Concerns have intensified among local law enforcement officials regarding substantial cuts to mental health services, particularly the Assertive Community Treatment (ACT) program. At a recent meeting of the Region II Behavioral Health Board, officials voiced their worries about how these cuts, estimated at approximately $20 million, could adversely affect their departments and the communities they serve.
ACT is a vital program designed for individuals with severe mental health disorders, such as schizophrenia and bipolar disorder, who have not responded to other forms of treatment. According to a report from the Idaho Association of Community Providers and the Idaho ACT Coalition, the financial implications of these cuts could lead to an additional burden of over $150 million on local governments as they attempt to manage the fallout.
Changes implemented on December 1 resulted in the unbundling of services that had previously been billed together, which has significantly reduced the financial support available for programs like ACT through Medicaid. Shane Anderson, public information officer for the Latah County Sheriff’s Office, noted that he anticipates a rise in mental health-related calls due to the loss of support services. He explained, “Many of those services worked unnoticed in the background, preventing people from hospitalization or incarceration.”
Orofino Police Chief Vince Frazier echoed these sentiments, indicating that diminished mental health services lead to more individuals cycling in and out of jail, which detracts from police resources. “That means we are not doing other things that we should be doing,” he stated. Frazier advocated for a comprehensive evaluation of the true costs associated with cutting behavioral health services, suggesting that other areas of the budget be considered for cuts instead.
The meeting included several Idaho lawmakers, such as Representatives Lori McCann and Kyle Harris, alongside Senators Cindy Carlson, Jim Risch, and Mike Crapo who participated via video calls. Harris expressed frustration over the lack of legislative input regarding the cuts to acute behavioral health services, stating, “We didn’t have a say in where Health and Welfare was gonna make these cuts.”
McCann, who sought clarification from the Idaho Department of Health and Welfare about the cuts, was directed to Magellan Healthcare, the state’s Medicaid administrator. During her meeting with Magellan, she learned that they had advised against cutting the ACT team, emphasizing the program’s importance.
In a statement, the Idaho Department of Health and Welfare confirmed ongoing collaboration with Magellan to identify necessary provider rate reductions. AJ McWhorter, Public Information Officer for the department, explained that these measures are intended to achieve required budget holdbacks in accordance with the Governor’s Executive Order issued in August 2023. The changes, however, did not mention the significant impact of the unbundling of services like ACT.
Harris believes that if legislators are presented with evidence demonstrating that the Medicaid cuts could ultimately cost more than they save, there may be a chance for reinstating funding in the next legislative session. “The more information we get in committee, you will change votes. I’ve watched it happen,” he stated.
The ramifications of these cuts may already be dire for individuals reliant on such services. A class-action lawsuit was filed in late November on behalf of ACT recipients, asserting that the absence of the program increases their risk of hospitalization or incarceration. One plaintiff, referred to as “Ramon,” reported experiencing homelessness, unemployment, and an inability to function independently due to severe psychotic symptoms before joining ACT. His situation improved dramatically, with no hospitalizations or incarcerations since receiving support.
Another plaintiff named “Thomas” had a history of frequent hospitalizations prior to referral to ACT, but has remained stable since engaging with the program. The lawsuit underscores the potential dangers posed by the loss of these critical services.
Jim Rehder, chairperson of the Behavioral Health board, highlighted the significance of ACT for individuals reintegrating into society after incarceration. “The Assertive Community Treatment Program is really helpful for people that have mental illness,” he remarked. He emphasized the need for legislative support to expand Medicaid services, which could provide treatment for many individuals who currently go without.
Additional priorities for the behavioral health board include advocating for affordable housing, loan forgiveness for medical professionals to address the healthcare provider shortage, and establishing a youth crisis center in Region II, which encompasses several counties in Idaho. McCann raised concerns about the lack of available resources for minors in crisis, noting a specific case of a young person who spent an entire month in an emergency room due to the absence of appropriate care facilities.
Board members confirmed that there is currently no dedicated facility in Region II for minors facing crises, forcing them to seek help only through hospital emergency rooms. Michelle Mendenhall, the representative for schools on the behavioral health board, estimated that between five and eight children in the region encounter a crisis each month.
As discussions continue surrounding the future of mental health services in Idaho, local officials emphasize the pressing need for effective support systems to prevent further deterioration of community health outcomes.
