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April 16, 2013 8:09 am

EDITORIAL: Legislature needs to clarify Title 25

Written by Ilene Olson

Park County didn’t need more confusion over Title 25 commitments — hospital admissions and emergency detentions for people who are considered a danger to themselves or others due to mental health issues.

But that was the result of a Feb. 6 decision by the Wyoming Supreme Court. That decision states that county attorneys don’t have the authority to object to the release of patients who are released from the Wyoming State Hospital in Evanston after they have been treated and stabilized.

Park County Attorney Bryan Skoric has since stopped his office’s practice of reviewing Title 25 cases when patients are released.

That job has fallen to an attorney for West Park Hospital and Yellowstone Behavioral Health. But that attorney, Chris Edwards, objects to performing that work, which she said conflicts with the hospital’s role as a health care provider.

“This burden shouldn’t be on the hospital,” Edwards said.

This is far from the first time that state laws regarding Title 25 admissions have caused problems and confusion for the county and its hospitals.



Years of disagreement and confusion over who is responsible for the cost of Title 25 admissions were settled recently with long-awaited agreements between the Park County Commission, West Park Hospital and Powell Valley Hospital. The hospitals had billed the county for the cost of initial care for Title 25 patients, as state law allows. But county commissioners disputed some of those bills, saying they included the cost of care not associated with the Title 25 admissions.

Through the agreements, completed in August and September, the county paid a negotiated portion of the bills, and a process was established to prevent similar disagreements in the future.

All three parties breathed a sigh of relief to have the issue settled.

Now, just a few months later, Park County finds itself embroiled in yet another quandary regarding Title 25 emergency detentions, and Skoric — not for the first time — has called on the Wyoming Legislature to clarify state law to end the ongoing confusion.

“I’ve long said ... the Legislature does not understand Title 25, they never have, and it’s time that they do,” he said.

Skoric also criticized the State Hospital, saying it fails to do more than stabilize mentally ill patients long enough to send them home, only to have many of them relapse shortly afterward — often multiple times.

During a Park County Health Coalition meeting last week, former Park County District Judge Hunter Patrick said, “There is a crisis in mental health.” Patrick, representing the National Alliance on Mental Illness, said the court decision, and Skoric’s interpretation, “affects the most the people who can least afford it.”

Jo Ann Cozzens of Powell, also at the meeting, said, “Mental health in Wyoming is at the bottom of the totem pole. We’re looking at guns; it isn’t guns. It’s mental health.”

At the federal level, U.S. Sen. Mike Enzi, R-Wyo., announced last week he is cosponsoring the Mental Health Awareness and Improvement Act of 2013, which would improve programs related to awareness, prevention and early identification of mental health conditions without requiring more funding.

“People tend to be quiet on this particular issue, making condition awareness and access to treatment difficult,” Enzi said.

It’s time for leaders at the local, state and national level to take a serious look at dealing with mental health issues.

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