Last week Idaho’s three branches of government, legislative, judicial and executive made a joint announcement. They agreed through resolution and executive order to form a Behavioral Health Council and Advisory Board. It’s a wise move. But hasn’t this been done before?
If this sounds familiar, it might be because there already exists a Behavior Health Planning Council. It was established in law in 2006. Of note, there was expected to be $4M in funding to support the duties assigned to the Council that year, which included the development of transitional housing. This Council was directed to give a yearly report to the Governor and the legislature. They are interesting reading.
Maybe this new executive order sounds familiar because there have been many studies in the past. But they were different. Usually these were done by outside entities that would come in and review what Idaho was doing around our “Behavioral Health System” and make recommendations. The most recent ones I am familiar with include the first WICHE report (2008) and their 10 year follow up in 2018. Further, there was another recent report evaluating Idaho’s Crisis “System of Care” which reviewed the performance of the regional crisis centers.
But maybe this time the work will be different. The work you get out of an effort often reflects the people doing the work. This Council will have appointees from the Governor, the Chief Justice and the legislature. This is not an independent evaluation. This is Idaho folks with skin in the game.
The Council has four directives:
1. Develop a plan to inventory expenditures, access and utilization
2. Assess the effectiveness of the current system and look for ways to efficiently coordinate
3. Determine Idaho’s unique needs
4. Recommend actions to “materially improve” Idaho’s behavior health system
Finally, the Council is supposed to develop a strategic plan and deliver it to the governor, legislature and judiciary this coming Halloween. I kid you not, that’s the deadline. Any ideas for a costume?
I applaud these goals. Why not get all the folks who see this problem from their many perspectives together?
Let’s look at number one: counting up where and how much we are spending. Did you know that the courts have money for “specialty courts?” These can be called behavioral health court, family court or “Drug Court.” Offenders may have a plea or sentencing delayed if the court decides the main problem they are dealing with is drug addiction or alcoholism. If the offender agrees to the recommended treatment plan and sticks with it, they might get off without incarceration.
Further, the Department of Corrections pays for treatment of incarcerated addicts, and supports recently released offenders with drug problems on parole or probation. Many are now eligible for Medicaid, which can also support treatment. So, we pay through the state judiciary budget, the state corrections budget and the Department of Health and Welfare. It seems adding all this up, counting what we are treating makes common sense.
Number two might be harder; assessing effectiveness. I have wondered before, what are we counting? But I have no doubt there are efficiencies that coordination could accomplish, but remember how some legislators reacted to classroom standards? Maybe setting standards for behavioral health will be easier.
Number three, assessing Idaho’s unique needs can’t be any tougher than driving to Boise from the Panhandle in January.
The final task, recommend “material” improvements, is easy, unless there is a budget item to consider.
I suspect the people who put this together, the governor, the judges, legislators are all tired of dealing with this problem from their limited vantage point. Maybe they see hope that together, maybe we can make a difference. That’s an inspirational view. I wish them the best.
Dan Schmidt is a family physician who lives in Moscow. Dr. Schmidt, a Democrat, served in the Idaho state senate from 2010 to 2016.