Layoffs hit County Public Health

Mono’s Gimpel thinks Sacramento Mental Health budget cuts are ill-advised

Here we go again. In an update to Mono County’s Board of Supervisors earlier this month, Mental Health Director Ann Gimpel outlined what could end up being yet another difficult next fiscal year, based on yet another round of shocking cuts proposed by the state. Based on Governor Arnold Schwarzenegger’s May Budget Revision, Gimpel said her department is looking at $422,637 in total possible reductions.

According to Gimpel, the cuts would mean that about 100 Medi-Cal clients would lose access to individual and group psychotherapy. The only service they would receive is medication from the psychiatrist and involuntary psychiatric placements for 72 hours. This would translate to more strain on the hospital emergency room and local law enforcement, as these clients need ongoing therapeutic support to maintain their stability, Gimpel explained.

Some 120 indigent clients stand to lose access to all Mono County Mental Health services.

Funding cuts also mean personnel cuts. Mental Health would be looking at staff reductions of one support staff and between two and four clinical staff, depending on how we redesign MHSA. “We would, however, be looking to add a part time Nurse Practitioner or mid-level Physician’s Assistant who can prescribe medications to help support the psychiatrist,” Gimpel added.

The governor’s May Revision reportedly shifts much of the responsibility for youth mental health services to school districts. “I actually think that the schools should be taking responsibility for youth. This about the only bright spot that I see in this (potential) disaster,” Gimpel said.

Other portions of the May Revision include more “cost sharing,” meaning Medi-Cal clients would have co-pays for any remaining services. Also, the Medi-Cal formulary [pharmacy] would shrink significantly in terms of which drugs are available to Medi-Cal beneficiaries.

California mental health directors are already facing severe challenges when it comes to implementing their part of President Obama’s Healthcare reform law, and balk at what they see are impacts that have far-reaching law enforcement impacts, and tie up or other wise divert critical funding.

“What the Governor proposed [last month] would take us back to the 1960s and re-institutionalize people with mental illness,” Kirsten Barlow, Associate Director of Legislation and Public Policy for the California Mental Health Directors Association, said in a statement. “This budget proposal leaves at least half a billion dollars in federal Medicaid funds in Washington, DC, rather than in California where they could be used to serve people and help us implement federal health reform.”

Health layoffs make Supes ill

The first round of layoffs hit the Mono County Department of Public Health, just on the heels of contract renewals with several other county employees. The layoffs come in anticipation of cuts in funding looming at the state and federal level.

During their June 15 meeting, Public Health Director Lynda Salcido informed Mono County Supervisors that of the three positions to be cut, one position was saved last year due to H1N1 funding that has since run out, another was due to a consolidation of two positions and a third was due to a loss of drug and alcohol program funding.

“We’re still positioned well, but this does reflect what’s going on statewide,” Salcido said.

“The County’s fiscal responsibility has allowed us to survive as well we have until now, but we’re finally getting down to the point where these fiscal impacts are coming home to Mono County, and,” Vice Chair Hap Hazard commented. “These layoffs affect us all, and we don’t take them lightly.”

The layoffs came on the heels of contract renewals in the District Attorney’s office, Economic Development, Finance and Information Technology departments. All the renewed contracts, however, remain at current salary levels, with no increases. Supervisor Bob Peters said he wanted the public to know the renewals weren’t handled cavalierly, and were negotiated and considered carefully before being approved.

The layoffs, meanwhile, represent a savings to the Public Health Department budget of $203,344 for fiscal year 2010-2011.