Legislators hear mental health budget

A 150-bed state psychiatric hospital, to be built in Las Vegas for $32 million, was questioned Thursday by a state senator who warned project proponents against a "mumbo-jumbo" response.

The hospital, mental health courts and more funds for community-based service providers are the main initiatives in Nevada Gov. Kenny Guinn's budget for mental health services in the coming two fiscal years.

The $371.6 million budget, up more than 30 percent from the current budget cycle, and the $32 million hospital project were presented to lawmakers by Carlos Brandenburg, administrator of the state's Mental Health Developmental Services.

But Sen. Sandra Tiffany, R-Henderson, immediately asked whether the proposed hospital meets the terms of the U.S. Supreme Court's Olmstead decision. The ruling says states can't discriminate against disabled people by providing services in institutions rather than community-based services.

"Other states, what they're doing because of the Olmstead act, is not building more hospital facilities," Tiffany said. "They're building the community-based centers, like you're talking about. So I disagree with you that it doesn't fly in the face (of Olmstead) and that it's some 'core resource.' That's mumbo-jumbo."

Brandenburg said other states don't need to build hospitals because they historically put resources in hospitals, where as Nevada has not and lacks sufficient core services.

"Today I have 29 severely mentally ill individuals in the 11 emergency rooms in Las Vegas," said Brandenburg, adding that he lacks space in the state's existing Las Vegas-based mental facilities to handle them.

To further comply with the Olmstead decision, the state plans to increase pay rates to community-based mental health service providers, which will help ensure providers keep taking the state's patients.

Their rates are projected to increase 7 percent in fiscal 2004 and 8 percent in fiscal 2005, for a total 15 percent increase. Those rate hikes should cost the state $6.5 million over the biennium.

Guinn also recommended budgeting $600,000 to the mental health court pilot program in Washoe County. Brandenburg said the program has achieved excellent results in reducing recidivism and keeping people out of expensive state mental hospitals.

Brandenburg also said he hopes a Las Vegas court will organize a mental health court program, which he would try to fund with existing dollars.

Another $600,000 was figured into the budget to establish an emergency response team, for 24-hours-a-day help in evaluating mentally ill individuals in hospital emergency rooms, and getting the appropriate services for them.

Mental health services expects a caseload increase of more than 2,000 people over the upcoming two fiscal years. Developmental services, which provides aid to people with lifelong disabilities, such as mental retardation, expect an increase of more than 850 people.

Of the total agency budget, mental health programs receive 52 percent of the money, and developmental services programs receive 46 percent of the funds. The two areas, along with administration, have 1,255 employees.