NORTHERN KENTUCKY ISSUES
 

Regional Planning Council
 

Locally, the Regional Planning Council (RPC) meets monthly.  The RPC continues to make reports to the State Commission on needs and barriers for Northern Kentucky.  The RPC is also focusing on defining the full continuum of care needed for this region. As this process continues to be developed we will update what information is available or how the reports can be obtained. 
 

Regional Planning Council Recommendations adopted in 2002.
 

As a result of HB 843, each region in the state created a local Regional Planning Council (RPC) to make recommendations on mental health and substance abuse needs in their region.  Each region in turn submits their local needs to a State Commission, which compiles a state-wide list of common needs to be submitted to the Legislature for possible action. 

Included below is a summary of the local recommendations of the RPC.  Please review this and keep in mind this is the initial list of recommendations to the State.  The RPC is continuing to meet and will revise and update the needs over time. 

The most significant recommendations are:

• Northern Kentucky to get its fair share of State and Federal dollars.  For too long other regions of the State have gotten a higher percentage of allocated dollars.  As a result this region, while 3rd in population, is about 14th in per capita expenditures.  This region still does not have crisis stabilization services and lacks many other basic supports. 

• To move Kentucky to 25th over a 10 year period as it is currently 46th in funding for mental health and substance abuse services. 

• Include Substance Abuse services for everyone medicaid eligilbe in the Medicaid plan, not just a a few targeted populations. 

A 4th concern, especially important to many individuals in this region, is adopting the Federal Ticket To Work Provisions.  This law allows individuals with any disability, and currently on Medicaid, to work and earn over the minimum allowable limits and to share in the cost of their Medicaid coverage.  Currently, individuals cannot work in significant jobs or earn over $700 a month.  If they do, eventually, they will lose all medical coverage.  Adopting this provision allows such individuals to continue to work, earn more, pay more in taxes, and to keep their Medicaid coverage by paying a premium or co-pays for services. 

"The key issue for our region is the need to increase the availability of services 'across the board.'  This overshadows any specific targeted area.  Our current funding severely limits the number of people we can serve." 
- Northern Kentucky Regional Planning Council (December 21, 2000)

Top Priority Needs:

• more psychiatrists At times waiting lists reach six months for both adults and children.

• earlier assessment and treatment for children  Treatment must begin before problems worsen and more damage is done.

•  crisis stabilization services for adults and adolescents  Mentally ill adults or those on drugs often end up in jail because they fall through the treatment gaps in our region and no one will serve them.  Children and adults usually have access to some acute inpatient treatment and traditional outpatient services, but crisis stabilization services are not adequately funded.  Thus, crisis or emergency situations often worsen due to lack of immediate service availability.

•  Medicaid coverage for substance abuse treatment Currently, it only pays for short-term medical detox services now.  Coverage for treatment services would help individuals receive timely and consistent care. 

•  funding for psychiatric medications Medicaid does not provide medications for jail prisoners and the indigent can't afford to buy them.  Without continuation of proper medications, treatment effectiveness is undermined and people can act out and increase the risk to themselves and others.

•  adult substance abuse residential treatment facilities  People must receive the treatment and 24 hour supervision they need to begin an effective recovery process and develop better coping skills.

•  mental health and substance abuse residential treatment services for adolescents We need both short-term and long-term facilities so the adolescents can be kept safe and appropriately managed until they are ready to go back to their homes and families.

•  intensive outpatient treatment for adolescent substance abusers   More treatment resources are needed to treat adolescents and reduce their substance abuse behavior.

•  expanded school based services Children who have problems must be identified, diagnosed and plugged into appropriate care.  School based services are more easily accessible to the children who need them.  Services to families need to be expanded so  positive long-term results are achieved.

•  transitional support and recovery services  Substance abusing adults must be better prepared and better supported to live with their addictive disease long-term.

"The people in Northern Kentucky need more mental health and substance abuse services, and faster access to them!  We can build upon existing services, but we need additional funding to do it."
 Main Regional Planning Council Recommendations 
 

1.  Increase the availability of quality mental health and substance abuse services to the residents of Northern Kentucky by:

• Changing the formula for state dollar allocation to be primarily tied to the population of a region so that Northern Kentucky gets its fair share of funds.  We are the third largest urban region yet our per capita mental health and substance abuse services funding is in the bottom third of the state.

•  Adding mental health and substance abuse Crisis Stabilization Units (CSUs) for both adults and children so we can provide immediate and long term care to both of them.  CSUs can be an important treatment option for providing both mental health and substance abuse treatment.  CSUs can stabilize the mentally ill, detox the substance abuser and get both plugged into necessary treatment and care.

•  Expanding Medicaid covered treatment services to include substance abuse services, so people can get off and stay off alcohol and other drugs.

•  Broadening the Medicaid eligibility requirements to qualify more families and children for Medicaid coverage.  We need a "ticket to work" program so the working poor can buy in to Medicaid at reasonable premium rates while they are getting stabilized in the work force (say $200-$300 per month instead of $750 or more per month for the High Risk Pool.).

•  Expanding the number of providers eligible for Medicaid reimbursement so more service options are available for the people who need services.  This will reduce waiting periods.

•  Investing in the development of additional consumer directed recovery services so those receiving a form of treatment can counsel and support others with the same illness in a cost-effective manner.

•  Developing collaborative funding streams through partnerships between state and regional/local-funding agents so that the full continuum of needed services can be developed within the region to expand our ability to help people.

•  Working with state, regional and local authorities to develop transportation options to help clients get to necessary appointments.  Some are prevented from getting help because they can't get to it.

•  Maximizing the use of existing resources through the development of local service coordinating efforts so people needing help are directed to the right provider quickly.

•  Collaborating with colleges, universities and medical schools to facilitate the development of clinician resources for the region so we develop the psychiatrists and others we need to provide services.

•  Developing regional grievance procedures that involve an independent external review process so we insure that the quality of services we provide are the best.  The criteria used to judge success/quality must account for service specific issues - "One size does not fit all."

2.  Formally validate the needs assessment and planning process established by HB 843. 

We need to continue the process and provide adequate financial support to the process so that the data can continue to be gathered to more fully assess the needs in some emerging and on-going services areas, such as:

• The aging population, which is expected to continue growing and which is now under served.

•  The non-English speaking population that is rapidly expanding in our region.

•  Individuals involved with the criminal justice system who need treatment in prison and half-way houses.  Additionally, long-term treatment approaches for artist individuals need to be developed and evaluated so as to help prevent them from getting into the system only after they have become "criminals."

•  Individuals who experience other disabilities (i.e. hearing impaired and physically challenged) have special requirements that are not now being met.
  HB 843 State Commission on Mental Illness and Substance Abuse
  The 2000 Legislature established a Commission to study, in-depth, the needs and issues related to mental health and substance abuse in the Commonwealth. Briefly, each community mental health region has submitted a needs assessment/report for their region to the State Commission. The State Commission reviews all the regional reports and has broken down into a number of working committees to explore specific issues such as: children, adults, commitment, justice issues and others. The charge of the group is to issue regular  reports to the Legislature for use in the Legislative Sessions.
  The state commission has approved an initial report and adopted a set of recommendations. To see the full report and recommendations, 
   

For more information: http://mhmr.ky.gov/MH/HouseBill843.asp