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Elizabeth Pagano is the editor of the Austin Monitor.
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County plans major investment in emergency psychiatric care unit
Wednesday, July 18, 2012 by Elizabeth Pagano
The Travis County Commissioners Court agreed Tuesday to invest more than $2 million – including at least $1.1 million in federal matching funds – to beef up a 5-year-old program to provide specialized medical personnel to respond on the scene to emergency psychiatric crises.
The Mobile Crisis Outreach Team (MCOT) is a collaboration between Travis County and Austin Travis County Integral Care. Composed of medical and mental health professionals, the team provides around-the-clock emergency on-site care for psychiatric crises. Started in 2007, the MCOT program gets by with just $400,000 in annual funding.
“It makes a lot of sense to me,” Commissioner Margaret Gomez said in praising the program. “As much as we’ve struggled to try to find the funding that is required, if this is a way to further expand these services, we know it’s needed.”
The increase in the funding for the program is possible after the commissioners decided to take advantage of a federal program that will match 1.4 times the contributions made to county programs that “expand or create transformational programming in heath care and behavioral health.”
In December 2011, the federal government approved a request by Texas for a 1115 Medicaid waiver, which could save the state $300 million in improved medical access and care. It is part of the Social Security Act, and separate from the controversial Affordable Care Act.
The Commissioners Court unanimously decided to take advantage of the federal program by investing $1 million in the Mobile Crisis Outreach Team program, which would mean $1.4 million in federal matching funds. With the planned MCOT expansion expected to cost about $2.1 million, $300,000 federal funds would remain for other as-yet-undetermined qualifying projects.
Health and Human Services County Executive Sherri Fleming told the commissioners that the county’s estimated $1 million investment could increase or decrease without penalty. Additionally, there would be time to “flesh out the details” during the review period.
“If the other counties of Texas are as confused as I am, or we are, it seems to me that there will be other changes we can expect to occur over the next few months,” said Judge Sam Biscoe.
Commissioner Ron Davis stressed that he wanted to see a return on any investment in the waiver, and asked for additional data.
Austin Travis County Integral Care Executive Director David Evans explained that one immediate economic benefit of expanding MCOT would come from diverting patients seeking psychiatric care away from emergency rooms and law enforcement.
“There should be some offset of law enforcement, of jail time, of emergency room use,” said Evans.
Biscoe noted that the county has a one-time extra $300,000 in mental health reserve funds that it is earmarking for its share of the funding. But the source of the rest of the money has yet to be determined. Travis County expects to take part in the program for four years.
On July 20, proposed health care projects are due to Central Health, the Travis County public health care agency that is responsible for putting together partnerships and plans for the region. Public hearings are scheduled on July 30, with final project plans due to Central Health on Aug. 4.
“I absolutely concur that MCOT is an already-existing, proven benefit to our community and expanding its capacity could only mean good things. Plus, we only have until July 20 to submit, so why not do something we know works?” said Commissioner Sarah Eckhardt.
City Council’s Health and Human Services subcommittee will receive a staff update on the city’s potential health care projects today at 3pm.
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