The Baton Rouge Area Foundation released a detailed plan Monday to build a mental health treatment facility in the city aimed at decreasing the number of mentally ill people ending up in the parish jail, floating the proposal a year after the East Baton Rouge Parish Metro Council sidelined a public safety tax plan that included this kind of center.
At the time, members of the Metro Council said they embraced the idea of expanding mental health treatment but needed more information, particularly about how much it would cost.
BRAF enlisted Michigan-based Health Management Associates to do the research that went into the 143-page report it presented Monday to a room of more than 60 public officials, health professionals and others. East Baton Rouge Parish Mayor-President Kip Holden pledged his support, as did Sheriff Sid Gautreaux III, Police Chief Carl Dabadie and District Attorney Hillar Moore III.
The plan calls for a new nonprofit group to oversee the building of a mental health center over 18 to 24 months, and BRAF leaders said putting an executive director in place is the first step to kicking off the project.
The report says an ideal location for the mental health center is in Mid City, downtown or north Baton Rouge, while noting that the Baton Rouge Detox Center on South Foster Drive already has empty space. Most of the mental illness-related phone calls to law enforcement during the first half of 2015 came from Mid City and north Baton Rouge.
Despite the report’s level of detail, exactly how East Baton Rouge Parish would come up with the $5.7 million in annual operating expenses remains a sticking point. BRAF Project Manager Patricia Calfee also estimated that another $2 million would be needed to renovate space at the detox center.
Specific ideas for new taxes weren’t floated at Monday’s news conference. Council members asked last year for every source of private funding and grants to be explored before asking for public money to make the center a reality.
“This is a big lift, and you’re not going to be able to do it without parish funds,” said Karen Batia, one of the consultants who presented the study.
She said they found no miracle dollars to pay for the center. Instead, the study says BRAF needs to leverage federal grants and be able to make a compelling case for tax money.
“Tax increases are always a difficult sell with taxpayers, who — justifiably — want to see their tax dollars invested wisely,” the study reads. “Despite growing evidence of the effectiveness of diversion programs, the direct benefits of the program are not always immediately evident to taxpayers, and savings achieved through effective reforms can quickly be eaten up by other budget priorities.”
Despite the state’s grim budget outlook, Batia said the good news is that Medicaid expansion, which Gov. John Bel Edwards has signed an executive order to implement, would create some funding streams for mental health treatment. While the Medicaid program, which provides insurance for low-income people, likely can’t be tapped to cover the center’s administrative costs, Batia said the center could receive Medicaid reimbursements for some of its services.
While last year’s push for a tax combined the mental health center with a more expensive plan for a new, larger East Baton Rouge Parish Prison, the idea of building a new jail was not a focus of Monday’s news conference.
But Gautreaux did emphasize that he believes the jail his office runs has significant problems, including that it is too small and old.
“We don’t have a mental health wing and we don’t have a chemical dependency wing, and we’re in dire need of both,” he said.
Gautreaux, Dabadie and Moore all reiterated on Monday that funding mental health services is a public safety issue and that the jail is not designed to treat mental illness.
“We are dealing with an issue that does not call too much for debate,” the mayor said.
Dabadie likened the scenario as “trying to squeeze blood out of a turnip.” He said his officers sometimes waste hours waiting with mentally ill people at emergency rooms because they cannot leave them alone. A drop-in center for the mentally ill would put his officers back on the streets where they could do their jobs, he said.
One of the top goals of the mental health center is to decriminalize mental illness, giving some mentally ill people who encounter law enforcement a place to go that is not jail. If officers picked up a mentally ill person on a call of a minor crime like disturbing the peace, they could drop them off at the center, and that person would not be saddled with a criminal case.
The facility envisioned under the plan is a 30-bed mental health center that would be open and staffed seven days a week.
A group of sobering beds would let self-medicating mentally ill people come down from drugs and alcohol. It would be designed for the short-term, with people staying up to 12 hours, and those who come there would be encouraged to get treatment.
“This is not the Hyatt or Four Seasons,” Batia said about the sobering beds. “This is a very minimal treatment.”
A medical detox program would help people who are trying to fight substance abuse over a longer period of time. That program would last for seven to 10 days.
A respite program would be geared toward people in the midst of psychiatric crises. Both the respite program and medical detox plan should be reimbursable through Medicaid expansion and private insurance, Batia said.
She also said that no matter how many resources exist, some mentally ill people will always cycle in and out of the system. A team would target around 100 of those people who have been in and out of behavioral health facilities and the criminal justice system, with the goal of intervening before that happened again.
The center would also employ a two-person mobile assessment team, called MAT, that would be on-call for law enforcement at all times.
A registered nurse and a licensed social worker would man the MAT team. They would be dispatched to situations where police officers suspect someone is psychotic but might not be able to determine if they need in-patient hospitalization or something else.
People could come to the center via the police, their families, community partner referrals or they could walk in themselves. But the services offered there would be voluntary, and nobody would be held against their will.
Batia said the center is not designed to meet the needs of every type of mental illness in the city-parish.
She said they expect that some people would visit frequently and have trouble connecting to the other services out there for them, but the center should aim to treat people before they become too ill and need to be hospitalized.