Mental health cuts called 'illogical,' 'harmful'

April 15--A proposed cut in community behavioral health service funding in Missouri could result in a loss of services for 1,700 patients statewide, including cuts in local services in 2016.

Last week, the Missouri Senate passed a budget proposal including the 4 percent cut, or a total of $6.8 million, for behavioral health funding. The state general revenue is up 6.8 percent through March.

If approved, the proposed budget cuts would negatively impact local services to those with mental illnesses, said Garry Hammond, president and CEO of Family Guidance Center for Behavioral Health.

Family Guidance served 4,400 adults and children last year in a nine-county area around St. Joseph. Last year, the center took a $900,000 budget cut, which resulted in layoffs and the closing of the residential detox services.

"We deal with people who have severe, persistent mental health issues, not just mild depression," Mr. Hammond said. "... we don't want to be in a position where we have to discharge people who have severe mental illnesses and are at risk for suicide or hospitalization."

If the cuts were to be approved, Family Guidance could be forced to reduce the number of people treated without reimbursement, said Kristina Hannon, vice president of behavioral health. Last year, the agency provided $750,000 in uncompensated care to people without Medicaid.

"We are concerned that with the cuts, locally, we would not be able to continue to admit people who don't have any reimbursement source," she said.

They also use general revenue dollars to support housing costs for clients, she said. That program also could be threatened by budget cuts.

"Homelessness is a huge issue," Mr. Hammond said. "If someone has a stable home, they are more likely to be successful in the programs."

Services in rural communities also cloud be threatened by budget cuts, he said. Last year, Family Guidance staff traveled half a million miles delivering services in rural areas.

"Services in rural areas are very expensive because you spend so much time on the road," Mr. Hammond said.

Existing programs save money by providing primary, preventative care and reducing costly emergency care, Ms. Hannon said. The statewide Health Care Home program saved Missouri approximately $23.1 million in Medicaid costs in its first year.

"That program has saved the state millions of dollars statewide because we've been able to decrease hospitalization, decrease visits to the ER, and improve overall health outcomes," Ms. Hannon said. "We decrease emergent care and transfer the care to a more appropriate primary care setting, which saves the system money."

Missouri's Disease Management 3700 Project also has produced a savings of approximately $18 million in the last fiscal year, Ms. Hannon said. Locally, staff reach out to people in the community with mental health or substance abuse problems identified through the project.

"These folks are not linked up with a mental health system, so we go cold call them or show up at their door unannounced to say 'Hey, I know you aren't feeling well. I'd like to help you with that,'" Ms. Hannon said. "We try to get them into our services, because through appropriate care management techniques, we can improve their physical health outcomes, their mental health outcomes and decrease the cost of care."

Mental health services also can reduce the related responsibilities of law enforcement, Ms. Hannon said.

"When people who have a mental illness or chronic substance abuse problem can't access the services they need, the law enforcement community become really the de facto provider for those individuals," she said. "...Whenever law enforcement are running into individuals who may have a mental health condition, they take a lot of time from the officers."

If budget cuts were to cause clients to be discharged from mental health programs, individuals could face dangerous, potentially life-threatening situations without help, Ms. Hannon said.

Their services intervene when necessary, including in life-threatening situations. Last week, a staff member and law enforcement went to check on a client, who had threatened suicide in the past, after he failed to attend therapy. When law enforcement arrived, they smelled natural gas in the apartment, and, upon further investigation, discovered a gun and syringes.

The man admitted he was planning to commit suicide after everyone left the apartment, and they were able to intervene , Ms. Hannon said.

"This is exactly what could have happened if this person was discharged because of funding cuts," Mr. Hammond said. "He would have committed suicide."

Mr. Hammond said it's "illogical" to cut programs that actually safe the state money. "It's false economy," he said. "It's harmful to people."

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