Uninsured people suffering from mental illness have fewer places to seek treatment after a set of decisions made two weeks ago by Santa Barbara County Alcohol, Drug and Mental Health Services.
More than 400 patients per year are transported to Vista del Mar, a psychiatric hospital in Ventura, to be checked in involuntarily because of a lack of facilities in Santa Barbara, but ADMHS has reduced the number of its contract beds with the hospital to save money.
Reducing the beds from 12 to five for uninsured patients would save about $800,000 a year for ADMHS.
ADMHS has provided services to more than 1,300 patients who are medically indigent, meaning they have no health insurance. That cost of care amounted to nearly $3.5 million, just within the first six months of the 2009-10 fiscal year. It also funded outreach services to 400 indigent adults who were deemed to be a danger to themselves or others because of mental illness.
But looking ahead, things look much worse for the department’s 2010-11 funding, which is expected to be affected by dwindling state and general fund revenues.
According to documents from the department, ADMHS has determined it needs to shave off at least $2 million in spending for services for the indigent.
In addition to capping the beds at Vista del Mar for the uninsured, services also will be discontinued for 600 to 900 indigent people receiving treatment services through Fund 44.
The department will keep “very limited medication management support” for 300 of the 900 indigent adults who are currently served, and the priority will go to those most affected by mental illness.
According to ADMHS documents, the changes were effective March 15, which for some raises the question of why the change wasn’t approved by the Board of Supervisors.
“They’re implementing policies before they’ve been approved,” said Roger Thompson, who sits on the Mental Health Commission and who leads the Consumer Advocacy Coalition.
If beds continue to be capped, Thompson predicts a dramatic increase in people flooding emergency rooms.
“We’re going to get huge backlash from the hospitals, and that’s going to cost us more in the long run,” he said. “This is a direct immediate threat to this community on so many levels. We’re facing a potential catastrophe.”
One of the first places most likely to be affected by the change would be hospital emergency rooms.
Santa Barbara Cottage Hospital sees 250 to 300 people per month enter the emergency room for issues involving substance abuse and mental health, spokeswoman Janet O’Neill said.
She said that since the cap was put in place only two weeks ago, it’s too soon to say whether there’s been an increase, but she added that the hospital has seen a steady increase in patients seeking psychiatric and substance abuse help during the past five years.
“We do feel that this cap is probably going to have severe impact on the length of stay,” she said.
ADMHS Director Ann Dietrich acknowledged that there’s a great need for beds for involuntary care, but that the department just doesn’t have the money.
She said that in the past, the department has amended its contracts with Vista del Mar when money has been an issue or demand changes. In this case, the demand is still high, but the department has reached what Dietrich called its “contract capacity.”
“We’re seeing very clearly with the budget situation that we really can’t exceed that,” she said, but she wasn’t clear about why the decrease in beds this month hadn’t gone before the Board of Supervisors for approval.
Dietrich is expected to go over the details of the 2010-11 budget at Tuesday’s Mental Health Commission meeting, from 2 p.m. to 4 p.m. in the Ball Room of Hotel Corque, 400 Alisal Road in Solvang.
— Noozhawk staff writer Lara Cooper can be reached at lcooper@noozhawk.com.