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HomeMy WebLinkAboutC.054.93011_1049Swann said it had taken longer to obtain the national accreditation for the Crisis Center. He said the transportation problem (involuntary petitions) had impacted all three counties, and there had been an increase in petitions. Commissioner Johnson asked when the problem would get better. He said the situation was so severe that a few weeks ago, the county had to appropriate additional funds for the sheriff's department to add two new deputy positions for the transports. Swann said (1) there had been more involuntary commitments in the past few months, (2) more of the people being involuntarily committed had other chronic medical problems associated with their psychiatric disorder and (3) the receiving hospitals were closing down fast. (In the central area of North Carolina, over the past six years, 240 beds have been lost.) Swann said that when a patient had serious medical complications, the first order of business was getting them stabilized. He said these patients had to go to a hospital and law enforcement had to stay with them. Then, when stabilized, the patients had to be transported to a secondary hospital, and sometimes this required an ambulance transport. Swann said the hospitals often denied admittance. He said recently a 74 -year-old resident of an adult care home with chronic obstructive pulmonary disease (oxygen dependent), along with having a major psychiatric disorder that made him dangerous and violent, needed care, but no facility was willing to accept him. He said the individual eventually wound up being transported by an ambulance. Commissioner Williams asked if the Crisis Center had never been built, if the patients would be going to Broughton Hospital. Swann said perhaps, or they could be staying in emergency rooms until there was a "receiving hospital." He said in both examples, law enforcement personnel would be used for the transport. Commissioner Robertson said that in listening to Mr. Swann, it sounded like instead of saying when the situation might improve, the board members were being told why the situation wouldn't improve. He asked if there were other options available to reduce the waiting time for the law enforcement officers. Swann said "system redesign" could occur. Robertson asked how far out in time was the redesign. Swann said, "It is mostly out of our control." He said, "When the psychiatrically ill are assessed early on, we can intervene before they get to that need." Robertson asked if the problem was primarily with the patients having both physical and mental problems. Swann said for the most part. He said the patient's age and gender were also factors. Swann said adolescent patients, without physical problems, but with psychiatric or substance abuse problems, would almost guarantee a 15 -hour process. He said the time involved with a client was tracked from start to finish. Swann said a geriatric patient with medical complications and psychiatric problems would take 12 hours, and the law enforcement personnel were experienced enough to predict on their own how much time would be needed. Commissioner Williams said there had been a discussion about the three - counties providing the security. He said this method would allow the deputy to transport the patient and then relinquish custody to the security person. Williams said he understood; however, that one county was resistant to the concept.