photo by: Austin Hornbostel/Journal-World

Bert Nash Community Mental Health Center CEO Patrick Schmitz — also a member of nonprofit Behavioral Health Partners' board — addresses the Douglas County Commission during BHP's presentation about the Treatment and Recovery Center of Douglas County on Wednesday, Dec. 14, 2022.

Behavioral Health Partners, the nonprofit formed to guide Douglas County’s yet-to-open crisis center, wants to step away from that responsibility and is recommending that Bert Nash Community Mental Health Center run the facility instead.

That’s according to Nancy Thellman, a member of BHP’s board of directors, who addressed the Douglas County Commission on behalf of the board on Wednesday night. She announced the board’s recommendation toward the end of a presentation about the status of the Treatment and Recovery Center of Douglas County.

“The BHP board of directors, after careful consideration and discussion, we recognize that at this time we are not the best vehicle to operate the TRC,” Thellman said.

Thellman said there’s a “clearer path to follow in moving forward together,” and that BHP would like the county to enter into direct operating and lease agreements with Bert Nash. She said that structure should allow for streamlining the operations, leadership and governance of the facility and that Bert Nash was a known entity within the county and state of Kansas. Bert Nash and LMH Health originally partnered to form BHP, and Bert Nash CEO Patrick Schmitz is currently a member of BHP’s board.

“We’ve worked tirelessly to try to address final barriers that continue to prevent simplicity and clarity in the TRC’s business operations, leadership and governance,” Thellman said. “We have had to do this in light of significant challenges and changes in our world since (BHP’s) inception.”

Before the announcement, the presentation from BHP also included more information about the TRC’s operating plans. It wasn’t clear whether any of that would change if BHP steps away from the facility, but officials shared information about staffing plans, a 2023 budget, phased opening plan and more.

Those items were part of a laundry list of outstanding obligations that Douglas County Administrator Sarah Plinsky shared last month. Representatives with Behavioral Health Partners, the nonprofit formed to guide the center, began to outline exactly how BHP was addressing those and the other 20-plus items on that list more than a month later.

The facility’s clinical program manager, Bri Harmon-Moore, said that in terms of staffing, the facility is “ready to open.” Harmon-Moore added that all of the county’s requested workflows and staffing plans are written and have been submitted for approval.

On day one, though, folks like Schmitz and TRC clinical nurse educator Jesse Belt said the center wouldn’t be ready to accept patients experiencing an especially severe behavioral health crisis yet and would instead continue sending them to LMH Health’s emergency department. In part, Belt said that’s because Lawrence Police Chief Rich Lockhart had asked that any training involving law enforcement officers wait until there’s an announced opening date for the center so it’s fresher on officers’ minds.

“I’m surprised, maybe it’s fair to say I’m a little disappointed, but I want to be open to understanding why the goal is to phase open without accepting those law enforcement and EMS patients,” Commissioner Shannon Reid said. “From my understanding, that’s been a part of the conversation from day one, and I just want to put that out there that I feel like that’s a piece of this to have some more discussion about, to try to have a better understanding of that.”

But Bert Nash Chief Operating Officer Stephen O’Neill walked that back later in the presentation and said the facility didn’t plan to turn anyone away.

The phased opening plan itself lays out plans for both the front-of-house “access center” intended for less severe patients and the observation and stabilization units intended to accommodate patients who need to stay from 23 to 72 hours. Multiple presenters noted that the phased opening would be intended to take just a matter of weeks.

The first phase would see the access center open on weekdays, which would expand to include weekend hours in the second and third phases. In the time between when BHP submitted its presentation slides to the county and Wednesday’s presentation itself, the capacity for the longer-stay units has been increased. In phase one, those units would have a capacity for 10 patients per day, which would increase to 16 and 24 patients in phases two and three, respectively.

But O’Neill said despite any incremental progress toward operation, the facility would plan to ultimately meet the expectation of being open “24/7, 365.” The phases are only limited, he added, by how quickly the facility can hire and train more staff.

O’Neill and others didn’t offer a specific target opening date, though he did note that he had to assume a February opening in his draft budget. He said TRC leadership has worked to re-align the facility’s operating budget with an understanding of available revenue sources, and on Tuesday the leaders submitted that draft to county staff with an expense budget of approximately $7.6 million.

Commissioner Patrick Kelly expressed some concern about what happens if the center exceeds its expected expenses. O’Neill said Bert Nash would be prepared to take on the liability in that case.

In terms of how the TRC will get its revenue, O’Neill said that’ll be from three sources. The first will be health insurance; state Medicaid funding is estimated to cover anywhere from 56% to 65% of the center’s operating budget, he said. The second source will be state Crisis Intervention Center funding, which O’Neill said is estimated to be $3.1 million in the 2023 state fiscal year.

The final source of revenue is the county’s quarter-cent sales tax approved by voters to fund the campus the TRC now exists on back in 2018. O’Neill said BHP is recommending using those funds to support services for uninsured and underinsured patients, but only as a last resort.

O’Neill said he will likely submit a fresh draft of the 2023 budget soon after he’s had more time to digest it, and anticipates submitting a 2024 budget for review sometime next week.

As of the Journal-World’s print deadline Wednesday evening, public comment and commission discussion about the presentation were still in progress.