Mental health agency faces more cuts

Governor’s budget proposal would eliminate $50 million from the department
Sunday, March 6, 2005 | 12:00 a.m. CST; updated 1:58 p.m. CDT, Tuesday, July 22, 2008

Providers of mental health services face a loss of state funding under Gov. Matt Blunt’s budget plan that would cut about $50 million in state funds from the Department of Mental Health.

Roland Meinert, chairman of the Boone County Mental Health Board of Trustees, said state mental health funding has decreased from 10 percent of the total state budget to 5 percent of the total state budget during the past 10 years, creating waiting lists for services and overextending the staffs of providers.

Further cuts would exacerbate the problems, Meinert said. “It’s obviously going to have devastating effects,” he said.

The Boone County Mental Health Board continues to look into putting a tax proposal before voters to support local services. The board tried to pass a tax in 1994, but was defeated.

Additional cuts at the state level, Meinert said, “will certainly, I think, cause members of the board and the community at large to look more favorably on a tax.”

Boone County Group Homes and Family Support works with about 1,200 people who have developmental disabilities. It receives approximately 18 percent of its about $6 million budget from the Department of Mental Health. Les Wagner, executive director of Group Homes, said he does not know how his agency would be affected by the proposed cuts because he is assessing the impact.

Wagner said he has not heard of alternative programs or sources of income being proposed by the state. He said if the proposed cuts are approved by the legislature, services will have to be reduced and local government will have to take on some of the responsibilities.

The group homes agency assists people in living as independently as possible through services that include transportation, job coaching and therapy. Without local agencies to work with people with disabilities, Wagner said, those people are more likely to be placed in a state institution or nursing home at much greater cost to taxpayers.

Bruce Horwitz, director of University Behavioral Health Services, said the proposed cuts would result in a loss of services for people with severe mental illnesses who are not eligible for Medicaid. He noted that Blunt’s proposed budget also proposes changing Medicaid eligibility and income requirements, which could mean the loss of medical insurance for some mentally ill people.

Behavioral Health is a service of University of Missouri Health Care and serves as an administrative agent for the Department of Mental Health for 10 central Missouri counties, including Boone. It serves 1,550 adults and children with serious and persistent mental illnesses.

Schizophrenia and bipolar disorder are two of the most common types of disorders treated. The agency does not receive a set amount of money from the Department of Mental Health each year, Horwitz said. Instead it has a fee-for-service contract with the state. Horwitz said that though there is a state fiscal crisis, the governor’s spending plan is detrimental to people with severe mental disabilities. He said the public would have to pay for the care in one form or another, and hospital emergency room visits and psychiatric hospitalizations would likely increase.

“It shifts the cost of care to the community instead of the state,” Horwitz said.

Dianna Moore, executive director of the Missouri Association for Social Welfare, said the Department of Mental Health reported to the House Mental Health and Social Services Appropriation Committee that about 8,200 people not on Medicaid statewide with serious mental illnesses would lose access to medication management and therapy provided through the psychiatric services division. She said an additional 5,800 Medicaid-eligible adults would lose services.

Moore said nearly half the participants in drug and alcohol residential and outpatient treatment programs are referred by drug courts or probation and parole. The Department of Mental Health anticipates cuts of about $10 million in non-Medicaid cuts for these programs under the governor’s proposed budget.

“It has a real domino effect,” Moore said. “These programs help to keep people in communities and we’d prefer the community treatments rather than prison.”

Paul Sloca, spokesman for Gov. Blunt, said the governor is suggesting a cut of about $50 million and the elimination of more than 1,000 jobs in the Department of Mental Health, including 900 jobs that would come from closing the Bellefontaine Habilitation Center in St. Louis.

Lois Thomas, a spokeswoman for the Department of Mental Health, said state cuts of about $37.6 million would take effect when the 2006 budget year begins on July 1, if the governor’s spending plan is approved. That amount does not include about $12 million that would be saved by Blunt’s decision to close the state-operated Bellefontaine Habilitation Center in St. Louis

An additional $40.9 million in federal cuts affecting the department would occur in October 2007, Thomas said.

The cuts include reductions in both Medicaid and non-Medicaid services for adults in the three major divisions of the department: drug and alcohol abuse, psychiatric services and developmental disabilities.

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