by Cailin Durbin, Cleveland.com 

Cuyahoga County’s mental health and addiction treatment network could be in for a major shakeup next year as funding cuts and a new commitment to a county crisis center force officials to rethink where millions of dollars will go.

In the past, the Alcohol, Drug Addiction and Mental Health Services (ADAMHS) Board has pushed out over $63 million to mental health and addiction service providers throughout the community, expanding access to care. But following budget strains and revenue cuts, it expects to have just $55 million to divvy up this year, about $10 million of which is federal and state money that is already spoken for.

With less to go around, ADAMHS Board CEO Jason Joyce said they’re re-evaluating which providers get money and how much.

That means that some providers that have routinely received funding may see their allocations reduced next year — or cut entirely. They may have to scale back services or close altogether, as some warned they might after learning about potential funding cuts earlier this year.

At the same time, Joyce said he hopes the shift will also create opportunities for smaller organizations to receive more support.

The end goal, he said, is to reshape the “ideal” system, one that is better equipped to support residents and deliver stronger outcomes.

“It’s going to be a total reevaluation,” he said. “We want mission-driven work. We want people to be out in the communities.”

He thinks it’s already working.

When he took over at the ADAMHS Board, Joyce said one provider that operates children’s crisis beds was averaging about 65% occupancy. Now faced with the new evaluation process, their occupancy has climbed to roughly 97% in recent months.

“We’re getting some better performance,” Joyce said. “Even saying ‘hey, we got to look at this and we’re going to be looking at the contracts’ has motivated providers to make sure that they’re outreaching and getting everybody in that they can.”

What is the ADAMHS Board looking for?

The Board has outlined 12 service categories it’s looking to fund, including crisis, detox, employment, housing and prevention services. Though Joyce said the board’s recent commitment to help fund The Centers’ planned 24-hour crisis center will represent the bulk of their crisis funding.

That’s not to say other crisis providers shouldn’t apply, he stressed, but there will likely be fewer dollars to devote in those areas to balance funding for the rest of the system.

“We want to make sure we have the full continuum of care,” Joyce said.

Providers will then be judged on 10 criteria to determine which programs are funded and how much. Criteria include the organization’s experience, capacity, finances, accessibility, cultural responsiveness, and how well the services coordinate with others, according to the Board’s request for proposals.

It’s especially important that providers show that they can work collaboratively with other system partners to strengthen the safety net, Joyce said. That could include coordinating care with other providers, hospitals, schools, the criminal justice system or housing agencies, with additional points awarded to organizations that are geographically close enough to allow for smoother transitions.

Organizations will also have to report back their performance data, which could factor into funding decisions for the next cycle. Joyce said they haven’t decided yet whether providers will have to reapply every year or every other year.

“We want more of that spirit of competition,” he said.

Proposals are due June 16, with funding recommendations expected by Sept. 16 and final approval slated for Sept. 23. New contracts would largely begin Jan. 1, 2027.

Could residents lose access to services?

The potential changes raise questions about what might happen if the programs people currently rely on for services lose funding, but Joyce said the ADAMHS Board is working to minimize disruptions.

He said the board is deliberately starting the review process earlier than usual to allow time for smooth handoffs. Current contracts would continue through the end of their terms — typically through the end of the fiscal year or June for state-funded programs — giving providers and the board several months to develop transition plans and communicate changes with clients.

He pointed to the recent closure of Recovery Resources as an example, noting that the board worked with the provider to ensure clients were connected to alternative services first.

“It wouldn’t be something that would happen overnight,” Joyce said.

Why is the board doing this now?

Following years of overspending that depleted reserves and the county’s decision to cut its annual subsidy by $4 million, the ADAMHS Board was forced to impose 20% provider cuts across-the-board last year, without weighing individual program impact or use. That already left providers’ budgets strained.

But with the county cutting $4.5 million in subsidy support next year and the ADAMHS Board agreeing to fund the new crisis center at the same amount, more provider cuts will be needed to keep the ADAMHS Board in the black. This time, Joyce said he wants those reductions to be more methodological.

He isn’t limiting dollar amounts or the number of awards. Funding will depend on the quality of the applications, he said, pledging “to make the best fit we can with the money that we’ve got.”

He encouraged providers to start preparing their applications early to best represent the work that they do.

Providers can find the application on the the Board’s website and learn more about the process during a virtual information session on May 13.

“If you’ve got a good idea, please apply,” Joyce said.

Read the original article here.