Thursday, February 7, 2008

Medical Care for Dangerously Mentally Ill Offenders reduces Crime

SSB 5698 title: An act relating to case management services for dangerous mentally ill offenders (DMIO)

In 1999, the legislature passed a measure that provides services for dangerously ill offenders that provides medical treatment for up to five years after release from prison. The legislation authorized the Department of Social and Health Services to contract with Regional Support Networks (RSN) to provide these services.

(In Support) The purpose of this legislation is to try to get a consistent, systemic approach across RSN systems. Four RSNs contract directly with the Mental Health Division to serve as case managers for these programs. Ten additional counties provide services without RSN oversight.

A recent study conducted by the Washington Institute of Public Policy shows that these programs are effectively reducing recidivism. There has been a 45% reduction in felony offenses and a 38% reduction for new offenses post discharge from prison. The benefit-cost analysis in that report indicated that the reductions in Dangerously Mentally Ill Offender (DMIO) recidivism generated financial benefits to taxpayers that were less than program costs.

(The cost study was based on the records of 114 DMIO participants who were released between
July 1, 2002, and December 31, 2003, and for whom cost data were available. For pre-release
transitional services and two years of post-release services, costs averaged $19,390 per person. Expenditures were highest in the first six months then declined in each successive six-month period).

There is a liability question of liability protections for service providers. The cost to society of not having such programs available across the state is far greater than the cost without the program.

(Opposed) There is no question that this is an effective program. In 2001, the North Sound Regional Support Network (RSN) looked into taking this program. The RSN chose not to because at that time the Washington Governmental Entity Pool insurance company indicated that the RSN would be charged $50,000 per offender for the program. (Keeping an inmate behind bars in Monroe costs taxpayers $36,836 a year, according TO the Washington State Department of Corrections. That figure does not include medical care for mentally ill patients).

Currently the insurance company has indicated a complete unwillingness to cover the RSN if the RSN takes on this program. The North Sound clients are being served by the same providers under the current system. The counties that are currently covering this population are self-insured. The name of the program is unfortunate and should be reconsidered. The liability protections provided by statute are inadequate.

Fiscal Note: no impact

The SSB can be read at:

The Substitute Senate Bill Report is here:

And the Fiscal Note is here:

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