State mental health leaders are turning up the pressure to see a combination of the Legislature's and Gov. Kathy Hochul's proposals in the next state budget as the deadline looms and talks continue.

The Legislature and the governor are committed to historic investments in the state's mental health, but differ on where to prioritize funding in the overwhelmed industry.

Lawmakers are pushing for the 8.5% cost-of-living adjustment pay increase for mental health workers, included in both the Senate and Assembly's one-house budgets, compared to the 2.5% Hochul proposed.

A 8.5% pay increase in the final budget remains the No. 1 priority for mental health leaders.

"You can build the best system in the world, but if you don't have the workforce to be providing out there and working, then what difference does a great system make?" said Glenn Liebman, CEO of the Mental Health Association of New York State. "From both sides of the aisle, this universal declaration of the 8.5 is incredibly important to us."

Liebman has also been pushing the Legislature for weeks to budget for a program that would create a pathway for someone with a high school or two-year degree who wants to pursue a career in the mental health field.

The program to help bolster the workforce was left out of the Legislature's proposals.

"It was disappointing that it was not in either of the Assembly or Senate one-house budgets," Liebman said.

Hochul included a historic $1.1 billion for mental health programs in her executive budget, with millions of dollars proposed to expand psychiatric treatment, mental health services in schools and to develop housing.

Advocates say the budget must fix the disparity in the commercial and Medicaid coverage for students using school-based mental health clinics the governor proposed to expand. 

Students enrolled in Medicaid can currently get more services while others pay out of pocket beyond deductibles or co-pays — a focus as anxiety and depression in school-aged students reaches historic highs in wake of the COVID pandemic.

Matthew Shapiro, with the state chapter of the National Alliance on Mental Health, praised the governor and Senate for addressing this in their budgets, but is disappointed it was omitted from the Assembly's.

Cost, a lack of insurance coverage and network adequacy leads to about 36% of people to decide not to seek mental health care, Shapiro said.

"Making sure people have access to mental health care in a timely manner, and that it's covered, is our primary concern," he said, adding the governor's plan to create more school clinics would improve ease of access to care for students and their families. 

"Those services need to be covered right now," Shapiro said. "And right now, they wouldn't be. ... We're really urging the Assembly to join that cause as well."

Advocates also want the Legislature to support Hochul's proposal to spend $30 million to increase inpatient beds for psychiatric treatment, reopen 150 more beds in facilities that closed during the pandemic and fine facilities that don't comply $2,000 per day.

The Senate proposed reducing the fine to $1,000 a day while the Assembly didn't include the provision to ensure beds reopen.

In the early days of the COVID-19 pandemic, former Gov. Andrew Cuomo instituted a mandate requiring all hospitals to keep 30% of their beds available to help with an over surge of coronavirus patients in other parts of the state. It was a catalyst for hospitals reducing the number of available psychiatric beds to meet the requirement.

"When we talk about hospital beds, in no way are we trying to return or to go back where hospitals are overused and asylums and things like that," Shapiro said. "Hospitals are really designed for acute stays, and are a necessary part of continuum for care. We don't want to overuse hospitals, but we want hospitals to be used more effectively."

People across the state typically wait days for an available psychiatric bed in a hospital, or are often placed on even lengthier waitlists.

Advocates also continue to push legislative leaders and the governor to strengthen the state's required procedures when a person seeking mental health care is admitted or discharged to a facility, and ways to connect them with other care available through local community organizations.