Access to mental health care services in Jefferson County could be under one umbrella – Jefferson Healthcare – by the end of the year.

Jefferson Healthcare CEO Mike Glenn told hospital commissioners Feb. 1 that he would seek approval from them on Feb. 15 for the public health care system to affiliate with Discovery Behavioral Healthcare effective March 1, and work toward acquiring the private nonprofit organization by Dec. 31. Discovery Behavioral Healthcare is more commonly known as Jefferson Mental Health Services; it changed its name to Discovery Behavioral Healthcare last year.

“It is a really big deal,” Glenn acknowledged during one part of his PowerPoint presentation, which did not include a possible purchase price, but did outline the reasons for the proposal as well as the benefits to both patients and providers.

Motivations includes the reality that patients seeking behavioral health services often have the “the greatest needs, fewest resources and softest voices,” Glenn said.

And there are financial reasons. By 2020, the Washington State Health Care Authority, which buys health care for Medicaid clients around the state, is requiring the integration of health care systems.

“The Health Care Authority is requiring that behavior health and primary care, both financially, clinically and electronically, integrate in order to drive whole-body care,” Glenn said.

Glenn reminded commissioners, and more than two dozen people who came to listen to the presentation, that the two health care systems already have a strong track record of working together. They cooperated in recruiting and hiring psychiatrist Dr. Sue Ehrlich and psychiatric mental health nurse practitioner Althea Fournier. They also have worked together to apply for mental health grants and currently are looking to develop an outpatient mental health facility that could have transitional housing in the same building.

The two also have hired medical social workers to provide care in clinics and have developed two crisis “safe rooms” in the hospital’s emergency department.

Glenn also noted that the hospital now has a psychiatric safe room, Room 322.

“It looks identical to what you would find in an inpatient psychiatric hospital,” Glenn said, adding that the room cannot provide services and that without policies and staff, it “doesn’t deliver to the community what you are pledging to deliver on.”

“It’s our responsibility to make the availability of those resources easy and respectfully offered,” Glenn said.

Adam Marquis, executive director of Discovery Behavioral Healthcare, said in an email after the meeting that the board and leadership team of Discovery “favors a closer partnership.”

The private nonprofit mental health care system currently has 51 employees and subcontractors.

PHASING IN

If the board approves the idea, the two organizations would start on March 1 to co-manage the clinic and financial operations of Discovery Behavioral Healthcare. Both would remain separate entities until plans are finalized about where services would be provided, how contracts would be switched and a master site plan developed, Glenn said.

Both boards also would need to approve the deal with formal action.

And down the line – a timeline was not given for this – a public hearing would be set to seek community input.

A final decision would be made no later than Dec. 31.

Employees of Discovery Behavioral Healthcare would become employees of Jefferson Healthcare when the agreement is completed, Glenn said.

“In return for our commitment to continue their legacy of providing mental health services to Jefferson County, Jefferson Healthcare will assume ownership of all assets and liabilities of Discovery Behavior Healthcare,” Glenn concluded.

In an earlier interview, Glenn noted that while there was disappointment last year when he recommended the hospital board give back $1.5 million for a seven-bed inpatient psychiatric facility, he said the new proposal “is going to provide a framework that we think we can reach out and touch many more residents of the community.”

‘ROOM FOR IMPROVEMENT’

Dr. Joe Mattern, chief medical officer of Jefferson Healthcare, started off a presentation on current mental health services by saying, “We have room for improvement.”

Washington ranks 48th in the United States in terms of caring for patients with mental health issues, he said of a study by the Advancing Integrated Mental Health Solutions (AIMS) Center, based at the University of Washington’s Department of Psychiatry and Behavioral Sciences.

Closer to home, concern about a lack of mental health care in Jefferson County was the top concern listed in the Community Health Improvement Project, a project that assessed the needs of county residents.

In Jefferson County, 33 percent of adolescents report experiencing depression, with 24 percent reporting thoughts of suicide, according to health statistics, Mattern said.

In general, nationwide, Mattern said there has been a history of physicians and mental health care providers operating in “silos.”

“In the medical care, as the patient, it seems incredibly silly that people don’t seem to talk to each other when you have different people taking care of you,” he said.

He said it came to his attention not long ago that not all mental health professionals think family physicians should even know about the care given by mental health care providers.

“There are concerns about privacy. There’s stigmatization around mental health. Even record sharing has extra barriers. There are separate types of consent,” he said.

He said he had had patients who were hospitalized for mental health issues, and when they came to him, he asked why they missed an appointment, only to learn they had been hospitalized for 30 days without his knowledge.

One of the main concerns for Mattern is that most mental health care providers are older and there is not a lot of providers “in the pipeline” who can come to the rescue.

That said, Mattern noted that only about 25 percent of people diagnosed with depression get better with a prescription.

“So a prescription pad is not going to solve the mental health problem,” he said, suggesting that someone with time and a comfortable chair – such as the people currently employed by Discovery Behavioral Healthcare – is more effective.

REACTIONS

Kathleen Kler, chair of the Jefferson County Board of Commissioners, said what Discovery Behavioral Healthcare and the hospital are doing is “ahead of the pack” in the state. She said there have been funding and relationship issues in the past.

“As the chair of the Salish Behavioral Health Organization, I am definitely in support of the collaborative efforts to provide increased mental health and substance use disorder services to Jefferson County,” Kler said. “In this rapidly changing health delivery world, the sooner we get full integration of care and records, the better opportunity we have for restoring and maintaining the full health of our community members. I am excited and grateful that these agencies are exploring new options to increase the coordination, vitality and sustainability of services.

Kler called the idea of record-sharing “truly epic.” The word ‘epic” is also the name of the electronic medical-record-keeping system used by Jefferson Healthcare.

“Thank you,” said Steve Workman, who identified himself as a behavior health care “agitator.” “I’ve been coming to these meetings for seven years, and this is huge.”