Butler County – Butler County officials have lobbied the Emergency Mental Health Crisis Stabilization Center because more specific plans and cost estimates are needed before they can look for proposals.
Scott Rasmus, executive director of the Butler County Council on Mental Health Services and Addiction Recovery, had hoped to issue a request for proposals this month for the Emergency Mental Health Crisis Stabilization Center, but he has delayed the RFP until January or February.
He told Journal-News after discussions with the three county commissioners — they’ve already committed $3 million in federal bailout money and a portion of the vacant care facility — he has more work to do.
“You want to do it right and not say we’re moving too fast, I don’t think we’re moving comfortably,” Rasmus said. “But I think we need to look at the metrics and make sure the unit itself and the tax timeframe are appropriate.”
Officials across the county have talked about this for years, and Rasmus has conducted two rounds of eight focus group meetings. Attendees were from a wide cross-section of society including police, judges, clergy, doctors, and elected officials, about 80 to 100, all fee being paid.
He has also studied five models so far, two in North Carolina, two in Ohio and one in Oregon. Based on these models, it is estimated that the Butler facility could cost $7 million to operate, an increase from the original $5 million price to $6 million.
Commissioner Cindy Carpenter traveled with Rasmus to tour two crisis units in North Carolina last month, one in Durham County that costs $7-8 million a year and a smaller one in Henderson that costs $3-3.5 million a year. The Durham County facility serves about 250 people per month and is similar in size to Butler County.
They are taking the extra time because “we will do everything we can to make sure that the crisis stabilization unit meets our needs and is as efficient and effective as possible, because it is backed by taxpayer money,” Carpenter told Journal-News.
“The commissioners have asked the Board of Mental Health to provide data from entry points to the Crisis Stabilization Unit,” Carpenter said. “We want to make sure that we build the facility of the right size to house it. We are continuing to research a variety of solutions for the homelessness and individuals with mental health and substance abuse issues who are in the county jail.”
“There were no concrete plans,” Commissioner TC Rogers told the newspaper, and before they could follow through, they needed to know “how you’re going to manage it and how much those costs.”
“It has to be a design built here,” Commissioner Don Dixon told Journal-News recently.
“We’re going to have to open it up on a small scale, test it, see the results, and then see where to save…” said Dixon. “Anticipate how it will start small as a prototype for testing and see how it works and we will build on it.”
Over the past several years, there have been many conversations about what such a center could offer. Early on it was called a “drop-off” center for homeless people who had suffered a psychotic episode or had caused a drug disorder so that the police would not have to take them to prison.
Recently, the definition has been expanded to include a place where police and family members can take mentally ill people who are having a seizure. This type of facility has been in demand for years, said Rhonda Benson, county director of the National Alliance on Mental Illness.
“There’s that gray area out there where they’re really sick that they can’t be alone at home, but they’re not sick enough to get them anywhere,” Benson said. “Not only would it benefit the police, but someone could drop someone and just help them stabilize and decide what kind of services they need.”
The commissioners made a decision in May to close the county’s nursing home and use part of it for a crisis stabilization unit. Rasmus said his board of directors hired an architect to determine the design and cost of retrofitting the building. The $3 million that commissioners have promised to fund the US Bailout Act will likely go to cover these capital costs. The idea is to start with 10 lookout chairs and 10 private rooms and potentially double the number of each down the road.
Reflecting the two facilities they saw in North Carolina, this model both had a communal space with 23-hour observation chairs as well as long-term treatment rooms. After patients are settled in the observation area, they are either referred to bypass services or are admitted for two to five days for further in-home treatment.
“It treats clients in an open area to meet their crisis needs but also to allow them to mingle with each other without any walls and that helps because of the socializing part, maybe they get some support, some suggestions from each other about resources,” Rasmus said.
The MHARS Council does not provide direct services to clients, it provides funding to local service providers such as Sojourner Recovery Services who have their own facilities. Rasmus said his board could provide services on a short-term basis but would have to find an external provider in the long-term, hence the RFP.
To pay for it, Rasmus said his board would ask voters to approve some form of a new tax to support the project. The council has two letters, a half mill taxpayer approved in 1985 that generates $1 million annually and ends in 2024 and a single mill approved in 2006 that generates $9.3 million and ends in 2025. Voters have strongly supported the renewal of these funding sources over the years. years, most recently at 73% in November 2020.
“We are due to levy a tax next fall and that’s still the thought process here, and that fee will not just be for the Crisis Stabilization Unit to support that, but the community mental health system itself,” Rasmus said. “We’re just going through what that would look like, the type of tax, and the size of the tax.”
Commissioners must agree to tax ballots for county agencies such as the MHARS Board. Carpenter said she’s not quite ready to ask for more money from voters.
She said, “We’ll see.” “I think we can get the Crisis Stabilization Center up and running before the commissioners decide whether or not to vote on a tax and at that time we’ll have the actual numbers, the cost of operations.”
The county also discussed using some of the OneOhio opioid lawsuit settlement to fund the unit. The county received a down payment of $232,669 from a settlement with certain distributors and should receive a total of $3.8 million to $5.4 million over 18 years, depending on a combination of unsettled variables. In addition to reaching a stake of $38.1 million, $54.4 million, as part of a regional grouping of seven counties that will decide future funding distributions.
A settlement was also reached with Johnson & Johnson but those details were not documented. County Administrator Judy Boyko said the initial estimate is an annual allocation of $97,243 to $138,919 over nine years for the county’s share.
Rasmus said they have also applied to the Department of Mental Health and Addiction for $750,000 – he said this sounds “promising” – to put towards the capital costs of the project and his board will be asked to match that amount if they win the grant.
Once the RFP is released, Rasmus said, it will take three or four months to vet offers before they can award a contract for the program.
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