Study Reveals Growing Funding Gap

by Pamela Vincent  

   The Federation for Community Planning (FFCP) recently completed a study on Mental Health funding and services in Northeast Ohio.  The study, which looked at specifically targeted issues, was close to a 3 year process and included an advisory board consisting of practitioners and people in the medical field. Data was gathered from the Ohio Department of Mental Health’s financial reports, claims processed by the Mental Health Board and client interviews. 

   Over the course of the study Mental Health services experienced an increase in costs that was compounded by a 6% loss in state funding.  This was bad news for the already stressed system which sees an increase in mental health case loads each year.  There was a dramatic increase in Medicaid cases in Cuyahoga County alone.  The Mental Health Board focuses on the severely mentally ill people and emotionally distraught children first.  These people usually require more extensive treatments and medication costs than the less severely ill. In fact it costs 4 to 5 times as much to treat the severely ill clients as the less severely ill. 

   For example, the costs associated with treating a person with schizophrenia, which is considered a severe mental illness, is between $4,500- $5,000 per year. The cost of treating a less severely ill client is about $1,000 a year. The state wide costs per clients usually run about $3,500 for the more severely ill and under $700 for the less severely ill.  The sad part is there is not enough funding to treat all of the more severely ill clients let alone the less severely ill ones.

   The 50 public mental health boards in Ohio are looking at ways to improve services, cut costs and help more clients.  This is where the Federation for Community Planning’s study comes in to play.  Rich Marountas, who worked on the study, says “our mission is to help the people that help people, make better decisions and look at who’s being treated so that the system can be improved”.  He says they also play an advocacy role to provide information that can help plan and implement changes for the future of the mental health board.  They are there to provide support to the agencies and county boards.  Marountas states that some of the boards cover 5 to 6 smaller counties because they may be too small to maintain an agency on their own.

   The data gathered in the study confirmed that case loads are rising in every county and the FFCP board is focused on helping, Marountas says, “we believe case loads should be prioritized with the most severely ill clients getting help first but, we need to figure out how to help the less severely ill receive treatment too.  We need to look at ways to come up with resources to help everyone and plan for funding.”  The board is looking at a long term strategic plan for financial resources.  The federal funding they receive is in the form of a match through Medicaid.  Unfortunately the growth rate among clients far exceeds the funding they receive.  They’re also looking at ways to stretch the dollars per case load that is spent.

   So what happens to the clients who aren’t helped?  According to Marountas they often up in emergency rooms or jails.  When asked about the percentage of the homeless who are treated, Marountas claims “they don’t have that kind of information available.”

   “The homeless are hard to track because they float in and out of the system and move around a lot. The agencies that help the homeless need to track them better, get them into a comprehensive system, assign them each a UCI number (uniformed client identifier).  That way they can be tracked from agency to agency and it easier to review their history of aid.”  The catch is the homeless have to give their consent to be entered into the UCI system.  “ The hard core homeless often don’t seek agencies for help and it’s difficult to treat them and do case management for them.”

   Marountas goes on to say that “right now there’s an estimated 77,000 eligible people in the county that need mental health services.  About 20,000 of them will receive treatment, which leaves a startling 50,000 plus that will go untreated.  In some of the cases the people needing help choose not to get it because of the stigma attached to the problem.

 Marountas claims that the lack of available mental health care is a national problem and even if more funding were available, they would still need more facilities and practitioners to treat the clients and meet the growing demand.  Hopefully with the help of the Federation for Community Planning, the Mental Health Community in North east Ohio can come up with an effective plan for funding and a more efficient way to treat more clients.  Maybe then the numbers will shift so more people are being helped and less are being turned away.  To contact the Board of Mental Health in Cuyahoga County for general information call: 216-241-3400.

Copyright to the Northeast Ohio Coalition for the Homeless and the Homeless Grapevine Cleveland Ohio 2004.