Johanns visits to tout mental health reforms

COLUMBUS - An uproar was heard across the state when Gov. Mike Johanns proposed closing the Norfolk and Hastings regional centers for mental health care.

Local professionals from many fields said eliminating these inpatient facilities would spell disaster.

Now, it appears the tide of opinion is slowly turning, not only here but across Nebraska, according to the governor.

"LB1083 has really caught the imagination of mental health providers across the state," he said. "It is just so gratifying for us to see."

Johanns said the delivery of mental health services doesn't necessarily come from a place, but from a method. "It's caused people to think about delivery of services and how they may address the needs as close to home as possible," he said.

The governor was in Columbus on Tuesday to visit the East Central District Health Department and listen to several local experts speak on proposed changes in the community's mental health care services. These changes were instigated in the wake of the governor's backing of LB1083 - a bill that would eliminate the regional centers, which is being debated today in the Legislature.

Health department officials and the Columbus Behavioral Health Consortium are against closing the regional centers without strong plans in place that include quality, appropriate, comprehensive family-centered services.

Whether or not the regional centers are closed, the area health department will go forward with a consortium plan for improved local mental health care services, according to Rebecca Rayman, health department executive director.

In January, the local MAPP (Mobilizing for Action through Planning and Partnerships) mental health subcommittee - which was organized by the health department - wrote a Mental Health Reform Plan for East Central District of Nebraska and submitted it to the governor. Included in the plan are:

n The creation of a Four County Behavioral Health Consortium, managed by an executive director (the only employee) to oversee the development and evaluation of the local mental health care system.

n Standardized mental health and substance abuse assessment through a crisis intervention program called Crisis Navigators.

The 24/7 service deals with the initial calls for help and is linked with professional therapists to provide additional services.

n A full-time psychiatrist in Columbus who is expected to start in July.

n Additional outpatient services, like therapy, medication assistance and transportation assistance.

n Inpatient psychiatric services, that could be provided by Family Psychiatric Services via a contract with a residential provider.

n Local hospitals would help stabilize mental health patients who are experiencing a behavioral health crisis and would also be able to provide medically monitored detoxification programs.

n Adolescent residential beds for inpatient mental health care - a plan that is in the process of being implemented at the Boys and Girls Home's Family Resource Center in Columbus.

n A residential facility for adult females who are suffering from a mental illness as well as substance abuse and who are mothers with children.

n A residential facility for adult males suffering from a mental illness and substance abuse.

Rayman said restructuring the mental health care services when the current system is so fragmented and dysfunctional is a monumental task.

The problems that have developed have not been short-term, they have developed over the past 30 years, she said.

The proposed budget for the local plan is about $2.8 million, with about 60 percent of that amount reimbursable through Medicaid, Medicare, private insurance or private pay.

This would leave about $1.3 million that would need to be funded in some other way.

Johanns' plan is to funnel funding through the Region 4 Behavioral Health Service District office that serves 22 counties including Platte, Colfax, Nance and Boone counties.

During his Columbus visit, Johanns applauded the proactive efforts of the community and East Central District Health Department.

He said he has always acknowledged the need for some long-term care to help people get back on their feet. But he doesn't think the current system is working.

"What we're seeing across the state is people are starting to come together under the 1083 umbrella," he said. "It's been a remarkable thing that's happening across Nebraska."

About 47,000 people were estimated to have mental health problems within the state's mental health service area in 2003, Johanns said. The regional centers in Norfolk and Hastings worked with 700 people last year at a cost of about $25 million.

The governor said he wants to spread those funds across the state, to places like Columbus that keep people out of the regional center through successful local mental health care systems.

"I hoped for this - hoped it would pull communities and regions together," he said.