New revenue sources should be considered to fill the state’s$715 million budget shortfall instead of deep, far-reaching cuts toprograms and services, said the state mental health department’schief administrator.

Mississippi Department of Mental Health Executive Director EdLeGrand told The DAILY LEADER editorial board Tuesday he and otherstate officials have discussed another tobacco tax increase and thecreation of a statewide lottery to bring in new money for Medicaid,education or other fund-thirsty agencies. The new revenue sourceswould help alleviate pending budget cuts that, for mental health,would eliminate jobs and expel patients if programs and facilitiesare closed, he said.

“I think it’s a combination of maximizing our revenue andtightening our belts until we meet in the middle,” LeGrand said. “Idon’t expect it to be fun.”

LeGrand’s consideration of new taxes and a lottery comes afterGov. Haley Barbour’s suggestion last month that 10 mental healthfacilities around the state, including two in Brookhaven, be closedto save close to $30 million over the next two years. Barbour’sexecutive budget recommendations left no state agency untouched,especially DMH, its approximately 8,800 employees and more than$660 million annual budget.

But DMH is taking to steps to ensure its facilities’ survival,LeGrand said. He said the department has spoken with the governor’soffice and the leadership in the House and Senate about thenecessity of the targeted facilities, the closure of any one ofwhich would leave mental health patients without treatmentoptions.

“We’re going to ask them not to sign an appropriations bill thatwould require us to close any mental health facilities,” LeGrandsaid. “

Brookhaven would be especially hard hit if the governor’s budgetrecommendations are carried out, losing 120 jobs with the loss ofthe Brookhaven Crisis Intervention Center and the MississippiAdolescent Center.

LeGrand said the local facilities – especially MAC – always comeup in facility closure talks because the vast majority of theirfunds come straight from the state, with neither able to draw downMedicaid or other forms of reimbursement. Ninety-nine percent ofMAC’s $4.9 million budget is drawn from state funds, while almost79 percent of the Brookhaven CIC is funded by Mississippi.

“The general fund dollars are where the governor and theLegislature are required to make some decisions,” LeGrand said.”Once you’ve given education 64 cents on the dollar, you’ve onlygot 36 cents left over for anyone who is a state agency.”

If cuts to DMH force the closure of the Brookhaven facilities,LeGrand said DMH would work “hand in glove” with Brookhaven andgovernment officials to find alternative uses for the property.

“I think our agency will remember what a good partner Brookhavenand Lincoln County was in locating these facilities,” he said. “Thetown and county rolled out the red carpet for our department.”

DMH cannot afford to lose either local facility.

Bo Chastain, director of the Mississippi State Hospital andoverseer of the Brookhaven CIC, said 464 patients have been treatedin the Brookhaven crisis center since it opened two years ago thisweek. The patients have come from every county in SouthwestMississippi’s regional mental health center and from eight othercounties. He said a patient’s average length of stay is 19.1 days,and the waiting period for entry into the state hospital is twodays.

Chastain said DMH is hoping to reproduce the pilot program underway at the Grenada CIC, which is being operated under contract byRegion Six Community Mental Health Centers.

Since the region took over the Grenada CIC – the only crisiscenter not recommended for closure in the governor’s budgetrecommendations – three months ago, the facility has served 86patients, on pace for 344 per year. Patients’ average length ofstay at that facility is 11 days, and 86 percent of them are beingreleased into a less restrictive environment instead of beingcommitted to a larger facility like the state hospital.

“We need to replicate this in other areas,” Chastain said.

As for MAC, LeGrand pointed out the Legislature last yearremoved requirements that the facility’s juvenile patients have tohave been in legal trouble before admittance.

The new rules should allow MAC to play a greater role in youthmental health care, he said. Likewise, DMH continues to work withstate and federal officials to obtain Medicaid reimbursements forservices at the facility.

LeGrand also took time to rebut local state board member JohnnyPerkins’ call for closing DMH’s two large nursing homes at thestate hospital. The two homes have a combined capacity of 644 bedsand cost the state $8 million per year in Medicaid matching dollarsto operate. The bulk of the $50 million annual cost to operate thenursing homes is paid by Medicaid.

Closing the facilities would only shift the cost to Medicaid andnot save the state money, LeGrand said. Furthermore, most of thenursing home patients have a more severe disability and have beenturned down by private sector institutions, he said.

“There’s probably some merit in Perkins’ stating those nursinghomes would be outside our scope of responsibility, but I’ve beenwith DMH for 30 years, and I don’t remember those nursing homes notbeing there,” he said. “It gets down to when you inherit something,it is within the scope of your responsibilities.”

Conversely, LeGrand said patients applying for treatment inDMH’s nursing homes do not have to have a mental condition and canbe private pay patients.

“I’ll be the first one to say it is not our intention to openany more, but we have to take care of what we have,” he said.