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Monday, July 31, 2017

It is time to make changes

Blogger Comments:  The mental health cuts within the State of Alabama have caused tremendous suffering within the the state.  The Morgan County sheriff has helped to exacerbate the local mental health problem in our county by claiming she has a 24X7 mental health ward with qualified personnel equipped to care for the inmates.  Another lie.  Franklin's first initiative upon receiving the mentally ill inmates was to take away their doctor prescribed medications which compounds the problems with incarcerated inmates.  Many of the mentally ill inmates without their medications cannot assist in their own defense when they get to court.  One inmate in particular spent almost two years in jail.  The inmate has recently been sent to Taylor Hardin for treatment.

Long blasts state over mental health cuts

  • By Evan Belanger Staff Writer
  • Updated 
County Commission Chairman Ray Long complained last week that state cuts to mental health care constitute an "unfunded mandate" that is forcing the county to spend tens of thousands of dollars annually.
“The state has continuously, every year, cut mental health funds,” he said. “They live in a world that is different from ours. They pretend that there are no issues in mental health, but we all know that mental health is just as great a problem today as it was 10 years ago.”
Long made the comment during a presentation for his proposed fiscal 2018 budget. The proposal projects a 3.4 percent decline in county revenue and calls for a 4.5 percent cut in spending, including $108,250 from a dozen local nonprofit agencies.
Despite the cuts, it projects a shortfall of nearly $100,000. Long pointed out the county’s spending on mental health care for indigent residents had climbed from nothing in 2008 to $89,522 in 2016.
As of June, the county had spent $55,304 for fiscal 2017, which ends Sept. 30. Long proposed including $50,000 for indigent mental health care in the fiscal 2018 budget.
He said he is hopeful state officials will realize they should never have closed some state-run mental health facilities, such as North Alabama Regional Hospital in Decatur.
The 74-bed facility shuttered in 2015.
“In a sense, what the Legislature is doing is an unfunded mandate,” Long said. “They’re making the counties pick up the tab, but they’re offering no resources to help pay for it.”
Morgan County Probate Judge Greg Cain acknowledged the closure of North Alabama Regional had caused the county’s mental health expenses to “skyrocket.”
The problem, he said, is that there aren’t enough state beds available since the state pared down its facilities to the 268-bed Bryce Hospital in Tuscaloosa and a host of small contracted facilities with 16 beds each.
At one time, if he committed a person to the state hospital because they were a danger to themselves or others, they would be at North Alabama Regional by the end of the day.
Now, if there’s not a state bed available, the county has to send them to Decatur Morgan West until a state bed is available.
If the patient doesn’t have health insurance, Medicare or Medicaid, the county picks up the bill, paying the hospital Medicaid rates, Cain said.
“In the last two years, we’ve actually seen people have to stay at Decatur Morgan West two or three weeks waiting on placement in the state hospital, and the state says we are responsible for that, even though they’re waiting for placement in the state hospital,” Cain said.
The arrangement is also tying up law-enforcement resources, he said, because sheriff’s deputies must take the committed person to the emergency room at Decatur Morgan Hospital’s Parkway Campus to be medically cleared before they can be admitted to Decatur Morgan West.
“It has not been out of place for them to be there five to seven hours waiting on that person to get medical clearance,” Cain said.
Sen. Arthur Orr, R-Decatur, said North Alabama Regional and other large facilities closed, in part, due to pressure from the U.S. Justice Department for the state to stop warehousing the mentally ill in large facilities, encouraging them to switch to small, 16-bed crisis centers that are embedded within communities.
While grant funding was available to help pay for the centers, no such endeavors were undertaken in Morgan, Lawrence or Limestone counties, Orr said.
“I am not an expert in the mental health arena, but this area missed an opportunity to secure funding for establishing its own 16-bed crisis centers that would take a lot of these individuals,” Orr said. “Now we have to rely on other areas to take those that need mental health care, or the commission pays for it at Decatur General West. In sum, we lost our ability to control our destiny.”
Cain said Morgan County relies on crisis centers in Cullman, Huntsville, Anniston and Jasper.
The Mental Health Center of North Central Alabama, a private nonprofit that is contracted by the state to provide mental health intervention services in Morgan, Lawrence and Limestone counties, did not pursue crisis centers due to costs, Executive Director Lisa Coleman said.
“It was a funding issue,” she said. “There were only so many dollars to build and operate those units, because basically they function like a very small hospital and they have to meet very high certification requirements to operate.”
Rep. Danny Crawford, R-Athens, said he would love to see the Legislature entertain a more robust budget for mental health, noting the cuts contribute to prison overcrowding.
"Once you cut it out though, it's hard to put it back in," he said. "It's like pulling hen's teeth."

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