OKTIBBEHA COUNTY — Three to four times a week, Chancery Clerk Sharon Livingston sees the same heartbreaking process play out.

A person who has been evaluated for behavioral health issues is brought before a judge for commitment. Some have attempted suicide. Others suffer from mental illness.

All have family members who have brought them to court as a last resort to get help. Livingston said the petitioners are often in tears.

“Commitments are very sentimental to my heart,” she said. “Every family has that, and I’ve had it in mine.”

Since 2021, in the wake of the COVID-19 pandemic, chancery court commitments have jumped to between 150 and 200 per year, Livingston said. It cost the county almost $1 million last fiscal year to house those patients at Alliance Health Center in Meridian, and Livingston wants to bring that money home.

“We are just in dire need of help,” she said. “It would bring that revenue here to help our county and to help our hospital.”

The board of supervisors earlier this month authorized its attorney Rob Roberson and Livingston to meet with the leadership for the county-owned OCH Regional Medical Center to gauge their interest in taking on the services.

So far, that meeting hasn’t happened, hospital CEO Jim Jackson told The Dispatch on Tuesday.

“I hope it’s soon,” Livingston said.

The county’s Alliance contract

The county has contracted with Alliance for about 15 years, Livingston said, but the cost rose to $500 per patient per day last year — up $50 from the previous rate.

“That was the only option that we had,” Livingston said, adding providers like Baptist Memorial Hospital-Golden Triangle can’t provide enough bedspace based on their contracts with other counties.

Alliance serves as a holding facility before patients can be transferred to a bed at East Mississippi State Hospital, also in Meridian, but the facility has psychiatric staff on hand to provide care while patients are there.

Some commitments are emergencies and have to go immediately. In cases when even Alliance doesn’t have space available, care and holding might be delayed by two to three days.

“Our jail is not accessible to hold commitments, so … they go home,” Livingston said.

Chancery judges normally commit patients for 60 to 90 days, Livingston said, but that can be adjusted based on treatment needs.

“We’ve had some who have been down there five months,” she said. “So we’re paying months on end because the person isn’t stable enough to leave, and the state hospital doesn’t have a bed available.”

Still, about half of the county’s commitments are discharged directly from Alliance, which establishes their followup care guidelines with Community Counseling Services. The aftercare isn’t always successful.

“We’ve got a lot of repeaters … that will do good, then they’ll get off their medicine and have to come back,” she said.

If OCH took on those services, it would save the sheriff’s office money on transportation and deputy overtime, Livingston said, in addition to benefiting the local hospital’s top line. She said surrounding counties, like Webster and Choctaw, could also be interested in using the services.

“Once that would get started, it would pay for itself,” she said.

What OCH would need

To do that, OCH would have to designate a wing it could secure, something Livingston described as a “locked down facility.”

While Jackson said he doesn’t know what it would cost to prepare such a facility at OCH, that’s a secondary issue. The main problem is hiring a psychiatrist as the “captain of the ship,” along with a nurse practitioner in behavioral health.

OCH has been trying to hire a psychiatrist for years to no avail. Without at least that person on staff, a conversation with the county over a commitment wing is likely a non-starter.

“There’s so few of them and there’s such a demand for them,” Jackson said. “That’s what makes it so hard to recruit.”

OCH is licensed for 96 inpatient beds but staffed for only about 50, Jackson said, owing to an industry-wide shift to more outpatient services.

None of the hospital’s vacant space is currently “conducive” to holding the county’s court-committed patients, but he said OCH is looking for ways to reopen its third floor, which has 26 of the unused beds.

Jackson said OCH has considered other service lines for that space, such as inpatient rehabilitation or a geriatric psych unit.

Still, he wants to hear out the county officials as OCH continues its recruitment efforts for qualified staff.

“Behavioral health needs are nothing but growing,” he said. “It would be silly for us to turn our cheek and say, ‘We don’t want anything to do with that.’”

Zack Plair is the managing editor for The Dispatch.

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