DMH axes 100 case managers assigned to help the mentally ill

TELEGRAM & GAZETTE

Thursday, January 8, 2009
By Lee Hammel TELEGRAM & GAZETTE STAFF
lhammel@telegram.com

The state Department of Mental Health, which chronically has too few case managers to serve its clients, will lay off 100 case managers.

Pink slips went out yesterday to 100 case managers and 20 administrators as part of budget-cutting announced in October to offset a $1.4 billion deficit in the state budget, according to Kristina Barry, a state Health and Human Services spokeswoman. Eleven of the case managers to be laid off work in Central Massachusetts.

Those positions will be eliminated by the end of the month, she said. Those case workers served 3,444 clients, according to Michael Grunko, president of Service Employees International Union, Local 509, which represents 900 DMH employees among its 11,000 members.

The 22 percent cut in case managers will leave 350 case managers to serve a caseload of about 10,000 clients, Ms. Barry said. DMH yesterday could not say what the gap is between case management and the need for it.

But two years ago, DMH said it had enough case managers for 10,650 of the 20,400 adults eligible for them. It also said it had enough case managers for 2,000 of the 3,600 children and adolescents who need them.

And since then, said James E. McDonald, vice president of the Central Massachusetts Alliance for the Mentally Ill, the number of case workers seems to have dropped. Family members of people with mental illness say their loved ones already “are not receiving case managers when needed,” he said.

If case managers are laid off, “where would people with mental illness go for assistance trying to find jobs or with problems?” asked Mr. McDonald, a Shrewsbury resident. “The case manager was a highlight of their life. They could rely on that one person.”

Ms. Barry said, “area offices are working on transition plans for the affected clients to make sure they have appropriate service.” She was unable to say to what extent caseloads of the remaining 350 case managers will be expanded or how many clients will lose case management.

Mr. Grunko said, “it’s my understanding that they’ve determined that 3,444 clients can get along without a case manager. We’re concerned how it will affect the care of clients, and we do expect that many of them that might have been able to avoid extensive hospitalization through interventions will now be going straight to the emergency room and costing the state many, many thousands of dollars.”

The department has been reducing its inpatient population, saying that clients who moved from the hospital to the increased number of group homes and apartments would have access to case workers in the community.

The outlook is not good, as only yesterday Gov. Deval L. Patrick asked the Legislature for additional budget-cutting powers as he identified a $1 billion revenue shortfall on top of the $1.4 billion deficit addressed in October.

Last fall the administration said that the DMH would have to cut $33.5 million as its part of the deficit reduction. But Ms. Barry said the department was given one-time access to $24.2 million in trust funds, leaving its net cut at $9.3 million.

To achieve that, state grants to community mental health agencies were cut in addition to slashing jobs at DMH. Funds to Community Healthlink in Worcester, for example, were cut $2 million on an annual basis, resulting in entire programs such as Gateway Resources disappearing.

With the financial hole in which the state finds itself, Mr. Grunko said he understands why the Department of Mental Health took the actions it did, but “as the union that represents social workers, this is when society needs us most. We’re doing our best, but it’s going to be very difficult for this agency to do what it has done in the past.”

Mr. McDonald said, “It would really decimate the care and treatment of the mentally ill.”