One-shot federal funding for NV behavioral health services is winding down. Now what?

As local governments in Nevada have used one-shot federal recovery relief dollars toward mental and behavioral health services, city and county officials stressed the importance for state lawmakers to figure out a sustainable funding source.

During Monday’s Interim Committee of Health and Human Service, officials from Clark County, Washoe County, the City of Las Vegas and rural Nevada updated lawmakers on successes and failures of efforts to connect people experiencing mental health crises to behavioral health services. 

The options for people needing emergency mental health services largely have been for them to go to the emergency room or be arrested and jailed. 

Jurisdictions have been able to use dollars provided by the American Rescue Plan Act, a relief package signed into law by President Joe Biden in 2021, to begin setting up regional crisis stabilization centers, operating mental health courts and expanding mobile outreach programs as an alternative. 

Those funding operating many of those programs is finite. 

Clark County Commissioner Justin Jones noted the county was able to use ARPA dollars to purchase a psychiatric hospital to turn into a crisis stabilization center. 

“The state has provided fantastic funds for many programs such as the funding for a crisis stabilization center,” Jones said. “In order to make that facility or any facility viable, there has to be a dedicated funding stream for years to come.” 

Many jurisdictions across the country that are able to offer more robust mental health services have access to stable and consistent funding sources that Nevada does not, Jones added.

“In San Diego County, they benefit from a millionaire tax,” he said. “In Miami-Dade County, they collect a 1% sales tax on food and beverage for homeless programs that support mental health services.” 

Local governments during Monday’s hearing highlighted various efforts in recent years to fund a 988 crisis line and expand mobile crisis teams that come to meet people in help

UMC, which Clark County is working with for its crisis stabilization center, is in the process of contracting a mental health provider to administer and staff it. 

The center is expected to start taking patients starting late December. 

“We don’t think one crisis stabilization center is going to meet the entire needs of Clark County,” said Abigail Frierson, the deputy county manager with Clark County. “We believe we need three or four.”

Officials said additional types of care are needed when people leave the crisis stabilization center. 

“Where do people who are unhoused go to continue their care once they’ve been stabilized?” Frierson asked. 

The City of Las Vegas is looking to expand its Recuperative Care Center, which  offers medical services for the unhoused population, to also offer mental and behavioral health.

Sabra Newby, the deputy city manager with the city of Las Vegas, said the city contracts with the federally qualified health center, Hope Christian Health Center, to operate the facility within the Corridor of Hope, the area downtown where homeless services are located. 

The center currently has 40 beds. The expansion would increase the number of beds to 76. 

“That would add the crisis stabilization unit to the facility and let us service the type of patient that we currently can’t serve that may be both recovering from sort of injury or illness or surgery but may have a higher level of mental health need,” Newby said. 

Newby said the city was awarded a $10 million grant from the state, which came from the ARPA dollars, for the expansion. It is taking an additional $7 million from the city’s share of ARPA funding.

While the city is still determining the exact costs of the project, Newby said early estimates indicate the city will be short about $5 million. 

Similar to efforts in Southern Nevada, a crisis stabilization is in the process of opening in Washoe County later this year, in partnership with Renown Regional Medical Center. 

Steve Shell with Renown said ARPA dollars are being used to renovate the space and cover operating expenses in the first year.

“I want to stress we really have to think beyond the first year at sustainability,” he said. “It’s great to stand up centers like this but we are going to really need to make sure they can sustain for the long haul. I don’t think anyone wants to stand up a new model that can’t continue beyond a certain time.”

Aside from a sustainable funding source to operate facilities, health officials also named other issues hindering access to behavioral health services, including low Medicaid reimbursement rates for providers and the lack of mental and behavioral health providers within the state.