Good afternoon, Chair Cabán and members of the committee.
I’m Laura Savino, Senior Vice President of Care Management at the Institute for Community Living.
ICL serves more than 10,000 New Yorkers annually and houses 4,000 people each night across the five boroughs. Behind those numbers are people – parents, veterans, survivors – who rely on us not just for services, but for stability.
IMT is a multidisciplinary, community-based team that provides long-term care to New Yorkers with severe mental health and substance use challenges — many with deep involvement in the justice and shelter systems.
IMT works because it is sustained, mobile, and rooted in the community. It helps people stabilize, remain housed, and avoid costly and traumatic system cycling.
Yet today, nearly 700 New Yorkers sit on the IMT waitlist – individuals cycling through shelters, emergency rooms, and incarceration while we know there is a model that works.
The problem is not effectiveness. The problem is capacity.
Without funded step-down services, clients who have stabilized in IMT remain in high-intensity slots longer than clinically necessary because there is no structured bridge to lower levels of care.
That bottleneck prevents us from reaching people in acute crisis. It keeps the door closed to those who need it most.
That is why ICL launched STEPS – Step-down Treatment Ensures Personal Success – a recovery-oriented pilot designed to provide structured, transitional support and free up critical IMT capacity.
In year two, STEPS served 73 clients: 97% were housed, 89% avoided hospitalization, 86% avoided ER visits, 100% were not arrested or incarcerated.
STEPS also reduced IMT and ACT waitlists by 5 percent – expanding access without expanding crisis.
STEPS is also cost-effective (a fraction of the cost of IMT) and expands system capacity.
The Council recognized this and allocated $11 million for IMT step-down services and $4.5 million specifically for STEPS in the FY26 budget. Yet the $4.5 million has still not been procured
Today, approximately 100 high-need New Yorkers are being served through temporary philanthropic funding. If the City does not follow through, those individuals risk disruption, displacement, and a return to instability.
Full citywide scale would require approximately $31 million – an investment that would unlock capacity across the crisis response system.
We cannot allow a proven, life-changing intervention, and continuity of care for 100 vulnerable New Yorkers to stall during a mayoral transition.
We urge immediate procurement of the allocated funds and full investment to scale step-down services citywide. If we want a crisis system that works, we must fund what works.
Thank you for the opportunity to testify.
