Gov. Kathy Hochul appears to have secured many of the expansions to involuntary commitment that she pushed for in the state budget.
On Monday, the governor announced a preliminary agreement with legislative leaders on a record $254 billion budget for the current fiscal year following months of negotiation. Talks had stalled long past the April 1 start of the fiscal calendar due to impasses on a series of policy issues, including the increased reliance and ease of involuntary commitment, that appear to have been largely resolved.
Initial details of the agreement include language to codify the ability of clinicians to commit people to a psychiatric hold against their will when they appear to be unable to meet basic needs like food, medical care and shelter, according to Brian Mahanna, Hochul’s counsel.
Assembly Speaker Carl Heastie and Senate Majority Leader Andrea Stewart-Cousins initially opposed any expansion to the state’s commitment laws in their response to the governor’s original $252 billion proposal citing the need to protect civil liberties and invest more in voluntary treatment options. But the leaders appear to have capitulated, at least in part, to the governor’s push, which echoed previous budget negotiations in which Hochul forced changes to the state’s involuntary mental health treatment laws, pushing negotiations beyond the fiscal year deadline. Full details will be available in the coming days.
Stewart-Cousins’ office did not respond to requests for the details of the agreement. Heastie’s office referred Crain’s to the speaker’s remarks Monday afternoon after the governor’s announcement, in which he told reporters the deal fell “along the lines of the governor’s plan” but with assurances related to discharge planning for psychiatric patients and opportunities for mental health providers to offer interventions.
Hochul has been pushing to give police and clinicians a stronger hand in holding and treating people who appear to have untreated severe mental illness as part of a broader push to address street homelessness and perceptions of public disorder.
The budget agreement will allow nurse practitioners to be one of two clinicians required to sign off on an involuntary commitment in some cases, according to Mahanna, another of Hochul’s proposals, which was backed by the state’s nurse practitioners’ union. Current law requires the signature of two doctors.
Hochul is also continuing with her expansion of state-run psychiatric institutions with the inclusion of $160 million for additional so-called “forensic” beds – high security wards reserved for people entering involuntary commitment through the criminal legal system – in facilities in the five boroughs. The money will continue the administration’s aggressive expansion of institutions, which added 125 beds in the first four months of 2025, a reversal of decades of downsizing.
The agreement includes $16.5 million to support so-called assisted outpatient treatment under Kendra’s Law, which allows court-ordered services, including medication, for people with mental illness. The budget contains other changes to Kendra’s Law, including making it easier to reinstate mandated treatment within the first six months of exiting the program and clarifying that a person may still be eligible for AOT even if the treatment was unsuccessful in the past, according to Nicolette Simmonds, a spokeswoman for Hochul. The plan will establish training for police officers on the new program and another $2 million will go to support general staffing at the state Office of Mental Health, which runs long-term institutions and oversees many of the state’s community-based and residential services.
The budget will also require better care coordination between hospitals and community providers after a patient is discharged from psychiatric treatment and mandates that Emergency Medical Services transport people who have been involuntarily removed from a public space due to an untreated mental illness wherever practical, Mahanna said. Full details on both measures have not been released.
