Chair Cabán on mobile treatment team wait lists and capacity

The exec plan, it increases...

Includes baseline funding for $47.3 million starting in fiscal year 27 to address a funding cliff for mobile treatment teams.

So my understanding, my reading of the proposed exec budget is that they're not operational expansions associated with funding.

It's just addressing federal cuts.

So it's not like an investment above what we have been doing.

And obviously, we're interested in seeing the admin expand mobile treatment teams because there's a growing need, but also...

There has been an existing wait list that we would like to clear.

So is DOHMH planning any operational expansions for mobile treatment teams in FY27?

Yeah, thank you again, Chair, for that question.

It's incredibly important we get this right on mobile treatment.

Since 2016, so about 10 years now, we have doubled the mobile treatment capacity in this city.

We know that that's just the scratching surface.

There's much more work to do on this.

I'm going to hand it to Aaron to talk a little bit more about the budget here.

Yeah, I just wanted to echo Chair Cabana.

That's correct.

Your reading is correct about the 47.3.

And to stay in order,

For a second, we may have doubled the capacity, but also we're seeing, and this is why there should be coordination, we're also seeing a vast increase in what we call broken windows policing or low-level offenses, and a lot of these folks that are getting picked up

on those kinds of offenses and then finding their way to Rikers Island are people living with a mental health diagnosis.

So we have like some cross-competing outcomes where like you may be expanding capacity, but then we're doing harm on the other end.

So yeah, if you could continue.

Yeah, no, I'll leave it to others to talk about any potential future plans, but just to say yes, it stabilizes the funding that had been covered by expired federal stimulus dollars.

And are you looking on adding on top of that?

I mean, I think we're always thinking about what the resource needs are for the agency, but from a programmatic perspective, I'll leave it to others.

So what, in terms of the, what is the total funding allocated for IMT and ACT and the executive budget?

And then just to break that down a little bit, what's coming in from the state and whatever's coming in from the state, will that get used towards new contracts or that's just to keep the status quo of what we've got right now?

I'm going to hand it to Aaron to talk about the budget here.

Yeah, so thanks.

So putting aside the one-time funding from FY26, this is the partnership between the admin and the council.

So the CTL budget is baselined at 20.5.

Which we should probably baseline, I think.

So the current CTL budget, aside from that,

Anyways, 20.5 for ACT, 4 million for FACT, 44.3 million for IMT.

Okay.

And how much of that is coming in from the state?

I can get back to you probably shortly with a specific breakdown.

Okay, thank you.

How many people are currently on the citywide ACT and IMT wait lists?

Let me hand it to Assistant Commissioner Jamie Nichols for that.

Thanks.

So we get about 5,000 referrals a year to our adult single point of access.

Everybody who's referred is offered a care coordinator.

I'm happy to say that we have capacity in care coordination.

Those folks go out and visit with people proactively wherever they are in the community, help them find or stay connected to treatment and benefits and address housing and things like that.

Some people, that's sufficient.

The care coordination is what they want, and they stay there, and they go to clinics or other places to get their treatment.

And I know we got this information on the prelim budget.

Again, I just want to move to what currently is the wait list.

And I understand also some people qualify for both, and so that kind of complicates the numbers.

But, again, I just want to.

I'm trying to help our team stay on time.

Yep, yep.

We've got 600 people waiting for IMT, 200 for FACT, 367 for ACT, and 87 for SPAC.

Okay.

Those change daily, right?

Assignments are...

Made people are connected probably you know 80 90 people a week are connected to these programs newly as other people transition off so it's very dynamic yeah

But still, even with the dynamic nature of it, that's a significant need.

What are the resources needed to clear the wait list?

Yeah, so I think, as the Commissioner mentioned, we've doubled mobile treatment capacity over the last 10 years, and yet wait lists have persisted in that time.

So obviously, it's not simply straightforward, just adding teams, eliminating the wait list, because there's other pressures on the system.

We're focused on offering additional resources for people to step down from these services into other...

longer-term treatment arrangements.

So we have our Connect Clinic Enhancement Model, which we're, a demonstration project has been going really well, handling step-downs.

We have Flex Act teams, which provide larger capacity state caseloads.

Those are RFP'd by the state, but those services flow through us.

And so we think those step-down resources can allow us to use the existing mobile treatment capacity more efficiently.

And I'm going to apologize to my, oh wait, he's not here.

Okay, so I'm not taking his question.