County proposes measures to cover gaps in service

By JOHN BLODGETT

The Western News

Lincoln County health officials and health care providers have made strides in filling the void left by the Jan. 2 closure of Western Montana Mental Health Center in Libby, but there’s still work to do.

“There are so many layers of issues here,” said Nancy Huus, a certified mental health professional working under a short-term contract with the county. “It isn’t going to be a quick fix.”

With the abrupt loss of vital mental health services — the closure was announced mid-December — the community has been scrambling to find replacement providers.

The Mental Health Center, based in Missoula, closed its Libby and Dillon offices following sweeping cuts state lawmakers made during November’s special legislative session to address a $227 million deficit.

In addition to serving more than 200 area patients, the Mental Health Center since the early 2000s had provided crisis evaluation services under contract to the county.

Crises can result from situations in which someone has harmed or threatened to harm themselves or others and has arrived at the Cabinet Peaks Medical Center emergency room, where a properly certified mental health professional evaluates the person’s mental health needs.

Because the Medical Center has no mental health professionals on staff, the county contracted with the Mental Health Center to provide those services.

If the person requires commitment for treatment, and the person is committed involuntarily — a scenario that happens an average of 12 to 15 times a year — the county must cover the costs of the evaluations and pre-commitment services.

Huus, who once worked as an outpatient therapist for the Mental Health Center, has been on call to provide crisis evaluations in the interim until her contract ends in early March.

Since mid-December, a broad coalition of health care providers, county staff and others have met six times and will continue to meet to hammer out replacement mental health services, said Jennifer McCully of the Lincoln County Public Health Department.

In addition to filling the county’s need for emergency room evaluations, the coalition seeks to address mental health services on a broader scale, including issues surrounding transportation and case and medicine management.

At the Feb. 7 meeting of the Lincoln County Commission, McCully presented a proposal for a crisis care program that has resulted from those meetings. The program aims not only to have services in place for when people suffering from mental health crises arrive at the emergency room, but also to divert them, when appropriate, to other resources either in Libby or in Kalispell — where the nearest neuro-behavioral health unit is located — to reduce the burden on primary care, law enforcement, ambulance and other resources.

As proposed, the Health Department would create a behavioral health network comprised of local mental health professionals, each of whom agrees to commit at least one hour per week to providing crisis intake or consulting services. An education campaign would be drawn up in parallel to encourage mental health patients suffering from crises to visit with one of these providers rather than go to the emergency room.

The education aspect would be broadened to encourage community members to care for their mental health before it reaches crisis levels.

When it comes to handling emergency room evaluations, the Health Department wants to sufficiently pay certified mental health professionals to respond to these calls for service. It proposes paying $100 per mental health evaluation, no matter if it results in a voluntary or involuntary commitment, and $300 per involuntary commitment, to account for any necessary time mental health professionals must spend in court.

To coordinate the behavioral health network and its intersections with the community, the Health Department is proposing it hire a half-time behavioral health liaison. When McCully presented the program outline to Commission, she requested $7,000 in wages and $1,500 in employee contributions for the remainder of the fiscal year, and for subsequent years $21,000 in annual wages and $4,000 in employee contributions.

Other costs for the employee, including training, would be covered by grants, McCully said.

To cover the pay and incentives of the mental health professionals who participate in the behavioral health network, McCully asked that the county use the $18,500 it has already been setting aside for paying Western Montana Mental Health Center for its services.

Because McCully’s presentation was informational only, the Commission made no decision on her budget requests. She’ll next present at its 10 a.m. Feb. 20 budget meeting.