Concerns are mounting regarding the impact of significant cuts to behavioral health services in Idaho, particularly the Assertive Community Treatment (ACT) program. Local law enforcement officials, during a Region II Behavioral Health Board meeting held on December 7, 2023, expressed their apprehensions about how these reductions will affect their operations and the community’s mental health support system.
ACT is essential for individuals with severe mental health disorders, including schizophrenia and bipolar disorder. These individuals often do not respond well to other forms of treatment. According to a report from the *Idaho Association of Community Providers* and the *Idaho ACT Coalition*, cuts to behavioral health services, including ACT, amount to approximately $20 million. This reduction could lead to local governments facing expenses exceeding $150 million due to increased demands on law enforcement and emergency services.
Shane Anderson, the public information officer for the Latah County Sheriff’s Office, anticipates that the elimination of ACT will result in a surge of mental health-related calls to law enforcement. He emphasized that many of the services provided by ACT previously operated quietly, preventing individuals from needing hospitalization or incarceration. Anderson stated, “The way we used to deal with it is we only had two options: we’d take ’em to the hospital if they’re suicidal or find some crime they’ve committed to take ’em to jail so we can at least watch ’em.”
Orofino Police Chief Vince Frazier echoed these concerns, noting that the removal of mental health services leads to a cycle of repeated incarcerations. This not only strains police resources but also diverts attention from other critical duties. Frazier urged the state to reconsider the cuts, suggesting that lawmakers explore reductions in other budget areas instead.
Impact on Vulnerable Populations
Jim Rehder, chairperson of the Behavioral Health Board and a former corrections official, highlighted the crucial role of ACT for individuals reintegrating into society after incarceration. “The Assertive Community Treatment Program is a really helpful thing for people that have mental illness,” he noted.
The meeting also featured participation from several Idaho lawmakers, including Representatives Lori McCann and Kyle Harris, and Senators Cindy Carlson and Charlie Shepherd via video call. Harris clarified that the decision to cut acute behavioral health services was made without legislative input. “We didn’t have a say in where Health and Welfare was gonna make these cuts,” he remarked. McCann added that her inquiries to Idaho’s Department of Health and Welfare were directed toward Magellan Healthcare, the state’s Medicaid administrator, which she claims indicated that they did not support the cuts to ACT.
In an official response, the Idaho Department of Health and Welfare stated it had been collaborating with Magellan to implement necessary budgetary holdbacks. AJ McWhorter, Public Information Officer for DHW, explained, “The Magellan service and rate cuts are to achieve the required budget holdbacks.” However, the announcement did not address the “unbundling” of ACT services, which has effectively defunded the program.
Lawmakers like Harris believe there is a possibility to reinstate funding if evidence shows that the Medicaid cuts would lead to greater long-term costs. “If you can’t show up in Boise … give your presentation on Zoom, make the phone call, send an email,” he urged. “The more information we get in committee, you will change votes.”
The ramifications of these cuts may already be severe. A class-action lawsuit was filed in late November on behalf of ACT recipients who argue that without the program, they face a heightened risk of hospitalization or incarceration. One plaintiff, referred to as “Ramon,” reported significant improvements in his condition after receiving ACT services, which allowed him to reunite with family and avoid hospitalization or incarceration. Another plaintiff, “Thomas,” who had experienced multiple hospitalizations prior to accessing ACT, has since remained stable.
Future Legislative Priorities
Rehder stated that a top priority for the Behavioral Health Board is to re-implement Medicaid services and consider Medicaid expansion. He noted that many individuals currently lack access to necessary treatment, often resulting in incarceration or emergency hospitalizations.
Other legislative priorities include advocating for affordable housing, offering loan forgiveness for medical professionals, and establishing a youth crisis center in Region II, which encompasses Nez Perce, Latah, Clearwater, Lewis, and Idaho counties. McCann expressed concern regarding a minor in crisis who reportedly spent nearly a month in a local emergency room due to a lack of appropriate facilities.
Michelle Mendenhall, the behavioral health board representative for schools, estimated that five to eight children in the region experience crises each month, often leading them to emergency rooms without proper follow-up care.
As the situation unfolds, the community’s response to the behavioral health service cuts will likely have lasting implications for the individuals affected and the local law enforcement agencies tasked with managing the fallout.
