Audit suggests ways to improve mental health services

CARSON CITY – An audit suggesting ways to improve the delivery of mental health services while saving the state money was reviewed by Gov. Brian Sandoval and other officials Friday.

But Sandoval and others noted that substantial hurdles stand in the way of implementing many of the recommendations.

The audit by the state Division of Internal Audits was reviewed by the Executive Branch Audit Committee, which includes Sandoval and other top state elected officials as well as a member of the public.

Among the findings:

—The state Division of Public and Behavioral Health should consider implementing jail-based competency programs in Clark and Washoe counties. Such programs could save the state $1.2 million annually by reducing the number of beds needed at the Lakes Crossing Center for mentally ill offenders in Sparks.

—The opening of the rehabbed Stein Hospital in Las Vegas to serve both mentally ill offenders and the civil mentally ill population could allow the agency to close two units at Lakes Crossing at a savings of $3 million a year.

—Creating a Lakes Crossing satellite unit at the Department of Corrections Regional Medical Facility in Carson City would allow the agency to provide improved treatment to mentally ill inmates. The proposal could save $323,000 by allowing Medicare billings for eligible inmates, along with a potential savings of $9.6 million from reduced recidivism due to improved treatment.

Auditors noted that Lakes Crossing first must become certified by the federal Centers for Medicare & Medicaid Services, an effort that is underway but is not finalized.

Lakes Crossing is the only state facility treating mentally ill offenders.

Mike Willden, director of the Department of Health and Human Services, welcomed the recommendations but noted that many of them could take several years to implement. The Stein Hospital won’t be ready for two years, and Lakes Crossing issues can’t be addressed until then, he said.

“We support the findings, we support the need for evaluation … but there are several hurdles for us to get through over the next year to 18 months,” Willden said.

The agency’s current priority is getting the Rawson-Neal Hospital in Las Vegas re-certified by CMS following the controversy over allegations of patient dumping by the facility, he said.

Inspectors are expected to revisit the facility at any time ahead of a Nov. 4 deadline when Medicare funding could be cut off, Willden said.

Sandoval said the audit is well-intentioned, but he expressed concern about the idea of reducing beds for mentally ill offenders at Lakes Crossing.

“There are some uncertainties that we can’t control that will have an effect on this,” he said. “In Clark County the amount of commitments has tripled in the last six months by the courts there.”

It is that unexpected increase in court commitments to Lakes Crossing that has made it necessary to expand the number of beds at the facility, Sandoval said.

Contact Capital Bureau reporter Sean Whaley at or 775-687-3900. Follow @seanw801 on Twitter.

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