Tobacco fund starting to help
Jill Portsche twirls around in the living room to get a closer look at Amy, then bends her head close to the parakeet's cage.
"Hey you, you're OK," Portsche says to her little friend who shares her new home and her new independence.
Portsche, 22, moved out of the home of her parents, Susan and Paul Portsche, to her own pad just two weeks ago. She brought along her favorite stuffed animals and Amy.
"She was ready for the next step in her life," said Portsche's mom. "The public school system has a wonderful program. In the transition program, the students are taught to live lives of their own."
But when Portsche graduated from high school, there was no money for supervised residential programs for developmentally disabled adults who need a little extra help. Her name went on a waiting list.
This fall, money from the state's share of the national tobacco settlement has helped the state provide more services and shorten that waiting list.
Across the state, 175 people on the waiting list have already been offered services and 110, including Jill, have accepted.
Jill will soon have two roommates, including Martha Sposato, 29, who will also be leaving her family home for the first time.
Sposato's mother, Beth, has mixed feelings about seeing Martha move on, the kind of ambivalence most parents feel when children leave the nest.
But she is glad she and her husband didn't have to wait for an emergency to get their daughter settled in a new home. Until the state provided extra money through the tobacco settlement, only those people with developmental disabilities who faced an emergency were able to get residential services.
"It's an opportunity for her to get established in a home, where people know her and she can create her own life with the help of others," said Beth Sposato.
"It's better than having a parent die, then you have to scramble," she said.
The $50 million first-year installment from the tobacco settlement is spreading across the state. It will add 11 mental health and substance abuse counselors at the youth centers in Kearney and Geneva, raise the pay of hundreds of psychologists and counselors who work with low-income Nebraskans, and help adults with developmental disabilities move into supervised apartments and group homes, among other things.
State senators decided last legislative session to earmark tobacco settlement funds for health-related programs, from public health to mental health. The money began flowing to local programs July 1, the beginning of the state's fiscal year, and there are some early signs that it is beginning to help.
Emergency Protective Custody
One top priority for the money is to help get people who are seriously mentally ill into appropriate emergency care faster. In Lincoln this means ending so-called cruiser therapy.
Lincoln police occasionally have to baby-sit mentally ill people in crisis for hours in the back of their cruisers because there is no room at Lincoln's Crisis Center. The Crisis Center is full because patients there can't move on to the Lincoln Regional Center, a state mental hospital. The regional center is full because there are not enough case managers available to help newly released clients adjust to life in the community.
About $500,000 in tobacco settlement money should ease the bottleneck at the regional center.
The Community Mental Health Center of Lancaster County is in the process of hiring seven new case managers and a supervisor - the professionals who will help keep clients stable and out of the regional center.
The waiting list should soon shrink by 120 people, said Dean Settle, executive director of the community mental health center.
The first priority will be the regional center patients who need a case manager before they move back into the community, said Settle. That will open up beds at the regional center, which in turn will free up beds at the local crisis center, which has been full for months.
Some of the money will also be used to hire a counselor who will be available for outpatient appointments in the evening, and to expand the center's job development and job coaching program.
"A longtime promise is being delivered," Settle said about the tobacco settlement funding to relieve the strained mental health system.
Sixty-two counties have applied for $5,000 each in planning money, the carrot that encourages rural counties to create regional public health departments.
Of the $5.6 million available this year for public health, $465,000 is earmarked for these planning grants. "We've had a pretty good response and we know more counties will apply in the future," said Dave Palm, with the state's Office of Public Health.
The regional departments must join at least three counties and serve a minimum 30,000 population.
Building multicounty departments is particularly difficult in western Nebraska, where you need a lot of counties to make the population threshold, said Palm.
Palm anticipates that three or four multicounty health departments will form before Jan. 1 and be ready to receive the second tier of funding.
Counties are asked to name the other counties that they are talking with when they apply for the $5,000 planning grant so the state has some idea of what counties might join together in multicounty departments.
"It is a pretty dynamic situation, but we are beginning to see some semblance of order here," Palm said.
Another $2 million is available to organized county or regional health departments for developing new programs.
Another $3.135 million will be distributed to qualifying health departments on a per capita basis, $1,83 per person.
The Lincoln-Lancaster County Health Department is still brainstorming exactly how it will spend the $600,000 in new funding from the state.
The number of people waiting for services has dropped dramatically with the infusion of about $3 million from the tobacco settlement fund.
By the first week in September, with 110 people having accepted services, the waiting list now starts with people who requested services in June 1998, rather than 1994, said Roger Stortenbecker, administrator for the Developmental Disabilities System.
Many of these people, like Jill and Martha, are moving out of family homes into supervised housing.
In Southeast Nebraska, 57 people on the waiting list accepted services, Stortenbecker said.
The state will continue to move down the waiting list until the $3 million, plus some federal match money, is depleted.
Behavior Health in Southeast Nebraska:
About half of the $2.256 million available for mental health and substance abuse treatment in the 16-county Southeast Nebraska region has been earmarked. It will be used by local agencies to increase the number of people they can serve.
Cornhusker Place, Lincoln's detoxification center, will be expanding its intermediate residential program from five to 13 beds. People with serious substance abuse problems generally stay in this program from nine to 18 months.
St. Monica's Substance Abuse Treatment for Women will add four beds to its short-term residential program, and Houses of Hope, a halfway house program for men, will add about three beds to its program.
Lutheran Family Services received funding so it can offer more outpatient substance abuse for people from the Adult Drug Court. The agency also will offer outpatient counseling in Saunders County through a new grant.
CenterPointe, a program serving people with both substance abuse and mental health issues, will add two staff members.