County mental health and addiction services merging

March 11--BUTLER COUNTY -- The Butler County Mental Health and Alcohol and Drug Addiction Services boards are merging, and while it doesn't take effect until this summer, officials say the county has already saved $97,000 in advance of the move.

Butler County is one of the last counties in Ohio to combine the two boards, which often serve some of the same clientele. County commissioners approved the merger on Monday.

"The merger process is just beginning, and cost savings will occur, but they are secondary to the benefits that enhanced coordination of treatment services will provide to county residents," said Mental Health Board President Barbara Desmond.

The mental health board's budget for 2015 was set at $12.6 million, and there are eight staffers and an 18-member board. The board's funding comes largely from two tax levies and state and federal funding that continues to shrink. The bulk of the budget is spent paying external mental health professionals. They served about 10,000 clients last year.

The ADAS Board's 2015 budget is $3.7 million, and there are four staffers and a 14-member board. The bulk of their revenue comes from state and federal funding, and like the mental health board, professional services is their largest expense. The board helped 3,021 people last year.

In preparation of the potential merger, the ADAS board did not replace Executive Director John Bohley when he retired last fall. His salary was $97,318. Since the ADAS board will be moving out of their offices in downtown Hamilton and into the mental health offices in Fairfield, an additional $57,179 could be saved, based on what was budgeted for rent, supplies and other expenses for the ADAS board this year.

Mental Health Board Executive Director Scott Rasmus said the efficiencies a combined board brings are monetarily intangible right now, but will certainly be realized. It's estimated that 50 percent of people with addiction issues also have mental health problems.

"The combination of these boards will help because you're bringing this expertise together to day-to-day operations, and there's got to be efficiencies with that," he said. "Discussions of client needs and treatment planning and supporting of our contract providers, there is a lot of benefit to that."

The issue was first raised last summer when the mental health board asked the commissioners to put a 0.5 mill levy on the ballot. The levy passed handily in November, but both boards have seen burgeoning numbers of people seeking help and deep cuts from the federal and state governments.

The demand for mental health services has grown exponentially. Clientele shot up from 5,271 in 2006 to 9,770 in 2013. Meanwhile, state funding dropped from $4.3 million annually from 2007 to 2011 to a projected $860,043 in funding for this year.

The heroin epidemic has also taken a stranglehold on the county, affecting everything from the jail to Children Services. State and federal funding has dropped from $6 million in 2011 to $3.7 million projected for this year at the ADAS board.

The merger, which doesn't take effect until July, is in the infancy stages, but there are some tricky issues county officials need to sort out. At first blush, the county thought budgeting as a combined agency would be complicated because mental health levy funds could not be used for addiction services.

Rasmus said that might not necessarily be true. The Ohio attorney general issued an opinion in February 2013 saying the funding could be co-mingled, as long as the levy language authorizing the taxes doesn't prohibit it. Rasmus said they will get a legal opinion as to whether they can share funding.

Before Bohley left, he said he was concerned the sharp focus each board had on their own services could be diminished a bit in a merger. Julie Payton, who has picked up executive director duties at the ADAS Board, as well as her clinical director and program development responsibilities, said their priorities won't change.

"We will not reduce our mission in any way," she said. "We will continue our focus on alcohol and other drug addiction and services, both prevention and treatment."

Kimball Strickland, CEO of Butler Behavioral Health, who has been a provider for both boards, said the merger is a good concept that is "long overdue."

"Will this make my life easier? Yes," he said. "Where it will make my life easier is we're all going to be in the same tent now. I don't think we'll have any choice but to get to know one another better... I think a greater familiarity with one another, identifying and implementing opportunities for better coordination, are certainly now going to be more doable than they were before."

The state merged its mental health and addiction services in July 2013, and now every county in the state has followed suit, with the exception of Lorain County, which maintains separate boards, according to Eric R. Wandersleben, director of Media Relations & Outreach for the state agency. Combining "back office" functions such as human resources, information technology and finance management has saved $3 million. He said merging just makes sense.

"Both addiction and mental illness are diseases of the brain that can be treated successfully, so it makes sense that services for Ohioans with these illnesses are coordinated," Wandersleben said. "Through consolidation, we've established a cost-effective system of prevention, treatment and recovery support services with no wrong doors, shared resources and combined expertise."

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