Planned hospital already seen as inadequate

Thursday, Aug. 5, 2004 | 10:06 a.m.

CARSON CITY -- The $32 million 150-bed state mental hospital that will be built in Las Vegas will be inadequate when it is completed in 2006, the director of the University Medical Center emergency department told state lawmakers Wednesday.

Dr. Dale Carrison told a legislative committee that the day the new mental hospital opens it "will be overcapacity."

Carlos Brandenburg, administrator of the state Division of Mental Health and Developmental Services, said Carrison's statement may be true but he will have other resources to draw from.

He said he could use one ward of the present hospital that could accommodate 16 patients. And he said he intends to continue the 28-bed center that has been rehabilitated to care for mentally ill patients that are crowding the emergency rooms of hospitals.

Brandenburg said the 150 beds in the new hospital are just the first phase and a second calls for another 40 beds. He said he wants to see how the first phase pans out before adding more beds. In addition, he said there are aggressive programs in the community to care for these patients outside a hospital setting.

It costs $400 a day to keep a patient in the mental hospital compared with $700 to $800 a month for a patient who is in a group home or is considered an outpatient on medication.

Carrison's remarks prompted Sen. Barbara Cegavske, R-Reno, to ask why a mental hospital was built in Reno several years ago rather than Southern Nevada.

"Why is it in the north when the growth is in the south?" she asked.

Assemblywoman Ellen Koivisto, D-Las Vegas, who is chairwoman of the Legislative Committee on Health Care, said the committee staff would look into that decision.

The 1997 Legislature allocated $10.8 million for a new mental hospital in Reno to replace a deteriorating building that could not be brought up to an acceptable standard. But the money was turned back to the state during the financial crisis and construction was delayed.

The 1999 Legislature then reauthorized the project with 90 beds.

The existing adult mental hospital in Las Vegas has 103 beds.

Carrison reviewed for the health committee the problems of the mentally ill crowding the emergency rooms in Clark County hospitals. As of Wednesday morning 74 mentally ill patients were cleared medically for admission to the state facility but were still waiting to be accepted. That means they were occupying 25 percent of the emergency room beds in Clark County hospitals, he said.

"Mental health in Southern Nevada remains in crisis," he said.

The Legislative Interim Finance Committee is holding a special meeting Aug. 12 to consider allocating $1.9 million in emergency funds to pay for staffing of a 28-bed unit to handle those mentally ill patients who are in hospital emergency rooms waiting to be admitted to state care.

Carrison recommended steps to meet the problem now and in the future, and the committee agreed to draft a bill to be presented to the 2005 Legislature with his suggestions.

Carrison suggested that the proposed new 28-bed unit be continued in the future and that the state's mobile crisis team also continue visiting the emergency rooms to determine what patients might be released to go into community programs rather than the mental hospital.

There also needs to be aggressive recruitment of psychiatrists for Southern Nevada and the state must provide financial support for a psychiatric residency program at UNLV, Carrison said. He said the majority of psychiatrists stay within 300 miles of their residency.

In the future, Carrison said there must be a place at the mental health campus, 6161 West Charleston Blvd., for patients to be medically cleared for admission for mental health treatment. He said this would provide "one-stop shopping" for those who have mental problems rather than being admitted to the emergency rooms to get clearance to go to the state mental health facility.

Cegavske said her concern was the potential cost. She said, "We don't know if the state will be in the financial condition" to finance these programs. "We've got to take a look at that. We have to be very cautious," she said.

But Sen. Ray Rawson, R-Las Vegas, said the bill to be drafted would have a cost estimate attached and would be considered by the legislative committees.

Koivisto said, "One way or another we pay," whether these patients would wait in the hospital emergency rooms or more quickly get to the right mental care facility.

Carrison said he was a member of the Homeland Security Commission and there would not be enough emergency beds available if disaster struck southern Nevada because of the mentally ill using up beds in the emergency rooms.