JoCo Sheriff Hayden to drop county-run mental health care in jail, sparking tension
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Johnson County leaders are at odds as the sheriff’s office moves to terminate its contract with the county’s mental health center for services offered to inmates, and instead hire a private provider to take over.
Johnson County Mental Health Center for the past few years has provided behavioral health services at the two adult detention centers, ensuring inmates have access to psychiatric evaluations, medications, suicide assessments and other interventions. The center also offers ongoing support as people leave jail in an effort to continue treatment and decrease recidivism.
And it’s been working, said Director Tim DeWeese. He argued county-provided services have shown positive outcomes in recent years, helping to keep lower inmate numbers and slash recidivism rates.
A 2021 study from the University of Notre Dame showed that Johnson County detainees who qualified for mental health outreach had a 12 percentage point reduction in recidivism after 60 days. That was at least partly attributed to mental health screenings, started in 2016, and the county’s work outside of jail walls, since 65% of detainees are pre-trial released within 48 hours. If a detainee has symptoms of a serious mental illness, the center reaches out to refer them to care with the county or a past provider.
That outreach work, DeWeese argued, has become more effective since the county mental health center has started offering services in the jails.
But at the end of last month, Sheriff Calvin Hayden’s office notified the county it intends to terminate the agreement with the mental health department, effective June 30.
“I think it’s a bad decision. I think it’s the wrong decision,” DeWeese said. “But I understand it’s his (Hayden’s) decision to make.”
McKenzi Davis, spokeswoman for the sheriff, said the office is “adjusting to work with a provider who can focus more on correctional based mental health care for our inmates.
“We are thankful for the work and services Johnson County Mental Health has provided for us, and we hope to continue to work with them outside of our jails so inmates can continue working on their mental health once they are reintegrated.”
Davis said the sheriff’s office is planning to enter into a contract with VitalCore Health Strategies, which already provides medical services and prescriptions at the jails. She said there “will be projected cost savings by us using them as both our mental health and health care provider,” but did not offer the estimated cost, saying details have yet to be finalized.
Frank Fletcher, with VitalCore, declined to comment.
The Johnson County Board of Commissioners would need to approve the new contract. A date has yet to be set for when a proposal will come before the board.
Commission Chairman Mike Kelly said he was still waiting on details from the sheriff’s office on why there’s a desire to switch to a private provider.
“It’s important we have good coordination of services within Johnson County,” Kelly said. “Our mental health department has done a fantastic job in all of its endeavors, including at the detention center. It would be my hope we’d find a way for that partnership to continue.”
DeWeese said he’s been told the decision is mainly a financial one. In 2019, he said the mental health center estimated it would cost about $2 million annually to provide the services. But the two departments agreed to cap the cost at $1.5 million for the first year, then slowly increase the budget.
In 2022, the sheriff’s office paid $1.75 million, and DeWeese said the mental health center pulled more than $340,000 out of its budget to cover additional costs. DeWeese said the center each year has done that, taken money out of its own budget to cover expenses, in order to maintain an appropriate level of services.
He said the budget was set at the full $2 million for the first time last year.
“I think we have been able to meet all of the expectations that we set to provide the services in a good, quality way,” he said. “I have a hard time thinking that a private, for-profit organization could do it cheaper without cutting the quality or amount of services.”
But Davis said the sheriff’s office believes “the relationships with VitalCore and Johnson County will enhance the services we provide to those under our supervision and care.”
DeWeese said Hayden approached the county department in 2019 about offering services at the jails, and it has since embedded a 12-member team of case managers, clinicians, a nurse practitioner and a psychiatric provider.
The Johnson County Department of Corrections estimates about 27% of people in their jails have serious mental illness, compared to 5% of the general adult population in the U.S.
DeWeese said an argument can be made for a private provider, already offering medical services to inmates, to take on the work. But he countered, “The problem is they don’t serve them outside of jail. We do.”
“We have a relationship with the court system, with the corrections system, with the jail,” he said. “We know the community resources. We know how to get people connected with those when they’re coming out of jail. The relationship you provide with the person is key. If you have the ability to build trust in that setting and they are released, they’ll continue to work with you. It’s about developing a good therapeutic relationship. We’re able to start that process much earlier if we’re located in the jail.”
DeWeese said his main concerns in losing the contract are about “consistency and continuity of care.”
“That was one of the big reasons why we started providing those services to begin with,” he said. “I don’t know what’s changed.”
The county has put a higher priority on integrating law enforcement and mental health professionals in recent years, recognizing that police are often on the front lines of mental health crises. Last month, the county announced the mental health center’s team that answers local crisis line calls will move into the same building as 911 dispatchers to work together more efficiently. The center also has placed a mental health responder within police departments, to respond to scenes where behavioral health is a factor, in hopes of preventing unnecessary arrests.
If a contract with a new provider is approved, DeWeese said his department plans to continue providing outreach services. And he anticipates those 12 employees working at the jail now could be moved to other jobs within the mental health center.
His main hope moving forward, he said, is that “whoever provides the services are held to a high standard.”
“My primary concern is not with who provides the services within the jail but rather the array, quality, and extent of those services, as they do have impact upon our community. My hope is that the same set of comprehensive behavioral health services are provided within both facilities and that the provider is held to the same standard of reporting data and outcomes.”
This story was originally published January 11, 2024 at 6:30 AM.
