ADAMH struggles with Medicaid
Board preparing for third round of cuts in three years

By TAMARIA L. LIDDELL
The Eagle-Gazette Staff

LANCASTER -- Some Fairfield County mental health agencies will face extinction if non-Medicaid services are eliminated.

The Fairfield County Alcohol, Drug Addiction and Mental Health Board discussed proposed budget reductions Tuesday for the third year in a row that will affect the board's contracting agencies.

In order to balance ADAMH's budget, nearly $412,000 in reductions must be made for fiscal year 2005, which begins July 1, 2004.

A reduction in funds will affect non-Medicaid services, in turn affecting a vast majority of the county's working poor, who aren't Medicaid eligible, Hall said.

"We're circling around in the same exact place as we were last year, but it's worse this year," said Orman Hall, executive director of the ADAMH Board, on Tuesday. "This is a very complicated situation. We have a serious Medicaid crisis on our hands."

The ADAMH Board provides funding to New Horizons Youth and Family Center, Fairfield Mental Health Consumer Group, The Lighthouse, The Recovery Center and Mid-Ohio Psychological Services.

The ADAMH Board is required by law to fund Medicaid services. Should funding continue to be reduced, non-Medicaid services in these agencies are the first services to be cut.

For Janet Galligan, executive director of the Fairfield Mental Health Consumer Group/Our Place, the depletion of discretionary dollars for non-Medicaid services is scary.

The agency, which offers a host of supportive services to mental health consumers, doesn't receive any Medicaid dollars.

"All of our money comes from the board and a small grant from United Way," Galligan said. "If the board has to go to Medicaid funding only, we won't have an agency. We hope that won't happen. We're looking for grants and funding elsewhere, but money is tight everywhere."

The primary topic discussed during the meeting was whether to transfer the court diversion program from Mid-Ohio to New Horizons. Initially, Hall recommended that the program, along with a jail-based program, be transferred because of Mid-Ohio's excessive Medicaid expenditures during the past fiscal year.

Mid-Ohio billed the county more than $1 million for Medicaid. The agency's projected expenditures were not to exceed $863,000, Hall said.

"The rationale for movement is based on decisions from last year," he said. "The commitment of the board was if there were significant Medicaid increases from Mid-Ohio, we would terminate our non-Medicaid services at Mid-Ohio."

A letter written to Hall by Mid-Ohio's executive director Brad Hedges, who was not at the meeting, stated Mid-Ohio committed to not increase the capacity for clinical services.

"To this end, we have not hired any additional clinical staff in this county during this period of time," Hedges wrote. "In spite of our efforts, MOPS has increased our Medicaid billings in Fairfield County by approximately $211,000."

Hedges listed contributing factors in the deficit of a slight increase in agency productivity and a higher percentage of Fairfield County clients being served.

Board members questioned the agreement that was made between the ADAMH Board and Mid-Ohio, and the advantages and disadvantages of moving the non-Medicaid programs.

Hall recommended a meeting be set up with Hedges to reassess the proposed cuts. The issue and proposed cuts were tabled until the board's regularly scheduled meeting on May 25.

Fairfield Mental Health Consumer Group/Our Place already has cut $16,300 out of its budget. Galligan asked the board if the agency's cut could be reduced to $15,000 instead of the proposed $22,500. The board will consider Galligan's request.

Tony Motta, executive director of New Horizons, attended Tuesday's meeting but said he would not oppose the allocation.

More than $191,000 in cuts were proposed for his agency; this makes $500,000 in non-Medicaid funding cuts in the past 18 months, Motta said.

"We know they're strapped, and we know they don't have it," he said. "But reductions will be in services. The less we have, the less we'll be able to serve people who need the sliding fee scale. ... We're down to the bare bone."

Originally published Wednesday, May 12, 2004