Leonardtown, MD — The Commissioners of St. Mary’s County have voted to move the administration of behavioral health services out of county government and into the health department. The May 17 decision came over objections of one commissioner and two of the agencies that provide the services. The majority decision will become effective in Fiscal Year 2018.
Behavioral health is the general category that includes both mental health and substance abuse services.
Representatives of Walden Counseling Services and the Department of Social Services testified against the proposal at a March 29 public hearing called by the county commissioners.
At the decision-making meeting, Commissioner Todd Morgan [R- 4th District] (shown above) expressed concern about what might happen to the county staff of four-and-a-half county employees who currently administer grants received from the state Mental Hygiene Administration and Alcohol and Drug Abuse Administration. The employees are within the Department of Aging and Community Services, an agency formed in 2011 under the leadership of Lori Jennings-Harris, the former aging director.
The county agency in turn contracts services out in the form of grants to such providers as Walden, Pathways and Adult Recovery Court through the circuit court. The system does leave the commissioners in the loop in that they must approve the grants, but sometimes that slows down the process, state officials say.
That is one reason the state recommended last year that the county turn over administration of the programs to the health department. The state also says the majority of the counties have the health department as the administrator.
County Administrator Rebecca Bridgett convened two meetings last year of “stakeholders” to discuss the issue and out of those meetings came the recommendation to the commissioners for the change.
At the March 29 public hearing, Walden CEO Dr. Kathy O’Brien, Walden Board Treasurer Julie Randall (a former county commissioners’ president) and county Department of Social Services Director Ella Mae Russell all testified against the move. O’Brien heads the leading agency in the county that provides behavioral health services. She said the agency is in its 43rd year so it must be in a mid-life crisis with the proposal.
Dr. O’Brien said that the county is a model for the rest of the state with its continuum of care for behavioral health issues. She said the argument that the current system is burdensome is not an issue for her agency. “We are used to the lag time,” she said.
Randall called for an even stronger county role in the behavioral health area, not less. “The citizens depend on the county to meet their needs,” she asserted.
Russell noted that Walden has a staff person embedded in her agency to deal with her client’s needs. “I am very concerned how that will be impacted if the changes are made,” she said.
At the public hearing two spokespeople for Adult Recovery Court run by the St. Mary’s County Circuit Court argued on behalf of the proposed administrative changes. John K. Parlett, who serves on the program’s citizen’s advisory board, said health is not part of the day-to-day responsibilities of the Office of Aging and Human Services.
Commissioner Tom Jarboe [R – 1st District} agrees with that argument. He expressed concern about the opioid epidemic, but said he was not the expert of the subject of what to do about it. “I have no background or training,” he said. Jarboe concluded that the professionals in the health department could do a better job than the commissioners.
One of the changes at the state level that prompted the proposal is the switch to fee-based service for behavioral health. Morgan also asked what impact that would have on the future of the programs both for those able and unable to pay for the services. At the May 17 meeting Morgan reiterated his concern that the trend would affect the people least able to afford to pay for needed services.
St. Mary’s County Health Officer Dr. Meenakshi Brewster said at the public meeting that the health department was not advocating one way or the other for the change and would do whatever was decided. She did however point out that the health department was a county health department serving exclusively the citizens of the county.
The decision by the commissioners reflects confidence in Dr. Brewster, who has proven to be a popular leader during her several years on the job. She has become the point person in the county’s attack on the opioid problem, a point noted by Commissioner John O’Connor. “Dr. Brewster is leading the way. Every single facet of it is Dr. Brewster,” he said.
Regarding the shift of county staff to another agency, Commissioner Mike Hewitt {R – 2nd District] said, “Maybe the state employees can do a better job.” Commissioner President Randy Guy [R] agreed.
Contact Dick Myers at dick.myers@thebaynet.com