County receives heat after mental health agency that it withdrew from closes doors

Mille Lacs County’s non-renewal on Jan. 1 of its contract with the Braham-based regional mental health agency Riverwood Centers brought criticism of the county when Riverwood folded on March 17.
Known for decades as the Five County Mental Health Centers because it originally contracted with the counties of Mille Lacs, Isanti, Chisago, Pine and Kanabec, its name was changed to Riverwood Centers about four years ago. The name change reflected Kanabec having pulled out long ago, though Riverwood remained a provider that Kanabec residents had to access until it closed in March. When Riverwood Centers abruptly closed its doors that day, only three counties had been part of its contracted services for uninsured or underinsured people – Isanti, Chisago and Pine.
Mille Lacs County Board made its decision official this past December to not renew Mille Lacs County’s contract with Riverwood Centers that expired on Dec. 31.
Riverwood Executive Director Kevin Wojahn told the Minneapolis Star Tribune  the pull out of Mille Lacs from the four-county mental health agency was the “death knell” for Riverwood. The Union-Eagle was unsuccessful in reaching Wojahn for comments.
Mille Lacs County Administrator Roxy Traxler put out a press release on March 20 that stated the county “did not cancel our contract with Riverwood early; we simply chose not to renew it upon its expiration.”
Traxler continued that the decision was made “after attempting to work through several concerns over the past year related to both services and the financial operations of Riverwood. Clearly the financial issues facing Riverwood did not just arise on Dec. 31, 2013. Mille Lacs County also wants our residents to know that we are ready and able to serve all of the mental health needs in the county.”
County Commissioner Tim Wilhelm thanked Commissioner Roger Tellinghuisen at the March 18 Mille Lacs County Board meeting for having alerted the rest of the Mille Lacs commissioners last November about the finances at Riverwood. That saved Mille Lacs County from being in the situation that Isanti, Chisago and Pine found themselves in on March 17 having to “scramble” to find other mental health providers, Wilhelm said.
But Mary Fehring, a long time member of the Local Advisory Council for mental health services, was not going to let the Mille Lacs County  Board off so easy last week as she talked about Riverwood.
Fehring said that the first inkling she got that Mille Lacs officials were considering not continuing with Riverwood was when Tellinghuisen (who was on the Riverwood Centers advisory board) called her in November.
Fehring said a six-month notice would have been preferable and then Riverwood staff might have been able to work on changes so that Mille Lacs might have renewed its contract.
Riverwood Centers has always had its ups and downs and was able to make it through lean times, furloughing some employees and later hiring them back, Fehring said.
“We adapted to the money (available) and did the best we could with the money, and we probably could have continued if we didn’t lose Mille Lacs County,” she said.
More notice from Mille Lacs could have also helped prepare the Mille Lacs clients who were receiving medical assistance make the transition, Fehring added. She said some of the clients have big mental health issues to deal with.
Tellinghuisen said giving more notice wouldn’t have altered Mille Lacs Board’s not renewing its contract. He also said the reason the board didn’t announce its intent earlier was because the commissioners weren’t sure of a decision until close to the last month of 2013.
The Mille Lacs clients had been meeting for their support group and counseling meetings at a Riverwood satellite center in downtown Milaca prior to Riverwood’s closing. Trinity Lutheran Church in Milaca has opened its doors to provide the space for those group meetings, Fehring said.
Mille Lacs County, after not renewing its contract with Riverwood, arranged for Mille Lacs County-contracted clients formerly served by Riverwood to get services elsewhere. The new providers include Lighthouse Child and Family Services, and Nystrom & Associates mental health counseling services.
The mental health clients that Mille Lacs contracts to receive service receive government medical assistance money funneled from the state through the county to pay for those services.
Mille Lacs County Community & Veterans Services Director Beth Crook spoke to the commissioners during a County Board workshop earlier this year about the transition for the Mille Lacs County clients who had to switch from Riverwood. Crook said the clients were working things out with the change in the providers. She noted that the providers teach the clients coping skills to go out into the public and conduct activities including shopping.
“Change is hard and Riverwood may have changed workers two to three times in the last two years, therefore clients had to get used to changes there,” Crook added.
Mille Lacs County Board Chairman Phil Peterson responded during the workshop that despite change being difficult for people, he predicted the clients would be all right with their new providers within a couple months.
Fehring last week recalled some clients who came to the local advisory council for mental health services in January expressing “hurt” about Mille Lacs County no longer contracting with Riverwood. Fehring also said that since the departure of Mille Lacs County from the Riverwood group, the number of mental health clients showing up for the community center meetings in Milaca has dropped significantly. At one time the attendance reached as high as 15-20 and now it has been down to five or six, she said.

Client comments
Alan Neumann, of Princeton, commented last week on the closing of Riverwood and how he sees its effects. Neumann, 53, said he has been dealing with paranoid schizophrenia for 30 years and that the therapists with Riverwood Centers helped him deal with “my pain, my negative thoughts, my troubles.” He talked about mental health improvement through therapy as being a series of “baby steps” over a long period of time.
“It doesn’t happen overnight,” he said. “When I first started (with therapy) I really struggled.”
Neumann said he receives a combination of insurances and government assistance to pay for his therapy and psychiatric help and that he switched to new providers of those services sometime prior to Riverwood closing. The therapist is in Anoka and the psychiatrist is in St. Cloud, he said.
Neumann said that because he was able to successfully get re-established with mental health providers he feels comfortable with, he is OK with Riverwood being gone. But he said he doesn’t think the change has been OK for some of the clients he knows who had been served through Riverwood.
“They’ll melt right down,” he said. “It will take time for them to do better. They have to find the proper people, and it’s not easy to find ones you can trust or feel good about.”
Fehring said the state doesn’t have enough psychiatric services for the mentally ill and because of that there have been situations where the psychiatrists have only given their patients 20 minutes during a session. That’s not enough time, said Fehring, adding that she knows of one psychiatrist who quit his position because it was “awkward” working under that time constraint. If someone wants to go into psychiatry today, there are a lot of jobs in that field, Fehring added.
Tellinghuisen said the day after the closing of Riverwood that he felt bad about the closing but also felt the board did the right thing in not renewing its contract. He also said he “absolutely disagrees” with the statement that Mille Lacs County’s non-renewal of its contract with Riverwood Centers was the “death knell” for Riverwood.
Tellinghuisen said he and his fellow commissioners “were not trying to single out people in need of mental health services. We just seen a better way to service them at a lower cost. It was a board decision. I hope things work out well. I don’t want to cut services for people in need.”
Tellinghuisen said he has notified Mille Lacs clients who formerly went to Riverwood that if they aren’t happy with their new providers, to let the commissioners know. The county Community & Veterans Services Department can help lead them to resources regardless of their financial situation, Tellinghuisen said.