Many questions remain regarding the Governor's proposed budget. If the Department of Public Welfare has done an analysis of the impact on community mental health services, they have not shared it. To date, providers, advocates and most importantly consumers of the services have been shut out of any discussion regarding the block grant proposal.
The impact is clear:
•The state is backing out of its long term commitment to ensure that persons with mental illness receive the needed level of services and supports.
•There will be increased homelessness of persons with mental illness who won't get housing supports.
•More people with mental illness will end up in in-patient psychiatric units or state hospitals when current supports go away — all at greater cost to the taxpayer.
•Less funding will be available for the expansion of mental health courts, which have been demonstrated to be an effective method of redirecting persons away from inappropriate incarceration and toward successful reintegration into the community.
•People who have lived successfully in the community with supports could end up in jail when other options are not available.
We do know the following proposed budget details:
•The budget will reduce funding for our community mental health system by at least 20%. This catastrophic level of cut is unprecedented in Pennsylvania's history.
•It gets even worse. The Governor proposes to put these dollars into a county administered Human Services Development Fund Block Grant (HSDF) with NO requirement that they be spent on mental health services even though the overwhelming majority of dollars are from the mental health system.
•The proposed cut for mental health and drug and alcohol services and supports total $122,620 million. That is a loss of one out of every five dollars.
Mental Health and Drug and Alcohol Services and Supports cut includes:
•$550,469 million which currently supports community mental health services will be reduced to $440,376 million.
The dollars which support people who have left the state hospitals (known as CHIPPS) are included in this 20% cut and in the proposed block grant to counties.
As state hospitals were closed or downsized, counties identified the amount of money needed to replace the institutional beds with community services. The plans and funding included the services and supports both for individuals moving from the institution and people who would have needed this level of service in the future. State hospital beds have been closed but the money supporting people has been cut 20%.
•The current year's budget included $47,908 million for Behavioral Health Services (BHSI). BHSI services were created when 18,800 individuals in need of mental health and/or drug and alcohol treatment services lost their Medical Assistance in the 1990's. The proposed budget's 20% cut reduces BHSI to $38,326 million.
•The current year's budget included $14,727 million for Act 152 Drug and Alcohol Program. The proposed 20% cut reduces that amount to $11,782 million.
And still more bad news:
•General Assistance (GA) cash grants will be totally eliminated
•In order to keep Medicaid health insurance coverage, people receiving General Assistance Medicaid will have to work 20 hours per week.
•Mental Health and drug and alcohol treatment represent approximately 35% of the GA Medicaid expenditures translating into a potential cut of $59.61 million.