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Eye On Boise

Proposed community ‘crisis centers’ would try to keep mentally ill from landing in jails, emergency rooms

Legislative budget writers held hearings this morning on mental health services through the state Department of Health & Welfare, as they continued a week of budget hearings on health and human services programs. Taking center stage: A proposal from Gov. Butch Otter to establish crisis centers for the mentally ill in three Idaho cities, with plans to expand eventually to seven; the idea is to help people who otherwise face incarceration or other costly measures that don't help resolve their problems. Law enforcement officers increasingly are answering calls involving people with mental illness, H&W division administrator Ross Edmunds told the Joint Finance-Appropriations Committee. "Their intervention is, by and large, jail and emergency room care, hospital care." He said the hope is that the community crisis centers will serve as a "gateway" to the care those patients really need.

"I hope what we can do is through this pilot, demonstrate to you the effectiveness of this model," Edmunds told legislative budget writers, "that we are actually going to save our state money, we are going to save resources by utilizing this model." AP reporter Katie Terhune reports that the crisis centers are modeled after a Billings, Mont. facility that officials say has proven itself a success since opening in 2006; click below for her full report. Said Edmunds, "We don't want to criminalize mental illness."


Crisis centers could help Idaho's mentally ill
By KATIE TERHUNE, Associated Press

BOISE, Idaho (AP) — Idaho lawmakers considered a proposal Wednesday that would establish a trio of crisis centers as a safety net to treat at-risk mentally ill people whose symptoms often land them in hospitals or jail.

The head of the state's Health and Welfare Department behavioral health division presented the plan to the Joint Finance-Appropriations Committee, which represents the proposal's first hurdle.

"We don't want to criminalize mental illness," said Ross Edmunds, the agency's administrator. At these proposed centers, he added, staffers "take the steps to reduce the risks that cause crisis."

Gov. C.L. "Butch" Otter says such centers are a cheaper, more effective way of getting people the help they need, and made the proposed facilities a high priority for state lawmakers when he raised the idea in his State of the State address that began the legislative session last week.

"Routinely in Idaho, people with any combination of mental health and substance abuse issues are taken to local emergency rooms or county jails when their condition or behavior puts them or others at risk," Otter said in his speech.

Planned for Boise, Idaho Falls and Coeur d'Alene, the crisis centers are largely patterned after a Billings, Mont., facility that officials say has proven itself a success since opening in 2006.

Otter wants the proposed Idaho centers to function similarly, specializing in short-term mental health and substance abuse treatment. He's asking lawmakers to approve $5.1 million to establish and staff the facilities.

The proposal is in its earliest stages, but state Rep. Fred Wood, a Burley Republican who is chairman of the House Health and Welfare Committee, said he thinks the bill has enough support to advance.

The Community Crisis Center in Billings aims to quickly stabilize less severe patients, who can stay up to 24 hours. The 20-bed facility can provide a safe place to sleep, a warm meal and clean clothes. And facility staffers help connect patients with counselors to improve long-term care.

During the facility's first year, only one-third of patients came in on their own, said program director MarCee Neary. The rest were transferred from hospitals or picked up by police. Today, half those treated at the center come in by themselves.

Supporters say there is a clear need. The number of people in crisis taken to Idaho's ERs is trending steadily upward, with police bringing in about 4,600 patients in fiscal year 2012, up from about 4,000 in fiscal year 2010.

The numbers for fiscal year 2014 are projected to hit nearly 5,200.

Since fiscal year 2008, at the start of the recession, Idaho spending on mental health services for adults has dropped from nearly $25 million to an estimated $20 million this year.

House Minority Leader John Rusche, D-Lewiston, a physician and former health insurance executive, said these cuts have set back Idaho's progress toward establishing a broad system of addressing the state's mentally ill population.

These new crisis centers will be a welcome addition, Rusche said, while insisting they aren't the final answer.

"They're adding services that will probably be quite helpful to police and emergency rooms," he said. "But it doesn't take the place of a mental health system."

Both he and Kathie Garrett, a board member for the National Alliance on Mental Illness in Idaho, would ideally like to see Idaho expand eligibility for Medicaid to cover more low-income people, since that government-supported health care program would provide a broader range of mental health services for people in need.

The expansion was pushed by President Barack Obama in his 2010 health care overhaul and would cover an additional 54,000 Idaho adults, many of them suffering from mental health problems.

Since Otter has so far declined the expansion offer, however, Garrett's group sees these crisis centers as an initial step, focused on three of the state's urban centers, to provide immediate help.

"It's a model to help people reduce their symptoms, get a little better control and then signing them up to go see a doctor or to a mental health clinic later," said Garrett, a former Republican legislator from Boise. "In a state where we have so many needs, this is one way we'll have some ability to help people in crisis, but also relieve strain on some of our other services: Our emergency rooms, our jails and our prisons."

Among the hurdles she worries about overcoming: Since the crisis centers are planned for Idaho Falls, Coeur d'Alene and Boise, Garrett says one challenge will be convincing lawmakers from other, more rural areas to back them if they see no concrete benefit for their own community.

Rep. Jeff Thompson, R-Idaho Falls and a budget committee member, says he thinks rural legislators will come around. He's optimistic funding for the centers will succeed this session.

"This is a new program that needs to be where the majority of the population is," he said. "And we can eventually branch out from there."


Copyright 2014 The Associated Press

Betsy Z. Russell
Betsy Z. Russell joined The Spokesman-Review in 1991. She currently is a reporter in the Boise Bureau covering Idaho state government and politics, and other news from Idaho's state capital.

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