'Unfair' cuts weigh on mentally ill

Terry Marcille, 48, lives in Concord and has a master's degree in geography. She also has bipolar disorder.

Marcille has tried to commit suicide and has been in and out of hospitals. For 16 years, she has been getting services from Riverbend Community Mental Health.

"The mentally ill are being dealt an unfair hand," Marcille told the House Finance Committee yesterday in a hearing on the proposed 2012-13 budget. "We didn't ask for mental illness any more than people with cancer or diabetes ask for their illness.

"The latest round of budget cuts are hurting the mentally ill," Marcille said. "We deserve a life that is healthy and happy, too."

Marcille was one of more than 500 people who attended an afternoon budget hearing yesterday, with more expected for an evening hearing that was scheduled to last late into the night. Patients and advocates, people with mental illness and physical illness, homeless advocates and bridge builders, all came to advocate for their causes. The most concern was for the services provided by the state Department of Health and Human Services. Gov. John Lynch proposed a $10.7 billion biennial budget that would give Health and Human Services - the state's largest department - $621 million less than what the agency calculated it would need to maintain current services. The House Finance Committee recently asked Health and Human Services Commissioner Nick Toumpas for a list of an additional $346 million in cuts, which would bring the department back to its 2004 funding levels.

The list Toumpas gave the committee includes such ideas as eliminating funding for "children in need of services," a category of at-risk children ordered by the court to obtain treatment or counseling before they commit a crime. Among other things, it would get rid of state-funded homeless prevention activities, domestic violence programs, tobacco prevention and child care; decrease payments to hospitals for uncompensated care; stop voluntary admissions to New Hampshire Hospital; and get rid of in-home support services for the elderly.

Toumpas opposes the cuts and told the House Finance Committee earlier this week that he is "deeply troubled" by their potential impact. He warned of downshifting costs to cities, towns, counties and families.

"The impacts will be devastating, and we believe the sum of these actions will have global impacts, including the dismantling of the health and human services infrastructure that is vital to all New Hampshire citizens," Toumpas said.

Yesterday's hearing put the human face on those impacts.

About 30 people from Riverbend, which has offices in Concord, Hillsboro and Franklin, came to show the importance of mental health services. Erica Thibeault, program manager for the day program that Marcille participates in, challenged committee members to imagine being told their child has cancer and needs five days of treatment a week - but could only get one day because of financing.

"If anyone was told this when their child had cancer they would be devastated, shocked and outraged," Thibeault said. "Why is it thought of in our society any differently when it is a mental health illness?"

Under the governor's proposed budget, Riverbend would see higher caseloads and would be able to treat people less often, CEO Louis Josephson said. Under the proposal given to the House, Riverbend would either close altogether or would have to turn away patients.

According to the New Hampshire chapter of the National Alliance on Mental Illness, about 4,000 adults and another 4,000 children with serious mental illnesses would lose services under the proposal before the House, as would 7,000 individuals with less serious mental illnesses.

New Hampshire's 16 Community Health Centers would also be hit badly - potentially losing more than $4 million, or 42 percent of their state funding. Community Health Centers provides primary care services to people, regardless of their ability to pay, in areas with a shortage of health care services.

Dr. Fred Kelsey, medical director at Mid-State Health Center in Plymouth testified that access to primary care saves money by reducing emergency room visits and hospitalizations.

"It is in New Hampshire's interest to maintain access to timely medical care, delivered in the most efficient setting . . . to the most vulnerable populations and communities," Kelsey said.

Some of those in the most dire of straits said they would be hit the worst. Cheri Salie of Raymond relies on One Sky Community Services, a nonprofit agency helping people with developmental disabilities in Rockingham County. Salie's 17-year-old daughter Samantha has a rare disease where her muscles are turning to bone. Samantha weighs 75 pounds and sits hunched in a wheelchair hooked up to life support equipment. Salie, who is divorced, can't work because her daughter requires 24-hour care.

When the 2008 ice storm hit, One Sky gave Salie a generator to power Samantha's life support equipment so she could avoid a night in the hospital. The group helped Salie find a lawyer to handle her divorce and leave an abusive situation. They helped her fill out insurance paperwork and sent a notary to her home when she needed one.

"They're my Yellow Pages of resources," Salie said.

Lynch's budget would cut One Sky's funding in half, One Sky officials said.

Chrissy Shaffer of Litchfield urged the committee to spare a proposed $2 million cut in in-home support, the proposed elimination of funding for a waiting list for services for adults with developmental disabilities and several other cuts.

Shaffer's 9-year-old son Wesley has several disabilities, including a rare chromosome disorder and developmental delays. The family gets state money for in-home care providers, and Wesley's sister attends a program for siblings of children with disabilities. Shaffer said if families cannot support loved ones with disabilities, they may be forced to turn care over to the state, which would be more expensive.

"Have you ever had the thought that it would be better if you outlived your child?" Shaffer asked. "It is an awful thought to have, and there are many parents that have had this thought because they fear for the lack of available funding, services and qualified providers for their children."

Several people testified against cuts to homeless services - among them, Joe Lyons, a case manager for homeless services at Southwestern Community Services in Keene, which faces a $100,000 cut. Lyons, who previously ran a furniture rental center and worked in industrial supervision, said he became homeless in 2007 after getting divorced. He moved into the shelter, where he now works. A case manager taught him how to get food stamps and unemployment benefits.

"Before I became homeless, I knew nothing about that group of people or how to get out of it," Lyons said.

With the proposed cuts, Lyons worries others will not be able to benefit from the case management services that helped him move on.

The Rev. Gene Robinson, the Episcopal bishop of New Hampshire, testified to his anger at proposed cuts that would hurt the state's most poor and vulnerable residents.

"When sacrifice is perpetrated on the vulnerable and weak by the strong and prosperous, it is social abuse," Robinson said. "If there is belt-tightening to be done, we should be tightening our own belts and coming up with the resources to do what a civilized society does: to care for, and not cut services for, the poor, the disabled, the blind, the unemployed, the impoverished elderly, the uninsured and children living in poverty.

"Do what you are going to do," Robinson continued, "But make no mistake: This budget is simply irresponsible and immoral."

(Shira Schoenberg can be reached at 369-3319 or sschoenberg@cmonitor.com.)