his story is published in collaboration with North Carolina Health News.
Confusion and concerns about cuts to local health programs emerged during public meeting held last week by Wake County’s new mental health management entity.
Alliance Behavioral Healthcare — a partnership between Durham, Wake, Johnston and Cumberland counties — held meetings in Durham and Wake this week to speak with advocates and mental health consumers about how they would be affected by $20 million in federal funding cuts to the Social Services Block Grant and the Substance Abuse Prevention and Treatment Block Grant.
Attendees expressed confusion about which programs will be trimmed or eliminated, particularly if those programs are funded by Medicaid.
Suzanne Goerger, intellectual and developmental disability care coordination manager at Alliance, stressed that Medicaid-funded services aren’t affected by these cuts.
“For somebody who has Medicaid health insurance, these cuts do not apply,” Goerger said.
Reductions for State-Funded Services
Mental health management entities around the state were informed in late July that they would receive reduced funding from the two federally funded block grants. Wake County’s share of the cut is about $1.6 million.
The block grants fund programs such as transportation and respite care for people with disabilities, drug and alcohol treatment services, outreach, detoxification services, residential treatment and vocational counseling for people in recovery from addiction. Mental health managers have said those are the programs that will lose out.
However, the cuts will only affect services for those who are indigent – people who don’t have health insurance, but make too much money to qualify for Medicaid. To qualify for Medicaid, an adult must earn less than 49 percent of the federal poverty level or about $5,400 per year.
Those who make more than that the Medicaid minimum, but not enough to purchase private insurance or who don’t receive benefits from their employers, will be eligible for these programs.
Many people at the meeting complained about the lack of information about the cuts and how they affect services.
“You don’t have time to figure out all of the ins and outs of this complex system,” said one woman, who said she is a mother of a child with disabilities.
She said she had difficulty getting information from everyone she contacted.
People at the meeting also complained that the lack of information isn’t just related to the budget cuts, but also the merger between Wake’s and Durham’s mental health management entities, which went into effect in the beginning of June. Some said they didn’t know what outside resources could be contacted during times of crisis.
Goerger said because the information is constantly changing, they are hesitant to release information until it is finalized.
“As soon as you put something in writing, it turns out to not be the case,” she said.
But Alliance staff members said they will work with healthcare advocates to update the website and create fact sheets for advocates and consumers.
While Alliance hasn’t made any cuts to programs yet, staff has identified areas that will likely see a reduction in funding or will be eliminated.
Targeted case management services across disabilities will be frozen, a decision that was handed down by the Department of Health and Human Services.
“The loss in case management affects people differently depending on how it’s funded,” Goerger said.
Alliance will begin limiting those with developmental disabilities who are eligible for personal assistance by reducing the authorizations to those who have the greatest need.
Alliance will also begin referring more people to Wake Behavioral Health, which is funded by the county. The management agency also plans to reduce the amount outpatient treatment sessions available from community providers and continue a shift to group treatment.
Wake Site Director Carlyle Johnson said staff tried to impact as few patients as possible, but some will ultimately be affected, such as those who are in preventive treatment programs.
“There is a cost to making these reductions,” he said.