Sonoma County officials propose cutting nearly $16 million from health services budget

Facing yet another significant budget shortfall, Sonoma County officials are proposing slashing nearly $16 million from the Department of Health Services, a move that would result in almost 30 staff layoffs and reduce funding for about 50 nonprofits providing direct health care-related services.

The proposed cuts would also eliminate 78 vacant positions in the health services department. In total, the proposed reductions would reduce the department’s full-time staffing roster by one-sixth, from about 650 to 543 positions.

The county Board of Supervisors is expected to consider the proposal at its meeting this afternoon. It is not a done deal, said Supervisor Shirlee Zane.

“There’s nothing here to be happy about,” Zane said. “This could get turned around in the budget, who knows. We are trying everything we can to find additional general fund dollars to fill this gap.”

The proposed cuts include a reduction to salaries and benefits of nearly $8.4 million, and reducing by $7.3 million the total amount of funding for mental health and substance abuse services providers. Some 118 nonprofits receive about $40 million of the county’s $95 million behavioral health budget.

Earlier in the year, the department faced a $8.6 million deficit in its current 2017-2018 fiscal year, caused primarily by “imprecise” forecasting and revenue projections associated with Medi-Cal funds. 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.

Health services officials are expecting $10 million less in federal Medi-Cal dollars in the coming fiscal year than what was projected during the 2017-2018 fiscal year. Also, 1991 state realignment dollars - which provide significant funding for public health, mental health and substance abuse services - are expected to remain at current fiscal year levels, officials said.

The proposed cuts are yet another blow to the county’s mental health and substance abuse safety net, said Ella Jackson, a marriage and family therapist who works as a clinical specialist for county Behavioral Health Division.

Jackson, who is part of the bargaining team for Engineers and Scientists of California, Local 20, said she works on the transitional recovery team, which has a caseload of 125 adults who struggle with severe and chronic mental illness and are so disabled they cannot provide food, shelter or clothing for themselves.

One of the extra help staff on Jackson’s team was carrying a caseload of 45 similar clients, people with severe mental illness, some of whom are coming out of jail or locked psychiatric facilities like Napa State Hospital.

“We’re leaving the most vulnerable people without crucial treatment,” she said

Jackson said about half of the 30 filled positions health officials plan on eliminating are staff including counselors, social workers, psychiatric technicians and other client support workers, according to a list of job classifications identified for possible layoffs. Nine positions, including a number of counselors, would be eliminated from county alcohol and drug treatment programs.

Lisa Gurian, a client support specialist whose team works with people over 60 who have mental illness and often other disabilities, said her job is on the layoff list. Gurian’s team provides medication and psychiatric support to clients, as well as therapeutic services, transportation and other service referrals.

Though her job is listed at half a full-time position, Gurian said she works 32 hours and four days a week. She said others on the layoff list work more hours.

The actual impact of the layoffs would likely be more severe than what’s listed, she said.

“There are clients right now that would be dead if they had not been brought to our team and we had not started assisting them,” Gurian said.

Jackson, the clinical support specialist with ESC Local 20, said last year’s devastating wildfires only exacerbated the county’s already fragile mental health and substance abuse safety net.

“If we cut services to our most vulnerable population in the wake of this natural disaster, we’re going to see an even bigger crisis on our streets,” Jackson said.

Barbie Robinson, director of the Department of Health Services, could not be reached for comment Monday and her office did not respond to emailed questions about the proposed cuts.

Zane insisted she and other county officials are trying to find other sources of funding. She is asking local state legislators to put pressure on Gov. Jerry Brown to use funds from the state’s $6 billion surplus for mental health programs.

“How about if the governor puts a billion dollars aside to fix the broken mental health care system,” she said.

“If this is not a time to fix the broken mental health care system, then when is?”

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