Missed details and deadlines surrounding the management of the Treatment and Recovery Center of Douglas County led the county administrator to consider bringing in an out-of-state for-profit management company to assist local nonprofit behavioral health leaders, she said.
On Monday, leaders of LMH Health and Bert Nash Community Mental Health Center issued statements about the county’s interest in contracting with Connections Health Solutions, a for-profit management organization that received $30 million in growth funding from a health care-focused private equity firm in 2021.
At the Douglas County Commission meeting on Wednesday, County Administrator Sarah Plinsky read a statement outlining her concerns about the county’s alliance with Behavioral Health Partners Inc., the county’s nonprofit partnership with LMH Health and Bert Nash.
Plinsky told commissioners a contractual agreement with BHP specified the TRC would open its doors by July 1. That deadline, and several others, however, were missed.
The contractual agreement itself, Plinsky said, expired at the conclusion of February, but the county did not receive a draft from BHP to extend the contract until three months later.
Plinsky said BHP still had not submitted to the county TRC’s budget for fiscal 2022-23; that budget is needed to secure $3.1 million in state funding to operate the TRC.
“My understanding is, that budget is under development, and I know that’s being worked on, but today I don’t have it,” she said.
And despite licensing being noted as a top priority by TRC leadership a year prior, Plinsky said, BHP did not address hurdles to licensing with the Kansas Department for Aging and Disability Services (KDADS) between July 2021 and February 2022.
Dr. George Thompson, medical director and executive director for TRC, laid out the licensing timeline during the commission’s Oct. 12 meeting. He said since March, local leaders had been working with KDADS to address the licensing challenges related to the state’s lack of regulations for crisis intervention centers.
Cara Sloan-Ramos, spokesperson for KDADS, confirmed Thursday afternoon BHP applied for its provisional private psychiatric hospital license July 12. The license runs Oct. 17 through June 30, 2023.
“I want to remind the commission that since September of 2021, the county has paid LMH and Bert Nash over $1 million for the purposes of developing and opening the TRC,” Plinsky said.
“Over the summer, it was clear to me that in addition to clinical and operational steps that needed to be taken, numerous legal agreements between LMH, Bert Nash, BHP and the county were not even in development.”
Plinsky said she informed BHP leadership Aug. 1 about her concerns, including whether the group would be able to operate the center successfully. Plinsky requested an “achievable, executable and realistic” plan by Sept. 1, along with a to-do list.
When the county received that plan Aug. 23, she said, the documents were “inconsistent, incomplete, and demonstrated that BHP was not ready to open and operate the center successfully,” so the county consulted legal counsel – Foulston Siefkin LLP, of Wichita, a firm with health care experience.
BHP also asked for an extension and additional funding, Plinsky said, and that put her in a difficult spot.
“Douglas County has the obligation to open the TRC,” Plinsky said. “Sales tax funds used to build and operate the center came to Douglas County. State funding to operate the TRC comes to Douglas County. LMH Health does not have that obligation. Bert Nash does not have that obligation.”
Plinsky told commissioners since Sept. 1, “substantial progress has been made” and “agreements and action steps that were delayed months have been accelerated.”
She said her intention was that TRC would operate with local staff provided by Thompson. She called Connections “a collective role model” in integrative crisis care for the TRC, and noted Douglas County leaders have traveled to its facilities in Arizona.
But Plinsky disagreed with assertions that Connections’ involvement with the TRC paralleled efforts in 2020 by LMH Health to partner with a national firm to oversee hospitalist and emergency department services. After community opposition, that plan stalled.
“In this situation, the county wants to supplement local expertise with national expertise. Not replace,” she said.
Plinsky said no recommendations had been put before the commission, leaving the possibility open that BHP could still retain its management position over the project.
Commissioners voiced their support for Plinsky and emphasized the need for community collaboration.
Commissioner Karen Willey said she trusted Thompson and his leadership. She questioned some of the messages shared in the community on behalf of BHP.
“I’m also disturbed to see other entities claim to speak for BHP in the media in ways that they do not have the right to, but also that are directly contradictory to ongoing and frequent conversations that I have with Dr. Thompson and BHP board members,” Willey said.
In an email, Thompson said he would provide more information about the BHP board at a later date. The board is made of representatives appointed by LMH Health, Bert Nash and Douglas County.
“I am planning to send a press release soon to introduce the community to Behavioral Health Partners, who we are and what we do.” Thompson said. “Our plan is to continue to work closely with Sarah Plinsky to open the TRC as soon as possible. I don’t have any further to add at this time.”
Commissioner Patrick Kelly said he would like to hear more from the BHP board and questioned whether its construction by the commission two years ago could have set it on a path for tension within its structure.
Kelly urged stakeholders to come together. Although Plinsky has not yet made a recommendation or proposal to the commission to contract outside Douglas County, the community might need to consider it. A lot more conversation needs to be had, he said.
“I think as a community, we have to think about our allegiance to local support,” Kelly said. “It is my aspiration — I want to be very clear here — my aspiration to have the Treatment and Recovery Center locally governed and locally operated. But we may not be there yet, we may need to develop and we may need to build more capacity. I don’t think that means we’re bad. I don’t think that means we’re weak, or any of those things. I think it’s something we have to consider.”
Commission Chair Shannon Reid said the project has required adjustments over time due to its evolving nature, and integrated health care inherently involves “a spirit of collaboration.” She likened the behind-the-scenes process to troubleshooting and workshopping rather than an attempt to hide information from the public.
Representatives of LMH Health and Bert Nash were offered the opportunity Thursday morning to respond to Plinsky’s statement.
Russ Johnson, CEO of LMH Health, addressed the recent tensions in an emailed response but said questions about licensing, budgets and timelines should be directed to BHP.
“I know that there have been frustrations in this project — that’s not unexpected when developing an innovative model in a complex environment,” Johnson said. “Still, the remarkable nature of this community collaboration is what stands to make the Treatment and Recovery Center successful, and it’s why LMH Health answered the county’s call to play a role in this important initiative. Right now, our only focus is supporting BHP’s efforts to open the TRC as soon as possible, because that’s what’s best for our patients, their families and the community.”