Northeast Michigan Community Mental Health Authority

Serving Alcona, Alpena, Montmorency and Presque Isle Counties
REPORT
400 Johnson Street • Alpena, Michigan 49707
September 2010
Letter to the Community
Northeast Michigan Community Mental Health (CMH),
like many public and private organizations in 2009, faced
declining revenues and increasing costs. The resolution was not
pleasant and, indeed, resulted in some reduction in availability
of service. At the same time, we are proud of and acknowledge
our CMH employees who stepped up to shoulder the lion’s
share of the burden. Most employees experienced a 4% pay
cut last year and employees’ share of health care insurance also
increased to 16%.
Meanwhile, we are planning for a future that will certainly
continue to present challenges. This year, 2010, may be
characterized as a plateau due to Federal “stimulus” dollars the
State of Michigan used to staunch the flow of its red ink. At
CMH, we have used this period to prepare for the budget cuts
that are sure to come in 2011. Those federal stimulus funds,
even in the most optimistic scenarios, will end during the next
fiscal year, putting Michigan in at least a billion dollar hole.
Planning with so much unknown is daunting, but we do have
some help.
CMH is a member of the Northern Affiliation together
with its partners, North Country Community Mental
Health and AuSable Valley Community Mental Health. This
partnership, led by North Country, is responsible for managing
the Medicaid-funded portion of publicly funded mental health
services in the 13-county region served by these three CMH
boards. This Affiliation is responsible for setting markers
guiding the three member boards toward resolution of budget
dilemmas that supports and pursues the mission, despite
significantly diminished resources.
Pursuing the mission to provide services that support
and treat people with mental, emotional and developmental
disabilities remains our focus. In addition to brief updates
on services and the 2009 financial report, we’re pleased to
highlight in this newsletter the successes of two people who
have used CMH services. Their stories are representative of
many more throughout the four-county region and show why,
even as we face challenging budget conditions, the CMH
Board and staff are thankful for the opportunity to do what we
love to do for people in our communities.
Sincerely,
Gary Nowak, Chairman Tony White, Executive Director
MARY KOSEBA
ROGER FRYE
Longtime Board members retire
A combined 66 years of
service and experience left
the CMH Board in 2009 and
2010 with Board member
retirements.
Longest serving was Mary
Koseba of Alpena who retired
in 2010 after 32 years of
service. The Alpena County
Board of Commissioners
appointed Richard Anderson
to succeed her.
Roger Frye of Hillman
had 18 years of service,
including terms as chair from
1992 to 1994 and again
from 2001 to 2009. The
Montmorency County Board
of Commissioners appointed
Tom Young to the slot.
Mark MacConnell,
nine years, and Tom Male,
seven years, both retired
in 2009 as Alpena County
representatives from the
board. Tom Mullaney
and Linda Canfield
were appointed by the
Alpena County Board of
Commissioners to succeed
them.
In March 2010, member
Pat Przeslawski was
recognized for 10 years of
service on the Board.
2010 Community Mental Health Board
Alcona County
Virginia DeRosia, Secretary
E.A. Fischer
Alpena County
Richard Anderson
Linda Canfield
Judith Hutchins
Thomas Mullaney
Patricia Przeslawski, Vice Chair
Montmorency County
Maggie Clay
Tom Young
Presque Isle County
Marie LaLonde
Terry Larson
Gary Nowak, Chair
Members are appointed by their respective County Boards of Commissioners
Supported Independence Program brings Sarah home
Sarah is a 28-year-old woman
(CMH) began plans for Sarah’s
return to her community. These
plans included support staff from
her community visiting her and
spending time with her at Mt.
Pleasant Center, and training for
all staff working with her in the
philosophy of Gentle Teaching.
with a developmental disability who
spent a little over seven years of her
life living in Mt. Pleasant Center (a
state facility). Sarah was placed at Mt.
Pleasant Center in 2002 because she
had begun to exhibit behaviors that
could not be handled or controlled in
a family home setting. She had become
aggressive at times and destructive of
property.
A brief picture of life at Mt.
Pleasant Center might include the
following views:
•
•
Most activities were “ongrounds”—banking, recreation,
“shopping,” hair cuts, etc. were all
mostly within the buildings and
grounds of the facility. Residents
rarely went off grounds and into
the community unless family
members visited and took them.
When residents became upset
and their behaviors became
uncontrollable with words, people
had to be physically restrained. At
other times, mechanical restraints
SARAH
were used, and as a last resort,
chemical restraints were used—
usually an injection which not only
settled the person but often left that
person drowsy and unsteady.
With the announcement that the
Mt. Pleasant facility would be closing in
September 2009, Northeast Michigan
Community Mental Health Authority
In July 2009, Sarah returned to
the community. Today she rents
a house and has one roommate.
Sarah enjoys getting out into the
community in which she lives. She
shops, goes to parties, visits with
her family, spends holidays with
her family, has made friends, and is
enjoying life.
Assistance for Sarah is provided
by staff through the Supported
Independence Program at CMH.
There are still some difficult days, but
with the help of her support staff to
make her feel safe and cared for, Sarah
is doing well. And, we believe Sarah
is much happier and living a much
more fulfilling life here in her own
community.
‘Gentle Teaching’ is transforming public mental health system
The Philosophy of Gentle Teaching
is one example of the transformation
the public mental health system is
undergoing, and Northeast Michigan
Celebrate service milestones
Six staff members have reached
milestones of 35 or more years of service.
In 2009, Sharon Seguin and Kathy
Piontkowski were recognized for 35 and
40 years, respectively.
Recognition in 2010 went to Cathy
Meske for 37 years and to Marlene
Barkley, Larry Textor and Tony White,
who each marked 35 years of service.
Milestones of 5, 10, 15, 20 and
25 years were celebrated for 66 staff
members in 2009 and for 50 in 2010.
Community Mental Health (CMH) is
taking a leadership role.
Working with the Michigan
Department of Community Health and
the Center for Positive Living Supports
in Clinton Township, CMH has
initiated training in Gentle Teaching in
order to create a “culture of gentleness”
for individuals served.
The approach, based on the work
of Dr. John McGee, helps people
with developmental disabilities and
challenging behaviors live happily and
productively in the community.
Gentle Teaching focuses on building
companionship with individuals and
helping them to feel safe, cared for and
2 - Northeast Michigan Community Mental Health September 2010 Report
valued for the person they are. This
approach places emphasis on pro-active
options and positive interactions to
create an environment where learning
and meaningful relationships will
naturally occur and develop.
The core principles are based on a
psychology of human interdependence.
It asks care givers and care providers
to look at themselves and their spirit
of gentleness in order to find ways to
express warmth and unconditional
valuing towards those who are the
most disenfranchised from family and
community life. It views the care giver
role as critical and requires a deep
commitment to personal, organizational
and social change.
Bill lives successfully with a mental illness In Brief. . .
Bill’s story spans many decades,
In 2006, Bill began to participate in
from adolescence through adulthood,
a multi-family psychoeducation group
from years of difficulty to the
for individuals with schizophrenic type
transformation of recovery.
symptoms. He embraced the group and
His formative
his recovery, learning
years were
about his illness and
troubled by
how to diminish
drinking and drug
symptoms. Today, Bill
use. In his 20s, Bill
continues to attend
had interactions
the multifamily group
with the legal
and is an inspiration
system, incarceration
for recovery to other
and psychiatric
members.
hospitalizations.
So greatly improved
Bill was diagnosed
is Bill’s insight into
with chronic,
his illness that over
undifferentiated
the past several years
schizophrenia. That’s
he has not required
a severe and persistent
hospitalization.
mental illness which
Recovery enables
BILL
was manifested by symptoms
him to live life to the fullest.
of psychotic thoughts, auditory
“Services (at CMH) have
hallucinations, and fear. He
been great,” Bill says. “They
and his family were plagued by the
treat you like a human being, not
uncertainty of how to live with a mental
different because you have a mental
illness.
illness. I’m treated with respect and
With psychiatric treatment at
courtesy, the best treatment. It’s done
Northeast Michigan Community
wonders for me.”
Mental Health (CMH), Bill’s recovery
CMH is proud to be part of Bill’s
blossomed. Encouraged to partner with
recovery and very pleased at his
CMH staff, he learned about his illness
commitment to improving his lifestyle
and how to live the best possible life as a
in order to live a happy and successful
person with a mental illness.
life while having a mental illness.
• Northeast staff members Cathy
Meske, Renee Curry, and Nena Sork
received training in Critical Incident
Debriefing. They can now provide
group and individual crisis critical
incident stress management for persons
who have been exposed to a traumatic
event such as the suicide of a colleague,
line of duty death, serious line of duty
injury, and disasters.
• In conjunction with Thunder
Bay Community Health Services,
Northeast began in 2009 to offer
service in Atlanta. This is part of a move
toward integrating behavioral health
care and primary care services.
• Paul Rajasekhar, MD succeeded
Carolyn Koppenol, MD as Northeast’s
Medical Director in November 2009
when she joined Alpena Regional
Medical Center Behavioral Health
Services.
• Ten area residents, consumers of
CMH services and family members,
participated in the sixth annual Walka-Mile-in-My-Shoes Rally at the
Capitol in Lansing in May 2010. The
rally is held to advocate for legislative
support for mental health services
and to reduce the damaging effects of
stigma often associated with mental
illnesses and developmental disabilities.
IDDT, System of Care approaches addressing community needs
Integrated Dual Disorder Treatment
(IDDT) is continuing the transition
toward making CMH the single point
of service for people who have both
serious mental illnesses and substance
use disorders.
IDDT is an evidenced-based practice,
and all staff have been trained in the
model, including eight who are now
certified addiction counselors (CAC) as
well as mental health professionals.
Northeast System of Care (SOC)
for Children and Youth with Serious
Emotional Disturbances (SED) and
their families is another recent initiative
now serving the four-county region.
Groundwork began in 2008 with a
Michigan Dept. of Community Health
planning grant and moved along to a
five-year implementation grant received
in 2009. The Wraparound process began
serving children with SED and their
families in April 2010.
Partners in Prevention facilitated
planning and continues to assist with
SOC development, while Catholic
Human Services is coordinating
Wraparound.
A SOC fosters more effective and
efficient services for families by bringing
all child-serving community agencies
and stakeholders together to work with
the family to create one plan of service
rather than each agency having a separate
plan. While this seems like a simple goal,
each agency is accountable for state or
federal mandates that can be at odds or
even undermine each other as well as
sometimes duplicate services.
A true culture change is necessary to
persuade local leadership and staff that
coordinating plans is worth the effort.
Our four-county SOC is working
to link the efforts of as many as eight
school districts, four family courts, three
Department of Human Services offices,
Community Mental Health and private
providers.
Northeast Michigan Community Mental Health September 2010 Report - 3
Northeast Michigan Community Mental Health Authority FY 09 sources and uses of funds
$22,704,853
Three-Year Trend of Increasing Service FY07 FY08 FY09
Total Expenditures $22,678,115
Total People Served
Net Income
$
Adults with Mental Illness
Total Revenue
26,738
Northeast Michigan Community Mental Health
Authority has no unfunded pension or retiree benefit
costs.
1,531 1,823 1,844
Children with Mental Illness
398
394
470
Persons with Developmental Disabilities 383
402
433
Total Revenues $22,704,853
Local Funds
$253,015 (1%)
2,312 2,619 2,747
Contracts, Grants & Other
$1,098,100 (5%)
Total Revenues
Reimbursements
$ 219,630 (1%)
State General Funds
$1,869,782 (8%)
Medicaid & Other Managed Care
$19,264,326 (85%)
Total Expenditures $22,678,115
Medicaid & other managed care
Administration & Buildings
State
General Funds
$1,019,170 (4%)
Local Funds
Children with Mental Illness
$ 636,861 (3%)
Other Support Services
$1,976,128 (9%)
Total Expenditures
Contracts,
Grants & Other
Adults with Mental Illness
$4,951,684 (22%)
Reimbursements
Contact information
Northeast Michigan Community Mental Health, 400 Johnson St., Alpena
To request services:
1-800-843-3393 After hours: 1-800-442-7315
Administrative offices: 989-356-2161 Toll free: 1-800-968-1964 TDD/TYY hearing impaired services 989-354-8826; toll free 1-800-836-6282
Assertive Community Treatment, 400 Johnson St., Alpena 989-354-2515
Light of Hope Clubhouse, 229 S. Third Ave., Alpena 989-356-8468
Alcona Office, 311 Lake St., Harrisville by appointment only
Hillman Office, 630 Caring St., Hillman 989-742-4549
Presque Isle Office, 156 N. Fourth St., Rogers City 989-734-7223
4 - Northeast Michigan Community Mental Health September 2010 Report
People with Developmental Disabilities
$ 14,094,272 (62%)
CMH earns high marks in
accreditation survey and
Recipient Rights Review
Northeast earned “Exemplary
Conformance” ratings in four areas—
prevention, supported living, job
development and clinical supervision of
children’s services—during its triennial
CARF accreditation renewal survey in
March 2010.
The CMH Recipients Rights Office,
led by Ruth Hewett, achieved a nearperfect score in its triennial audit
conducted by the Michigan Department
of Community Health.