Mental and Medical Health Care Changes Coming to County Jail

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Grand Traverse County Jail is aiming to overhaul its treatment options for inmates, with county commissioners due to consider a proposal this month to hire a new company to provide both medical and mental health services to prison – an integrated care approach. reduce errors and miscommunications that have arisen from using two separate companies in the past.

Prison administrator Captain Chris Barsheff provided an update to commissioners on Wednesday on efforts to find a new medical and mental health care provider for the prison. The county has outsourced medical care for inmates since 2010, with a company called Wellpath providing those services at a current cost of $780,000, a rate that includes two hours a week of onsite psychiatric care.

Previously, the county 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 per year. However, the two sides failed to agree to continue these services last year. The NLCMHA is still offering crisis services under its $682,200 enabling agreement with Grand Traverse County to provide mental health services to the area, but staff said the arrangement was insufficient to meet the needs of prisoners. A 2020 consultant report also pointed to issues resulting from a lack of communication between Wellpath and NLCMHA, saying there was a “significant disconnect” between staff and issues with record keeping and administration due the use of two separate suppliers.

After failing to finalize a new contract with NCLMHA, the sheriff’s office issued a request for proposals (RFP) last summer to seek a new mental health care provider. However, after staff realized that the medical contract with Wellpath was also up for renewal, the county decided to republish the RFP and seek a combined medical and mental health provider. Four companies responded with offers, including two national suppliers and two local suppliers; the names of those companies were not disclosed on Wednesday.

Barsheff said local companies responded late to the Jan. 7 RFP deadline, but their bids offered “something very different” at a lower cost than national companies. He said the benefits of using a vendor with local community connections and ties merited expanding the review process to consider such offers. Barsheff will return to the commission later this month to recommend a company for hire. “We want to make sure that whatever direction we take, we don’t regret it,” he said. “Any company will have an integrated care system with medical and mental health…the more cooks you have in the kitchen, there is room for error.” Barsheff said the county would also consider 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 people went through prison. While that number has halved during the pandemic, the number of requests for services at the NLCMHA “has remained constant,” Barsheff said, showing that “mental health issues in prison are a real widespread problem that we face. “. He added that there was also a “tremendous need for medical services”, with the prison having nearly 16,000 nursing contacts with inmates in 2021.

Grand Traverse County is one of 27 Michigan counties participating in a program called Stepping Up, which aims to reduce the number of people with mental illness in prisons. Through a partnership with Wayne State University, the program collected data on Grand Traverse County Jail inmates and reported shortcomings in the county’s screening process for identifying new inmates who need mental health treatment. About 38% of the county’s prison population tested positive for mental health issues through a Stepping Up screening system, compared to 18% who were flagged using the county’s screening process. During a two-and-a-half-month period, 40 inmates were reported for “serious mental illness,” according to Barsheff, with all of those inmates being referred to the NLCMHA for services. Of those referred, 31 received services and nine did not, with the latter category likely made up of people who were discharged 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 close coverage gaps, such as when inmates are released before they can access the processing. Barsheff said that currently it takes an average of six days for inmates who are referred to mental health services to receive those services. He hoped that this period would be cut in half when a new supplier was hired for the prison. Barsheff said prison staff have already been trained in the new screening process, which includes protocols for reporting substance and opioid use disorders in addition to mental health issues. “We are making great progress,” he said, adding that the new screening system will be implemented in the prison from this week.

Deputy Michael Shea told commissioners that the sheriff’s office takes the care of inmates at the Grand Traverse County Jail seriously and is working to ensure adequate coverage on the medical and mental fronts. “We don’t take this lightly,” he said, “and we know that in the past we haven’t, in our view, received the services we want in prison for our inmates.”

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