Carrying signs reading, "Mental wellness is a human right," a few hundred Illinoisans took to the Thompson Center Wednesday afternoon to rally against Republican Gov. Bruce Rauner's proposed budget cuts to mental health services and other crucial programs.
At the event, spearheaded by the National Alliance on Mental Illness (NAMI) of Chicago, speaker after speaker denounced Rauner's 2016 budget plan, which seeks to slash funding for the mental health division of the Illinois Department of Human Services by 15 percent. That works out to be a proposed cut of $82 million.
Cash-strapped Illinois faces a $6 billion budget deficit in the 2016 fiscal year, beginning July 1. To plug that hole, Rauner wants to significantly cut funding from a range of budgetary items, including $1.5 billion from Medicaid.
The governor has rejected calls for increased taxes to help balance next year's budget, which is under a tighter squeeze due to the January rollback of the state's 2011 temporary income tax hike.
Alexa James, executive director of NAMI Chicago, said cutting social services in general "doesn't make any fiscal sense."
"In the long run, it's going to end up being more expensive," she said. "All we're going to see is an increase in ER visits. We're going to see an increase in incarceration rates, and more importantly, it's the wrong thing to do. It's not good, quality treatment. We have a fiscal plan that makes sense. Community treatment and housing saves dollars. And for some reason, that is not being discussed in (Rauner's) budget."
NAMI Chicago is one of some 200 Illinois child and family advocacy organizations involved with the Responsible Budget Coalition, which is lobbying against Rauner's proposed budget cuts and pushing for new revenue options.
Mark Heyrman, board member at Mental Health America of Illinois, said there is reason to be optimistic that lawmakers won't give in to Rauner's deep budget cuts. That's because earlier this month, the Illinois House voted down a component of Rauner's budget that sought to cut millions from human services, including mental health care. Of the lawmakers who voted, not one supported the measure. All Democrats voted "no," and all Republicans voted "present."
"I think I am at least optimistic that the governor's budget will not pass," Heyrman said. "Whether there won't still be cuts, I'm fearful there will be."
Heyrman said he hopes lawmakers will approve new forms of revenue, including a restoration of the 2011 temporary income tax hike, to help ease Illinois' budgetary pressures.
Advocates point out that Illinois has already slashed about $187 million from mental health programs from fiscal years 2009 to 2012.
New revenue options are important, Heyrman said, to ensure that Illinois has "enough of a safety net" so that people with mental illnesses don't end up homeless or in hospitals or jails.
Dr. Nneka Jones Tapia, first assistant executive director of the Cook County Department of Corrections who oversees the Cook County Jail's mental health strategy, spoke at the rally. As of Wednesday morning, she said the Cook County Jail had 1,836 inmates with some form of mental illness.
"As we see services decreased in the community, we see more and more mentally ill individuals coming into our custody," Jones Tapia said. "And they're not just coming in with basic mental health services, they're coming in in such a severe state that they really require hospitalization. So, to hear the proposal that we would further cut services in the community is astonishing."
Here's more from the rally, including additional comments from Tapia Jones and Heyrman:
The Rauner administration says Medicaid expansion via the Affordable Care Act, plus the health reform law's mental health coverage requirements for private plans, has allowed room for some cutbacks in the area of mental health services. But mental health advocates say that's a weak argument. Medicaid, for example, does not cover a number of services Rauner is looking to cut, including supportive housing.
There is also a great need for the state to address its Medicaid reimbursement system, Heyrman explained.
"It's absolutely wonderful that Illinois chose to expand Medicaid under the Affordable Care Act, and that is important, but the problem with Medicaid in Illinois is the rates are so low that doctors, hospitals, providers lose money on every single client," Heyrman said. "All of the mental health providers are basically hanging by a thread, and Rauner (has) proposed ($1.5 billion in) cuts to Medicaid. So it's disingenuous to say, 'Look, it's all going to be solved by Medicaid, but I'm going to cut $1.5 out of Medicaid.'"
Rauner's proposed budget would further eliminate DHS grants for psychiatric care and medication for uninsured people.
"Because Medicaid pays psychiatrists so little, community providers can't get psychiatrists," Heyrman said. "So there's been a special pot of money so that they can attract psychiatrists. That's one of the cuts in the Rauner budget. And that means (community providers) won't have psychiatrists."
James MacKenzie, president of the Illinois Psychiatric Society, said his group is gravely concerned about the cuts Rauner is pushing.
"I'm hoping and praying as we get closer to the real budget, the final budget, that we're going to see more services, because it will be a disaster," he said. "The No. 1 provider of mental health services [in Illinois] is the Cook County Jail. That doesn't work. We can't have that."
Advocates point out that six of Chicago's 12 public mental health clinics closed back in 2012. And a major Chicago mental health community provider, Community Counseling Centers Of Chicago (C4), is on the brink of closing.
MacKenzie works as medical director of consultation-liasion and emergency psychiatric services at the Ann & Robert H. Lurie Children's Hospital of Chicago. He says C4's potential shutdown, combined with other mental health cutbacks at various levels of government, has made referring patients for mental health services difficult. And it will only get more challenging if Rauner gets his way on the budget, MacKenzie explained.
"As it stands, I don't have many resources and places to send patients to get help, other than the ER," he said. "So, if we end up with just ERs and just jails, that makes no sense."