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Ryan Fortner’s room at Hope House in west Santa Rosa has a linoleum floor, wooden dresser and nightstand, small white plastic laundry basket and a twin bed covered in a dark brown fleece blanket.

Though the room is modest by any standard, Fortner has found respite here from the streets and psychiatric facilities that he said are often frightening.

“I’m not as scared here,” said the 32-year-old Santa Rosa native, who is diagnosed with schizophrenia and bipolar disorder.

Fortner, who has lived at Hope House since it opened about 13 months ago, has more than just a bed at the licensed board-and-care home. Staffed around the clock, seven days a week, the program helps Fortner and 11 other residents monitor their medication; counsels them on how to integrate themselves back into the community; and teaches them everything from personal hygiene to how to foster healthy relationships and avoid being exploited by others.

All for $75 a night per client — a fraction of what it costs the county to send Medi-Cal clients to an inpatient psychiatric facility, where beds cost $1,000 or more a night, said Tom Bieri, director of Community Support Network, a nonprofit that runs Hope House.

But Hope House may have to shut down, one of a host of nonprofit programs threatened by county budget cuts.

In an effort to save $1.85 million, the Health Services department has proposed cuts to a bevy of mental health and substance abuse programs operated by nonprofit “community partners,” including a $236,000 reduction to Community Support Network, which runs Hope House and five other supportive housing homes. If the cuts go through, Bieri said all six homes would have to be closed — a move that would affect 72 county behavioral health clients.

The loss of supportive housing like Hope House could lead to an increase in people with mental illness ending up in more expensive settings such as inpatient psychiatric facilities, hospital emergency rooms or jail, Bieri said.

“This is an extraordinary success,” Bieri said of Hope House. “You can’t save money by cutting contracts to cost-saving partners.”

Child Parent Institute is facing similar pressure, said Robin Bowen, executive director of the Santa Rosa nonprofit. The county Health Services department asked her organization to cut its budget by 35 percent, amounting to $338,000. Bowen said CPI was told to cut spending from both Medi-Cal funds and monies received from Proposition 63, the 2004 Mental Health Services Act that imposed a 1 percent income tax on people who make more than $1 million annually.

To reach the county’s target, CPI has proposed cutting $273,380 from its Medi-Cal contracts and $64,620 from Prop. 63, or MHSA funds.

The loss of those MHSA dollars would jeopardize a wide array of services, including perinatal mental health services for 21 to 28 of the 60 to 80 moms that participate annually in a program that helps reduce symptoms of depression and anxiety to help them develop healthy bonds with their children, Bowen said.

The loss of Medi-Cal dollars would dramatically reduce the number of abused and neglected children CPI helps with counseling and treatment to reduce symptoms of post-traumatic stress such as nightmares, intrusive thoughts, fears, depression, withdrawal and angry outbursts. With the cuts, the number of kids CPI is able to help would drop from 110 to 70, Bowen said.

The cuts are being proposed by Barbie Robinson, director of the county Health Services department, as a way to bring county spending on mental health and substance abuse services in line with realistic revenue projections. Late last year, the behavioral health division faced an $11 million shortfall, which Robinson said was caused by “imprecise” forecasting and revenue projections associated with Medi-Cal funds.

At that time, Robinson took steps to close that gap, including eliminating about 36 behavioral health staff vacancies, eliminating overtime and extra help, implementing a hiring freeze and using reserve funds. All that brought the shortfall to $2.6 million.

Earlier this year, Robinson proposed both laying off more than 30 county behavioral staff positions and making cuts to nonprofit contracts. Last month, Robinson shelved the proposed layoffs after she learned the county would receive a one-time infusion of $2 million in state substance abuse funds that were unused by other counties.

The funds saved county jobs but not the need to reduce funds to local nonprofits that for years have become a crucial player in Sonoma County’s safety net. What’s more, nonprofits are being asked to make the cuts in the current budget year, which is three quarters over.

Robinson and Health Services department officials did not respond Friday to a list of questions about the proposed funding cuts. The questions, which county officials requested in writing Friday morning, included inquiries about the current funding gap in the behavioral health division and reaction to criticism that the cuts threaten to undo years of community-based care. Critics warn the cuts could end up costing the county much more, with more people receiving care in locked psychiatric facilities, jail and hospital emergency departments.

Health services officials did say Friday the proposed cuts to provider contracts total $2.26 million in the current fiscal year, with a net contract savings to the county department of $1.85 million. The county is forced to make a larger cut to services because many of the services are funded through Medi-Cal, the state’s version of the federal Medicaid program. That program is partially funded by the federal government, so any reduction in county spending on Medi-Cal would result in a loss of federal dollars.

Those affected said the cuts to their current budgets would leave little funds for them to finish out the rest of the current fiscal year.

Elece Hempel, executive director of Petaluma People Services, said her organization is being asked to cut 20 percent, or about $110,000, from her existing budget. Petaluma People Services, which provides behavioral health, housing, employment and senior services to south county and Sonoma Valley residents, also provides services to people who receive health care through the federal Affordable Care Act, or Obamacare.

The organization’s services to its Obamacare clients, who generally have a lower level of mental health needs, would not be affected, Hempel said. Those most affected by the proposed cuts, she said, are the organization’s most vulnerable clients.

Hempel and other service providers said they want the county to rethink the proposed cuts and work with nonprofits to create a more efficient system of care. The proposed cuts would create a “domino effect” that could end up costing the county more money in the long run, she said.

“We’re just setting ourselves up for accidents and tragedy,” Hempel said. “The safety net starts to really fray fast once you start to pull the strings out. ... We built a system that relied on the community care and now we’re fraying it apart.”

The proposed reduction in nonprofit contracts has drawn some opposition from local supervisors, who say it’s too onerous.

Sonoma County Supervisor Lynda Hopkins said cutting mental health and substance abuse services is a bad idea.

“We’re in a very scary place quite frankly,” Hopkins said. “I actually feel that the existing system is inadequate.”

Hopkins said nonprofit executives are being asked to “amortize” cuts of between 15 and 30 percent over what’s left of the fiscal year, which ends in June.

“You can’t think of that as a 15 or 30 percent cut,” she said. “People are having to consider shutting down programs entirely.”

Hopkins said she hopes one-time fund balances can be used as an immediate patch to the behavioral health budget shortfall. For the long term, Hopkins said the county should consider creating a mental health foundation in partnership with cities and the region’s major health care systems.

The cuts as proposed go too far, she said.

“Because it was an emergency situation, we were using a hammer when we should have been using a chisel,” Hopkins said, adding that contracts with nonprofits should be examined.

“I also think we need to take a careful look at all contracts — not all are created equal,” Hopkins said, pointing out that, for example, acupuncture services for people making their way through drug court may have to be eliminated.

Supervisor Shirlee Zane agreed. Zane, a longtime advocate of mental health services, said that if she had to choose between supportive housing services for those with severe mental illness and a peer support program she would do whatever she could to save the housing program.

“Peer programs are great, but I do not believe we should be putting a million dollars in peer support versus clinical care or supportive housing,” she said.

Ryan Fortner, the Hope House resident, said the 13 months that he’s stayed there have given him the stability necessary to get his medications straight, overcome some of his fear and actually become a “role model” for other residents.

“It would hurt to take a place like this out of the picture,” he said. “Where would I go? A baseball field?”

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