By Philip Dawdy
PostGlobe
Even though King County's mental health system got a fresh infusion of cash less than a year ago, by way of a 0.10 cent sales tax increase, it's facing having to make cuts that could affect the mentally ill on the streets.
Already the county has had to scale back on housing programs for the mentally ill homeless, and more cuts are possible.
The situation, which is contributing to a $50 million budget hole the county is facing in next year's budget, is an outcrop of the poor economy: People are buying less and the tax is bringing in less money.
"Revenue is not what we expected," says Amnon Shoenfeld, director of the county's Mental Health, Chemical Abuse and Dependency Services Division, "so we're having to scramble."
Proceeds from the tax are estimated to come in at about $42 million in 2009 compared with earlier projections of $49.7 million, according to Amnon Shoenfeld. The shortfall stems from decreased consumer spending due to the economic recession.
Historically, revenue cuts to public mental health systems have resulted in hundreds and thousands of people being forced onto the streets with no access to services while being severely mentally ill or addicted to drugs. The stories that inevitably result--chronic homelessness and encounters with law enforcement--are never pretty.
Shoenfeld reports having to postpone a dozen new programs the so-called MIDD tax was supposed to fund and covering for state funding cuts to crucial programs imposed by the state legislature earlier this year. And David Stone, CEO of Sound Mental Health, says that his agency has already had to shelve a few programs aimed at providing housing and support services for homeless people with mental illness.
But, despite the revenue shortfall, no one is pushing the panic button yet. That's because things could be far worse.
"If we didn't have the MIDD in place right now, you'd be hearing all kinds of horror stories out there," says Stone, who heads the county mental health system's largest provider at over 14,000 clients. In total, the county system served about 27,000 people in 2008. "To some extent, it's been a life saver for provider agencies and people getting services."
Stone says the county has been wise in ensuring that major programs were funded ahead of the decrease in sales tax revenue, in particular the funding of clients in the system without Medicaid coverage whose services were often left underfunded by the state, resulting in budget problems for the county. One SMH program that the legislature cut entirely this year is a program for transitioning high-risk felons with mental illness back into mainstream society.
"That was an idiotic thing to do" on the part of legislature, says Shoenfeld.
The program serves 25 former inmates at $450,000 a year. Shoenfeld says that the county will have to step up and cover the program itself.
"We're not going to let that go unfunded," he says.
Stone says his agency has had to recently cut new housing and support services for about 100 homeless people with mental illness.
The tax--formally known as the Mental Illness and Drug Dependency Action Plan--was designed to address decades of wrestling matches between the state legislature and King County. State budgets sometimes resulted in King County being underfunded to the tune of several million dollars a year, making it difficult to operate a consistent mental health system that serves low income and disabled people. The tax was approved by the Metropolitan King County Council in 2007 and went into effect in April 2008. Proceeds from the tax were first released to the county mental health system last October.
With the county's looming budget deficit, it's not clear how much mental health services might be cut, but they would certainly be affected, regardless of whatever buffer the MIDD tax might offer.
The MIDD tax was estimated to increase over the next few years to as much as $56 million in 2012.
"All those projections are not going to happen now," says Shoenfeld, who says he has no guess as to what kind of revenue the MIDD tax might generate in 2010.
County officials are currently in scramble mode trying to figure out a way to plug the projected $50 million gap in next year's county budget. Metropolitan King County Councilmember Julia Patterson yesterday proposed an early renewal and expansion of the county's veterans and human services levy to help backfill possible health and human services cuts. If approved by the County Council, the measure would go before voters this November.
County Executive Kurt Triplett is expected to roll out a proposed tax increase of some kind in the next week.
