Local directors say slicing treatment dollars would send more to hospitals, jail

By Susan Redden

Globe Staff Writer

Thousands of area residents could no longer get treatment for psychiatric, alcohol and drug problems, spokeswomen for two local service providers said Monday, if state lawmakers approve cutbacks in mental-health spending that have been proposed by Gov. Matt Blunt.

Proposed funding cuts for the Missouri Department of Mental Health were reviewed Monday by the Senate Appropriations Committee.

The cuts would translate to a loss of "essential services in mental-illness and substance-abuse programs," said Paula Baker, chief executive officer of Ozark Center. She said the cuts would increase state costs later, when many people ended up in local hospitals or jails.

"It really is a situation of pay now or pay later," agreed Alison Malinowski, executive director of Lafayette House.

"If we remove the treatment dollars, more people are going to end up in prison," she said. "We also expect there will be an increase in domestic violence against women and children, because substance abuse and domestic violence are so closely related."

Baker and Malinowski said their organizations have contacted local lawmakers with their concerns about the impact of the proposed cuts.

"We've prepared impact statements, and given them to our legislators and members of the appropriations committee," Baker said.

Dorn Schuffman, director of the Missouri Department of Mental Health, said the Division of Alcohol and Drug Abuse alone would lose nearly half its funding under Blunt's proposed budget.

"We would see a 45 percent reduction in the coverage program if these cuts go through," Schuffman said at a hearing of the Senate Appropriations Committee.

The division's costs were an estimated $23 million last fiscal year.

Sen. Gary Nodler, R-Joplin, co-chairman of the committee, said the funding must be cut because Missouri is short on money.

Spence Jackson, a spokesman for the governor, said current programs "have grown beyond the taxpayers' ability to pay."

"These have been difficult decisions that the governor believes will lead to a sustainable program," he said. "Missouri has and will continue to have one of the most generous social welfare programs in the country."

Ozark Center's programs for psychiatric programs and alcohol and drug abuse would be reduced about 35 percent if the governor's cuts are enacted, Baker said.

The center now provides those services for about 10,000 residents of Jasper, Newton, McDonald and Barton counties, she said.

"So, we'd be talking about 3,000 people not getting services," she said.

With the cuts, she said, seriously ill adults would lose access to medication and services that allow them to live in the community. The center also would have to reduce the outpatient services it now provides to people who don't have Medicaid or health insurance, she said.

In both cases, Baker said, the cuts would increase other state costs down the line.

"Many of the people who don't get the services that allow them to live in the community would have to be institutionalized," she said. "And people who can't get the outpatient services they need would delay treatment to the point they would have to be hospitalized.

"One thing we know is that whenever people don't have access to mental-health care, the cost of primary health care skyrockets."

Baker said the cuts also would reduce money available for medical detoxification and residential drug treatment programs, to which judges often sentence drug offenders.

"When we lose those services, they'll have no alternative but to send them to jail, which costs a lot more," she said.

Malinowski said federal funding for alcohol and drug treatment programs is tied to state funding levels, so state cuts proposed for next fiscal year would be followed a year later by reduced federal funds.

She said that under the proposed cuts, she estimates funding for Lafayette House's alcohol and drug treatment programs would be reduced by 25 percent the first year, followed by a 25 percent cut in federal funds.

"That means about 600 women and children would not be able to receive those services," she said. "We provide services for mothers and dependent children, because children are so affected, living in those households."

Malinowski said Lafayette House gets some Medicaid funding that might otherwise offset some of the cuts, but the state also is looking at cuts in that program.

Capitol correspondent Elizabeth Baird contributed to this story.

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