Some 6,500 severely mentally ill people would be forced out of their community treatment programs under a proposal to cut $17 million from Sacramento County's behavioral health budget.
The proposed cuts could be disastrous for patients who may be unable to navigate a new system of county care, and for hospitals and private clinics that already are overloaded with mentally ill people, specialists said.
"We represent stability for these patients," said Alexan Bolte, program director for El Hogar, one of four "regional support teams" that would lose their county contracts if the budget becomes reality. "If they no longer have us, it's going to be ugly."
County administrators said they have no choice but to make wrenching cuts in an effort to resolve an enormous budget deficit. Should the cuts be made, they said, they hope that most patients will adjust and do well in a streamlined system.
"We're planning for a change in the way we deliver services to adult outpatient consumers," said Mary Ann Bennett, the county's mental health director. "Our main focus is ensuring that our clients receive services at the level that they should be receiving them.
"But we're operating under fiscal constraints and constraints related to labor. It's not easy. Believe me, we're all losing sleep over this."
Under its latest proposal to deal with the general fund shortfall, the county department of Behavioral Health Services proposes cutting its ties with El Hogar and three other regional support teams, nonprofit community clinics that provide outpatient care to people with severe mental illnesses such as schizophrenia and bipolar disorder.
Those programs have been slashed by more than half during the past year, leaving area hospitals and private clinics struggling to fill gaps in care. If the current budget proposal passes, as many as 6,500 more patients would have to find care elsewhere.
Behavioral health cuts, including reductions in mental health services in juvenile institutions, special education, alcohol and drug abuse, public guardian and other programs, would save the county $17.5 million. The recommended budget will be debated in hearings in June.
To make up for proposed cuts to outpatient mental health services, the behavioral health department has proposed expanding its Adult Psychiatric Aftercare Clinic and opening four new outpatient mental health "wellness centers" staffed by county workers.
Private care providers are sharply criticizing the plan, arguing that the proposed new system will cost more to run and will disrupt care to numerous patients. The result, they said, will be more psychotic people going untreated, crowding emergency rooms, wandering the streets and committing crimes.
"This system has been in place for 17 years and has been very successful," said Ken Eskow, executive director of El Hogar, one of the four programs that have contracts with the county to provide outpatient mental health care. "Our folks have made a lot of progress, and now they are being told they can no longer come to us. They're scared, and they're angry."
Patients affected by the looming cuts plan to take part in a protest Thursday morning in front of the county administration building on H Street in Sacramento.
During the past year, El Hogar and the other three programs cut their client loads by more than 4,000 people. Administrators referred patients elsewhere, but many have ended up on long waiting lists, without proper support services and medications, Eskow and others said.
The county also has shuttered the crisis unit at its Mental Health Treatment Center on Stockton Boulevard, and closed 50 of the facility's 100 patient beds. The center handles the most seriously ill psychiatric patients in the county.
Emergency rooms and private clinics have reported a flood of new psychiatric patients, some of whom have bounced back to the regional support teams for help.
Aaron Huffman, 27, was one of those clients. Huffman was released from El Hogar during the last round of budget cuts, and tried to get help through the county's primary care center. But because of bureaucratic complications, he said, he was unable to do so in a timely manner and spent four months without medications and counseling that have helped him cope with bipolar disorder.
"I got really nervous. I started drinking, and I wondered if I would end up homeless again," Huffman said. El Hogar took him back, but he has been told he might soon have to leave the program again.
"They helped me establish a life plan," said Huffman, who is studying to become a personal trainer. "I feel like I made it to a good place in life, with their help. Now I feel kind of sad, not only for me but for other patients who haven't been able to open the door toward stability."
Rachael Hassan, 40, also would be cut from El Hogar under the latest budget proposal.
Hassan, who has been diagnosed with bipolar disorder, said the clinic has helped her get medications, counseling, housing referrals and computer classes that have put her on the road to stability.
Should the cuts go through, she said, "I will have to manage. I'll do whatever it takes to survive."
Hassan said she worries that cuts in mental health programs could backfire on the community.
"If they don't deal with the mentally ill now," she said, "they're going to have to deal with them later. Because thousands of them are going to be out on the streets."
Read more:
http://www.sacbee.com/2010/04/21/2693524/mentally-treatment.html#ixzz0ljPrDmZp
