Pavilions, Northern Lakes Community Mental Health Look to Future

The Grand Traverse Pavilions and Northern Lakes Community Mental Health (CMH) are both looking to the future – making investments now, like infrastructure and service upgrades, while also considering the long-term structure of their organizations. Grand Traverse County commissioners heard updates from both groups Wednesday as part of the first gathering of the new board of nine commissioners, which also included chair/vice chair elections, appointments, and adjustments to the county’s meeting schedule.

CEO/Administrator Rose Coleman said the county-owned Pavilions – which provides a variety of care services for aging adults – continues to experience staffing struggles like many other organizations in the healthcare and nursing home industries. However, Coleman said the Pavilions has made recent “significant changes” in its wage and benefit structure that helped attract 26 new employees last quarter. With six employees leaving, that was a net gain of 20 staff – making a “small dent” in the 150 open positions at the Pavilions, she said.

“Staffing impacts how many people you can take care of,” Coleman added. The Pavilions has been “hovering around 135 (patients) for the past-year-and-a-half,” she said, though at full capacity it could accommodate 240. Fifty-five older adults live in the assisted living cottages of Grand Traverse Pavilions, though at capacity there could be 78, according to Coleman. Staffing levels also continue to be impacted by COVID; anytime an employee tests positive, whether symptomatic or asymptomatic, it requires a minimum seven-day quarantine and can go up to 14 days, Coleman said.

In addition to staffing, the Pavilions is also working on infrastructure improvements. The organization recently experienced a setback when a fire suppression line burst in one of the cottages, flooding apartments and requiring five occupied residences to be relocated. No one was injured in the accident, Coleman said, but the cottage was “significantly damaged” and is still undergoing restoration work. On a more positive note, county commissioners recently approved $256,515 in American Rescue Plan Act (ARPA) funding for the Pavilions to install a new air purification system. Coleman said the Pavilions would be “one of the first long-term healthcare facilities” to install such a system, which is expected to arrive at the end of this month. The system reduces bacteria and fungus on surfaces by up to 60 percent and in the air by up to 75-80 percent, Coleman said. She was hopeful the system will help reduce the spread of COVID, influenza, and RSV. “We’ve had all of those things going around in this county,” she said.

Coleman also said board members are looking more broadly at “the future of healthcare and how that’s going to impact” the Pavilions. Operating a 24/7 care center comes with “significant struggles,” she said, including challenges with local housing affordability and the ability to attract younger workers. Coleman said the board was looking at what the next 5-10 years could look like for the Pavilions and will produce a report at the end of the first quarter this year.

The future of another healthcare organization – Northern Lakes Community Mental Health (CMH) – was also discussed Wednesday as Interim CEO Brian Martinus provided an update to county commissioners. Grand Traverse County is one of six counties that entered a joint agreement in 2003 to provide mental health services to their residents by founding CMH. The organization serves adults with serious mental illness, individuals with intellectual and development disabilities, children with serious emotional disturbance, and individuals with co-occurring substance abuse disorder. Leelanau, Crawford, Missaukee, Roscommon, and Wexford counties join Grand Traverse County in contributing funds annually to receive mental health services through CMH. A majority of CMH’s $83 million budget comes from other sources, however, primarily Medicaid.

In May, Grand Traverse County commissioners voted to begin the process of dissolving the county’s relationship with CMH, citing dissatisfaction with costs and services. Since then, administrators and commission chairs from all six counties have been meeting regularly in an effort to rewrite the CMH enabling agreement – which could preserve the organization and update the contract to better reflect the terms sought by each county. Grand Traverse County Administrator Nate Alger said discussions were chilly at first, but have warmed at recent meetings, noting he expected a new agreement to be brought forward to the various county commissions for consideration in May. “It’s absolutely crucial that we fix this,” he said.

Grand Traverse County contributes the most of any county to CMH at $682,200 annually (those dollars are then leveraged to receive additional Medicaid and other funding to pay for patient services). In 2021, a total of 2,306 individuals in Grand Traverse County received CMH care, a 10 percent increase from 2020. That included 1,554 adults with serious mental illness, 339 adults with intellectual/development disabilities, 311 children with serious emotional disturbance (a 15 percent increase over 2020), and 102 children with intellectual/development disabilities, Martinus said. The average cost for services per person was $12,011, with Grand Traverse County receiving over $27 million total in services.

In addition to updating the six-county enabling agreement, CMH is also searching for a new CEO and working to add more crisis services. CMH recently opened a 24/7 crisis welcoming center – staffed by seven mental health professionals and six peers – and is working on contracts to open a crisis residential unit (CRU), Martinus said. A CRU would provide seven adult beds and five youth beds to offer short-term stays and crisis care until patients can be connected with longer-term services. CMH also hopes to eventually open a crisis stabilization unit (CSU), which would allow for observation up to 72 hours and provide psychiatry and the ability to treat minor ailments and injuries. Alger noted that there is a “serious need to have a CSU” in Grand Traverse County and that significant grant dollars have been allocated to open one.

Also at Wednesday’s commission meeting…
The new board of nine county commissioners – up from seven in 2022 thanks to population growth and redistricting – started Wednesday with an organizational meeting to select board leadership, make committee appointments, and set meeting times. There are five new commissioners and four returning incumbents on the board, representing a 6-3 Republican-Democrat split. The board expansion means it will now take five votes to achieve a majority to pass a motion (instead of four) and six to achieve a super majority (instead of five).

Chair Rob Hentschel was selected to serve another two-year term as commission chair in a 6-3 vote along partisan lines, while Commissioner Brad Jewett was selected to a one-year term as vice chair in an identical 6-3 vote. Commissioners also agreed to move back the start time of their meetings from 8am to 9am. Some commissioners expressed interest in holding at least occasional meetings or study sessions at night to allow more members of the public to attend. County staff were asked to research options and meeting room availability for night meetings and report back to the board. Commissioners also divvied up committee assignments Wednesday, choosing which members would represent the county on various boards. The approved list of appointments is as follows:

Brian McAllister, District 1: Economic Development Corporation, Parks and Recreation Commission
Lauren Flynn, District 2: Economic Development Corporation, Networks Northwest, Northern Nexus, Veterans Affairs
Ashlea Walter, District 3: Area Agency on Aging, Commission on Aging, Community Action Agency
Brad Jewett, District 4: BATA, Emergency Management, GT Central Dispatch, Local Planning Team, Traverse Transportation Coordinating Initiative
Rob Hentschel, District 5: Northwest Regional Airport Authority
Darryl Nelson, District 6: Board of Public Works, Community Corrections, Northwest Regional Airport Authority
T.J. Andrews, District 7: Building Code Board of Appeals, Community Collaborative, Criminal Justice Coordinating Committee, Farmland Preservation
Scott Sieffert, District 8: Brownfield Redevelopment Authority, Land Bank Authority
Penny Morris, District 9: Department of Health & Human Services/Pavilions, Northern Lakes Community Mental Health, Northern Michigan Regional Entity