<br><br><div class="gmail_quote"><div lang="EN-US" vlink="purple" link="blue"><div><p class="MsoNormal"><span style="color:rgb(31,73,125);font-family:"Calibri","sans-serif";font-size:11pt">Visioneers:<u></u><u></u></span></p>
<p class="MsoNormal"><span style="color:rgb(31,73,125);font-family:"Calibri","sans-serif";font-size:11pt"><u></u> <u></u></span></p>
<p class="MsoNormal"><span style="color:rgb(31,73,125);font-family:"Calibri","sans-serif";font-size:11pt">We are now about 1 month past the shootings at Sandy Hook elementary. Predictably, there has been discussion of gun control. It takes a human being to pull
a trigger. I believe cuts we have continually made to our national mental health system since the Reagan era are the primary culprit. What I couldn’t mention at the time of the shooting was that I had seen a draft survey of how mental health state budget
cuts made in FY2011 have impacted us in central Idaho. This survey shows the direct impact of lowered funding of mental health treatment. It indicates funding mental health saves us money in more expensive areas. I believe this
same relationship holds for the national picture.<u></u><u></u></span></p>
<p class="MsoNormal"><span style="color:rgb(31,73,125);font-family:"Calibri","sans-serif";font-size:11pt"><u></u> <u></u></span></p>
<p class="MsoNormal"><span style="color:rgb(31,73,125);font-family:"Calibri","sans-serif";font-size:11pt">The survey is now officially out. I have copied it for your perusal below. Copies are also going to legislators.
<u></u><u></u></span></p>
<p class="MsoNormal"><span style="color:rgb(31,73,125);font-family:"Calibri","sans-serif";font-size:11pt"><u></u> <u></u></span></p>
<p class="MsoNormal"><span style="color:rgb(31,73,125);font-family:"Calibri","sans-serif";font-size:11pt">Survey conducted by members of the Idaho Region 2 Mental Health Board. Its purpose was to see what impact 20011 cuts to the states mental health budget
have had in our local area. <u></u><u></u></span></p>
<p class="MsoNormal"><span style="color:rgb(31,73,125);font-family:"Calibri","sans-serif";font-size:11pt"><u></u> <u></u></span></p>
<p class="MsoNormal"><span style="color:rgb(31,73,125);font-family:"Calibri","sans-serif";font-size:11pt">Looks like that 2011 budget cut cost us a lot of money!<u></u><u></u></span></p>
<p class="MsoNormal"><span style="color:rgb(31,73,125);font-family:"Calibri","sans-serif";font-size:11pt"><u></u> <u></u></span></p>
<p class="MsoNormal"><span style="color:rgb(31,73,125);font-family:"Calibri","sans-serif";font-size:11pt">Without further comment:<u></u><u></u></span></p>
<p class="MsoNormal"><span style="color:rgb(31,73,125);font-family:"Calibri","sans-serif";font-size:11pt"><u></u> <u></u></span></p>
<p style="text-align:center;margin-top:12pt" class="MsoNormal" align="center"><b>LEGISLATIVE IMPACT SURVEY – FY 2012<u></u><u></u></b></p>
<p style="margin-top:12pt" class="MsoNormal"><b>Purpose of the research: </b>To identify needs and gaps in the delivery of behavioral health services to Region II. Follow up research to Fiscal Year (FY) 2011 Legislative Impact Survey<u></u><u></u></p>
<p class="MsoNormal"><b>Participants: </b>County Prosecutors; Law Enforcement; Private Behavioral Health Providers; County Health and Welfare Directors; Region II – Director of Health and Welfare; School Counselors, School Social Workers, School Psychologists;
and Hospitals.<u></u><u></u></p>
<p class="MsoNormal"><u></u> <u></u></p>
<p style="line-height:normal;margin-bottom:0pt">
<u></u><span style="font-family:Symbol"><span>·<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">Total Surveys completed - 28<u></u><u></u></span></p>
<p style="margin-top:12pt" class="MsoNormal"><b><u>Increasing number of individual requiring behavioral health services</u></b><u></u><u></u></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:0.5in">
<u></u><span style="font-family:Symbol"><span>·<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><u><span style="font-family:"Times New Roman","serif"">Region II – Health and Welfare<u></u><u></u></span></u></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1in">
<u></u><span style="font-family:"Courier New""><span>o<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">Crisis Response – Children
<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1.5in">
<u></u><span style="font-family:Wingdings"><span>§<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">FY 2010 -- 35 incidents<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1.5in">
<u></u><span style="font-family:Wingdings"><span>§<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">FY 2011 – 28 incidents<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1.5in">
<u></u><span style="font-family:Wingdings"><span>§<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">FY2012 – 38 incidents<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1in">
<u></u><span style="font-family:"Courier New""><span>o<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">Crisis Response - Adults<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1.5in">
<u></u><span style="font-family:Wingdings"><span>§<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">FY 2010 – 265 incidents<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1.5in">
<u></u><span style="font-family:Wingdings"><span>§<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">FY 2011 – 274 incidents<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1.5in">
<u></u><span style="font-family:Wingdings"><span>§<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">FY 2012 – 340 incidents<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1in">
<u></u><span style="font-family:"Courier New""><span>o<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">Hospitalizations – Mental Health Holds<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1.5in">
<u></u><span style="font-family:Wingdings"><span>§<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">FY 2010 – 25 days
<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1.5in">
<u></u><span style="font-family:Wingdings"><span>§<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">FY 2011- 47 days<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1.5in">
<u></u><span style="font-family:Wingdings"><span>§<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">FY 2012 - 105 days<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1in">
<u></u><span style="font-family:"Courier New""><span>o<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">Cost of Hospitalizations<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1.5in">
<u></u><span style="font-family:Wingdings"><span>§<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">FY 2010 – $27,175<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1.5in">
<u></u><span style="font-family:Wingdings"><span>§<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">FY 2011 – $53,295<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1.5in">
<u></u><span style="font-family:Wingdings"><span>§<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">FY 2012-- $112,700<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1in">
<u></u><span style="font-family:"Courier New""><span>o<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">Clients with Substance Abuse Disorders<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1.5in">
<u></u><span style="font-family:Wingdings"><span>§<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">FY 2010 – 585 individuals<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1.5in">
<u></u><span style="font-family:Wingdings"><span>§<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">FY 2011 – 903 individuals<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1.5in">
<u></u><span style="font-family:Wingdings"><span>§<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">FY 2012 -- 958 individual<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:0.5in">
<u></u><span style="font-family:Symbol"><span>·<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><u><span style="font-family:"Times New Roman","serif"">County Prosecutors<u></u><u></u></span></u></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1in">
<u></u><span style="font-family:"Courier New""><span>o<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">Number of defendants with mental health and/or substance abuse involvement<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1.5in">
<u></u><span style="font-family:Wingdings"><span>§<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">Increasing over last three years in 3 jurisdictions<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1.5in">
<u></u><span style="font-family:Wingdings"><span>§<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">15-30% of defendants have mental health issues<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1.5in">
<u></u><span style="font-family:Wingdings"><span>§<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">30-80% of defendants have substance abuse issues<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1.5in">
<u></u><span style="font-family:Wingdings"><span>§<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">These cases require more time, money and resources<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1.5in">
<u></u><span style="font-family:Wingdings"><span>§<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">Individuals more likely to be incarcerated<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1in">
<u></u><span style="font-family:"Courier New""><span>o<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">Resources<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1.5in">
<u></u><span style="font-family:Wingdings"><span>§<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">Increasingly fewer options and fewer volunteers since 2009<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1.5in">
<u></u><span style="font-family:Wingdings"><span>§<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">Defendants unable to access services due to inability to afford and/or lack of transportation<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1.5in">
<u></u><span style="font-family:Wingdings"><span>§<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">Loss of ACT Team in one community increased number of crises and reduced general level of functioning of individuals<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:0.5in">
<u></u><span style="font-family:Symbol"><span>·<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><u><span style="font-family:"Times New Roman","serif"">Law Enforcement<u></u><u></u></span></u></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1in">
<u></u><span style="font-family:"Courier New""><span>o<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">Mental Health Holds and Transports<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1.5in">
<u></u><span style="font-family:Wingdings"><span>§<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">Between 2010 & 2011 number of holds and transports almost doubled in one jurisdiction – 31 to 59 respectively<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1.5in">
<u></u><span style="font-family:Wingdings"><span>§<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">Between 2010 & 2012 in same jurisdiction number of suicide attempts also increased from 34 to 62 incidents. Each incident requires 2 to 5 hours of staff time<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1in">
<u></u><span style="font-family:"Courier New""><span>o<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">Indirect Costs<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1.5in">
<u></u><span style="font-family:Wingdings"><span>§<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">Removing officers from area<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1.5in">
<u></u><span style="font-family:Wingdings"><span>§<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">Calling in off-duty officers<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1.5in">
<u></u><span style="font-family:Wingdings"><span>§<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">Fuel costs to transport<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:0.5in">
<u></u><span style="font-family:Symbol"><span>·<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><u><span style="font-family:"Times New Roman","serif"">Private Medicaid Providers<u></u><u></u></span></u></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1in">
<u></u><span style="font-family:"Courier New""><span>o<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">Medicaid Client Served<u><u></u><u></u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1.5in">
<u></u><span style="font-family:Wingdings"><span>§<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">Agency 1<u><u></u><u></u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:2in">
<u></u><span style="font-family:Symbol"><span>·<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">2010 – 157 individuals<u><u></u><u></u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:2in">
<u></u><span style="font-family:Symbol"><span>·<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">2011 – 121 individuals<u><u></u><u></u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:2in">
<u></u><span style="font-family:Symbol"><span>·<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">2012 – 106 individuals<u><u></u><u></u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:2in">
<u></u><span style="font-family:Symbol"><span>·<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">Served by 12 clinicians<u><u></u><u></u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1.5in">
<u></u><span style="font-family:Wingdings"><span>§<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">Agency 2<u><u></u><u></u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:2in">
<u></u><span style="font-family:Symbol"><span>·<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">2010 – 60 individuals<u><u></u><u></u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:2in">
<u></u><span style="font-family:Symbol"><span>·<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">2011 – 60 individuals<u><u></u><u></u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:2in">
<u></u><span style="font-family:Symbol"><span>·<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">2012 – 100 individuals<u><u></u><u></u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:2in">
<u></u><span style="font-family:Symbol"><span>·<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">Served by 4 clinicians<u><u></u><u></u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1in">
<u></u><span style="font-family:"Courier New""><span>o<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">Neither agency would continue to serve Medicaid clients if agencies required to complete accreditation requirements due to cost<u><u></u><u></u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1in">
<u></u><span style="font-family:"Courier New""><span>o<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">Reasons for continued services for Medicaid clients<u><u></u><u></u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1.5in">
<u></u><span style="font-family:Wingdings"><span>§<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">Idaho’s rural residence deserved care<u><u></u><u></u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1.5in">
<u></u><span style="font-family:Wingdings"><span>§<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">Medicaid is often only way rural clients can receive services<u><u></u><u></u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1in">
<u></u><span style="font-family:"Courier New""><span>o<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">Experience as Medicaid contractor<u><u></u><u></u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1.5in">
<u></u><span style="font-family:Wingdings"><span>§<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">Reimbursement rate 55% below standard hourly rate & 50% below insurance reimbursement rate<u><u></u><u></u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1.5in">
<u></u><span style="font-family:Wingdings"><span>§<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">Rules not readily announced and interpretations may be subjective<u><u></u><u></u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1in">
<u></u><span style="font-family:"Courier New""><span>o<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">What is working<u><u></u><u></u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1.5in">
<u></u><span style="font-family:Wingdings"><span>§<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">State of Idaho pays bills on time<u><u></u><u></u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1.5in">
<u></u><span style="font-family:Wingdings"><span>§<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">Overall coverage of services for psychotherapy and testing good<u><u></u><u></u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1in">
<u></u><span style="font-family:"Courier New""><span>o<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">Perceived needs and gaps<u><u></u><u></u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1.5in">
<u></u><span style="font-family:Wingdings"><span>§<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">Testing<u><u></u><u></u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:2in">
<u></u><span style="font-family:Symbol"><span>·<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">Reimbursement too low<u><u></u><u></u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:2in">
<u></u><span style="font-family:Symbol"><span>·<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">Waiting list extraordinarily long<u><u></u><u></u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1.5in">
<u></u><span style="font-family:Wingdings"><span>§<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">Compensation<u><u></u><u></u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:2in">
<u></u><span style="font-family:Symbol"><span>·<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">No reimbursement for collateral contacts, case reviews or paperwork<u><u></u><u></u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1.5in">
<u></u><span style="font-family:Wingdings"><span>§<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">Privatization<u><u></u><u></u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:2in">
<u></u><span style="font-family:Symbol"><span>·<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">Will not improve services<u><u></u><u></u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:2in">
<u></u><span style="font-family:Symbol"><span>·<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">Will increase cost and reduce services<u><u></u><u></u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:2in">
<u></u><span style="font-family:Symbol"><span>·<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">Will be fewer Medicaid providers<u><u></u><u></u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1.5in">
<u></u><span style="font-family:Wingdings"><span>§<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">Excessive rules and regulations cost businesses more and reduce patient care<u><u></u><u></u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:2in">
<u></u><span style="font-family:Symbol"><span>·<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">Streamline for more efficient care<u><u></u><u></u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:2in">
<u></u><span style="font-family:Symbol"><span>·<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">Reduce number of rules and regulations<u><u></u><u></u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1.5in">
<u></u><span style="font-family:Wingdings"><span>§<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">Physician supervision added expense<u><u></u><u></u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:2in">
<u></u><span style="font-family:Symbol"><span>·<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">Make use of client’s primary care provider<u><u></u><u></u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:0.5in">
<u></u><span style="font-family:Symbol"><span>·<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><u><span style="font-family:"Times New Roman","serif"">Hospitals<u></u><u></u></span></u></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1in">
<u></u><span style="font-family:"Courier New""><span>o<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">Emergency Room Visits – Mental Health
<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1.5in">
<u></u><span style="font-family:Wingdings"><span>§<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">2010 – 1532 visits<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1.5in">
<u></u><span style="font-family:Wingdings"><span>§<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">2011 – 1649 visits<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1in">
<u></u><span style="font-family:"Courier New""><span>o<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">Emergency Room Visits – Substance Abuse Disorders<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1.5in">
<u></u><span style="font-family:Wingdings"><span>§<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">2010 – 160 visits<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1.5in">
<u></u><span style="font-family:Wingdings"><span>§<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">2011 – 158 visits<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1in">
<u></u><span style="font-family:"Courier New""><span>o<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">Hospital Admissions – Mental Health
<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1.5in">
<u></u><span style="font-family:Wingdings"><span>§<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">2010 - 499<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1.5in">
<u></u><span style="font-family:Wingdings"><span>§<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">2011 - 529<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1in">
<u></u><span style="font-family:"Courier New""><span>o<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">Hospital Admission – Substance Abuse Disorders<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1.5in">
<u></u><span style="font-family:Wingdings"><span>§<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">2010-- 242
<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1.5in">
<u></u><span style="font-family:Wingdings"><span>§<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">2011 – 272<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1in">
<u></u><span style="font-family:"Courier New""><span>o<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">Indigent Costs for Mental Health and Substance Abuse Disorders<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1.5in">
<u></u><span style="font-family:Wingdings"><span>§<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">2010 - $672,296<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1.5in">
<u></u><span style="font-family:Wingdings"><span>§<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">2011- $877,190<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:0.5in">
<u></u><span style="font-family:Symbol"><span>·<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><u><span style="font-family:"Times New Roman","serif"">County Health and Welfare Directors<u></u><u></u></span></u></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1in">
<u></u><span style="font-family:"Courier New""><span>o<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">Cost of Mental Health Holds in one county<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1.5in">
<u></u><span style="font-family:Wingdings"><span>§<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">2010 – $51,008<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1.5in">
<u></u><span style="font-family:Wingdings"><span>§<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">2011 – $84,923<u></u><u></u></span></p>
<p style="margin-top:12pt" class="MsoNormal"><b><u>Need for school-based behavioral health services</u></b>
<u></u><u></u></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:0.5in">
<u></u><span style="font-family:Symbol"><span>·<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">Number of children with mental health diagnoses has increase from the 2010-2011 school year to 2012-13 school year<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:0.5in">
<u></u><span style="font-family:Symbol"><span>·<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">87% of respondents indicated that community mental health services are less than adequate<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:0.5in">
<u></u><span style="font-family:Symbol"><span>·<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">Services needed
<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1in">
<u></u><span style="font-family:"Courier New""><span>o<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">More community based services (73% of respondents)<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1.5in">
<u></u><span style="font-family:Wingdings"><span>§<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">Additional staffing for community based mental health services
<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1in">
<u></u><span style="font-family:"Courier New""><span>o<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">Availability and accessibility of community services particularly for low income families<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1in">
<u></u><span style="font-family:"Courier New""><span>o<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">Child psychiatrist who will communicate with schools (87%)<u></u><u></u></span></p>
<p style="line-height:normal;margin-right:0in;margin-bottom:0pt;margin-left:1in">
<u></u><span style="font-family:"Courier New""><span>o<span style="font:7pt/normal "Times New Roman";font-size-adjust:none;font-stretch:normal">
</span></span></span><u></u><span style="font-family:"Times New Roman","serif"">School –based mental health and PSR services (60%)<u></u><u></u></span></p>
<p style="margin-top:12pt" class="MsoNormal">Eleanor Pepi Downey, MSW, PhD<u></u><u></u></p>
<p style="text-align:justify" class="MsoNormal">Diana Pals, LCPC, M.Ed.<u></u><u></u></p>
<p class="MsoNormal"><span style="color:rgb(31,73,125);font-family:"Calibri","sans-serif";font-size:11pt"><u></u> <u></u></span></p>
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