Suit Filed in Effort to Block County From Mental Health Program Cuts

Seeking to block a planned $3.2-million cut in San Diego County’s mental health programs, the Legal Aid Society on Tuesday filed a lawsuit charging that the proposed cutback would illegally reduce services for indigents.

The suit filed in Superior Court alleges that, under budget cuts approved earlier this month by the Board of Supervisors, the County Mental Health Services program would fall below legally mandated minimum service levels.

The suit also charges that the county has failed to provide required disclosures of the specific cuts and has not provided individual notices to mental health patients affected by the reductions, scheduled to take effect this fall.

Discretion Claimed

CMH spokesman Patrick Stalnaker, however, insisted that, even with the cuts, the county’s $56-million mental health budget for fiscal year 1988-89 will enable it to provide all mandated mental health services. County lawyers and other administrators, meanwhile, noted that the county has discretion in determining certain mental health services levels.

“Cuts per se are a fact of life,” said Tony Albers, chief deputy county counsel. “They can’t possibly think that we can’t make budget cuts.”

Legal Aid lawyer Anson Levitan said Tuesday that the organization plans to seek a preliminary injunction blocking those cuts at a court hearing next month.

“The question is whether the county can reduce such a basic service beyond minimally required levels,” Levitan said. “We don’t think they can.”

Available Options

If a court were to order the county to restore the $3.2 million in mental health funding, the supervisors would have the choice of either largely depleting the county’s $3.7-million contingency reserve or cutting other programs, county administrators said Tuesday.

Chief Administrative Officer Norman Hickey, facing what he termed the county’s “most difficult fiscal crisis since the passage of Proposition 13” a decade ago, last spring proposed a $7.5-million cut in the county’s mental health program to help balance the county’s $1.2-billion budget.

But, after strong protests from mental health advocates, the supervisors restored more than $4 million to the CMH program, reducing the final cutback to $3.2 million.

2,000 People Affected

County officials estimate that about 2,000 persons now receiving publicly financed mental health care will be affected by the cutbacks, which, among other things, will eliminate 31 county staff positions and reduce a wide range of outpatient treatment and community-outreach programs.

The cuts are scheduled to become effective Oct. 1, with the county now in what Areta Crowell, the county’s mental health chief, describes as “a phase-down . . . transition period” in which patients who do not meet new eligibility requirements are gradually being culled from county programs and referred, if necessary and feasible, elsewhere for care.

The Legal Aid lawsuit, however, contends that the cutbacks would illegally reduce mental health service to indigent San Diegans.

‘Provider of Last Resort’

“The county is the provider of last resort for people who have no other means of obtaining basic and essential mental health care,” the lawsuit says. “As a result of the CMH budget cuts, many of the indigent mentally ill will lose their ability to work and will withdraw from their daily activities. Some will lose their ability to cope with the tasks necessary to obtain and maintain the necessities of life. . . . Others will suffer severe exacerbations of their mental illness and require hospitalization.”

The lawsuit, filed on behalf of four individuals who have received county mental health care “and all others similarly situated,” the Welfare Rights Organization and the group’s director, cites various laws that require counties to provide “necessary health care” to indigents and that establish mental health service guidelines.

If the $3.2-million cut is implemented, the suit charges, the county would not satisfy those minimum requirements.