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Capitol Insider: Mental Health Commissioner Terri White Says ‘We're Talking About Life And Death’

Oct 20, 2017

The Oklahoma Department of Mental Health and Substance Abuse Services announced it will be forced to cut half of its services if lawmakers don’t fix the state’s budget.

During the last legislative session, lawmakers passed a cigarette fee intended to fund three state health agencies, including the Department of Mental Health and Substance Abuse Services (ODMHSAS). After the state Supreme Court found the fee unconstitutional, the $215 million shortfall fell primarily to those three agencies.

ODMHSAS Commissioner Terri White says her agency alone has been left to cut $75 million. She says that is nearly a quarter of the department’s budget. However, the cuts have to be made over a six-month period,essentially, forcing the department to shed half its budget for the remainder of the fiscal year if lawmakers don’t find a fix by Nov. 1.

White says ODMHSAS will be forced to eliminate all outpatient services in addition to the state’s psychiatric residential treatment for children. She says the cuts would have a profound effect on the lives of Oklahomans who depend on those services.

“If we have a kid who could be receiving outpatient treatment and stay in school and do well and move onto a full and productive life and head towards college, but loses their mental health and substance abuse services and now becomes entangled with the Office of Juvenile Affairs and has a juvenile criminal record, it changes the trajectory of their life.” White said.

She says outpatient mental health services are inexpensive compared to the cost of incarceration and foster care. Outpatient services like counseling, drug rehabilitation and programs to help at-risk children are the backbone of the department and on average cost about $2,000 per person, White says.

White says putting a person in prison for one year in prison costs the state about $19,000. She says potential cuts mean more? than dollars and cents for the state’s most vulnerable.

“If these cuts go into effect because there is no action and no agreement, we will see an increase in suicides. We will see an increase in overdoses. We will see an increase in arrests. We will see an increase in people who spend time in jail and ultimately end up in the Department of Corrections. We will see an increase in foster care.”

 

Transcript:

 

Dick Pryor: This is Capitol Insider, an insider's guide to Oklahoma politics and policy. I'm Dick Pryor with eCapitol News Director Shawn Ashley. The state capitol building has been closed for restoration work for several days and the special session is still stalemated with no announcements about any deal to fix the state's $250 million budget hole. What is happening is that the three state health agencies affected are making plans for severe cuts in services due to loss of funding. One of those is the Department of Mental Health and Substance Abuse Services, whose Commissioner is Terri White. Commissioner White, you have announced your department is planning to eliminate funding for many outpatient services due to the loss of about one fourth of the agency's budget. How much money do you expect to lose and what will be cut?

 

Terri White: We were appropriated $75 million out of the revolving fund that held the tobacco tax money. That's 23 percent of our budget. That $75 million is gone. We have to make the $75 million of cuts over a six month period, which basically instead of being 23 percent of the budget for the year, over six months, is 46 percent of our budget. So, we are forced into a position where we basically have to eliminate half of the services we provide to Oklahomans. In order to get to $75 million, we will have to eliminate every outpatient service that we provide in the state of Oklahoma. And I don't mean just our state-operated, because we have very few state-operated services. The vast majority are provided by private contractors. The vast majority. In fact, when we look at the providers they're going to be affected, it's about 700 providers. The only service we will be able to preserve in the community is medications. People will be able to continue to get their psychotropic medications. Other than that all outpatient services will be gone. In addition to that, what we will be eliminating is what is called psychiatric residential treatment for children. It's one step down from acute--that service will be gone as well. Basically, Oklahoma will be providing beds and meds and that's all that will be available.

 

Shawn Ashley: How many people would be affected by this?

 

White: This affects about 189,000 of our fellow Oklahomans.

 

Pryor: The department is also losing federal money.

 

White: When you look at the money that we spend on outpatient for anyone who has Medicaid eligibility we're able to pull down a federal match for those dollars. So while we're losing $75 million in state dollars the additional hit is another $106 million federal dollars.

 

Ashley: Based on the conversations we're hearing at the Capitol, they'll probably come to some sort of an agreement but you probably won't get all $75 million back. Is there a magic number somewhere in there for you where you still have to make cuts but the cuts are not as bad?

 

White: We were asked to prepare scenarios early on for a 3 percent cut and a 5 percent cut. At a 3 percent cut, we lose about 10 million dollars, which is still significant because we lose the federal match associated with that. We still have some pretty dire choices to make. And the reason for that is this agency. And it is not the fault of the current legislature, although they do have the responsibility to fix the problem now, but we have been underfunded for decades. So right now, only one out of every three Oklahomans who needs help can get help. And so when we face cuts we truly have no fat left. These are real services to real Oklahomans and believe it or not, they're not expensive. We can provide services on an outpatient basis for about $2,000 a year, per person. Prison for example, is about $19,000 a year per person. When you make cuts at $10 million, and it only costs $2,000 to treat someone, that's a lot of people affected. Even though they're saying it's a 3 percent cut, it's still a lot of Oklahomans.

 

Pryor: If this kind of thing were to happen, how does that affect the other agencies, the other departments that are trying to provide services?

 

White: I think the other directors of other state agencies have been trying to make clear that what will happen to their agencies is increased demand. What's awful about that is that it's increased demand for deeper-end services that end up being more expensive to taxpayers in the end and more most important end up being tragic consequences. If we have a kid who could be receiving outpatient treatment and stay in school and do well and move onto a full and productive life and head towards college, but loses their mental health and substance abuse services and now becomes entangled with the Office of Juvenile Affairs and has a juvenile criminal record, it changes the trajectory of their life.

 

Pryor: Do you think there will be a solution in time, by Nov. 1?

 

White: I have to hope there's going to be a solution before Nov. 1 because these consequences are too catastrophic. We're talking about life and death for Oklahomans who rely on these services. If these cuts go into effect because there is no action and no agreement, we will see an increase in suicides. We will see an increase in overdoses. We will see an increase in arrests. We will see an increase in people who spend time in jail and ultimately end up in the Department of Corrections. We will see an increase in foster care. And those can't happen. That's not our state. So I have to believe they're going to find the solution.

 

Pryor: Mental Health and Substance Abuse Services Commissioner Terri White. Thank you. For an extended version of our interview go to the Capitol Insider extra podcast on iTunes. Until next time with Shawn Ashley, I'm Dick Pryor.