Changes In Mental, Medical Healthcare Coming To County Jail

The Grand Traverse County Jail is aiming to significantly overhaul its treatment options for inmates, with county commissioners set to review a proposal this month to hire a new company to provide both medical and mental healthcare services to the jail – an integrated care approach staff said would reduce errors and communication issues that have stemmed from using two separate companies in the past.

Jail Administrator Captain Chris Barsheff provided an update to commissioners Wednesday on efforts to secure a new medical and mental healthcare provider for the jail. The county has outsourced medical care to inmates since 2010, with a company called Wellpath providing those services at a current cost of $ 780,000, a fee that includes two hours per week of on-site psychiatric care.

The county previously also contracted with the Northern Lakes Community Mental Health Authority (NLCMHA) to provide two full-time mental health professionals at the jail at a cost of $ 163,000 annually. However, the two parties failed to reach an agreement to continue those services last year. NLCMHA still offers crisis services as part of its $ 682,200 enabling agreement with Grand Traverse County to provide mental health services to the region, but staff said the arrangement is insufficient to meet the needs of inmates. A 2020 consultant report also flagged issues arising from a lack of communication between Wellpath and NLCMHAsaying there was a “significant disconnect” between staff and challenges with record-keeping and administration due to using two separate providers.

After failing to finalize a new contract with NCLMHA, the Sheriff’s Office posted a request-for-proposals (RFP) last summer to look for a new mental healthcare provider. However, after staff realized the medical contract with Wellpath was also coming up for renewal, the county decided to repost the RFP and look for a combined medical and mental healthcare provider. Four companies have responded with bids, including two national providers and two local providers; the names of those companies were not disclosed Wednesday.

Barsheff said local companies responded late to the January 7 RFP deadline, but that their bids offered “something that’s significantly different” at a lower cost than the national companies. He said the advantages of using a provider with relationships and ties to the local community merited expanding the review process to consider those bids. Barsheff will return to the commission later this month to recommend a company to hire. “We want to make sure whichever direction we go, we do not regret it,” he said. “Whatever company it is will have an integrated system of care with medical and mental health… the more cooks you have in the kitchen, there’s room for error.” Barsheff said the county will also look at reallocating funds under the NLCMHA enabling agreement to create a different model for those services.

Barsheff shared data with commissioners that demonstrated the mental health needs of Grand Traverse County Jail. In 2016, 4,131 individuals came through the jail. While that number was cut in half during the pandemic, the number of requests for services to NLCMHA “remained consistent,” Barsheff said, showing that “mental health issues in the jail is a real prevalent issue that we face.” He added that there’s also a “huge need for medical services,” with the jail clocking nearly 16,000 nursing contacts with inmates in 2021.

Grand Traverse County is one of 27 counties in Michigan participating in a program called Stepping Up, which aims to reduce the number of people with mental illnesses in jails. As part of a partnership with Wayne State University, the program collected data on Grand Traverse County Jail inmates and flagged holes in the county’s screening process to identify incoming inmates who need mental health treatment. Approximately 38 percent of the county’s jail population screened positive for mental health issues under a Stepping Up screening system, compared to 18 percent who were flagged using the county’s own screening process. In a two-and-a-half-month period, 40 inmates were flagged for “serious mental illness,” according to Barsheff, with all of those inmates referred to NLCMHA for services. Of those referred, 31 received services and nine did not, with the latter category likely consisting of individuals who were released before receiving care, Barsheff said.

Based on the study, Grand Traverse County Jail is implementing a new screening system for incoming inmates and working to shore up coverage gaps, such as when inmates are released before they can access treatment. Barsheff said that right now, it takes inmates who are referred for mental health services an average of six days to actually receive those services. He hoped that time period would be cut in half when a new provider is hired for the jail. Barsheff said jail staff have already been trained on the new screening process, which includes protocols for flagging substance and opioid use disorders in addition to mental health issues. “We’re making great progress,” he said, adding that the new screening system will be implemented in the jail starting this week.

Undersheriff Michael Shea told commissioners the Sheriff’s Office takes inmate care at Grand Traverse County Jail seriously and was working to ensure adequate coverage on both the medical and mental healthcare fronts. “We do not take it lightly,” he said, “and we know that in the past we have not, in our opinion, received the services that we want in the jail for our inmates.”

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