Mental health efforts win with tobacco tax

LAWMAKERS who are uncomfortable with the idea of boosting Oklahoma’s tobacco tax by $1.50 per pack should consider one area that would benefit as a result of the increase: the state’s mental health agency.

The tax increase, requested by Gov. Mary Fallin, would generate roughly $185 million per year. A taxincrease bill being considered (but so far not acted upon) at the Legislature calls for giving 28 percent of that total, or about $50 million, to the Department of Mental Health and Substance Abuse Services.

This is an agency whose services are needed to help keep Oklahoma’s jail and prison population from growing at an even faster rate than it already does. But its state appropriation was reduced by about $20 million last year, which when paired with the loss of federal matching funds meant that 73,000 Oklahomans received fewer services than the previous year.

That’s important, because those who wind up using the state mental health system generally are low-income Oklahomans who have few if any private options for care, and who without treatment can wind up in the criminal justice system.

If the tobacco tax were approved and $50 million went to the DMHSAS, Commissioner Terri White would use $5.8 million to cover the state’s Medicaid match. Without that match, cuts in services will result.

White would use another $20 million to restore the services lost as a result of last year’s appropriation, which led to provider rate cuts averaging 13.5 percent, and thus a reduction in therapy treatment. The remainder of the tobacco tax revenue would go to provide additional drug court and mental health court services across the state. Sixteen counties have mental health courts, but more are needed.

Why? Data provided by White’s agency makes the answer abundantly clear.

The Department of Corrections estimates that four out of every five people who enter its system need mental health or substance abuse treatment. It costs $19,000 per year to incarcerate a person, and $23,000 per year if the person has a severe mental illness. Meantime, it costs the state $2,000 annually for a person to receive DMHSAS treatment, $5,000 per year for drug court and $5,400 per year for mental health court.

Three years after graduating, only 7.9 percent of drug court participants have wound up back behind bars, compared with 23.4 percent for those inmates released from prison. The large majority of drug court graduates find jobs, come off the Medicaid rolls and are able to reunite with their children.

“Not only is this an inexpensive investment, but these things actually work,” White says.

Last year’s provider rate cuts led two providers to end their work with the agency. White fears a flat budget this year would mean further provider rate cuts, and the potential for cuts to already-full crisis centers, drug courts and mental health courts.

Approval of the governor’s tobacco tax proposal, which enjoys broad public support in polling, would help drive down the smoking rate in Oklahoma and thus improve the state’s general health. But it also would keep White from having to take steps that would harm her agency’s vitally important — and effective — work in the mental health arena.