In April, the Mississippi Board of Mental Health was presented with a proposed annual budget for the operation of the Mississippi Department of Mental Health (DMH) based on funding authorized by the Mississippi State Legislature in the 2017 session.
This includes the agency’s 11 programs and the service budget that provides grant funding to community providers.
DMH’s reduction in general funds compared to FY17 levels, prior to the mid-year reductions that have taken place, is $14,381,861. The total impact of the FY18 DMH appropriations bill is a $19,732,261 reduction in general funds. This is the result of the general fund reduction plus a requirement to fund 2,515 Intellectually Disabled and Developmentally Disabled (ID/DD) Home and Community Based Waiver slots, which is estimated to be an additional $5,350,400 expense in FY18.
The ID/DD Waiver provides supports and services to assist people who have an intellectual or developmental disability in living successfully at home and in the community and is an alternative to receiving services in an institutional setting.
The $19,732,261 reduction will affect most general fund services except for the community expansion services and the ID/DD Home and Community Based Waiver slots that are currently funded.
Senate Appropriations Chair Buck Clarke told News Mississippi that the cut from DMH is really only about 4%, and that state support was only cut about $10 million.
“The true picture of the Department of Mental Health’s budget is… last year, their state support appropriation was $240, 960,000,” said Clarke. “After budget cuts, it’s $236,900,000… the $241 million isn’t a real number, because they never got that.”
Clarke said the total FY 2018 appropriation is $226,715,000, or a cut of 4.3%.
DMH officials have said they will continue to closely review all positions as employees retire or leave the agency to determine which positions can remain unfilled, according to DMH spokesperson Adam Moore. In addition, positions associated with services that are transitioned to other providers will not be filled.
As part of the proposed budget, the Board approved a reduction in workforce of up to 650 jobs by June 30, 2018. This includes retirements, agency departures, currently vacant positions, and a reduction in force. A large number of employees will have an opportunity to apply for positions with community providers.
Rep. Tom Miles said loss of workforce of this magnitude will have a detrimental impact on services rendered.
“It’s sad when you have grown men and women in tears, calling you, not knowing if they’ll have a job or be able to feed their families,” said Miles. “They’re sugarcoating these layoffs.”
Miles said this could only further the pending lawsuits Mississippi faces regarding mental health by the Department of Justice.
“I only hope and pray that when those lawsuits come down,” said Miles. “We’ll have time to right our wrongs.”
The representative added that mental health treatment is a much bigger necessity in Mississippi than many realize.
“Mental illness doesn’t discriminate,” said Miles. “It doesn’t care if you are white, black, or what political party… if you live long enough, you’ll know or love someone struggling with mental illness who may need these services.
The Department of Mental Health provided a deeper breakdown of the impact of the cuts:
- The operation of the Crisis Stabilization Unit (CSU) and the Footprints program at Central Mississippi Residential Center (CMRC) will transition to Weems Community Mental Health Center on July 1, 2017. These services are not being eliminated. DMH will continue to fund these services through the service budget. There are eight CSUs in Mississippi and seven of those are operated by Community Mental Health Centers (CMHCs). The CSU at Central Mississippi Residential Center will be the final CSU to transition to a CMHC. These program transitions will result in CMRC seeking approval from the State Personnel Board to do a reduction in force of 52 employees. All employees will have the opportunity to apply for positions with Weems.
- Due to low occupancy in the acute inpatient child and adolescent units at East Mississippi State Hospital (EMSH) in Meridian and Mississippi State Hospital (MSH) in Rankin County, these services will be consolidated on the campus of MSH. The services previously provided at EMSH will now be provided at MSH. This transition will result in EMSH seeking approval from the State Personnel Board to do a reduction in force of 73 employees. All of these employees will have the opportunity to apply for vacant positions currently on recruitment at either the main EMSH campus or any other DMH Program.
- North Mississippi Regional Center (NMRC) will eliminate evaluations and therapeutic services to infants and children under age three. This is a function under the Department of Health’s early intervention program. On average, NMRC conducts 350 evaluations each year.
- North Mississippi State Hospital (NMSH) will have a reduction of five psychiatric beds which serve people in need of treatment for a serious mental illness. These five beds serve more than 63 people each year. The reduction of these five beds has the potential to increase the waiting list for the 18 counties in NMSH’s catchment area.
- DMH has ceased enrollment in the ID/DD Home and Community Based Waiver program at this time. DMH is required to fund 2,515 slots for this program. Though that number is approximately the same amount of slots currently funded, expenses in FY18 are expected to increase by $5,350,400. This is a result of an expected increase in the reimbursement rates paid to providers and the loss of Balancing Incentive Program funding through Medicaid, which previously supplemented the ID/DD Home and Community Based Waiver.
- DMH has currently ceased admissions to the five IDD Regional Programs (Hudspeth Regional Center, Boswell Regional Center, Ellisville State School, South Mississippi Regional Center, and North Mississippi Regional Center). DMH also ceased admissions to the nursing homes located at East Mississippi State Hospital and Mississippi State Hospital. Nursing home services and IDD programs continue to be offered by other providers throughout the state.
DMH is continuing to review the utilization of services through the DMH Strategic Plan and progress reports to plan for consolidation of services within DMH’s 11 programs. DMH is also planning to shift the operation of some services to Community Mental Health Centers and other providers. In addition, DMH is reviewing areas where services can be outsourced.
DMH is reviewing the agency’s core mission and responsibilities as plans are being discussed and the agency is aware there will be an impact from the budget cut. People who were receiving specific services from DMH may now receive those services from other providers. Individuals may be placed on wait lists for services that are provided by DMH. People may have more restricted access to services provided by DMH. This includes access to IDD Regional Programs and the ID/DD Home and Community Based Waiver due to a limited amount of resources expected to be available.
