Guidance clinic facing financial crisis

West Yavapai Guidance Clinic, the county's only psychiatric inpatient center, is facing an impending financial crisis that may force the agency to suspend treatment of 60 to 80 seriously mentally ill clients.

Don Ostendorf, CEO, said in a meeting Wednesday that the clinic is expecting a $1.5 million shortage in payment for the seriously mentally ill for fiscal year 2000-2001, which ends June 30, 2001.

The shortage results from several major factors:

• Increase in number of clients.

The agency spends a minimum of $6,000 annually to help each person classified as seriously mentally ill. In July 1999, the clinic was serving about 500 people in that category. In July 2000 the number had jumped to 600 people. Now the clinic serves about 620 people who meet eligibility criteria. But state financial support has not increased proportionately.

• Eligibility criteria for treating the seriously mentally ill.

In a 1989 court decision, Arnold Vs. Sarn, the Arizona Supreme Court ruled that individuals with serious mental illness are entitled to a full range of services regardless of income or funding availability. State funding for this mandate did not follow.

• The "in-migration" of eligible clients moving from other areas in the state and country to be near family and friends.

In the past week, the clinic processed five new seriously mentally ill clients, from Phoenix, Washington state and Florida. Four of those five had moved to the area to be with family or friends.

"We do not want to abandon our mission to serve the people of this county, but we are at a crisis point," Ostendorf said. "This financial situation has been building for more than two years, and we cannot continue to do too much with too little.

"This crisis is one of public policy," he continued. "The executive and legislative branches of state government will have to solve it."

The courts cannot expand the number of eligible clients without the Legislature providing money to serve those clients, he said.

West Yavapai Guidance Clinic has continued to accept clients entitled for services without receiving sufficient money from the state to serve them.

"We want to do what is right for the most vulnerable people in our community," Ostendorf said. "We've always had budget struggles just because of the nature of non-profit organizations, but we've never had such a gap – $1.5 million. It will mean moving people out of the system if a solution is not found."

The money problem is not unique to Yavapai County, Ostendorf said. Other northern Arizona facilities and clinics for the mentally ill in Tucson are facing similar situations.

The situation affects only services for the seriously mental ill, he said, because those services are the most costly to provide.

Bob Newman, a client who also serves on the clinic's board of directors, said he would have to pay $6,000 a year for his medications without help from the state.

Ann G. Lugaric-Hicks, who has fought serious mental illness much of her life, fears the possible loss of services through the clinic.

"I would not be able to manage it financially without state assistance," she said. "I'd be strapped."

If she loses state-paid services, her options would be to borrow money from her elderly parents or divorce her retired husband so she would be destitute and eligible for federal assistance.

Clinic staff and board members see only three apparent solutions:

• Bring spending in line with the cost of serving clients.

• Limit enrollment of seriously mentally ill clients to the number that the clinic can adequately serve with current money.

• Eliminate non-essential administrative processes. It takes an estimated 36 pieces of paper to enroll one seriously mentally ill client.

West Yavapai Guidance Clinic serves clients from centers in five locations – four in Prescott and one in Prescott Valley. The clinic opened in 1966 and provides a wide range of mental health services to the people of western Yavapai County.