Madison — A legislative task force unanimously approved a sweeping batch of recommendations Wednesday to reform the state's mental health system, and the head of the Assembly said he wanted to take up some of those measures in November.
Among the proposals by the Speaker's Task Force on Mental Health are ones that would give professionals in the industry the authority to send people into emergency detentions, relieving police of bearing that responsibility alone.
The move is meant to decrease the number of emergency detentions in Milwaukee, a problem outlined in a Journal Sentinel investigation that found the number of patients cycling through the county's psychiatric emergency room is unchanged in the past 20 years.
The 11-0 vote by the task force marked a rare moment of bipartisanship in the Capitol.
"Mental health issues affect everyone," said Rep. Sandy Pasch (D-Shorewood), vice chairwoman of the task force. "It is not a partisan issue by any means."
The task force also recommended modifying a requirement that treatment directors in Milwaukee County determine within 24 hours whether those on emergency detention should continue to be held. Milwaukee County psychiatrists report that dozens of petitions to detain the sickest patients fail each year because the patients are unconscious — recovering from suicide attempts, gunshot wounds and overdoses — and cannot be examined for their state of mind.
Under the proposal, the 24-hour period would not include any time needed to address non-psychiatric medical conditions.
The task force also signed off on creating a way for families and other interested parties to request that counties begin an emergency detention and petition a judge to require the detention if the county does not act.
They also supported creating or expanding grants and establishing a hotline doctors could use to consult with child psychologists.
The recommendations will now be drafted as 10 or more bills to be considered by regular legislative committees. Assembly Speaker Robin Vos (R-Rochester) said he hoped to have some of those bills on the Assembly floor by November, though he did not say which ones.
The proposals to overhaul the state's mental health laws come amid the Journal Sentinel's ongoing "Chronic Crisis" series.
Separately, Rep. Joe Sanfelippo (R-West Allis) — a task force member — has said he wants to strip the Milwaukee County Board of mental health care oversight. Vos said he was focused on the task force's recommendations for now but would "definitely consider" Sanfelippo's ideas later.
Pasch said she did not favor Sanfelippo's plan because it focused on just one county. Pasch instead backs sunsetting Wisconsin's mental health laws in an effort to force legislators to rewrite them.
Wisconsin is one of only five states that require that police officers detain a patient in an emergency. In other states, doctors and other health professionals can order a person into care.
Under the task force's proposal, a pilot program would be created in Milwaukee County and would last for two years. If the program is successful, legislators could expand it to other counties.
Officers don't have as much training and ability to handle situations to get people mental services without confining them against their will, Pasch said.
The problem with the overuse of emergency detention is especially pronounced in Milwaukee County, where most of the funding goes to emergency and inpatient care.
The Journal Sentinel found that one of every three people treated at the county's psychiatric emergency room returns within 90 days.
Over the past three years, Milwaukee County's cost for emergency care rose nearly 14%; at the same time, spending for care in the community was virtually flat.
The county spends 56% of its mental health budget on expensive inpatient care, including emergency room services. The national average is 36%. In Dane County, it's about 14%.
Last year, police in Milwaukee County brought in 973 people whom doctors sent home because they did not meet the standard of dangerousness. At the same time, police have refused to bring in others, whom family members — even doctors — consider dangerously ill.
Emergency detentions are responsible for 65% of the volume of patients who come to Milwaukee County's psychiatric emergency room.
The task force also signed off on creating a way for families and other interested parties to request that counties begin an emergency detention and petition a judge to require the detention if the county does not act.
In August, the Journal Sentinel told of the frustrations of Debbie Sweeney, a Franklin woman who tried to get her son, Rob, 26, committed for mental health care. Lawyers for the county refused to accept a petition filed by Rob's doctor, saying it was too vague. The doctor refused to resubmit the petition. His case was dropped again when police failed to show at his commitment hearing.
The task force's recommendations also include:
■Forming pilot programs in up to four counties that would assist inmates in signing up for BadgerCare Plus health insurance and other public benefits when they are released from jail. The effort is meant to reduce recidivism and is based on a similar program already running in some state prisons.
■Making it easier for families to access in-home treatment for children through BadgerCare Plus and other Medicaid programs.
■Providing grants to law enforcement crisis intervention teams that are trained to respond to people with mental health issues.
■Providing matching funds to counties for mobile mental health crisis teams in rural areas.
■Providing matching funds to counties for pilot peer-run respite services. Those facilities are for people in a mental health or substance abuse crisis and are meant to reduce hospitalizations.
■Creating a hotline for doctors to consult with child and adolescent psychiatrists because of a lack of such psychiatrists in many counties, particularly in the North Woods.
■Eliminating the requirement to file a petition for review when admitting children under 14 for mental health or substance abuse treatment. The petitions also would not have to be filed for children 14 to 17 if they were voluntarily participating in the treatment.
■Expanding a treatment and diversion grant program that provides alternatives to prosecution for those with substance abuse problems. Nine counties offer such programs.
■Making state statutes track more closely with federal medical privacy laws so health care providers can more easily share information about patients' mental health.
■Creating a grant program to encourage primary care doctors to practice in underserved areas of the state.
■Requiring that consumers, family members, law enforcement personnel and hospital representatives serve on boards that govern community programs. Already the boards are required to include people familiar with the problems of the mentally ill, developmentally disabled and those with addictions.
■Studying Iowa's move from a county-based mental health system to a regionally based one.
The task force mostly steered clear of recommending specifics for new funding. The cost of new and expanded programs will be spelled out in any legislation.
Meg Kissinger of the Journal Sentinel staff contributed to this report from Milwaukee.
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