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Daily Journal

May 7, 2010

Suit Targets Sacramento Health Cuts

Sacramento County crossed a line when it eliminated funding for mental health programs and services for thousands of severely ill adults, according to a lawsuit filed Thursday by Western Center on Law and Poverty and Disability Rights California.

The county plans to end funding for several private nonprofits and support centers it funds to treat about 5,000 residents suffering from schizophrenia, bi-polar disorder, depression and other mental illnesses.

Advocates said eliminating those services could lead to patients becoming homeless, ending up in jail, or even committing suicide.

"You're talking about extremely vulnerable people," said Robert Newman, an attorney with the Western Center in Los Angeles. "We think the county threatens to put thousands of people back in institutions."

As California counties grapple with growing budget gaps, many are shrinking health and mental services, Newman said. But he called Sacramento's cuts the "harshest" and "most irrational" because the county has to find other ways to treat these residents, or face even costlier care in hospitals and mental institutions.

The class action, filed in U.S. district court in Sacramento, alleges the county's impending cuts violate the Americans with Disabilities Act as well as federal Medicare laws and state statutes. It asks for injunctive relief.

Federal district judges and appellate courts have shot down more than half a dozen recent state efforts to shrink the massive Medi-Cal program, ruling local governments that accept federal dollars for health and mental health programs must abide by certain requirements, such as studying the impact of service cuts before acting.

Sacramento County officials said they do not comment on pending litigation. But the agency has insisted in public meetings that services would be replaced with comparable care provided by county workers instead of private nonprofits. The agency has said it is "redesigning" the safety net programs, not cutting them.

Many view the cuts as a way to save county mental health jobs.

The Sacramento County Board of Supervisors has not formally approved the proposal but is expected to do so this month. The agency has already notified nonprofit providers that funding will end July 1.

Advocates said they have repeatedly asked how the county plans to replace critical services, but have largely been ignored.

Leslie Napper, 41, said the county hasn't told her how she can continue the psychiatric services she credits with saving her life.

Napper ended up in a lockdown cell of a Sacramento hospital eight years ago after a mental breakdown.
The hospital paired her with a coordinator for a local mental health support center called Turning Point, where doctors evaluated her and diagnosed her with bi-polar disorder.

Napper has visited the center two days a week ever since for psychiatric counseling and medication management. She said the center has helped her family understand her illness. She now lives with family members.

The program is one of several that the county plans to stop funding.

Napper said she and other patients fear ending up back in a hospital or worse. "The majority of my peers and there are several thousands of us we're very concerned that relapse is eminent," Napper said.

Along with the advocacy groups, lawyers at the Palo Alto office of Cooley are working on the case pro bono.