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Spokane, Washington  Est. May 19, 1883
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Funding crunch poses threat to Elder Services

For the second time in the past year, a program that serves elderly residents with mental illness has asked Spokane County commissioners for emergency money to keep it afloat.

Elder Services will be unable to continue caring for 420 people through the end of the year unless it receives $180,000 in funding, according to Nick Beamer, executive director of Aging and Long Term Care of Eastern Washington.

The program serves elderly Spokane 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.

But under new enforcement guidelines from the Bush administration, Washington’s public mental health system must serve only people who have officially qualified for the program and discretionary funding can no longer be spent on “non-Medicaid” people.

State analysts estimate the guidelines will reduce Washington’s federal funding by at least $41 million annually.

To protect existing programs, the state Legislature approved $80 million for the next two years to support the programs previously funded by Medicaid. But state guidelines placed a priority on urgent care, the criminal justice system and inpatient care.

“Their priorities for those monies appear not to include us at this point,” Beamer said.

In December, Spokane County agreed to provide about $180,000 for the program, which historically depended on state and federal funding. The money was intended as a stopgap until the state money arrived, and commissioners expressed uneasiness about the state and federal governments shifting the cost of mental health care to local entities.

Spokane County Commissioner Phil Harris said many residents who don’t qualify for Medicaid still need help. Many of the clients can’t cook, clean their homes or get to the store or doctor’s appointments, he said.

“All at once they wake up in the morning and they don’t have someone to help them,” Harris said.

The program also received financial help from the city of Spokane and Spokane Mental Health, a nonprofit mental health agency, to supplement its budget until the state’s funds arrived.

Now it appears those funds may not reach the Elder Services program because of spending guidelines drafted by the state.

“It’s unfortunate because it’s a tremendous program,” said Edie Rice-Sauer, administrator of the Spokane Regional Support Network, the region’s public mental health system. “Traditionally the state funding has been flexible, but it’s become more restrictive as the state watches its dollars more closely.”

Beamer made the request for additional funding this month, stating in a July 20 letter to commissioners that he must notify his elderly clients by Friday.

Program officials have said 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. Hospitalization at Eastern State Hospital for care would cost approximately $500 per day, Beamer said.

In the past two years, more than 1,300 low-income people in Spokane County have lost public mental health care.

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