Weekly Address – June 24, 2022

From the historic hallways of the most beautiful state Capitol in our nation, this is Senator Keith Ingram.


Over the past several decades, one of the most significant trends in health care is how we treat and care for people with severe disabilities and mental illness.


We have steadily moved away from institutional care, and placed more emphasis and resources on home care and community care.


There are two reasons for this trend. For a lot of people with chronic mental illness, or with a disability, home care is more effective.


For the state, which pays most of the costs of providing care, home care is cheaper than institutional care.


Legislators saw yet another example of the trend this week, at a hearing before the Joint Performance Review Committee.


Representatives from therapeutic communities appeared at the hearing and presented their case for higher reimbursements.


They also asked legislators to consider expanding the number of therapeutic communities in Arkansas.


Currently, two providers operate therapeutic communities that house about 420 people.


The majority were referred from the State Hospital or the judicial system, because they committed a crime and were found not guilty because they suffer from a mental illness.


They were released, conditionally, to the therapeutic communities under what is known as the 911 program.


The name comes from Act 911 of 1989, which set up the system for evaluating and committing people who are acquitted of crimes due to mental illness.


Some therapeutic communities are secure lockdowns. In others, the doors are not locked but the clients are always under supervision.


Legislators were told of a year-long clinical study of 78 people who were admitted to a therapeutic community under the 911 program.


During the year before they were placed in a therapeutic community, they received institutional care that cost about $3.9 million.


In comparison, during the following year, when they lived in a therapeutic community and received inpatient psychiatric care, the cost was $492,000.


The state Human Services Department has agreed to increase the reimbursement rate for therapeutic communities, to $500 a day at secure facilities and $358 at level 2 facilities, where the doors are not locked.


That is still cheaper than care at the State Hospital, which averages $700 a day. At centers where care is provided for people with developmental disabilities, the cost averages $450 to $500 a year.


Aside from any cost savings for the state, the important thing is that people receive the level of care they need.


From the Capitol, it is always my great honor and sincere privilege to serve you as your state Senator. This is Keith Ingram.