View Full Version : Counties face dilemma with mentally ill


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08-01-2005, 05:24 PM
8/1/2005 9:28:23 AM
Daily Journal

By ROBBIE WARD


Daily Journal

Mentally ill people are being locked up in jails because counties say they can't put them anywhere else.

A state law that took effect a year ago has many county officials complaining that it compromises safety for the mentally ill, opens some counties to lawsuits and has others threatening to sue themselves, county officials say.

The law states that people legally ruled incompetent must be taken to state-run mental health hospitals. Until these people get to the state hospitals, counties must pay for them to be at approved mental health facilities.

The problem is, many of them aren't getting to mental health facilities.

In Monroe County's jail are about six people who were declared mentally incompetent by Lunacy Court.

Lunacy Court is where people are declared mentally incompetent by a judge. A person is legally incompetent if he poses a threat to himself or others, can't care for himself or will hurt others.

"I regret that we don't have a place to keep them for their condition," said Ronnie Boozer, Monroe County chancery clerk.

Many officials in Monroe and other counties who keep mentally incompetent people are concerned about injuries these people could cause while in jail. Injuries could open the county up to lawsuits because the mentally ill are supposed to be in health facilities instead of being locked up.

Many counties say they can't afford fees to keep mentally ill people in approved facilities. They say keeping them in hospitals costs $300 to more than $450 a day.

"The jail is certainly not a treatment facility," said Ann Odom, an attorney in Monroe County who handles lunacy court cases. "It definitely is a case where our patients are outrunning the funds assigned to their care."

Others troubled, too

Lafayette County Chancery Clerk Sherry Wall said the situation puts counties in a tight spot having to juggle enormous facility costs with liability issues.

"It's a catch-22," she said of deciding between jailing mental patients because the county can't afford otherwise or to trying to find way to finance stays in approved facilities.

Lafayette County usually jails its mental patients until a bed opens up in a state hospital.

Roger McMurtry, assistant chief for the Mississippi Department of Mental Health, said these decisions are a problem state- and nationwide.

"I personally find it abominable for people to be in jail because they're mentally ill," McMurtry said.

Records show that in mid-July 24 people statewide were in jail because of mental conditions, and McMurtry said many others wait in jail for openings in alcohol and drug rehabilitation programs.

Mississippi's state mental hospitals are full nearly all of the time, which makes for long waits to get in.

"You've got only so many beds and so many doctors available," he said.

Of the 11 state mental facilities, two are in Northeast Mississippi - Tupelo and Corinth.

Lee County Sheriff Jim Johnson said keeping mentally ill people in the jail can't help their state-of-mind. Recently four people were in the Lee County Jail waiting for a spot in a state facility. He said some mentally ill people have spent up to 40 days in jail waiting to get into the hospital.

"They've been locked and denied freedom," Johnson said. "They're being punished for something they can't help."

Paying for supervision and care for mentally ill people while in jail comes from the jail's budget, Johnson said.

Suing the state?

Oktibbeha County's lunacy court budget allocation - judge and court fees along with any facility costs - was $32,000 this fiscal year.

In April, that county stopped holding mentally ill people in the county jail, but then mental facility bills made local officials wonder if they were doing the right thing. The county's bill from Alliance Health Center in Meridian was $123,370 for keeping six people for a month.

"I don't know how we can keep funding it," said Don Posey, Oktibbeha County administrator.

Posey and County Attorney Jack Brown are talking about forcing the state government to pay for the law it passed.

"This is grounds for litigation," Brown said.

Posey nor Brown has said whether the county will file a lawsuit. However, if nothing changes the county can expect to pay lots more for mental health facilities. The Lunacy Court budget proposal for fiscal year 2006 is $500,000.

Jacob Ray, a special assistant to Attorney General Jim Hood, said the courts must determine if it's appropriate for counties to sue the state on an issue like this.

"However, Mississippi courts have said time and time again that counties are creatures of the Legislature," Ray noted. "And if the Legislature says that a county shall spend funds in certain ways, then the county shall spend funds as the Legislature directed."

In another approach to a solution, Posey said he's trying make a deal with the Oktibbeha County Hospital to keep some of the mentally ill people waiting to go to a state mental hospital.

However, hospital administrator Sonny Kelly said the facility isn't equipped to keep mentally ill people more than short periods.

Posey said even if a deal is reached with the county-run hospital, legal action should be taken.

"I think we ought to bring a suit against the state," he said. "If they pass the law, they should fund it."

Senator's view

Sen. Ralph Doxey, R-Holly Springs, who is on the Senate's Corrections Committee, said he's wasn't aware of the problem but is also against unfunded mandates.

"It's easy to pass a law like that and walk away from it," said Doxey, who wasn't in the Senate when the law was passed.

Doxey, an attorney, said he has handled lunacy hearings and knows the importance of having mentally ill people in health facilities instead of jails.

A state-funded "mechanism" should pay for the health care instead of counties, Doxey said. However, he's not for tax increase to do it.

Posey said the Legislature is passing the buck on the funding, forcing counties either to raise local taxes or break the law, opening up possible lawsuits.

"I don't know how we'll be able to afford it without a sizable tax increase," Posey said.

Contact Robbie Ward at 323-9831 or robbie.ward@djournal.com


What the law says: The court shall commit the patient for treatment in the least restrictive treatment facility that can meet the patient's treatment needs. Treatment prior to admission to a state-operated facility shall be located as closely as possible to the patient's county of residence and the county of residence shall be responsible for the cost.

Appeared originally in the Northeast Mississippi Daily Journal, 8/1/2005 8:00:00 AM, section A , page 1