In the statewide effort to deflect the mentally ill from Arkansas jails, Pulaski County took a notable stride last week, but it and other counties are still behind schedule.
A Quorum Court committee recommended Tuesday that $1 million be doled out for a regional crisis stabilization center, where law enforcement officers can take people in the throes of mental health episodes instead of to the county jail.
Despite that momentum, progress on the facility, and three others like it in Arkansas, has crept slower than the state's timeline, which called for a startup date of mid-November.
Three of the crisis stabilization centers got the green light earlier this year from Act 423 of 2017. A fourth center was added in August when Gov. Asa Hutchinson said he'd seek $1.4 million on top of the $5 million already budgeted.
When operational, the centers are supposed to keep people with mental illnesses from a cycle of incarceration. Often those people can be jailed, fined, left untreated and burdened with a criminal record, only to be arrested again.
Arkansas ranks among the lowest states in the nation in access to public psychiatric beds, according to the nonprofit Treatment Advocacy Center. The group estimated about 75,300 adult Arkansans have either schizophrenia or severe bipolar disorder, based on 2016 data. Slightly under half -- 35,700 -- go untreated.
Pulaski, Sebastian, Craighead and Washington counties were chosen to sponsor the 16-bed crisis stabilization centers. Each of those counties is to supply and maintain a building for the unit and foot the utility bills, while the state will reimburse operation costs.
In addition to aiding mentally ill people, cutting jail costs is another expected benefit of the centers.
Pulaski County Comptroller Michael Hutchens echoed that thought at Tuesday's Quorum Court agenda meeting. Of the county's facility, he told the justices of the peace: "You're not making money. You're lowering expenses."
Committee members backed the $1 million appropriation order with a unanimous do-pass recommendation. The full Quorum Court will vote on it later in October.
Pulaski County's center will serve Faulkner, Garland, Grant, Lonoke, Perry and Saline counties, according to a proposal from County Judge Barry Hyde's office, submitted to the state in mid-September. It's an area of Arkansas populated by more than 700,000 people.
In just Pulaski County, about 370 people with "serious mental illness" were booked into jail three or more times between August 2016 and August 2017, Hyde's office estimated. One person was locked up 35 times.
In that same period, the University of Arkansas for Medical Sciences in Little Rock handled about 50 people with similar afflictions.
Pulaski County officials have yet to pinpoint a location for a permanent center, but a temporary facility at the Psychiatric Research Institute on UAMS' campus was included in the proposal.
At first, an interim space at the institute seemed workable because, "the lights are on, it's air-conditioned and the rooms could be occupied," Dr. Richard Turnage, the academic hospital's chief executive, said.
However, the idea was dropped after the proposal was submitted because it became clear that in-patient psychiatric beds would have to be sacrificed to make it work, he said.
UAMS does want to staff the permanent center with medical personnel when it opens, said Turnage, who emphasized the submitted county proposal was a preliminary document.
Justin Blagg, director of Quorum Court services, told justices of the peace Tuesday that county officials are still "actively negotiating" with UAMS on locating a permanent site.
The future of a temporary center hasn't been decided, he said.
Whenever Pulaski County's facility opens and starts accepting patients, they'll be transported, with their consent, by participating law enforcement agencies. To defray costs, cities and counties will pay $100 a day, for up to three days, for every person delivered, the county proposal says.
For a person to be admitted to the center, a trained officer must come across the potential patient during a shift. Displaying suicidal tendencies is one criteria for admission, as is showing "disordered or bizarre behavior," or not being able to care for physical needs, the plan says. Only those over 18 qualify.
Once admitted, a patient will be assessed by a health care professional and screened for drugs. The person can undergo a psychiatric consultation and will be given medication if he needs it, the proposal says.
Social workers will also try to link people with community services for ongoing help once they are released.
A typical stint will last 72 hours or less. Physicians can decide whether someone should be involuntarily held for longer, the proposal says.
After each county submitted its crisis stabilization center proposal, a division of the state Department of Human Services gave feedback. Pulaski, Craighead and Sebastian counties now have until Wednesday to tweak their plans, said Kathryn Griffin, Hutchinson's justice reinvestment coordinator.
Washington County, which plans to house its facility on county property west of the UAMS Northwest campus in Fayetteville, was given an extended deadline so it can provide "a little more detail," Griffin said.
Pulaski County, along with the others, is "making every effort ... to meet the aggressive timeline set by the state," Blagg said in an email.
"I'm not aware of any county ready to open their center by the Nov. 15 deadline, interim or permanent," he said.
"However, I can assure you that everyone involved is diligently working to do this right and open their units as quickly as possible. It's a complicated process with a lot of moving parts, and Pulaski County is still in the process of hammering out the final details."
Craighead County's center recently faltered when a location fell through.
The Homeless Ministries of Jonesboro recently donated a 24,700-square-foot nursing home to eventually house both a homeless shelter and the 16-bed crisis stabilization center. But a week after its unveiling, the idea was scrapped.
Jonesboro School District Superintendent Kim Wilbanks said she was concerned because an elementary school is near the proposed facility. Neighbors also objected, which caused the nonprofit to renege.
"I still plan to go forward with the unit," Craighead County Sheriff Marty Boyd said earlier this month. "We're just delayed now."
Sebastian County had little trouble finding a location, County Judge David Hudson said, but it still won't meet the state's November start-up date.
A portion of Fort Smith's Western Arkansas Counseling and Guidance Center at 3113 S. 70th St. will be remodeled for the crisis stabilization center, Hudson said. The county's Quorum Court appropriated $140,000 for renovations, he said.
However, construction was to start mid-October, with the facility up and running by January, according to the county's proposal. That timeline has since shifted, Hudson said.
Incorporating state feedback, procuring a building permit and working over the holidays all mean it will take more time, he said. A slew of agencies -- health care providers, police, county management and state higher-ups -- are all "moving parts" to monitor, he said.
Plus, Hudson said, "We're creating something that hasn't been done before."
Despite the snags, everyone involved is eager for the centers to start treating those in need, so the program can prove its worth, Hudson said.
Nov. 15 was a "target date" for the centers to be operational, Griffin said. The state does not have a new projected target date. Rather, everyone is striving to open the centers "as soon as possible," she said.
Information for this article was contributed by Ken Heard of the Arkansas Democrat-Gazette.
Metro on 10/16/2017