Program eyes in-home mental health care
The Hawk Eye - 6/26/2019
Jun. 26--House calls could join the available options for mental health care in Des Moines County.
"We're working on contracting with another region for ACT, its a new core service," Community Services Director Ken Hyndman told the Des Moines County Board of Supervisors at its meeting on Tuesday.
Assertive Community Treatment, or ACT, is a kind of mental health service that is targeted at the severely mentally ill in the community -- specifically those with schizophrenia, bipolar disorder and schizoaffective disorder. Rather than the person going to services, the services come to them. The goal is to reduce hospitalization.
According to a webinar presented by the University of Iowa in 2016, the program is one step down from residential care. It allows individuals to stay at home, but they still receive intensive mental health services. The service goes beyond mental healthcare and also includes helping individuals find jobs, make friends, and do other daily living tasks. The program also helps individuals get off drugs, which is especially important when considering that persons with severe mental illness who use drugs are eight times more likely to be violent than the general population.
And the program works. A study by the Iowa Department of Human Services found that both hospitalizations and incarceration rates among those receiving the services were decreased by 80%.
By July 2021, all of the state's mental health regions will be required to provide ACT services, along with more than a dozen other services.
But those services come at a cost. ACT relies on multidisciplinary teams that include a psychiatrist, social worker, occupational therapist and nurses. These all are employees the regions will have to hire if they wish to have their own ACT programs.
While the number of individuals who would receive these services hasn't been stated, DHS estimates about six-in-10,000 Iowans will need the service, though that number could be as high as one in 1,000. In the South East Iowa Link region, that means between 97 and 162 individuals across the eight member counties. In Des Moines County, its between 20 and 40 people. Each team can service between 60 and 80 clients. Meaning the SEIL region would need at least two teams to meet the needs of residents.
The need for two psychiatrists is a particularly challenging in southeast Iowa. Throughout the state of Iowa, there has been a shortage of psychiatrists. The shortage, along with lack of funding, led to Great River Medical Center to reducing its number of psychiatrists on staff from five to three. Without funding and individuals to staff the teams, providing the services would be impossible.
The staffing shortage is why SEIL is planning on contracting with other regions for the service. The closest teams to the SEIL Region are in Iowa City and Ottumwa.
The money side is another matter.
Recently, Supervisor Tom Broeker attended a meeting with the Mental Health Disability Services Commission, of which he is a member. He said that in the meeting, it was discussed that ACT will be paid for by Medicaid. However, Broeker said before this can happen, there are a number of administrative rules that needed to be changed.
"All the rules, they stifle innovation," Broeker said during the meeting.
A 30-day notice is required to amend the rules of Medicaid. There has been no timeline given as to when this would happen.
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