Costs mount for transporting Rock County psychiatric patients

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Frank Schultz
Sunday, May 18, 2014

JANESVILLE—A change in how the state handles emergency detentions of the mentally ill is costing Rock County thousands of dollars each month.

Instead of taking patients to the Mendota Mental Health Institute in Madison, as they have done for many years, sheriff's deputies now must take them to the Winnebago Mental Health Institute in Oshkosh.

Mendota will continue to take crime-related psychiatric cases.

The extra time and distance mean more overtime for deputies, said Capt. Brent DeRemer the Rock County Sheriff's Office Court Services Division.

The change began March 31.

From March 31 to April 24, deputies logged 137.75 hours of transport time and about $6,800 in overtime pay, DeRemer said.

Overtime also increases if too many deputies are taken off patrol duties to handle transports. Deputies are called in to fill gaps.

“The sheriff has to keep people out on the street. That's his responsibility for community safety,” DeRemer said.

Mendota was a two-hour round trip, DeRemer said. Winnebago is a five-hour round trip.

Two deputies must make the trip—one to drive and one to keep an eye on the patients.

Deputies use minivans and large-capacity vans. Patients are handcuffed and shackled in the cage-like rear of the vans, DeRemer said.

The main cost is overtime, but gasoline and vehicle maintenance also cost more than when deputies took patients to Mendota, DeRemer said.

The detentions, allowed under state Statute 51.15, can be invoked in the case of drug dependent or developmentally disabled people, as well as the mentally ill.

Law enforcement agencies often invoke 51.15 to keep people from harming themselves or others, DeRemer said.

Rock County Human Services' crisis intervention office determines whether emergency detention is appropriate.

Human services staff use different hospitals to meet the needs of clients who need  psychiatric inpatient care, said Linda Scott-Hoag, the Chapter 51 court services social worker for the county.

“Both Winnebago and Mendota have been the option we use when all other hospital choices are exhausted,” Scott-Hoag said. “We were very disappointed (with the change at Mendota). We certainly have always had a good working relationship with both institutes, but taking a client that much further away from their home community is difficult.”

Some transports are done by U.S. Securities, a contractor, Scott-Hoag said. But if the person has been placed on a jail hold or if there is concern about safety during transport, deputies take over.

A detained person must be cleared by a physician, and that can take two to four hours, depending on how busy the medical facility, DeRemer said.

A deputy must wait at the facility while the clearance is being determined.

Patients who have insurance or can afford local treatment don't need to be transported, but those who can't afford it must be held and taken to Oshkosh, DeRemer said.

Even more expense comes when the patients are transported back to Rock County Court from Oshkosh. The law requires a court hearing within 72 hours of a commitment.

The deputies' days can be up to 11 hours long if they drive to Oshkosh to pick up the patient, deliver them to the court hearing, and then return them after the hearing, making for two round trips in one day, DeRemer said.

It's important that patients be transported to the Winnebago Mental Health Institute quickly because they must be evaluated there, generating a report to the judge before the hearing, DeRemer said.

For that reason, it's often not feasible to hold patients in Rock County and transport several at one time, DeRemer said.

The patients can appear in court via video conferencing, but if the patient requests to be there in person, officials must grant that request, DeRemer said.

Sheriff Robert Spoden sits on a state mental health council that is looking for solutions, DeRemer said.

Rock County has 110 to 125 people on civil mental health commitments at any given time, Scott-Hoag said. The cost of treatment per day at Mendota or Winnebago is about $1,000.

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