Mental health triage may be closed

By Timothy Pratt (contact)

Tuesday, Oct. 21, 2003 | 11:08 a.m.

A triage program lauded as a way to save the state millions, free up emergency rooms and help the Las Vegas Valley's mentally ill has laid off a third of its staff and may soon shut its doors, said Dick Steinberg, Westcare chief executive, the nonprofit organization that runs the program.

The reason: a lack of state funding. More than half of $1.3 million the project hoped to get from the state in a complicated funding formula has yet to be paid, despite the program being halfway through its 18-month trial period.

Lawmakers moved no closer to a solution Monday. A subcommittee of the Legislature's Interim Finance Committee voted to make no recommendation on the funding, which was denied once, to the full committee.

The outcome of Monday's meeting baffled the program's supporters, some of whom have testified on its benefits for years.

"We've been going through this for so long, it's hard to believe this hasn't been resolved," said Janelle L. Kraft, budget director of Metro's finance office.

"It seems like such a no-brainer."

The program, known as the community triage center, opened at Westcare in January, after more than two years of planning and a $3.6 million funding formula that counted on support from 10 hospitals, local municipalities, Clark County and the state.

In nine months the program has treated more than 4,000 people with mental health problems and addictions that otherwise would be in the Las Vegas Valley's hospitals or jails, saving taxpayers an estimated $11 million, based on what it would have cost to treat those people elsewhere, Steinberg said.

The program was created in response to a longstanding and growing problem caused by thousands of mentally ill people in Southern Nevada winding up in emergency rooms or behind bars without receiving treatment for their underlying conditions, costing the system money and shortchanging others in emergency rooms of treatment.

But the state Legislature never approved funds for the program and the state hasn't found another way to pay $677,000 of the $1.3 million assigned to it as part of the funding formula.

The lack of the state's support has hit the center hard, Steinberg said. He has laid off about a third of the program's staff of 60, while cutting down the number of ambulances it uses from three to one.

The center has started to turn away some walk-in patients, Steinberg said, giving preference to those brought in by Metro or sent from emergency rooms.

"We're doing our best not to turn other people away, but that day will come soon," Steinberg said.

Testimony in Monday's meeting rehashed the fate of SB 151, the bill that would have funded the program and died after one hearing in the Senate Finance Committee.

"I guess the bill was not on somebody's favorite list," said Sen. Bob Coffin, D-Las Vegas, a member of that finance committee and the subcommittee that met Monday.

Assemblywoman Chris Giunchigliani, D-Las Vegas, said that members of the subcommittee favored the program, but faced a difficult situation when asked to fund something that was not approved by the Legislature.

"I don't think anybody's disagreeing about the importance of the program," she said.

"It's the policy issue ... (that) opens the door for everybody under the sun to come ... and say, 'My bill didn't move forward,' " she said.

Mike Willden, director of the state Department of Human Resources, said Gov. Kenny Guinn wants to keep the program afloat.

"The governor want to provide a funding mechanism to fund ... the center," he said.

The subcommittee asked Willden about several of those mechanisms, including a surplus from the Nevada Division of Mental Health and Developmental Services budget and federal funds. But none could be counted on at present, Willden said, adding that he would look for other funding sources before the Nov. 18 meeting of the full Interim Finance Committee.

"I have no spare change right now," said Carlos Brandenburg, administrator for the division of mental health, testifying via video from Carson City.

"Check back with me in March."

Steinberg said afterward he couldn't wait until March.

The Westcare chief executive also said he was concerned that the other supporters of the program would pull their funding in the coming weeks if a solution wasn't found.

"I feel like a Ping-Pong ball in a political game," he said. "This should have been a slam dunk."