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Jail officials will look for new mental health provider

The Record-Eagle - 2/27/2021

Feb. 27—TRAVERSE CITY — Grand Traverse County jail officials are seeking a new provider for mental health services after coming to a stalemate in contract negotiations with Northern Lakes Community Mental Health, its current provider.

The sticking point was whether those receiving services should continue to be housed in one six-man cell, something jail Administrator Chris Barsheff says could have some inmates waiting for several months to get a spot in the voluntary program. A study done in July found the program did not reach enough inmates, something Barsheff said would improve if those in the program weren't confined to one cell.

"Over the several months of contract talks, it became evident that Northern Lakes Community Mental Health was not willing to follow recommended best practices for our facility and we are now forced to look at other alternatives for mental health services in the jail," Barsheff said.

Negotiations have been ongoing since October.

"We were very close, but unfortunately we could not come to an agreement on what we believe would be needed to successfully deliver the services the jail needs and wants," said Joanie Blamer, chief population officer for CMH.

A contract proposed by CMH would have inmates remain housed in one cell, but would offer care that would include an assessment of all inmates referred from the booking process, which Blamer said would be about 70 percent of all inmates. It would also include individual and group therapy and discharge planning.

CMH also sought to add another full-time masters-level behavioral health specialist to administer services for a total cost of $261,000 per year.

Under the former $163,000 contract, which expired in December, a behavioral health specialist and a peer support specialist worked full-time in the jail, though they have not worked there since the contract expired.

The jail now has services only for those in mental health crisis provided by CMH under an enabling agreement that has been in place in Grand Traverse County since 2003. The county pays CMH $682,000 per year under that agreement.

Jail and county officials will meet next week to determine its next steps, Barsheff said. He said another service provider will likely be sought through a request for proposals.

The county recently worked with the Michigan-based Kona Medical Consulting to find alternatives to the way services were offered under the CMH contract. They could be divvied up to more than one provider, Barsheff said, though he has reservations because coordination of care can suffer when there are more providers in the mix.

Barsheff is also optimistic about a partnership with Wayne State University to implement Stepping Up, a national initiative that aims to reduce the number of people with mental illnesses in jails. The program was supposed to be in place by fall 2020, but was stalled by the pandemic, Barsheff said.

In a recent presentation to the Grand Traverse County Board, Barsheff said he believes the jail does not need a peer support specialist, who under the CMH contract helped inmates sign up for Medicaid, which is discontinued when they go to jail, make follow-up appointments for health care and substance abuse treatment and get connected with Veterans Affairs services.

Those services can be done by community partners such as Catholic Human Services, which does assessments and counseling for substance use disorder, and Keys to Freedom, a nonprofit organization that can help inmates with reintegration, Barsheff said.

Blamer said before the jail had a contract with CMH, classroom-style group sessions were held for decades.

"It has not rendered the results that they were looking for," Blamer said. "Having the group cell is where we think that we could make the most difference."

The group cell has the therapeutic component, but also allows inmates to put the skills they've learned into practice and be accountable to each other, she said. In the two years the program has been in place there has only been one verbal confrontation between inmates, she said.

"Clearly the opportunity to practice these skills while they were in the cell with each other was working," Blamer said.

But Barsheff said that there sometimes were only a few men in the group.

Barsheff told commissioners that he has done a lot of research and has reached out to other jails in Monroe and Washtenaw counties, both of which have similar programs to the one in Grand Traverse, but do not have a housing unit. Those jails pull inmates from various areas to a central location to provide curriculum-based programming, which is safer because there is staff nearby, he said.

It also allows for inmates who are in differing classifications based on the severity of their crimes to participate in the program when it is offered in an open area, as they cannot be housed with those in different classifications, he said.

The CMH program was modeled after one in Harris County, Texas. But Sheriff Tom Bensley has said the program is like a square peg in a round hole.

The Harris County Sheriff's Department is the second largest in the country — second only to the Los Angeles Sheriff's Department — and can house 10,000 inmates. The Grand Traverse jail houses 168.

The July study, done by NCCHC Resources, was commissioned by the jail about a year ago at a cost of $24,600. Other problems noted were a lack of documentation with a disconnect between CMH professionals and a psychiatrist provided under Wellpath medical services. It also found that assessments were not being done on everyone admitted to the jail and that about half of those assigned to the mental health caseload had no contact with CMH.

Blamer has said much of the report was not accurate, but agreed that more inmates could be reached.

CMH would like to focus on working with the jail in the future and with other community partners to improve the situation for people with mental illness who end up in jail, Blamer said.

The agency currently has a request for proposals out for alternatives to emergency rooms and jails, she said.

The hope is to someday develop a crisis center to treat people. The center would have observation rooms, as people are sometimes held for several days in emergency rooms, and may have a residential component, she said.

Other CMH initiatives include adding licensed mental health professionals for after-hours emergencies, establishment of mobile crisis units for families and a Juvenile Justice Diversion Program that helps divert young people from the juvenile system and connects them with needed services. So far, 49 youths have been diverted under the program, Blamer said.


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