DOJ Investigates Nebraska’s Behavioral Health Service System

By Gordon Hopkins Nebraska officials, both local and statewide, have expressed great concern that the state is not doing enough to provide for individuals with serious mental illness.The Department of Justice (DOJ) has now weighed in on the matter.The DOJ announced on Tuesday, May 14, 2024, that it found that Nebraska is unnecessarily segregating people with serious mental illness (SMI) in assisted living facilities and day program facilities, in violation of the Americans with Disabilities Act (ADA) and the U.S. Supreme Court’s decision in Olmstead v. L.C. The department found that Nebraska is restricting access to critical community-based services that people with SMI need to live and work in the community. Cuts to Mental Health AidThis announcement comes after Nebraska Governor Jim Pillen recommended a $15 million cut to the behavioral health aid base in fiscal year 2024 and 2025 as part of the biennial budget adjustment.Earlier this year, a number of local government officials and health care specialists testified in opposition to the proposed cut in front of the Appropriations Committee of the Nebraska Legislature.One of those who testified was Jefferson County Commissioner Gale Pohlmann, who said, “Every day I see Nebraskans across our community who are experiencing significant mental health and severe substance use issues, and we know there are access issues. This budget reduction would be a significant setback in the regional behavioral health authoritie’s effort to make improvements, cover gaps and needs, improve access and sustain capacity in the recovery oriented system of care.”Pohlmann explained that these safety net programs, “Offer them someone to respond, somewhere to go when experiencing behavioral health crisis versus going to emergency rooms, waiting for hours to learn that they will not be admitted or else filling up our jail.”Other individuals who testified in opposition to Pillen’s proposed cut were Don Lease, county commissioner for Banner County and a member of the Regional One Advisory Committee; Patty Jurjevich, administrator for Region Six Behavioral Health Care; and Tiffany Gressley, regional administrator for Region Three Behavioral Health Services.Despite these pleas, the legislature approved the cuts. Impact of Budget CutsMelanie Stormer, Chief Probation Officer for District 1 Probation (Jefferson, Gage, Fillmore, Johnson, Nemaha, Otoe, Pawnee, Richardson, Saline, and Thayer Counties), attended a recent meeting of the Jefefrson County Commissioners on Tuesday, May 14, 2024.Commissioner Mark Schoenrock said, “I'm really disappointed to see the $15 million in mental health dollars getting cut. What effect has that had on your programs?”“I was able to find out that $10 million of that $15 million,” said Stormer, “came out of probation's budget. The way that it's being managed, though, is through maintaining services, maintaining staffing levels. Those are the two most important things that probation brings to the table.”Stormer added, “It's important to note that, coming into this last budget session, we had $32 million of carryover funding. So when they cut $10 million of our carryover dollars, that certainly changed what the next year looks like, but we're able to survive it.”Schoenrock said, “It's going to have a negative effect on what you can accomplish.”Integration versus Segregation“Far too often, people with mental health disabilities are institutionalized when they could succeed and thrive in the community,” said Assistant Attorney General Kristen Clarke of the Justice Department’s Civil Rights Division. “It’s time to bring an end to the days of funneling people with disabilities down a dead-end road towards institutionalization and unemployment when they could succeed if provided pathways towards independence and dignity. The Justice Department remains committed to protecting the rights of people with disabilities and ensuring that the ADA’s promise of integration becomes a reality.”“By increasing its investment in community-based services for Nebraskans with SMI, the State can help these individuals become engaged and vibrant members of their communities,” said U.S. Attorney Susan Lehr for the District of Nebraska.The DOJ has indicated that ADA and the Olmstead decision require states to make their services for people with disabilities available in the most integrated setting appropriate to each person’s needs — places like people’s homes and workplaces. With the right services, people with SMI can live in their own homes. They can also get and keep jobs where they work alongside people without disabilities doing the same work for the same pay. DOJ LetterIn a letter to Governor Jim Pillen, Assistant Attorney General Kristen Clarke, Civil Rights Division, wrote, “Instead of helping Nebraskans with SMI find jobs, Nebraska relies heavily on segregated day programs that group these individuals together in facilities. People with SMI may spend years in segregated day programs with no path to employment. Instead of being able to live in their own homes, many people with SMI are forced to enter assisted living facilities to get help.”Failure to inform the public about available services is another problem the letter noted, “Nebraska fails to ensure that individuals with SMI know about and can access the State’s covered services in the community even though these services are more therapeutic and cost effective than institutionalization. For Nebraskans with SMI, a lack of access to community-based services, including crisis services, can trigger unnecessary admissions to hospitals or ALFs (assisted living facilities). When individuals experience mental health crises in Nebraska, law enforcement are often the first responders because the State has failed ensure access to necessary community-based crisis services.”That letter also states, “Nebraska already offers services that could help its citizens with SMI find jobs and live independently. For example, Nebraska offers a service called “supported employment” that helps people with SMI find jobs and supports them in the workplace. Nebraska also offers services that help people with SMI succeed in their own homes. But the department found that Nebraska limits access to community-based services and has not developed sufficient service capacity to enable people with SMI to avoid unnecessary institutionalization. As a result, many Nebraskans with SMI struggle to access community-based services. Instead, for many Nebraskans with SMI, the only options are institutions and unemployment. Nebraska could expand access to its existing community-based services so that people with SMI can get the support they need to live and work in the community.”

Gage County Primary Election Results Now Official

Memorial Day Preparations Underway

Related Articles

Area Ravaged By Wildfires

State Auditor Finds No Issues Worth Pursuing In Jansen

Personnel Committee Votes To Table Employee Survey

Early Voting Begins For Upcoming Election