Seeking to meet Texas Governor Rick Perry’s request to cut expenses by five percent for the coming two-year budget, Commissioners for the Department of Health and Human Services have selected a slew of preferred cuts, including closing 200 mental-health beds at four state hospitals, including 50 beds at San Antonio State Hospital.
If Bexar County Jail had any hope of creating additional space for those suffering psychiatric emergencies or suicidal impulses, they wither and die under this proposal.
As it stands today, state mental hospitals are already turning away those referred to them, said Mike Alkek, a clinical administrator at Bexar County’s Center for Health Care Services. “They tell me, ‘Mike, we don’t have any beds. Forget it,’ knowing I can put them in jail,” Alkek said recently. “They’ll sit there [in jail] for two or three months before the hospital has a bed for them.”
DHHS spokesperson Carrie Williams said the hospital bed-cut was one of the least desired options on the table. “It wasn’t an easy call to make,” she said. “[It] was the the last item on our list.”
It may have been the last item listed, but the hatchet job also represents nearly 30 percent of the proposed $100 million in budget reductions. Hard to imagine how the agency would have managed their five percent without kicking poor, mentally unstable residents into the street … and on into local soup kitchens, county jails, and morgues.
Among 24 proposed cuts, the reduction of space at state hospitals is expected to save $27 million.
The next highest cut has to do with freezing an immunization program fueled by federal stimulus dollars, with a projected savings of $12 million. After that are $7.3 million in indigent health care cuts and $7 million eliminated from planned new and expanded health clinics (this one also stimulus backed).
If that sounds like a lot of free federal money to be turning away, it is.
According to the analysis of the Center for Public Policy Priorities, the $100 million in savings involves the loss of “$176 million in federal dollars for our health care providers and local communities. Overall, the HHS reduction proposals would lead to a loss of $304 million in federal funds in the 2010-11 state budget.”
Governor Perry, Lieutenant Governor David Dewhurst, and Speaker of the House Joe Straus are expected to announce in three weeks what options they will accept.
Meanwhile, critics at the CPPP point out that Texas doesn’t need to take such drastic measures. “It’s not that they don’t have the money, it’s that they don’t want to raise taxes a year from now,” said Eva DeLuna Castro, one of the paper’s authors. “Well, maybe you shouldn’t have passed a big tax cut without finding a way to pay for it.”
After a record-breaking number of suicides at Bexar County Jail in 2009, the administration is desperate to find more room for mental-health and suicide-watch beds — particularly after an inspection by one of the nation’s experts in suicide prevention last month found that as overcrowding at the jail subsided this year, the mental-health units remained jam-packed.
Under the health department’s proposal, Castro said Tuesday, mentally disturbed “people [will] wander around until they hurt themselves or somebody else and then they end up in county jail.”
Or, to put it in report terms: “Reductions in services to children with special health care needs, cutting psychiatric hospital beds, and reducing personal attendant care hours are all moves that are likely to simply shift costs to local governments and exacerbate some illnesses and disabilities.”
Meanwhile, other cost-reduction measures include leaving 285 children with special health care needs on the state waiting list through 2012 ($3.5 million saved); cutting regional health care services around the state, including immunizations and tuberculosis control programs ($1.8 mil); and hiring delays in environmental-health, radiation control, and food and drug regulation.
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