Lawmakers hold votes on prickly mental health cuts

Lawmakers voted to preserve a program that would help keep mentally handicapped people at home with their families, but they held off on the most controversial items of a touchy, $617 million mental health budget during a weekend meeting.

Members of an Assembly panel on Saturday finalized some parts of the Division of Mental Health and Developmental Services budget, but steered clear of proposals to reduce capacity at hospitals for mentally ill criminals, make counties pay for services for mentally disabled children and restructure treatment programs for children with autism.

Up for consideration was the Family Preservation Program, which pays low-income families a monthly stipend of $374 so they can keep a mentally disabled family member at home instead of more expensive institutional care.

"If these families didn't get the money, that could be the trigger point - they may have to turn them over to the state," said Health and Human Services Department Director Mike Willden.

The program serves 528 families, but is depending in part on revenue from a major, class-action legal settlement with large tobacco companies. An arbitrator hasn't ruled on the settlement yet, and about $1.2 million of the program's $5.4 million budget for the upcoming biennium hangs in the balance.

If the tobacco companies pay up, the Family Preservation Program wants to do away with a waitlist and add another 72 families to the program. The Assembly Ways and Means voted not to add families unless the settlement money comes through; the Senate Finance committee voted to add the wait-listed families gradually over the biennium.

Legislators will have to reconcile that discrepancy in coming weeks.

But the program is one of the minor decisions the committee faces in the mental health budget. Elephants in the room include a proposal to shift the $6 million financial responsibility for mental health courts to cash-strapped counties, laying off psychologists and social workers who serve about 1,500 Nevadans each year, and cutting dozens of beds at two psychiatric wards.

Mental health advocates have argued that the reductions to the safety net will send some of the state's most vulnerable residents to the streets, where they would be a danger to themselves and others.

The grim situation took a turn for the better earlier this week when Republican Gov. Brian Sandoval announced he wants to add $46 million back to health and human services programs.

Add-backs to the mental health division include $1.7 million for substance abuse and treatment programs and $1.25 million to keep open triage centers for mentally ill people detoxifying from alcoholism or drug addiction.

Not including add-backs, Mental Health and Developmental Services has a proposed budget of $617 million in the upcoming biennium, a 12.5 percent cut from the budget approved by the 2009 Legislature. About $400 million comes from Nevada's general fund.