As all but one of the state's budget-related measures were losing Tuesday night, Stanislaus County supervisors voted to cut services for people who struggle with mental disorders and substance abuse.
County officials said the cuts, set to take effect July 1, could have been worse. But the county is limiting employee layoffs to five positions and will hold onto more staff for assisting people who need help.
In the next few weeks, county officials will assess the fallout from Tuesday's special election, which is expected to widen the state's budget gap by $6 billion for the fiscal year that starts July 1.
"With the failure of the propositions, I would expect we will have to revisit these numbers," Supervisor Bill O'Brien said.
The county board, in a unanimous vote, approved the cuts to close a $4.5 million deficit for Behavioral Health and Recovery Services. Officials had anticipated a $6.9 million gap and the potential layoff of 24 employees, but a recent analysis found that matters had improved because of salary savings and revenue increases in the past year.
During the public hearing, representatives of local hospitals asked the board to delay the decision until discussions are held with hospital officials.
Scott Seamons, regional vice president for the Hospital Council of Northern and Central California, said that as cuts are made to the services, people with mental disorders will end up in emergency rooms.
It often takes three to five hours for a county crisis team to arrive at hospitals to assess psychiatric patients, he said.
Denny Litos, chief executive officer of Doctors Medical Center, said it appeared the responsibility for providing care for people with mental health and substance abuse issues was falling to health care providers.
Supervisors told county staff to meet with the hospitals before the cuts go into effect to discuss their concerns and see if there is funding from outside sources to preserve some programs.
With the cuts, the county will eliminate an Oakdale clinic, requiring 58 clients to travel to Modesto or Turlock for psychiatric medication; do away with medication services for 57 people in Ceres; require 20 clients at a Patterson clinic to seek care in Turlock; and no longer provide psychiatric assessments for patients in skilled nursing facilities.
Officials spared the Oakdale Community Care Center for Children, which provides counseling and medication support.
As for substance abuse serv-ices, the county is cutting a residential program that reunites drug-addicted moms with their children. It is reducing Adult Drug Court services and restructuring other programs.
In the past few years, Behavioral Health and Recovery Services has closed outpatient clinics and cut 60 positions, reducing its annual budget by $14.6 million to $64.5 million.
The county has served about 9,500 of the 35,000 residents with mental illness or emotional disturbances. Most are low-income residents covered by Medi-Cal.
The department's budget plan for 2009-10 will restrict hiring and does not include employee furloughs.
Department director Denise Hunt said furloughs would not affect the deficit, because fewer clients would be served and the county's reimbursements would suffer.
Bee staff writer Ken Carlson can be reached at firstname.lastname@example.org or 578-2321.