REHAB PROGRAMS FACE CUTS

Blunt's Proposed Budget Could Force 70 Percent Of Treatment Facilities In
Missouri To Close

Local mental health care providers said Tuesday that their clients could be
severely harmed by proposed budget cuts to the Department of Mental Health.
Agency directors said hundreds of Boone County residents would lose
services if Gov. Matt Blunt's budget proposal is accepted in its current form.

About 80 people crowded into a news conference at the Roger B. Wilson
County Government Center commission chambers to listen to local providers
and a former drug addict speak about the likely repercussions of the
proposed cuts and the benefits the agencies provide to people within the
community. After the speakers finished, several people in the crowd also
spoke, including a few residents of the Phoenix House, an outpatient
substance abuse program.

Providers said an increase in crime, the closing of treatment centers and a
loss of services for individuals with mental and substance-abuse disorders
are possible consequences of the proposed cuts.

An increase in emergency room treatments and a rise in homelessness were
also mentioned as possible repercussions.

The Department of Mental Health estimated that the governor's proposed
budget would cut 83 percent - about $10 million - of non-Medicaid funding
from the drug and alcohol division of the Department of Mental Health. All
non-Medicaid funding for the psychiatric services division, about $9
million, would be cut.

An additional $5 million in cuts to Medicaid funding for the two divisions
would result in reduced services for people with Medicaid.

Al Tacker, director of the Family Counseling Center and McCambridge Center,
said cuts to drug and alcohol programs would result in the loss of
treatment for all non-Medicaid eligible people during the next two years.
Locally, 602 people at Phoenix Programs Inc. and 176 people at McCambridge
Center would lose services.

Tacker said that across the state, about 70 percent of treatment centers
would likely close. This would affect drug courts, which use these centers
for about 85 percent of their treatment programs.

Bruce Horwitz, director of University Behavioral Health, said that about
200 people who do not receive Medicaid assistance would lose psychiatric
services at the agency. He said these people are often individuals with
long histories of mental illnesses, who have reached a level of stable
functioning through services financed by the Department of Mental Health.

He said many cannot work and are under-insured or uninsured.

Horwitz said one hospitalization may cost as much as one year of
out-patient treatment.

"Cutting services is not the best fiscal or social policy," Horwitz said.

Deborah Beste, director of Phoenix Programs, said about 200 homeless men
receive treatment each year for mental and substance abuse disorders
through that agency. She said more than 60 percent recover or stabilize and
become functioning citizens within the community. These services would no
longer be available under the governor's proposed budget.

The agency would also have to eliminate its detoxification program, which
serves about 250 people a year. This program allows for the transfer of
patients with substance abuse problems out of the hospital and into a
community program.

"The costs to the community far outweigh any initial treatment savings,"
Beste said.

County Commissioner Skip Elkin, the commission liaison to the Boone County
Mental Health board of trustees, said the proposed cuts would create
"devastating consequences."

He said mental illness is a disease, and, like other diseases, it is better
economically to offer treatment and take care of the problem early, when
the costs are fewer to the individual and to society.

"They are going to either not get treatment or wait until it's a crisis and
they are going to end up in our emergency rooms and/or our jail and/or our
prisons," he said.

Elkin said the governor's proposal will not solve the state's healthcare
problem, just transfer it to local governments that could not afford the costs.

"Someone is going to have to pick up the pieces after it's all said and
done, and historically, it's been local governments," Elkin said. "That
will certainly affect our ability to provide the services that we already
provide and do a good job at doing that."

According to the Boone County Mental Health Needs Assessment for 2004, of
the participating mental health service providers, about 36 percent of
their total funding was provided by the Department of Mental Health. The
department provided about 65 percent of funding for alcohol and substance
abuse services.