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Albany County committee moves $6 million budget amendment to cover rising inpatient mental-health hospitalization costs
Summary
The committee approved a $6 million transfer from fund balance to the Department of Mental Health budget to cover sharply rising inpatient hospitalization costs, citing a large past bill and a state policy change that shifted counties to pay 100% of some restoration costs.
The Albany County Health Committee approved an amendment to the Department of Mental Health's 2025 budget to move $6 million from county fund balance into the inpatient hospitalization line to cover rising costs, department staff told the committee.
Department presenters described a substantial increase in inpatient hospitalization costs related to forensic restoration for individuals found incompetent to proceed in felony cases. Staff said a single patient bill of about $2 million covered care from December 2020 through December 2024 and that exam requests increased from 81 in 2023 to 125 in 2024.
"This is a request to amend the 2025 budget and to move in from the appropriate fund balance in the county, dollars 6,000,000 to pay for, exponentially grow growing costs. It's an unfunded mandate," Department of Mental Health staff said during the committee discussion.
Staff attributed the higher costs to multiple factors, including a 2021 state policy change that shifted counties from paying 50% to 100% of certain restoration costs and an increase in the number and acuity of competency examinations ordered by courts. Staff said restoration can be lengthy and daily hospital rates are high at the state psychiatric hospitals where forensic restorations occur.
Committee members asked detailed budget questions. A committee member noted the backup showed a $6 million requested increase and asked whether $2 million of that amount related to a single patient; staff confirmed a $2 million bill for one individual, spanning December 2020 through December 2024, compounded by late billing. Staff also said monthly billings can vary, and that the department is coordinating with the Office of Mental Health and state associations on legislative remedies.
The motion to move the budget amendment was made by Miss Lockhart and seconded by Mister Lane; the committee approved the amendment on a voice vote.
Staff said the county continues to press state-level solutions, including proposed legislation to limit lengthy and costly inpatient restorations and to allow more outpatient restoration where appropriate. The department also said it will continue to track expenditures and engage state partners to address systemic drivers of the cost increase.
