Sonoma County health department officials are considering closing inpatient alcohol and drug rehabilitation programs as part of a larger cost-cutting effort.

On the target list is the 20-bed residential program at the county's Orenda Center in southeast Santa Rosa where drug and alcohol abusers can stay for a month during recovery.

The proposal comes at a time when other health care providers such as St. Joseph Health Systems are also closing inpatient facilities for similar cost-cutting reasons.

``It is evident that existing revenue streams cannot sustain the current level of programs and services,'' health services director Rita Scardaci said in a letter that went out this week to dozens of community agencies that the county contracts for patient referrals. ``Reductions will need to be made to programs and contracts.''

The proposals are prompted by the prospect of declining funds from county, state and federal government revenue.

County officials said they may look to nonprofit agencies such as the Drug Abuse Alternatives Center to contract for placement of clients if closure of Orenda Center facilities is approved by county supervisors.

Sonoma County spent about $19 million on alcohol and drug services last fiscal year, much of it in seven programs that operate out of the Orenda Center at 1430 Neotomas Ave. Referrals to the Orenda Center often come from court drug and alcohol diversion programs.

Scardaci warned Monday that cuts at the Orenda Center may be the first of many public health programs that could be affected as county officials cope with reduced revenues from local property taxes, the governor's proposals for cutting health and human services and declining federal reimbursements.

Word of possible program cuts at the Orenda Center spread late last week as health officials began talking with employees and union officials about the impact of budget cuts. Scardaci denied reports that Orenda Center would close altogether.

Scardaci said health officials were in the midst of formulating proposals for health service cuts that are tentatively scheduled for presentation to county supervisors on March 18.

``We want to be transparent in this process of looking at programs that can be downsized,'' Scardaci said. ``As yet, we have not picked the programs.''

County administrator Bob Deis said county-operated health and human services likely will suffer the biggest program cuts because so much of their budgets come from revenue sources affected by the economic downturn.

For example, half of the county's $213 million expenditure on health services comes from federal and state governments, a third from a share of the state sales tax and vehicle license fees, and about 10 percent from the county general fund over which county supervisors have discretion.

Scardaci said none of the funding sources have kept pace with program costs and all are predicted to decline over the next three years.

She said the governor's proposals are likely to push county officials to trim programs by $2.5 million to $3 million, with cuts being implemented as early as July 1.

Deis said funding, mostly from the state, for alcohol and drug rehabilitation programs has been flat in recent years, making programs such as those at the Orenda Center a likely target for reduced funding or elimination. Figures were not available Monday on how much could be saved by closing the Orenda Center inpatient program.

Emphasis on community-based treatment, usually in the form of counseling or short-term residency in a facility, is prompting county health officials to reconsider whether maintaining taxpayer-supported institutional treatment programs is viable in the long run, he said.

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BYLINE: BLEYS W. ROSE
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