Money sought for crisis triage center

Tuesday, Oct. 15, 2002 | 11:01 a.m.

A study of drunks and mentally ill patients overcrowding hospital emergency rooms calls for the county and local municipalities to chip in $1.27 million to help fund a regional crisis triage center.

The Chronic Public Inebriate Task Force report, which will be presented to the Las Vegas City Council on Wednesday, also encourages the state to add more hospital beds and change admitting laws for mentally ill patients.

The $3.8 million crisis triage center, to be established at WestCare, a local nonprofit provider of substance abuse treatment, would allow police and paramedics to drop off drunks and the mentally ill, then return to service while the needs of the afflicted are evaluated for the best course of treatment.

The state would be asked to pick up another $1.27 million, or one-third of the cost, as would local hospitals.

When emergency workers take patients to emergency rooms, they must wait at the hospital until medical personnel can accept the patient.

"It's not unusual for police or emergency response personnel to spend eight hours with an inebriated or mentally ill person in crisis," said Metro Police Chief of Policy and Planning Kathryn Landreth, who also is the chairwoman of the Southern Nevada Adult Mental Health Coalition and a task force member.

"I am optimistic the crisis triage center plan will help ease the overcrowding of emergency rooms."

The plan, which is based on the simple formula of 85 cents per resident, was heard Thursday by a Regional Planning Coalition committee. It goes before the full Regional Planning Coalition Oct. 24.

Based on that formula, Clark County will be asked to pony up $544,356, Las Vegas, $433,895, Henderson $169,682, North Las Vegas $110,284 and Boulder City $12,727.

The task force expects to bring the formal requests for money to the various entities in November.

The three-year-old task force says the cost of a triage facility would be far less than the millions of dollars wasted under the current system.

"The estimated cost of an emergency room visit is $1,500, and it costs $824 per day for a stay in area hospitals -- and sometimes, these patients stay in hospitals for days and days," task force member Janelle Kraft said.

The task force study shows that 13,000 chronic drunks and seriously mentally ill people used emergency rooms in 2001 at a cost of more than $16 million.

In September University Medical Center had 175 psychiatric patients who were held for 2,390 hours, Kraft said. At all area hospitals during the same period, 645 psychiatric patients were held for 7,764 hours, Kraft said.

The Task Force report says the reason the afflicted are being held in emergency rooms for so long is there are insufficient mental health beds available, and that the state should take action to add more.

Southern Nevada Adult Mental Health on West Charleston Boulevard has only 10 crisis observation beds and 78 inpatient beds, the report says, noting that as many as 45 patients at a time were being held in local emergency rooms waiting for beds to become available at the mental hospital.

Gov. Kenny Guinn has proposed using $15 million saved in the prison fund to help build a mental hospital with up to 150 beds in Southern Nevada. Advocates estimate that would cover about half the cost of a hospital.

The state made drastic cutbacks to the mental health system in 1992 that continue to affect treatment, the task force study says.

"It's a big hit to taxpayers they may not be aware of," Kraft said, noting that an interlocal agreement could be reached by end of year and the triage center could open by Jan. 1.

The task force also says in its study that a change should be considered in the state law that requires the mentally ill to be transported to hospitals for medical screenings and instead authorize paramedics to transport patients who meet specific criteria to the state mental health hospital or another qualified facility.

The 2002 Mental Health Development Services need assessment study estimates that more than 83,000 people in Nevada suffer from serious mental illness, with 69 percent of that number -- 57,270 people -- residing in the Las Vegas area.

The same study found that 7,000 Clark County residents are homeless and many suffer from mental illness or substance abuse.

"The task force's report was a little more comprehensive than we thought it would be," Deputy Las Vegas City Manager Betsy Fretwell said. "But that's a good thing because we are doing what we can to get a handle on this situation.

"It will be interesting to see how the City Council responds to using the general fund to address what traditionally has been a regional issue," Fretwell said.

Because the issue before the council will be a discussion item, it cannot be voted on. The council, however, can direct city staff to study the feasibility of financing the plan and bring it back for vote at another meeting.

Officials at WestCare who are familiar with the task force report were not available for comment.