Baton Rouge – Gov. Bobby Jindal announced today a legislative package he is proposing to strengthen Louisiana’s behavioral health care system. The package of four bills is designed to create standards for local behavioral health agencies, allow for the use of telemedicine technology in the assessment and treatment of persons with mental illness if there is a shortage of available professionals, and create a mental health crisis safety net infrastructure for people in crisis.
The Governor also proposed “Nicola’s law,” a bill that, if passed, would provide a mechanism to ensure people with mental illness and a resulting history of high risk behavior receive the treatment they need in order to avoid harming themselves or others.
Gov. Jindal was joined at the announcement by Department of Health Secretary Alan Levine, several legislators who sponsored the bills, Chief Warren Riley of the New Orleans Police Department and family members of two NOPD officers who were killed by people with a mental illness (Nicola Cotton and LaToya Johnson).
The legislation follows a February announcement of a plan by the Department of Health to provide immediate assistance to the Metropolitan Human Services District to address the emergency behavioral health crisis in Orleans, St. Bernard and Plaquemines parishes.
The untimely death of New Orleans Police officer Nicola Cotton underscored the crisis in mental health care experienced all over the country as well as in Louisiana.
Jindal said, “The broken pieces in our mental healthcare system affect every Louisianian, but the problem is especially acute in New Orleans. New Orleans officials estimate that the annual suicide rate has more than tripled since Hurricane Katrina…and the World Health Organization estimates that tens of thousands of people in the storm-affect region today have a serious mental illness. We must take a comprehensive approach to address this crisis – one that incorporates the needs of patients, law enforcement, and the community as a whole.”
The package includes four bills.
LDH Secretary Alan Levine said that with permission of the family, a key piece of the legislative package would be named Nicola’s Law to honor the memory not only of Officer Cotton, but to respect the law enforcement officers all over Louisiana who confront the issues of untreated mental illness every day.
The proposed measure gives behavioral health experts and families more options and greater flexibility to seek appropriate treatment for a person with a mental illness.
“The goal of this bill is to give treatment professionals and the courts another tool to use to compel treatment if it becomes necessary to do so,” explained Levine. “Behavioral health experts and the courts will have greater authority to ensure that an individual with a violent history is in compliance with his or her treatment protocols.”
The model for this legislation is New York’s “Kendra’s Law.” More than 40 states have established similar laws. Levine said these laws get results.
According to data available from New York after implementation of Kendra’s law, incarcerations fell from 23 percent prior to Kendra’s Law to three percent. Arrests fell from 30 percent to five percent. Psychiatric hospitalizations decreased from 97 percent to 22 percent. And homelessness fell from 19 percent to five percent,” he said.
Establishment of Crisis Receiving Centers
Another bill addresses the need to establish mental health crisis receiving centers. According to Levine, an effective mental health system relies upon a gateway for people in crisis. The proposed legislation creates a framework for planning, establishment and licensing of crisis receiving centers throughout the state. The Governor’s proposed budget includes more than $6 million for the establishment of the first crisis centers.
Moving toward Community-based care, improving standards and expansion of Human Services Districts
The state currently has four human services districts governed by local communities. These districts are responsible for the delivery of services including mental health, addictive disorders and developmental disabilities. The proposed legislation will take a series of steps.
- Establishes districts throughout the state.
- Establishes strict and comprehensive readiness criteria which must be met before new districts become operational. This includes standards for governance, financial controls and policies, purchasing and contracting, clinical protocols and accountability standards.
- Creates strict non-interference language in the bylaws of all districts to ensure boards operate only as a body in the open, and that no individual board member may give direction to staff of the district behind closed doors.
- Establishes ongoing review of districts to ensure each district meets the most current standards for financial controls, contracting, clinical protocols and accountability.
Allowing the use of Telemedicine in the assessment and treatment of people in crisis
In consultation with the leadership of the Board of Medical Examiners, the Administration has proposed the use of advanced technology to help deal with the shortage of mental health professionals. Telemedicine would be used to evaluate, observe and recommend treatment for people in crisis if there is no mental health expert available for a face-to-face evaluation.
In his recommended budget for 2008-2009, Gov. Jindal included more than $89 million in additional funding. More than $26 million is dedicated to initiatives such as Assertive Community Teams, Crisis Intervention Teams and Receiving Centers. More than $60 million is dedicated to fully funding programs that were either funded through Social Services Block Grants or were not annualized.
“The combined impact of these bills and the Governor’s budget represents a sweeping transformation of our mental health system,” said Levine. “The mental health system has been neglected, and while it won’t be fixed overnight, this is the kind of commitment one would expect of a reform-minded Governor.”
“The families of Officers’ Cotton and Johnson understand why it is vital that we have better alternatives for people with a mental illness. Chief Riley and the law enforcement community also understand why. Just as importantly, families who face the daily struggle of getting their loved ones the help they need, understand the importance of ensuring that people who are in crisis get help,” said Sen. Cheryl Gray as she discussed her bill to ensure mandatory institutionalization in appropriate situations.