Advocates for people with mental illnesses are fighting to save regional mental health offices from state budget cuts they say jeopardize plans for better community care.
Alliance Behavioral Healthcare, the regional office that covers Wake, Durham, Johnston and Cumberland counties, says it would lose about $40 million over the next two years under the state Senate’s proposed budget.
The budget issue for legislators is the hefty reserves the offices are stockpiling. But advocates say the cuts will only make inadequate community mental health treatment worse.
The budget cut would mean that Alliance wouldn’t be able to afford to open two new crisis centers in Wake County (one for adults and one for children), expand the Durham Crisis Center and carry out other community mental health projects that are in the agency’s $41 million reinvestment plan, said Doug Fuller, Alliance’s director of communications.
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“This is the opportunity to make strategic investments based on the identified needs of our communities,” he said. “It’s what we’ve been planning for since Day One. We’re obviously disappointed and dismayed that it’s in jeopardy. We hope that there’s some moderation in the ultimate outcome.”
The seven regional offices had $954 million in the bank in March, according to the state Department of Health and Human Services. About $224 million of that was restricted, meaning the offices aren’t allowed to spend it. Alliance had just more than $120 million in the bank, including about $32 million it can’t spend.
The legislature reduced state funding to the offices in the last budget hoping that they would spend the money on services, Sen. Harry Brown said. Instead, the reserves grew, said Brown, a chief budget writer and Jacksonville Republican.
“It was discussed at length,” Brown said of the mental health spending. “We’re taking the issue seriously.”
Legislators are working to find out more about plans regional offices have in motion and the financial commitments they’ve made, he said.
The state cut nearly $153 million for regional mental health offices in the budget that was passed last year and is in effect through the end of June. Both Gov. Roy Cooper’s proposed budget and the Senate budget proposal would give some of that money back. Cooper would withhold some of it and direct it to substance abuse treatment, housing for people with mental illness and other community services.
Cooper’s budget would let the local offices keep $105.8 million in the first year and $83.4 million in the second year. The Senate budget would let the offices keep $84 million in the first year and $52 million in the second year.
To Ann Akland, a member of NAMI-Wake County, a mental health advocacy group, the regional offices are being punished for being efficient.
The local offices are managed-care organizations that purchase mental health services for patients using Medicaid, state and local funds. Money they save is supposed to go back into expanding and improving community mental health care.
Some of their spending decisions have drawn criticism. Kannapolis-based Cardinal Innovations Healthcare’s CEO could earn more than $1 million this year in pay and bonuses, a compensation package both legislators and the former head of the state Department of Health and Human Services denounced.
Akland said some of the offices have done “stupid things,” but it’s not a reason to punish people who need care.
Emergency rooms and jails are filled with people who can’t get community treatment, she said, and criticism about the regional offices hanging on to money is just an excuse to take state funds out of mental health.
“It’s not right to shift it off to Medicaid,” Akland said. “It’s not right to shift it off to counties. It’s not right to try to shift it off to hospitals. It’s not right to shift it off to jails. We need that money.”
The state House is working on its budget proposal. To finish off the budget, House and Senate negotiators will get together to work out their differences.
Rep. Josh Dobson, a Nebo Republican and one of the health and human services budget writers, said he “shared some of the concerns” about cuts but could not say how the House would handle state funding for the mental health offices.
“We’re working through the process,” he said.