The acting director of Nevada's rural mental health clinics said Thursday that budget cuts would mean only one pschologist would serve all of the clinics.

Although there are no plans to close the State of Nevada Mental Health Center in Ely, their only pschologist faces layoff in July 2009 because of budget cuts.

“We are in an extremely poor situation fiscally due to revenue shortfalls,” Sueann Bawden said, explaining that the agency hoped to provide the best services possible with diminishing financial resources.

Bawden explained the crisis during an afternoon public meeting, held at the Ely district BLM office.

The meeting was the 11th of 19 held in rural communities across the state to assure the communities that services would continue with changes.

Jill Atkinson, the staff psychologist at the Ely clinic, is one of 11 slated to lose her job on July 1, 2009. The statewide mental health services distribution system will retain just one of the 12 psychologist positions. That individual will travel between all the rural clinics.

The agency currently spends about $2.5 million annually for 12 psychologists.

With budget cuts handed down from Carson City totaling 14.25 percent for the Fiscal Year 2009 and 2010 budgets, all state agencies and school districts are forced to make deep cuts following recent state revenue shortfalls due to declining gaming revenues statewide and Gov. Jim Gibbons determination to retain a balanced budget.

Bawden also presented a new business model for the agency.

She said she wanted to convey the message that input was sought from the local clinic's patients and mental health professionals from White Pine, Eureka and Lincoln counties who were at the meeting. “We also want to know what our partners, our stakeholders in the community have to say,” she said.

Bawden said a survey has indicated that the biggest concern is that the ability to access children's services continue.

She noted the agency has reduced 21 mental health center sites across the state in April to a current total of 19 by consolidating services in several communities in the Sierra region in the western part of the state.

Seventy-one percent of the population served in Nevada live in Clark County followed by 16 percent in Washoe County. Just 13 percent of clients live in the remaining counties.

Bawden said there could be an increased use of telepsychiatry where psychiatrists in urban areas talk to patients in rural communities.

The agency has reported a 42-percent, statewide employee turnover rate due to what the agency called stressful working conditions. One person, speaking in support of the Ely clinic retaining Atkinson, said the turnover rate for psychologists is lower than for other positions, raising the question that it could be more costly to train people frequently for lower paying positions.

Bawden said the agency could use the current situation as an opportunity to improve by decreasing psychiatric hospitalizations and waiting times.

She also presented the hub-and-spoke model, with Ely serving as a hub with Eureka and Caliente being spokes. Services in those communities would be provided by the Ely center. Services in Caliente are currently provided from Mesquite.

Mark Costa was one of four representatives of Rural Clinics Community Mental Health Centers who made the trip to Ely from Carson City. He presented a precarious picture of the fiscal outlook.

Costa said 15 percent of the agency's funding comes from federal sources. As the federal deficit worsens so does the unemployment rate and the need for additional mental health services. The federal deficit is estimated to climb from $162 billion in 2007 to $482 billion in 2009.

The Fiscal Year 2009 budget for Nevada's rural clinics was originally over $18 million and is now decreased to about $17 million. Costa said the FY 2010 budget is now expected to be about $15.6 million.

There is a possibility that personnel cuts across the state could reach 20 percent. He said the agency has frozen 14 open positions throughout the state. In addition, Nevada's rural clinics could lose 38.79 positions statewide in 2010. What Costa called a “silver lining” is that there is a potential gain of seven new case management and rehabilitation positions.

“Unfortunately, in some other agencies, the layoff procedure has already started,” Costa said.