November 11, 2005 in City

Mental health patients may lose housing options

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A proposal under consideration by Spokane County officials would close a host of housing options for people with mental illness, from the sale of an apartment building to the closure of short-term and crisis facilities, as well the reduction of dozens of beds at private residential centers in the city.

County officials said the proposal is one of several under consideration – just days after voters supported a 0.1 percent sales tax to generate money for the beleaguered public mental health system.

“It’s premature to think that we’re anywhere close to finalizing the decision,” said Christine Barada, county director of community services.

Even if commissioners enact the sales tax as expected in the coming weeks, the money would not be available to the public mental health system until late June, officials said. In the advisory vote in Tuesday’s elections, voters supported the tax by 58 percent to 42 percent.

The tax is expected to generate $6.5 million a year. But because revenues cannot be immediately collected, county officials estimated the tax will only bring in about $3.9 million next year.

“The challenge is the first half (of the year),” county Commissioner Phil Harris said Thursday.

A shift in federal funding has commissioners scrambling to keep afloat programs once funded by Medicaid, the state-federal program for low-income people. In addition to backing a $2.8 million loan to the mental health system this fall, the commission recently provided $10,000 to prevent the shutdown of Care Cars, a program that shuttles sick, elderly residents to physicians’ appointments.

Commissioners proposed the three-year tax to support programs recently cut largely due to a decrease in federal funds. Spokane County’s system must not only repay the loan but also pay nearly $2 million into a reserve fund that the state requires it to keep.

This fall, the county cut $500,000 a month from mental health programs and warned that more cuts may be needed in January.

“I know that we can’t spend money we don’t have, and I don’t see any money coming in until June,” said Commissioner Todd Mielke.

Commissioner Mark Richard said the proposed cuts depend on several factors. Those include whether the county can restructure the loan to lower payments, whether the state’s supplementary budget will provide some relief, and whether the state’s Mental Health Division will terminate its practice of fining counties for sending too many people to state psychiatric hospitals.

If the cuts to housing are approved, it would signify a serious retrenching for the county, which sought to increase housing options for people with mental illness in recent years. On Thursday, the county announced the closure of its behavioral triage center, a $5.5 million building designed to ease the burden on hospital emergency rooms and the state’s psychiatric hospital in Medical Lake.

County officials credited the center with diverting patients from psychiatric beds, but state analysts estimated it incurred $2 million in operating losses in its first year. The building opened in 2004.

The county opened the 42-bed Phoenix Apartments in 2003, marking the first time the county owned an apartment complex catering to people with mental illness. In a proposal made public this week, the county estimated that the sale of the Phoenix would save $16,000 a month, as well as its sale price. The county spent $730,000 to purchase and renovate the building.

Another option – the closure of the Hartson House coupled with an increase in short-term psychiatric care programs – would save about $17,000 a month, according to the proposal. The Hartson House serves about eight to 10 people, who can stay for several days or weeks.

Other proposals would reduce the number of beds in private residential homes by about 40 – roughly one-fourth of the total beds in the county. The homes, known as congregate care facilities, house people with severe illnesses such as schizophrenia and bipolar disorder, and frequently take in people recently released from jail or Eastern State Hospital.

County officials are reviewing a 20 to 25 percent cut to mental health programs across the county in January.

Jim Emacio, the county attorney, said some programs may have to be temporarily cut and then refunded when tax revenue becomes available next summer.

The operators of the homes who attended Thursday’s commissioner meeting said that a Spokane Mental Health official informed them the beds would be closed. An agency official did not immediately return a call Thursday.

“I’m wondering why Spokane Mental Health would be making this decision without the board’s approval,” said Pam Brault, who operates a Spokane home.

Commissioners assured the providers that no final decision had been made and urged them to be patient with the board.

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