With eyes on the Obama and McCain campaigns, it's easy to lose sight of the decisions local voters will be making next week about funding mental health programs. For those deprived of services in Youngstown, Ohio, or St. Louis, Missouri, the outcome might be as important as the next occupant of the White House.

Local elections will be important for children and many of their parents as a result of issues such as SCHIP where Bush administration policies have endangered too many children without access to needed services. To their credit, many states have taken up the slack. Stateline.org reports that Montana is asking voters "whether to include more uninsured kids under the state's Children's Health Insurance Program."

In addition, those in Colorado "will decide whether to require businesses with more than 20 workers to provide health insurance. In Arizona, the 'Freedom of Choice in Health Care' initiative takes the opposite approach and would prohibit state lawmakers from passing legislation that would require Arizonans to join a government-run health care system." It is being discussed and came to the attention of national columnists such as George F. Will.

In Mass., decisions about abolishing the state income tax, Question 1, will have a direct impact on the budget which Gov. Deval Patrick has already slashed for social services and mental health.

California voters will be deciding whether to to pump money into drug treatment services by renewing the Nonviolent Offender Rehab Act, Prop 36. The estimated outlay is $120 million for services through courts. It is estimated to save the state $2.50 for every dollar spent - nearly twice that for those who successfully complete the program, reports the Sacramento Bee.

Ohio's voters will be voting support for local programs through local property tax levies. In Youngstown, "Issue 7" is a 0.85 mill tax to underwrite services including $42,000 for a hot-line that fields 1000,000 calls a year.

A measure in St. Louis, Missouri, is on the Nov. 4l ballot to raise $40 million to cover services for 12,000 kids. Funding would come from levying a quarter-cent sales tax.

Current fiscal crisis affects programs
Many of the local initiatives take on greater urgency as a result of the budget crisis sweeping state houses. The Center on Budget and Policy Priorities reports local budget deficits threatens insurance in 17 states.

"Nevada's governor has capped the state's SCHIP program at its approximate current number of enrollees and increased the premiums that families must pay. As a result, many applicants will be denied coverage, even though the economy is weakening and need consequently is rising. Health services for some pregnant women have also been eliminated.

Arizona has cut funding for community health centers, and California will shear the "SCHIP program, including increasing co-payments and reductions in dental services. The state will also require more frequent eligibility determinations for Medi-Cal recipients and is cutting payments to health care providers significantly through February of next year."

A coalition of state and local organizations has written to congressional leaders asking for an increase in the Federal Medical Assistance Program which underwrites Medicaid. They request help off-set the $26 billion shortfall expected by more than two dozen states.

It's nearly impossible not to be caught up in the national election this year. But for those needing services to treat a mental illness or substance use condition, local initiatives can be critical.