State looks at expanding inpatient care for mentally ill in Southern Nevada
Nevada officials are putting together a plan that could alleviate the crisis mentally ill patients are creating for Southern Nevada emergency rooms by making more psychiatric beds available in other facilities.
Mike Willden, director of the state’s Department of Health and Human Services, is planning to take the proposal to the Legislature’s Interim Finance Committee in June.
“We have two issues,” Willden said on Tuesday after Gov. Brian Sandoval’s Behavioral Health and Wellness Council met at the Sawyer Building. The council met Monday and Tuesday and is also working on possible solutions to the problem.
The first issue is expanding community triage centers for the mentally ill and the second is increasing the number of inpatient psychiatric beds at private hospitals. That would lessen the burden that valley emergency rooms face because a large number of their beds are taken by mentally ill patients that personnel are ill-equipped to treat. The problem forced several hospitals to close their doors to ambulances in February.
The proposal wouldn’t require new funding. Officials are trying to identify what existing money could be used for it in the current budget. The proposal could involve anywhere between $8 million and $10 million, Willden said.
WestCare, a nonprofit that offers mental health services, has a triage center that was built after Southern Nevada had a similar mental health crisis in 2004. The triage center has the capacity for 50 beds, but it’s currently only operating with 36 beds.
“Our goal is to get them up to 50,” Willden said. That is being examined as part of the proposal being worked out by state officials.
However, it has become evident that Las Vegas area needs about 100 triage beds, Willden said.
“We would want a second location (with another 50 beds) with WestCare or with a different provider,” he added.
Additionally, state officials are working with two or three private hospitals that are interested in opening a psychiatric wing and expanding the number of inpatient beds, Willden said. He couldn’t disclose the names of the hospitals because negotiations are ongoing.
“Private hospitals want to and have the ability to expand psychiatric beds,” he said.
But part of the negotiations is agreeing on a Medicaid reimbursement rate for the private hospitals and on how the ongoing costs for the additional triage beds will be covered. The state, the hospitals and the local jurisdiction currently each pay one-third of the cost for the WestCare triage center.
If the plan was to be approved by the Interim Finance Committee, the additional WestCare triage beds would become available almost immediately, Willden said. The rest of the beds would become available between 90 to 120 days after the approval.
“Anytime we can… divert those individuals in crisis away from the emergency room and detention, it’s a wonderful opportunity and intervention,” said Erin Kinard, Nevada area director for WestCare.
Kinard said Willden has communicated with WestCare about adding beds at the triage center.
Mary Woods, spokeswoman for the state’s Department of Health and Human Services, said no programs would be cut as a result of reallocating funding for the proposal. Officials are looking at where they have the flexibility to move funds around.
“The plan is to bring forward multiple funding options,” she said.
Joel Dvoskin, council chairman, at the end of the council’s meeting on Tuesday asked Willden to bring information about the proposal to share with the council at its April meeting.
After the meeting, Dvoskin said the council might endorse or disagree with some of the recommendations in Willden’s proposal.
“Some of these issues are really challenging to fix,” he said.
The council in April might begin to take action on recommendations that will go to Sandoval by May 31.
The council on Tuesday morning heard a presentation by a legislative subcommittee on health care on short-term solutions that could help with the crisis. Among the group’s recommendations was establishing mental health triage centers and replicating a program in San Diego that allows mental health workers to ride along with law enforcement and work with mentally ill patients in the field.
The program decreases the need for hospitalization and incarceration.
Cost estimates for the program with 10 mental health workers would be around $1.5 million, or $2.7 million for 23 mental health workers as San Diego has. The council didn’t act on any recommendations Tuesday.
There was also some discussion about targeting mentally ill patients who visit emergency rooms frequently.
Dr. Dale Carrison, University Medical Center’s chief of staff and head of emergency services, said it will take years to solve the problem, but targeting “frequent users” would have the most significant impact now.
“They are the low-hanging fruit,” he said.
Reporter Yesenia Amaro can be reached at yamaro@reviewjournal.com or 702-383-0440.
