through the phone to make sure that The reception was well. So hopefully it doesn't freeze on me. [Patricia Campos-Medina] 11:10:13 Yes, I can hear you now. Yes. [Patricia Campos-Medina] 11:10:27 And so I am excited to be here and I appreciate the opportunity to speak with you today on the things that New York State, New York State Civil Service is currently doing today to make sure that we are hiring and promoting that New York State workforce is starting to grow. [Patricia Campos-Medina] 11:10:47 And that the hiring freeze has been lifted. We know that coming off of COVID, The state was had a hiring freeze and so I joined the administration in June of 2022 and One of the first things the governor said to me is we have a bunch of vacancies in state government and I need you to make sure we get them filled. [Patricia Campos-Medina] 11:11:08 And so we went right to work. Building the New York State workforce has been one of Governor Hochul's top priorities, right along with making sure that mental health was something that she continued to invest in and fight for. And so she has championed protecting and promoting [] 11:11:31 The mental health of New Yorkers with historic investments and housing for people with mental illness and expansion of inpatient psychiatric bed capacity in our state operated and community-based hospital systems. [] 11:11:47 And significant expansions of our outpatient services for people with mental illness and improving insurance coverage for mental health services. [] 11:11:59 With programs like SOS, Safe Options Support. This initiative successfully transition nearly 850 individuals that were on the trains and streets that Senator Jackson spoke to and now these individuals are in stable beds She's fighting to make sure that the hospitals are using [] 11:12:23 The best industry standard standards when admitting and discharging patients. That have behavioral health care. [] 11:12:32 And needs. And so I also want to think, it looks like we have around a little over 70 individuals on the line that are participating with this call. So I thank you for your interest in paying attention to this. [] 11:12:44 Then I want to back up and thank those that put this together, as well as my fellow panelists. And I want to give a special thank you to the senators that have continued to show their support and invest as we continue to look to rebuild [] 11:13:02 The New York state workforce. And so early in my career in 2022, Once again, coming off the pandemic. [] 11:13:09 I had a bunch of the direct care agencies, we call them the O agencies, which include The Office of Mental Health that came to me and said, hey. [] 11:13:18 We need help. Our staffing levels aren't adequate. And the civil service process that we use takes too much time. And so how can we get people to staff these critical positions and direct care more swiftly and so We work together with my staff and we created a program that has been tremendously successful. [] 11:13:39 Called the HELP Program, and it stands for Hiring for Emergency Limited Placement Program. [] 11:13:45 And at that time, it was over 100 direct care titles in both the human And human services and health. [] 11:13:54 Area where we had seen major shortages and so um with that program, as of today, we've hired over, we've appointed over 22,500 individuals into New York State Service. And a lot of those individuals have gone into the direct care mental health services areas. And so we have seen an increase actually [] 11:14:18 And the staffing levels and the support for individuals in direct care and mental health specifically. And so those numbers, I know we had the cutoff at 2023 But that's when our program really kicked off. And so from 2023 to the end of 24, we have seen a significant [] 11:14:40 Increase. And I know we're running short on time But there are a number of initiatives that the Department of Civil Service under the direction of governor hochul we are doing to reduce the barriers to entry for individuals and especially those on underrepresented communities. [] 11:15:02 Senator Jackson knows that we did a job fair, a career fair together in his district. And it was a highly successful one And so with the HELPS program, what it does is it temporarily eliminates the need for individuals to take a civil service examination. And so we know [] 11:15:21 That a lot of times in black and brown communities and in other communities, there is a fear of testing. There's anxiety that goes around testing. And so those that may be able to do the job have been held out of these positions. [] 11:15:34 And these positions are a great pathway into the middle class and supports the economy. [] 11:15:39 We're excited about that. We've also teamed up with the Department of Labor. [] 11:15:46 To create career centers. There's 10 of them located across the state so that individuals can, when they come into the DOL Career Center, they can learn about careers in public service. And those same individuals go out into the communities [] 11:16:02 And do outreach to make sure that individuals know about the great opportunities that are happening and available throughout state government. And the last thing I'll mention is something that we had never done at this scale. [] 11:16:16 Was a marketing campaign. Our partners approved a marketing campaign and funded it. [] 11:16:23 And we were successful in getting so many individuals to come to the website to learn about New York Helps. [] 11:16:31 And one of the ways we did it was on the subways. And so one of our things was a QR code. We see that almost 12,000 individuals were driven to the New York State website to check out the opportunities and jobs and so [] 11:16:46 I'm excited about the direction we're going. I agree that mental health is a priority and the governor has stated that. [] 11:16:53 And she continues to invest in that. And I know that a lot of times, no matter what the thing is, black and brown communities are impacted more adversely than others. And so I'm excited to be a part of this call. I wish we could have had the commissioner for mental health as a part of this, but for whatever reason, that didn't happen. [] 11:17:13 But I think we have an opportunity to continue this dialogue. [] 11:17:18 And look at how we can support our New Yorkers in need and provide the critical services that they require And that they deserve it. So you on this call can do your part. You can drive individuals to the website. [] 11:17:34 Statejobs.ny.gov. Once again, that's statejobs.ny.gov. We still opportunities for individuals to join the workforce and have a fulfilling career. So once again, thank you for the opportunity and hopefully we're back on schedule. [Anne Marie Brady] 11:17:50 You might want to stay on, Commissioner Hogues, because we have a question and answer now. So there will be some questions probably you might want to answer so. [Anne Marie Brady] 11:17:59 Okay. [Anne Marie Brady] 11:18:01 Well, thanks everyone for your thoughtful comments. We have a couple questions from the audience that kind of are in three groups. On the one hand, there's some research related questions, there's some funding related questions, and then there's also some staffing related questions. [Anne Marie Brady] 11:18:15 So I'll start with Nathan Berger from the Robert Hood Foundation. He would like to know. [Anne Marie Brady] 11:18:21 He notes that the state is facing down the possibility of major federal Medicaid cuts. He would like to know Senator Jackson and Senator Brooke, what is the path forward to getting more investment into the system? [Anne Marie Brady] 11:18:34 And to our PEF friends, what is the current ask of PEF for expansion of mental health beds how many beds and how much money are they asking are you asking for in the state budget for this? [Randi DiAntonio] 11:18:47 Do you want me to start or do you want Senator Jackson to start? [Wayne Spence] 11:18:47 Who want to go first? [Anne Marie Brady] 11:18:50 Why don't we start with the first question, either Senator Jackson or Senator Jackson or Senator Brooke. [Senator Robert Jackson] 11:18:58 Well, obviously, we all wait for Washington to hear what's being said. [Senator Robert Jackson] 11:19:03 Day by day. And you and i know that day by day You never know what's going to be said on a particular day. [Senator Robert Jackson] 11:19:11 So what we're doing is obviously looking at what's needed. [Senator Robert Jackson] 11:19:18 And hopefully through our okay Our sources, the governor and others uh you know basically communicating loud and clear that we need help in New York City and New York State and the rest of the state. [Senator Robert Jackson] 11:19:34 That's, you know, important. Just lay out the need. [Senator Robert Jackson] 11:19:39 And hopefully they will hopefully listen and understand. [Senator Robert Jackson] 11:19:44 And if not, then we deal with what we have. That bottom line. And we won't give up. [Senator Robert Jackson] 11:19:51 And we will fight the good fight in order to ensure that We're doing the best that we can. [Senator Robert Jackson] 11:19:56 Under the circumstances with all of the resources that we have, as you know. [Senator Robert Jackson] 11:20:01 The state proposed budget is 252 billion dollars uh and uh Tom DiNapoli, our state controller, said that that about 100% of our pension fund So understanding what we want what we may get or not get from Washington, D.C, you have to be ready. [Senator Robert Jackson] 11:20:25 And getting ready is understanding what your needs are And making those needs known to washington And hopefully they will listen and understand. [Anne Marie Brady] 11:20:37 Senator Brooke, do you have anything to add there? [Senator Samra G. Brouk] 11:20:40 Yeah, quickly. Unfortunately, it's hard to have concrete answers and then non-concrete world right now. It's very chaotic. [Senator Samra G. Brouk] 11:20:50 To understand what is going to happen and we can really only kind of, we are thinking about it. There's forethought and all of these things, but in some ways you can't really act until you see what you're dealing with. And so I think as we get closer and closer to the budget. [Senator Samra G. Brouk] 11:21:05 One thing I thought a lot about is how do we make up for any gaps here in New York State? We have pathways of finding more funding in terms of raising revenue for the state, especially in a crisis time like we may find ourselves. So I think the key is that everything has to be on the table to ensure that we're not making drastic cuts and going back to this [Senator Samra G. Brouk] 11:21:29 Austerity place that was referenced earlier in this conversation because that's how we got here. So the hope, at least from our perspective, is that we've learned from that past and that we aren't going to go back there and make sure that the most critical programs are continuing to move forward. [Wayne Spence] 11:21:47 Patricia, before you go to the PEF question, I'd like to weigh in. [Anne Marie Brady] 11:21:47 Thank you. [Wayne Spence] 11:21:50 It's not going to be just up to electives. It has to be up to us. We are affiliated with two internationals, AFT and SEIU. [Wayne Spence] 11:21:57 We believe that funding that was appropriated by Congress needs to go out. We believe freezing stuff that was appropriated is not. [Wayne Spence] 11:22:05 So our staff will come up with something about don't cut me. We don't believe that these cuts are going to be The effects are going to be bipartisan. He might be a Republican and live in a rich area. [Wayne Spence] 11:22:16 But if you want to go see a Broadway play, you might have to step over, go in the places where mentally ill are going to be. They're going to have a direct impact. So we're looking at something to make sure that [Wayne Spence] 11:22:28 Our congressional delegates don't walk away and they're going to have to feel the pain. And as they feel the pain, they're going to have to hear. [Wayne Spence] 11:22:35 From us and we're going to have to educate our constituents and voters of what these frees and those impact will be. And we're looking to start doing a campaign like that. [Randi DiAntonio] 11:22:49 And I can take the last part of the question around the budget ask. So two things. One, if you go to the PEF website under departments. [Randi DiAntonio] 11:22:58 Our full mental hygiene budget is there and you can read it in totality. [Randi DiAntonio] 11:23:04 But just very quickly, there's many things that the governor put in her executive budget that we fully support. [Randi DiAntonio] 11:23:11 That would fund additional beds At the Manhattan Psychiatric Hospital, the Capital District Psychiatric center so In the budget, we support the $160 million to staff 100 forensic beds. [Randi DiAntonio] 11:23:27 Another acute care unit at the Capitol District Psych Center. As well as money to expand staffing at OMH by 604 positions. [Randi DiAntonio] 11:23:38 And, you know, those are all things that we think are really critically important. [Randi DiAntonio] 11:23:43 To enhance the safety net that is currently lacking. The other budget request that we have that I think is really important to highlight is we are asking for 25 million to increase the number of state operated teams which are a sort of community treatment teams [Randi DiAntonio] 11:24:01 As I mentioned earlier, there are many parts of the state and many OMH facilities that do not have those services. [Randi DiAntonio] 11:24:09 But our asks are around staffing as well. We can't just open beds And we're happy to have these beds budgeted for. But if we don't have the staff to provide the services. [Randi DiAntonio] 11:24:21 To provide the support, that's a problem. So in our budget request, we are also asking our legislators and the governor to look at enhancements to tier six additional ones. We are very thankful for the ones we already have. [Randi DiAntonio] 11:24:35 Have received, as well as looking at the wage study that was done I believe it was budgeted for two years ago to look at the totality of wages across all public sector jobs But I can tell you the staffing issues are not limited to OMH. They're OCFS, OPWDD, [Randi DiAntonio] 11:24:54 Oasis and those systems are interconnected If you have people with addiction issues and they can't get into Oasis and they can't get into OMH, or children or youth where there's no beds left you know we're looking to reinforce all of those services and our budget requests and our testimony do reflect that. So I encourage you to please look at it. [Anne Marie Brady] 11:25:16 Thank you, Randy. So there's been a lot of talk about budgeting and scaling up staffing, but we have a question here. What are the specific state level policy and legislative changes you are seeking as a solution to some of these issues that we talked today? [Anne Marie Brady] 11:25:32 Talked about. So is it just budgeting or are there actual other changes in the works, policy, legislative changes? [Anne Marie Brady] 11:25:42 Does that make sense? [Randi DiAntonio] 11:25:45 I can speak to one of what would be a policy initiative, a legislative change is related to the involuntary commitment process. [Randi DiAntonio] 11:25:54 Look, there are some individuals, and as a clinician, I will say there's no clinician I'm going to speak for all of us, even though that sounds odd. [Randi DiAntonio] 11:26:06 That we all want people in the least restrictive settings where they can be safe. [Randi DiAntonio] 11:26:10 Where they can help manage their own treatment needs. But there are a small minority of people that do need more than that. And so, you know, the process that the governor laid out would have to be supported by legislators. We think there were some concerns with it. [Randi DiAntonio] 11:26:27 That I'm not going to get into because they're details, you know, not the concept But conceptually, we do need a way to help people who are falling apart, decompensating. [Randi DiAntonio] 11:26:40 Having problems in the community to be able to bring them back into a setting where they can be safe and where the community can be safe. [Randi DiAntonio] 11:26:47 And so that's one proposal in the state budget right now that I know has a lot of There's a lot of discussion around it and a lot of controversy around it. And it has to be done with balance and caution. [Randi DiAntonio] 11:27:00 But it is a policy that I think would help a lot of people who are really the most seriously ill and are not able to get what they need. [Wayne Spence] 11:27:08 Right. And I want to piggyback on that because as we start to move away from incarceration of mentally ill. [Wayne Spence] 11:27:14 We are seeing more and more mentally ill folks who have core forensic meaning that they stabbed a person 32 times. [Wayne Spence] 11:27:25 And they were not competent to stand trial In court, they were deemed not competent and they go into a mental health facility. Then they assault staff. [Wayne Spence] 11:27:35 And when they assault staff, they go in front of a judge and a judge put them right back where they were. [Wayne Spence] 11:27:41 Because there's no forensic. We need to have, OMH is way behind. They're in 1980s. They are not looking at the fact that they're now have clients. [Wayne Spence] 11:27:52 Who needs forensic units. So we need to have a conversation with the governor to force OMH to reconsider their policy on the issue around forensic units. [Wayne Spence] 11:28:01 Because they don't exist. They got caught under the governor. Cuomo. And for some reason the commissioner And OMH will not acknowledge it. [Wayne Spence] 11:28:11 Will not acknowledge what's going on with staffing and the fact that the members I represent are being brutalized at times with no consequences. [Anne Marie Brady] 11:28:20 Thank you. Thank you. Senator Jackson, Senator Brooke. Any thoughts? [Senator Samra G. Brouk] 11:28:29 Yeah, I mean, I think two things. I mean. The budget is around the $200 billion plus spending that the state needs to do. So that's what we, I think, should be focused on. Obviously, in New York State, there's a lot of policy that gets into our budget year after year. [Senator Samra G. Brouk] 11:28:45 So we're going to have to make some of those decisions, but that doesn't all happen in the budget either. We have an entire legislative session where we look at different policies that, you know, through the second week of June, where we're looking at policies that need to address some of these issues. But, you know, I think that Honestly, one of the biggest things that we need to do [Senator Samra G. Brouk] 11:29:08 Is increase the investment and get more staff and workforce into these positions because We talked about supportive housing. We need more housing first. We need people to be able to get in housing more quickly. I know New York City has the most rapidly growing homelessness rate right now, right? These are problems and we need to get people housed. [Senator Samra G. Brouk] 11:29:31 And so, but you can't have supportive housing units if you don't have a workforce, right? So we can do things to speed that up. And we talked about this at our mental health hearing yesterday. But at the end of the day, we also need the staff there to do it. So I think we would be wise to make sure that we do everything we can in the next few weeks [Senator Samra G. Brouk] 11:29:52 The next month or so, I guess, before the budget is due to make sure that we have those allocated funds and also look at where we need to make changes, whether it's mental hygiene law or otherwise. [Senator Samra G. Brouk] 11:30:04 To ensure that we're better serving New Yorkers as well. [Anne Marie Brady] 11:30:07 Thank you. And we have one minute left for Commissioner Hogues. There is a question here. There have been lengthy delays in the HELP Act. [Anne Marie Brady] 11:30:15 Requests for local municipalities for titles and streamline hiring. How can this or how can you address those delays for local HR departments? [Anne Marie Brady] 11:30:27 So we have already streamlined our process to help agencies to help titles through the state civil service commission and They can reach out to me, but we've broadcasted it out to the local municipalities for that. And our last conference that we had where we brought everyone together, that was one of the things we heard. And then we made those changes. But the one thing I do want to say real quickly, I know we're short on time, is that [Senator Robert Jackson] 11:30:28 Every… [Senator Robert Jackson] 11:30:55 A couple of things. One. I ask that the mental health commissioner be part of this, but for whatever reason it was decided that that was not going to happen. [Senator Robert Jackson] 11:31:06 Number two, I would like to thank, I have a great relationship with PEF. We meet on a regular basis and talk through the issues or opportunities that we have in state government and hiring and around these issues. So I'm glad that we have formed that great relationship. And then number three, to elected officials, I am always available to have conversations about what's going on in the world of civil service and staffing and those types of things. [Senator Robert Jackson] 11:31:34 And we're always, we're available as well to come on site and do job fair, career fairs, or just do education about the program that we have as far as New York helps and what's going on. And the final thing I'll say is that [Senator Robert Jackson] 11:31:50 When we talk about filling positions and through this HELPS program, OPWDD and OMH have been some of the top users as far as bringing in folks to state government. And so we're excited about this. And a lot of the information is on our website. [Senator Robert Jackson] 11:32:11 And I keep lying, I sound like a Baptist preacher. I say, one more thing, one more thing. I know there was a conversation about compensation study. And so that has been awarded to Deloitte. And we believe that that will be completed by the end of this year. [Senator Robert Jackson] 11:32:28 And the group that is overseeing that is called Classification and Compensation, which last year just celebrated 75 years in existence. [Senator Robert Jackson] 11:32:37 And the thing that that does is make sure that titles make sense as far as the compensation that individuals get. [Senator Robert Jackson] 11:32:44 And to address a lot of the issues we've seen in mental health and other areas. [Senator Robert Jackson] 11:32:49 There have been compensation adjustments such as geographic differentials paid and also moving starting salaries to the mid-range point because we've talked to our partners and heard that we want to make sure that we stay competitive. [Senator Robert Jackson] 11:33:04 We're a partner and we're excited to be a part of this and look forward to what's to come next. Thank you. [Anne Marie Brady] 11:33:10 Well, thank you everyone and thanks everyone for taking an extra three minutes. I wanted to round out these questions. Rusty, I'm sorry we didn't get to the research questions, but Always feel free to contact Rusty Weaver or myself. [Anne Marie Brady] 11:33:24 And we can answer those for you. I would just a very heartfelt thank to Senator Robert Jackson, Senator Sandra Brooke. [Anne Marie Brady] 11:33:31 Commissioner Timothy Hogues, Vice President Randy D'Antonio and President Wayne Spatz from PEF. [Anne Marie Brady] 11:33:36 For your time today. And these are really crucial, important, very difficult issues, but we're moving forward