State’s mental health watchdog provides damning report on mental health agency here

Published 3:41 pm Wednesday, February 23, 2022

NATCHEZ — The Adams County Board of Supervisors received a damning report at its meeting on Tuesday, which detailed inadequacies in mental health services offered here.

Adams County is part of Region 11 of the state’s Community Mental Health Centers. Known as Southwest Mississippi Mental Health Complex, the region includes Adams, Amite, Claiborne, Franklin, Jefferson, Lawrence, Pike, Walthall and Wilkinson counties and serves a combined population of 139,735.

Bill Rosamond, who is coordinator of mental health accessibility for the state and whose job it is to evaluate mental health services, has given county supervisors 30 days to come up with a plan to address the adequacies in services offered here.

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In his report, Rosamond said his office had the opportunity to visit all nine counties served by Region 11 Community Mental Health Centers and “has determined that this region does not have sufficient operating funds to sustain the required mental health services and that the delivery of mental health services in inconsistent in the nine-county region.”

He reported deficiencies in staffing, which consequentially resulted in services offered inconsistently or inconveniently as well as unpaid accounts payable and missing payments into the state’s employee retirement system.

Those inadequacies include:

• Understaffing. As of Sept. 25, 2021, Southwest Mississippi Mental Health Complex had 98 filled positions and 30 vacancies, or 23.4 percent vacant positions. Rosamond said that means staffers are required to provide multiple series in multiple counties.

• Staff is not provided with health insurance and the lack of employee benefits and capital further hinders the agency’s ability to hire and retain staff.

“Consequently, the CMHC’s ability to develop adequate and comprehensive services with trained staff is impaired,” Rosamond said.

• Payroll costs of $2,357,646 exceed revenue collected, $2,124,062, by $233,584, Rosamond’s report cited. However, Region 11 received $984,090 in COVID relief and other federal grant funds that reportedly have allowed them to continue operations. Rosamond’s report said the relief funds are potentially subject to repayment should they not meet the required employment expectations, presenting a contingent liability.
Rosamond said Region 11 has accounts payable of $317,000, which leadership said are being paid as funds become available.

“Bank debt totals $292,672, most of which was used to purchase and remodel a building for a Crisis Stabilization Unit in Adams County,” he said in his report.

• Region 11 has an additional $571,000 of possible debts, which may be duplicates of amounts recorded in accounts payable or previously paid debts. Region 11 reports that no vendors are actively pursuing collections of amounts owed.

• On Aug. 31, 2021, Region 11 was delinquent in paying employer and employee contributions to PERS, the state’s retirement system.

Rosamond’s report reads PERS notified the Division of Medicaid that Region 11 was in arrears for delinquent contributions in the amount of $147,078.90 and requested that Medicaid withhold any future payments to Region 11 and redirect the reimbursements to PERS until the past due obligations are satisfied.

PERS has now reported the arrearages are approximately $190,000 and likely to grow. The total net pension liability amount is presently unknown, he said.

Sherlene Vince, executive director of Region 11 Community Mental Health Center, attended Tuesday’s meeting and said many of the deficiencies are the result of the effects of the COVID pandemic.

“The agency has had its challenges over the last few years,” Vince said. “Services have dropped by half to the individuals who are our clients and that because they were unable to come in. They didn’t feel safe coming into the office because of the pandemic.”

She said the agency has received two federal grants, one for an electronic health record system, which includes a billing component.

“We have had set up issues with that and haven’t been able to get billing out the door. And when you can’t get the bills out, you don’t have revenue coming in,” Vince said.

The agency has begun a program in Natchez for patients who are seriously ill, known as psychosocial rehabilitation.

“We started the PSR program today. We had a PSR program before COVID, but they were some of our most vulnerable clients. Now, we have a new space for them since Merit Health donated the complex, new staff — a new program manager and program specialists,” she said.

Children’s day treatment services will also be added, Vince said.

“We have been building services, but it takes time and passion. We are passionate about what we do. We are looking forward to sitting down with the committee (formed by the Adams County Board of Supervisors) and start looking at plans to move forward,” she said.

County Attorney Scott Slover said the report was expected and the deficiencies “are not unique to our particular region, but our region has the highest priority.”

The priority of the plan needs to be its solvency, Slover said.

“The county has 30 days to submit a plan, and the plan is a county plan, not a region plan. Each county has to submit its own plan,” he said. “They want to see it is fiscally able to complete the plan. That means being able to identify revenue sources and collect those revenues, whether it is Medicare, Medicaid or private insurance.”

Adams County is in a fortunate position because many leaders here, public and private, care deeply about mental health issues, Slover said.

“We have a circuit court judge who cares about drug and alcohol issues. We have a justice court judge who has formed sort of a mental health court. We have for almost three decades one of the strongest youth courts in the state. We have a sheriff who cares a lot about mental health issues and has put together and trained a crisis intervention team of officers to de-escalate situations. We have a chancery clerk who has worked tirelessly on it as well. We have Y’all Means All, which has raised lots of money for mental health. Not a lot of counties have this kind of interest and support for mental health care.”

Slover said he and others were meeting Wednesday to begin work on a plan as to how to proceed to present to the Board of Supervisors at its next meeting.

“The State of Mississippi is responsible for ensuring mental health services are available in the state. This isn’t a situation that the county will lose mental health services. It will be solved, whether it will be the state decides to use the county plan or a plan of its own,” Slover said.

Rosamond’s position was established when the Mississippi Legislature and governor approved the Rose Isabel Williams Mental Health Reform Act of 2020. The coordinator of mental health accessibility is part of the department of finance and administration and works independently to review mental health systems in the state.

Rosamond and his staff have the ability to reject any plan the county may submit as insufficient and implement his own plan for providing services in the county.