As Fort Smith serves as a testing ground for the state’s first Crisis Stabilization Unit to divert mental health patients from jail, questions remain on how stakeholders in the six-county region will pay for any potential gaps in funding.
Delay in federal reimbursement to the unit at The Guidance Center in Fort Smith has been created by denial of the center’s National Provider Identifier number because of the need for a CSU number separate from the center’s. A new number has been requested for reimbursements.
The Guidance Center on South 70th Street in Fort Smith serves as the CSU for Sebastian, Crawford, Franklin, Logan, Scott and Polk counties. A $1.6 million state grant will fund all but a projected $75,463 difference, but because it is a new program, there is no history to create accurate budget estimates.
Fort Smith City Administrator Carl Geffken noted the city pays $54.01 a day to hold a person in the Sebastian County Detention Center, after a one-time $20 booking fee. The interlocal agreement calls for the city to pay $5 a day per person in the CSU.
“The whole intent of this $5 a day is we don’t know what the difference is going to be,” Sebastian County Judge David Hudson told city directors at a study session Tuesday. “Pulaski County is setting theirs at $50 a day. I want it to be encouraging to participate.”
Pulaski County began use of its CSU this month. Two others are to be set up in Craighead and Washington counties.
Hudson said a review of expenses will begin in January, and the process “will be very transparent,” and Fort Smith is “paving the ground” for the diversion program that will join drug court and veterans court as tools to divert people from jail to treatment programs.
The interlocal agreement, drafted by Hudson and approved by Arkansas Attorney General Leslie Rutledge, is set to be voted on by the Fort Smith Board of Directors next week to make up any potential overage of the $1.6 million state grant.
The Crawford County Quorum Court signed the agreement Monday and the Sebastian County Quorum Court voted on it Tuesday.
Rusti Holwick, CEO of The Guidance Center, told Fort Smith Board of Directors at the study session no reimbursements from Medicaid have been received for services rendered since the CSU opened in early March because a new National Provider Indentifier number had to be issued. The Guidance Center requested a new number about 30 days ago. Holiwick expects to receive the new number soon.
Expenses to operate the CSU in June were $134,000, Holwick told city directors.
“So if it is $134,000 per month you’re looking at about $1.6 million,” City Director Tracy Pennartz said.
Holwick said because the first three months of operation were not fully staffed, June was the closest number yet obtained to an accurate estimate of what monthly expenses will be. There are now 29 people who staff the CSU, with some part-time staff on the weekend. The unit operates 24 hours a day, seven days a week.
Sustainability is possible, Holwick added, with per diem reimbursements.
“We see others in the nation and they’re making a difference,” Holwick said.
Gov. Asa Hutchinson’s spokesman J.R. Davis said Tuesday the governor is “committed to funding any successful program” and wanted to “give it time to work.” Davis noted the Crisis Stabilization Unit is a two-year pilot program and was a major part of his 2017 agenda with the Arkansas Legislature. Each of the four counties received $1.6 million in grants to fund launching the units.
“He’s dedicated to the CSUs and he wants to make sure they are doing what they should,” Davis added.
Holwick also said Hutchinson has been “supportive” of the program.