More than two years ago, York-Adams Mental Health/Mental Retardation opened an extended acute-care center in North York.

The 16-bed center was designed as an intensive treatment facility where adults could stay for several months as they dealt with mental illness. Experts considered a community setting better than a sterile hospital for patients’ long-term health.

The county would pay for patients who are not covered by health insurance or who do not qualify for medical assistance to stay at the center.

But since the beginning of the year, county mental health officials have not been able to refer those patients to the center because of a tight budget, said Steve Warren, Mental Health/Mental Retardation administrator.

York-Adams Mental Health/Mental Retardation allocated $300,000 for unfunded patients to stay at the center during the 2008-2009 fiscal year, which runs through June 30, Warren said.

By the end of December, the program had already spent $259,000, Warren said, because more of the people who needed to stay there were not covered by private insurance or they earned too much money to qualify for medical assistance. Medicare does not pay for the service.

As a result, new patients without alternate funding are being sent to Wernersville State Hospital. If Wernersville is full, Warren said, patients will have to wait in crisis units, such as the one at York Hospital, until a bed opens up in Wernersville.

The remaining money will be used to cover costs for the three medical assistance patients still at the center who were admitted before Dec. 31, Warren said.

The changes in admission policy at the extended acute care center are just one example of how budget cuts are straining the mental health system. As lawmakers look to the 2009-2010 budget, things do not appear to be getting better.

“Things this year are extremely tight,” Warren said, “tighter than I’ve ever seen them.”

Mental Health/Mental Retardation receives most of its money from the state.

In October, the agency requested an additional $820,000 for the current fiscal year to pay for several programs including the center in North York, Warren said. Of that, Warren said, the agency will receive $300,000 for its long-term structured residence in Heidelberg Township, which was built in conjunction with the extended acute care center.

In December, the agency’s general allocation for the year was cut by $93,000 because of a decline in state tax revenue. To fill the hole, Warren said, the agency had to empty its $25,000 emergency fund and eliminate an administrative position.

It costs the county $400 a day for a person without alternate funding to stay at the extended acute care center, Warren said. If the same person stays for 120 days — the type of stay the center was designed for — it costs the county almost $50,000.

The agency might try to shift more money to the center next year, but that would require a cut somewhere else, Warren said.

“We may have to look at shifting where our funding priorities are,” Warren said.

But Gov. Ed Rendell’s budget proposal for the 2009-2010 fiscal year calls for a 2 percent cut in the agency’s funding, Warren said. If that passes, he’s not sure where the money would come from.

These cuts come as mental health experts are seeing more people, in some cases due to stress brought on by the crumbling economy, said Rose Alberghini, president of the York County chapter of the National Alliance for the Mentally Ill.

“We’re in a bad spot, let’s put it that way,” Alberghini said. “When the economy is bad and the budget is bad in the state, mental health programs don’t seem to be that important.

“Services were lacking to begin with because the resources were inadequate, but with the budget, they could get worse.”

WARM LINE

Mental Health America of York/Adams Counties is operating Warm Line, a telephone support service providing confidential and empathetic listening and support, and offering referrals as needed.

Warm Line is designed for people to call when they feel sad, frightened, worried, overwhelmed, don’t know where to turn, don’t know what to do next, or just feel they need to talk. The idea is to help find a solution before the point of crisis.

The line is staffed from 5 p.m. to 9 p.m., Monday to Friday at 718-7711 or (866) 697-0001. Staffers will also check the e-mails sent to warmline@mhay.org