Community concerned about gap in mental health services

TRAVERSE CITY — A shock wave went through Grand Traverse County two weeks ago when county commissioners voted to end a relationship with the Northern Lakes Community Mental Health Authority.

Customers worry about a service outage, and employees worry about their jobs and their customers.

Justin Reed, of Traverse City, is a recipient of services and is also on the Northern Lakes Board of Directors. He spoke during public comments at Wednesday’s county board meeting.

“My quality of life has improved because I went from homelessness to a place to live,” Reed said. “I am horrified by all this.”

The plan to leave the authority was prompted by what commissioners said is a lack of response to the county’s needs, that not enough people can access services.

“We’re not talking about stopping services, we’re talking about reorganization,” said Toni Stanfield, whose son, now deceased, suffered from mental illness. Stanfield, co-founder of Before, During and After Incarceration, supports the separation.

“Our county has grown too large,” he said. “Other counties may have different needs than ours.”

The measure would effectively dissolve the authority of the six counties, according to their enabling agreement. Grand Traverse plans to form its own authority to continue services.

The first step for GTC is to send the Michigan Department of Health and Human Services a notice of intent to dissolve the agreement. When the county receives acknowledgment that MDHHS has received the notice, a 365-day clock begins for the county to form its own authority.

The Mental Health Code says that there can be no interruption of services during the transition.

That notice has not been sent and will not be sent until an attorney and a consultant to be retained by the county have been involved in the process. The notice will also go back to the board for approval before it is sent.

Several commissioners clarified the idea circulating in the community that the clock has already started.

“This board made a big decision two weeks ago to look into this,” Commissioner Darryl V. Nelson said. “The one-year starting gun was not fired at that time.”

Nelson said the transition will be a long process in which good and careful decisions must be made.

Several Northern Lakes customers and employees spoke during public comment, including Interim CEO Joanie Blamer.

“I hope that this county commission will reconsider their motion from the last meeting, that they work with Northern Lakes to repair the relationship,” Blamer said. “We are committed to working with you.”

Blamer rejected some of the claims made by the county board at its May 4 meeting. Those complaints include a lack of county jail services, a lack of a mobile crisis unit, a lack of response capacity for decades, and a lack of a diversion or community crisis center.

Northern Lakes provides jail crisis services and made 1,600 service contacts in 2021, Blamer said. A contract to provide other mental health services was not renewed at the end of 2020 after a study said the program was not reaching enough inmates.

Blamer said Northern Lakes has mobile crisis units for children and adults, although the adult service is not used as often as the children’s service. He said many people may not know it exists and the agency needs to do a better job of letting people know it exists.

The agency is also seeking grants and appropriation funds to establish a crisis intervention center. As for the lack of response, Blamer said she can’t talk to former leaders.

Lauri Fischer, chief financial officer for Northern Lakes, said that, on average, 37 percent of Medicaid funds received by the agency go to Grand Traverse County residents and 41 percent of services go to residents. of GTC. A $2.1 million annual shortfall in Grand Traverse means those services are subsidized by the other counties.

Additionally, 47 percent of Northern Lakes crisis services are provided to county residents, Fischer said.

County Board Chairman Rob Hentschel noted that the May 4 motion included the phrase “maintain and improve services.”

“The county board that sometimes fights like cats and dogs on some issues, we’re completely united on this one…” Hentschel said.

Hentschel said that as the parent of an adult child with autism who has an intellectual disability, he knows the fear and uncertainty a parent has about where that child will be in the future and who will care for them. He said he disagrees with an email Blamer sent that said the board’s decision will affect all services provided by CMH, including those with intellectual and developmental disabilities.

“That’s instilling fear,” Hentschel said. “That’s out of line.”

Blamer said it wasn’t about instilling fear, but about being transparent with his employees. She stated that she would be willing to work with the administration and the board to help with the transition.

The six Northern Lakes counties were formed about 20 years ago and include Crawford, Grand Traverse, Leelanau, Missaukee, Roscommon, and Wexford counties. Prior to that, Grand Traverse and Leelanau were served by the same authority, while the other four counties were served together in the North Central CMH.

Some Leelanau County commissioners have said they aren’t satisfied with the services and are open to talking about going back to that two-county deal. County Manager Nate Alger has been in contact with Leelanau Manager Chet Janik, and the two have a meeting scheduled for this week.

Alger will lead the transition and is in the process of putting together a team. He said Munson Healthcare President and CEO Ed Ness has dedicated a member of his administrative staff to work with the county.

A letter from Ness said she is concerned that dissolving the relationship with Northern Lakes without a plan in place to ensure stability and continuation of care will strain local resources, including Munson’s emergency department.

A transition plan must be in place before any final decisions are made, Ness wrote.

Commissioner Betsy Coffia said she is concerned about staffing, as there is a shortage of mental health workers in the region and across the country, along with an increasing need. She wants the transition to consider that in her plan.