Warning issued on mental health cuts
By TOM FAHEYState House Bureau Chief
11 hours, 35 minutes ago
CONCORD – Mental health agency officials warned Monday that about 8,000 mental health patients will be quickly cut off from services if the New Hampshire House passes a proposed two-year budget this week.
The budget is likely to be voted on Thursday, and would move to the Senate for a full review before a vote there.
►House's $10b budget proposal sees cuts (2)
The budget bill cuts out entire categories of mental illness that qualify for Medicaid coverage. It would leave approximately 3,400 children without mental health care and more than 4,000 adults, according to the New Hampshire Community Behavioral Health Association.
If the bill becomes law, the effect on patients would be swift, said Jay Couture, the association's president. "We would need to immediately discharge 8,000 people from care," she said.
The association said the cuts mean roughly one-third of Medicaid patients would lose access to mental health services. The bill would also force up to 500 layoffs at mental health agencies around the state, and force three agencies to consolidate with other agencies.
Rep. Neal Kurk, R-Weare, who chaired the House Finance Committee division that proposed the cuts, said the budget does its best with limited resources.
"I appreciate the fact that mental health service providers are very concerned about this budget, and they have reason to be. But I think it sets things up in a way that allows them to reallocate resources for those most in need. That is a reasonable thing to do in tough times," Kurk said.
The association warned Monday that passage of the budget would invite a lawsuit over violation of the federal Americans with Disabilities Act, for failing to provide community-based services that prevent institutional care. The state also risks having to reimburse the federal government for cutting services it promised to maintain when it accepted federal grants.
Many of those who continue to qualify for services would have a maximum $300 in annual Medicaid coverage for their condition. Couture said that amount would pay for an initial assessment, and perhaps one consultation.
Couture and others released a packet of information on 100 people from around the state who would lose services. Many of them are teens who are being bullied, have violent outbursts, who have been raped or abused, suffer autism or severe attention deficit disorder. Others are middle-aged patients who suffer schizophrenia, post traumatic stress or bipolar disorders.
Betty Welch, director of behavioral health at Elliot Hospital, said the first impact of the House budget will be felt at hospital emergency rooms. Already, mental illness and substance abuse account for one in eight emergency room visits, she said, adding that the numbers would escalate if thousands are cut off from support.
"We are watching our mental health system crumble around us," Welch said. If the House cuts stay in place, she said, "we will effectively recreate an institutionalized mental health system again. However, the new mental health institution will be scarier than it was before, as it will be fragmented and will undermine the dignity of individuals with mental illness in a way that we've never seen before."
Vic Topo of the Center for Life Management in Derry said the budget is not about economics.
"Some would have you believe this is about budget-balancing. This is savaging of the system we built up over several years, and the way in which to balance the budget is not to aim it at the most vulnerable in our community. This is unacceptable and inexcusable," Topo said.
Kurk said the budget could result in difficult cuts in services for patients. He noted it still spends $3.7 billion in all areas of health and human services, including mental health.
"A lot of people might receive treatment, but at a different level than they are currently receiving it," he said. The plan combines flexibility with challenges for agencies, he said.
"It allows them to provide essential services for those people who need them, and the state will be able to live within its existing revenues with a balanced budget," Kurk said.
The budget is likely to be voted on Thursday, and would move to the Senate for a full review before a vote there.
►House's $10b budget proposal sees cuts (2)
The budget bill cuts out entire categories of mental illness that qualify for Medicaid coverage. It would leave approximately 3,400 children without mental health care and more than 4,000 adults, according to the New Hampshire Community Behavioral Health Association.
If the bill becomes law, the effect on patients would be swift, said Jay Couture, the association's president. "We would need to immediately discharge 8,000 people from care," she said.
The association said the cuts mean roughly one-third of Medicaid patients would lose access to mental health services. The bill would also force up to 500 layoffs at mental health agencies around the state, and force three agencies to consolidate with other agencies.
Rep. Neal Kurk, R-Weare, who chaired the House Finance Committee division that proposed the cuts, said the budget does its best with limited resources.
"I appreciate the fact that mental health service providers are very concerned about this budget, and they have reason to be. But I think it sets things up in a way that allows them to reallocate resources for those most in need. That is a reasonable thing to do in tough times," Kurk said.
The association warned Monday that passage of the budget would invite a lawsuit over violation of the federal Americans with Disabilities Act, for failing to provide community-based services that prevent institutional care. The state also risks having to reimburse the federal government for cutting services it promised to maintain when it accepted federal grants.
Many of those who continue to qualify for services would have a maximum $300 in annual Medicaid coverage for their condition. Couture said that amount would pay for an initial assessment, and perhaps one consultation.
Couture and others released a packet of information on 100 people from around the state who would lose services. Many of them are teens who are being bullied, have violent outbursts, who have been raped or abused, suffer autism or severe attention deficit disorder. Others are middle-aged patients who suffer schizophrenia, post traumatic stress or bipolar disorders.
Betty Welch, director of behavioral health at Elliot Hospital, said the first impact of the House budget will be felt at hospital emergency rooms. Already, mental illness and substance abuse account for one in eight emergency room visits, she said, adding that the numbers would escalate if thousands are cut off from support.
"We are watching our mental health system crumble around us," Welch said. If the House cuts stay in place, she said, "we will effectively recreate an institutionalized mental health system again. However, the new mental health institution will be scarier than it was before, as it will be fragmented and will undermine the dignity of individuals with mental illness in a way that we've never seen before."
Vic Topo of the Center for Life Management in Derry said the budget is not about economics.
"Some would have you believe this is about budget-balancing. This is savaging of the system we built up over several years, and the way in which to balance the budget is not to aim it at the most vulnerable in our community. This is unacceptable and inexcusable," Topo said.
Kurk said the budget could result in difficult cuts in services for patients. He noted it still spends $3.7 billion in all areas of health and human services, including mental health.
"A lot of people might receive treatment, but at a different level than they are currently receiving it," he said. The plan combines flexibility with challenges for agencies, he said.
"It allows them to provide essential services for those people who need them, and the state will be able to live within its existing revenues with a balanced budget," Kurk said.
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