CEDAR RAPIDS, Iowa (KCRG) – A bill to double the number of inpatient psychiatric beds at state mental health institutions passed the State House unanimously Thursday.
Advocates said House File 2292 could improve access to vital services as Iowa ranks 51st among the states and D.C. in available beds for those in need of more intensive care.
The executive director of the Linn County chapter of the National Alliance on Mental Illness, Michelle Sutton, said advocates, law enforcement and hospitals have been pushing for this change.
“All of those people saying, ‘we need help, we need things to be better,’ it’s nice when the state listens and passes unanimously,” said Sutton.
Iowa ranks last in the country for mental health bed availability – with only two for every 100,000 people – according to a Treatment Advocacy Center study. If this bill passes through the Senate, advocates said it could add more than 90 beds.
Current situation a ‘logjam’ for healthcare system, creates burden on law enforcement
Leslie Carpenter is a longtime advocate for mental health care and the center’s legislative advocacy manager who also has a son with schizophrenia. She said adding these beds at state institutions would help people experiencing difficult mental health conditions to receive the level of care they need.
She cited the closure of half of the state’s then four mental health hospitals in 2015 as a factor in the worsening situation for healthcare and law enforcement.
“In one case, I know of a patient in the university hospital that’s been there for over a year because there’s no place to discharge that person to in a safe manner,” she said. “It causes a logjam back through the entire system, even just for people needing to get admitted to a hospital during an acute crisis.”
Carpenter explained expanded access would also save millions of dollars in other systems – according to her extensive calculations, somewhere between $20.5 to $39 million a year.
She cited these situations as places where this bill could reduce costs and burdens to law enforcement and the judicial system, adding that many costs come from the property tax level:
crisis calls and law enforcement intervention: $1.5-$3 millioncounty jail detentions: $4-$8 millionarrests and court processing: $1-$2 millionpsychiatric boarding: $8-$10 millionrepeated short hospitalizations: $2-$4 millionreduce prison admissions and length of stay: $5-$10 millionhomeless services outreach: $1-$2 million
“The people that are not being served by not having a state psychiatric bed, they’re ending up in that revolving door turn of repeated hospitalizations, homelessness, and criminal legal involvement and the other place we don’t measure is they’re ending up in our graves,” said Carpenter. “So many people are dying earlier than they have to because we are not doing a good enough job of taking care of their needs.”
If the bill passes, the Iowa Department of Health and Human Services will need to ask the federal government for a waiver of the Medicaid Institution for Mental Diseases exclusion.
Carpenter said this exclusion relates to a 1965 Medicaid rule that prohibits federal money from being used for mental health institutions – and that other states have successfully applied for this waiver to receive funding in a similar manner.
Advocates say this bill could help avoid tragedies
Sutton said services in Linn County provide help to those dealing with tough mental health conditions – like NAMI’s support groups and crisis stabilization services. The county jail now has an in-house social worker too.
Amidst this progress, she said severe mental illness can often get pushed aside for capacity reasons, as emergency rooms are “overflowing” and people must meet the criteria for admission to facilities. Even if the bill passes, effects wouldn’t come overnight, as she said the state will need to complete steps like hiring more staff.
Sutton said she has heard from families who have sought help but aren’t able to access in-patient care.
This type of story was one aspect of the recent murder trial of Matthew Schleier – the Marion father who killed his five-year old son after a hospital denied to admit him for suicidal thoughts.
“That’s heartbreaking. And that often is what can led to crises or violence, interactions with law enforcement, things with family members, you know, that can often escalate into incredibly tragic situations,” said Sutton. “If we can avoid those tragedies by simply implementing systemic changes like this bill aims to do, it’s a step in the right direction.“
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