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Less-costly options exist than expansion of legislation

We take issue with several of Lynne Shuster's assertions in her recent piece on the controversy over expanding Kendra's Law. Fourteen leading statewide mental health and disability advocacy groups join Phil Endress and the Conference of Local Mental Hygiene Directors in opposing such an expansion.

Joined by a number of family advocates, our groups oppose these proposals not because, as was suggested, we want to avoid serving our most vulnerable but because we are united in seeking better, more affordable, strategies. These include several proposals developed by Gov. Andrew M. Cuomo's Medicaid Redesign Team and approved by state legislators, like Regional Behavioral Health Organizations that are making sure that hospitals come up with better discharge plans and Medicaid Health Homes that require teams of providers to follow up closely to help avoid relapse-related crises.

These approaches are fully paid for, some with 90 percent federal funding, and will reach 1 million vulnerable people statewide while the Kendra's Law expansion would almost double the program's $32 million cost to reach a very small fraction.

Further, the person who caused Kendra Webdale's tragic death was not avoiding care and requiring court-ordered treatment. He had repeatedly sought help that never came – help that is now available through these new "feet on the street" approaches that are getting thousands of at-risk individuals the help they need. Court-ordered care has yet to be scientifically demonstrated to be the reason for improved results associated with Kendra's Law.

That is one of the reasons why lawmakers have shied away from expanding Kendra's Law or making it permanent three times since its 1999 passage. Studies have yet to compare court-ordered and voluntary care even though 28 upstate counties have had great results favoring a voluntary approach rather than relying on court orders.

Finally, we must object to violent depictions used by proponents to gain support by presenting Kendra's Law as a public safety measure. Despite lurid front-page coverage of rare tragic events, the facts are that people diagnosed with major mental illnesses are actually 11 times more likely to be victims of violence. We deserve more and better directed treatment, not more involvement with judges and police who are already overburdened with their primary duties.

We hope that lawmakers will continue to withhold support for Kendra's Law expansion and instead continue to focus on smarter, stronger solutions.?


Harvey Rosenthal is a member of New York's Medicaid Redesign Team and executive director of the New York Association of Psychiatric Rehabilitation Services. Maura Kelley is director of Buffalo's Mental Health Peer Connection.