HomeMy WebLinkAboutResolutions - 2023.11.16 - 40703
November 16, 2023
RESOLUTION #2023-3531 _ 23-156
Sponsored By: Gwen Markham
Executive's Office - Appropriating American Rescue Plan Act – Local Fiscal Recovery Funds
for the Pontiac Integrated Urgent Care, "Urgent Primary and Behavioral Health Center"
Chair and Members of the Board:
WHEREAS the COVID-19 pandemic has increased demand for both physical and mental health
services. The COVID-19 pandemic has negatively affected many people’s mental health and created
new barriers for people already suffering from mental illness and substance-use disorders; and
WHEREAS on September 14, 2023, the Board of Commissioners adopted Miscellaneous Resolution
23-3200 which accepted $5,000,000 from the Michigan Department of Health and Human Services to
support the creation of an integrated urgent care system to improve access to primary care and
mental health services; and
WHEREAS the Oakland County Health Division, St. Joseph Mercy Oakland Hospital, McLaren
Hospital, Oakland Community Health Network, and Honor Community Health will partner to address
the need for increased access to primary care and mental health services by creating an Urgent
Primary and Behavioral Health Center (UPBHC) in Pontiac; and
WHEREAS an integrated urgent care center would improve access to primary care and mental health
services and would be open to all individuals seeking service, regardless of ability to pay, and offer
both in person and telehealth visits to limit barriers to seeking care; and
WHEREAS a $1,000,000 investment will develop an innovative approach to providing integrated
behavioral and physical health-care services to Oakland County residents; and
WHEREAS under the initial guidance of the Interim Final Rule, the County may use American
Rescue Plan Act – Local Fiscal Recovery Funds at their discretion to support eligible investments in
public health expenditures, address negative economic impacts caused by public health emergency,
replace lost public sector revenue, provide premium pay to essential workers, and invest in water,
sewer, and broadband infrastructure.
NOW THEREFORE IT BE RESOLVED that the Oakland County Board of Commissioners authorizes
the appropriation of a not-to-exceed amount of $1,000,000 of American Rescue Plan Act – Local
Fiscal Recovery Funds for the Urgent Primary and Behavioral Health Center in Pontiac.
BE IT FURTHER RESOLVED that approval of appropriations of American Rescue Plan Act – Local
Fiscal Recovery Funds for programs and services by Oakland County shall not obligate a
commitment of the General Fund, unless authorized by action of the Board of Commissioners.
BE IT FURTHER RESOLVED that the Director of Health & Human Services shall act as contract
administrator for the assessment project and shall be authorized to enter into a contract for services
subject to review by the Purchasing Division and Corporation Counsel.
BE IT FURTHER RESOLVED the FY 2024 budget is amended as detailed in the attached Schedule
A - Budget Amendment.
Chair, the following Commissioners are sponsoring the foregoing Resolution: Gwen Markham.
Date: November 17, 2023
David Woodward, Commissioner
Date: November 17, 2023
David Coulter, Oakland County Executive
Date: November 17, 2023
Lisa Brown, County Clerk / Register of Deeds
COMMITTEE TRACKING
2023-11-08 Finance - Recommend to Board
2023-11-16 Full Board - Adopt
Motioned by Commissioner Yolanda Smith Charles seconded by Commissioner Philip Weipert to
adopt the attached Resolution: Appropriating American Rescue Plan Act – Local Fiscal Recovery
Funds for the Pontiac Integrated Urgent Care, "Urgent Primary and Behavioral Health Center".
Yes: David Woodward, Michael Spisz, Michael Gingell, Penny Luebs, Karen Joliat, Kristen Nelson,
Christine Long, Robert Hoffman, Philip Weipert, Gwen Markham, Angela Powell, Marcia
Gershenson, Janet Jackson, William Miller III, Yolanda Smith Charles, Brendan Johnson, Ajay
Raman (17)
No: None (0)
Abstain: None (0)
Absent: Charles Cavell (1)
Passed
ATTACHMENTS
1. Schedule A - Budget Amendment
2. Integrated Urgent Care. Pontiac 1 pager sent to state
STATE OF MICHIGAN)
COUNTY OF OAKLAND)
I, Lisa Brown, Clerk of the County of Oakland, do hereby certify that the foregoing resolution is a true
and accurate copy of a resolution adopted by the Oakland County Board of Commissioners on
November 16, 2023, with the original record thereof now remaining in my office.
In Testimony Whereof, I have hereunto set my hand and affixed the seal of the Circuit Court at
Pontiac, Michigan on Thursday, November 16, 2023.
Lisa Brown, Oakland County Clerk / Register of Deeds
Oakland County, Michigan
HEALTH - APPROPRIATION OF AMERICAN RESCUE PLAN ACT - LOCAL FISCAL RECOVERY FUNDS FOR THE URGENT PRIMARY AND BEHAVIOR HEALTH CENTER
Schedule "A" DETAIL
R/E Fund Name Division Name
Fund #
(FND)
Cost Center
(CCN) #
Account #
(RC/SC)
Program #
(PRG)Grant ID (GRN) #
Project ID #
(PROJ)
Region
(REG)
Budget
Fund
Affiliate
(BFA)
Ledger
Account
Summary Account Title
FY 2024
Amendment
FY 2025
Amendment
FY 2026
Amendment
R ARP Local Fiscal Recovery Fund Non-Departmental FND21285 CCN9010101 RC610313 PRG133095 GRN-1004358 610000 Federal Operating Grants 1,000,000 --
Total Revenue 1,000,000 --
E ARP Local Fiscal Recovery Fund Non-Departmental FND21285 CCN9010101 SC788001 PRG133095 GRN-1004358 BFA10100 788001 Transfer Out 1,000,000 --
Total Expenditures 1,000,000 --
R General Fund - Grants Health FND10101 CCN1060201 RC695500 PRG133095 GRN-1004358 BFA21285 695500 Transfer In 1,000,000 --
Total Revenue 1,000,000 --
E General Fund - Grants Health FND10101 CCN1060201 SC730373 PRG133095 GRN-1004358 730000 Contracted Services 1,000,000 --
Total Expenditures 1,000,000 --
Integrated Urgent Care in Oakland County (Pontiac)
Problem/Focus –
The COVID-19 pandemic affected everyone, however, it disproportionately impacted communities with
high social vulnerabilities such low income, homelessness, unemployment, limited access to mental and
physical health. One of those communities in Oakland County is the city of Pontiac. The pandemic
exacerbated the need for access to primary care and mental health services. Oakland County Health
Division, St. Joseph Mercy Oakland Hospital, McLaren Hospital, Oakland Community Health Network and
Honor Community Health will partner to address the need for increased access to primary care and
mental health services by creating an Urgent Primary and Behavioral Health Center (UPBHC) in Pontiac.
The center will provide a combination of 12 hours of walk-in and virtual visits and 12 hours of virtual
visits 7 days a week for urgent medical and mental health services. We believe that an integrated
response aimed to triage, coordinate treatment, provide mental health interventions, bridge
prescriptions, conduct medical interventions, and follow-up with individuals at risk is needed.
The COVID-19 pandemic has increased demand for both physical and mental health services. The
COVID-19 pandemic has negatively affected many people’s mental health and created new barriers for
people already suffering from mental illness and substance use disorders. During the pandemic, the
proportion of adults that report symptoms of anxiety or depressive disorder has increased from 11% to
over 40% of adults nationally. The pandemic has also disproportionately affected the health of
communities of color. Black (48%) and Hispanic or Latino (46%) adults are more likely to report
symptoms of anxiety and/or depression than White adults (41%) (The Implications of COVID-19 for
Mental Health and Substance Use). Approximately 21% of adults in Pontiac report poor mental health.
A COVID-19 diagnosis can exacerbate mental health issues. Once diagnosed with COVID-19, individuals
are quarantined, which causes social isolation and separation from family members, roommates, or
other social supports. Prior studies have shown increases in depression, acute stress disorder, Post
Traumatic Stress Disorder (PTSD), anxiety, insomnia, and cognitive impairment with quarantine.
Individuals with pre-existing mental illnesses exhibited even greater risk of anxiety, depression, anger,
and other mental health symptoms following quarantine. In Michigan during 2020, alcohol sales
increased 41% and marijuana purchases nearly doubled since the beginning of the pandemic. The use of
alcohol and other substances have also been shown to increase with unemployment.
According to the report “preparing Michigan for the Behavioral Health Impact of COVID-19, April 6, 2020
“Primary Care Providers (PCPs) are important community gatekeepers for mental health issues,
prescribing 79% of antidepressants and treating 60% of individuals receiving care for depression in the
US. Due to efforts to slow the transmission of COVID-19, outpatient health care visits have dramatically
decreased, including a 49% decrease in primary care visits and 30% decrease in behavioral health visits.
This decline in medical care visits may reflect delayed help-seeking by patient or decrease access to
treatment, resulting in worsening mental health symptoms.”
An integrated urgent care would improve access to primary care and mental health services. It would be
open to all individuals seeking service, regardless of ability to pay, and offer both in person and
telehealth visits to limit barriers to seeking care. Having both primary and behavioral health care on staff
would increase the likelihood that people with mental health needs would get diagnosis and treatment,
since primary care providers are often the first to detect mental health concerns.
The target population would be individuals in the Pontiac area that are experiencing medical concerns
including medication assistance, elevated levels of anxiety, depression, substance use, or other mental
health issues. These individuals may also need coordination of care. The target population would include
Medicaid enrollees and Medicaid eligible, those underinsured or uninsured, people that are low income,
as well as those commercially insured.
The center would provide integrated services on an urgent basis with same day appointments with a
Primary Care Provider (PCP). Mental health triage by a behavioral health consultant is also available if
needed, as well as referrals to a psychiatric nurse practitioner. If a mental health medication refill is
required, then a bridge prescription will be made by the psychiatric nurse practitioner until the patient
sees their regular mental health provider. The behavioral health consultant will coordinate care with the
treating mental health professional and obtain consent for coordination of care. If the patient does not
have a mental health professional, the behavioral health consultant will make a referral. They will also
conduct a follow-up appointment within 48 hours if there were mental health concerns. For patients
with physical health concerns, a medical assistant will follow up within 48 hours.
Budget Request –
This investment will develop an innovative approach to providing integrated behavioral and physical
health-care services to Oakland County residents.
The final service model, 12 hours of walk-in visits and 12 hours of virtual visits, 7 days a week including
weekends and most holidays, will provide 24-hour access for clients. This makes care available in
emergency situations and at times that are convenient for a variety of work schedules. Offering virtual
visits, through HIPAA compliant technology, reduces many barriers related to accessing care such as
transportation, childcare, and inflexible work schedules. Overall, this project significantly lowers barriers
and increases access to these services. Ultimately, through this increased access, we expect to see an
increase in screening and preventive care leading to early identification of physical and mental health
concerns, better physical and mental health outcomes, and a reduction of emergency department visits
and hospital admissions.
Estimated Project Timeline
June-July 2023-Finalize Business Plans
August 2023- Sign Contracts with OCHN and Honor Community Health
September 2023- Honor Community Health- Sign Lease with Pontiac General for space
June 2023- Operational Meetings begin with OCHN and Honor Community Health
September 2023/Summer 2024- Renovations, hiring of staff
Estimated Soft Opening- LSummer 2024
Early Fall 2024- Ribbon Cutting