The Seat at the Table Campaign

The Seat at the Table Campaign is a New York-based initiative that was organized by Steve in 2022 and is dedicated to reforming mental health services by actively involving service users, providers, subject experts, and local stakeholders in the planning, implementation, and evaluation of these services. The Campaign's primary objective is to create a more inclusive and cost-effective mental health care system that addresses the diverse needs of the community.

The New York Health Equity Reform 1115 Medicaid Waiver

Also in 2024, the Campaign drafted two policy papers related to the roll out of New York’s new Medicaid waiver program, which will, for the first time, allow Medicaid funds be used to support non-medical “health-related social needs.” The first paper, released in April, outlined the backgound and intent of the waiver and included recommendations for its implementation. The second paper advocated for a diverse, statewide oversight body that would be independent of government and any one interest group. The January 9, 2024 approval letter from the federal Centers for Medicare and Medicaid can be found here.

In November, the Campaign entered into a collaborative partnership with the Alliance for Rights and Recovery to organize a community education and engagement process so mental health consumers and providers could better take advantage of new funding for housing, food, and transportation that would be offered by the waiver beginning in January 2025. The awareness initiative includes statewide webinars, in-person forums across the state, and on-going access through phone and a webportal for peers and providers to send us questions and comments.

Mental Health Reform in New York

Historically, New York has been at the forefront of mental health care reform. In the 19th century, the state established institutions like the Bloomingdale Asylum in 1821 and enacted the State Care Act in 1890 to move people with mental illness out of poorhouses into state-run institutions. When this model proved unsustainable, both in cost and quality of care, the state passed the Community Mental Health Services Act of 1954, with the intent of fostering community-based care as a more humane and economical approach. By the mid-1960s it was clear the system was failing those most in need and led to decades of studies, reports, and policy adjustments that left many gaps, especially for people experiencing extreme poverty, homelessness, and incarceration.

The Campaign was organized to correct this by involving service users in the planning and delivery of mental health services and thereby create a more responsive and effective system. Since its inception, the campaign has facilitated dialogues between legislators, providers, and service users, fostering collaborative efforts to reform mental health policies. These initiatives aim to address the complex needs of individuals with mental health conditions, particularly those experiencing financial insecurity, racism, substance use, and trauma.