MENTAL HEALTH MONEY SOUGHT TO FIGHT DRUG ABUSE

DURHAM -- To kick off an initiative to combat drug abuse, local
mental health officials are asking Durham County for more than
$500,000 in the upcoming financial year.

The money would fund the first step in an ambitious 10-year plan with
a $54 million wish list to address substance abuse in the county.

Wednesday's budget work session was the first time County Manager
Mike Ruffin and the commissioners had seen the proposal, which mental
health staff finalized only last week. Ruffin will review it and
present a funding recommendation to the board at the June 15 work
session in which he'll also reveal any revisions to his proposed
schools budget.

The $516,300 request -- a 7.2 percent increase for the Durham Center,
which manages mental health, substance abuse and developmental
disabilities services in the county -- includes money to help
recruit, train and assist substance abuse treatment providers, plus
money for day treatment programs and supportive housing.

The N.C. Alcohol and Drug Council estimated the cost of substance
abuse to Durham County at $250 million in 2003. The Durham Center
used to provide substance abuse treatment directly, but state reforms
compelled the center to contract with private providers instead.
Wright said that led to some improvements, but that three of the six
initial providers are no longer operating in Durham and the remainder
can't keep pace with demand.

Durham Center Chairman Doug Wright told the County Commissioners an
estimated 19,000 people are addicted to alcohol or other drugs in
Durham County. Of those, around 7,000 seek treatment, but only 2,500
or so are getting it.

Although substance abuse accounts for 23 percent of service provided
by Durham Center-managed programs in the 2005 fiscal year, only 3
percent of allocated funding could be used to treat them, Center
Director Ellen Holliman said.

"We still have a long way to go just to see the 7,000 who will
actually seek treatment," she said. "This is a very difficult
population to serve. We've got to find a better way to engage people quickly."

Part of the plan is to address the stigma attached to substance abuse.

"We're dealing with a disease," Wright said. "The people we serve are
not bad folks; they're sick people. ? Stop saying you understand
substance abuse is a disease and start funding it like it is."

No funding promises were offered, but there was support for the plan
on the board.

"We have to begin somewhere," Commissioner Lewis Cheek said. "I hope
we'll take a very close look at it."

Commissioners Chairwoman Ellen Reckhow, who also serves on the Durham
Center board, said she wants to see "stronger community involvement"
in the planning process.

"The feedback I've gotten is that it hasn't necessarily been there," she said.

The commissioners also were concerned that existing resources aren't
being fully used, including space at the homeless shelter.

"I'm not at all opposed to seeing us move forward," Reckhow said. "I
want it done right and in as effective and efficient a manner as possible."

During a marathon work session Wednesday, the commissioners also
received budget pitches from health and social services staff.

Including federal and state funds, social services represents the
largest single chunk of the county budget because it includes
Medicaid, 91 percent of which is paid for with federal and state funds.

North Carolina is the only state that requires counties to contribute
to Medicaid costs. Durham's share is up 8 percent to $11.7 million in
Ruffin's proposed budget.

Excluding Medicaid, Ruffin is recommending a $390,881 increase in
county funds for the department. A $516,000 cut the department made
from its overhead doesn't quite make up for $590,000 in mandated
increases to other public assistance programs the county is required to fund.

The rest of the increase includes salary increases, and three new
positions, including two for the call center to enable it to handle more calls.

The health department is set for a $1.66 million increase in county
money. The new funding will pay for salary increases, an additional
public health nurse, a dental nutritionist and 15 vehicles in the
environmental health division, plus a $33,000 to improve the privacy
of electronic medical records.