Health Division reorganization is approved by subcommittee
April 24, 2013
The legislative subcommittee studying Health and Human Services budgets Tuesday approved an extensive reorganization of the Health Division.
The plan drew sharp questions when first presented because the fiscal division's review of the plan indicated no direct-cost savings.
Health and Human Service Director Mike Willden said the reorganization wasn't designed to save money as much as change the way mental health services are delivered from the traditional government model to a public health model. He and division director Richard Whitley had argued the plan streamlines services from determining eligibility to providing flexibility so that funding can follow the clients as they move between programs and institutions.
Subcommittee Chairman Maggie Carlton, D-Las Vegas, said there have been several hearings and a lot of discussion about the plan but that, "I've gotten a level of comfort with this and looking at the way it will be organized."
Assemblyman Mike Sprinkle, D-Sparks, said the issue has been painted as very important to the department.
"We've had a lot of discussion over this," he said. "There comes a point where we have to trust the people doing this every single say."
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He joined Carlton in saying he was now comfortable supporting the plan.
Under the reorganization plan, eligibility determinations will be made in what Willden described as a "one-stop-shop" where workers would take a person coming in for help and determine what services they need, what they are eligible for and then send them to the right places. At present, he said people often have to go through several different eligibility processes.
"The idea is better services for people trying to get service," he said.
He said eventually, eligibility determinations for everything from mental health programs to disability services, Medicaid and the Silver State Health Exchange would be handled in one place.
The plan also ties different programs together so that an individual doesn't have to go through the process of applying again as they move from program to program as they age or their needs change.
With mental health services, Whitley said the idea is to handle that the same way as public health.
At present, he said, there is no prevention focus in mental health — a sharp difference from public health.
The change would help the agency intervene earlier in behavioral health cases.
"Prevent, intervene and treat apply to behavioral health just like public health," he said, adding that early identification of mental illness can improve treatment outcomes.
The plan must still win approval from the full Senate Finance and Assembly Ways and Means committees.