End of county’s contract with RI ‘a big blow to the community’: Future of crisis services uncertain

For Montgomery County Jail Coalition member Yvonne Curington, the change in local care options is “overwhelming.”

The jail coalition is a group of community members who have advocated for inmates at the county’s pretrial facility, pointing to concerns with healthcare for inmates and other concerns with the jail.

RI International is the service provider, until May 22, for three behavioral health approaches in Montgomery County. This includes a crisis receiving center, mobile crisis response teams and a hotline people can call.

Curington said the receiving center was intended to be a space for people who are experiencing a mental health crisis to connect with resources. This helps people in need of care, but it also takes a burden off healthcare workers employed at the region’s emergency rooms and other agencies.

“It’s going to be a big blow to the community if they don’t find someone who can take their place,” she said.

The Greater Dayton Hospital Association (GDAHA) works with regional healthcare providers and oversees the county’s behavioral health taskforce. Sarah Hackenbracht, the president and CEO of GDAHA, said RI International’s decision was “not expected” and said the loss of its services could present a series of disruptions in the community.

She said the organization “actively participated” in the behavioral health task force and was a part of community conversations surrounding the improvement of the involuntary commitment process.

“The services under contract to RI International are essential to the behavioral health of our community and woven into the fabric of our care continuum,” Hackenbracht said. “It is essential that we ensure the crisis response teams and crisis stabilization center services continue.”

The potential impact on emergency rooms in the region stands out.

“Emergency departments assess and triage patients upon arrival. That means an individual in a behavioral health crisis may have to wait in a loud and chaotic environment,” she said. “Unfortunately, a hospital emergency department is not an ideal environment for someone experiencing a behavioral health crisis and can result in further decompensation. That is why the crisis stabilization center model is an important investment in our behavioral health ecosystem.”

RI International did not return numerous requests for comment.

Public funds

More than $6 million in public funds were used to support RI International since the beginning of 2022. This includes $3.6 million from Montgomery County’s human services levy.

RI International contracted with ADAMHS, whose director announced the severance of the relationship late Friday, effective May 22. Neither ADAMHS nor RI International have given a reason.

The 14-member ADAMHS board of trustees has eight members appointed by Montgomery County commissioners and six by the state of Ohio.

Montgomery County commissioners in a press release on Tuesday said they expect the ADAMHS board to “expeditiously identify a new behavioral health care provider so there is no disruption in services.”

Republican candidates for commission in November Mary McDonald and Kate Baker said they were disappointed to hear RI International was leaving the community, one calling the 14-day notice “unacceptable.”

Baker said the termination of the agreement has resulted in the loss of human service levy dollars.

“Our tax dollars are being poorly managed by Montgomery County commissioners,” she said. “It is time for better oversight in Montgomery County.”

Baker and McDonald are running against Democratic commissioners Judy Dodge and Debbie Lieberman, respectively.

Lieberman said addressing mental health and addiction challenges people in Montgomery County face is among her top priorities. She said both ADAMHS and RI International have played vital roles in the community, and the development of alternatives to incarceration for people experiencing a mental health crisis is crucial.

“These vulnerable populations deserve our unwavering support, and they should never be caught in the crossfire of disputes between service providers,” she said. “While the resolution of this issue primarily rests with ADAMHS leadership, I am committed to ensuring accountability and effective resolution.”

Law enforcement, courts

The Montgomery County Sheriff’s Office acknowledged but did not return a request for comment in time for this story.

Previously, Sheriff Rob Streck said the crisis receiving center was an idea his office had been requesting for years, as deputies are often the first people that come into contact with anyone experiencing a mental health crisis.

It’s not uncommon for his deputies to respond to a call, “pink slip” someone and have them released before their incident report is even finished. They end up responding to another call for that individual where they are ultimately taken to the Montgomery County Jail, Streck said.

Getting “pink-slipped” refers to when someone is brought to a hospital, such as by law enforcement, to undergo an involuntary mental health assessment. The individual may be hospitalized and go through the civil commitment process through the county probate court or may get released after the assessment.

Montgomery County Probate Court Judge David Brannon said he feels the exit of RI International won’t have an impact on his court, as it wasn’t a facility that was credentialed to accept “pink-slipped” people.

“This came after two and a half years of being promised this great center that we would use to centralize stabilization,” he said. “This county needs a stabilization center, but they were not credentialed. They could not hold people over 23 hours, which knocks out everybody that’s pink-slipped.”

Montgomery County ADAMHS Board Executive Director Helen Jones-Kelley said she encourages residents to continue using RI International’s services until their departure on May 22.

“ADAMHS is currently communicating with multiple providers for the seamless transition of services,” Jones-Kelley told the newspaper.

Resources still available in Montgomery County

Those seeking mental health support have other options, including:

Those experiencing a mental health crisis and needing immediate care should call 911 or go to the nearest hospital emergency room.