Reimbursement discussed for county jails

The Judiciary Committee heard testimony March 3 on a bill that would require the state Department of Health and Human Services to reimburse counties for costs associated with housing defendants who are awaiting competency restoration treatment.

Under LB1223, introduced by Lincoln Sen. Matt Hansen, DHHS would be required to reimburse counties for lodging a defendant at a rate of $100 per day after the first 30 days if a judge orders a defendant to be committed to the Lincoln Regional Center to receive competency treatment and the defendant remains in the county jail. Beginning July 1, 2023, and each July after, the amount reimbursed would be equal to the previous year’s compensation increased by the percentage of the consumer price index.

Hansen said county jails have become mental health facilities — something they were never designed for — because defendants are forced to wait a considerable amount of time before receiving required state services, such as competency treatment.

“Recently, the wait time for those in the Lancaster County Jail waiting to be transferred to the Lincoln Regional Center is averaging about 145 days,” Hansen said. “These individuals are the responsibility of the state of Nebraska, but instead of providing counties with some level of reimbursement for these costs, we allow them to remain in county jails and allow county resources to pay for them.”

The bill also would mandate that state hospitals for the mentally ill provide minimum numbers of beds for different commitment reasons totaling 200 beds.

Finally, the bill would require the DHHS Division of Behavioral Health director and the department CEO to provide an annual report and to testify annually at a joint hearing of the Appropriations and Judiciary committees regarding the department’s compliance with the bill’s provisions starting Nov. 1.

Commissioner Deb Schorr, representing the Lancaster County Board of Commissioners, testified in support of the proposal. Schorr said there has been a steady and significant increase in the percentage of mentally ill detainees compared to the overall Lancaster County jail population, adding that the severity of mental illness also has increased.

“As the wait times at the regional center continue to increase, those in the most need of acute care are housed in our infirmary area because all other less-restrictive options have been exhausted,” she said. “It is my belief that detainees who need to be restored to competency should not be housed in a correctional facility any longer than is necessary.”

C.J. Johnson of Region V Systems, an organization responsible for the development and coordination of publicly funded behavioral health services, spoke in support. It’s critical that the minimum bed requirement provision of the bill be approved to ensure proper resource management, he said.

“When individuals are not able to be admitted to [the Lincoln Regional Center] … the entire state and behavioral health emergency system is compromised as community hospitals and other treatment facilities are forced to reduce capacity, increase staffing and, many times, address damages to facilities,” Johnson said.

Larry Kahl, chief operating officer for DHHS, spoke in opposition to LB1223. Kahl said LRC has faced a number of challenges, including extensive construction delays during recent modifications, resulting in entire buildings and wings being out of commission at various times.

Additionally, he said, LRC has been impacted by the nursing shortage and relies on costly traveling nurses. These challenges would make it difficult for DHHS to comply with the bill’s provisions, he said.

“DHHS opposes arbitrarily establishing a minimum number of beds for a category of admission because this could be physically impossible, create gaps in services, leave beds empty or short needed beds at the facility,” Kahl said.

The committee took no immediate action on LB1223.