Contract for jail mental health services expires
The Record-EagleJan 15, 2021
Jan. 15—TRAVERSE CITY — A contract that provides mental health services to the
The
Bensley said CMH wants to continue with its current program that is modeled after one used in
But that program doesn't reach enough inmates, according to a study done in July by NCCHC Resources. The program is also not ideal for the size and layout of the
"We're trying to put a square peg in a round hole with this program," Bensley said. "That's unfortunate because I think there's a need, but we can't force inmates into this."
"We are negotiating services to include reaching more inmates," Blamer said. "We would like to see more people served, so that has been our focus — how do we reach more people?"
As part of the now-expired contract, CMH provided a behavioral health specialist and a peer support specialist for the jail, each of whom worked 40 hours per week. Neither is now working at the jail since the contract expired.
A meeting is scheduled for next week to continue negotiations.
The county also is working with the
"What the consultant had to offer in terms of replacement for that contract was encouraging," Alger said, though no steps have been taken.
Blamer said she was not aware the county had hired a consultant.
The study by NCHHC Resources, which provides consulting services for correctional health care systems, was commissioned by the jail about a year. The county paid
The company visited the jail in July and, among other problems, found mental health services were too narrowly focused and were fragmented, with a disconnect between CMH professionals and a psychiatrist provided under the
In addition, mental health assessments that are supposed to be done on all inmates admitted to the jail are not being done, treatment planning is lacking, and about half of inmates assigned to the mental health caseload have had no contact with the CMH specialists, the study found.
A discharge planning program is robust, the study found, but is based on self-referrals, with many inmates not receiving the important service.
Blamer said she doesn't agree with many of the study's results.
"The report is not accurate in many ways," Blamer said. "The reality is they spent less than 10 minutes with our staff and came away with these conclusions."
Blamer agrees that more people could be reached in the jail and CMH is now offering services that would assess more inmates and develop plans that provide a continuum of care.
"We're here to advocate for what the best thing for the inmate is," Blamer said.
Bensley said part of the problem in not reaching enough inmates is the layout of the jail, as those in the program have to be segregated. Another problem is the jail is not able to mix inmates with different security classifications, he said.
The jail has 168 beds, though that number is often reduced by classifications and now by COVID-19, which requires some inmates to be isolated.
Blamer said that when the program was first introduced there were two cellblocks being used — one that could house 12 men and another for women. That later changed to just one cell that can house up to six male inmates.
"We didn't have the interest from the female population," Blamer said.
An inmate at the jail must request mental health services, she said. When the program was put into place it was supposed to include a mental health survey that is given to every inmate; Blamer said the survey never came to fruition.
Bensley said he does not know why it was never put into place.
Some recommendations from the NCCHC Resources study are that all mental health services should be provided under one authority and should follow NCCHC standards for things such as assigning responsibilities, completing assessments, discharge planning and more.
The requirement that all inmates in a group program be housed in one cell should be eliminated, the study said, and the county should adopt an electronic health record system to store and keep records organized and accessible to all who provide care.
The jail should also do a psychological autopsy on all suicides, something that is an industry standard but was not done on two suicides the study looked at.
Since the contract expired, CMH is providing services for inmates who are in mental health crisis under an enabling agreement that has been in place between CMH and the six counties it serves since 2003. The agreement allows CMH to draw down Medicaid to provide behavioral health services, with county funds used to pay the required match dollars to Medicaid and the
"We believe that payment entitles us to some of this care in our jails," Alger said.
He said the consultant has reviewed the
"We just need to know what direction the sheriff wants to go and we can go from there," Alger said. "The sheriff wants to get it right and he's trying to work with CMH to do that."
Bensley said the jail could decide to go with the consultant's recommendations, it could have
"It would be nice to continue working with CMH," Bensley said. "They know us and we know them. There's a lot to be explored. Unfortunately it's taking time."
Blamer said she is very supportive of the jail and the work they are doing to try and improve services.
"Despite the challenges, we are still working together to identify what the mental health needs are and how they are best met," she said.
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