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Confusion Over Cuts at Public Meeting

Alliance Behavioral Healthcare held a public meeting to educate mental health consumers and healthcare advocates about cuts in state funding, but many attendees were confused by which programs would be sacrificed.

By Ariella Monti

Confusion about which programs would be cut and a request for more information were the overriding concerns at at public meeting held Tuesday evening by Wake County’s new mental health management entity.

Alliance_WakeMeeting

Wake Site Director Carlyle Johnson discusses state funding cuts to mental health and substance abuse services at a public meeting on Tuesday. Photo by Ariella Monti.

Alliance Behavioral Healthcare, a partnership between Durham, Wake, Johnston and Cumberland counties, held meetings in Durham and Wake this week to inform advocates and mental health consumers about how they would be affected by $20 million in federal funding cuts to the Social Services Block Grant and the Substance Abuse Prevention and Treatment Block Grant.

Most of the concern came from confusion as to which programs would see cuts or be eliminated completely, and whether those programs were funded by Medicaid.

Suzanne Goerger, intellectual and developmental disability care coordination manager at Alliance, stressed that Medicaid funded services aren’t affected by these cuts. “For somebody who has Medicaid health insurance, these cuts do not apply,” said Goerger.

Reductions are in state-funded services

Mental health management entities around the state were informed in late July all of them would be seeing reduced funding from the two federally-funded block grants. Wake County’s share of the cut totals about $1.6 million.

The block grants fund programs such as transportation and respite care for people with disabilities, drug and alcohol treatment services, outreach, detoxification services, residential treatment and vocational counseling for people in recovery from addiction. Mental health managers have said those are the programs that will lose out.

However, the cuts will only affect services for those who are indigent – who don’t have health insurance, but make too much money to qualify for Medicaid. To qualify for Medicaid, an adult must earn less than 49 percent of the federal poverty level or about $5,400 per year.

Cuts to Wake County Mental Health

Data courtesy Alliance Behavioral Healthcare

Those who make more than that the Medicaid minimum, but not enough to purchase private insurance or who don’t receive benefits from their employers, would be eligible for these programs.

Many people at the meeting also complained about the lack of information about the cuts and how they would change services.

“You don’t have time to figure out all of the ins and outs of this complex system,” said one woman who said she is a mother of a child with disabilities. She added she had difficulty getting information from everyone she contacted.

Merger confusion

People at the meeting also complained that the lack of information didn’t just apply to the budget cuts, but also to the merger between Wake’s and Durham’s mental health management entities, which became effective in the beginning of July. People at the meeting also complained they didn’t know what outside resources could be contacted during times of crisis.

Goerger said that because the information is constantly changing, they are hesitant to release information until it is finalized.

“As soon as you put something in writing, it turns out to not be the case,” she said.

But Alliance staff said that they would work with healthcare advocates on updating the website and creating fact sheets for advocates and consumers.

Possible Cuts

While Alliance hasn’t made any cuts to programs yet, staff has identified areas that will likely see a reduction in funding or will be done away with completely.

Targeted case management services across disabilities will be frozen, a decision that was handed down by the Department of Health and Human Services. “The loss in case management affects people differently depending on how it’s funded,” said Goerger.

Alliance will begin limiting those with developmental disabilities who are eligible for personal assistance by reducing the authorizations to just those who have the greatest need.

Alliance will also begin referring more people to Wake Behavioral Health, which is funded by the county. The management agency also plans to reduce the amount outpatient treatment sessions available from community providers and continue a shift to group treatment.

Wake Site Director Carlyle Johnson said that staff tried to impact as few patients as possible, but some will ultimately be affected, such as those who are in preventive treatment programs.

“There is a cost to making these reductions,” he said.

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