Behavioral health care providers call $15 million ‘sweep’ of their funds wrong-headed

LINCOLN — In a blunt letter, the head of an advisory committee on behavioral health care called on Gov. Jim Pillen on Tuesday to abandon a proposed $15 million cut in funding for mental health services.

Such a reduction would be personal, wrote Tim Heller of Omaha, who has a son with severe and persistent mental illness.

Proper funding of such services, Heller maintained, could reduce visits to emergency rooms, homelessness and spending on prisons — which has become one of the state’s top mental health facilities.

It could also avoid some violent incidents involving persons with untreated behavioral health needs, he said.

‘Not the time to cut’

“Now is not the time to cut the budget,” Heller said in an open letter to the governor he shared with the Examiner.

“We do not need another Robert Hawkins (Von Maur), Joseph Jones (Target) or Zachary Bear Heels,” he wrote, referring to a mass shooting in Omaha, the shooting of an armed man inside a west Omaha Target store and an incident in which Bear Heels died in a struggle with Omaha police amid a mental health crisis.

Heller, along with members of the Nebraska Association of Behavioral Health Organizations, are pressing for a reversal of a decision by the Pillen administration to cut $15 million from behavioral health care spending.

They maintain there are plenty of unmet needs involving the mentally ill in Nebraska and that the cut in funding could reduce or eliminate services, forcing more emergency visits to hospitals and more law enforcement calls to deal with mental health crisis situations.

“There’s just a ripple of effects if we don’t have this money. All those folks will end up at an emergency room or a jail cell,” said Tami Lewis-Ahrendt, the chief operating officer at Lincoln-based CenterPoint.

She said that CenterPoint’s unique outreach program with homeless people on the streets would be at risk, as would a planned family resource and crisis center in Lincoln.

Programs could be cut, wait lines increased

In Grand Island,  there’s a wait list of 60 people seeking outpatient counseling for substance abuse at the Mid-Plains Center for Behavioral Health Care Services — a wait list officials there fear will grow without adequate funding.

In Omaha, the 46-bed CenterPoint Campus for Hope can only operate 26 beds for patients due to a lack of staff, with a list of 80 people waiting to get a bed, and concerns that hiring and services will be harmed by a funding cut.

“We know the needs are out there, we know they’re growing. But it feels like we’re finally starting to turn the corner, and now it’s going to get ripped out from underneath us,” said Chase Francl, the CEO of the Mid-Plains Center.

Pillen administration officials defended the cut, saying it represents unspent funds that accumulated after Medicaid expansion reduced the patient load and expenses for such regional behavioral health providers.

‘Right sizing’

Jeff Powell, a spokesman for the Nebraska Department of Health and Human Services, said in the past two fiscal years, there have been unexpended balances of $35 million and $27 million. Even with the $15 million cut, Powell said about $30 million would be left over in the current year.

“The existing appropriation to the Division of Behavioral Health is sufficient to meet existing needs,” said Powell.

Lee Will, the governor’s top budget official, agreed, calling the reduction more of a “right sizing” than a cut. He said additional needs could be addressed in future budgets, if need be.

Annette Dubas, who heads the behavioral health association, and others in her organization disagreed.

Medicaid doesn’t cover all

They said that while Medicaid expansion has reduced patients, it doesn’t mean that all needs have been met.

Plus, they said, Medicaid doesn’t cover all services, citing a program in Lincoln in which mental health providers accompany a police officer on some calls, and a 24/7 crisis hotline.

Officials with the state’s behavioral health regions say their requests for approval of new programs are being slow-walked by the state — taking 500 days or longer — which results in an artificial surplus in the budget.

Also, they say, some approved programs haven’t gotten off the ground yet, resulting in funds appearing to be unexpended when they just haven’t been spent yet as intended.

One example is the $4.2 million “Crisis Stabilization Center” planned in Sarpy County. The 16-bed facility is designed to care for someone in crisis as an alternative to jail or an emergency room.

“It’s something that isn’t quite off the ground yet, but the money is reserved in the budget,” said Patti Jurjevich, administrator of Region 6 behavioral health services.

The $15 million cut has already been included in the preliminary budget crafted by the Legislature’s Appropriations Committee. But providers of behavioral health services are hoping that the committee will reconsider.

Members of the Appropriations Committee recently began the task of crafting a final state budget, which will be debated later by the full Legislature.

Heller, the parent and head of the State Advisory Board for Behavioral Health, said Nebraska ranks low in providing behavioral health services, getting a “D” grade in a recent ranking from the Virginia-based Treatment Advocacy Center.

“This is not ‘The Good Life.’ ” he told the governor. “We can do better. But not by cutting the budget.”