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Home My WebLink AboutCOM 0050.002 2008-2010 Page 1 of 1 Murashige, Laura From: Julie Nagasako [Julie.nagasako@catholiccharitieshawaii.org] Sent: Monday, January 05, 2009 11:34 AM To: counciltestimony@co.hawaii.hi.us Subject: Comm 50 - 01//06/09 (Committee on Human Services and Economic Development) Attachments: Testimony - Communication 50 - Community Alliance Partners.pdf Aloha, Please find attached testimony from Community Alliance Partners regarding COMMUNICATION 50 to be heard on January 6, 2009 at 10:30 am before the Committee on Human Services & Economic Development. We appreciate your assistance in relaying this testimony to the Committee Members. Please let me know if you have any questions. Mahalo! Julie Nagasako CATHOLIC CHARITIES HAWAII tjt Hawaii Island Community Director Catholic Charities Hawaii 204 Waianuenue Ave. NJ Hilo, Hawaii 96720 Phone (808) 961-7051 Fax (808) 961-7059 julie.nagasakogcatholiccharitieshawaii.org www.catholicchari6csha-,vaii.org "Catholic Charities Hawai'i - helping people in need to help themselves, regardless of their faith." The information in this e-mail is confidential and is legally privileged. It is intended solely for the addressee. Access to this e-mail by anyone else is unauthorized and may lead to civil and/or criminal penalties. If you have received this message in error, please delete all electronic copies of this message (and the documents attached, if any); destroy any hard copies you may have created and notify Catholic Charities Hawaii immediately at (808-535-0129). Z Comm; No. 50 - Ref. Tot Y SEDG Ref. Date JAN 6 1/5/2009 TO: Emily Naeole, Chair J Yoshimoto, Vice Chair Committee on Human Services and Economic Development FROM: N^ej"z3 Pf Julie Nagasako, Vice-Chair Advocacy Committee Community Alliance Partners DATE: Monday, January 05, 2009 RE: Comm 50: PRESENTATION BY STAKEHOLDERS OF THE ADULT MENTAL HEALTH DIVISION IN RESPONSE TO THE RECENT BUDGET curs Please find a statement, included on behalf of Community Alliance Partners regarding the impact of recent budget cuts to mental health services. The attached letter has been submitted to the State Department of Headth and we would also like to provide this feedback as testimony for the informational hearings of the Hawaii County Council Committee on Human Services and Economic Development regarding this topic. We thank you for your consideration of this urgent situation and hope productive action can be Laken to reach a solution. r Eh, got one house? Community Alliance Partners (CAP) Hawaii Island Continuum of Care to End Homelessness P.O. BOX 2819 Kailua-Kona, H196740 Chiyome Fukino, MD Director of Health State of Hawaii 1250 Punchbowl Street, TO Floor Honolulu, HI 96813 January 2, 2009 Re: Big Island Mental Health Service Reductions Aloha Dr. Fukino, I am writing on behalf of the Big Island Community Alliance Partners (CAP) to express our concerns about the reductions in public mental health services, and to ask that you do everything possible to both ameliorate and redirect the decisions to reduce services that are currently being implemented. We have questions as to whether the degree and distribution of cuts to mental health services is necessary and fair. As important, we believe that they are being made in a manner that will cause unnecessary harm to those with the highest level of need, and, in addition, will waste the precious resources that remain. The CAP is a broad based consortium of homeless services providers and community members that work to implement the state plan to end homeless in the County of Hawaii. This includes delivering and assuring the availability of programs that homeless individuals and families need to overcome the obstacles they face in obtaining and maintaining housing. As you know, a significant proportion of the homeless population suffers from serious mental illnesses that can impede their ability to access and utilize the community resources that are available for them. Therefore, a large number of the homeless people that CAP providers work with are dependent on mental health treatment, and particularly, case management services, in order to succeed in community settings. We are concerned that the mental health service reductions on the Big Island will render ineffective the case management services that homeless people with mental illnesses need, and this, in turn, will result in an increase in homelessness, dangerous behaviors, hospitalization, incarceration, and death. Our members are already reporting an increase in symptoms and the crises among homeless individuals. First of all, we would like to be assured that people with mental illnesses are being treated fairly in Hawaii. We understand that there is a budget crisis that is affecting everyone, however, we would like to know whether the Department of Health (DOH) is being cut disproportionately to other state funded services, and that within the DOH that mental health services are not being reduced to a greater degree than other health services. If the cuts to mental health services are greater than for other health services we would like to know why and what you are doing to correct this situation. Secondly, within the DOH adult mental health system, we would like to understand why services to the most seriously mentally ill are being most severely impacted. Earlier this year DOH decided to eliminate all of the Assertive Community Treatment (ACT) teams in the state. This approach to treatment has repeatedly been demonstrated to be most effective for the highest need individuals with serious mental illnesses including those who are homeless or at-risk of homelessness. We were assured by your department that Community Based Case Management services (CBCM) would continue to be available to address these needs. Now we are learning that the CBCM services are both being dramatically reduced and those that remain will be restricted in a manner that will render them ineffective. Of particular concern is the decision to limit case management services to 3.5 hours per consumer per month. With the distances that case managers must travel on the Big Island, a single routine home visit for one consumer could require more time than is being allowed. We would like to strongly suggest that if CBCM services must be cut, that the decisions about how the remaining services will be used, in terms of who receives priority for these services and how they are distributed within the caseload, be made locally by the providers who understand the unique situation of the Big Island. In this way we will be able to assure that the CBCM services that remain available are implemented in keeping with the intent and principles of case management programming, so as to minimize the destructiveness of these cuts. We are also wondering why the programs offered by contract providers that serve those in greatest need are apparently being reduced to a greater degree than state operated programs that, in general, serve a broader population of people with mental illnesses. i We do understand and accept that during the current fiscal climate that cuts to state services are inevitable. However, we also believe that budget cuts can be an opportunity to move a system of services toward its strategic priorities by making greater cuts to lower priority services, and, sometimes, even adding resources to higher priority services. At the very least, the cuts should be made in a way that will maximize the effectiveness of the funds that remain. We do not see how the cuts that are now being implemented achieve either of these goals. We would expect that DOH strive to maintain the evidence based programming that has been established in recent years as a result of Federal supervision of our system of care. This system has raised Hawaii from being one of the lowest ranking mental health systems in the country to one of the best, and, we, on the Big Island, have experienced the positive results of this programming. We are concerned that this services system is being systematically dismantled as a result of the current budget crisis. In our view this will maximize the pain for highly vulnerable people, result in cost increases in other areas and waste the precious treatment resources that remain. We would appreciate a response to the questions and concerns we are raising. We would also ask that your staff work with Big Island representatives and providers to redirect the cuts you are making to best respond to our particular needs. We thank you now for your time and consideration and await your reply. Sincerely yours, 41 David Garcia Chair, Community Alliance Partners cc: State Legislators