Sonoma County proposes cutting community mental health services by $7.9 million

Paranoia and schizophrenia tormented Michael Escobar when he lived in San Francisco more than a decade ago. Convinced people were trying to hurt him, the soft-spoken man sometimes escaped those demons by jumping out of moving Muni buses. He once flung himself from a second-floor apartment, breaking his back and ankles.

Escobar, now 56, said he spent many years going in and out of locked psychiatric facilities. Sitting in his modest Petaluma apartment last week with his Chihuahua, Happy, on his lap, he recalled those days with unease.

“It was scary, I was frightened,” he said as Happy licked Escobar’s wrist near his watch. “People with schizophrenia deal with a lot of fear.”

But that all changed when mental health counselors and rehabilitation specialists from Buckelew Programs entered his life and helped him find subsidized housing, get stabilized on the right medications, and learn to cook, shop, clean and maintain good personal hygiene.

“I like it here. I feel safe,” he said. “I used to harm myself in the city a lot.”

The Buckelew program that gave Escobar a chance at the rest of his life would be gutted under dramatic budget cuts being proposed by the Sonoma County Department Health Services, which faces a $19 million deficit in the 2018-2019 fiscal year.

Buckelew’s county contract to provide independent living and supportive housing services to formerly homeless people living with mental illness would be reduced by 84 percent, slashing the program by more than 80 percent- from $1.45 million to about $250,000. County health services officials also seek to reduce or eliminate funding for three other Buckelew contracts by a total of $392,258, a move that would cripple Buckelew’s supportive housing and mental health services for youth, employment services and education referral services for families.

Dozens to become homeless

Buckelew’s CEO Tamara Player said the cuts would be “devastating,” forcing the nonprofit to, among other things, lay off 23 employees, eliminate “master leases” for 36 people with severe mental illness and cut in half mental health education and referral services that currently serve more than 1,000 families annually.

“We’d have to give up all of our master leases, which would mean 36 people becoming homeless,” Player said. “We wouldn’t have any funds to provide services.”

Player said she is hoping county health services officials can find alternative sources of funding that could save Buckelew’s services currently targeted. Those cuts are outlined in a spreadsheet listing all the service reductions being proposed by the county’s health services director, Barbie Robinson.

The list was released to The Press Democrat on May 18 in response to a state public records request. According to the list, county officials are proposing cutting community partner contracts resulting in a $7,888,137 savings to the county.

Those cuts would lead to an anticipated loss of $2.9 million in federal matching Medi-Cal funds, the states version of the Medicaid program.

That is, nonprofits who provide mental health and substance abuse services would be forced to absorb another almost $3 million.

The spreadsheet listing the proposed cuts also lists another possible $7.3 million in cuts to two nonprofits, Progress Foundation and Drug Abuse Alternatives Center.

Those proposed cuts are listed as “to be determined” in the spreadsheet.

Kelley Naiman, accounting manager for the health services department, said in an email that “it had not been determined if or how much” the alternatives center or Progress Foundation contracts may be reduced.

The proposed cuts would affect dozens of nonprofits county officials refer to as “community partners,” and that provide a significant share of outpatient mental health and substance abuse services. Robinson has said her department’s current budget deficit is primarily the result of by inaccurate forecasting and revenue projections associated with Medi-Cal funds.

$19 million shortfall

Earlier in the year, the department faced a $8.6 million deficit in its current 2017-2018 fiscal year. Layoffs and reductions to nonprofit partners were averted through hiring freezes, the elimination of extra help and overtime, and the use of one-time funds.

Robinson said the current budget shortfall of $19 million and future deficits can no longer be addressed with one-time fixes.

The health services department must undergo a transformation that can stabilize its finances. She said in an email that she and other county staff continue to try to find funding alternatives to mitigate reductions.

“If additional funding becomes available, we will use that funding to lessen the impact of the reductions” for the next fiscal year, she said. That will allow time to explore additional options for funding, she said.

The proposed cuts are sending shock waves throughout the local mental health community. Some local nonprofit executives say the cuts threaten the system of community-based services that are essential to keeping those with moderate to severe mental illness stable and preventing psychotic episodes.

Services at schools hit

Under the proposed cuts, Support our Students would lose its $224,705 county contract to provide mental health outreach and counseling services in local schools. That money supports counseling staff at four Sonoma County high schools and their alternative schools.

Julie Waters, the nonprofit’s executive director, said the prevention and intervention program screens school-age youth for mental health needs, often addressing such issues suicidal and homicidal ideas, child abuse and substance abuse that has reached a point where it is threatening a child’s well being or life.

“We’re doing prevention work that mitigates the need for such high-level services in the future,” Waters said.

Another $212,672 cut is being proposed for a Support our Students program that provides mental health service interns to the county’s Mobile Support Team, a county-funded intervention team that works with local law enforcement officials responding to mental health crises. The interns comprise a third of the mobile support team staffing, Waters said.

She said the interns provide coverage for sick time and vacation time to the team’s full-time county staff.

Even more cuts

Other proposed cuts are just as extensive. Goodwill Industries stands to lose its $57,000 consumer operated “warm line” that provides support to those in crisis or experiencing troubling thoughts or feelings. A proposed $50,477 cut to a county contract with the Petaluma People Services Center has already caused the organization to eliminate one position, a therapist who visited the Mary Isaak Center shelter four days a week and provided counseling there.

A $105,107 cut to Petaluma People Services’ Medi-Cal contract that provides specialty mental health services will likely result in a waiting list for youth who receive mental health services, said Shannon Ryan, the organization’s director of counseling and prevention.

“These are kids with moderate to severe mental health issues,” Ryan said, adding that many have mood disorders, or are disruptive at home and school. Some can be very depressed and miss school, or self-harm and in some cases become suicidal, she said.

“If they’re sitting on a wait list and we’re not able to get to them quick enough - I can’t answer what’s going to happen,” Ryan said.

The proposed budget must ultimately be approved by the county Board of Supervisors, which is scheduled to take up the issue during budget hearings in June. But local nonprofits have already begun to scale back services in anticipation of some cuts.

You can reach Staff Writer Martin Espinoza at 707-521-5213 or martin.espinoza@pressdemocrat.com. On Twitter @renofish.