Monday, July 21, 2014
PLACERVILLE, CALIFORNIA
99 CENTS

El Dorado County mental healthcare

By
From page A5 | April 03, 2013 |

EDITOR:

Item No. 5 on the El Dorado County Board of Supervisors March 12 agenda, approved on the consent calendar, allows an increased expenditure of $367,500 through June 30, 2013 “for the provision of inpatient mental health treatment for county clients” at the Sacramento-based Heritage Oaks Hospital. The funding source is state and federal funds (i.e., us, the tax payers). This is but one of several high-cost contracts the county has with psychiatric hospitals in other counties.

El Dorado County recently closed its six-bed “crisis residential treatment” center, presumably because it cost too much to operate. It was created originally to prevent expensive hospital readmissions by providing temporary housing and intermediate care for patients discharged from the Psychiatric Health Facility (the PHF). Ironically, it was replaced by adding six beds to the PHF for patients requiring more intensive (i.e., expensive) mental health treatment. The paradox, of course, involves replacing a lower-cost, readmission prevention facility with a higher-cost extension to the inpatient unit. This begs the question of whether the need for additional inpatient beds would be necessary with better, more comprehensive outpatient care.

There is no question that inpatient mental health treatment is very expensive. It typically accounts for the largest percentage of costs incurred by both for-profit behavioral healthcare insurers and publicly supported, county-run mental health plans. In the 1990s and early 2000s, cost-conscious share holders and taxpayers demanded controls be placed on these inpatient expenditures. Managed behavioral healthcare resulted and instituted cost-limiting tools such as annual limits and concurrent utilization review. While the inpatient costs may have been contained, severe mental illness persists and necessitates less-costly outpatient alternatives to hospital (re)admissions and jail incarceration.

Laura’s Law became effective in California in 2003 and allows local courts to mandate treatment for residents with severe mental health conditions and a history of violence or hospitalization. California’s counties are allowed to decide whether to implement the law. So far, Nevada County is the only county to do so. In September 2012, Gov. Brown signed a bill (AB 1569) that extends Laura’s Law until 2017.

In March 2013, the Los Angeles County Board of Supervisors threw “its weight behind Laura’s Law saying in a resolution that such programs have been shown to ‘significantly reduce’ homelessness, hospitalization and arrest.” The California legislative bills cited by the LA BOS resolution clarify that local counties 1) can use existing revenue and Proposition 63 for Laura’s Law, 2) eliminate the need for local board of supervisors approval, 3) expand the period of court-ordered treatment from six months to a year and 4) add those treated under Laura’s Law to the database of people prohibited from owning firearms.

So, an obvious question is this: Would El Dorado taxpayers receive a better return on their mental healthcare investment by implementing Laura’s Law locally rather than funding “the provision of (more expensive) inpatient mental health treatment?” Specifically, is it not the right time to reexamine spending millions on inpatient hospital costs and consider implementing assisted outpatient treatment services (Laura’s Law) instead?

As a licensed psychologist involved in managing and providing mental healthcare in this county for the last several years, I urge our county Board of Supervisors and the taxpaying citizens they represent to conduct an open and exhaustive cost and quality analysis of how and to whom publicly funded mental healthcare is delivered here; and to determine whether implementing Laura’s Law would lower the costs and improve the quality of that care.

JOHN BACHMAN, Ph.D.
Placerville

Comments

comments

Letters to the Editor

.

News

IRS unveils Taxpayer Bill of Rights

By News Release | From Page: B1

 
Highway 50 collision fatal

By Cole Mayer | From Page: A1

Stay connected through sheriff

By El Dorado County Sheriff's Office | From Page: B1

 
EDH community unites to patch up historic barn

By Mike Roberts | From Page: A1 | Gallery

P’ville hires Camino superintendent

By News Release | From Page: B1

 
Bird tests positive for West Nile

By Ross Branch | From Page: A1

Heard over the back fence: Public swim times announced

By Bob Billingsley | From Page: B1

 
County gets partial refund on promotional event

By Dawn Hodson | From Page: A3

 
Jeepers expo Wednesday in Georgetown

By Dawn Hodson | From Page: A3

Help SWR with squirrel babies

By Sierra Wildlife Rescue | From Page: A9

 
.

Opinion

The rural life: Save the day: Neuter and spay

By Jennifer Forsberg Meyer | From Page: A4

 
Different place, different priorities

By Mountain Democrat | From Page: A4

California rambling: Giving cities a pass

By John Poimiroo | From Page: A4 | Gallery

 
.

Letters

A thank you note

By Letters to the Editor | From Page: A5, 1 Comment

 
Prada belongs in Berkeley

By Letters to the Editor | From Page: A5

Ready for Hillary?

By Letters to the Editor | From Page: A5, 2 Comments

 
Fukushima

By Letters to the Editor | From Page: A5

Diamond Springs Firefighters Union is corrupt

By Letters to the Editor | From Page: A5, 1 Comment

 
100+ years and thanks

By Letters to the Editor | From Page: A5

.

Sports

Valley View Sports Park

By Julie Samrick | From Page: A6 | Gallery

 
Under the Scoreboard: July 20, 2014

By Democrat Staff | From Page: A6

Schedule: July 21-26

By Democrat Staff | From Page: A6

 
Becker slips by in wild KWS finish

By Gary Thomas | From Page: A6

Sports Scene: July 20, 2014

By Jerry Heinzer | From Page: A6

 
Roundup: July 20, 2014

By Democrat Staff | From Page: A6

Season over for Post 119

By Mike Bush | From Page: A6 | Gallery

 
Sophia Barden wins strut title

By Special to the Democrat | From Page: A7

.

Prospecting

How to safely help a horse

By Wendy Schultz | From Page: B2 | Gallery

 
Railroad Museum offers a fun ‘History Happy Hour’

By California State Railroad Museum | From Page: B4

 
As we were: Money for home repairs

By Ken Deibert | From Page: B4

Marshall Medical Center to host day of fitness and fun

By Marshall Medical | From Page: B10

 
Kids parade for free admission to the fair

By Amador County Fair | From Page: B10

Volunteer kitchen help needed in EDH

By Health and Human Services Agency | From Page: B10

 
.

Essentials

Crime Log: July 6-8

By Cole Mayer | From Page: A2

 
.

Obituaries

Betty Ellene Hock

By Contributor | From Page: A2Comments are off for this post

 
Douglas J. Beam

By Contributor | From Page: A2

Arthur J. Funston

By Contributor | From Page: A2

 
Jerry Grant Young Jr.

By Contributor | From Page: A2

Kathryn Noreen Nolan

By Contributor | From Page: A2

 
.

Real Estate

.

Comics

Horoscope, Monday, July 21, 2014

By Contributor | From Page: A8

 
Shoe

By Contributor | From Page: A8

Sukodu

By Contributor | From Page: A8

 
Rubes

By Contributor | From Page: A8

New York Times Crossword

By Contributor | From Page: A8

 
TV Listings

By Contributor | From Page: A8

Speed Bump

By Contributor | From Page: A8

 
American Profile Crossword

By Contributor | From Page: A8

Tundra

By Contributor | From Page: A8

 
Horoscope, Tuesday, July 22, 2014

By Contributor | From Page: A8