Mental health system braces for cuts
by Kellen Moore
The already fragile spectrum of mental health services in Watauga County is about to get another shock to the system.
In a community forum Tuesday in Boone, leaders of Smoky Mountain Center outlined how they plan to manage more than $3.5 million in state and local funding cuts this year across their 15 counties.
More than 50 people, including service providers, consumers and their family members, and local government representatives, crowded into the space to learn more about the unsettling outlook.
“This year is a bad year. It is a very bad year, and you’re going to hear me say that over and over tonight,” Smoky Mountain Center CEO Brian Ingraham said. “Regardless of that, we have to do the best job of figuring out how to manage that money.”
Smoky Mountain Center is the local management entity for parts of western and central North Carolina. LMEs are responsible for coordinating and managing mental health services, and they establish contracts with providers who offer services for substance abuse, mental health problems and people with intellectual or developmental disabilities.
Across its service area, Smoky Mountain Center was dealt state cuts to several pots of funding, according to chief financial officer Lisa Slusher:
— $974,070 from its substance abuse block grant
— $1.67 million from its single-stream funding, which can be used for any age, disability or service
— $783,979 from its social services block grant, which provides for child mental health services and adult and child intellectual/developmental disabilities
— $48,000 for its drug treatment court in the northern region, which includes Watauga County
It also will operate with $113,574 less from county contributions.
Only one of those cuts — the single-stream funding — was considered a “one-time” cut. Ironically, that “one-time” cut also occurred last fiscal year, Slusher said.
Part of what makes this year’s cut painful is that Smoky Mountain Center spent about $2.308 million from its fund balance to buffer major cuts last year, Slusher said.
To tackle the cuts, Smoky Mountain Center will be eliminating some programs, reducing others or ceasing planned expansions, Ingraham said. The organization also looked to consolidate similar services and find any instances in which Medicaid money could replace lost state funds.
Watauga and several surrounding counties are not strangers to upheaval in mental health services, a fact that wasn’t lost on Smoky Mountain Center.
“We have to be very, very careful about making any changes in an environment that by its nature is very, very fragile,” Ingraham said.
The collapse last fall of New River Behavioral HealthCare, a major provider in the area for more than four decades, destabilized the entire area, said Billy West, CEO of Daymark Recovery Services, which took on many of New River’s former duties.
From the start, Daymark had to make major cuts and service reductions — a fact that will help it “hold the line” for these new cuts, West said.
Instead, the funding reductions will mean that Daymark cannot expand, keeping its services very thin, he said.
“I would say, you’re not going to see a retraction right now in services or staff, (but) it’s not nearly where it needs to be,” West said.
But in other facets, particularly vocational services for adults with intellectual/developmental disabilities, the overall cuts from Smoky Mountain Center will likely be around 20 percent, said Michael Maybee, director of Watauga Opportunities.
Maybee said he has not yet been provided exact figures, so it’s not clear how Watauga Opportunities will have to cut services.
“I will try my darnedest to find a way to work it so people don’t have to go home,” he said.
Maybee said part of problem was an accidental
“double cut” from the social services block grant. Legislators planned to transfer
$4.3 million statewide from mental health to the Department of Social Services for guardianship
services, but that transfer happened twice, he said.
The problem wasn’t noticed until the very end of the legislative session, and it slipped into the budget anyway, he said.
Maybee said he’s cautiously optimistic that that change can be reversed, as several at the state level have said it was not their intent.
“The question is, how do you fix it now that it’s law?” he said.
Several who attended Tuesday’s forum said the key would be contacting state legislators and asking them to respond to the problems, particularly regarding that social services block grant.
Some expressed interest in traveling to Raleigh on Tuesday to address a legislative oversight committee on mental health when it discusses the topic.
Ingraham said Smoky Mountain Center has contacted every stakeholder it could at the state level to get them to hear its needs.
“It’s not what we want to do. It’s not good for people,” he said. “We do it in the best way we can to try to minimize the impact, knowing there will be impact. It’s the reality that we have to be responsible for creating.”