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Proposed FY2012 Budget for Mental Health

posted Apr 1, 2011, 2:31 PM by DC Behavioral Health Association   [ updated Apr 4, 2011, 9:28 AM ]
D.C. ranks 4th among states making the deepest rate of cuts to their mental health budgets, according to a recent report by the National Alliance on Mental Illness (NAMI).  Only Arizona, Alaska and South Carolina made deeper cuts to their mental health budgets than the District of Columbia.


The Mayor’s FY2012 budget continues this trend by cutting millions of dollars from mental health treatment; perversely, many of the services targeted for cuts are precisely those that are effective at reducing more expensive interventions.  DCBHA's factsheet is attached belowAlthough more detailed scrutiny will confirm the exact scope and depth, it appears that the budget cuts may come from the following sources:


Ø      $900,000 reduction from DMH’s contracts for non-Medicaid reimbursed services for children.  These services may include mobile crisis response – which prevents children from being hospitalized for psychiatric emergency – and D.C. Choices, which works to prevent youth in schools and the juvenile justice system from being sent to psychiatric residential treatment centers. 


Ø      $2,500,000 reduction from DMH’s funds that support specialized, non-Medicaid reimbursed mental health treatment for traumatized children through CFSA's intra-district transfer, including Choice Provider assessment, training and practice capacity funds.


Ø      There is a $3 million local-funding cap on DMH’s specialty, in-home treatment services; if this applies to Medicaid-funded services, it would translate to an overall $10.3 million reduction in treatment funds.


Ø      An additional $80.7 million reduction in Medicaid provider payments that is not further detailed, but which may further reduce Medicaid funding for mental health providers. 


While cutting the services that are effective at preventing acute care use, the proposed budget perversely expanding funding for acute care.  The FY2012 proposal contain a $16.7 million increase to DYRS to support expanded secure bed capacity for all those youth placed in residential treatment centers without medical necessity. 


These spending choices reinforce care trends that make D.C. one of the highest-spending healthcare jurisdictions in the country. 


Ø      D.C. Over-Spends on Acute Care.  D.C. spends more money per Medicaid beneficiary on acute care – like hospitals and residential treatment centers – than all but one other jurisdiction in the country. 


Ø      D.C. Under-Spends on Community-Based Care.  Vermont and D.C. have similar population sizes, and a similar structure for delivering public mental health services.  Vermont’s FY2012 budget for children’s community-based mental health treatment is $72 million annually.  By contrast, D.C. budgeted only $13 million in FY2011.

DC Behavioral Health Association,
Apr 4, 2011, 9:28 AM