Following the money: Douglas County partners beefing up behavioral health services with funding
It was only last week that Douglas County commissioners decided to ask voters to support a half-cent sales tax to pay for $5.7 million a year in new mental health services in the county.
That vote, which also will ask voters to approve funding a jail expansion, won’t come until May. Despite that, millions of taxpayer dollars already are flowing into new mental health projects in Douglas County.
The reason is because Douglas County commissioners last summer agreed to start spending nearly $2 million on new behavioral health initiatives in advance of the sales tax vote to meet what they said were pressing needs, in the wake of the state backing out of mental health funding.
As part of its 2018 budget process, the county approved $1.9 million in new funding for mental health programs. Some of the new programs are expected to begin in February; others are still working to find psychiatrists. The county has been aggressive in its funding of mental health programs. Recently, Lawrence Memorial Hospital withdrew its request for $400,000 in funding for an emergency behavioral health unit. County officials, rather than allowing the money to go unspent, allocated it to another behavioral health project.
The recent spending creates a question: Should the county have waited to see if voters approve the sales tax before agreeing to add $1.9 million in mental health funding to the budget? That $1.9 million increased property taxes by 1.547 mills, or about $26 for the owner of a $150,000 home.
County officials believe the timing was right for the increase.
Douglas County Commission Chair Nancy Thellman said funding addressed pressing needs.
“I think everybody knows about the gaps in mental health services, but I don’t think we’ve talked enough about the need for substance abuse programming, particularly with the opioid epidemic coming,” she said.
The 2018 county-funded behavioral health initiatives encouraged cooperation among the county’s health and behavioral health partners to address problems efficiently, Thellman said.
“The outcome is more cohesive care throughout the county,” she said. “The fact that our health and behavioral-health partners are working together will have lasting impacts. It’s about relationships and not dollars, and those relationships are strong now.”
The $1.9 million the County Commission allocated for 2018 behavioral health will fund:
• About $900,000 for Bert Nash Community Mental Health Center Inc. and Heartland Community Health Center to each hire two new psychiatrists.
• $397,000 to create a multi-agency team to provide intensive case management for patients of the five-bed behavioral health unit of Lawrence Memorial Hospital’s emergency department. A start date for that program hasn’t been set. Interviews are underway for a supervisor, said Karen Shumate, LMH chief operating officer. Once the supervisor is hired, that person will put the team together with the cooperation of partnering agencies.
• $150,000 for DCCCA to send qualifying county residents to out-of-county detoxification treatment centers, which are unavailable in Douglas County. That program is scheduled to begin Feb. 8, said Sandra Dixon, DCCCA director of behavioral health services.
• $110,000 for a pilot program by the Douglas County District Attorney’s Office, the county jail re-entry program and DCCCA, which will offer diversion and treatment for female inmates with substance abuse problems. The program is scheduled to begin March 1. Dixon said the goal is to provide pre-trial diversions to eight women this year.
There was one more behavioral health spending measure commissioners added to this year’s budget — a $400,000 allocation to help LMH open a $1.2 million behavioral health crisis stabilization center. However, Shumate told county commissioners in December the hospital ended plans for the stabilization center because of difficulties in securing a state license and data showing LMH rarely needed more than five behavioral health beds at one time. LMH now plans to add two more behavioral health rooms to the three it has in its emergency department, Shumate said.
LMH, thus, said it no longer needed the $400,000 in county funding; however, county officials decided to spend the $400,000 on another mental health project instead. The money would be set aside to help build a proposed $11 million behavioral health campus next to Bert Nash and LMH, County Administrator Craig Weinaug said. That mental health campus — which will include housing and treatment options — is dependent on approval of the sales tax.
The $900,000 project between Bert Nash and Heartland Health is working to add more psychiatrists to the Lawrence community. But health officials previously have said that is a difficult task. For years, LMH officials cited difficulty in attracting psychiatrists to work at the hospital.
Despite receiving the funding approval in August, Bert Nash and Heartland have not yet filled all the psychiatrist positions.
Bob Tyranski, Douglas County director of behavioral health services, said Bert Nash has hired one psychiatrist and was looking to fill the second position funded through the county allocation.
Jon Stewart, Heartland CEO, said his agency has not filled either of its two new psychiatric positions. Heartland would use the funding to contract for remote psychiatric service until positions were filled.
“We are actively recruiting,” he said. “We had good candidates who found Lawrence was not the community for them. We are looking to recruit someone who is the right fit.”
Heartland is looking for candidates who are early in their careers and interested in making a life in Lawrence, Stewart said. The agency has had success in attracting primary health care providers who fit that description, and he is confident it will have the same success with psychiatrists, he said.
His confidence is grounded in the opportunity Heartland offers young psychiatrists, Stewart said. As a federally qualified health service provider obligated to serve a higher rate of the uninsured, Heartland receives a higher reimbursement rate for Medicare and Medicaid, he said. That should allow young psychiatrists to build practices that benefit the doctors and county taxpayers, he said.
“Our psychiatrists won’t be a permanent subsidy of county government,” he said.