Not-for-Profits Play Major Role in Rockland County

August 17, 2011

Not-for-Profits Play Major Role in Rockland County's plan to close clinics, other county run programs

NEW CITY — Two nonprofits are prepared to serve the residents now enrolled in a mental- health program targeted for closure because of Rockland County's $51 million budget deficit.
County Executive C. Scott Vanderhoef pitched a list of possible cuts in June in an effort to cut expenses and address the deficit. He said they were meant to launch a public discussion about which non-mandated county programs could be cut.
The list included the county-run adult home, a prenatal program, the sheriff's prisoner transport unit and two mental-health programs — a clinic in Haverstraw and a day-treatment program in Ramapo.
Vanderhoef is proposing that the cuts, which total more than $4 million, be implemented before the end of the year. He has a second list of suggested potential cuts totaling more than $9 million ready for 2012.
To save about $65,000 in rent, he wants to close the county Department of Mental Health's Outpatient Mental Health Clinic in Haverstraw, where about 135 people receive services, said county Mental Health Commissioner Mary Ann Walsh-Tozer.
Walsh-Tozer said those consumers would still be able to access all services at a similar clinic on the grounds of the Dr. Robert L. Yeager Health Complex in Ramapo.
Both clinics provide counseling, evaluations and medication management, and are staffed by psychiatrists, nurses and social workers.
To save $650,000, Vanderhoef has proposed closing a day-treatment program on the grounds of the Yeager complex called the Community Support Center, or CSC.
The 135 people receiving services at the CSC suffer from various mental illnesses, everything from severe depression to paranoid schizophrenia.
The program provides daily structure in their lives and allows them to build a relationship with the staff, including psychiatrists, nurses and social workers, who help consumers learn how to manage their symptoms.
Those same professionals can also spot and address any "negative" symptoms that arise to help consumers avoid relapses and the need for costly re-hospitalization.
But the services of the CSC and of many day-treatment programs, Walsh-Tozer said, are only treatment-based.
The state has been encouraging more recovery-based programs and the county has been preparing to shrink its day-treatment program as a result.
The state wants an updated program that not only provides the services found at the CSC, but also works with consumers to allow them to identify their life goals, Walsh-Tozer said.
As a result, Rockland has been preparing to transition its CSC program, and many of its current consumers will soon find themselves in a Personalized Recovery Oriented Services program, or PROSE.
Both Jawonio and the Mental Health Association of Rockland will offer a PROSE program. Jawonio launched its version Aug. 1 and already has 140 participants, with room for up to 230, said Jill Warner, the agency's executive director.
Warner said PROSE would help address individuals' needs and abilities "holistically," playing to their strengths and how those strengths can be used to help them be as independent as possible.
The Mental Health Association of Rockland plans to launch its PROSE program in January, said Karen Oates, the agency's executive director. An estimated 230 people will be able to participate in it, she said.
Oates said PROSE takes mental-health treatment "from an illness model to a wellness model."
All of the experts stressed that the terms "recovery" and "wellness" did not mean a person would be "cured," but that approaches to his or her care were intended to be more holistic and individually empowering.
Warner and Oates said their agencies could provide PROSE services at a much cheaper cost than the county because they paid lower wages and benefits.
The experts also said that there would still be a need for the county's day-treatment CSC because some consumers would not meet the criteria to participate in a PROSE program.
But a two-thirds reduction in the number of consumers in the county program would bring some cost reductions, Walsh-Tozer said.
She said she suggested both the Haverstraw clinic and day-treatment CSC cuts to Vanderhoef after he requested ideas for reducing expenses.
Walsh-Tozer said her suggestions totaled at least $400,000 because some CSC staff could be relocated to other department programs, in turn reducing the need for relief workers.

Category: ACL Updates