County analyst seeks $99,000 to launch street psychiatry pilot for people who are unhoused

Anna Sapak, a policy analyst on the county executive’s team, asked the Albany County Legislature health committee to approve a $99,000 transfer from the improvement initiative fund to the Department of Mental Health to initiate a street psychiatry pilot.

The program would deploy mobile teams to reach people who are unhoused and in vulnerable positions, with a psychiatrist on staff who could prescribe medication and a nurse or case manager to provide follow-up and connect clients to traditional services, Sapak said. "I'm here tonight to request that we, approve the transfer of $99,000 from the improvement initiative fund to the Department of Mental Health to initiate a street psychiatry program," she said.

The request is for a start-up pilot rather than full program funding. "This is probably not enough money to fully fund a program," Sapak said, adding the transfer is intended to initiate a pilot in 2025. Committee members discussed staffing and coordination: Sapak described a goal of hiring a part-time psychiatrist and a nurse or case manager for initial operations and said some unfilled positions in the Department of Mental Health budget could be reassigned to support the pilot.

Committee members asked where the teams would operate and how the work would relate to existing services. "Wondering about targeted areas for that street psychiatry program," said Miss Bedell, a committee member. Sapak said the program would be mobile and likely operate in more urban portions of the county, going where people are unhoused. A member asked whether the program would run through or in conjunction with the county’s mobile crisis unit; Sapak said the programs are similar but that the street psychiatry teams would include a prescriber and aim to stabilize people so they can access other services.

Members also asked about coordination with police in volatile situations. Sapak said the Department of Mental Health already communicates with municipal police departments and that outreach programs often overlap, but she did not describe a formal co-response protocol.

Because the committee did not have a quorum, members could not take a formal vote. Committee leadership said the executive request can be introduced "through the individual exchange" and go directly to the legislative floor as an executive item. Chairman Cunningham asked to be added as a sponsor and members indicated they would sign on individually so the measure can proceed to the floor without a committee vote.

Next steps: the county executive’s request will be introduced on the legislative floor through the individual-exchange process; the committee did not record a formal motion or vote at the meeting.