Regrettable politics behind Nixon's ax

On June 24, state representative Kathy Swan received an email from a legislative liason regarding the fate of the Cottonwood Residential Treatment Center. The director of behavioral health was meeting with the Cottonwood Residential Treatment Center staff regarding the closure of that facility by the end of the year.

Swan asked the liason whether this was a result of the withholdings the governor had just made.

"This is part of the withhold," the liason wrote in the email, obtained by the Southeast Missourian. "The decision to close the facility will stand regardless of any changes to the state's fiscal health."

This email casts shadows about the motives of the executive branch.

Speaking publicly at an event in Cape Girardeau in mid-August about proposed cuts to the autism center here in Cape Girardeau, Gov. Jay Nixon's comments indicated the cuts were all about the money and the fiscal health of the state.

Because of Nixon's posturing that certain tax breaks for businesses would result in catastrophic consequences, he vetoed the bill and then ordered the department of mental health to slash $87 million.

"DMH would be forced to close both state-operated residential facilities for mentally disturbed children," Nixon said, "including the Cottonwood Center here in Cape."

So which is it? Is the decision to close a facility that helps mentally and emotionally disabled children a matter of fiscal health, as the governor has said publicly? Or is it a decision already made for other reasons, as indicated in the email to Swan?

Swan has been operating on the assumption that the governor's ax fell upon Cottonwood for fiscal reasons. Others within the executive branch, including MDH health director Keith Schafer, have indicated it's about the money as well.

So Swan and many others went to work, coming up with financial plans aimed at saving the institution.

As reported in the Southeast Missourian by staff writer Samantha Rinehart, Cottonwood is a 32-bed residential treament facility (the email from the liason reported it at 28) in Cape Girardeau. It is one of two remaining state mental-health facilities for children, serving patients between the ages of 6 and 17. The other is in St. Louis, which, according to Swan, is not on the chopping block, even though it costs more to the state than the Cape Girardeau facility.

By our measure, Gov. Jay Nixon is using the cuts in general, and Cottonwood specifically, as pawns to disuade a veto of a tax cut bill passed by the legislature.

Swan and others have worked up a proposal that greatly reduces the financial impact on the state. It's enlightening, or at least interesting, that the governor or the people under him didn't make the same attempt or try to work with legislators in the district to come up with a solution before deciding that Cottonwood needed to go. But this is Nixon's style of leadership. It's regrettable, albeit understandable, that the governor doesn't want to rub elbows with the legislative branch that holds Republican majorities; he tends to govern via news conferences and vetoes. But it is surprising and disappointing that the governor is not working harder at finding ways to save programs that help disabled children. To avoid political involvement is one thing. To avoid executive oversight and the work it takes to find solutions is something else entirely.

According to Rinehart's reporting, Swan and state Rep. Donna Lichtenegger of Jackson have worked with Cottonwood staff on a plan that seeks to increase revenue and decrease costs so the facility can remain open. Swan presented the plan Wednesday morning at a House appropriations committee meeting, and was joined by more than 15 staff members, supporters and parents of children who have received help from Cottonwood. Lichtenegger is a member of the committee.

The numbers are a bit complicated, and Swan is still asking questions about funding mechanisms and how dollars are allocated. The state has had access to the new plan for more than two weeks, and thus far the state has not disputed Swan's figures.

In general terms, loosening restrictions on who can qualify for services will help generate revenue. According to local officials, certain restrictions put in place in recent years have made it harder for children to qualify for services, and as a result, the center's occupancy numbers have dropped far from capacity. Under the newer requirements, children in the northern part of the state aren't eligible unless they have a mental health diagnosis and meet a low IQ threshhold. The state is disputing whether the referral policy has changed at all.

By readjusting requirements and allowing more children to qualify, revenue could considerably close the gap in the dollars the state loses. In fact, when Swan and others began running the numbers they found that some of Cottonwood's costs -- such as fringe benefits and lease contracts -- aren't applied to the DMH, but to other areas of government.

In an Aug. 20 conference call, Swan said the director of the state mental health department offered to support the plan if it was proved to be financially effective. Swan's latest calculations, based on more referrals and medicaid contributions to the state, the facility could run in the black from a state perspective.

The governor can and should be credited for spurring the conversation to make Cottonwood more efficient.

Cottonwood should certainly not be a consideration as lawmakers decide on whether to override the governor's veto on tax cuts. Regardless of the veto voting this week, the governor should reinstate Cottonwood.

To shut down the facility would show the Democratic governor to have put his political agenda above what's best for all Missourians, but specifically children (and families) who are struggling with mental illness and disabilities.

One can only imagine the attack ads that would be hurled in Nixon's direction during his next political quest, whatever that might be. How odd it would be if the Democratic governor were to shut down a last-resort mental health facility for kids when it made no economic sense to do so.