Health organizations ‘gravely concerned’ over governor’s mental health services cuts

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ANCHORAGE (KTUU) - Organizations that advocate and provide services for Alaskans with mental illnesses and substance abuse disorders are “gravely concerned” over Gov. Michael Dunleavy’s budget vetoes.

In a letter to the Alaska Legislature sent July 8, the Alaska Mental Health Trust Authority CEO Mike Abbott wrote that “we cannot support budget reduction measures that hinder access to behavioral health care and essential safety net services for Trust beneficiaries.”

The Trust was also doubtful that a full statutory dividend could replace a loss of services. “For a vast majority of Trust beneficiaries, a $3,000 PFD will not cover the annual costs of needed services like supportive housing, behavioral health treatment or dental care,” the letter read.

The Trust, representing roughly 100,000 Alaskans, has a long list of complaints with the vetoes including a roughly $80 million cut to Medicaid, the elimination of the Senior Benefits Program and the elimination of Adult Preventative Dental.

The Alaska Behavioral Health Association, a trade organization representing service providers across Alaska, was similarly concerned by the cuts, saying they jeopardize “the health, safety, well-being, and prosperity of all Alaskans.”

The ABHA pointed to $12 million vetoed by the governor to behavioral health grants as particularly problematic.

“We know these cuts will limit access to necessary treatment and result in more public safety issues, more kids being removed from their family homes, more Alaskans headed out of state for the care they need, more homeless individuals on the street, more issues of domestic violence, and more Alaskans in jail,” read a prepared statement from Tom Chard, the CEO of ABHA.

Chard said that cutting services would also cost the state more in the long-term by pushing patients into higher-cost acute care.

In an interview with Channel 2, Abbott said the Trust had heard concerns from service providers particularly on the cuts to Medicaid and Medicaid reimbursement rates made through emergency regulations.

On July 12, the Alaska State Hospital and Nursing Home Association filed a lawsuit against the State of Alaska and the Department of Health and Social Services for the method of making the rate cuts.

Abbott said the Trust currently had no plans to join ASHNA’s lawsuit against the State.

The Alaska Legislature passed House Bill 2001 in July that restores a vast majority of the governor’s vetoes. The bill is yet to be transmitted to the governor who has the authority to veto the items again.

Matt Shuckerow, the governor’s press secretary, said the governor would weigh the bill and consider the merits of programs being funded but that there would be “a limited number of add backs” to the budget.

The fiscal year 2020 operating budget is considered settled, according to the governor.

Comprehensive mental health plan
The Trust’s letter to the Legislature was sent ten days before the announcement of Alaska’s Comprehensive Integrated Mental Health Program Plan, a partnership between the Trust and the DHSS.

The five-year plan, required under Alaska statute, lists broad aspirational goals to improve Alaska’s health outcomes in areas such as early childhood health, substance abuse disorders and suicide.

“I’m pleased that the 2020-24 plan has a strong focus on prevention and early intervention. Including these types of activities as part of our goals ensures that we promote resiliency in Alaskans, which can reduce their risks of developing serious health problems over the course of their lifetime,” read a prepared statement from DHSS Commissioner Adam Crum for the plan’s launch.

The comprehensive plan states some of the stark health care challenges facing Alaska:

According to the Alaska Behavioral Health Systems Assessment Final Report (2016), approximately one in nine adults, or roughly 62,815 adults in Alaska, required treatment for an illicit drug or alcohol problem.

Statistics from the Centers for Disease Control and Prevention (CDC) show that 193 Alaskans died by suicide in 2017, resulting in a statewide suicide rate of 25.8/100,000. Alaska’s rate remains nearly double the national average.

The health situation of many individuals residing in institutional levels of care is, generally speaking, worse than in the community. This health decline is often attributed to the ways they lived before, as well as the pains that institutional settings impose on them.

Despite the cuts and the letter sent to lawmakers, Abbott said that the DHSS was maintaining that the goals were achievable under the governor’s budget vision.

“The State believes it can make progress toward these goals with the budget that they proposed, that’s Commissioner Crum’s commitment,” said Abbott. “I know he’s made that commitment in good faith and we’re working with the department to ensure they spend their dollars, whatever dollar level we end up with, as efficiently and productively as possible for our beneficiaries.”

In coming years, the Trust will be carefully evaluating whether the goals are being met for its beneficiaries, said Abbott.

Chard had looked closely at the plan and was less optimistic, saying “none of these goals, none of these objectives can be met without the necessary resources.”

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