Upcoming local stakeholder meetings to help develop the plan will be moderated by a neutral party and will highlight tensions between county entities and call for greater cooperation.
“Real cooperation is key — real, genuine cooperation,” said Montgomery County Probate Court Judge David Brannon.
Some of these groups recently spoke with the Dayton Daily News to discuss the frustrations between the county and Montgomery County ADAMHS, including where this crisis services model began, what went wrong since it was proposed and while it was being built, and where the county goes from here.
“The loss of emergency services has created a lot of backlash, but all involved parties have come together to bring ideas and solutions to the table,” said Sarah Hackenbracht, president and CEO of the Greater Dayton Regional Hospital Association.
Origins of the Crisis Management Service Model
In February 2020, the federal Substance Abuse and Mental Health Services Administration (SAMHSA) released national guidelines for behavioral health crisis care.
“This was cutting-edge, evidence-based best practice serving our community,” said Montgomery County ADAMHS Executive Director Helen Jones Kelly.
The guidelines included a three-tiered model that included a hotline people could call if they were experiencing a mental health crisis, community-based mental health crisis response teams, and places where people could seek help without overcrowding local emergency rooms.
RI International was one of the featured case studies SAMHSA National Guidelines For behavioral health crisis services.
RI International’s Crisis Recovery Center model initially incorporated a living room-style 23-hour drop-in treatment center, but has since incorporated its own direct emergency department access in the form of a subacute crisis program.
ADAMHS partners with RI
Montgomery County ADAMHS partnered with RI International after the release of SAMHSA’s crisis care guidelines, patterning the county’s crisis services after RI International’s centers.
Jones-Kelly said there was no need to issue an RFP, which is when an organization solicits proposals from outside vendors and describes how the vendors can meet the organization’s needs.
Montgomery County ADAMHS researched and met with various service providers and also hosted community meetings, though at the time the meetings were held on Zoom due to the pandemic, Jones-Kelly said.
“We believe we have done our due diligence,” Jones Kelly said.
Jones-Kelly said Samaritan Behavioral Health had contracted with Montgomery County ADAMHS for crisis care requests for the past few years, but that it and other local organizations did not have the capacity ADAMHS was looking for.
Crisis Reception Center
There have been complaints about competing crisis lines (Crisis Now, which is partially funded by grants, and 988, which is receiving federal start-up funding at the state level), but much of the frustration seems to be focused primarily on the Montgomery County Crisis Reception Center.
“From the beginning, we were told it was going to be a 72-hour crisis reception center, but that never happened,” said Butler County Police Chief John Porter, vice president of the Miami Valley Police Chiefs Association.
The Montgomery County Crisis Reception Center would have a 23-hour observation area with reclining chairs and a short-term psychiatric area with beds for people who need to be hospitalized for 72 hours.
“This was supposed to take the strain off police officers on the streets, it was supposed to take the strain off our jails having to house people in crisis, it was supposed to take the strain off our hospital emergency rooms, and all of that never happened,” Porter said.
Community partners have been working on crisis services for years, and Hackenbracht called the creation of OneFifteen, an addiction treatment provider that opened in 2019, a win for people with substance use disorders. The community had hoped to do the same for mental health.
“What has brought our partners together in the past has been our shared goal of making sure individuals get the right treatment and services at the right time,” Hackenbracht said. “The concept of a crisis stabilization center or crisis reception center was a shared goal. Unfortunately, we haven’t achieved that goal.”
The original vision for the center was never fully realized, despite lengthy discussions about where to locate it.
“It’s taken a long time to launch, longer than anyone expected, but the pandemic played a big role in that,” Jones-Kelly said.
Jones Kelly said the 72-hour detention was not part of the concept for the first phase of the stabilization center project.
“The first step was to set up the observation unit. The second step was going to come afterwards, because it’s more expensive,” Jones Kelly said. “And the biggest obstacle to the landing site was space.”
One site previously considered would have allowed RI International to secure additional space above the surveillance area to install beds in the 72 cargo hold area, which would be set up more like a living unit, Jones Kelly said.
RI International and ADAMHS originally wanted to locate the crisis reception center in the former AAA building at 825 S. Ludlow St., but Dayton’s Zoning Board of Review denied the permit application in March 2022.
Located at 601 S. Edwin C. Moses Blvd., RI International had to lease additional space to build out the 72-hour storage area.
“The zoning should have been worked out before the agreement was made,” Brannon said.
While there is a persistent perception in the community that public funds were used for the center itself, Montgomery County ADAMHS says no public funds were used for capital costs such as purchasing or leasing the center.
“We only pay for services provided,” Jones-Kelly said.
About $3.6 million in human services levy money was earmarked for these direct services between 2022 and 2024, according to ADAMHS records.
The remaining funding for services included about $1.3 million in state funds allocated by Ohio MHAS and $1.8 million in federal funds, totaling about $6.7 million, according to Montgomery County ADAMHS records.
Where is the county heading now?
Montgomery County ADAMHS will be hosting public meetings with both in-person and virtual options to gather input on the RFP process for new crisis response services.
“We welcome everyone to participate in our community meetings as we learn from each other about how to best provide crisis mental health services to Montgomery County’s most vulnerable residents,” Jones-Kelly said.
It is unclear whether all three services will be replaced or only some of them. ADAMHS board members have expressed interest in keeping 988 as the crisis line to reduce competing crisis numbers.
“We will continue to work collaboratively with the hospital, ADAMHS and all community partners as ADAMHS prepares for public consultations with the public, community partners and stakeholders,” Hackenbracht said.
The Montgomery County Police Chiefs Association said it was not their goal to appear as if their association was in opposition to ADAMHS.
“In this particular area of mental health services, our goal is to raise voices and address those concerns just as our officers work with them every day,” Vandalia Police Chief Kurt Althaus said.
Details of the meeting are as follows:
- It will be held June 24 at 5:30 p.m. at Woodbourne Library, 6060 Far Hills Ave. in Centerville.
- It will be held at 1 p.m., June 25, at the Montgomery County Business Solutions Center, 1435 Cincinnati St., Dayton.
- June 27 at 9 a.m. at the Montgomery County Employment Opportunity Center, 4303 West Third St. in Dayton.
Scott McGohan, former CEO of McGohan Brabender, will moderate the community meeting.
If you or someone you know is experiencing a mental emergency, please call 988.
