Counties look to Medicaid to slow mental health costs

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Capital News Service
LANSING – Jail inmates’ mental health costs will continue to rise without an expansion of Medicaid, according to sheriff’s departments across the state.
In 2012, the Allegan County Jail spent about $15,250, averaging about $1,270 per month to improve mental health, the Allegan County Sheriff’s Department said.
In March of this year, mental health services for inmates cost about $2,400, almost double the monthly average of 2012, the department said.

Ann Russell, the corrections administrator at Oakland County Jail, said her sheriff’s office spends about $1.3 million annually on inmate mental health services, including the cost of medications.
“The Oakland County Sheriff’s Office has been working for many years to assist in reducing the jail’s cost for mental health services,” Russell said.
Under Gov. Rick Snyder’s Medicaid expansion proposal, the federal government would pick up the full cost of mental health care for newly-covered state residents for three years and 90 percent after.
Michigan Sheriffs’ Association Executive Director Terrence Jungel said about 80 percent of inmates in county jails are mentally ill, more than half of whom are diagnosed with depression.
Mental health is “without a doubt the most significant expense within a jail or a prison,” Jungel said.
The Allegan County Sheriff’s Department said the most common jail mental health problems include depression, bipolar disorder and post-traumatic stress disorder.
The department said it tries to reduce the cost of treatment by using community resources like Renewed Hope, a health clinic that serves uninsured adults in poverty.
The clinic serves only those without Medicare or Medicaid coverage and is staffed by volunteer doctors and nurses.
Russell said the Oakland County Jail has a partnership with Oakland County Community Mental Health Authority, which provides psychiatric services and clerical support.
Russell said the sheriff’s office also developed a training program, Tools for Appropriate Response to Individuals with Mental Illness and Developmental Disabilities, which all deputies have attended.
“This training focuses on signs and symptoms of mental illness and developmental disabilities as well as appropriate techniques for response,” Russell said.
Department of Community Health public information officer Angela Minicuci said, “Oftentimes, inmates do not have health coverage, so for those who don’t, the expansion of Medicaid would help cover that population.”
Jungel said, “Anytime a prisoner goes to a county jail, they are excluded from Medicaid. The new health care act may have an impact on that,” if the expansion takes effect.
If Michigan expands Medicaid, Snyder said 470,000 more people will be eligible by 2021, some of whom have been convicted of crimes, according to a legislative report.
Jungel said the decision to expand Medicaid—or not—leaves people uncertain about who will get covered.
Jungel said, “What happens in a county jail is eventually going to get back to prisons. If the cost of mental health is reduced in county jails, prisons will have less mentally ill inmates,” because inmates who start off in jail often end up in prison.
“Nobody should be in jail because they’re mentally ill, but just because you’re mentally ill doesn’t mean you don’t belong in jail,” Jungel said.
Snyder has created a 14-member Mental Health Diversion Council under the Department of Community Health to further look into the costs of mental health, which includes legislators.
Lt. Gov. Brian Calley will chair the commission and Department of Community Health Director James Haveman will serve as vice chair.

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