Ulster County committee reviews HSRI behavioral‑health assessment calling for better navigation, more outpatient access and a 24‑hour pharmacy

The Ulster County Health, Human Services and Human Rights Committee on March 5 heard a behavioral‑health needs assessment prepared by the Human Services Research Institute (HSRI) for the Ulster County Department of Mental Health.

HSRI senior research associate Bevin Croft summarized a multi‑method study that included three public listening sessions, 179 interviews (51 with people with lived experience), quantitative data review and document analysis. Croft said the final report contains 24 recommendations and noted the county’s 2023 resolution directing a five‑year plan for behavioral health informed the study.

Why it matters: HSRI reported large geographic and racial disparities in access to services, with many resources clustered in Kingston and growing needs in rural areas such as Ellenville and the southeastern county. The study flagged an unusual service pattern among Medicaid enrollees: locally, 42% of Medicaid beneficiaries who use behavioral‑health services received outpatient care versus 69% statewide, while inpatient use was higher in Ulster (about 14% locally versus 8% statewide), Croft said. HSRI also emphasized that youth data were largely missing from the available datasets.

Key recommendations and specifics: HSRI urged the county to streamline and enhance public resource directories so residents and private providers can more easily find appropriate services; Croft said multiple, static phone‑list directories can be overwhelming, and a single navigable tool would reduce confusion. The report also recommended a coordinated prevention strategy, inventorying school‑based and community prevention programming and partnering with public health to identify gaps.

On youth services, HSRI highlighted the LaSalle School program — a short‑term, in‑home intervention for middle‑school students — as effective but currently funded by county general revenue. HSRI recommended exploring ways to braid Medicaid and other funds to sustain and expand the model. HSRI further recommended building specialized teams for youth with substance use problems and those in unhoused families and strengthening partnerships with the Department of Social Services to create better on‑ramps to intensive programs.

Crisis care and medication access: HSRI said Ulster’s mobile crisis team is well regarded but does not operate around the clock; it suggested a gradual expansion of hours (by region) tied to data monitoring and noted the county’s new CSU stabilization unit may change demand for mobile crisis response. HSRI also recommended exploring incentives and partnerships to attract a 24‑hour pharmacy to the county so patients discharged overnight from emergency departments can promptly fill prescriptions.

Workforce and equity recommendations: The assessment called for bolstering bilingual/bicultural providers and workforce competencies to serve people with disabilities, LGBTQ residents, and other groups with higher needs. HSRI recommended creating a designated position to develop the peer support workforce and increase lived‑experience roles inside the Department of Mental Health.

Data gaps: HSRI recommended the county encourage administration of the Centers for Disease Control’s Youth Risk Behavior Survey (YRBS) through school districts and the Department of Health to provide comparable youth prevalence data; deputy commissioner Katrina Williams told the committee that district‑level buy‑in has been a barrier to countywide YRBS implementation.

County response and next steps: Tara McDonald, commissioner of the Department of Mental Health, thanked HSRI and said the department will use the recommendations as an action plan and report progress to the committee. McDonald noted some items are already underway and that her office — with deputy commissioner Katrina Williams — will work with HSRI and county partners to follow up.

What was asked: Committee members pressed HSRI and DMH on prevention scope, law‑enforcement participation in outreach, the feasibility of 24/7 mobile crisis coverage, and how to scale effective youth programs. Several legislators representing rural areas, including Ellenville, urged prioritized satellite clinics and more outpatient options closer to residents who face transit barriers.

What comes next: DMH agreed to provide follow‑up information to the committee on specific implementation steps and data strategies. HSRI and DMH encouraged continued partnership among the county executive’s office, Department of Health, school districts and community providers to move the recommendations into practice.