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Fairfield County isn't the only one up to its neck in Medicaid
expenditures.
The
Washington County Mental Health and Addiction Recovery Board has
experienced the same fate, but on a slightly greater scale.
"We've
never had a levy pass," said Ronald Reese, executive director of the
agency. "This is a fairly impoverished area. We tried to pass one twice
last year and it went down two to one both times."
Reese,
who has been with the agency for 11 years, said three attempts have been
made to pass a levy since he's been there. Prior to that, two attempts
were made -- each failing.
"We have
seen the same cuts as Fairfield County," he said. "It started a few years
back -- things began declining and we had to discontinue services, such as
a successful school outreach program. We've had to turn away people who
are seeking therapy but don't have Medicaid."
The
county has six contracting agencies and only one mental health clinic
takes non-Medicaid clients.
"We want
to serve people without Medicaid, but we're not able to because of
Medicaid match. And we expect that to continue," Reese said. "Costs are
going up and funding is down. Costs to use the state hospital are going up
and we have had to decrease the number of days we buy, buying fewer days
than we ever have before, because of decreasing revenues. We have to be
very judicial about when we use that (hospital) resource."
The
agency operates from state allocations and operates on a $4 million
budget, serving 5,000 people.
"We're
being reduced to core services for core people," Reese said. "We have
people complaining all the time, but you give up a whole lot when you
don't have a levy or an adequate one. The people who don't have Medicaid
go without and at this point, we've been instructed by the state
department that the top priority is Medicaid."
Next to
be served on the list are -- non-Medicaid clients -- those who suffer from
chronic illnesses and some emergency services.
Those
who don't fall into this category are left to fend for themselves.
"A lot
of these people have no support and get turned away, basically because we
have no levy," Reese said. "It's tragic to turn anyone because these
people will continue to suffer, but the financial situation just isn't
there to help people who seek help."
At this
point, another levy attempt is far off, Reese said.
"We have
to do some more groundwork before we try to go for another levy," he said.
"People have to make several decisions to vote yes. They have to agree
that mental illness should be treated, it's proper for public entities to
provide that and it's appropriate for them as a property owner to pay
increased taxes to support it.
"Until
people feel it's their responsibility to help other people, it won't
happen," he said. "People have to actually start caring about their
neighbors and unfortunately that's not as common as it used to be."
"Certainly all boards in the state are suffering the same thing because of
flat-lined funding," said Matthew Markley, executive director of the Paint
Valley ADAMH Board.
"Expenses at contracting agencies are going up while our revenues are
staying the same, leaving boards with no healthy fund balance."
Fortunately, the Paint Valley ADAMH Board -- made up of Ross, Pickaway,
Pike, Highland and Fayette counties -- is doing OK, Markley said.
"We are
in a good position," he said. "We've been very frugal and careful in how
we allocate funds each year to agencies."
The
board's operating budget is $14 million and their levy generates $2.1
million a year, which makes up about 15 percent of their revenue.
"We're
fortunate because we have a little higher funding balance," Markley said.
While
things are going well now, the agency has used their operating reserves.
"It's
scary once the reserve fund is gone," he said. "We're probably close to
reducing our operating reserves by close to $1 million by the end of this
fiscal year, so that's kind of scary.
"We're
not in dire straits like Fairfield County, but in the next couple of
years, (if things continue declining) the board may have to cut some
services to people," Markley said. "It's not that we want to keep people
from getting services, but it's hard to manage the system."
Timing
is everything for the Delaware-Morrow ADAMH Board.
Since
passing a 1-mill replacement levy in 2001, the board has generated
sufficient funds.
"It
provided an a little bit of additional money for the system," said Steve
Hedge, executive director of the board. "We had some growth in Medicaid
programs and the levy provided enough to maintain our services. That's the
major reason we haven't had to cut any services -- it was timing for us --
so the problems haven't hit us at the same level as other boards."
The
board has a $10 million operating budget and generates $4 million in levy
money. There are five contracting agencies, two who bill Medicaid and
three who don't.
"The
replacement levy really helped the number of people we serve who don't
receive Medicaid," Hedge said. "It's a tough time for ADAMH Boards and
social services with Medicaid being uncapped and funding from the state
level. We're being squeezed from both ends."
The
non-Medicaid programs provide housing for those suffering from severe
mental illnesses, a domestic violence program, and Helpline.
There
still is concern about the long-term effects of not being able to manage
expenditures, Hedge said.
Originally published Tuesday, August 12, 2003 |
