Douglas County Commission approves expansion of care coordination; Kelly requests race data

photo by: Mackenzie Clark

Left to right, Douglas County Commissioner Nancy Thellman, Commission Chair Michelle Derusseau and Commission Vice Chair Patrick Kelly listen to a proposal to expand a behavioral health service during their meeting on June 26, 2019.

Douglas County commissioners on Wednesday approved expanding a program in which care coordinators “walk with” clients through behavioral health recovery, as its supporters put it.

Bob Tryanski, the county’s director of behavioral health projects, and Stacey Cooper, supervisor of intensive case management/clinical coordinator for Heartland RADAC, talked to the commission about Intensive Care Coordination, or ICC.

Cooper said the program is where care coordinators can create relationships with clients to address recovery, housing, and mental and physical health stability.

Tryanski said there are complications when clients disengage. But, for instance, if a client needs to connect with residential treatment after detoxing, with ICC “there’s somebody walking with them — not doing a warm handoff, but walking with, for 30 to 90 days to make sure that the person is getting the care that they need,” he said.

photo by: Mackenzie Clark

Stacey Cooper, supervisor of Intensive Case Management/clinical coordinator for Heartland RADAC, and Bob Tryanski, Douglas County’s director of behavioral health projects, stand by to answer questions from the Douglas County Commission at its meeting on June 26, 2019.

He also said care coordinators can help clients if the first providers they see aren’t the right matches for them — making a new connection, rather than disengaging or losing touch.

The expansion will make ICC services available seven days a week with extended hours, and it will focus more resources to serve clientele of the Lawrence Community Shelter. It will also support residents who access crisis stabilization services at the RSI crisis center in Wyandotte County.

Commissioner Patrick Kelly asked about data and encouraged Tryanski and Cooper to work on getting outcomes data related to clients’ race and ethnicity.

“What you see in the Health Equity Report is dramatic differences between races and their health,” Kelly said, referencing the 2018 report from the Lawrence-Douglas County Health Department that found several stark health disparities along racial and ethnic lines, as the Journal-World has reported. “And so if we’re not keeping that data, how are we knowing if we’re making a difference and we’re moving those numbers?”

Cooper said a meeting next month will look at data to see what’s missing. She said she’d “push that up the chain of command” to see how that data could be added.

Tryanski said there are other equity factors to consider as well, including employment, insurance status, gender and race. For instance, those with Medicaid might actually have more access to services because private insurers often won’t pay for a stay in a crisis center, he said.

“All of those pieces are pieces of the equity question, and it’s just important to stay focused, I think, on that spectrum, and we need to get better on that,” Tryanski said.

The county has also received a $25,000 budget request from the Lawrence-Douglas County Housing Authority to partially fund a housing case worker. Kelly asked for clarification on the difference between what the care coordinators provide and what that case worker would offer for residents of the shelter. Tryanski said the case worker would likely cover a broader spectrum of issues related to housing, such as legal and family matters or dealing with the state Department for Children and Families.

Commissioner Nancy Thellman said she thinks care coordinators and peer support specialists are key to the county’s behavioral health efforts.

“It’s not just a pretty picture we’re painting — it is the reality of having enough people in our system to do that ‘walking with,’ rather than handing off an appointment card,” she said.

The expansion of the contract with Heartland RADAC for the remainder of fiscal year 2019 will cost the county an added $60,000, for a total of $240,000 for the year. To continue through FY 2020, the cost would be $340,000. Funding comes from the county’s behavioral health sales tax revenue.

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