Health group targets opioids

Centerstone to receive funds from county property tax revenue

Bartholomew County’s 2017 contract with Centerstone Behavioral Health Services underwent a number of revisions this week, mere days before terms of the contract expire.

The most significant change calls for the non-profit to be paid to treat indigent residents battling addictions, not just people with mental health problems, county commissioner chairman Carl Lienhoop said.

Centerstone is due to receive $590,039 for 2017 from property tax revenue collected through its own separate levy, Bartholomew County Auditor Barb Hackman said. It’s an amount comparable with what the provider has received in previous years.

Since another agreement will have to be signed after the first of the year, Lienhoop said the revisions have little consequence, and were made simply to authorize final 2017 payments.

But after Centerstone announced that it had acquired two grants to bolster addiction-treatment programs, and confirmed it was trying to purchase a building in Columbus to serve as a medical-addictions treatment program, the nonprofit is making clear it wants to be a significant player in addressing the local opioid crisis, Lienhoop said.

“There will be a lot brought to the table and a lot of discussion (regarding the new contract) during the first six months of 2018,” Lienhoop said.

What’s ahead

Discussions about next year’s Centerstone contract will begin 6 p.m. Tuesday during a Bartholomew County Council work session in the offices of the County Auditor, near Third and Franklin streets.

But before Centerstone is allowed to expand its offerings to indigent residents, council president Laura DeDomenic said she wants to better understand what the agency already is doing for the county.

Tensions between county government and Centerstone surfaced after council attorney Chris Monroe reported the agency had not been providing required annual reports on how county tax monies are being spent.

In response, Centerstone’s chief administrative officer, Shirley Arney, and other agency administrators appeared during a council work session early this year.

But following their presentation, council members such as Jorge Morales said they still didn’t know specifically how Centerstone was spending local tax dollars.

“We haven’t really gotten that yet,” DeDomenic said. “I’d still like to see more accountability for the money they receive.”

Council officials have made it clear that they are not accusing anyone of accepting public funds without providing services in exchange.

But Centerstone operates in five states, with more than 60 facilities in 17 Indiana counties.

For that reason, DeDomenic said she suspects the nonprofit operates on such a large scale that it doesn’t have the small details desired by the council, DeDomenic said.

Another concern expressed by the council president are reports that some indigent patients who go to Centerstone are referred to other agencies such as Family Service Inc. that receive no county taxpayer support.

Ongoing dialog

The Bartholomew County commissioners seem more satisfied with the investment made into Centerstone, however.

Since the three commissioners talk more frequently with agency officials, they may be more in the loop about provided services than county council members, commissioner Rick Flohr said.

Kleinhenz said he suspects the behavioral health provider actually is giving more in indigent care than it is receiving in compensation.

“Whether a patient is getting any good out of it depends on who you are talking to,’ Kleinhenz said. “But Centerstone is doing a lot of good things for the county.”

The commissioner admits both the contract language and the accountability reports from Centerstone are both vague, however.

“I do wish they would come out with better numbers,” Kleinhenz said.

What both Lienhoop and Hackman stress is that Centerstone doesn’t have any competition for providing indigent mental health or addiction services.

It is the state that chooses which — and how many — agencies are authorized to provide such tax-supported care for the uninsured in a particular county, Hackman said.

“Frankly, they (Centerstone) are going to get this money — one way or the other,” Lienhoop said.

Statewide discussions

State lawmakers believe they can receive more accurate and consistent assessments regarding indigent needs by having one provider handling the records and services in most of Indiana’s 92 counties, Hackman said.

Nevertheless, discussions are expected to be made in the Indiana General Assembly regarding possible expansion, Hackman said. Lawmakers also will  consider changes to funding formulas that could make providers eligible to receive larger sums, she said.

The growing demand for indigent care certainly warrants the establishment of another tax-supported provider, said Lienhoop, one of the three main sponsors of the Alliance for Substance Abuse Progress in Bartholomew County.

He suggests those who agree with him express their concerns to State Rep. Milo Smith and State Sen. Greg Walker, both Republicans from Columbus who represent their constituents in the legislature.

But ultimately, it will be the market, rather than government, that will ultimately decide whether multiple providers become a reality, Tucker said.

Most of the contract revisions approved Tuesday were requested by Centerstone, rather than the county, Tucker said. That includes dropping a requirement that a member of the Bartholomew County Council be allowed to sit on the organization’s governing board, he said.

Since Centerstone already has a Monroe County Council member on the board, the nonprofit felt that person provides adequate representation for other counties, Tucker said.

What's next?

Two public safety funds that will contain new revenue generated by a local income tax increase have been created by the Bartholomew County Commissioners.

The first fund will have money to be shared with incorporated communities such as Columbus, Hope, Elizabethtown and Jonesville.  The second is for exclusive use of county government.

During their work session Tuesday, the Bartholomew County Council will hold informal discussions on how to appropriate $2.3 million earmarked for public safety in 2018.  That meeting begins at 6 p.m. in the Bartholomew County Auditor’s office.

But decisions will not be considered until the council formally meets in regular session. That meeting is scheduled to begin at 6 p.m. on Jan. 9 inside the council chambers, located on the fourth floor of the county’s governmental office building at Third and Franklin streets.

About Centerstone

Centerstone, a not-for-profit organization, has provided a wide range of mental health, substance abuse, education and integrated health services to Indiana residents for 60 years.

Through more than 60 facilities in 17 Indiana counties, Centerstone serves about 25,000 children, adolescents, adults and seniors each year.

For more information about Centerstone, call 800-344-8802 or visit centerstone.org.

Author photo
Mark Webber is a reporter for The Republic. He can be reached at mwebber@therepublic.com or 812-379-5636.