BY THE NUMBERS: Butler County Mental Health and Addiction Services Board
The two behavioral health agencies merged in July 2015, but levy funds the mental health side collects cannot be used for addiction services.
MENTAL HEALTH SERVICES
Clients served: 10,500
2016 budget: $12 million
Funding source: Two property tax levies, plus state and federal funds
Clients served: 3,021
2016 budget: $2.7 million
Funding source: State and federal funds
With heroin-related overdoses at an all-time high, Butler County Mental Health and Addiction Recovery Services is developing a plan that could include asking taxpayers to fund addiction treatment services.
The MHARS board has determined it needs about $3.5 million more a year to deal with addictions. Taxpayers already agreed to fund more mental health services by approving a five-year, 1-mill mental health levy on March 15, but dealing with the county’s opiate epidemic will require more funds, officials said.
“We looked at practically addressing the opiate epidemic,” said Scott Rasmus, executive director of the MHARS board. “… It was around $3.5 million as we developed this business plan to address the opiate epidemic in a practical way in Butler County.”
More people died in Butler County from heroin-related overdoses in 2015 than suicides, traffic crashes, other accidents, homicides and undetermined causes combined, according to the Butler County Coroner’s Office.
The office said 189 people died from drug overdoses last year, and 149, or 79 percent, were heroin-related.
Funds from the mental health levy renewal, which costs the owner of a $100,000 home about $31 annually, cannot be used for addiction services.
Voters also passed 0.5-mill levy in 2014 that costs that same homeowner about $8.50 a year. If MHARS moves forward with the levy request, they would merge the 0.5-mill levy with the addiction services levy, according to Rasmus.
First, however, MHARS will reach out to the county’s state legislators and the state’s Department of Mental Health and Addiction Services before going to voters, Rasmus said.
Since November 2013, there have been 43 mental health/addiction services levies on ballots across the state and all but four passed.
Statewide there are 70 levies, and Butler and Lucas counties are the only jurisdictions with mental health-only levies.
“There is an increased stigma associated with addiction even over mental health problems,” said Julie Payton, the senior director of addiction services for the MHARS board. “There is still an underlying thought that individuals who are addicted are choosing this behavior.”
Scott Gehring, CEO and president of Sojourner Recovery Services, one of the MHARS’ main service providers, agrees that heroin addiction isn’t a choice.
Most people, he said, graduate to heroin because they can’t obtain prescription pain killers anymore.
“They’re not looking for a high, but the problem is, once you become addicted you’re not doing it because you want to get high, you’re doing it because you don’t want to be sick,” Gehring said.
He described the drug sickness as seven to 10 days of feeling “like you’ve got the flu times 10.”
“Your muscles hurt, your body hurts, you’re dizzy, you’re nauseous, you’re vomiting, you’re getting cold sweats and chills,” he said. “The drug sickness is absolutely miserable.”
While many disagree with the view that addiction is not a choice, officials point out that treatment is much less expensive than its alternatives, such as incarcerating addicted persons who commit crimes to fund their addiction.
Part of the reason for a possible levy is also funding cuts from state and federal governments totaling more than $1.3 million between fiscal year 2014 and 2015.
The county’s mental health and former Alcohol and Drug Addiction Services Board merged last summer and Payton said that has allowed some savings in personnel to offset the shrinking funding.
“But the cuts also get passed on to the providers because the cuts are for services. We cut administratively, but we also have to cut services,” she said.
MHARS also faces possible reductions in Medicaid rates.
“When they are doing this redesign they are cutting the rates that haven’t been changed in 18 years, and they are pretty drastic cuts,” Gehring said. “Our outpatient rates are like a 70 percent cut in reimbursements. It’s pretty severe.”
Sam Rossi, director of communications for the Ohio Department of Medicaid, said it is premature to say rate reductions are in the offing. There is a behavioral health redesign underway, but he said what the MHARS board and Gehring are saying about rate reduction is wrong.
“… we’re still in the process of negotiating rates and we’re doing that with the provider association, the advocate groups, the sister state agencies,” he said. “There is a lot of work going into this.”
If the MHARS board decides to move forward with pursuing a levy for addiction services, county commissioners must first approve putting it on ballot. The commissioners have asked all of the social services agencies not to compete on ballots with one another and the Children Services levy is up next year.
But Payton said if all other funding options fail, MHARS can’t wait.
“We are concerned that in the current and upcoming years we will loose more lives that could have been helped with an expanded treatment and prevention system,” she said.
Butler County Coroner Dr. Lisa Mannix recently wrote column featured in the Journal-News calling heroin a ‘rampant killer in our community.’
“Beginning in 2014 there were more deaths due to drug overdose than deaths by natural causes among the cases my office investigated,” she wrote. “This is the first time since these statistics have been recorded that overdose deaths outpaced natural deaths. Among deaths investigated by the coroner, 2015 was even worse — not just the total number of overdose deaths (189), but heroin-related deaths alone (149) were greater than the number of deaths by natural causes (123) handled by the coroner’s office. That is a five-fold increase in the number of heroin related deaths in only three years.”
Commissioner Cindy Carpenter, who sits on the opiate task force, has her hands in a number of ongoing efforts by outside agencies to tackle opiate addiction. She said until she sees levy specifics she can’t say how she would vote, but she definitely encouraged the board to go for state dollars.
“It is not surprising to me that we need additional funds,” she said. “I find that to be a very valid request and justified.”
Commissioner Don Dixon said until he sees a potential proposal he also won’t comment on the issue.
Likewise Commissioner T.C. Rogers said he can’t commit his support at this early stage, but he acknowledged the problem is huge.
“Addiction is a bigger problem than anybody ever knew about so no one planned for this much of an epidemic,” he said. “We’re getting pulled in many directions on this.”
Nationally, President Barack Obama announced last week he wants to inject $1.1 billion in new funding to fight the opiate epidemic.
Locally, State Sen. Bill Coley has introduced a bill that would send more money to local governments for addiction services.
Citing the Ohio Constitution, Coley said two percent of the tax on casino revenue is supposed to go for gambling and other addictions but tax exemptions on promotional gaming have been allowed. His bill would limit the exemptions.
“One of the things we are pushing is to do away with the tax exemption for promotional gaming,” he said. “It was a giveaway and they are not entitled to it under the Constitution. The total amount not taxed is about $88 million a year to schools and local government and a substantial portion of that is for addiction services and problem gaming. That’s something we can do right now to get more money for addiction services and heroin treatment.”
Charlie Niles, a West Chester Twp. resident who prompted a challenge from Dixon to other politicians to raise $2,500 to buy 3,000 water bottles with the anti-heroin message “Heroin kills you” said he would absolutely support a tax levy for addiction services
“We’ve got to try to make an effort to stop this heroin stuff and drugs,” said Niles, whose son died of a heroin overdose at age 53.