Cuts in state funding have prompted Sonoma County to begin shifting hundreds of mental health outpatients to private, community-based treatment centers.
The move is expected to save as much as $900,000 this budget year but won't affect the quality of care, a county official pledged. However, a mental health advocate said it's too soon to say how well the new arrangement will work.
"The community clinics do a terrific job if they have funding," said Rosemary Milbrath, who leads Sonoma County's chapter of the National Alliance for the Mentally Ill.
The county should track its clients to ensure they're being adequately served, she said.
The outpatient shift is part of a larger cutback that has previously focused on inpatient services for the mentally ill. Counties across the state are slashing programs because of California's budget crisis, and Gov. Arnold Schwarzenegger has warned of additional 10 percent cuts beginning in July.
Last year, Sonoma County closed its psychiatric hospital, Norton Center. This year, it has announced plans to close inpatient services at Orenda Center, which serves drug and alcohol abuse patients. It also has disclosed plans to eliminate funding for A Step Up, a private program that provides the county's only inpatient care for people suffering both substance-abuse and mental-health problems.
Private programs also are facing pressure. Santa Rosa Memorial Hospital has begun to close its acute-care mental health facility in Santa Rosa, the area's last such program for psychiatric inpatients. It will cease operations April 13.
In the latest development, about 300 county outpatients are being shifted to community providers, said Art Ewart, the county's mental health director. They are not considered seriously disturbed, he said.
"They are really quite stable on medication," Ewart said. "They don't require a lot of service."
The county will provide some staff and psychiatric services at the community centers to help with the additional patient load, Ewart said.