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The Honolulu Advertiser
Posted on: Thursday, June 11, 2009

CARE Hawaii to shut its mental-health services on Maui, Kauai


By ILIMA LOOMIS
Maui News

WAILUKU — CARE Hawaii, which provides an array of mental-health services, will shut down its operations on Maui and Kauai, state health officials confirmed.

CARE's final day of services on Maui will be Saturday. Patients and clients who had previously been receiving mental-health services from CARE will move to another Maui provider, such as Aloha House or Mental Health Kokua, said Michelle Hill, deputy director for behavioral health in the state Department of Health.

"We have worked with them to assure the safe transition of all the consumers in their care," Hill said.

Some of the other agencies may also take on staff from CARE Hawaii's Maui offices, she added.

Officials with CARE Hawaii, who would have accurate information on the number of clients affected by the shutdown, did not return phone calls from The Maui News.

Hill said the closure of CARE's Maui offices was initiated by the organization, not by the state.

"They have in fact indicated to us that they needed to make some adjustments in their business operations to weather the economic conditions," she said.

CARE is based in Honolulu and provides a variety of mental-health and addiction services. On Maui, the agency has provided community-based case management services, which involves providing mental-health clients with a case worker who helps them manage their condition by arranging for medical care or counseling, linking them with public assistance or other services, and even reminding them to take their medication.

Last year, the state Department of Health announced it would cut funding for community-based case management services from three hours a day per patient to three-and-a-half hours per month. The move came in response to a severe budget shortfall that left the department's Adult Mental Health Division needing to reduce spending by more than $20 million just to make it through the end of the year.

Aloha House Chief Executive Officer Jud Cunningham said his agency had hired more staff to take on the additional case load. On top of CARE's closing, the Health Department's Adult Mental Health Division asked the agency to take people on a waiting list for case management services, and Aloha House was receiving about 100 new clients from both sources, Cunningham said.

Most of the clients had already been transferred from CARE to Aloha House as of this week, Cunningham said.

"There may be some loose ends, but it's pretty much been accomplished at this point," he said.

Colleen O'Shea Wallace of Mental Health America of Maui County said the closure of CARE's Maui offices would be just one more disruption in the lives of an already fragile population.

Mental-health clients under the state's care were transferred to private providers like CARE several years ago; they saw their case management reduced drastically in January, and the state's plan to reduce Medicaid benefits by $42 million over the next two years will further cut the services of mental-health clients on Medicaid can receive, O'Shea Wallace said.

"I know they've been working on the transition, but it's too many transitions," she said.

Hill said the state's finances were in a "dire situation," and her department was working on a plan to maintain services at its mental health centers while implementing Gov. Linda Lingle's order to furlough state workers for three days each month to cope with deepening budget deficits.

"We're all hoping for the best, but so far we're managing within the current scenarios of economic downturn and limited resources," she said.

Cunningham said he understood the state's grave fiscal situation, but he said the strict limitations on mental-health services were continuing to make it difficult for case workers to provide the amount of service their clients need to stay well.

"It's our hope that whenever the economy rebounds that the state won't maintain the status quo, that they'll take another look at that and ease up on the restrictions and allow for higher levels of service where they're indicated," he said.

More Maui News at www.mauinews.com.