After her adult daughter was rejected for Social Security disability benefits, Lynn Padlo of Modesto finally got psychiatric medications for her daughter's bipolar disorder through a doctor at a Stanislaus County health clinic.
Joanna Padlo, 43, is one of 157 patients who get psychiatric medications through Stanislaus County's Medically Indigent Adult Program because they have nowhere else to turn. That will change if the county Board of Supervisors approves a recommendation this evening to eliminate no-cost mental health services from the MIA program.
Lynn Padlo, a retired teacher who takes care of her daughter, would have to pay $300 to $400 a month for the drugs that control the severe disorder, or rely on clinic staff to apply for free drugs through pharmaceutical companies.
Social Security, which covers the cost of a psychiatrist and drugs, has denied disability benefits even though Joanna Padlo has been hospitalized eight times for psychotic episodes, her mother said. If she goes off her medication, she is delusional, doesn't sleep, talks rapidly and becomes belligerent to the point where she can hurt someone, her mother said.
"As a widow and retired person, I would have to go back to work," Lynn Padlo said. "What is going to happen to homeless people who are (in the MIA program) and don't have a mother to support them?"
The MIA program provides medical care for about 6,100 men and women who are not eligible for Medi-Cal, Medicare or other public programs. It's not obligated to offer mental health services, but as is true in the private sector, the county's primary care doctors receive numerous requests to see patients with serious mental disorders.
Because of a local shortage of psychiatric services, they've worked the patients in if they are MIA eligible.
The county pays for the psychotropic drugs, and denying these patients would save the financially troubled Health Services Agency $280,000 a year, officials said.
Advocates for the mentally ill are asking county supervisors to spare the budget ax.
"To suddenly cut people off from treatment is tragic," said Jack Waldorf, a member of the county Mental Health Board. "(The MIA program) is not the ideal way to take care of these people, but in some cases it is the only way."
Waldorf said the issue is complicated. These patients would be better served by the county mental health department, but the department's resources are strained and its services typically are for Medi-Cal beneficiaries.
Many of the MIA patients with mental disorders live with relatives, are homeless or live in board and care homes. It's hard to get approved for Social Security disability benefits, and they aren't earning money to pay for medication, Waldorf said.
In a letter to county supervisors, Mental Health Board chairman Robert Angell said many of the patients will end up in emergency rooms or the psychiatric hospital if they can't get their medications. Others will be arrested and jailed for disorderly behavior.
The costs to law enforcement and county departments likely will exceed $280,000 a year, Angell wrote.
Mental health advocates are afraid patients will lose the serv-ices. The Health Services Agency is in the third year of efforts to reduce the agency's multimillion-dollar deficits and supervisors have approved most of the cuts brought before them.
Under the proposal, clinic physicians still would write prescriptions for minor conditions such as mild depression. They will try to accommodate patients needing treatment for a severe mental disorder and a physical health issue.
Another proposal would limit MIA program dental benefits to $1,000 a year. The board also could eliminate 10 full-time employee positions in the HSA.
The HSA began the 2007-08 fiscal year with a projected $17 million shortfall, which was adjusted to $12.6 million because of $4.4 million from the county's general fund. A federal designation that boosted Medi-Cal and Medicare reimbursements, coupled with efficiency improvements, reduced the shortfall by $8.4 million. The agency will need an additional $4.2 million from the county general fund to break even this year.
A public hearing on the cuts to MIA mental health services and dental benefits is at 6:35 p.m. today, in the board chambers, 1010 Tenth St., Modesto. Bee staff writer Ken Carlson can be reached firstname.lastname@example.org or 578-2321.