County Mental Health Preps for Crippling Cuts

A passionate uprising from the community, spurred by a group of nonprofit mental health and housing agency leaders, has sprung up as a result of anticipated cuts recommended by Santa Barbara County’s Alcohol, Drug and Mental Health Services (ADMHS). A Web site has been established, newspaper advertisements have been placed, a rally is taking place April 18, a bus is being rented to transport people up to Santa Maria for an April 22 meeting, and an April 15 press conference attracted more than 120 supporters and media. “We refuse to make people homeless on purpose,” said Mike Foley, executive director of Casa Esperanza.

At stake is a potential $8.4 million cut to the Mental Health Services (MHS) department-from $34.8 million annually to just $26.4 million-that aims to balance the county’s budget for the 2008-2009 fiscal year, which will begin July 1. MHS has been facing problems for years. Last fiscal year, roughly $5 million was cut from the budget, while the department got only 2 percent of the county’s General Fund. But MHS is certainly not the only department facing trouble next fiscal year. Even the Sheriff’s Department, which as a public safety entity has been pegged as a top priority, will still lose $12 million, said county spokesperson William Boyer.

In 2006-07, MHS collectively assisted 5,200 adults, including 1,600 by the community-based organizations it helps fund. According to mental health agency directors, the budget cuts would mean 800 fewer clients treated next fiscal year. From their perspective, the cuts are devastating. Funding to community clinics and organizations is expected to drop from $18 million this year to about $9.8 million the next. Annmarie Cameron, executive director of the Mental Health Association, expects her funding to drop from almost $1 million to $105,000. “Almost the worst-case scenario is coming true,” she said.

J.T. Turner, executive director of Phoenix of Santa Barbara, awaits the elimination of an entire outpatient program. Phoenix’s Mainstream program serves 60 adults with severe forms of mental illness and helps them move out of costly institutional settings to live in the community. If the program were to end, Turner estimated, the cost to the county in inpatient costs would get up to $1.2 million because the clients would lose their housing and, in turn, their stability. Barry Schoer, executive director of Sanctuary Psychiatric Services, expects his contract for two beds at Sanctuary House and a contract for services at the Arlington Outpatient Center to both be eliminated.

More real than numbers and dollar signs are the stories from those with mental illnesses. James DeVoe, a staffer for the Work Training Program, has also been a client for about 20 years. Hospitalized with a mental illness, he was given a chance when he was provided medication and housing in Goleta, which in turn allowed him to graduate from UCSB in 1998 and then from graduate school at Antioch University in 2001. “I would’ve never been able to do anything without the support of the mental health community,” he said. Now the house manager at Heath House on Sola Street, he has lived for more than 10 years with others who have mental illnesses. Should cuts go through, the seven people now living there, including DeVoe, would be without a home.

But it isn’t that simple, according to Ann Detrick, the new MHS director who took over the embattled department in January. Detrick certainly finds herself in a dilemma. Cuts are doubtlessly part of the solution, as even organization directors admit. “I’m coming into a system where everyone is facing a tough time,” Detrick said cautiously in a sit-down interview, with deputy director Marianne Garrity and Boyer sitting at her side. “It’s not easy seeing the impact on families, clients and providers,” she said.

While community mental health leaders are upset about the impending cuts, their general consensus is that they wish the best for Detrick and realize she came into a difficult job. Many believe Detrick doesn’t even want to do what she is prescribing for her department, but that she’s following marching orders from County CEO Mike Brown.

Detrick explained that state mandates about providing certain elements of care leave little remaining funding, especially with the state lagging in providing reimbursements. “There’s not enough money to support services at the current level,” she said. Add to that the growing number of uninsured adults receiving care and growing pharmaceutical costs, and money vanishes quickly. Other counties, she and Garrity stressed, are going through similar straits. With that said, Detrick doesn’t want to see any more people on the streets. “We’re trying not to completely cut someone off from services,” she said.

MHS entered this fiscal year with a $2.4 million deficit left over from the prior year, and the figure grew to $6.9 million this January. At a February meeting, the County Board of Supervisors agreed to fund the department in three installments of $2.3 million, provided the department underwent restructuring to become more efficient. With the first two payments handed over in February and March, the final $2.3 million will be discussed April 22, as will the potential cuts.

One element of the redesign was that county officials work with their contracted agencies to determine restructuring. This prompted the formation of the Association of Local Leaders for Community Mental Health, the leaders of which were to meet with county staff to help with the restructuring and redesign of the department. But after a few meetings, agency directors realized that the supposed restructuring was actually reduction. “It was a fraud from the beginning to think we’d be able to work to redesign the department,” Cameron said.

Since then, group meetings stopped, and Detrick began meeting one-on-one with agency directors, defining for them cuts that would be made come June, should the supervisors approve them. “The conversations have been along the lines of ‘This is what we want to try to continue’ [in the contracted agencies],” said Detrick, who admitted this problem was more complex than any she has encountered in all her years of working in mental health. “They’ve been really hard decisions to make about this.”

According to those who’ve sat with Detrick, the meetings have been emotional and have come as a surprise to many of them. But Detrick countered by saying a restructuring plan had been composed, with hard work from county staff and input from community members, service providers, and clients.

So it remains to be seen what the supervisors will do at the upcoming meeting. But in the meantime, the community continues to speak up loudly. City of Santa Barbara Mayor Marty Blum, along with city councilmembers Iya Falcone, Roger Horton, and Helene Schneider gathered with the April 15 crowd, urging the county supervisors to consider less drastic cuts. “The truth is,” Blum said, “when the county budget goes awry, we’re going to have to face the consequences in the city.”