Inmate mental health program may be at risk

October 25, 2010
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The Kent County Sheriff’s Department and network 180 had to scramble recently to find the necessary dollars to continue providing mental health services through the end of this year to jail inmates. But the financial fate of the program, which the Sheriff’s office and the mental health provider have called successful, remains uncertain for next year.

It was a ruling from Michigan Attorney General Mike Cox that created the rush for funding. Cox, who leaves office at the end of the year, answered a question from State Rep. Steven Lindberg, a Marquette Democrat, about who is responsible for funding mental health services for inmates in county jails. Cox said the responsibility lies with the counties; he cited MCL801.4 and MCL801.4(2) as the legal foundations for his opinion.

“The costs incurred providing mental health services to an inmate incarcerated in a county jail are ultimately the responsibility of the county under MCL801.4. The community mental health program serving the county in which that jail is located must nevertheless seek to obtain payment from available insurance or other sources before resorting to the county for payment in accordance with MCL801.4 (2),” wrote Cox in his opinion.

The difficulty in that decision for the local program is that it cut off a funding source: money from the state’s Department of Community Health. Network 180, the county’s mental health and substance abuse provider, has included some of those dollars in its past financial support for the program — which provides screening and treatment to inmates at the correctional facility.

To make up for the funding shortage, which was $51,000 for the last three months of this year, the Sheriff’s Department transferred $17,000 from its 2010 budget to the program. Network 180 matched that amount from its budget with dollars that didn’t come from the state’s general fund and put other monies, mostly from Medicaid, into the program. Those two efforts ensure that the service will be available through the remainder of this year.

As for next year, county and network 180 officials asked the Michigan Association of Counties to get lawmakers to include dollars for mental health services in the DCH budget for this fiscal year, which began Oct. 1. The legislature agreed to add those monies to the general fund, but that doesn’t necessarily mean the money will find its way into the program at the jail.

“We don’t know what a lawyer or the auditors are going to say if they look at the Attorney General’s ruling and then look at what the legislators decided, so we’ll probably have to get some legal counsel on that. We’re hoping that come Jan. 1, we can continue to use some of our mental health dollars to support that program,” said Paul Ippel, executive director of network 180.

“We’re working on that,” said Assistant County Administrator Mary Swanson.

If a state auditor or attorney follows the Cox opinion and nixes the use of those dollars for mental health services, Ippel said he may move to a Plan B to continue the program at least for next year.

“We’ve been working with the county and the Sheriff because we know this is very important. We know there are significant numbers of mental health problems in the jail and we have actually proposed to our board to use some of our fund balance — this is our reserve fund — to cover this on a temporary basis until we can try to get this worked out.”

“We really believe in this (program), but this certainly isn’t a long-term solution for the problem. So we’re hoping that this legislative thing will be a better fix for that program. That’s really conversations that we’ve been having with county staff, county commissioners and the Sheriff to try to figure out how to keep this thing going.”

Swanson said the total annual budget for the inmate program hovers around $700,000. The county picks up $450,000 of that amount each year from its general fund, while network 180 has given $240,000 to the effort. “Hopefully, network 180 will be able to continue funding the program,” said Daryl Delabbio, county administrator and controller.

Almost 17 percent of the inmates were identified as having mental health problems last year. Nearly 14 percent were taking medications for those problems, while slightly more than 9 percent said they have been treated in a psychiatric hospital. Another 3.6 percent reported a history of mental illness exists in their families, and 2.4 percent said they’ve been “case managed” for a mental illness.

According to the Corrections Division of the Sheriff’s Department, 29,135 individuals were booked at the correctional facility in 2009; the jail’s average daily population was 1,223.

“It is incredibly important that this (program) is happening at the jail,” said Commissioner Jim Talen.

The service offered to inmates is an offshoot of the Family Engagement Program, which is part of the county’s larger $2.6 million Prevention Initiative. Network 180 designed the FEP as a way to work with mothers who are at the risk of substance-abuse disorders. “That program is going well. We’re continuing to expand that program, and the county dollars have been very helpful in that regard,” said Ippel.

As FEP grew, Ippel said network 180 identified ways to charge Medicaid for some of those services. That move allowed the agency to get clearance from the county to use some of the dollars Kent contributed to FEP for the mental health program at the jail.

“This program was jointly developed by the jail and network 180. The county and the jail put up about two-thirds of the cost of the program and network 180 puts up about one-third of the cost,” said Ippel. “It’s been a really successful program.”

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