Mental Health Braces for Budget Bloodbath

Below is the article about mental health budget cuts that appears in the Nov. 15 issue of the Independent, followed by an addendum that details the decision made at the meeting.

It began with a November 1 memo from County Executive Officer Mike Brown to all department directors, budget staff, and executive staff, explaining that 3rd District Supervisor Brooks Firestone had asked him to find possible budget reductions for the current fiscal year. All county departments responded with potential cuts, including Alcohol, Drug & Mental Health Services (ADMHS), which submitted a list of $1.1 million in potential reductions in programs.

The list set off a spark in the community of service providers who help the mentally ill and homeless and who also receive funding from ADMHS. Many showed up at the November 6 Board of Supervisors’ meeting, worried that potential cuts could happen that day. Brown assured those in attendance that was not, in fact, going to happen at the meeting, but could be discussed at some future date.

That date, apparently, was Wednesday, November 14. In two follow-up emails over the course of the two days after the November 6 board meeting, ADMHS interim Director Doug Barton informed a small group of program directors that, while the initial list was “intended to give the board an indication of the scope of our current budget crisis,” it was not an actual budget proposal. But Brown had asked for an actual reforecast from the department, so Barton suggested $2.4 million in reductions in the first email, and a total of $3.4 million worth of cuts in the second, tripling the deficit in a matter of days. Additionally, Barton called a meeting with service providers for November 14. The purpose of the meeting wasn’t clear. Nowhere in the emails did Barton elaborate beyond calling it a “planning meeting.”

Several executive directors of the service providers were perplexed about the meeting. “We don’t know what’s going to happen tomorrow,” said Casa Esperanza Executive Director Mike Foley the day before the meeting. Nobody-including the supervisors, it seems-was in the know when it came to Wednesday’s meeting. Supervisors Salud Carbajal and Janet Wolf both knew about the meeting but had no clue exactly what would transpire or how serious discussions were regarding budget-cutting midway through the fiscal year. Several phone calls from The Independent to Barton were not returned. His secretary directed inquiries to county spokesperson William Boyer, who offered as much insight as he could on the situation. “The meeting is designed to discuss shortfalls in the budget,” he said. “[Barton] is taking prudent fiscal steps, and he’s wanting to keep the door open [for discussion].”

On the list of $1.1 million in possible reductions originally submitted to Brown were cuts in funding for the recently opened El Carrillo housing project, Casa Esperanza, Casa del Mural, and the Santa Barbara Community Housing Corporation Independent Living Resource Center, among others. Boyer said he’s not sure if it’s been determined from where the additional $2.3 million in cuts might come. “By law, they have to have a balanced budget,” he said.

A host of directors had been preparing for Wednesday’s meeting. Several are worried potential cuts will have the most detrimental effect on those who need help most. “I can see the potential devastation to the entire mental health system,” Foley said. “It’s certainly going to drive many more people out [onto the streets].”

Rob Pearson, executive director of the Santa Barbara City Housing Authority-which built the 61-unit El Carrillo project, a permanent affordable housing complex for the previously homeless-said a possible $75,000 cut to the Work Training Program, which offers mental health services, drug and alcohol rehab, and more at the complex, could mean the end of the relationship between the Housing Authority and the county. “I’m very concerned,” Pearson said. “If they can’t deliver on the service side, I don’t know how we can keep providing housing. El Carrillo,” he said, is “such a success story, I don’t know how they could think about cuts.” Pearson added that the recidivism rate is only about 20 percent for those living in the complex.

ADHMS has been facing problems for years. Last fiscal year, roughly $5 million was cut from the budget. The county has had problems receiving reimbursements and funding from the state, and only a small percentage, 2 percent, of the county’s General Fund goes to the department. Wolf said the county needs to look at the entire budget across the board-not just at ADHMS-and ask whether it is cutting services to the most vulnerable. While some providers suggested any cuts should wait until a new director takes over in January, Carbajal said action is needed now. He said the options aren’t limited solely to cutting programs, but looking at alternative choices like the county’s reserves. “If the ship is sinking, you don’t wait,” he said. “We need to address the issues now.”

The following is Chris Meagher’s addendum to the story that ran in print

“You have the opportunity to leave this town a hero.” Those were the words Casa Esperanza executive director Mike Foley said to Doug Barton, Alcohol, Drug and Mental Health Services interim director, at a tense meeting Wednesday which was supposed to be a discussion of possible budget reductions for the department. “I just want the opportunity to leave town,” Barton said in reply. Foley’s words came as part of a plea from mental health and homeless service providers for Barton to delay a series of potential cuts to the department’s budget which those on the receiving end claim would have a devastate the service they provide to the county’s most indigent population.

Barton called the meeting between ADMHS staff and contracted service providers to discuss what to do about a $3.4 million-and potentially growing-deficit facing the department. Providers and community members reacted last week to a memo from County Chief Mike Brown explaining how 3rd District Supervisor Brooks Firestone had asked him to find possible budget reductions for the current fiscal year. All county departments responded with potential cuts, including Alcohol, Drug & Mental Health Services (ADMHS), which submitted a list of $1.1 million in potential reductions in programs. When members of the public voiced their concern about the total, Brown explained the cuts wouldn’t be coming that day, but possibly in the future. Two days later, Barton scheduled the meeting as a beginning to the planning process of how to make up the deficit. “One thing that bothers me is we had one county supervisor asking for that,” said John Buttny, former assistant to Firestone’s predecessor Gail Marshall, expressing frustration at the lack of public involvement. “It’s insane. Look what it set in motion. How this kicked off is inexcusable.”

The $3.4 million comes as a result of three things, Barton explained Wednesday to the group-a $2.4 million deficit from the previous fiscal year, $387,000 in an equity adjustment that had received funding from the county the two previous years, but not this year, and an anticipated contract settlement of $613,000. Failed state and federal reimbursement promises are also hindering the ability of ADMHS to keep up. In the end, the county is left to cut big. “Counting the paper clips is not going to do it at $3.4 million,” said Marianne Garrity, ADMHS deputy director.

Community members went into the meeting tentative about what they would hear from county staff, and many came into the meeting unwilling to discuss the possibility of cutting any funding for the department. “Suggesting a cut anywhere is gross negligence on our part,” Foley said. Despite the overarching feeling that everyone had the same end goal-helping people who need it most- tense moments and high emotions were often present in the conversations. At first, Barton insisted the budget cut discussion had to take place so he’d have options to give to Brown. But a majority of the providers in the packed room refused to be a part of the discussion, and many walked out in defiance of the idea on grounds that any cuts would lead to the loss of services and more people on the street without help. It’s a public safety issue that is in need of help, just like funding the sheriff’s department, some argued. And their pleas worked.

After discussion of the county possibly providing bridge funding to the department while a group works to begin a process to overhaul the troubled department-an action everyone agreed needed to happen-Barton gave his word to the group that he would hold off on budget reduction talk until after a meeting next week with Brown. Barton said he isn’t sure the county has the financial capacity to provide a loan to the department, nor does he know how much his department would need. Paul said the solution would have to have a multi-layered effect, expanding beyond a one-time fix it to get the department headed in the right direction.

Those in attendance were more than happy to commit to being a part of restructuring ADMHS. “The physician can’t heal himself right now,” said Roger Heroux, the former director of the county’s Public Health Department who conducted the county’s study on its Ten-Year Plan to End Chronic Homelessness. To a certain extent, the process has already begun within the department. A new system is being implemented to develop data on and better understand and evaluate the population of the people being served by the department and whether the care they are receiving is appropriate. Some of the population, ADMHS assistant director Al Rodriguez pointed out, is being overserved, while some is underserved. “It’s evolved to a point where we’re serving more people than we can,” Rodriguez said. Foley said that with an overhaul of the program, more people can be served more efficiently and effectively using less money. And the faster the process gets under way, the better, county staff stressed. The department’s deficit will grow by $575,000 per month after January, should the issue not be resolved by then.

So, for the time being, at least, everybody is content, although that could all change in a week or two. Annmarie Cameron of the Mental Health Association said the outcome was the best she could hope for. “We came to make them notice,” she said. And they did. “Although we didn’t achieve what we intended to achieve, I think we got somewhere,” Barton said.