LOUISIANA Community Mental Health Services Block Grant ...

SECTION II – IDENTIFICATION & ANALYSIS OF SERVICE SYSTEM‟S STRENGTHS,
NEEDS, & PRIORITIES
UNMET SERVICE NEEDS & PLANS TO ADDRESS UNMET NEEDS
LOUISIANA FY 2011 - ADULT & CHILD/ YOUTH PLAN
Criterion 1: Comprehensive Community-based Mental Health Services
The effort to provide an improved and seamless system of services is an ongoing goal for the Office
of Behavioral Health. Service and system integration at the local level as well as the organizational
level continues. This is shown most poignantly in the merging of the Offices of Mental Health and
Addictive Disorders described earlier in this document. Additionally, the integration of the acute
psychiatric inpatient hospital units with the various community based programs continues, utilizing
the Louisiana State University (LSU) Medical Center administration‟s help and commitment. OBH
and the LSU hospitals have implemented statewide and local agreements that govern the roles and
responsibilities of the two organizations in their collective efforts at developing a more
comprehensive range of acute care services for adults. This agreement addresses budgetary, clinical,
and human resource issues.
Mental health services for individuals and families who come before the State‟s criminal, family, and
juvenile court systems are inadequate. Civil psychiatric beds continue to be used for forensicallyinvolved
persons, thereby limiting access to inpatient psychiatric care for the general population.
More than a majority of the existing civil inpatient service capacity is constricted by the demand for
forensic inpatient services. Despite the addition of forensic beds for competency restoration and the
implementation of competency restoration services in the parish prisons and the implementation of a
juvenile competency restoration program, the lack of community based resources for managing the
forensic population prevents discharging a sufficient number of those in the forensic facility who
would otherwise be eligible. Judicial restraint on approving such releases also creates a „back door‟
barrier which directly affects access and creates a sustainable and growing forensic waiting list.
Access to medications has historically been difficult due to the limited number of psychiatrists
working in the clinics. OBH now has a policy that allows non-physician professionals who have
prescriptive authority to prescribe within OBH facilities. The inclusion of Medical Psychologists and
Advance Practice Nurse Practitioners allows patients and consumers greater access to the care they
need. Several mental health clinics have taken advantage of this added resource to the benefit of their
clients.
The Office of Behavioral Health has a formulary that includes all of the newer antipsychotic agents,
antidepressants, and mood stabilizers; however the cost of these medications is often high. Thanks to
the efforts of outpatient clinic employees, the Office of Mental Health has capitalized on the available
Patient Assistance Programs (PAP) to offset the cost of providing medications to OBH outpatient
clinic clients. The cost of 70% of outpatient medications is underwritten by PAP. Staff members
have also assisted all clients who are eligible with obtaining Medicare Part D or Medicaid benefits.
In the past few years, these efforts have resulted in a savings of several million dollars each year from
the six Regions alone. It is estimated that OBH pharmacies have dispensed almost $9 million worth
of prescriptions from Patient Assistance Programs and sample medications during each of the last
two years; and that local community pharmacies have dispensed medications valued at roughly an
estimated $20 million utilizing Medicaid and Medicare funding to OBH clients.
PART C LOUISIANA FY 2011 PAGE 71
SECTION II: ADULT & CHILD/ YOUTH
IDENTIFICATION & ANALYSIS OF SERVICE SYSTEM’S STRENGTHS, NEEDS, & PRIORITIES
UNMET SERVICE NEEDS & PLANS TO ADDRESS UNMET NEEDS