A waiting area in the emergency department of Connecticut Children's Medical Center in Hartford.
A waiting area in the emergency department of Connecticut Children's Medical Center in Hartford. During the pandemic, the number of children and teens waiting in emergency departments for inpatient psychiatric beds increased. Yehyun Kim / ctmirror.org

New psychiatric beds and other services for children spearheaded a list of mental health investments in the $24.2 billion budget Gov. Ned Lamont unveiled Wednesday.

The administration, which recommended $160 million in new behavioral health funding, did not propose any major increase for the community-based nonprofits that provide the bulk of Connecticut’s social services.

And while key leaders on the legislature’s budget, health and insurance committees ranged from cautious to hopeful in their assessments of Lamont’s plan, the state’s largest health care workers’ union charged that the governor failed to respond to a growing crisis.

“I’m not certain that it addresses the issues we have to address,” Sen. Cathy Osten, D-Sprague, co-chairwoman of the Appropriations Committee, said late Wednesday, adding she would reserve judgment until after nonpartisan analysts complete their review of the package.

But SEIU 1199 NE released a statement from one of its members, an addiction counselor at Connecticut Valley Hospital, who said the facility is facing an unprecedented surge in demand for mental health services, from adults and children.

“Connecticut is experiencing a crisis in mental health care, and my colleagues and I have watched with horror as the state’s failure to fill hundreds of staff vacancies and sufficiently fund mental health services has compromised our ability to provide lifesaving care for people who need it,” said counselor Brian Williams. “Without access to specialized treatment services — some of which have been shut down due to understaffing — people have nowhere to turn.

Williams added that “There’s a human cost when elected leaders decide to defund and de-prioritize care—including overdoses, homelessness, jail time and even death—and the most serious consequences are borne by young people, working class and poor communities, white, Black and Brown.”

Lamont’s budget includes $15 million to develop a new, 12-bed psychiatric unit at Connecticut Children’s Medical Health Center. 

Another $12.6 million in state and federal funds would be used to continue an effort Lamont and lawmakers began this year to bolster doctors’ rates and expand access to inpatient pediatric mental health beds and services. The goal of that initiative is to ease pressure on hospital emergency departments, which receive many behavioral health cases when other care options aren’t available.

Nearly $26.5 million would be used to expand mobile crisis intervention services for both adult and pediatric patients, and another $26 million would help establish urgent crisis centers and other treatment units for children.

Leaders of the legislature’s Insurance & Real Estate and Public Health committees both expressed optimism that lawmakers and Lamont ultimately could agree on a plan to respond to the mental health crisis.

“I think the governor shares our goal of making sure that everyone in Connecticut who needs health care coverage can get it, and focusing on areas like mental health that have really been given short shrift for entirely too long,” said Sen. Matthew Lesser, a Middletown Democrat who is co-chair of the insurance panel. “We can do a lot to build on what we did last session.”

“We’re on the same page with the governor. We’re very hopeful this will be the year we’re able to address a lot of the problems that were highlighted during the pandemic,” said Rep. Jonathan Steinberg, a Democrat from Westport and one of the leaders on the Public Health Committee. “We’re very excited the governor is helping us make a difference.”

Nonprofits continue to press for inflationary adjustments

But the community-based nonprofits that deliver the bulk of state-sponsored social services in Connecticut say Lamont’s new budget makes no progress addressing a longstanding problem that continues to plague them.

The industry charges that state payments have grown minimally over the past decade, and the CT Community Nonprofit Alliance estimated in 2021 that trend, coupled with inflation, costs these community agencies collectively about $461 million annually.

Lamont and lawmakers agreed last year to increase funding by about $184 million, but the bulk of it was focused only on nonprofits providing group home services for the developmentally disabled. Unionized caregivers were planning to strike, and the state directed most of that extra funding into salaries and benefits to prevent a work stoppage.

But Gian-Carl Casa, president and CEO of the alliance, said the industry still is losing hundreds of millions of dollars each year. Low salaries coupled with the dangers of the coronavirus now have many providers facing a staffing crisis.

“While the governor’s budget proposal targets some new initiatives, it doesn’t address the underfunding of the statewide network of community nonprofits that are struggling to continue to operate,” Casa said Wednesday.

Osten, one of the legislature’s most vocal advocates for increased funding for nonprofit providers, also said the progress made last year, though important, is not sufficient.

“We’ve moved so many in our safety net into the nonprofit sector,” she said. “We still have to fund it.”

Improved data collection program to combat racial inequities in health care, explore anti-competitive practices

Lamont is also committing $1.2 million in his new budget to improve race, ethnicity and language health care data collection across agencies. The funding relates to a sweeping bill passed last year that declares racism a public health crisis and mandates better data gathering and analysis on race and ethnicity in health care, among other initiatives.

The governor also set aside $400,000 to a hire a consultant in the state’s Office of Health Strategy who will help develop a plan to address anti-competitive practices within the health care industry. The move comes on the heels of a lawsuit filed by Saint Francis Hospital and Medical Center against Hartford HealthCare. In it, Saint Francis accuses Hartford HealthCare of trying to create a monopoly on services by acquiring physician networks and demanding they refer patients to Hartford HealthCare.

Victoria Veltri, executive director of the Office of Health Strategy, said plans to examine anti-competitive practices began long before the lawsuit, but such developments are concerning.

“The entire mission of OHS is to use data to drive policy and initiatives that can bring down health care cost growth, ensure equity, and ensure access to health care,” she said. “What we are seeing in the ether does have us concerned about how the rate of growth that we’re seeing in the health care space in Connecticut – while maybe a positive development in some ways –may also be contributing to cost growth unnecessarily.”

“We feel strongly that the system has been somewhat static in terms of health systems planning. There hasn’t been a deliberative undertaking of what the future should look like. That’s the concept here – we need to have a deliberative vision of where we want to go.”

Keith has spent most of his 31 years as a reporter specializing in state government finances, analyzing such topics as income tax equity, waste in government and the complex funding systems behind Connecticut’s transportation and social services networks. He has been the state finances reporter at CT Mirror since it launched in 2010. Prior to joining CT Mirror Keith was State Capitol bureau chief for The Journal Inquirer of Manchester, a reporter for the Day of New London, and a former contributing writer to The New York Times. Keith is a graduate of and a former journalism instructor at the University of Connecticut.

Jenna is CT Mirror’s Health Reporter, focusing on health access, affordability, quality, equity and disparities, social determinants of health, health system planning, infrastructure, processes, information systems, and other health policy. Before joining CT Mirror Jenna was a reporter at The Hartford Courant for 10 years, where she consistently won statewide and regional awards. Jenna has a Master of Science degree in Interactive Media from Quinnipiac University and a Bachelor or Arts degree in Journalism from Grand Valley State University.