Ed Day, Rockland County Executive

August 21, 2015
Contact:  Scott Salotto (845) 638-5645


NEW CITY, NY -- County Executive Ed Day, District Attorney Thomas Zugibe and other local officials today released the final report of the County Executive's Commission on Community Behavioral Health, which sets out its recommendations to reshape the behavioral health service delivery system in Rockland County in a financially sustainable way.

"Improving behavioral health services is a top priority of my administration," said County Executive Day. "With these valuable recommendations, we take a major step toward ensuring that individuals and families facing behavioral health issues get the help they need, anywhere, anytime in Rockland County."

As part of his mission to improve the lives of all residents of Rockland County, including some of our most vulnerable citizens, County Executive Day formed the County Executive's Commission on Community Behavioral Health in August, 2014. Pulling together some of the most dedicated, passionate and talented individuals with experience and expertise in the human services field in Rockland County, the Commission's primary task was to conduct a thorough, countywide community assessment of behavioral health needs, including an analysis of strengths and gaps. This year-long assessment would assist in better meeting these needs in a comprehensive and culturally-sensitive fashion, both now and in the future.

Upon conclusion of the assessment, the Commission provided both a comprehensive profile of Rockland County's current behavioral health needs, resources and opportunities, and made more than 200 recommendations for specific actions to re-design the County's mental health, chemical dependency treatment and prevention and developmental disabilities services.

Critical findings and related recommendations were divided into five categories:

Strengths of the Current System
Programs where consumers, residents and providers felt satisfied with services.
RECOMMENDATIONS: Use of consumer satisfaction surveys, expansion of services that are working, County taking a role in encouraging collaboration.

Lack of Awareness of Behavioral Health Services
Both the public-at-large and the providers/consumers were unaware of many of the services currently available in Rockland County.  The Commission identified a need for a centralized site to find behavioral health resource information.
RECOMMENDATIONS: Create a "one-stop" site for information regarding behavioral health, possibly by an expansion of or connection with InfoRock, and the County changing contractual requirements to ensure that agencies provide updated information - at least annually -  on their services.

Barriers to Receiving Care
The barriers included transportation and housing. The largest obstacle involves a lack of insurance or insurance not accepted.  Cultural competence was lacking (languages spoken, cultural awareness). Hours of operation, location of services were also identified as problems.
RECOMMENDATIONS: Include reduced bus fare to help consumers access behavioral health services; County advocacy on state and federal levels to address insurance restrictions (make behavioral health parity a reality); training on cultural issues; recruit a diverse workforce; change/increase hours of operation to include evenings, weekends, satellites in the community.

Gaps in Services
Gaps in service represent the largest shortcoming in the County's current behavioral health delivery system.  Gaps fell into seven categories:  adult mental health, chemical dependency, child and adolescent mental health, crisis services, co-located services, criminal justice, intellectual/developmental disabilities.
RECOMMENDATIONS: Adult mental health included re-imagining/expanding services of Rockland Psychiatric Center through telepsychiatry and a re-branding of clinic; intensive outpatient services, and increased access to beds at Rockland Psych.  Chemical dependency included and expansion of prevention counseling services and treatment services; children and adolescents included a new child clinic through RCPC; expansion of school-based programs and family support; expansion of behavioral health services at the Rockland County Jail and probation department.

Role of Government
All felt that local government plays a vital role. State and federal governments are perceived to be too large to understand and focus, while municipalities are too small to appropriately meet needs. Expectations of government included planning and coordination, advocacy, needs assessment, policy development.
RECOMMENDATIONS: Revitalize the former Unified Services System (rename to the Unified Services Behavioral Health system);  re-empower the Community Services Board and County planning process to be more connected to County Executive and Legislature; allow greater government input into decisions affecting behavioral health;  coordinate overall behavioral health system re-design through the County Executive's Office (cuts across multiple departments and systems both within and outside of government).

During the Commission's assessment process, the County began working collaboratively with local nonprofit partners to develop ways to support the services provided by the agencies, creating a seamless relationship between government and providers. This includes improving the system in which agencies apply for County dollars to provide services. (applications are now found on the County's website)  In addition, all County departments will schedule visits to the agencies to provide guidance, identify areas for improvement and to see that residents are receiving the services they need and deserve.

In the months ahead, the County will move to an oversight role in the delivery of behavioral health services. As funding is secured from the state and federal levels, the County will act as a "pass-through" to local nonprofit partners to develop and implement programs in the form of direct care services to residents.

Said County Executive Day, "In response to the recommendations of the Commission, we are moving our County approach to services from a 'direct provider' to the role of oversight, facilitator and policy-setter. The recommendations of the Commission will be the road map that will guide our efforts to secure state funding, which will be passed on to our nonprofit partners."

Many of the Commission's recommendations can be accomplished with current resources, while others will require a modest increase in resources.  The Commission found that many recommendations can be implemented immediately, while others will take place over a longer period, due largely to the challenge of overall system redesign. The Commission proposed a five-year-plan for full implementation.

In the first eighteen months of the Day Administration, several unique behavioral health initiatives have been successfully launched, including the County's first Behavioral Health Response Team (BHRT) and the MACSHY (Multi-Agency Collaborative for Safe and Healthy Youth) at BOCES in Nyack. Additionally, two new clinics were opened in the community: a school-based clinic inside Fieldstone Middle School in Thiells and a separate community-based clinic inside the Haverstraw Center. Rockland Psychiatric Center in Orangetown has also committed to an increased percentage of beds for Rockland County residents.