[Vision2020] Fwd: Mental Health in central Idaho

Wed Jan 16 11:50:54 PST 2013

I would agree with you on this. The cuts in Mental Health was probably the worst thing The Reagan Administration did. More effort needs to be done in this area. One should be carefull though not to go over board and lock up people that are a little strange but pose no harm to any one. There is also the problem of those that appear normal in all respects but then go over the edge. When I worked for Coast Trading in Spokane, we had a vary good guy there that was also an excellent employee. One day he though he was back in Veitnam and started shooting at everything that moved from his apartment. There is no system that is just and full proof.
Roger

-----Original Message-----
Subject: [Vision2020] Fwd: Mental Health in central Idaho
From: "Darrell Keim" 
To: vision2020 at moscow.com
Date: 01/15/13 23:12:12

 Visioneers: We are now about 1 month past the shootings at Sandy Hook elementary.  Predictably, there has been discussion of gun control.  It takes a human being to pull a trigger.  I believe cuts we have continually made to our national mental health system since the Reagan era are the primary culprit.  What I couldn't mention at the time of the shooting was that I had seen a draft survey of how mental health state budget cuts made in FY2011 have impacted us in central Idaho.  This survey shows the direct impact of lowered funding of mental health treatment.  It indicates funding mental health saves us money in more expensive areas.  I believe this same relationship holds for the national picture. The survey is now officially out.  I have copied it for your perusal below.  Copies are also going to legislators.   Survey conducted by members of the Idaho Region 2 Mental Health
Board.  Its purpose was to see what impact 20011 cuts to the states mental health budget have had in our local area.   Looks like that 2011 budget cut cost us a lot of money! Without further comment: LEGISLATIVE IMPACT SURVEY - FY 2012Purpose of the research:  To identify needs and gaps in the delivery of behavioral health services to Region II. Follow up research to Fiscal Year (FY) 2011 Legislative Impact SurveyParticipants: County Prosecutors; Law Enforcement; Private Behavioral Health Providers; County Health and Welfare Directors; Region II - Director of Health and Welfare; School Counselors, School Social Workers, School Psychologists; and Hospitals.
·        Total Surveys completed - 28Increasing number of individual requiring behavioral health services·        Region II - Health and Welfareo   Crisis Response - Children §  FY 2010 -- 35 incidents§  FY 2011 - 28 incidents§  FY2012  - 38 incidentso   Crisis Response - Adults§  FY 2010 - 265 incidents§  FY 2011 - 274 incidents§  FY 2012 - 340 incidentso   Hospitalizations - Mental Health Holds§  FY 2010 - 25 days §  FY 2011-   47 days§  FY 2012 - 105 dayso   Cost of Hospitalizations§  FY 2010 - $27,175§  FY 2011 - $53,295§  FY 2012--  $112,700o   Clients with Substance Abuse Disorders§  FY 2010 - 585 individuals§  FY 2011 - 903 individuals§  FY 2012 -- 958 individual·        County Prosecutorso   Number of defendants with mental health and/or substance abuse involvement§  Increasing over last three years in 3 jurisdictions§ 
15-30%  of defendants have mental health issues§  30-80% of defendants have substance abuse issues§  These cases require more time, money and resources§  Individuals  more likely to be incarceratedo   Resources§  Increasingly fewer options and fewer volunteers since 2009§  Defendants unable to access services due to inability to afford and/or lack of transportation§  Loss of ACT Team in one community increased number of crises and reduced general level of  functioning of individuals·        Law Enforcemento   Mental Health Holds and Transports§  Between 2010 & 2011 number of holds and transports almost doubled in one jurisdiction - 31 to 59 respectively§  Between 2010 & 2012 in same jurisdiction number of suicide attempts also increased from 34 to 62 incidents. Each incident requires 2 to 5 hours of staff  timeo   Indirect Costs§  Removing officers from
area§  Calling in off-duty officers§  Fuel costs to transport·        Private Medicaid Providerso   Medicaid Client Served§  Agency 1·        2010 - 157 individuals·        2011 - 121 individuals·        2012 - 106 individuals·        Served by 12 clinicians§  Agency 2·        2010 - 60 individuals·        2011 - 60 individuals·        2012 - 100 individuals·        Served by 4 clinicianso   Neither agency would continue to serve Medicaid clients if  agencies required to complete accreditation requirements due to costo   Reasons for continued services for Medicaid clients§  Idaho's rural residence deserved care§  Medicaid is often only way rural clients can receive serviceso   Experience as Medicaid contractor§  Reimbursement rate 55% below standard hourly rate & 50% below insurance reimbursement rate§  Rules not readily announced and
interpretations may be subjectiveo   What is working§  State of Idaho pays bills on time§  Overall coverage of services for psychotherapy and testing goodo   Perceived needs and gaps§  Testing·        Reimbursement too low·        Waiting list extraordinarily long§  Compensation·        No  reimbursement for collateral contacts, case reviews or paperwork§  Privatization·        Will not improve services·        Will increase cost and reduce services·        Will be fewer Medicaid providers§  Excessive rules and regulations cost businesses more and reduce patient care·        Streamline for more efficient  care·        Reduce number of rules and regulations§  Physician supervision added expense·        Make use of client's primary care provider·        Hospitalso   Emergency Room Visits - Mental Health §  2010 - 1532 visits§  2011 -
1649 visitso   Emergency Room Visits - Substance Abuse Disorders§  2010 - 160 visits§  2011 - 158 visitso   Hospital Admissions - Mental Health §  2010 -  499§  2011 -  529o   Hospital Admission - Substance Abuse Disorders§  2010--  242 §  2011 - 272o   Indigent Costs for  Mental Health and Substance Abuse Disorders§  2010 - $672,296§  2011-  $877,190·        County Health and Welfare Directorso   Cost of Mental Health Holds in one county§  2010 - $51,008§  2011 - $84,923Need for school-based behavioral health services·        Number of children with mental health diagnoses has increase from the 2010-2011 school year to 2012-13 school year·        87% of respondents indicated that community mental health services are less than adequate·        Services needed o   More community based services (73% of  respondents)§  Additional staffing for
community based mental health services o   Availability and accessibility of community services particularly for low income familieso   Child psychiatrist who will communicate with schools (87%)o   School -based mental health and PSR services (60%)Eleanor Pepi Downey, MSW, PhDDiana Pals, LCPC, M.Ed.  NOTICE:  THIS ELECTRONIC MESSAGE TRANSMISSION CONTAINS INFORMATION WHICH MAY BE CONFIDENTIAL OR PRIVILEGED.  THE INFORMATION IS INTENDED ONLY FOR THE USE OF THE INDIVIDUAL(S) OR ENTITY(IES) NAMED ABOVE.  IF YOU ARE NOT THE INTENDED RECIPIENT, PLEASE BE AWARE THAT ANY DISCLOSURE, COPYING, DISTRIBUTION, OR USE OF THE CONTENTS OF THIS INFORMATION IS PROHIBITED.  IF YOU HAVE RECEIVED THIS ELECTRONIC TRANSMISSION IN ERROR, PLEASE IMMEDIATELY NOTIFY THE SENDER AND DELETE THE COPY YOU RECEIVED. 
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