Ongoing struggles within B-HEARD, the city’s mental health crisis response pilot

Good morning and welcome to the Weekly New York Health Care newsletter, where we keep you posted on what’s coming up this week in health care news, and offer a look back at the important news from last week.

Beat Memo

It’s been nearly two years since the launch of a pilot program aimed at reforming the city’s response to mental health crises.

The pilot, B-HEARD, dispatches social workers and emergency medics to a select portion of 911 calls that involve a mental health emergency.

Mayor Eric Adams said in March he wanted to make the program available citywide, but ongoing hiring struggles are delaying its expansion efforts and limiting its bandwidth to serve New Yorkers in the neighborhoods where it already operates.

Last month B-HEARD rolled out its biggest expansion so far, adding 10 new police precincts to its operating area and marking its first foray into Queens. The program now has a presence in every borough but Staten Island.

But city officials still haven’t released any data on the program’s performance and outcomes in the current fiscal year, and earlier figures indicate that B-HEARD is falling short of its promised impact: In the 2021-22 fiscal year, the teams responded to only 16 percent of mental health calls in the pilot areas.

That has worried even B-HEARD’s biggest boosters, who are concerned that the city is forging ahead with an expansion before releasing more data and taking the time to assess what works and what needs improvement.

“I’m so, so grateful and excited that it exists,” City Councilmember Tiffany Cabán told POLITICO. “But we have to make sure that it is the best sort of product that we could put out in our communities to get the best outcomes.”

Adams’ administration has not yet released a timeline for B-HEARD’s citywide expansion or a complete funding proposal for the upcoming fiscal year, but it’s clear that he intends to grow it slower than his predecessor, former Mayor Bill de Blasio, had planned.

De Blasio budgeted $92 million for a citywide B-HEARD expansion in the 2021-22 fiscal year.

But after Adams took office, he slashed B-HEARD’s budget to $50 million and then again to $30 million, which the administration determined would better match costs based on the expansion schedule, a spokesperson for the Mayor’s Office of Community Mental Health told POLITICO.

The decreased budgets also reflect the program’s struggles to hire, which has contributed to lower than anticipated spending two years in a row.

The police-driven status quo, meanwhile, continues leaving people in crisis seriously injured or dead.

IN OTHER NEWS:

— State Sen. Pete Harckham and Assemblymember John T. McDonald III introduced legislation that would allow pharmacists to dispense fentanyl and xylazine testing kits to anyone, the lawmakers announced Friday. Transactions would be limited to five kits at a time.

A version of the bill, called “Matthew’s Law” in honor of a Westchester resident who died of a fentanyl overdose in November 2020, was introduced last year but didn’t make it out of the rules committee.

— Physician network SOMOS Community Care has formed a partnership with RENDR, an independent physicians association of over 200 providers who specialize in treating patients in New York’s Chinese communities. Together the two organizations will include more than 3,200 local providers and be responsible for almost 1.5 million patients.

A spokesperson said the agreement is not a financial partnership or business transaction.

ON THE AGENDA THIS WEEK:

— Tuesday at 10 a.m. The state Public Health and Health Planning Council convenes for a full council meeting.

— Tuesday at 10:30 a.m. The Assembly Committee on Mental Health meets.

— Tuesday at 12:30 p.m. The Senate Committee on Health meets.

— Tuesday at 1 p.m. The Assembly Committee on Health meets.

— Thursday at 10 a.m. The state’s Drug Utilization Review Board meets.

GOT TIPS? Send story ideas and feedback to Maya Kaufman at [email protected]

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What you may have missed

— The state Legislature approved a one-week budget extender that quietly included $9 million for health centers in the federal Ryan White program, which provides medical care to low-income people living with HIV/AIDS. It includes initial six-month infrastructure grants and contracts for multi-year grants starting in October, according to the state Health Department.

Officials said the funding is meant to be a stopgap measure for providers affected by the recent Medicaid pharmacy carveout, since a state analysis indicated that Ryan White centers would face significant cash flow issues starting in May barring new funding in the enacted budget.

Odds and Ends

NOW WE KNOW — The world has a 28 percent risk of a new Covid-like pandemic within a decade.

TODAY’S TIP — For sensitive skin, stick to products labeled “hypoallergenic” rather than “natural,” which is largely a marketing gimmick.

STUDY THIS — Greater representation of Black primary care doctors in the workforce is associated with higher life expectancy among Black people, according to a new study.

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What We're Reading

— Covid is still a leading cause of death as the virus recedes, The Washington Post reports.

— Via STAT: “Demand for home health aides is soaring. So why are they still so undervalued?”

— VA pauses rollout of $16 billion health record system, The Wall Street Journal reports.

— Millions expected to lose dental care coverage after Medicaid review, NBC News reports.

— New research holds clues about why some people get recurrent UTIs, NPR reports.

— “Adult ADHD is the Wild West of psychiatry,” The Atlantic reports.

Around POLITICO

— Moderna, Merck unveil positive trial results for drug-cancer vaccine combo, Katherine Ellen Foley reports.

— U.S. and Mexico announce more actions against fentanyl, Carmen Paun reports.

— Medicare advisers say it’s too soon to judge telehealth’s performance, Ben Leonard reports.

MISSED A ROUNDUP? Get caught up on the New York Health Care Newsletter.