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Spokane County officials worry Senate budget will restrict mental health, substance abuse care

Spokane County officials are unhappy with a proposal from state Senate Republicans that would deplete accounts set aside to fund programs treating substance abuse and mental illness.

Commissioners Shelly O’Quinn, Al French and Nancy McLaughlin earlier this month sent a letter to state lawmakers and behavioral health officials expressing “extreme concern” about the Senate budget’s proposal to shift money in the reserves of county-level health networks back to the state’s general fund. The commissioners argue the money in their reserve accounts already is earmarked to pay providers of services to roughly 44,000 people in the region.

“The service providers are already under contract, but they’ve not yet billed us,” said Christine Barada, director of the county’s Community Services, Housing and Community Development department. “Essentially, we’re just waiting for the bill” that will be paid with the money in reserves, she said.

Regional support networks were established under state law in 1989 to provide mental health services under the guidance of counties, rather than at the state level. A change in state law will add substance abuse programs to this system of care beginning April 1. Spokane County will oversee this new network, called a behavioral health organization, which also includes Adams, Ferry, Lincoln, Okanogan, Pend Oreille and Stevens counties.

Between mental health and substance abuse services, Spokane County has budgeted roughly $82 million in 2016 from a variety of funding sources including grants, according to county records. Barada did not provide an estimate of how much local money in reserves is at stake in the budget negotiations but did say the amount in reserves changes throughout the year, based on contractual obligations with different providers.

“If you take a look at regional support networks around the state, with the new Medicaid dollars we received a few years ago, it makes it look like we have a huge amount of reserves,” O’Quinn said. “The Legislature took a look at the reserves and realized that, oh, they’re not using it. We’ll sweep it.

“What they don’t understand is that money’s encumbered,” O’Quinn said. “It’s there, but it’s not actually free money. It actually is dedicated to programs that we will have to cut if they sweep the reserves.”

Barada said the county is required to provide some services under state law. If the Senate’s budget proposal is accepted, counties will have to tighten belts to meet legal obligations to provide services to people with drug addictions and mental illness.

At stake are a number of services, including counseling, methadone treatments and detoxification procedures, Barada said. The county would need to find another way to pay for these required services if the Senate’s budget proposal is adopted and the money that’s been set aside is returned to the state.

“They’re gutting our mental health programs, if you want to be pretty blatant about it,” O’Quinn said. “The Senate action is not a positive for our community, and it raises red flags for all of us on how we treat our mental health and substance abuse issues in our community.”

Budget leaders from the Senate and House are negotiating a final spending plan. The House proposal would not automatically sweep counties’ reserves for mental health funding, but requires them to work with the Department of Social and Health Services to ensure the public dollars in reserve accounts are spent wisely. Spokane County officials back that plan.

Rep. Timm Ormsby, D-Spokane, is vice chairman of the House Appropriations Committee. He said House Democrats contend Senate Republicans miscalculated the amount of money available in these reserve accounts because they didn’t look at current estimates.

Republicans have adjusted the amount of money that would be available to move into the general fund, but they have not taken the shift out of their budget proposal, Ormsby said.

The House budget does not make that change, and the two budgets still are under negotiation.

“It remains a point of contention,” Ormsby said.

Staff writer Jim Camden contributed to this report.

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