With a new fiscal year beginning July 1, the effects of difficult budget decisions made by the state Legislature in the last session will become evident in our community. One involves approximately 3,800 people in Southern Arizona who have a serious mental illness and are ineligible for the state's Medicaid program, the Arizona Health Care Cost Containment System (AHCCCS).
These are people whose mental illness is so severe that they have extreme difficulty with daily functioning and self-care, relationships and employment. In the past, Arizona has funded services that have helped many of them recover from their illness enough to become increasingly self-sufficient, avoid or emerge from homelessness and re-enter the workforce.
Community Partnership of Southern Arizona (CPSA), which oversees publicly funded mental-health and substance-abuse treatment services in Pima, Cochise, Graham, Greenlee and Santa Cruz counties, has been proud to have a part in these success stories. However, this loss of services jeopardizes their ability to successfully remain in the community.
The Legislature cut more than half the already-limited funding for services to these individuals, leaving only enough money to pay for largely generic medications and related medical services, plus limited crisis services. Beginning July 1, these 3,800 people are no longer eligible for case management, counseling, employment preparation and support, inpatient treatment or other services. They will be expected to cope with their illness without most of the services that have been a hallmark of the system of care for decades.
This will be a devastating blow for many of our members, some of whom already are struggling financially on disability payments. Its likely human cost - in lives that could have been and lives that may be lost - and impact on families and other community services such as hospitals and law enforcement is apparent to many of us.
Regardless of our dismay, we have maintained our focus on what will be most helpful for our members given the current reality. Mental-health systems across the state, along with the Arizona Department of Health Services' Division of Behavioral Health Services (ADHS/DBHS), have worked tirelessly to prepare members for this transition.
CPSA held forums with ADHS/DBHS in Tucson and Sierra Vista for members, families and others to provide input into the transition. Once details of the benefit change were known, CPSA and local chapters of the National Alliance on Mental Illness (NAMI) held a second round of forums to provide information and answer questions. (For information on these and other efforts, see www.cpsa-rbha.org online.)
Our network providers have met with these members and their families to prepare them for the change, discussing how to handle needed medication changes and linking them with community resources that can provide limited, but still important, support.
CPSA staff has met with all local hospitals, court systems and other entities that will be affected to try to anticipate and prepare for the cascading effects of such a dramatic change.
Peer-run organizations and peer helpers have stepped up to help in creative ways. CPSA has provided funds to these organizations for support groups, linkages with resources, employment services and more for members whose benefits have been cut. Other human-service agencies have offered help to the extent possible, given their own funding issues.
If there is anything resembling a happy ending to this story, it is about how some of our members will be able to call upon their innate resiliency and natural support systems to continue on their road to recovery, and about how the people in this community whose lives intersect with these individuals are doing their utmost to rise to an unwelcome challenge.
Neal Cash is the president and CEO of Community Partnership of Southern Arizona. Dr. Edward M. Gentile is CPSA's chief medical officer.