The Lucas County Mental Health and Recovery Services Board is considering cuts in services and programs to save up to $3.5 million in its next fiscal year, and the board will lay out a menu of options to its member nonprofit boards today.
One proposed cut would save $450,000 by referring a projected 500 people with low-priority mental health issues to support groups rather than to professional treatment.
A list of 21 program cuts is to be reviewed by the health board and the boards of its nonprofit contractors at 3:30 p.m. today at the McMaster Center in the main Toledo-Lucas County Public Library downtown.
"It makes for some very hard decisions to be made," Jacqueline Martin, executive director of the mental health board, said.
"We can't afford the luxury of the same level of benefits in distributing the services that we had in the past."
Tom Bartlett, the associate executive director of business operations and strategic planning, said the agency has seen its state funding drop $5.67 million since October, 2008, from a budget of about $60 million.
Those cuts were partially offset by the American Recovery and Reinvestment Act that lowered the agency's mandatory Medicaid match from 32 percent to 25 percent.
If Congress does not renew the support when the stimulus funds expire at the end of December, the mental health board would lose about $1.7 million for the last six months of the fiscal year, or $3.4 million for a full year.
Also, the agency is expecting to lose $1.5 million from one of its publicly voted levies because of reduced property values in Lucas County.
Ms. Martin said the agency primarily serves those who don't have medical insurance and aren't poor enough to qualify for Medicaid, in addition to subsidizing Medicaid for the very poor.
Under the proposed change in screening, about 500 people would be unable to obtain treatment for mental health stress that falls into the lowest of three categories when they present themselves at Rescue Mental Health Services.
People in that category have problems such as marital discord, grief, and drug and alcohol abuse not deemed to be addiction. If the cuts are implemented, those people would be referred to group support meetings that are sponsored and monitored by the mental health agency, such as Alcoholics Anonymous and Narcotics Anonymous, Ms. Martin said.
David Schlaudecker, chairman of the mental health board, said even if the board weren't facing a shortfall it should review whether to keep scheduling low-priority applicants for treatment.
"Often a group is more appropriate. AA or NA may well be more appropriate than individual counseling, than going through the whole admission process," he said.
For one thing, low-priority applicants may have to wait 60 days to be seen, while referral to a group can get them support the next day.
"It's better if we try to get them some help so it doesn't escalate. We want to preserve that in the system. But we want to get them in the lowest-cost service appropriate for their need at the time," Mr. Schlaudecker said.
Richard Arnold, a mental health-care consumer advocate, said the administration should include itself for some of the cuts.
"If I was the executive director, I would at the very least have put forward a token reduction of 1, 2, or 3 percent," Mr. Arnold said. "These are the worst cuts the mental health board has seen in 40 years and I don't believe consumers have had nearly enough input."
Ms. Martin said no pay raises have been built into the agency's budgets, and administrative cuts will be considered. She said the board has a consumers' group called the recovery council whose representatives are getting the same information the board gets.
The list of 21 possible cuts proposes saving $261,843 by reducing the number of beds reserved at North Coast Behavioral Health Care psychiatric hospital from 6,000 a year to 4,750.
Ms. Martin and Mr. Bartlett said the change would not result in denying admission to anyone who needs it, only in how the beds are paid for.
Also slated for possible elimination is the mobile crisis unit operated by Rescue Mental Health Services known as "community-based stabilization."
Ms. Martin said that Rescue makes what amount to house calls to respond to individuals who are psychiatrically unstable.
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