DRUNKS, DRUG ABUSERS CROWDING OUT 'ACUTE PSYCHIATRIC' PATIENTS

Chronic drunks and drug abusers are crowding West Virginia's only two
state-run psychiatric hospitals, prompting Health and Human Resources
Secretary Paul Nusbaum to call Tuesday for immediate action.

Nusbaum warned the Joint Committee on Government and Finance at Glade
Springs Resort the matter cannot be put off until the 2005 legislative
session.

At the root of the matter was a change in state law excising the
phrase "harmful to themselves and others," opening the door to send
abusers to state hospitals, he said.

Under the old system, he explained afterward, the mental hygiene
commissioner had to make a finding before involuntarily committing
such people.

In short, it meant the drunk or druggie had to pose "harm to
themselves and others."

"Once that was removed, someone shows up at the mental hygiene
commissioner on Friday night, 2 o'clock in the morning, drunk, and
they don't want to keep them in jail," he said.

Instead, the abuser is shipped off to either Bateman Hospital in
Huntington or Sharpe Hospital in Weston to dry out a few days.

"And it's costing us a fortune," he said.

Sen. William Sharpe, D-Weston, for whom one hospital was named,
suggested the panel start the ball rolling for remedial
legislation.

Nusbaum told reporters hygiene commissioners are weary of seeing the
same drunk or drug abuser, "and they think this is the best source of
treatment."

Additionally, the county is relieved of keeping such people in jails
and the expense is dumped on the state, he said.

Perhaps, the secretary said, psychiatric treatment is warranted in
some cases.

"But we only have a finite number of beds," he said. "We just can't
continue to handle the load because what we're doing, for the acute
psychiatric patient who truly needs in-patient setting, we may not
have a bed available. Now, we've got problems."

Nusbaum said the two state hospitals have been at capacity for several
months, forcing DHHR to contract with private psychiatrist entities.
Within the past three months, he said, his agency has witnessed "an
unbelievable increase" in drug and alcohol cases arriving at the two
state hospitals. If this trend continues, he said, it means an
additional expense to the state of $5 million to $6 million a year.

"Patients could be treated within the community," the secretary said.
"That's our problem. We don't have enough out-patient community
treatment services. We need to be developing those. It's something
we've neglected for years and years. We're in the process of trying to
address that."

Senate President Earl Ray Tomblin, D-Logan, agreed a problem exists
and suggested Nusbaum work with legislators to produce a proposal
within 30 days.

"We can't just slam the door on these people," Tomblin said.

Nusbaum unveiled another problem -- a snafu in a "state-of-the-art"
billing system that results in health care providers collecting less
than what they're entitled to for Medicaid services.

"It's not that they're not getting paid," he said. "They're not
getting the proper amount."

These cover a wide gamut of providers -- doctors, dentists and the
like.

House Speaker Bob Kiss, D-Raleigh, said his vision of state-of-the-art
is a system that doesn't delay full payment.

"We need to correct it," he said.