State announces 2009 budget cuts to mental health and substance abuse

Facing a significant budget shortfall, the state Department of Social and Health Services (DSHS) has announced cuts to state funded mental health and substance abuse services and programs. The state Division of Alcohol and Substance Abuse (DASA) and state Mental Health Division announced impending cuts to their 2009 budgets, most of which are to be implemented Feb. 1, 2009.

Mental Health Cuts: Statewide $10.1 million; King County cut $2 million

Reductions : Mental health services are primarily coordinated by Regional Support Networks (RSNs) - counties or groups of counties - across the state, including King County RSN managed by the Mental Health, Chemical Abuse and Dependency Services Division.

• Reduction of $3.2 million to Medicaid rates paid to RSNs statewide; King County's share of the cut will be only $70,000 or a monthly cut of 0.19%. Cuts to some of the other RSNs are much larger, with Greater Columbia RSN taking a cut of $906,000 (5.51%) and Thurston Mason RSN taking a cut of $582,000 (9.86%). The reason King County's cut is much less than others is due to the fact that the state is already paying King County near the bottom of the rate range and couldn't be cut more without falling out of the actuarial range as required under the state Medicaid contract.
• Reduction of $6.9 million to non-Medicaid services statewide; King County's share is based on its percentage of the total state non-Medicaid funds, which in turn is based on the state population. King County has 28.79% of the population, so it will lose 28.79% of the $6.9 million, which is $1,990,253. This represents about a 15% monthly cut for the next five months.

King County Response : Using one-time only dollars in reserve, King County RSN will not cut any programs during the remainder of this biennium (through June 30, 2009). Contract community mental health providers have been notified that King County RSN will use its reserves to cover the loss of state funding during this period.

Substance Abuse: Statewide total unknown; King County cut $1.3 million

Reductions : The State DASA announced cuts of about $1.3 million to King County's programs for low-income substance abuse programs over the next five months. This is significantly less than a previous announcement from DASA that had estimated cuts of over $3.7 million to King County, but will still negatively impact access to treatment services. Cuts will:

• Eliminate five outstation staff supporting Temporary Assistance for Needy Families (TANF)
• Reduce the number of Children's Administration Chemical Dependency Professionals (CDPs) from five positions to one
• Eliminate crisis nursery funds
• Reduce residential treatment funding for drug court clients
• Significantly reduce residential treatment funding (which doesn't go through the counties, but is administered at the state level), although the exact amount is not yet known. A loss of at least 25 beds in King County alone is anticipated and many more statewide.
• Reduce low-income and detoxification funds by $1,135,328
• Reinstated stipends for current Alcohol and Drug Addiction Treatment and Support Act (ADATSA) clients and those admitted through Jan. 31, 2009 for a maximum of three months but eliminates stipends for ADATSA clients admitted February 2009 forward
• Cut intensive case management pilot program (two CDP positions) at 1811 Eastlake serving persons with chronic alcohol dependency.

King County Response : Using a combination of under expended funds from 2008 contracts and delaying contracts for outreach funds from a Request for Proposal, King County will be able to fully fund core services for sobering/detoxification, youth outpatient, adult outpatient, and opiate substitution through June 30, 2009. In addition, King County will use reserves to fund the two CDP positions at 1811 Eastlake through June 30.

Next Steps: The 2009 Legislative Session convened on Jan. 12, 2009. Members of the State Legislature and the Governor will need to come to agreement on a 2009-2011 biennial budget during the course of the session, in the midst of a continuing national economic downturn. Mental health and substance abuse services, as well as other areas of human services, are threatened.