Dear Governor Cuomo:

On behalf of the Campaign for Healthy Minds, Healthy Kids, thank you for your work to help New Yorkers respond to and recover from the impacts of COVID-19. As children and families in New York continue to grapple with the emotional and psychological effects of this pandemic, we seek your continued support and protection of essential children’s behavioral health services, and the restoration of the 1.5% cut to children’s Home and Community Based Services (HCBS).

Your Administration has taken important steps towards combatting the negative mental health impacts of COVID-19 on children and families. Waiving insurance copays and other fees for mental health services for essential workers and their children was an important recognition of the toll this pandemic has taken on frontline workers and their families. By advancing new regulations around parity compliance, you have helped ensure greater access to essential behavioral health supports for struggling families. Even prior to this pandemic, your support of children’s behavioral health in the FY 2021 budget has been essential for ensuring our mental health workforce was better prepared to confront the explosion in needs facing children and families.

As important as these steps are, we know that children’s need for behavioral health services has never been greater. Social isolation, loss of peer contact, and loss of routine have all impacted children’s emotional wellbeing. Extreme economic distress and the loss of loved ones have created heightened stress for young people, which can manifest as depression, difficulty sleeping, anxiety, and suicidal ideation. Even prior to this crisis, we were beginning to see a rise in suicide among Black youth. The factors driving this spike – including job loss and economic insecurity, lack of access to mental health resources, and the toxic stress of racism – have all been heightened during this crisis. Though hospitals saw a temporary decline in patients during the height of COVID, doctors are seeing a growing number of young people come to hospitals with dangerous psychiatric emergencies, and fear that conditions will only worsen without an adequate response.

Too many young people have seen their regular access to behavioral health supports reduced or eliminated due to this pandemic. Many students relied on school not just as a place for education, social support, and routine, but as a place to receive school-based behavioral health services. Budget cuts at the city, state, and federal level have made it harder and harder for clinical and community-based providers to serve their communities. Telehealth has been a critical lifeline for many children and families, and the State’s actions to provide temporary flexibility and codify reimbursement of audio-only services has enabled greater access to these resources. We appreciate these recent steps and look forward to working with your Administration to build on these actions. However, we also recognize that telehealth cannot alone meet the needs of every family, particularly with those facing barriers due to the digital divide, age, privacy, type of services needed, or inadequate linguistic or cultural supports, nor can telehealth make up for inadequate capacity more broadly.

Only by investing in children now can we avoid the long-term repercussions of trauma and unmet mental health needs. Those families most impacted by the economic downturn, illness, and loss are those most in need of behavioral health supports for their children. We strongly support the State’s efforts to pull down additional federal funding, and stand ready to support in any way we can. We also recognize that by protecting and strengthening investments in the state, we will see reductions in hospitalizations, emergency room visits, and the development in children of more complex needs that will be harder to address later in life.

This is why we remain so concerned about recent decisions to withhold local aid, and the potential for state budget reductions in the future. We are also deeply concerned about the recent announcement of a 1.5% across the board cut to HCBS services on or after September 1st 2020. HCBS services are at the core of the State’s Medicaid redesign, intended to help meet the mental health needs of children in their homes and communities and prevent the need for institutional levels of care. We believe this cut must be reversed in order to ensure this program is able to survive and continue to support families during this time of crisis.

We appreciate your commitment to the supporting children and families, and strongly urge you to continue to protect children’s behavioral health services from any funding cuts or delays in the future. Our state’s wellbeing depends on it.

Thank you for your time and consideration.