Residents protest county’s mental health cuts
March 7, 2009
SOUTH LAKE TAHOE ” Residents voiced their frustrations with the El Dorado County Mental Health Department on Thursday after the county’s latest round of budget cuts.
About 15 residents gathered at the South Lake Tahoe Mental Health Commission meeting Thursday to express their concern about four positions eliminated from the South Lake Tahoe Mental Health Clinic, which will phase out the positions in one to two months. The El Dorado County Board of Supervisors asked staff to complete an analysis in six to eight weeks to ensure that services are operating efficiently.
The meeting gave county officials information on how the South Lake Tahoe clinic would be affected by the cuts, so that solutions could be crafted to address any problems.
Since the start of the department’s fiscal year in July, about 37 positions have been cut from the department ” 11 positions from South Lake Tahoe and 26 from Placerville, said Neda West, health services department director.
Ninety positions are left, West said.
Pamela Nance, South Lake Tahoe Mental Health Commission member, said it’s not feasible to run South Lake Tahoe clinic with the recent February cuts, which could leave the clinic with seven people to manage more than 350 clients.
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There are already too many clients who aren’t served, said Erica Toth, the mother of a client.
Toth said that if case managers are cut, clients’ lives will be affected.
“It concerns me greatly because they are the lifeline for our clients,” Toth said. “Once you lose those good people, it’s hard to get them back.”
Many clients don’t have families, so case managers are their only support system, Toth said. They need to have medication, counseling and support, she added.
“The goal is to keep people out of the hospital and jail, and if you cut case managers, that’s where (clients) go,” Toth said.
Because of the cuts, many feared that the clinic would be closed.
“This clinic will be closed over my dead body,” El Dorado County Supervisor Norma Santiago said at the meeting. “You have that support from me.”
Santiago said budget reductions must be made in every county department because of the unprecedented fiscal crisis.
“We have a $3 million bleed in this department that we can’t afford to continue,” Santiago said. “To fix and turn around this elephant is not going to be easy.”
Santiago said the department finances looked good a year ago, but then Medical reimbursements stopped flowing. She asked for an audit of the department about six months ago.
“The expenses stayed the same, but the revenue was a lot less,” Santiago said.
Chris Kondo-Lister, deputy director for mental health, said county representatives are working to get the medical reimbursements at the state level. The California Mental Health Directors Association is advocating for counties to get the reimbursements flowing.
Residents at the meeting voiced their frustration.
“We also get treatment like we’re just the same as Placerville, and Tahoe is not like Placerville,” said Diana Hankins of the National Alliance on Mental Illness.
Placerville has more services than South Lake Tahoe, Hankins said. For example, Tahoe doesn’t have a psychiatric hospital where people can be dropped off, so they have to be sent down to Placerville’s facility.
Tahoe also doesn’t have transitional housing for patients to go to after they’re released from the hospital, but Placerville does, Hankins said. Placerville also has full-time psychiatrists, and Tahoe does not.
South Lake Tahoe used to have a full-time psychiatrist, but Vernon Bry’s hours have been cut to 25 per week, Hankins said. Clients have to wait two to three months to get an appointment, she added.
“How do you tell someone who’s having a mental crisis that they have to wait two months?” Nance said.
The only psychiatrist available for children is Sonia Rupp, and she works only six hours per week, Hankins said.
Santiago said funding for an additional 15 hours per week for Bry needs to be looked into. Since there is no transitional housing or other services, his additional hours are important.
“It can’t be a one-size-fits-all solution,” Santiago said. “We can’t compare what works in Placerville to here.”
The county’s budget issues aren’t only affecting clients, but also other health organizations around town.
When the county cut its number of Psychiatric Health Facility beds in Placerville from eight to six, Barton Memorial Hospital was affected, said Lisa Fisher, Barton social services director.
“That immediately put (Barton) behind the eight ball with that reduction,” Fisher said.
Because the county has reduced its mental health services during the past year, more people end up at Barton, and there isn’t a psychiatrist on staff, Fisher said.
Sometimes the hospital has to keep patients who might be a danger to themselves because they can’t get to the Psychiatric Health Facility.
The Barton Community Clinic is looking to have a psychiatrist on staff by April if everything goes according to plan, said Sharon Bishop, Barton Community Clinic practice manager.
The clinic is already cramped for space. Last month it served 1,375 patients, Bishop said. Since the county cut its mental and public health budgets, the clinic has acquired between 150 and 200 more clients.
About half of the patients have Medical, and the other 50 percent are under-insured or uninsured, Bishop said.
The clinic charges $5 to $35 on a sliding scale, depending on the income and number of family members, Bishop said. The clinic usually has a $1.2 million deficit every year, she added.
Santiago said it’s crucial to forge partnerships with organizations in town, such as the Family Resource Center, Barton HealthCare System, and Tahoe Youth and Family Services.
“In my gut, I know we will come out OK at the end of this fiscal crisis if we forge these partnerships,” Santiago said.