Tuesday, April 22, 2008

County hears budget cut plan


For more than five hours, fleets of mentally ill residents and mental health advocates addressed the Santa Barbara County Board of Supervisors yesterday and put a face on what $8.4 million in budget cuts to the county’s Department of Alcohol, Drug and Mental Health Services will look like.
One of those faces was Roger Thompson, who said when he pressed a gun to his head a couple of months ago, the only thing that stood between his finger and the trigger was the services he had been receiving from Sanctuary Psychiatric Centers — a community-based organization that stands to lose more than $600,000 in funding, which is all of the money it receives from the county.

“I as well as many others linger in the shadows of life,” Thompson told the board. “It is my civic duty to advocate for those who can’t. This is where I protest to the very end.”
More than 130 people packed the board hearing room in Santa Maria and dozens of others watched the meeting from the County Administration Offices in Santa Barbara.
The heavy attendance was the result of weeks of outreach by local non-profit leaders, whose organizations currently receive about $9.9 million in county funds each year to serve the severely mentally ill.
Of the $8.4 million being cut from the ADMHS budget, CBOs could lose $5.9 million next year — a number they say would crimple their ability to provide current services.
Non-profit leaders say the cuts could purge as many as 800 mentally ill residents from the system, many of whom could end up on the streets or dead as a result. ADMHS Director Ann Detrick refuted this number, saying the actual figure is closer to 500.
Mike Foley, executive director of the Casa Esperanza Homeless Shelter, urged county leaders to refrain from sending out eviction notices and acting on the proposed budget until it becomes final in June.
He said the last time eviction notices were sent out prematurely to mentally ill people residing in the Casa del Mural facility, three had breakdowns and ended up being admitted into psychiatric care wards and the hospital — a costly process, he said, since the board ended up funding the program anyway.
The fiscally challenged department has battled budget issues for more than a year, and though much focus was placed yesterday on the 2008-2009 budget, the main item of the day for the board was shoring up a $6.9 million deficit for the current year.
The board did just that by unanimously approving the third and final infusion of $2.3 million into ADMHS coffers. The three-tier plan was agreed upon by the board in February and included a stipulation that the department present a balanced 2008-2009 budget.
That budget balancing act has been referred to by some as an “exercise” that is subject to change between now and June when next year’s budget will officially be adopted.
Between now and then, non-profit leaders say they hope to sit down with county leaders and stem some of the bleeding that could occur as a result of the cuts.
“I’m 80 percent positive that things can move forward positively,” Foley said. “But we’ve been through so many disappointments over the last six months that I’m striving to be optimistic.”


The second piece of yesterday’s puzzle was for the board to “receive” the budget presentation by Detrick, which they voted unanimously to do.
But the supervisors made it clear that by “receiving” the proposed budget, they were not adopting the cuts.
First District Supervisor and Chair of the Board Salud Carbajal said he didn’t believe the proposed budget was as “creative” as it could be. As a result, he directed county staff to join hands with all of the stakeholders and begin looking for ways to come up with additional sources of funding, which could include tapping into the county’s strategic reserve or increasing certain fees for county services.
Carbajal’s request was also approved with a unanimous vote.
“Certainly we have to cut and certainly I think there’s room to continue the discussion with the stake holders,” he said. “This is a start but I think we need to continue discussing this.”
Carbajal suggested another way to get creative would be for individual cities to kick in funds. One example he used was for the City of Santa Barbara to give back some of its roughly $4 million in annual county provided redevelopment funds back to the county.
Rusty Felix, executive director of the California Council of Community Mental Health Agencies, who was the co-author of state Proposition 63, or the Mental Health Services Act, told the board they might be able to get millions in funding from the state if they play their cards right.
Felix said Prop. 63 money was initially earmarked exclusively for the creation of new services. When it became apparent many counties were going to have to cut the services they were trying to build, Felix said the state told him they would allow counties to use the money to fund existing programs.
He said Los Angeles County recently shored up a roughly $60 million budget shortfall in their Department of Mental Health Services with such money.


Aside from the $5.9 million in cuts to community-based organizations, the majority of through roughly $2.5 million will come from county run clinics.
In order to make those cuts, Detrick said 75 fill-time positions in the department would be eliminated. Forty-Five of those positions are currently vacant. She said these positions won’t be filled and 30 people will be laid off.
The entirety of the cuts will come from the Adult Mental Health Services budget, which had an operating budget of roughly $24.4 million this year, but under the proposed cuts could be shrunk to $17.6 million next year.
Non-profit leaders aren’t the only ones tuned into the possible human costs such cuts could provoke.
Detrick told the board “potential” impacts could include: relapse of symptoms, acute psychiatric inpatient care; law enforcement involvement; homelessness; emergency room and crisis visits; detox bed days for persons with dual disorders; foster care placement for children of clients and costly medical conditions.
Foley said there is little doubt these impacts will cost far more in the long run than providing preventive care.
“The cost of not giving them the care is more than giving them the care,” said Felix.
Non-profit leaders say they have the ability to provide most services cheaper and more efficiently than the county. They contend that instead of taking money away from the community based organizations; the county should spend more there.
Felix said there is a 20 to 40 percent cost savings when services are provided by non-profits.
A representative from the Service Employees International Union, which represents thousands of county workers, said he hasn’t seen any evidence to support Felix’s claim.
Second District Supervisor Janet Wolf said the proposed budget is one she’s not happy with and doesn’t believe the partnerships the county has worked to develop for decades with the non-profit community should be dismantled.
“In my mind I think all of these things are important,” she said. Everything together is what keeps these systems working.
“I look at this as a dismantling. I look at this as something that’s very large and it is going to touch people’s lives.”

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