Los Angeles County Budget Cuts for Mental Health Department Will Transfer Patients, Restrict Care

Thousands of Los Angeles County patients with mental illnesses who receive government-funded treatment will be moved from residential treatment facilities to "less-restrictive" treatment centers or receive restricted treatment as the county begins to eliminate some services after the county Board of Supervisors in June approved a budget that eliminated $28.6 million for the Department of Mental Health, the Los Angeles Times reports (Fox, Los Angeles Times, 8/10). Under the budget, the county DMH must eliminate funding for programs that provide prescription drugs, hospital beds, day treatment and other services for the uninsured (California Healthline, 6/23).

The funding cuts, which represent 3% of the total county DMH budget, include eliminating funding for 65 of 307 beds at state hospitals and 85 of 733 beds at institutions for mental disease. Although a 1999 U.S. Supreme Court ruling guarantees patients in state mental hospitals the option of moving to community homes with physician approval, Los Angeles County has been "particularly sluggish" in building a network of alternative housing and in-home services for residents with mental illnesses, the Times reports. The funding cuts have caused a "ripple effect throughout the mental health system" as patients are being forced into IMDs or less-restrictive, licensed board-and-care homes.

County DMH also will begin restricting treatment and medication for many of the county's 35,000 uninsured patients by referring "less severe" cases to clinics outside the agency and limiting uninsured patients to 30-day supplies of prescription drugs to help prevent patients from losing or wasting medications, the Times reports.

Clinic workers now are "aggressively pushing" to enroll eligible patients in government aid programs, but enrollment in such programs can take months to complete, according to the Times. In addition, undocumented immigrants typically are not eligible for the programs.

County DMH Director Marvin Southard said, "There are going to be an awful lot of people caught in the cracks," adding, "You can't cut $30 million from a chronically underfunded system without negative consequences. People will probably die as a result of the curtailments we are creating, but we are still trying to minimize the harm."

Some health advocates are hoping the shift in care will result in improvements for community-based services, such as residential treatment programs, case management, crisis intervention teams and peer support groups.

Richard Van Horn, president of the National Mental Health Association of Greater Los Angeles, said the budget cuts will result in "pushing and wedging people into programs [that] they may or may not be ready for." However, he added, "It's more important to get stuff moving in the community than to conserve some of those beds" (Los Angeles Times, 8/10).