Money short forBy Helen Altonn
services for special
The state Health Department is running out of money to provide court-ordered mental health services for special needs children.
According to the last estimate, the department is short about $31 million to cover costs through May for children identified under the Felix consent decree, Health Director Bruce Anderson told legislators yesterday.
An emergency appropriation will be requested this session, he said. This is in addition to the $68 million set aside by legislators for the current fiscal year.
Supplemental funds also may be needed in addition to money listed in the governor's proposed two-year budget for children's mental health services, Anderson said. He said the figures constantly change with more cases.
The 1994 Felix consent decree, resulting from a lawsuit against the state, requires a system by June 2000 to provide special education and mental health services to disabled children.
The Child and Adolescent Mental Health Division in 1995 had 1,549 clients. Now it has 8,200, of whom 6,200 are eligible for services under the consent decree, said division chief Christina Donkervoet.
Legislators are concerned about the spiraling costs of the program and their inability to get total figures from state officials.
Anderson, who recently became the Health Department's director, said, "That is one of the dilemmas I had coming into this. How much is it costing? Every time I asked I got a different number."
He said the Felix decree is "a continuing drain on all resources . . . We're trying to figure out ways to get costs under control."
Linda Colburn, Felix Project Operations manager in the governor's office, told legislators last week she would give them a combined health and education budget for the decree.
House Health Chairman Alex Santiago yesterday said he's still waiting for it. A governor's office representative said it will be ready in a few days.
Anderson told lawmakers they will they will see more accountability by his department on Felix costs. He has hired a certified public accountant, Anita Swanson, as a special assistant to oversee consent decree issues.
The Health Department head said he received some figures in the past few days. "I wasn't happy to see the numbers but they're firm numbers."
Anderson said he spent four hours with Gov. Ben Cayetano Saturday discussing major issues affecting health services -- primarily the Felix and Hawaii State Hospital consent decrees.
The governor's budget includes about $96 million in the next year for Felix-related programs and expenses, including an increase from 148 to 156 care coordinators.
The coordinators, serving as case managers, are the key to planning appropriate, cost-effective services for each child, Donkervoet said.
They have such huge caseloads now that "they're going into meetings knowing less than everyone else," she said. "They need to be fully informed to guide the process."
Anderson also said a more efficient system is needed to hold costs down.
For example, more than a dozen people may be involved in drafting a service plan for a child, including attorneys and "self-referring providers" who bill the state for meetings that may last eight to 10 hours, he said.
Donkervoet said her division must provide the services designated by the team, even if it disagrees.
"What are we to do as legislators when a gavel is hanging over our head from a judge?" Santiago said.