Of The Oakland Press
A projected $11 million deficit at the Oakland County Community Mental Health Authority has officials admitting that cuts to service providers, programs and layoffs are distinct possibilities to mitigate the shortfall.
After recently releasing some budget numbers on the projected deficit, Oakland’s authority said it is working with its provider agencies to look at reductions that could be necessary before Oct. 1, which is the beginning of the entity’s 2015-16 fiscal year.
Executive Director and CEO Willie Brooks said since 2013, a $14 million reduction in Medicaid dollars from the state, combined with an $8 million decrease in the general fund and a $7 million increase in service demand, left the agency with a $29 million budget shortfall.
After reserve money was used to reduce the deficit to $11 million, in 2015 “what happens is that the budget does not go away — it carries over into the next year. We still have that $11 million that we have to make up,” said Brooks.
AdvertisementLayoffs, the consolidation of providers and reductions to improve efficiency could all be on the table, Brooks said, adding he’s meeting with providers later this week to discuss the impact to those the entity serves. Some providers could potentially go out of business, he added.
Effects to residentsTom Kendziorski, executive director at mental health advocacy group The Arc of Oakland County, said the deficit is “yet another low point” for people with mental health care issues, and for those who serve them.
The Arc, which has hosted three packed town hall meetings on the issue and has reached out to the community for action in other ways, has more than 1,000 dues paying members whose family members have some type of disability.
“With another decrease in funds, it’s going to mean less services for people with disabilities ... staff people for these service providers are essentially at minimum wage, maybe a little higher, with very little benefits,” said Kendziorski.
“If cuts continue, who wants to work for close to $8 an hour? They could make more working at their local WalMart or McDonald’s.”
Kendziorski added that the state’s Medicaid cuts are not proportional to the number of people served — and benefits provided — in Oakland County, which is about 27,000, by the mental health authority’s count. Less and less are individuals seeing community living support services, vocational training programs, transportation to those programs and residential services, he explained.
“Parents may have to shoulder more responsibility for caring for their adult children. But parents do get older, too, you know. They become 60 and 70 and can’t do what they used to do in their 30s and 40s.”
Jerry Wolffe, writer in residence and advocate at large at the Macomb Oakland Regional Center (MORC) in Clinton Township, said although he isn’t speaking on behalf of MORC, he personally believes society will regress if adequate funds aren’t seen for mental health statewide.
“You can’t cut millions of dollars and expect to provide services where the person has an optimal life,” said Wolffe.
“In these last 10 years, the rate of inflation has increased 30 percent, and funding had been chopped by millions of dollars. It leaves providers with the only option of cutting the salaries of the caregivers, who make an average of $9.06 an hour. There’s no more room to cut.”
“We’re leading toward a collapse,” Kendziorski said.
“If we don’t have enough money to maintain the level of services that this generation expects ... it could mean that only the most severely disabled could be served, and the moderately impaired wouldn’t see much help, if any. That’s not a good situation.”
Kendziorski added that there is no cap on how much in reserve money the Community Mental Health Authority can use to stave off the deficit.
But Brooks said: “We can’t continue to use reserves — we’ll be out of Medicaid reserves next year at this time, at this rate.
We have to balance what’s going out to what’s coming in.”
More state cuts?Last year, Medicaid cuts came to Oakland, Macomb and Wayne counties mental health authorities to the tune of $48 million. The three regional mental health authorities cover more than 60 percent of the state’s Medicaid recipients.
The cuts came after years of assessment from the state’s Department of Community Health to reshuffle, or rebase, a new Medicaid rate across Michigan.
On top of the $14 million Medicaid dollars cut in Oakland alone, a worst-case scenario would be more cuts handed down from the state in 2016, Brooks said.
The county’s mental health authority has been working with legislators and the Department of Community Health to help the statewide division “develop a statewide solution, and understand their goal,” Brooks said.
“But at the same time, we want to maintain the infrastructure that we have here.”
Vicki Suder, the mental health authority’s director of rights and advocacy, said in 2010, the state closed the last institution for people with developmental disabilities. She said state funding is needed “to show people that they are valued members of the community, and we need to be able to support them.
“They are getting some of the basic care, not way above and beyond.”
In Macomb and Wayne, budgets seem to be balanced, barring any more state cuts, directors of each regional mental health authority recently told Crain’s Detroit.
The Detroit Wayne County Community Health Authority serves about 75,000 people, and has made reductions that have led to no projected cuts in services necessary in fiscal year 2015-16 fiscal.
The Macomb County Community Mental Health Authority said although it saw $23 million in cuts the past two years, it doesn’t expect reductions in 2016, either. It serves about 30,000 people.