Budget Cuts Threaten Mental Health Services, Projected Costs Soar

Health care providers have raised alarms over recent budget cuts to mental health programs in Idaho, warning that these changes could lead to costs exceeding $150 million in the first year. The cuts, which took effect on Monday, target services crucial for individuals in crisis and those suffering from severe mental health disorders.

According to a report from the Idaho Association of Community Providers and the Idaho ACT Coalition, the cuts amount to approximately $20 million and could have a ripple effect that drives up expenditures in emergency services, law enforcement, and child welfare programs. Ric Boyce, co-director of the Idaho Association of Community Providers, stated, “By the time you calculate increases in predictable (state program) usage, hospital usage, that’s gonna cost $150 million to $180 million on the very conservative end.”

Impact on Local Governments and Services

In Region 2, which encompasses Nez Perce, Latah, Clearwater, Lewis, and Idaho counties, local governments are projected to face additional costs of $12 million to $16 million annually due to the service reductions. The cuts are part of a broader effort to address an estimated state budget shortfall of $58.3 million, which has also been attributed to a loss of $253 million in tax revenue primarily benefiting Idaho’s wealthiest residents.

Sara Bennett, owner of Riverside Recovery, has expressed deep concerns about the elimination of the Assertive Community Treatment (ACT) program, which provided behavioral health support to individuals with severe mental illnesses. Bennett stated that ACT significantly reduces hospitalizations by engaging patients in their communities. Until recently, her team had served about 42 individuals in the region through ACT, which is now effectively dismantled.

“The budget cuts, which providers were told would ‘unbundle’ services previously funded as a package, effectively eliminate the program,” Bennett said. “With what they call ‘unbundling’ of ACT, nursing isn’t even a billable service.” She noted that patients, some of whom have relied on ACT for over 20 years, are now anxious about their future treatment.

Rising Burdens on Local Systems

Boyce anticipates that as many as half of the 400 patients statewide who were receiving ACT services will likely disengage from care, which poses risks for individuals with acute mental health disorders. “These are people who can barely answer their door consistently to us,” Boyce explained. “Realistically, these [unbundled services] are not the appropriate services. They’re not the evidence-based services that will keep those individuals out of hospitals, out of jails, out of homelessness.”

Local officials, such as Tom Lamar, Latah County commissioner and chairperson of the Region 2 Behavioral Health Board, predict that the burden will shift significantly to local crisis centers, mental health providers, and law enforcement. “They really need to develop a more mature view of the costs of providing services at the state and local levels,” Lamar stated.

In a letter to Governor Brad Little and state lawmakers, the Idaho Sheriffs’ Association warned that the elimination of these services will lead to increased call volumes, involuntary holds, and civil and criminal court cases. “The loss of these stabilization programs will not reduce the overall cost to the State of Idaho. Instead, it will shift those costs directly onto county budgets, jails, E.M.S. agencies, and local taxpayers,” the letter expressed.

Bennett hopes that state legislators will reconsider and reinstate vital programs in the next legislative session. “These are the individuals with the highest needs, and this is the only evidence-based treatment that we offer,” she emphasized.

The Region 2 Behavioral Health Board plans to meet this Thursday to discuss strategies for advocating for local needs with legislators. The long-term implications of these budget cuts remain a significant concern for both providers and the communities they serve, as the stability of mental health services hangs in the balance.