Legislation to create several regional Behavioral Health Community Crisis Centers in Idaho has passed the Senate Health and Welfare Committee. However, funding them is not assured, according to testimony at the committee hearing.
Richard Armstrong, director of the Idaho Department of Health and Welfare (DHW), said one intent of the legislation is to assist law enforcement in dealing with mental health issues. He explained that law enforcement has few options when handling a behavior issue. “Law enforcement is frequently left with only two options, put a person in jail or take them to an emergency room at a hospital.”
Armstrong, along with Ross Edmonds, administrator for DHW’s behavioral health division, supported what they refer to as “24/7 crisis centers.” The centers would be established as their own entities separate and apart from existing private hospitals and other government health facilities, while the “24/7” reference would designate their hours of operation and not the length of stay of the patients.
Sen. Lee Heider, R-Twin Falls, committee chair, asked Edmonds “do we have the funding for this in the department?"
“The department does not have the funding,” Edmonds replied, “but there is a request in for funding and the budget for behavioral health has not been set yet. I’ve talked with the members of JFAC (Joint Finance-Appropriations Committee) and there is certainly interest in the crisis centers there. But, of course, they are always concerned about where the money is going to come from.”
Edmonds told the committee “The model here is not a solution to the behavioral health crisis in Idaho, it’s only a part of it. I view the crisis centers as a preventative model. Most people don’t come into our system until they are in a crisis; these centers will create a doorway for people to enter into our system.”
The crisis centers are viewed as a companion to the “justice reinvestment” legislation that seeks to reform the state’s criminal justice legislation. They are also viewed as a companion to the Medicaid expansion agenda.
“Medicaid with its advancements towards transforming the way behavioral health is delivered, that’s another part of it,” Edmonds said.
Noting that the crisis centers are intended to help people who have run-ins with the law, Sen. Sheryl Nuxoll, R-Cottonwood, vice chair of the committee, asked Edmonds “did you talk to the department of corrections? Could they handle this problem?”
“I have talked with the department of corrections and they are very supportive of our model,” Edmonds responded. “I think the problem with having the department of corrections handle this is that it would be criminalizing behavioral health problems and Idaho doesn’t want to do that.”
In looking at language in the bill, Sen. Todd Lakey, R-Nampa, asked “why are people only to be held in the centers a total of 23 hours and 59 minutes? Why wouldn’t you limit their stay to 26 hours or 12 hours?”
“Because if you hold a person for more than 24 hours, you’re getting into the realm of inpatient care and that gets you in to a whole new level of government regulation,” Edmonds replied.
“But what do you do over the holidays when you would obviously need to hold a person longer than 24 hours?” Sen. Jim Guthrie, R-McCammon, asked.
Edmonds said “Twenty-three hours and 59 minutes specifies a treatment period. Now, a person can check out of the center, walk out to the parking lot, determine that they don’t feel well and come check in again. That’s fine. But we don’t want these centers to fall under the regulations of inpatient care.”
The committee approved a motion to send the bill to the full Senate with Nuxoll the lone “no” vote.
After the hearing IdahoReporter.com spoke with Edmonds and asked which government regulations the crisis centers are intended to avoid.
“We want to stay clear of both federal and state regulations that regulate hospitals and those kinds of places,” he said.
Edmonds also noted that there is no limit in the legislation on how many consecutive 23-hour and 59-minute treatment periods a person could utilize the crisis centers, noting that “ostensibly one could just check in over and over again, but if that happened then we’d want to find another resource for that person.”