Short $19 million, Mental Health freezes community care program

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Perteria Allen and her grandson, Bertrand, ready for the school prom

Perteria Allen waited seven and a half years for last April 5 to arrive. Early that morning, she got her grandson Bertrand, 21, into the car and drove from their home in Greenville to Whitfield, where he began enrollment in the Department of Mental Health’s developmental and intellectual disability waiver program.

Bertrand has autism. Under the waiver program, Allen said, he would be eligible for up to 296 hours of services each month, paid for by the Department of Mental Health. This could be one-on-one instruction with a trained aid or group classes out of the house. Allen, who is 68, said she hoped someone would finally teach Bertrand how to bathe himself and wash his own dishes, tasks she struggles with daily as his sole caregiver.

“I’m an old woman, and I’m doing the best I can with him. But he needs help, real help,” Allen said. “We were so excited when they finally told us to come down to Jackson.”

But two weeks later, Bertrand’s family received another letter from the Department of Mental Health. This one said Bertrand would be going back on the waiting list — not because he did not qualify for services, but because Mississippi’s Department of Mental Health did not have the funds to provide them.

So far, the Department of Mental Health has sent out 84 of these letters to people who had begun enrolling in the department’s intellectual and developmental disability waiver program. In total, 1,300 people remain on the waiting list, where the average wait time can stretch to eight years.

The ID/DD waiver provides support and services to people who have an intellectual or developmental disability in an attempt to let them live at home, as an alternative to moving them to an institutional setting.

The problem, according to Adam Moore, spokesman for the Department of Mental Health, is two-fold. First, the Legislature cut the general fund appropriation for the Department of Mental Health by $14.4 million. In addition, Moore said, costs for the waiver program, which currently enrolls 2,515 Mississippians, are increasing next year by another $5.3 million. In total, this leaves a $19.7 million hole in the department’s budget.

As a result, the department has capped enrollment in the waiver program to the 2,515 people currently enrolled. They also closed admissions to all five regional intellectual and developmental disability programs (Hudspeth Regional Center, Boswell Regional Center, Ellisville State School, South Mississippi Regional Center and North Mississippi Regional Center) and to the nursing homes located at East Mississippi State Hospital and Mississippi State Hospital.

“The DMH appropriations bill was a significant cut to the agency that will have an impact in most general fund services of the department. While the ID/DD Home and Community Based Waiver participants currently enrolled will not be affected, it will affect future enrollment due to limited funding available for the waiver program. As a result, we have had to stop the enrollment process for the program at this time,” Moore said in an email.

Access to home-based services is particularly crucial for Mississippi’s Department of Mental Health. Last August, the U.S. Justice Department filed a complaint against the agency for “failing to provide adults with mental illness with necessary integrated, community-based mental health services.”

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Rep. John Read, R-Gautier

“It’s a very good program,” said House of Representatives Appropriations Chairman John Read, R-Gautier. “I wish we had unlimited resources, so we could put everybody who needs to be in that system in there. Because to me it really is the backbone of care, people staying at home with their parents, receiving services that way. It’s a better outfit, and everybody’s happy.”

As news of the letters trickled out, state Democrats were quick to point fingers at Republican leadership, accusing them of a slash-and-burn approach to budgeting that reduces spending with little regard for consequences.

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Rep. John Hines, D-Greenville

“Nothing surprises me about what’s happening in government,” said Rep. John Hines, D-Greenville. “When the leadership brags about shrinking government at the behest of the citizens who need it most, those actions are going to have ramifications across all the agencies.”

Read, along with House Public Health Chairman Sam Mims, R-McComb, met informally with representatives from the Departments of Health and Mental Health to discuss these and other budget issues on Wednesday. And Read acknowledged that the cuts to these departments have been tough this fiscal year.

“It’s not a pretty picture,” Read said. “I hope we get a little uptick, and I hope we can relieve some of these problems. But right now we’ve just got to deal with them.”

Bertrand entered the waiting list in November 2009, when he was 13 years old. He is now, technically, an adult, but his grandmother said he struggles with even the most elementary tasks. He learned how to tie his shoes recently, something she said she worked on for three years.

Allen said she tries to integrate Bertrand into the community herself, but it’s difficult. She describes her grandson as “a lonely person.” So when prom rolled around this spring, she decided she would take him.

With the help of his 13-year-old sister, Leticia, Allen dressed Bertrand in a tuxedo. But he became agitated, first ripping off his tie, then his cummerbund and finally stuffing his pants into the garbage can. An hour later, they made it out the door.

According to the Department of Mental Health, anyone currently on the waiting list will retain their places and be notified as soon as enrollment in the waiver program resumes. Allen said she hopes that day is soon.

“It’s just like having a child all over again at this age,” Allen said, becoming emotional. “If I had some help, I could have a life. I’m a nice looking woman. But people don’t want to come into a home where you’ve got children you’re taking care of.”