The Grays Harbor Board of County Commissioners approved funding Tuesday for several public health initiatives, including $1 million toward creating a mental health clinic in the county.

With the commissioners’ go-ahead, Grays Harbor County Public Health officials will begin crafting Requests For Proposals for three projects, each in some capacity related to mental health — an area where services are significantly lacking, according to a series of health assessments conducted in 2022.

Takeaways from those studies — including the Behavioral Health Gap Analysis, Community Health Improvement Plan and Community Health Assessment — led to public health’s Strategic Plan for 2023-2025. Along with the recently-approved recommendations, including the mental health clinic, the strategic plan paves a two-year path for each division of public health. The strategic plan was approved by the Grays Harbor County Board of Health on Jan. 26.

Grays Harbor County Public Health Director Mike McNickle said creating an outward-facing strategic plan is a new concept for the public health department.

“Since we have a new board of health that’s very outward-facing and full of community members, it seemed to me this was a great time to get a strategic plan they could also be involved with and have a say in,” McNickle said.

In addition to the $1 million for a mental health clinic, county commissioners also approved $100,000 to develop a mental health crisis triage model and a plan for a “third space” — a community facility for youth.

The approved funding is one-time, McNickle said, and will come from the county’s Treatment Sales Tax Fund.

McNickle said public health will begin to seek providers for the mental health clinic as early as March. The proposals would then be subject to several rounds of feedback and review, McNickle said, and then county commissioners would ultimately approve contracts for final proposals.

“There are several steps to come, this is just the first hurdle,” McNickle said.

The clinic will ideally “address mental health and substance abuse issues of all residents of Grays Harbor County,” according to the strategic plan.

“The biggest issue found in all three documents was access, or lack thereof,” McNickle said. “What this really addresses is the overarching issue of access to healthcare services, especially mental health.”

It’s likely that more than one group or agency would come together to provide the clinic, McNickle said. Funding could also be awarded to further operation of existing clinics.

The mental health clinic would be closely related to a new triage model for addressing mental health crises. Currently, McNickle said, hospital emergency rooms are the only option for those in mental health crisis.

McNickle said the triage model will include two parts: a short-term aspect, based on the ability of the current system, and a long-term model coordinated with the arrival of the new mental health clinic.

“Knowing a mental health clinic might be on the way, we wanted to get this triage model at the same time, implement that at the same time this is happening so we can actually deal with folks without sending them to the emergency department, or jail,” McNickle said.

He added: “If we’re talking about social cost, sending someone to the emergency department for a mental health crisis is incredibly expensive.”

Another $100,000 will be devoted to planning for “community centers” or “third spaces” throughout the county. According to public health Communications Officer Dan Hammock, a third space is “a place where youth can gather separate from home and school to get them engaged in healthy socialization with peers and get access to needed services.”

“If we are going to do upstream public health interventions, they have to begin at the early ages, otherwise they aren’t going to be solving the problem,” McNickle said.

Request For Proposals for all three initiatives will outline the requirements providers must meet to receive funding, $1.2 million in total, which will be invoiced by providers once outcomes are delivered, McNickle said.

Treatment Sales Tax fund

As the three initiatives move forward with planning and development, some questions still exist about the viability of the county’s Treatment Sales Tax account.

McNickle said other than the recently-approved initiatives, public health doesn’t have any projects funded by the Treatment Sales Tax.

Adopted by a county ordinance in 2009, the tax is authorized by RCW 82.14.460 for “new or expanded chemical dependency or mental health treatment and therapeutic court programs or services.” The tax rate is one-tenth of a percent, according to the ordinance, and is administered by the Board of County Commissioners.

County Commissioner Vickie Raines said at the meeting that county officials verified public health’s initiatives as “an allowable expenditure” for the tax and “one that the commissioners want to support.”

Raines added the approval was for one-time funding only.

But the Treatment Sales Tax fund also supplies about 95% of the budget for Grays Harbor County Therapeutic Court, according to Jamie Wintrip, coordinator for the court. At the meeting, Wintrip said she supported the effort to increase mental health services in the county, but she also had a “great concern about the long term forecast of this fund, and what that looks like moving forward.”

“The way that I read the numbers, there is more money going out of this fund than coming in,” Wintrip said.

“We want to make sure that therapeutic court, that those funds are sustained,” said Grays Harbor County Superior Court Judge Katherine Svoboda.

Darrin Wallace, Grays Harbor County Sheriff, said he had similar concerns about the future of the fund. He said the sheriff’s office uses “substantial amount of money” from the Treatment Sales Tax fund that goes to corrections, mental health and medications.

Raines said she looked at the budget for the Treatment Sales Tax and was confident the board could move forward with the items on public health’s strategic plan and still have enough funding for therapeutic court’s operations.

“There is confidence that there is sustainability of this fund,” added County Commissioner Kevin Pine.

Further discussion of the Treatment Sales Tax fund will take place at a county commissioner’s workshop on Monday, Feb. 13 at 1:30 p.m.

Contact reporter Clayton Franke at 406-552-3917 or clayton.franke@thedailyworld.