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Involuntary commitments. |
05LSO-0092.C1 |
FISCAL NOTE
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FY 2007 |
FY 2008 |
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NON-ADMINISTRATIVE IMPACT |
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Anticipated Expenditure Increase: |
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GENERAL FUND |
3,100,000 |
4,100,000 |
5,100,000 |
Source of Expenditure Increase:
The expenditure increase will be due to the treatment of individuals detained under Title 25 in a hospital other than the State Hospital.
In addition, there is an anticipated expenditure increase for additional services to be provided by community based mental health centers. Although some of the treatment by community based mental health centers may already be provided, it is anticipated by the Department of Health that additional treatments will be requested.
Assumptions:
1. Emergency Detentions (ED) – The State Hospital does not know the number of emergency detentions that are initiated and then dropped throughout the state in the different counties. By not having these numbers, the budgetary estimate will be significantly increased from what the Department of Health does know.
2. The State Hospital receives approximately 250 Title 25 involuntary admissions each year. The average time from the ED to the time that the court order is instituted and the subsequent admission to the State Hospital, by Department of Health responsibility of providing the transportation, is approximately eight days. This equates to 2,000 patient days at an average of $1,000 per day for hospitalization for basic psychiatric care. This equates to an additional increase in expenditures of $2,000,000.
3. The next consideration is the cost of any medical, non-psychiatric, interventions that would be necessary to provide to individuals being held on an ED status. This could easily be predicted to cost an additional $1,000,000.
4. The final item would be consideration to the utilization of the ED status should this legislation pass. The Department of Health offers that the number of ED's will increase dramatically given that there will be no utilization review or other review process to determine the absolute necessity of an ED as well as the continued hospitalization of an ED.
5. The triaging of the patients and the communication between the State Hospital and other providers will be absolutely essential in preventing problems with admissions to the State Hospital.
6. It is anticipated that an additional $100,000 will be needed for the treatment requirement for local providers while persons are in detention. Basis for this portion of the estimate is $100 per hour for four hours per detention for 250 persons per year (100 x 4 x 250 = $100,000). It is further assumed that the Wyoming State Hospital will not be reimbursing community based mental health centers for this additional anticipated cost.
This bill has administrative impact that appears to increase (or decrease) duties or responsibilities of one or more state agencies and may impact agency spending or staffing requirements. As introduced, the bill does not modify any state agency budget or current personnel authorizations.
The following state agencies will be asked to provide their estimate of the administrative fiscal impact prior to the first committee meeting held to consider the bill:
Department of Health
Prepared by: Paul Mullenax & Chuck Hayes, Department of Health
Phone: (307) 789-3464 ext 710 & 777-5698