By Gari Voss
The invitation to the groundbreaking on January 28, 2022 at 3pm of the Allegan County Community Mental Health ACCMH) center at 540 Jenner Drive in Allegan made it official. The ink is dry and Mark Witte, executive director, could announce that on January 4, 2022, ACCMH had signed a 30-year loan agreement for the former ShopKo building.
When ShopKo closed several years ago, Witte and the ACCMH Board began conversations with the previous owners and hired Schley Nelson Architects in Oshtemo to design a floor plan that would allow all of the ACCMH services to operate under one roof.
CMH applied to the USDA for a rural development loan which was approved for $5.635 million. This amount was considered to be the upper limit value of the finished building. ACCMH had also been approved as the first certified community behavioral health clinic (CCBHC) in Allegan County and was eager to begin renovation of the Jenner Drive building, but bids were coming in at about $2 million more than budgeted. Before the USDA would release the approved funds and allow the loan to close, Witte and his team had to find the extra dollars.
Because ACCMH services all residents in Allegan County, Witte and his team visited every municipality that would be receiving COVID Relief dollars. He pitched for a promise of 10% from each township, village and city allocation to be designated to CMH. “Everyone gave us supportive words on the work we do, but there was not one to approve the allocation,” Witte said.
Finally, the Michigan Department of Health and Human Services invited CMHs to submit proposals that could use COVID Relief funds for “worthy projects” addressing mental and physical health needs. Mary Whiteford, State Representative for Allegan County, had been working to get more mental health funds released, “I contacted people and gave all the support I could in order to obtain the grant from the appropriate State COVID Relief dollars for the approximate $2.5 million gap in funding.”
On December 15, 2021, the Department of Labor and Economic Opportunity allocated $2.5 million to Allegan County Community Mental Health. “With that, the USDA agreed to release the original $5.635 million, and the closing took place on January 4, 2022,” Witte acknowledged. “We will also have some startup funds for programs.”
Even before the COVID pandemic, the need for high quality mental health was on the rise. Adults and children with a wide variety of mental illnesses and developmental disabilities were seeking care, and their families were pleading for support, but little was available.
In 1970, Allegan County Community Mental Health was established by Allegan County to assist children with developmental disabilities who were at risk of being institutionalized. These individuals had previously been supported in Kalamazoo, but the goal was to give them local required assistance so they could remain in their own communities.
Slowly, the goal to assist only those at risk of institutionalization because of developmental disabilities was expanded to include a wider population. In the beginning, the State of Michigan funded these programs with supplemental funds from the Federal government.
Witte explained, “Historically, Medicaid, which started in the 1960s, gradually grew though the past 40 years to become 95% of the funding for our services. Until the arrival of our CCBHC grant in late 2021, which we are only now implementing, one of the major barriers to access services was the fact that one had to be on Medicaid to qualify – which usually meant that your needs were extreme or you were disabled. The new opportunities we have through our CCBHC grant to serve a much wider segment of the community – people whose needs are considered more mild or moderate (vs. severe or acute) – will coincide with the move to our new building in a very beautiful way.”
During the last few decades, funding sources for mental disabilities have slid from State funding with supplements from the Federal government to primarily Federal funding with supplements from the State government. The new focus has encompassed health services for all individuals and families plus guidelines for employment and work incentives to remove significant barriers so people with disabilities, including psychological or mental disabilities, could find employment.
The desire to open a pathway to recovery and employment can be found in other programs like special education Individual Education Plans (IEPs) and in how health professionals counsel clients. The goal now is to address the mental disability and/or substance abuse issues in ways that assist individuals in becoming productive members of their communities.
To expand services to a wider variety of health care facilities, Debbie Stabenow, a Democrat from Michigan, and Roy Blunt, a Republican from Missouri, designed the Excellence in Mental Health Act of 2009. Their push increased federal Medicaid support for high quality mental health and substance use treatment services. This led to the establishment of eight two-year, eight-state demonstration health centers through Section 223 of the Protecting Access to Medicare Act of 2014.
In 2020, Allegan County Community Mental Health went through the federal application process and became the 20th Certified Community Behavioral Health Clinic (CCBHC) in Michigan. In addition, their partnerships have been able to provide a more comprehensive range of mental health and substance use treatment services to “vulnerable individuals with both physical and behavior health needs.” CCBHC requires a focus on wellness, recovery, trauma-informed care and physical behavioral health integration.
A CCBHC must meet certain quality standards. Requirements include providing a comprehensive set of behavioral health services including 24/7/365 crisis services; outpatient mental health and substance abuse treatment services; immediate screenings, risk assessments, and diagnoses; plus care coordination with emergency rooms, law enforcement, and veteran groups.
“No longer can the mental health care system focus primarily on those who may require institutionalization. All who require assistance – children, adults, veterans, insured, uninsured – must be served,” added Witte.
Witte continued, “Four years ago, ACCMH had three rounds of layoffs during which we lost 42 staff members. We had been operating over budget and needed to become more fiscally responsible in order to receive funding. This led to working more closely with other agencies across the county who shared clients. We improved our use of other community resources, and in the process have become tightly connected to our community’s needs and services.”
It may still be a year away, but by becoming a CCBHC and creating a central location for services, the clinic now looks to the future. Knowing that some individuals view mental health assistance different than physical needs, Witte knows that ACCMH must distinguish themselves as a place that serves people with needs, whether those needs are physical or psychological.
In an email, Jenifer Garcia, Foundation Director with the Ascension Borgess Allegan Foundation, wrote, “I’m excited for ACCMHS to be moving into the old ShopKo building to bring all of their services together under one roof! Mark Witte, Executive Director for ACCMH, has been working so hard to bring this idea to fruition, and it sounds like they have succeeded in securing their USDA loan to make this all possible.”
Witte explained that many individuals do not realize that ACCMH is not only responsible for advanced mental health needs, but is also the county’s housing authority and responsible for other services that lead to anxiety or mental stress. Therefore, as the clinic takes shape, there will be more support addressing mild to moderate needs associated with mental illness.
The acquisition of the USDA/SAMHSA and State COVID Relief grants is just the beginning of a long road to identifying the needs of individuals and providing programs and services that assist them in becoming productive community members.
As Witte stated, “SAMHSA funds will support access to care (including mobile response) for those previously ineligible for services, identify and treat trauma, and integrate physical care for those with mental illness and/or substance use issues. There are many needs in Allegan County that we care a lot about. These grants will go a long way toward meeting those needs.”
The gathering to “commemorate the start of construction for the new headquarters” will begin a new chapter in mental health services in Allegan County.
The purchase agreement was signed on January 4, 2022 and work has begun on the previous ShopKo building to renovate it into the headquarters for Allegan County Community Mental Health programs. Official groundbreaking will be held on Friday, January 28th.