Advocates for mentally ill fight budget cuts

Posted Jan. 07, 2010, at 8:57 p.m.

AUGUSTA, Maine — Advocates for the mentally ill in Maine were sharply critical Thursday of proposed cuts in spending for a wide range of services, and proposed alternatives.

But some lawmakers said there is not enough time to deal with alternatives, given the urgent need to cut spending by $438 million to bring the budget into balance.

“We are going to have $140 million less to provide needed services under this budget proposal,” said Carol Carrothers, executive director of the National Alliance on Mental Illness-Maine.

“These are real cuts that will hurt real people,” she said Thursday.

She released a report that shows the history of programs aimed at helping Maine’s mentally ill and the decrease in funding for those programs. For example, in 2004 about $110.5 million was expended in state and federal funds. Under the proposed budget, that would drop to $90.4 million in budget year 2011.

“We need to look at what works and what does not,” Carrothers said. “We should not be cutting all programs by 10 percent.”

The group is suggesting that the state freeze spending for adult mental health services at current levels and that the administration establish a commission to determine what treatment programs work. They also want officials to implement managed care for all Medicaid patients and consider whether the state can afford to operate two psychiatric centers.

Cumberland County Sheriff Mark Dion attended the advocates’ news conference and said the proposed cuts would shift costs, not solve the problem. He said law enforcement officers should not be thrust into the role of mental health workers, and he said he worries that will occur more often if resources are cut by the state.

“For street cops, this is about human lives, this is about public safety,” he said. “There are many instances I have seen where the cost of a stand-off is more than the cost of a month of treatment.”

Dion said many inmates in the state’s correctional system have some sort of substance abuse or mental health diagnosis. He said it is far more cost-effective to have community-based treatment systems in place instead of trying to provide treatment in a jail or prison.

“These cuts are just going to shift costs; they are not going away,” he said.

Rep. Anne Perry, D-Calais, co-chairwoman of the Legislature’s Health and Human Services Committee, said many of the points raised by the advocates are “on target” but are not practical as lawmakers must balance the budget in the next few months.

“We don’t have the money to freeze spending,” she said. “We have been and will continue to look at what are the most effective programs, but we don’t have the time and ability to do that now.”

Perry said claims by the advocates that the bureaucracy overseeing community mental health services has not been cut while the budget for community services has been cut are untrue. She said there have been several “rounds” of consolidation and that has resulted in a reduction in staffing levels.

“We are very limited in what we can cut and maintain the effort required by federal law,” she said.

Perry said only 23 percent of the state Department of Health and Human Services’ budget is state funding, and most of that is needed to match federal funding. She said that means programs funded entirely by state resources are bearing the brunt of the budget cuts.

Sen. Peter Mills, R-Cornville, the GOP senator on the committee, agreed with Perry that federal law greatly restricts what can be cut. He said there are studies under way to assess which programs are the most effective, but they will not be completed in time for budget considerations.

“That has to be done over the long haul to do it right,” he said. “It will need a sustained effort to assess the quality of programs.”

Mills said lawmakers are faced with a lot of difficult choices in the budget, and none are more difficult than those in the human services area. He expects lawmakers will have to establish their own criteria for weighing budget decisions.

“I will want to know if the program is keeping people alive,” he said. “If it is keeping people alive, I am pretty much going to say lets keep going with that. If it is a program that is perhaps less vital, that is probably where the cuts will come even though they may be very valuable services.”

The Health and Human Services Committee will join the Appropriations Committee in a public hearing on the proposed cuts to mental health services at 1 p.m. Wednesday, Jan. 13.

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