Butler County mental health crisis stabilization unit project delayed by months
He’s also studied five models so far, two in North Carolina, two in Ohio and one in Oregon. Based on these models, he estimates a Butler County facility could cost $7 million to operate, which is up from the original price of $5 million to $6 million.
Commissioner Cindy Carpenter traveled with Rasmus to visit the two crisis units in North Carolina last month, one in County Durham that costs $7-8 million a year and another smaller one in the town of Henderson which costs from 3 to 3.5 million dollars per year. The County Durham facility serves approximately 250 people per month and is similar in size to County Butler.
Carpenter told the Journal-News that they were taking the extra time because “we will do everything possible to ensure that the Crisis Stabilization Unit meets our needs and is as effective and efficient as possible, as it is funded with taxpayers’ money.
“Commissioners have asked the Mental Health Board to provide data on entry points into the Crisis Stabilization Unit,” Carpenter said. “We want to make sure we’re building the right size facility to house it. We continue to explore various solutions for the homeless and people with mental health and addiction issues who are in our county jail.
Commissioner TC Rogers told the Journal-News ‘there are no specific plans’ and before proceeding they need to know ‘how you are going to handle it and how much it will cost’.
Commissioner Don Dixon recently told the Journal-News “it’s going to have to be design construction here.”
“We’re going to have to open it up on a small scale, test it, see what the results are and then see where the savings are…” Dixon said. “My anticipation of how this will start is small as a test prototype and let’s see how it works and we will build on that.”
Over the past few years, there have been many conversations about what such a center would bring. At first, it was called a “drop-in” center for homeless people who had a psychotic incident or caused a drug-induced disturbance so the police wouldn’t have to take them to jail.
More recently, the definition has been expanded to a place where police and family members can take people with mental illness who are going through an episode. Rhonda Benson, director of the county’s National Alliance on Mental Illness chapter, said this type of facility has been needed for years.
“There’s this gray area where they’re really too sick to be home alone, but they’re not sick enough to bring them anywhere,” Benson said. “It wouldn’t just benefit the police, but anyone can drop someone off and they just help stabilize them and identify what kind of services they need.”
Commissioners made the decision in May to close the county nursing home and use part of it for the Crisis Stabilization Unit. Rasmus said his board had hired an architect to determine the design and cost of the building’s renovation. The $3 million pledged by the commissioners on American Rescue Plan Act funding would likely go toward those capital costs. The idea is to start with 10 observation chairs and 10 private rooms and potentially double the number of each later.
This model mirrors the two facilities they saw in North Carolina, both facilities have a common area with 23 hour observation chairs as well as longer term treatment rooms. Once patients are stabilized in the observation area, they are either referred for wraparound services or admitted for two to five days for further in-house treatment.
“He treats clients in an open space to meet their needs in a crisis but also to allow them to socialize with each other without any walls and that helps because of the socialization they maybe get support , suggestions from each other on resources,” Rasmus says.
The MHARS board does not provide direct services to clients, it provides funds to local providers like Sojourner Recovery Services who have their own facilities. Rasmus said his board could provide short-term services, but he needs to find a long-term outside provider, hence the RFP.
To pay for it, Rasmus said his board would have to ask voters to approve some form of new tax levy to support the project. The council has two levies, a 1985-approved half-mill ratepayer that generates $1 million a year and expires in 2024 and a 2006-approved mill that generates $9.3 million and expires in 2025. Voters strongly supported the renewal of these funding sources over the years. , the last of 73% in November 2020.
“We’re scheduled for a swab next fall and that’s still the thought process here, that swab wouldn’t just be for the crisis stabilization unit to support that, but the community mental health system itself. “, Rasmus said. “We’re just going to see what it’s going to look like, what kind of swab, the size of the swab.”
Commissioners must approve the imposition of ballot levies for county agencies such as the MHARS council. Carpenter said she wasn’t quite ready to ask voters for more money.
“We’ll see,” she said. “I think we can get the crisis stabilization center in place before the commissioners decide whether or not to vote on a levy and by then we will have real figures on the cost of operations.
The county also considered using a portion of the OneOhio opioid litigation settlement to fund the unit. The county received the first payment of $232,669 from the settlement with some of the distributors and is expected to receive a total of $3.8 million to $5.4 million over 18 years, depending on a host of still unsettled variables. Plus access to a $38.1 million share and $54.4 million more, as part of a seven-county regional group that will decide future funding distributions.
A settlement has also been reached with Johnson & Johnson, but those details have not been confirmed. County Administrator Judi Boyko said early estimates were for annual stipends of $97,243 to $138,919 over nine years for the county’s share.
Rasmus said they also asked the State Department for Mental Health and Substance Abuse for $750,000 — he said it sounded “promising” — to spend on capital costs for the project and that his board of administration would be required to match this amount if awarded the grant.
Rasmus said once the RFP is released, it would take three or four months to review the proposals before a contract for the program could be awarded.