The Douglas County Commission on Wednesday will hear an update on the county’s Treatment and Recovery Center, including a proposed phased opening plan. It will also consider providing additional funds for social detox services until the TRC is fully operational.
Although no dates are specified in agenda materials, a three-phased opening plan shows the center could open its doors by offering services in all three of the major components that comprise the TRC.
As the TRC’s front door, the Access Center will offer Douglas County adults and children access to the community’s behavioral crisis assessment and treatment services. Proposed hours are Monday through Friday from 8 a.m. to 8 p.m. in phase one.
Also included in phase one are services and staffing for up to five adult patients within the Observation and Stabilization units — provided their medical needs have already been assessed by LMH Health’s Emergency Department. The Observation Unit can accommodate a maximum stay of 23 hours per individual, and the Stabilization Unit will provide services up to 72 hours per patient.
By phase two, the Access Center would add weekend hours of 8 a.m. to noon Saturday and Sunday, making it fully open to the public. The TRC also could start accepting voluntary walk-ins and operate at up to half its capacity with eight individuals in each of its inpatient adult units, according to the presentation slides.
In the third and final opening phase, the center could begin accepting referrals from law enforcement and emergency medical services and reach its full inpatient capacity of 16 patients in each of its units.
Additionally, the county’s mobile crisis response team will be stationed at the TRC after closing hours at Bert Nash Community Mental Health Center. The mobile response team “will be available for support” in the Access Center when staff aren’t already working response calls, the materials read.
“Timing of each phase collaboratively determined,” a slide said. “Communication regarding each phase done prior to initiation.”
A funding bridge for social detox
The commission is not expected to take action on any items on the TRC update, but a separate agenda item for county commissioners to consider asks for up to $153,000 in additional funding for a county partnership with DCCCA and LMH Health. The extension would fund peer-led substance abuse intervention services in the LMH Health Emergency Department from January to June 2023.
The four-year project’s outcomes had been “impressive and impactful” with nearly 70% of participants engaged in social detox seeking treatment for a substance use disorder, according to a memo by Bob Tryanski, director of behavioral health projects for Douglas County.
“Peers are three times more likely to engage clients than professionally trained counselors,” Tryanski wrote.
Typically, a social detox treatment plan limits services to counseling, therapy and monitoring for people experiencing addiction once they’re medically stable. Medical detox, on the other hand, requires close supervision and monitoring due to its risks; if necessary, it offers medication to help with withdrawal.
Tryanski’s memo said the project targeted “the limited availability of detox beds in Douglas County until the (TRC) was fully operational” while seeking to address disparities in grant funding for men and to estimate needs for medically assisted detox services at the TRC.
Funding expires at the end of 2022, Tryanski said, and delays in opening the TRC have led to concerns by behavioral health and county leaders that clients needing social detox services won’t have access to services past December.
“The six-month extension would still cover social detox needs in the (emergency room), but also serve community members who are medically stable and able to avoid a costly (emergency room) visit,” Tryanski wrote.
The proposed funding would identify clients in need of detox and transport, provide peer support services and pay for detox services when necessary. The funding would come from sales tax dollars for behavioral health that were originally budgeted for peer support services by DCCCA employees to be stationed at the TRC, according to the memo.
“This allows DCCCA to continue to hire peers while the TRC opening is delayed and provide DCCCA some flexibility as they transition peer support services into the TRC and continue to develop capacity to provide peer support across the system of care,” Tryanski wrote.
Other TRC updates
Numerous status updates also are included in the online presentation materials, including a progress report on TRC management’s to-do list from the commission’s Nov. 9 meeting.
Agenda materials show behavioral health leaders expressing confidence in the crisis center’s business model and recommending development of a lease and operating agreement for the center as soon as possible with stipulations the county serve as the payor of last resort and only for uninsured and under-insured patients.
Leadership, the materials said, also has worked to realign the center’s 2023 operating budget during the last month with estimated revenues between $6.5 and $7 million in 2023. Medicaid funds through Bert Nash’s certification as a CCBHC, or Certified Community Behavioral Health Clinic, will cover between 56% and 65% of the revenue needed to operate the center, according to a presentation slide.
Agenda materials also show the symbiotic nature of community partnerships within the county’s behavioral health system. All TRC employees will transition to employment under Bert Nash Community Mental Health Center by Jan. 1. Negotiations for DCCCA’s peer-support employees remain underway, according to the agenda.
Other highlights include TRC staffing bios and information, a list of developed policies, and quality measures the TRC will have in place to comply with CCBHC requirements through its designated collaborating organization status with Bert Nash.
Neither future control of the TRC’s management nor hiring information about the permanent replacement of Dr. George Thompson, the former medical director and executive director who left the TRC last month, were addressed in the agenda packet.
The Douglas County Commission will meet starting at 5:30 p.m. Wednesday (Dec. 14) at the county courthouse, 1100 Massachusetts St. See the full meeting agenda at this link.
The commission accepts written public comment sent via email to rcrabtree@douglascountyks.org no later than 24 hours ahead of the scheduled meeting start time. Members of the public may also provide comments during the meeting in person or via Zoom. Meeting recordings are uploaded to the county’s YouTube page.
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Tricia Masenthin (she/her), equity reporter, can be reached at tmasenthin (at) lawrencekstimes (dot) com. Read more of her work for the Times here. Check out her staff bio here.
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