County will fund mental program
A program that serves elderly residents with mental illnesses won a reprieve Tuesday when Spokane County commissioners approved an emergency funding request.
The commissioners took the rare step of intervening to save a program that historically relied on state and federal money. That funding has evaporated in recent months as the federal government tightened oversight of Medicaid spending.
After listening to emotional testimony, the commissioners agreed to fund the program for four months at $47,000 a month. They urged the managers of the Elder Services program to seek money from the state, as well as the cities of Spokane and Spokane Valley – where many of its clients live.
“It’s the state responsibility,” said Commissioner Kate McCaslin. “For the county to step in for a state responsibility – for which they collect taxes … it’s a huge step.”
McCaslin worried that the county will be inundated with requests from other programs that face state and federal cuts.
The Elder Services program provides care to 420 residents with mental health problems who are living independently. It also dispatches mental health workers in emergency situations.
The Elder Services program has long used Medicaid money to serve people who aren’t enrolled in the program – either because they haven’t filled out the paperwork, or because they make too much money or hold too many assets. New federal guidelines prohibit the use of Medicaid money for people not enrolled in the program, though for more than a decade the federal government allowed a small discretionary fund for mental health systems to spend regardless of enrollment status.
Pam Sloan, director of Elder Services, emphasized that the population served by the program is low-income and carefully screened.
On the day before Thanksgiving, the county’s Regional Support Network, which oversees Spokane’s public mental health system, announced that it would end its $560,000 contract with Elder Services on Dec. 31, six months before the contract expired.
Sloan argued that the county will face higher bills for hospitalizing mentally ill patients if they do not help fund a program that cares for patients in their homes. The program spends about $4 a day per client, compared with $42 a day in a nursing home or $58 a day to house a psychiatric patient in jail, according to Elder Services’ figures.
“Somebody has to be there, or the cost is going to just skyrocket,” Sloan said.
As a result of stricter enforcement of Medicaid rules under the Bush administration, Washington will lose about $41 million in funding annually, analysts estimate.
The state’s Mental Health Division may allocate $20 million in emergency money to continue a host of programs across the state that serve the mentally ill. But to permanently replace the federal funding, the state would have to increase its mental health budget about 20 percent, according to a state task force assigned to study the problem.
Kasey Kramer, the RSN’s director of community services, said even if the state funding comes through, spending restrictions may prevent the money from being used for the Elder Services program.