Community mental health programs are likely to be among the human services hit hardest in the budget approved by a House-Senate conference committee early yesterday.
"It is a dark day," said mental health advocate Sheila Schuster, who said the state's regional community mental health centers have been chronically underfunded for 12 years.
The budget cuts about $40 million overall for human services. In addition to a possible share of those cuts, mental health centers will also have to come up with $14 million the budget bill requires they contribute for employee pensions in the next two years.
"It leaves people in mental health struggling to meet the demand for services," said Steve Shannon, who represents the centers.
Affiliated services, including regional mental health crisis centers, already are struggling, said officials who operate two centers in Louisville.
"It's looking very bleak," said Katharine Dobbins with Wellspring, a nonprofit agency that operates two residential centers in Louisville where people can get help with a psychiatric crisis. "We wonder if we can continue to operate our two centers."
The proposed budget gives Janie Miller, secretary of the Cabinet for Health and Family Services, broad authority to decide how to cut the $40 million from human services, said Rep. Jimmie Lee, D-Elizabethtown and chairman of the House human services budget subcommittee.
The House had proposed providing $130 million to restore most of Gov. Steve Beshear's cuts to human services. The version approved by the conference committee provides about $90 million, Lee said.
He said lawmakers did preserve funding for two projects, including replacing the aging Eastern State Hospital in Lexington and new group homes at Hazelwood Center in Louisville.
But Lee said it's clear the budget will hurt most areas of human services, including mental health. "I'm sure that's going to be very painful," he said. "We just could not get any additional revenue."
Mental health advocates say even if they aren't affected by the $40 million in cuts, they can't sustain the pension increase without cutting services to the growing number of people seeking help. This year, the 14 centers will serve about 200,000 clients, Shannon said.
Dobbins said about half the nearly 700 clients the Louisville crisis centers serve have no insurance and no way to pay for psychiatric help. The centers rely on state money and other sources, such as donations, to make up the difference, she said.
Shannon said offering community mental health care avoids costlier options such as emergency rooms, psychiatric hospitals and jails.
"It keeps people out of more expensive places," he said.