Your View 3/11

Impact of budget cuts

Thank you for the opportunity to address a few concerns that I have regarding recent budget cuts and withholdings. It is evident that nearly every state agency will be experiencing drastic measures in an effort to balance the state's budget. I for one agree that there needs to be some reform in spending. However, I have specific concern regarding how the cuts will affect those that are much less fortunate. Not only will the reductions and withholdings affect the clientele being served, but us as taxpayers.

Allow me to elaborate on specific services within the Department of Mental Health (DMH). As an administrative agent contracting with DMH, Bootheel Counseling Services serves clientele of all levels of socioeconomic backgrounds, race and ages. The cost of services to individuals and families depends on family income, private insurance and service being provided. The primary goal of our services is to provide the best quality of services in a timely fashion. The ultimate goal is to provide individuals and families with the tools that assist them in returning to the level of functioning and quality of life that they deserve.

As a result of the proposed budget cuts and withholdings, the following may occur at some centers and communities: waiting lists for clients may become longer; some consumers will go without medications due to changes proposed in the spend-down procedures; without medication, the seriously mentally ill will undoubtedly need more intense services; many may end up back in the state hospitals, emergency rooms, jail or homeless. This sounds drastic, but even the Bootheel has individuals that are homeless.

Providing services on an outpatient basis costs much less than inpatient hospitalizations. In comparison, a stay at the state hospital for only four days will cost more than the amount of services one would receive in outpatient services for one month. These outpatient services would include case management, psychosocial rehabilitation and psychiatric care from a board certified psychiatrist. The four-day evaluation period at an inpatient facility is generally the amount of time an individual would stay for a commitment order. At this critical point, sadly enough, the police or local sheriff's department must also be called to carry out the order issued by the judge. This in turn requires overtime in some instances for the police departments, evaluation at emergency rooms or jails, and more costs. Furthermore, the protocol is that the consumer in a critical situation is to be handcuffed and shackled for safety reasons of both officer and consumer. Through community programs, this is often avoided through treatment provided in the home and community. The fiscal comparison given is quite conservative and includes the most intensive amount of services to prevent unnecessary hospitalizations at the same time improving the quality of life for those being served.

In closing, if these cuts and withholdings occur, the community as a whole will need to come together for the care of family and friends. If there are any questions regarding mental health issues, fell free to call Bootheel Counseling Services at 471-0800.

Thank you,

Bill Terrell, MSW

Community support supervisor