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Multnomah County leader calls planned state mental health cuts 'devastating'



Lawmakers in the control of the state budget are eyeing multimillion-dollar cuts to county mental health care programs, reductions that advocates and other legislators say are hypocritical and harmful – and based on flawed assumptions.

The proposal – to slash $ 15.4 million from a portion of the Oregon Health Authority budget – would deal with a "devastating" blow to county mental health programs, said Sharon Meieran, and Multnomah County Commissioner

That money pays for preventative health care programs such as Multnomah County's walk-in clinics and crisis outreach teams, helping people avoid costly stays in jails and psychiatric hospitals, Meieran said in an interview.

The commissioner, who is also an emergency room physician, said cutting program budgets would cause more people to spill into county jails and hospitals. "Sarah Radcliffe, an attorney with advocacy group Disability Rights Oregon, said county mental health care programs are an essential safety net for Oregonians on the brink of crisis."

The programs, she said, "are really designed to prevent people from entering higher levels of care that are more expensive and more restrictive."

The cuts proposed in Salem have observers like Meieran, Radcliffe and others wondering: Why diminish supports for Oregon's mentally ill people when it is more than ever

"For the life of me I can not figure it out," Meieran said. "It really deeply concerns me."

Rep. Cedric Hayden, a Republican lawmaker who is vice-chairman of the House Health Committee, said he too, is perplexed by the cuts proposal, adding that the backs "should not happen."

"Why would we do that? "Hayden said. "We're cutting an area I think is vital."

Both policymakers have pushed for bolstering mental health programs in light of problems spotted by Oregonian / OregonLive's investigations. One examined the costly and at times cruel system by which homeless people who have mental illnesses are jailed for low-level offenses because they are disabled. Another investigation showed how more than 200 mentally ill people had their rights violated by very long jail stays ̵

1; a situation that led the judge to hold the state in contempt of court.

Beyond the questioning of the wisdom of cutting mental health programs, Hayden and Meieran have voiced skepticism about the methods used by state officials to predict the use of programs.

In this case, the Oregon Health Authority predicts there will be a steep drop over two years in the number of people thought by doctors or judges to be a danger to themselves or others due to mental illness.

That assumption led and the fiscal analyst to recommend the $ 15.4 million cut to community mental health care programs.

Meieran said the forecast is based on a "flawed" formula. She pointed to a paragraph tucked into the Health Authority's 2013 budget, which notes that the caseload forecasting method is "not adequate" because it is based on program use – which can be limited by low budgets rather than true need

A note in this year's forecast states that the predicted predictions may be "artificially low" and are at "major risk" from being based on outdated information.

Hayden said he had asked for more information on the funding formulas from government bureaucrats but received no response.

Sen. Elizabeth Steiner Hayward and Rep.

Gregory Tooman, the administrator of the State Office of Forecasting Research and Analysis, said in an email that the accuracy of forecasts is " of critical importance. "He said the mental health program forecasts had been refined since 2013 with the identification of new data points and added that the underlying methods were" sound, "but did not respond to a request for information on updated forecasting accuracy.

Cherryl Ramirez, who directs a trade group of community mental health providers, said the updated formula still measures programs poorly by emphasizing institutionalized care over less intensive programs.

Oregon Health Authority spokeswoman Saerom England said the agency's leadership "recognizes the growing overall needs of the community's mental health system,"

"It's something we've believed needed to be updated for a long time" has been committed to maintaining funding for at least 18 months in part through the use of unspent federal grants.

Meanwhile, Health Authority leaders will "critically evaluate the funding formula" to ensure it aligns with the agency's priorities, England said.

– Gordon R. Friedman

GFriedman@Oregonian.com


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