$600M More in State Budget Cuts—Tough Times Ahead for the Mental Health Community?

Section 9C: Whenever, in the opinion of the commissioner of administration, available revenues as determined by him from time to time during any fiscal year under section 5B will be insufficient to meet all of the expenditures authorized, he shall within 5 days notify in writing the governor and senate committees on ways and means of the amount of such probable deficiency of revenue and the governor shall, within 15 days after such notification, reduce allotments under section 9B, and submit in writing a report stating the reason for and effect of such reductions, or submit to the general court specific proposals to raise additional revenues by a total amount equal to such deficiency…. As an alternative to the submission of such proposals to raise additional revenues and to the extent funds are available, the governor may recommend an appropriation equal to such deficiency from the Commonwealth Stabilization Fund….

    On October 15, Governor Patrick announced additional cuts to the state budget for fiscal year 2009, in order to attempt to plug a gap of an estimated $600 million. The 9C cuts represent a five-point approach to reduce spending, which involves potential elimination of 2,000 jobs, unilateral budget cuts, consolidation of state agencies, collaboration on energy purchases, and a request for expanded budget powers, according to information sourced in the Public Policy Institute, ONE Massachusetts’ website.  
    Patrick is currently allowed to reduce anything in the budget except matters regarding local aid, the courts, legislature and constitutional offices. Other than that, he has free reign to make cuts in the budget as he sees fit. Governor Patrick is, however, seeking to expand his 9C authority.
At an October 15th press conference at the State House, Governor Patrick announced, “We have to find cheaper ways to get the job done.” He emphasized the need for sacrifices from state employees including eliminating up to 2,000 positions and the requirement of all Executive Branch Managers to take up to nine furlough days, depending upon salary levels.
 In addition to affecting many realms of the community, reductions in spending to bridge the $600 million budget deficit will drastically cut provisions to the for mental health services in Massachusetts. Tens of millions of dollars from DDS (Dual Diagnosis Services) programs will be slashed and the human services and disability safety net will be endangered. Programs such as residential, employment, family and support, as well as day programs, will be greatly affected and severely diminished.
    In parallel to the drastic 9C spending reductions, plans for the construction of a new hospital in Worcester, which will cost about $350 million, are being developed. The project will be the second biggest undertaking since the Big Dig, which drove the state into debt that lingered for years after the project was finished. For example, recent MBTA fare increases are directly resultant from efforts to pay back debt from the Big Dig.
    Mental health advocates are currently roiled in discussions about the Olmstead Initiatives, which are a campaign to place people in the least restrictive setting possible. The proposed Worcester hospital would violate these principals by creating new places of more restrictive settings.
    Hospitals for the mentally ill create environments that further debilitate an already vulnerable population. These settings are problem rather than solution focused and create a sense of dependency and disempowerment in patients. Instead, advocates for the Olmstead Initiatives suggest that people have the capacity to recover themselves. The way to do so is through rehabilitation, not hospitalization.
    In the context of the 9C budget cuts, the most effective formula for empowering people towards improving personal well-being will be reversed by the allocation of revenue. Instead of increased spending on a new hospital, the money might be used for enhancing rehabilitation services, like the ones that are being severed by the Governor.
    These services include residential homes, which provide places for people who need an assistance in life skills and medication management, or those who are disabled. Employment services could also be funded, which would help people to avoid homelessness in a brutal economy, and could assist people who have difficulty finding work because of a CORI history or a relative lack of education. Services such as family support are also crucial for single mothers and fathers, and for parents whose children are mentally ill. Day programs for individuals struggling with addiction, criminal history, or mental illness, would also be critical to keeping people off the street and out of trouble, meanwhile providing structure and support as a step-down from an intensive inpatient psychiatric unit. All of these services seek to keep people out of hospitals, not put people in them. Incidentally, hospital stays cost the State around $1,000 per person, per night.  
At this past Thursday’s press conference, the Governor refused to answer the question of whether specific cuts would be made to health and human services would impact the mental health community, responding only by saying, “Nothing’s on or off the table. I’m not ruling anything out. My general directive is to try as much as possible to achieve the savings without harming essential services particularly to vulnerable people.” Patrick went on to orate about people with developmental disabilities that he had recently spoken with, how he had listened to their stories, and how they were more than just numbers to him. When officially released, the numbers indicating the amount of money budgeted or not budgeted for health and human services in the state will tell the real story.

The 9C cuts must be made within 10 days of their October 15th announcement, going public by the end of the month. Their effects will be in full force by the end of the calendar year.
    If you have thoughts or opinions to express about the 9C budget cuts, you can call the Governor at 1-888-870-7770.

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