More than 13,000 drug and alcohol abusers across Maryland will be shut out of treatment programs this year as just one result of deep budget cuts ordered to help balance the state's $450 million budget deficit, health officials say.
But Health and Mental Hygiene Secretary Nelson J. Sabatini warned that many of those same people will only turn up later in the state's psychiatric hospitals and prisons, which are suffering their own cuts, or in acute care hospitals as charity cases.
"I am concerned that reductions of this nature could begin to undermine the social underpinnings of this state," he said.
The state is slashing $88 million from its current $2.4 billion Health and Mental Hygiene budget in a deficit-balancing move that Sabatini yesterday called "painful" and "Draconian."
Besides the cuts in addiction treatment, about 31,000 disabled Marylanders will lose medical assistance, and as many as 740 state-paid workers in local health departments may lose their jobs Nov. 1.
"These cuts, in one way or another, are going to impact on everybody in the state," Sabatini said. Besides hurting the state's most "vulnerable and very fragile" citizens, they will curtail such local services as restaurant, pool and summer camp inspections.
Howard R. Sampson, director of the state's Alcohol and Drug Abuse Administration, whose operations took some of the heaviest cuts, blinked back tears as he talked privately about the losses to state-funded drug treatment programs.
"These are your brothers and sisters," he said. "That's who we're talking about. These aren't people we've imported with drug problems."
At Tuerk House, a 58-bed residential treatment program that served 559 addicts last year and recently moved and expanded to serve up to 800 this year, executive director Joseph C. Verrett said the cuts "will shut me down."
Of the men and women he serves, he said, "a good number are going to die or go to jail" without a residential program to turn to. And if jail-based treatment programs also are cut as planned, "then God help us all; and you can quote me."
Here are some of the cuts Sabatini announced to help Gov. William Donald Schaefer balance the $450 million deficit he faces in the current state budget:
* $54.4 million from the non-federally assisted portion of the state's Medicaid budget. That means an end to medical assistance for 31,000 of the state's poor who do not qualify under other Medicaid programs for families with children, the aged, blind or disabled. Included are single men with mental problems that prevent them from working, and women who no longer qualify for Aid to Families with Dependant Children. As many as 700 Medicaid-assisted "slots" for heroin addicts in methadone programs may also be lost.
* $12.5 million from state matching funds to local health departments. The cut means up to 740 doctors, nurses, health inspectors, drug counselors, clerks and other employees working in city and county health departments may be laid off. Some may be hired with local tax dollars.
* $11.9 million from state-funded addiction treatment services. The cuts include reductions in outpatient addiction treatment, and the elimination of all state-funded residential addiction treatment programs for adults. Gone will be 1,072 residential treatment "beds" that now serve 7,690 people each year.
* $3.9 million from such community services as mental health rehabilitation and clinic services, and developmental disability day programs.
* $3.3 million from nursing home assistance programs, including Medicaid payments for durable medical supplies such as wheelchairs and walkers.
* $1 million in cuts from central administrative programs, including the elimination of 11 jobs.
In making the cuts, Sabatini said, he tried to avoid injury to programs serving infants and children, and those threatened with decertification or under court orders to improve services. That left little else but adult addiction programs and local health services under the ax.
"The frightening thing," Sabatini said, "is that, absent something happening with revenue, the problem probably gets twice as bad next year.
"I think we're at a point in time where we have to make some conscious decisions as citizens of this state," he said.
"We are making Draconian cuts in programs that are of vital importance to people who are vulnerable and fragile. Are we going to meet the social and moral obligations that we have, and pay the cost, or . . . turn our backs on these people and let them fend for themselves?"
At Tuerk House, executive director Joseph Verrett said his 21-year-old program serves mostly unemployed and homeless people who can't succeed in outpatient programs because it is too hard to avoid drugs in their homes and neighborhoods.
"If this goes, these people have nothing," he said.
"The sad part of this is, even in the best of times . . . we are really not able to do the job right, because there are not enough resources out there for us to discharge a person into," Verrett said.