Friday, January 15, 2010

Maine mental health advocates oppose more budget cuts

From the Bangor Daily News in Maine:

BANGOR, Maine — Maine’s community mental health service agencies will oppose another round of budget cuts as the state scrambles to reduce spending by $438 million to keep the biennial budget in line with projected revenues.

A public hearing at 9 a.m. Wednesday promises to draw providers, consumers and other opponents to the Appropriations Committee room at the State House to weigh in against the cuts.

The state Department of Health and Human Services has proposed an across-the-board cut of 10 percent in MaineCare, the state’s Medicaid program, to save a total of $32 million in the second year of the biennium. Of that amount, $6 million would come from mental health services for adults and children.

In addition to losing the state Medicaid funds, programs would forfeit approximately $12 million in federal matching Medicaid dollars.

Other proposals would cut state spending on community mental health services paid through grants and other non-Medicaid sources.

Brenda Harvey, director of the Maine Department of Health and Human Services, said Monday that the mental health cuts are painful and difficult but must be made, even though mental health budgets have been cut significantly in recent years.

Reductions since 2003 have focused on paring departmental expenses, providing better management of services, and standardizing reimbursement rates, Harvey said.

“Now we’re at the point of having to make even more difficult choices,” she said.

Juliana L’Heureux, executive director of the Maine Association of Mental Health Services, said Monday that taken in combination with other recent reductions, the new proposals would cut about 25 percent out of community mental health funding.

“This is too much for Medicaid providers and beneficiaries to absorb,” she said.

In Bangor, Dale Hamilton, executive director of Community Health and Counseling Services, said the cuts could spell the end of some services that help keep people with mental illness safe in the community.

CHCS provides services such as crisis response, medication management, personal counseling and case management to about 4,500 Mainers in a four-county area that stretches from northern Aroostook County to Lewiston.

“We’ll do everything we can to continue to deliver all the services, but the system has to realize that there is a limit to the number of times you can go back to the same source without impacting services,” Hamilton said.

Budget cuts already have forced the layoff of about 100 CHCS clinical and administrative employees over the past 18 months, Hamilton said. Reducing access to critical services will shift costs dramatically to other areas, he said, including the correctional system. Dollars spent in that setting, he pointed out, do not attract matching funds the way MaineCare attracts federal Medicaid funds.

Penobscot County Sheriff Glenn Ross said he would testify in opposition to the proposed cuts.

“I understand these are tough times and cuts must be made,” Ross said Monday. But recent erosion of support for people with mental illness already has driven up criminal and violent behaviors, he said, significantly increasing costs to correctional programs while imperiling public safety.

“I cannot even begin to imagine what it will be like to have further reductions,” he said.

Ross said about 30 percent of the inmates at the Penobscot County Jail are on some kind of psychiatric medication and estimated the incidence of inmate mental illness and substance abuse at about 50 percent.

Ross also decried proposed defunding of the Maine chapter of the nonprofit National Alliance on Mental Illness, which advocates for people with mental illness and the communities in which they live. Ross said NAMI Maine is a valuable presence in Maine, working closely with law enforcement groups to promote understanding between public safety officers and people with mental illness.

Harvey at DHHS said she values the role that NAMI has played and hopes to retain funding for the organization’s work with the public safety sector. But NAMI’s family support services would receive no funding under the proposed cuts.

Harvey said it is difficult to give up federal Medicaid funds, but that state funding is required to attract each federal dollar.

“We have pared back all our accounts to the bone,” she said.