Add tobacco windfall to mental health programs, Sandoval says

Gov. Brian Sandoval said Wednesday he wants to put the Health and Human Services Department’s share of the tobacco settlement windfall into programs for the severely mentally ill.

A settlement reached through the Attorney General’s Office gave the state a one-time windfall of about $21 million this year. Sandoval’s plan would use Health’s $12.5 million share of that total to expand beds at both the Lake’s Crossing Center in the north and Rawson-Neal Psychiatric Hospital in Las Vegas, as well as help several other programs.

The other $8 million from the added tobacco funding goes into the Millennium Scholarship program.

Sandoval said that with the $2.76 million in remaining cash in the HHS healthy Nevada Fund, that adds up to $15.2 million to spend.

The proposals would spend just over $8 million of that, keeping the rest in reserve.

Lawmakers must sign off on the governor’s plan for the money.

The Lake’s Crossing expansion will upgrade the center that houses mentally ill offenders. But most of the $3 million over the biennium will pay to add the necessary staff to manage them.

HHS Director Mike Willden said those patients are committed to Lake’s Crossing by the courts, which also mandate they be evaluated in a timely fashion. The problem is that those patients sit in jail until there is space for them at Lake’s Crossing.

A federal judge criticized the institution for that problem and ordered it to get space for those patients, as well as do evaluations more quickly. Willden said the institution is at capacity that and Lake’s needs the additional beds to comply with the judge’s order. The funding will increase total beds at Lakes Crossing to 76.

An additional $1.4 million would pay for adding 10 beds at Rawson-Neal, the Southern Nevada mental health facility. Willden said most of that is one-shot work, given that it consists of construction and upgrades to existing facilities.

Those who fill them are likely to be long-term mentally ill patients, Willden said.

In addition to the hospital expansions, Sandoval said he wants to restore the second Program for Assertive Community Treatment team in Southern Nevada. PACT was cut from two teams to one in recent budget cuts.

Willden said those teams are a kind of “hospital on wheels” that serves those who need mental health services outside the hospital setting. He said each PACT team can serve up to 75 patients. PACT will cost about $1.4 million over the biennium.

According to Willden, those teams would enable some severely ill people who are involuntarily committed to be released into the community instead of kept in the hospital. A judge has to sign off on their release and, if they don’t comply with the court-ordered treatment plan, caseworkers just call the judge for action.

Sandoval said the added PACT team would be joined by a pilot Home Safety Program that provides support for people newly released from mental health programs. That refers to people who “will follow our mental health patients when they are discharged from the hospital,” Willden said.

That includes going to their homes to ensure the family has a safety program in place and understands what to do when there are problems, he said.

The $2 million Home Safety Program would be a pilot program.

According to Willden, it applies a model long used in the public health sector for mental health. The money will pay for three community-provider staffers in the north and 15 in the south.

“They will work with families over time to make sure there is safety in the home or safety in the community,” he said. “I think we will actually be one of the leaders in the nation with this home-safety program.”

Sandoval said the additions were recommended by Willden as the best use of the money to strengthen the state’s mental health services. He said the additions are on top of the $4 million already added for a jail re-entry program.

But because of the unpredictable nature of the tobacco funding, which isn’t coming in as high each year as expected, he kept $7.89 million of the total available as a reserve.

Willden said Nevada is budgeted to spend $25 million a year in tobacco money on health programs but has only been receiving about $23 million a year. He said the reserve will cover that shortfall at least some distance into the future.

Budget amendments to implement the additions will be sent to lawmakers shortly, Willden said.