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Supervisors discuss mental health evaluation costs

By Staff | Jul 16, 2008

The Emmet County Board of Supervisors Tuesday wrangled with doctor costs for mental health evaluations for committals at the state hospital in Cherokee.

The discussion came after the supervisors earlier met with Avera Holy Family Health officials regarding the costs. Apparently, while the county is not responsible for the mental health evaluations for people who can’t afford them, the board has indicated a willingness to work with the hospital on the matter.

Board Chair Alan Madden said the mental health evaluation is apparently not required before a committal. However, hospital committal assessments have become a standard procedure. A judge will decide whether to approve a committal based upon a doctor’s recommendation.

Emmet County Mental Health Coordinator Dorothy Christensen said of 11 adult committal assessments that went through the Avera Emergency Room in the past year, four did not have insurance. She said Iowa Code says the sheriff’s office “may” commit an individual who is a danger to himself or herself or others. “Nine times out of 10 it’s themselves,” Christensen said.

The difficulty for the county is that a person being considered for a committal may not be under arrest.

“They’re not always in jail on a committal,” said Sheriff Larry Lamack. If a subject being considered for committal were in jail, then it would clearly be the county’s responsibility, Lamack said.

“There’s nothing in the code that says we’re responsible for taking them to the emergency room,” Christensen said.

As for costs, Christensen said Clay County pays $150 for committal assessments and Dickinson County also takes persons to the hospital for committal assessments.

“We have a finite amount of dollars and it’s a nonmandated service,” Christensen said.

Christensen recommended that the county not pay for juvenile committal assessments since the state pays those costs when the person goes to Cherokee. She said last year two juveniles and four adults who did not have insurance had committal assessments through the Avera emergency room.

“Maybe we should get this to the state level to see where it should come from or if we’re responsible at all,” said Supervisor Jim Jenson.

Christensen listed a number of northwest Iowa counties that do not pay for hospital committal assessments. Those counties included Kossuth and Palo Alto.

The board agreed to get more information from the state regarding the county’s responsibility as well as actual non-reimbursed costs to Avera before making a final decision.