County to consider contracting for children’s mental health services

While saving the county money is a potential benefit of the proposal, it’s not what’s driving Murray to explore the idea.

“It’s not about money,” he said, although he has been asked to cut the department’s 2012 budget by $150,000. “I’m here for the kids this time, the services.”

The proposal would save the county money, but could result in the elimination of two county positions in the Community Services Department. The potential loss of jobs for two workers concerns leaders of the American Federation of State and County Employees Council 65, which represents the two staff.

But Murray says that the department would be able to provide other services it now does not provide by contracting with Northland Counseling to provide the children’s mental health services.

In a committee meeting with the county board and union representatives this week, Murray provided a plethora of statistics about the county’s use of out-of-home placements in residential and foster care settings.

Murray said Koochiching County has three times the state average of children receiving mental health service and four times the state average of kids requiring outpatient psychotherapy.

And while the county has three to four times the state average of kids needing services, Murray said the county is “way under” the state average for providing family community support services.

Murray also said the county has three to four times the state average of children with behavioral problems requiring out-of-home placements. Koochiching’s children are spending twice the state average of days in residential care. He said the state average for residential care is 122 days per client, while Koochiching averages 230 days per client.

“We’ve got some problems we need to do something about,” he said.

The cost to provide residential care to children with mental health needs was $457,950 in 2010, Murray reported.

The total cost to provide human services to all Koochiching clients in 2010 was $31.5 million, with the county’s share of the cost at $1.4 million, or 4.67 percent, he said. The average percent of all counties in the state is 6.5 percent, he said.

“It’s important to maximize as much county dollars as we can and I think we do a pretty good job of that,” he said.

And while Murray said staff have done an excellent job with the resources available to them, contracting the children’s mental health services would allow the department to focus on delivering other needed services.

Murray provided support for the idea of contracting for children’s mental health services by presenting letters from Dr. Jeff Hardwig, a board certified psychiatrist with Rainy Lake Medical Center, and LeeAnn Meer, executive director of Friends Against Abuse.

Meer said she supports “thinking out of the box and looking at other ways to best serve the mental health needs of our children” in a time of shrinking budgets.

Hardwig said he was compelled to write the letter as a result of statistics about Koochiching County having the highest per capita placements out of the home and a doubling of the percentage of children going into out of home placement with behavioral problems.

“In my practice on a day-to-day basis, I see children and families in need of help and we have indeed a ‘thin soup’ with which to nourish them compared to larger communities,” he wrote.

But Joe Pershern, AFSCME Council 65 representative, said he’d like to see the county call for bids on the proposal to allow for a comparison of costs among providers as well as keeping the services internally.

Jennifer Heppner Long and Alysa Ruelle, Community Services Department staff and members of the union, asked how the department would provide more services with less staff.

Murray said because of federal and state cuts in funding to the department, staff have already been asked to do more with less and he believed it could be done again.

However, he said, “If we can’t do this I will campaign to bring someone back. If we can’t do it in a few months, I have faith the board will let me bring staff back.”

Keeping the staff and contracting out the services would mean asking the board for more money for the department, when it’s already been asked to make budget cuts, added Murray.

Murray also said he would develop measures to monitor whether the number of out-of-home placements is being reduced under the contract.

“If this is not successful, we will bring this back internally,” he said.

Ruelle said out of home placements have already been drastically reduced over the past few years with teamwork. “We deserve the chance to make it happen,” she said of further reductions.

But other staff in the Community Services Department supported Murray’s proposal.

Kathy LaFrance said she, too, doesn’t want to see the department lose employees, but said the department simply can’t provide the services that children need.

“With intensive services younger, we won’t have the severe problems we see as adults,” she said.

Also speaking at the meeting was Greg Walker, chief executive officer of Northland Counseling Center, which has an office in the Falls and a main office in Grand Rapids.

Walker said the center would develop a program and recruit staff locally if the proposal to contract with Northland moves forward.

Meanwhile, Murray is expected to develop a contract with rates from Northland Counseling for the board to review in February.

A copy of the draft contract will be provided to the union for review.