For the state’s community mental health services, 5 percent is half of all there is.
The House Appropriations Committee last week proposed using 5 percent across-the-board cuts to most state-funded programs in order to balance the budget.
“For SRS (Department of Social and Rehabilitation Services), that 5 percent comes to about $22 million,” said Mike Hammond, executive director at the Association of Community Mental Health Centers of Kansas. “To come up with that $23 million, SRS will have to have to cut our $10 million in state-aid grants by $5 million. That’s a 50 percent cut.”
The mental health centers use the grants to offset the costs of services for uninsured and underinsured patients who are low-income but are not eligible for Medicaid.
If enacted, the 5 percent cut will likely cost the state more than it saves, Hammond said.
“It means there will be a reduction in services, and there will probably have to be a reduction in workforce,” he said.
Jails or state hospitals
“That means people will turn to other places for mental-health care, which means they’ll be showing up in emergency rooms. If they choose to self-medicate, they may come in contact with the criminal justice system, which means jail or prison.
“Or if they choose to do nothing and just wait, they’ll end up in crisis in one of the state hospitals,” Hammond said.
The Senate Ways and Means Committee last week proposed a 2.5 percent across-the-board reduction in state spending.
“We’re sorting through what actions we may have to take, depending on which one passes — the 5 percent or the 2.5 percent,” said SRS Secretary Don Jordan. “Hopefully, we’ll have a list by Tuesday, Wednesday at the latest.”
Legislators return to Topeka on Wednesday for the start of this year’s veto session.
In many ways, Jordan said, the department’s hands are tied.
“We’re not able to cut big chunks of our budget because of caseload or (federal) stimulus requirements,” Jordan said. “What’s left, pretty much, are the grants to the community programs like the mental health centers.”
Already, SRS has cut $105 million from its initial fiscal 2010 budget.
Unfilled vacancies
To save money, hundreds of SRS positions have not been filled.
“Out the regional offices, 16 percent of the positions are vacant,” Jordan said. “At the central office, it’s 30 percent.”
Earlier, SRS announced plans for cutting more than $5.5 million from its General Assistance and MediKan programs. Eligibility is limited to childless adults with incomes below 30 percent of federal poverty guidelines — about $270 a month.
“The way it is now, eligibility is for 24 months with hardship exceptions,” Jordan said. “After July 1, it’ll be 18 months, no hardship.”
According to SRS, of the 4,734 people now on MediKan and General Assistance, 1,503 of them have been on the rolls for 18 months or more.
“These are people who’ll just be dropped out on the street July 1,” said Paul Johnson, an advocate for the poor who lobbies for the Kansas Catholic Conference.
“The rhetoric that what the House (Appropriations Committee) has proposed is a mere 5 percent is a gross distortion of the truth,” he said. “GA and MediKan have already lost one third of their funding.”
Like the mental health centers grants, MediKan and General Assistance are funded with all-state dollars.
Neither Johnson nor Hammond faulted SRS for the cuts.
“They pretty much have to go where the State General Fund money is,” Hammond said. “In our case, these are state-funded grants, so things are going to fall on us disproportionately.”
Jordan said he didn’t know if either of the proposed across-the-board cuts would force further reductions in General Assistance and MediKan.
“Hopefully not,” he said. “There has to be some kind of safety net.”
Rolling waiting list
In March, SRS instituted a “rolling waiting list” for Medicaid-funded home and community based services for people with physical disabilities.
“We were spending more money than we had appropriated,” Jordan said. “So what we’re doing now is for every two (people) who go off (the waiting list), one goes on. We’re trying to maintain thing at that level, we’re trying not to go three-off-one-on.”
-Dave Ranney is a staff writer for KHI News Service, which specializes in coverage of health issues facing Kansans. He can be reached at dranney@khi.org or at 785-233-5443, ext. 128.