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Updated 10:35 p.m.

COLUMBUS, Ohio – Mental health advocates, and associations for medical and health care professionals expressed bitter disappointment Monday evening about the two-year state budget passed earlier in the day by a 5-to-1 vote of a bipartisan conference committee.

Rep. Ron Amstutz, a Republican from Wooster, was the only conference committee member who voted no on the budget bill, according to the Columbus Dispatch.

Even as Ohio House representatives made statements about the conference committee’s vote in preparation for their own vote on the bill, the Coalition for Healthy Communities — a consortium of 27 advocates for mental health and addiction services in Ohio – urged members of the state General Assembly to vote “no” on House Bill 1.

The version of the budget bill that passed the conference committee ”will decrease community addiction prevention and treatment services by 30 percent and community mental health services by 6.5 percent,” the coalition said in a written statement. The coalition added that though media reports have funding for mental health services increasing by $65 million over the two-year budget, that increase includes $36 million in federal stimulus money that already is coming to the mental health system.

“I have to believe that what they are proposing to do violates state and federal law, not to mention our state constitution,” Jim Mauro, executive director of the National Alliance on Mental Illness of Ohio, said in the statement. “Lawmakers have an obligation, not just morally, but legally to protect the most vulnerable of our citizens, and if they vote to pass this bill — they are shirking that responsibility.”

More statements from mental health advocates:

• “Passage of this bill will devastate the community behavioral health system of care for the foreseeable future,” said Hubert Wirtz, chief executive of the Ohio Council on Behavioral Health & Family Services Providers in Columbus, said in the statement. “What took us 20 years to build will be torn down in the blink of an eye.”
• “We’ve said it before and we’re going to keep saying it until someone listens, cutting critical behavioral health services to this extent will mean that Ohioans are going to die,” said Donna Conley, executive director of the Ohio Citizen Advocates for Chemical Dependency Prevention and Treatment said in the statement.
• “I don’t know how our senators and representatives can vote for this bill knowing that there is no safety net for many of Ohio’s most ill individuals. A vote for this bill is a vote to cut services to 100,000 to 150,000 Ohioans with alcohol, drug addiction and/or mental health disorders,” said Cheri Walter, CEO of the Ohio Association of County Behavioral Health Authorities.

Ohio Hospital Association President and Chief Executive James Castle said Ohio hospitals were ”extremely disappointed” by the outcome of the contentious budget process. Castle said he is concerned that a shortfall in the budget equates a “tax of $145 million” on the state’s hospitals.

The association had presented the state with a plan to preserve hospital jobs and get much-needed federal money to fill a large hole in the state budget, however the that plan was disregarded, the hospital association said. “The hospital tax will cost hospital jobs and essential health care services,” Castle said.

These announcements add to exiting concerns from wheelchair manufacturers and suppliers, who said late last week that changes to the way the state diverts Medicaid funds could cost jobs, damage their industry and threaten nursing home patients’ access to rehabilitative wheelchairs.

The Ohio Skilled Nursing Care Coalition wasn’t happy with the budget, either. Skilled nursing facilities represented by the coalition’s three organizations ”will be confronted with the harsh reality of meeting increased demand for quality, around-the-clock care with $184 million less in available resources, even though costs continue to climb,” it said in a written statement. “As a result, skilled nursing facilities will have to reduce staffing levels even more than they already have; in some cases, facilities may be forced to close, uprooting patients from their current places of care.”

Peter Van Runkle, executive director of the Ohio Health Care Association, said, “The state is imposing a $391 million increase in fees that each skilled nursing facility has to pay on the total number of licensed beds,” in the coalition’s written statement. “Unlike in prior budgets, those fees are not being fully reimbursed. That unreimbursed amount ($184 million) is equivalent to a 5-percent rate cut. As a result, nearly 90 percent of Medicaid-participating facilities will be losing money compared to what they received last year.”

Other coalition representatives had this to say:

• “The statewide average Medicaid reimbursement rate is being held flat for the next two years while the costs of providing quality care continue to increase,” said Victoria Gresh, executive director of The Ohio Academy of Nursing Homes Inc. “For the last five years, the rate of inflation has been three times greater than the minimal rate increases (1.1 percent per year) we’ve received. We’ve already cut staff and reduced expenses; unfortunately, some of our facilities simply won’t be able to absorb the additional reductions and likely will have to shut their doors.”
• “Those who suggest that just cutting support for skilled nursing care facilities will somehow magically reduce the need for services provided to those who live there are not painting an accurate picture.” said John Alfano, president and chief executive officer of the Advocate Of Not-For-Profit Services For Older Ohioans. “People in our facilities are there because they need our care. We continue to support increased funding for home and community-based care but taking funds from skilled nursing doesn’t address the overall issue of a growing elderly population needing various levels of service and support.”