Reducing the number of mentally ill inmates in Alabama's crowded prisons, expanding services for people with autism, and reopening Searcy Hospital were among the priorities Alabama's mental health commissioner laid out Tuesday.
Jim Perdue, during a town hall discussion in Spanish Fort, outlined a five-point plan that he believes will require neither a significant General Fund commitment nor a tax increase. He said the plan is more managerial, but that will have to obtain lawmakers' support in Montgomery.
"We need more money," said Perdue, commissioner of mental health for the past 14 months and a former probate judge of Crenshaw County. "But in my experience with this Legislature and with the state of Alabama, there is no appetite to raise taxes or raise additional fees or anything else."
Perdue's stop in Spanish Fort was one of 19 similar events he's held statewide in Alabama this summer. The last scheduled town hall meeting is Friday in Demopolis.
His comments come as AL.com is undertaking an investigation into wide-ranging mental health woes in Alabama. A months-long analysis has found frustrated local law enforcement leaders dealing with a tide of mentally ill inmates as the state had scaled back services.
Prison reform
Perdue said he believes that the state's crowded prisons and jails are dealing with approximately 10,000 inmates who have substance abuse problems and/or mental health issues. That's close to a quarter of the overall population behind bars, according to federal incarceration data.
Perdue is advocating for more community behavioral health centers to treat people who otherwise will land in the hands of jailers and wardens.
Alabama Mental Health Commissioner Jim Perdue meets with attendees during a town hall meeting on Tuesday, Aug. 16, 2016, in Spanish Fort, Ala. (John Sharp/jsharp@al.com).
"When you are in prison, it's 100 percent ... paid for by the state," Perdue said. If 10,000 inmates were redirected into mental health centers or abuse-treatment centers, the state could scale back the big-box prison construction campaign being urged by Gov. Robert Bentley.
Perdue said he would like to utilize one abandoned state mental health hospital to serve terminally ill prison inmates. That's the historic Searcy Hospital in Mt. Vernon, which closed in 2012. Some sections of the Searcy property are nearly 200 years old.
Perdue envisions the state entering into a bid with a private company that would operate Searcy, providing hospice-like care. He said the Department of Mental Health will push for legislation next spring to define how the process will work.
"It's one of the most historic, untouched properties in the state," said Perdue. "If I can incorporate the delivery of services of those dying in prison by moving them to one of our facilities at Searcy, we can use that money that we might lease that to help improve and restore this historic property."
Autism 'hope'
Perdue also said he wants Alabama to join a majority of states in providing insurance coverage for autism services. Alabama is one of seven states that does not mandate insurance coverage for autism treatment for all children.
Perdue said that Alabama should incorporate Applied Behavioral Analysis, or ABA, for autism therapy. The program has seen a dramatic increase in its use over the past decade, by fostering skills like looking, listening and imitating, as well as basic life skills like reading and interacting appropriately with others.
"If we can incorporate this therapy into our delivery systems in the state of Alabama as (most states) have done, we can start giving hope to autistic children and their families," Perdue said.
The program, itself, is expensive. The highly specialized sessions can run up to $100 or more an hour, and most doctors recommend 10-40 hours per week, depending on the severity of the disorder.
"Naturally, the insurance companies don't want to pick up the tab," Perdue said. "But the hope it gives families ... these are kids that can be productive and effectively treated and not disabled by this disorder their entire life."
He said, in the long run, autism therapy can reduce the state's mental health costs. "If we don't do anything, these individuals by the age of 19, they become an adult disabled person and they are one of ours," Perdue said. "We'll spend $2 million to $2.5 million per individual, but if we can treat autism ... we can save money that we won't spend on the long run."
Tuerk Schlesinger, CEO of AltaPointe Health Systems in Mobile, said there are intellectual disabilities that can be treated with the proper attention. "A lot of states have already adopted this and autism is a primary goal to them. They do a fantastic job of taking care of the autistic people in their state and we do not in our state," he said.