Selling Care Facility's nursing beds could help fund mental health crisis center

Jun. 10—The Butler County commissioners announced recently they will be out of the nursing home business by year's end and now are debating how to finance transforming the space into an emergency mental health crisis center.

The county is working to shut down the 109-bed Care Facility by the end of the year and transform part of it into an emergency crisis center. Commissioner Cindy Carpenter told her fellow commissioners recently the local group working on the OneOhio opioid settlement for the region — the seven-county region is slated to get about $54 million — made the crisis stabilization a funding priority, but there is a hitch.

"We have identified that the crisis stabilization center is the primary project we're going to seek funding for," Carpenter said. "Unfortunately Butler County is part of a region and the guidelines say that everything we put forward has to support the region, so we have to adjust our crisis stabilization center to support these other six counties."

Her fellow commissioners balked at the idea.

"I'm not interested in building a facility that will be available for other counties that are far away to be able to bring different residents or indigent people to Butler County and have them put in our treatment center," Commissioner Don Dixon said.

"My philosophy all along has been Butler County takes care of Butler County, we get hooked up with all this other stuff it's just a massive, massive bureaucracy mess, I think it's a stupid idea. I think we have a way of funding it ourselves locally."

Commissioner T.C. Rogers said the crisis center is supposed to be a place where local law enforcement can bring people for evaluation and referral to services, rather than dropping them at the county jail.

"I think that the services the stabilization center would provide would be diluted, trying to have to make a compromise with these other counties. I thought we all along had established a funding source for that and it was just going to be a matter of how do you maintain it after it's up and running," Rogers said. "There's plenty of things to do with that opiate money which can be used for more general programs than for that one specific need."

County Administrator Judi Boyko said the county is supposed to get its own allotment of opioid settlement money, about $1.5 million over the first nine years and approximately $800,000 in years 9 through 18. But there are two other lawsuits yet to settle.

"If you decide to use your local funds to subsidize the crisis stabilization center you would not be required to invite the other counties to participate," Boyko said.

Chief Assistant Prosecutor Dan Ferguson told the Journal-News the first installment is coming soon.

"It's still somewhat sketchy the final report has not come out and they think the first payment to Butler County will be sometime before the end of June," Ferguson said. "And it's estimated that it would be $230,000 or so."

The OneOhio deal is part of a nationwide $26 billion settlement brokered by state attorneys general — with the three largest opioid distributors Cardinal, McKesson and AmerisourceBergen. Ohio's share was $808 million.

Nearly 4,000 jurisdictions nationwide filed lawsuits in state and federal courts years ago when the heroin epidemic was killing their residents, and budgets trying to deal with the pervasive problem. The commissioners sued 20 drug makers and distributors in federal court in 2017, they sought $5 million in that lawsuit, which is now part of the multidistrict litigation ongoing in the Cleveland federal court.

Carpenter said she will relay to the local OneOhio group the commissioners aren't interested in using the regional funds.

Scott Rasmus, executive director of the Butler County Mental Health and Addiction Recovery Services Board, told the Journal-News it will cost an estimated $5 million to $6 million to run the crisis center. He said they are planning a 20-bed center where people would stay for three days to be stabilized, screened and referred to further service in the community.

Until he gets an architect's opinion he won't know the cost to retrofit the building for the new use. He hopes to issue a request for proposals for the program in September.

The opioid money discussion ensued after Boyko asked the commissioners about "selling" some of the Centers for Medicaid and Medicare Services skilled nursing bed certifications at the Care Facility.

The county could possibly make as much as $750,000 selling the majority of Medicaid certified beds to other facilities, but Boyko said they need to move fairly quickly because the transfer process could take a few months.

"I'm not familiar with the current market for CMS certified skilled nursing beds but I do understand they are costly, and potential purchasers would want batches of 50," Boyko said. "A few influencers are in order to transfer the certifications the facility must be open, meaning operable with at least one resident."

The commissioners haven't decided how many beds to sell yet but Dixon, whose family is in the long-term care facility business, estimated they could get $10,000 per bed.

The county opened the Care Facility in 1975 and for nearly a half century has provided skilled nursing home care to the infirm and vulnerable populations with little alternative for care. The commissioners announced the closure last month when only 28 residents remained. Care Facility Administrator Evelyn McGee said the census stands at 19 today. The county believes it is the right time to close while the market can absorb additional residents.

As expected, Boyko said the commissioners will need to subsidize the facility while it is preparing to close. She said expenses were around $337,000 and revenues about $220,000 in April. She said costs have decreased because the number of residents is waning, but that also means there are fewer services that can be billed to Medicaid.

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