Committee moves county request to amend budget to cover mounting psychiatric restoration bills

Washington County staff told the Health and Human Services Committee on July 30 that psychiatric restoration costs tied to court‑ordered competency evaluations and inpatient restoration at state facilities have produced large county bills and requested the committee forward a budget-amendment request to the full board.

Staff reported the county had budgeted $350,000 for psychiatric restoration expenses in 2025 but had received billing through June that increased the total to roughly $436,000; staff further stated an outstanding invoice of $99,000 that would bring the current catch‑up billing to two individuals. Committee members asked where the money would come from and discussed the statutory obligation that counties accept state‑ordered restoration placements. Staff explained the sizable per‑diem costs that state psychiatric centers charge counties for involuntary restoration placements.

Committee members and staff discussed potential regional or local alternatives — including outpatient restoration models for lower‑risk cases and shared regional facilities — but noted regulatory and security constraints limit local options. Staff and committee members also cited the advocacy position of the New York State Association of Counties (NYSAC) seeking limits on county exposure; staff said some counties are already pursuing regional approaches.

A motion to forward the budget‑amendment request to the full board passed. Committee members approved moving the request and asked staff to continue monthly updates while the county works with finance to identify an appropriation source.

Ending: The committee forwarded the amendment request to the full board for consideration and requested monthly updates on outstanding bills and potential mitigation strategies.