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Paul Wellman

Casa Esperanza Executive Director Mike Foley (pictured) is one of the many people confused by the “planning meeting” called by ADMHS interim Director Doug Barton.


Mental Health Braces for Budget Bloodbath

County Looks to Cut More Than $3M in Deficit


Thursday, November 15, 2007
By Chris Meagher (Contact)
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Below is the article about mental health budget cuts that appears in the Nov. 15 issue of the Independent, followed by an addendum that details the decision made at the meeting.

It began with a November 1 memo from County Executive Officer Mike Brown to all department directors, budget staff, and executive staff, explaining that 3rd District Supervisor Brooks Firestone had asked him to find possible budget reductions for the current fiscal year. All county departments responded with potential cuts, including Alcohol, Drug & Mental Health Services (ADMHS), which submitted a list of $1.1 million in potential reductions in programs.

The list set off a spark in the community of service providers who help the mentally ill and homeless and who also receive funding from ADMHS. Many showed up at the November 6 Board of Supervisors’ meeting, worried that potential cuts could happen that day. Brown assured those in attendance that was not, in fact, going to happen at the meeting, but could be discussed at some future date.

That date, apparently, was Wednesday, November 14. In two follow-up emails over the course of the two days after the November 6 board meeting, ADMHS interim Director Doug Barton informed a small group of program directors that, while the initial list was “intended to give the board an indication of the scope of our current budget crisis,” it was not an actual budget proposal. But Brown had asked for an actual reforecast from the department, so Barton suggested $2.4 million in reductions in the first email, and a total of $3.4 million worth of cuts in the second, tripling the deficit in a matter of days. Additionally, Barton called a meeting with service providers for November 14. The purpose of the meeting wasn’t clear. Nowhere in the emails did Barton elaborate beyond calling it a “planning meeting.”

Several executive directors of the service providers were perplexed about the meeting. “We don’t know what’s going to happen tomorrow,” said Casa Esperanza Executive Director Mike Foley the day before the meeting. Nobody — including the supervisors, it seems — was in the know when it came to Wednesday’s meeting. Supervisors Salud Carbajal and Janet Wolf both knew about the meeting but had no clue exactly what would transpire or how serious discussions were regarding budget-cutting midway through the fiscal year. Several phone calls from The Independent to Barton were not returned. His secretary directed inquiries to county spokesperson William Boyer, who offered as much insight as he could on the situation. “The meeting is designed to discuss shortfalls in the budget,” he said. “[Barton] is taking prudent fiscal steps, and he’s wanting to keep the door open [for discussion].”

On the list of $1.1 million in possible reductions originally submitted to Brown were cuts in funding for the recently opened El Carrillo housing project, Casa Esperanza, Casa del Mural, and the Santa Barbara Community Housing Corporation Independent Living Resource Center, among others. Boyer said he’s not sure if it’s been determined from where the additional $2.3 million in cuts might come. “By law, they have to have a balanced budget,” he said.

A host of directors had been preparing for Wednesday’s meeting. Several are worried potential cuts will have the most detrimental effect on those who need help most. “I can see the potential devastation to the entire mental health system,” Foley said. “It’s certainly going to drive many more people out [onto the streets].”

Rob Pearson, executive director of the Santa Barbara City Housing Authority —which built the 61-unit El Carrillo project, a permanent affordable housing complex for the previously homeless — said a possible $75,000 cut to the Work Training Program, which offers mental health services, drug and alcohol rehab, and more at the complex, could mean the end of the relationship between the Housing Authority and the county. “I’m very concerned,” Pearson said. “If they can’t deliver on the service side, I don’t know how we can keep providing housing. El Carrillo,” he said, is “such a success story, I don’t know how they could think about cuts.” Pearson added that the recidivism rate is only about 20 percent for those living in the complex.

ADHMS has been facing problems for years. Last fiscal year, roughly $5 million was cut from the budget. The county has had problems receiving reimbursements and funding from the state, and only a small percentage, 2 percent, of the county’s General Fund goes to the department. Wolf said the county needs to look at the entire budget across the board — not just at ADHMS — and ask whether it is cutting services to the most vulnerable. While some providers suggested any cuts should wait until a new director takes over in January, Carbajal said action is needed now. He said the options aren’t limited solely to cutting programs, but looking at alternative choices like the county’s reserves. “If the ship is sinking, you don’t wait,” he said. “We need to address the issues now.”

The following is Chris Meagher's addendum to the story that ran in print

“You have the opportunity to leave this town a hero.” Those were the words Casa Esperanza executive director Mike Foley said to Doug Barton, Alcohol, Drug and Mental Health Services interim director, at a tense meeting Wednesday which was supposed to be a discussion of possible budget reductions for the department. “I just want the opportunity to leave town,” Barton said in reply. Foley’s words came as part of a plea from mental health and homeless service providers for Barton to delay a series of potential cuts to the department’s budget which those on the receiving end claim would have a devastate the service they provide to the county’s most indigent population.

Barton called the meeting between ADMHS staff and contracted service providers to discuss what to do about a $3.4 million—and potentially growing—deficit facing the department. Providers and community members reacted last week to a memo from County Chief Mike Brown explaining how 3rd District Supervisor Brooks Firestone had asked him to find possible budget reductions for the current fiscal year. All county departments responded with potential cuts, including Alcohol, Drug & Mental Health Services (ADMHS), which submitted a list of $1.1 million in potential reductions in programs. When members of the public voiced their concern about the total, Brown explained the cuts wouldn’t be coming that day, but possibly in the future. Two days later, Barton scheduled the meeting as a beginning to the planning process of how to make up the deficit. “One thing that bothers me is we had one county supervisor asking for that,” said John Buttny, former assistant to Firestone’s predecessor Gail Marshall, expressing frustration at the lack of public involvement. “It’s insane. Look what it set in motion. How this kicked off is inexcusable.”

The $3.4 million comes as a result of three things, Barton explained Wednesday to the group—a $2.4 million deficit from the previous fiscal year, $387,000 in an equity adjustment that had received funding from the county the two previous years, but not this year, and an anticipated contract settlement of $613,000. Failed state and federal reimbursement promises are also hindering the ability of ADMHS to keep up. In the end, the county is left to cut big. “Counting the paper clips is not going to do it at $3.4 million,” said Marianne Garrity, ADMHS deputy director.

Community members went into the meeting tentative about what they would hear from county staff, and many came into the meeting unwilling to discuss the possibility of cutting any funding for the department. “Suggesting a cut anywhere is gross negligence on our part,” Foley said. Despite the overarching feeling that everyone had the same end goal—helping people who need it most— tense moments and high emotions were often present in the conversations. At first, Barton insisted the budget cut discussion had to take place so he’d have options to give to Brown. But a majority of the providers in the packed room refused to be a part of the discussion, and many walked out in defiance of the idea on grounds that any cuts would lead to the loss of services and more people on the street without help. It’s a public safety issue that is in need of help, just like funding the sheriff’s department, some argued. And their pleas worked.

After discussion of the county possibly providing bridge funding to the department while a group works to begin a process to overhaul the troubled department—an action everyone agreed needed to happen—Barton gave his word to the group that he would hold off on budget reduction talk until after a meeting next week with Brown. Barton said he isn’t sure the county has the financial capacity to provide a loan to the department, nor does he know how much his department would need. Paul said the solution would have to have a multi-layered effect, expanding beyond a one-time fix it to get the department headed in the right direction.

Those in attendance were more than happy to commit to being a part of restructuring ADMHS. “The physician can’t heal himself right now,” said Roger Heroux, the former director of the county’s Public Health Department who conducted the county’s study on its Ten-Year Plan to End Chronic Homelessness. To a certain extent, the process has already begun within the department. A new system is being implemented to develop data on and better understand and evaluate the population of the people being served by the department and whether the care they are receiving is appropriate. Some of the population, ADMHS assistant director Al Rodriguez pointed out, is being overserved, while some is underserved. “It’s evolved to a point where we’re serving more people than we can,” Rodriguez said. Foley said that with an overhaul of the program, more people can be served more efficiently and effectively using less money. And the faster the process gets under way, the better, county staff stressed. The department’s deficit will grow by $575,000 per month after January, should the issue not be resolved by then.

So, for the time being, at least, everybody is content, although that could all change in a week or two. Annmarie Cameron of the Mental Health Association said the outcome was the best she could hope for. "We came to make them notice," she said. And they did. "Although we didn't achieve what we intended to achieve, I think we got somewhere," Barton said.

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Comments

Discussion Guidelines

There is something troubling about a supervisor whose financial interests lie in selling alcohol causing a reduction in services for those who are diseased due to alcohol consumption.

sevendolphins (anonymous profile)
November 15, 2007 at 10:19 a.m. (Suggest removal)

Perhaps the media should review the situations of other counties in California. Almost all have struggled in recent years to match the service need demand with adequate funding. It's nothing new. It's just that finally this dilemma has come home to roost in Santa Barbara County.

TheEvolOne (anonymous profile)
November 15, 2007 at 7:06 p.m. (Suggest removal)

The media should take a look at the recently fired ADMHS Assistant Director, Heidi Garcia, in order to fill in more information regarding that $5,000,000 deficit from the previous year. There is more to this story than the department having trouble collecting money from the feds and the request from County COO asking for departmental reductions.

mensunderpanties (anonymous profile)
November 16, 2007 at 8:03 a.m. (Suggest removal)

Brooks - Thank you, thank you, thank you!!!
The time has come for the County to stop trying to cover for programs that were started by the State and then dumped on the Counties to support. If you look at what we (County residents) pay for these programs, compared to other Counties, this area is WAY overfunded.

pundit (anonymous profile)
November 21, 2007 at 10:19 a.m. (Suggest removal)

The County General Fund contributes 2% of the Mental Health Budget of over $70 million. My research into other county's budgets reveals that the range of general fund contributions to other mental health budgets range from the very lowest being 4% up to 20% accross California. The median being around 11%. The amount of funding that goes into the budget from the local government places the amount of Value the community places on these essential human services for our most vulnerable community members. Doug Barton says that he does not know if the County has the $$ to contribute to the mental health budget deficit......this is pattently false. The County DOES have the $$, it just CHOOSES not to provide that money to mental health as an expression of the County's VALUES. As a Director, Doug Barton's role is to champion the cause of people with mental illness by convincing the County and the community (voters) that funding is essential. All other California counties are experiencing the same decay of funding and services. I applaud the ADMHS Department, for over the years they have generated ALL the revenue that supports the services from State and Federal funds. All local funds that are provided to the Department are used to pay the County back for general services. It is essentially a "wash". So, in closing, yes there is a budget crisis. Much of it has been brought about by the current administration of the Department by capitulating to the labor union at the direction of Sue Paul to not require the staff to document (therefore, bill to generate the revenue), the declining Medi-cal penetration rate and rising perscription drug costs, the neglect of the general fund contributions and the administrative decision to not fill vacancies in the department that generate funding, especially on the children's mental health side where there are enormous opportunities for funding. This is matched with the mis management of the Mental Health Services Act funds and the fact that the Alcohol and Drug side of the Department are sitting on a $3million reserve that could also be used to shore up the deficit in these hard times. Incompetence is abound.

anna (anonymous profile)
November 29, 2007 at 9:12 a.m. (Suggest removal)

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