Over- burdensome regulations are causing hardship for businesses and individuals, Congressman Derek Kilmer heard from multiple groups during a day-long stop on the Harbor last week.
Extra mental health regulations are making it harder to help those that need it on the streets, leading to longer jail time for offenders and draining local resources. Frankly, Kilmer was told, health providers are being forced to choose between helping someone with a substance abuse problem and those with a mental health issue — when it’s the same person that needs the help, leaving the most vulnerable in a situation where they’re falling between the cracks and not getting the real help they need. This is becoming an even more challenging issue in the face of increased heroin use on the Harbor.
Meantime, higher insurance premiums created by new FEMA flood maps and the financial impact on flood insurance from natural disasters from around the country are making it harder for banks to get potential home owners into homes and changing environmental regulations are making it harder for local cities to help businesses.
“I’m hearing this a lot,” Kilmer said. “But coming here, listening, it helps me figure out what we should be doing better.”
Kilmer spent last Friday meeting with the Elma Chamber of Commerce, conducting a round table discussion with local bankers and a separate discussion with the social service community. He also met with officials at Aberdeen High School, including a stop at a civics class, and had a listening session with city officials in Aberdeen.
“It’s getting harder to relay to the public what they need to get a permit because the rules keep changing at both the state and federal levels,” Aberdeen Community Services Director Lisa Scott told Kilmer. “We’re like the Detroit of Washington, it feels like. We’ve lost our industry. Our housing markets are gone. Our houses are empty. And yet the rules keep coming.”
“If I were air dropped into Congress, I would make it so we had less regulations so we can do more,” Grays Harbor Public Health Director Joan Brewster told Kilmer at a different round table discussion.
“There is just the sheer onslaught of changing regulations and the uncertainty and what we’re going to have to be prepared to deal with we’re just starting to get a sense of,” Timberland Bank CEO Michael Sand told Kilmer.
“There’s 200-some rules coming up that directly impact our industry so we’re out there wondering what the cost of all this is going to be to us and it’s challenging to plan for the future,” he added. “What we do know is it’s going to cost us more to do business.”
Sand says the bank has had to add staff just to keep up with new federal paperwork requirements.
Chief Financial Officer Larry Kahl of Grays Harbor Community Hospital told Kilmer in a separate conversation that the hospital has also had to add staff to keep up with paperwork requirements from new healthcare laws.
“As time goes by, the more and more time we’re spending on the paperwork aspect of healthcare, instead of the face to face time of healthcare with the patients,” Kahl told Kilmer.
Bringing the national healthcare debate closer to home, Elma Chamber of Commerce Director Debbie Adolphsen said that the federal Affordable Health Care Act requirements mean that she and her husband will both lose their existing insurance plan.
“The president said there were about 5 percent of us that would lose our plans,” Adolphsen. “Well, I’m in the 5 percent.”
Adolphsen noted that she and her husband are both independent contractors and have their own insurance.
“I’ve been conditionally approved for a higher policy with less coverage,” Adolphsen said. She added that she was worried for businesses like Bayview Lumber in Elma, which has 53 employees and was still trying to figure out the impacts to their business.
“The next few weeks are going to be really telling,” Kilmer said. “If people are still having difficulty, then maybe the individual mandate should be delayed.”
Scott said that the big issue facing her office right now is helping residents figure out how to move into a new business or home and deal with flood insurance issues proposed by the Federal Emergency Management Agency.
Aberdeen City Council President Kathi Hoder says it’s just the latest example of unfunded mandates coming from the state and federal government.
“Government mandates with no money to do the mandates — that makes me crazier than a bed bug,” Hoder said.
“Any particular ones?” Kilmer replied.
“All of them,” Hoder replied. “They mandate things for us to do and we’re just scraping by and we do them. I’m surprised our finance director hasn’t put a crazy hat on and run up the street. But if you’re going to give us a mandate, give us the money to go along with it. It’s insane. We can’t keep doing it.”
“Weeding through all of these environmental regulations is just getting harder,” Scott told Kilmer. “I know it’s not unique by any stretch of the imagination but we’re all trying to weed through that and it is getting harder.”
“I’m fairly sensitive to the fact that uncertainty can make a difference between a project moving forward or not,” Kilmer said. “One of the things we’ve done a fair amount of as an office are helping municipalities get the clarity they need on issues. Frankly, our job is to make the federal government work for you if you’re not getting what you need from federal agencies.”
“It’s getting harder for someone to put a single family residence even remotely close to the river,” Scott added. “We’re in the flood plain and FEMA has put a lot of single family home sales on hold, especially in the downtown because it’s all in the flood plain. There are people walking away because the price of insurance is escalated.”
Kilmer heard a similar story at a round table discussion with community bankers, including those from The Bank of The Pacific, Anchor Bank and Timberland Bank. Sand gave specific examples to Kilmer, where families qualify to buy a $90,000 home on the Harbor, but end up walking away from it all when it turns out they have to pay $6,000 a year in flood insurance.
Prices keep escalating in the wake of natural disasters in other areas of the country, such as Hurricane Sandy.
“How can someone afford any equity in their home when they’re paying those prices?” Sand said. “And it’s getting worse because FEMA is adding more areas here to their map so that even more people have to buy flood insurance. The premiums are so high, they’re unattainable.”
Kilmer said he had heard concerns about FEMA maps before, particularly in the Pierce County area, but it’s an issue that comes up a bit more on the Harbor. He says he supports finding a new way to allocate insurance costs based more on risk assessments than just maps, but didn’t provide specific details. He says it’s an idea he’s still working out.
DRUGS & MENTAL HEALTH
Aberdeen Superintendent Tom Opstad told Kilmer that when staff would see a student drawing a marijuana leaf or some other obvious sign of drug interest, they would have an assessment done and see if the student needs help.
But, then a change in rules directed all of those assessment dollars to the district with the highest need in Grays Harbor. In this case, that district is Hoquiam. That leaves districts like Aberdeen and Montesano without the dollars to get the critical prevention work done the way it should.
“So, Hoquiam gets the help they need, but it creates spikes of need in all of the other districts,” Opstad said. “That doesn’t make sense.”
Opstad’s story was just one of several told to Kilmer at a round table discussion of social service groups.
Kahl of Grays Harbor Community Hospital said that the hospital was forced to keep a mentally ill patient for 27 days recently in its Emergency Department because there was no where else for the patient to get its help.
“What they really needed was an out patient facility where they could go for three hours a day but that doesn’t exist here,” Kahl said.
In an earlier discussion with city officials, Police Chief Bob Torgerson relayed the common story that prisoners will stay in the Aberdeen Jail for up to six weeks at a time because the state doesn’t have the staff or money to do timely mental health assessments the way they should.
Torgerson said that his police officers will arrest someone who may be mentally disturbed for some crime like shoplifting or vandalism. At that point, the person goes before a judge, who orders a mental competency test be done.
“So, if the person pleads guilty, they get three days in jail,” Torgerson told Kilmer. “If they plead not guilty, they have to stay in jail for six weeks until the test can eventually be done to determine if they can stand trial. And that seems like an injustice to the system and those folks. And I saw that fall apart when the federal government decided to no longer fund mental health like they used to.”
Brewster, the county’s public health director, said that there are just too many rules separating the pots of money for mental illness and substance abuse when more than 50 percent of the time it’s the same person that needs the help.
Brewster and others with Sea Mar and Behavioral Health Resources laid the blame entirely on the federal reimbursement rates for Mediaid patients, specifically making health providers choose between helping someone with a substance abuse issue or a mental health issue.
“Our funding comes to us through two pots of money,” Brewster told Kilmer. “Somebody needs to step up and recognize that this is a problem.”
“That doesn’t make sense,” Kilmer said. “If you score this on a fiscal scale, it would probably be to the benefit of the taxpayer to work on these issues together.”
“Someone will show up at a hospital totally disoriented,” Brewster said. “Our mental health system will say, ‘You’re not a mental health client, you’re on drugs. See you later.’ And then these people will end up in jail because they have no where else to go. They have no access to medication. It’s a bad situation. …
“If we were allowed to work together and build systems that we think are commonsense, then we’d be able to help more,” Brewster said. “But state and federal regulations aren’t helping us. I think we can demonstrate ways for us to get things done efficiently and help substance abuse prevention with a savings.”
Meantime, the county’s heroin epidemic is just getting worse.
“If you’re looking for a place that needs to improve its health, you’ve found it,” Brewster told Kilmer. “We have a heroin epidemic that is really, really out of control.”
“Heroin is an epidemic in this nation and it’s worse here because of the situation we’re in,” adds Chief Torgerson.
“We have 1 percent of the state’s population, but we are the second highest when it comes to crimes linked to heroin,” Brewster adds. “Property crimes are twice that compared to rest of the state. That’s all people stealing goods to fence for drugs. It’s a very visible thing. You can do a windshield check to understand what we mean. You can just see it.”
“I hear that here and I think only here in the district I represent,” Kilmer said. “It comes up here in Grays Harbor more than anywhere else in the district.”
“Some of the broader issues we’re looking at are access to care issues,” Brewster said. “Why would you tell a heroin addict to wait 12 weeks and come back? That just doesn’t work. We’ve really got a gross inadequacy for access to care for in patients and out patients. We’ve been working to set up a treatment facility that will come into the community in a few months and we’re hoping that goes well to provide medical assistance for people with heroin issues. … We’re thinking we’ll have a huge pent up demand for treatment because there is no real treatment access here.”