Health care providers in Idaho are sounding alarms over recent budget cuts to mental health programs, which took effect on March 15, 2024. These cuts could lead to costs exceeding $150 million in the first year, impacting local governments, mental health care providers, and law enforcement agencies. According to a report by the Idaho Association of Community Providers and the Idaho ACT Coalition, the reductions total approximately $20 million and are expected to escalate expenses in areas such as emergency services and child welfare programs.
The cuts include the elimination of critical services such as Assertive Community Treatment (ACT), in-home residential treatment, and peer support programs. Ric Boyce, co-director of the Idaho Association of Community Providers, highlighted that increased utilization of state services could ultimately cost the state between $150 million and $180 million. In Region 2, which encompasses Nez Perce, Latah, Clearwater, Lewis, and Idaho counties, local governments may face annual costs ranging from $12 million to $16 million due to these cuts.
The budget reductions are part of a broader effort to address a state budget shortfall estimated at $58.3 million, which includes a revenue loss of $253 million attributed to tax cuts benefiting wealthier residents. The Idaho Center for Fiscal Policy has also noted that the state must contend with additional costs from tax credits for nonpublic education amounting to $675,000.
Local providers are now grappling with the practical impacts of these cuts. Sara Bennett, owner of Riverside Recovery, which operates in Lewiston and Orofino, previously led the regional ACT program, offering vital support to those with severe mental health issues. “ACT is that kind of aggressive outreach,” Bennett explained, emphasizing its role in helping individuals stabilize within their communities, especially those suffering from severe mental illnesses such as schizophrenia and major depression.
Prior to the cuts, Bennett’s team served around 42 individuals in the region, while the statewide program assisted approximately 400 patients. Now, those patients find themselves without the critical treatment they have relied on for years. The restructuring of funding, referred to as “unbundling,” effectively dismantles the program by removing essential services such as nursing care, which had previously been part of the ACT support.
Bennett expressed concern for her patients, many of whom have depended on the ACT program for over 20 years. “This is the lifeline that they know has kept them well,” she remarked, noting the anxiety felt by those who fear losing support during times of struggle. Boyce anticipates that around half of the 400 patients statewide may disengage from care as they transition to outpatient mental health counseling, which he believes may not adequately meet their needs.
The burden of these cuts extends beyond mental health providers. Tom Lamar, a commissioner in Latah County and chairperson of the Region 2 Behavioral Health Board, pointed to the expected strain on local crisis centers and law enforcement. He criticized the decision by the state Legislature to shift service responsibilities and costs to local governments, stating, “Counties are a subdivision of the state of Idaho… And they don’t act like it.”
In a letter addressed to Governor Brad Little and state lawmakers on December 1, the Idaho Sheriffs’ Association warned that the elimination of these services would likely result in increased emergency calls, involuntary psychiatric holds, and court cases. The letter highlighted that rural sheriff’s offices are already operating on thin margins, and the loss of stabilization programs will not lessen overall costs for the state, but rather shift them to local budgets and taxpayers.
The situation could exacerbate pressures on local jails and emergency services. In Region 2, the Nez Perce County Jail is projected to see a rise in inmate numbers, further straining resources after Latah County transitioned its jail to a court holding facility due to necessary upgrades.
Bennett remains hopeful that legislators will reinstate these essential programs in the next budget cycle, emphasizing the need for services that are evidence-based and cater to individuals with the highest mental health needs. The Region 2 Behavioral Health Board is scheduled to meet soon to discuss strategies and engage with local legislators about the pressing challenges ahead.
