Jan. 5, 2006
State budget reductions force local mental health cuts
Hundreds of men and women across King County will be unable to get needed mental health services because of funding allocation decisions made by the state last year that seriously reduces King County's allotment. Those decisions dramatically reduce funding for King County's already strained mental health system, while redirecting those funds in some cases to counties where they are not needed.
The impact of the cuts is expected to be severe. As of January 1, 2006, King County has been forced to close the door to mental health services for low-income individuals who are not covered by Medicaid. Those cutbacks in service could be reversed if the state approves an emergency budget supplemental appropriation of $7.4 million in the opening days of the upcoming 2006 session.
"Because of unjustifiable and unfair policy decisions in Olympia, King County's mental health system is being pushed past the breaking point while some counties have surpluses in funds," said King County Executive Ron Sims. "This inequity must be corrected, and corrected quickly, because of the irreversible harm this causes to people's lives and the added costs for taxpayers as more people who can't get services are hospitalized or jailed.
"I know that resources are always in short supply, but in this case decisions have been made over the past several years to shift funds to other parts of the state that were previously allocated to King County, resulting in surpluses in some counties while severely ill people in this region are being cut off from the services they so desperately need," Sims added.
This latest mental health funding crisis falls on the heels of years of severe budget cuts to King County's mental health system, in large part due to funding allocation decisions made by the state's Mental Health Division. In 2001, the Legislature passed a new funding allocation formula that reduced King County's mental health program over a six-year period. Budget reductions approved by legislators during the 2002 session cost King County an additional $10 million. In 2003, another state reduction cut cost King County approximately $1.7 million.
The results have been a significant tightening of eligibility for services, limiting or eliminating access to care for thousands of low-income individuals with mental illness. The January 2006 reduction closes the door to hundreds more.
The funding loss seriously erodes the county's mental health system and leaves very vulnerable people in danger of serious illness, homelessness, incarceration, hospitalization, or worse. Individuals most at risk due to the service cuts are low-income children and adults not currently enrolled in Medicaid benefit programs. These typically include young people suffering a first psychotic break, homeless people who are too unstable to complete the required paperwork, individuals exiting hospitals and prisons, immigrants and refugees. Communities of color may be particularly impacted by these funding reductions.
"This is an issue of basic fairness," Sims said. "We notified the Governor and Secretary Arnold-Williams last spring of the impact of their funding allocation in King County, and tried to work with them over the summer and early fall to seek a solution to terminating new enrollment of non-Medicare eligible clients in King County. We should not have to put our residents on a bus to Vancouver or Yakima for them to be able to access treatment services."
King County now gets 23 percent of the state funds for non-Medicaid low-income, but has 29 percent of the state's seriously mentally ill population. There are 26,000 persons in King County mental health outpatient care, and only about 600 are non-Medicaid. This is compared to over 2,000 non-Medicaid service recipients in 2001, before the cuts started.
Although the state Legislature responded to a serious federal funding shortfall by allocating $80 million in state funds for the public mental health system in the last legislative session, the state's Mental Health Division did not implement the funding distribution as recommended by the Legislature, which intended the funds to be allocated first to priority services and the rest by population.
Instead, the state chose to follow disproportionate funding practices, thus continuing a pattern of serious shortages in King County and several other counties, even as other counties are experiencing windfalls of new money.
Beginning July 1, 2005, changes in the way federal Medicaid funds can be used by state governments created an $82 million shortfall for the 2005-2007 biennium. The state Legislature responded to that crisis by allocating state dollars to replace the lost federal funds and proposed an allocation methodology for the distribution statewide, prioritizing expenditures for non-Medicaid services. However, in subsequent months the state's Mental Health Division created its own distribution formula, taking away $7.4 million from King County's budget and spreading it out among several other counties, in spite of the state's own recent studies on the prevalence and severity of mental illness and the costs of providing services statewide.
"Although the community mental health system throughout Washington state is woefully under-funded, the system in King County is even worse off," said David Stone, Chief Executive Officer of Seattle Mental Health. "Providers in this county already are turning away literally scores of severely disturbed children and adults every day because of lack of funding to serve them.
"If we are reduced another $7 million, we will all be seeing many more tragic consequences on the nightly news," Stone said. "Those of us who work in this field in King County do not have to watch TV or read the papers to see people in desperate straits; we simply have to show up for work every day."
"The inequitable state funding distribution has created a mental health crisis in King County," said Diane Narasaki, Director of Asian Counseling and Referral Services. "The disproportionate impact on communities of color dramatically institutionalizes unequal access to mental health care in King County. When the door closes to non-Medicaid services, hundreds of Latinos and Asians with mental illness who must rely on non-Medicaid services will be shut out of the care they desperately need and will be at greater risk of worsening illness, homelessness, institutionalization and incarceration."
"It is inhumane, unconscionable and unnecessary," Narasaki continued. "The state has a responsibility to ensure equal access to care, and we demand that the state take immediate steps to do so."
For more information on the mental health funding crisis, or for assistance in contacting mental health treatment providers or individuals and family members whose treatment services are threatened, please call Amnon Shoenfeld, Division Director, King County Mental Health, Chemical Abuse and Dependency Services Division, at 206-205-1313.