Last Updated on Tuesday, 28 June 2011 15:04

Several members of the Westchester County Board of Legislators (BOL) expressed major concerns today about the imminent closing of County-run mental health clinics, chief among them whether the thousands of patients under treatment have been properly transitioned to new programs and treatment providers.

The issues regarding the closing of the four County-run mental health clinics—in Yonkers, Mount Vernon, Mount Kisco and Peekskill—were addressed at a press conference this afternoon in the Rotunda outside the BOL Chambers in the Michaelian Office Building. Among those legislators in attendance were BOL Chairman Ken Jenkins (D-Yonkers), Community Services Committee Chairwoman Alfreda Williams (D-Greenburgh) and Community Services Committee member Bill Burton (D-Ossining).

Initially, the County Executive’s 2011 Budget proposed to close the Mount Kisco and Peekskill clinics on December 31, 2010, and the Yonkers and Mount Vernon clinics by June 30, 2011. The rationale for doing so has been to save money, since state reimbursement for these services has been steadily shrinking. Nonetheless, New York State requires that when County-run mental health clinics are closed, those suffering from mental illness who have been receiving treatment and attending programs at the clinics needed to be properly transitioned.

Realizing that it would be unconscionable and pose a public safety risk to simply close the clinics without a proper, and state mandated, transition for the patients, the BOL included in the budget money to keep all of the clinics open and staffed until June 30, 2011.

“To think that vital mental health services for county residents could be simply turned off, like water from a spigot, without any serious repercussions or ensuing incidents involving harm to the patients or others, is simply inhumane and incredibly short-sighted,” said Jenkins. “Restoring mental health funding in the budget, at least to transition the patients to new service providers, was absolutely mandatory.”

By June 30, 2011, all four of the County-run mental health clinics will be closed. (The Peekskill and Mount Kisco sites closed earlier this spring.) In 2010, it was estimated there were over 24,000 visits to the four clinics in total. Open since the 1950s, the County-run clinics were regarded as important havens for those with mental illnesses. Some patients have been on the rolls for decades. About a dozen not-for-profit community organizations around the county will be picking up the patients from now on.

As part of the 2010 Budget Act, Dr. Grant Mitchell, commissioner of the Westchester County Department of Community Mental Health (DCMH), was required to present a full transition plan for closing of the four clinics to the BOL for approval. The Committee received a single sheet of bullet points outlining a plan that was found unsatisfactory by the Committee members. Finally, following his appearance in front of the Community Services (CS) Committee (via video feed) on June 21, 2011, Dr. Mitchell provided a synopsis of actions taken by DCMH to close the clinics—and a slightly longer outline of a plan. He promised the committee a more detailed plan this week, but it has not arrived.

Meanwhile, transition for the clinics has ended up costing an additional $300,000.

What has disappointed CS members is that Dr. Mitchell initially didn’t discuss the clinic closings with clinic directors and staff members, many of whom realized they were soon to be out of a job following receipt of a simple termination letter in the mail.

Meanwhile, all of the present patients of the clinics have not been found to be notified that clinics are days away from being closed—even though they were not supposed to be shut until after every last patient has been transitioned. A note on the door with a phone number to call will greet them when they come for help. Over 100 patients from the Yonkers and Mount Vernon clinics have not been “transitioned” as of today. Untreated patients, and those off their medications, can lead to serious, even tragic consequences, such as the Connie Russo incident a few years back.

Community Services Committee Chairwoman Williams noted that the BOL still has not received the letter signed by the New York State Mental Health Commissioner that exempts Westchester from Section 41.07 (a) of NYS Mental Hygiene law, which was also required by the adopted budget act in December, that states “(l)ocal governmental units may provide local services and facilities  directly  or  may  contract for the provision of those services by other  units of local  or  state  government,  by  voluntary  agencies,  or  by  professionally qualified individuals. “The County cannot oversee mental health services undertaken by the not-for-profits without a contract in hand,” said Williams. “Otherwise, the State needs to issue the County a written exemption, which we don’t have at this moment.”

In terms of the transitioning of patients, there are still a lot of unanswered questions, said Burton, pointing to waiting lists at some of the not-for-profit agencies that will be handling the mental health patients from the clinics. “How long a wait is too long for someone with a serious illness or problem?” Burton asked, adding that new patients will have to wait even longer to be helped. Also, in many of the transition cases, the clinicians seeing the patients weren’t among those actually closing out the casework files.

There are also concerns that Spanish-speaking patients will not find clinicians at the new programs who can converse in their language.

“We are eliminating an important program run by mental health care professionals that served thousands of people around the county and hoping that part-time clinicians at already strapped not-for-profit organizations will now do the work,” said Williams. “There has to be a better way to save some money in our budget rather than unfairly target those who truly need our help.”