After appeals from Cuyahoga County officials, the Alcohol, Drug Addiction & Mental Health Services (ADAMHS) Board is reconsidering its recent plan not to renew its contract with the county to manage the diversion center at Oriana House.
The diversion center offers mental health and substance use treatment to people accused of committing low-level offenses who would otherwise be taken to jail.
The ADAMHS Board has managed the facility since it opened in May 2021. Two weeks ago, Scott Osiecki, the board’s chief executive officer, said the board did not plan to continue to manage the diversion center after its contract expires Dec. 31.
At this week’s meeting on Wednesday, board chair Robert Fowler said, “There was a somewhat negative reaction on the part of some in county government.”
Since the announcement, Osiecki has met with county officials to discuss extending the contract and the county becoming a partner in the Behavioral Health Crisis Center that the board, St. Vincent Charity Medical Center and MetroHealth plan to open in 2025.
In partnering with the ADAMHS Board, the county would also help fund some of the diversion services at the new crisis center, Osiecki said. The county is asking that the new crisis center have a detox center.
The board’s next step is to talk with St. Vincent Charity Medical Center and MetroHealth and bring Oriana House into the discussion.
Fowler said discussions are fluid and nothing has been finalized.
Board member Rev. Benjamin Gohlstin said the board never intended to be involved in the criminal justice system. The intent of the diversion center was to intervene when people having a mental health crisis did not need to go to jail, he said.
In 2022, the city expanded the low-level offenses for which police officers are allowed to take someone to the diversion center. The expansion included all but three types of non-violent misdemeanor offenses – assault, a sex offense, or an escalating misdemeanor such as domestic violence or driving impaired.
“I think what has happened is some people have tried to take advantage and take our kindness for weakness,” Gohlstin said. “And move us in a direction that is inconsistent with what we do.”
Gohlstin said he supports partnering with the county but asked to add the word “temporary” to a motion of support for the evolving plan.
During Wednesday’s ADAMHS Board meeting, members approved the motion of “temporary support” of the ongoing talks between the board and the county.
The board also approved the Behavioral Health Crisis Center project and accepted more than $6.8 million in American Rescue Plan Act funding from the Ohio Department of Mental Health and Addiction Services.
Paramedic urges board to include EMS in care response
Osiecki also updated the board on its plans to start a non-police behavioral crisis response pilot program.
The pilot program would include five response teams, all serving Cleveland. Each team would include a social worker and a peer specialist with lived experience with mental illness or substance abuse.
ADAMHS Board staff members have met with city and county officials to talk about the program, Osiecki said. The City of Cleveland is helping to identify neighborhoods for the pilot program and will work with the board to train dispatchers, he said.
During public comment, Timothy Sommerfelt, a paramedic with Cleveland Emergency Medical Services, pointed out that EMS has been missing from conversations about non-police response, also called care response.
He listed other cities that have included a paramedic in their non-police response teams — Cincinnati, Boston, Denver, and Chicago.
“From where we sit, one of the greatest failings of our current system is that we treat mental health and physical health in totally separate silos,” Sommerfelt said.
Paramedics and emergency medical technicians have increasingly become first responders for mental health emergencies, he said, adding that EMS responds to hundreds of mental health calls each month. But EMS is not authorized to take people to the county diversion center.
Sommerfelt said that 1,766 calls EMS responded to came from 25 people last year. EMS took them to the emergency room repeatedly.
“You have to ask yourself, if you’re taking somebody to the emergency room literally 181 times, are we really solving the problem?” he said.
Sommerfelt, who is also secretary of the EMS union, urged the board to consider bringing EMS into its plans for a non-police crisis response program.
Having a medical professional on the team would help if a person turns out to be experiencing a physical health problem rather than a mental health crisis, he said.
“I’m going to offer a solution,” Sommerfelt said. “And that solution is to work closer with EMS and embed an EMS practitioner in that team, that can work toward medical clearance for some, but maybe not all, and get people directly into crisis stabilization units, into detox centers, into outpatient mental health services, without having to have that stressful ER experience that we know from research is less than ideal when you’re experiencing a mental health crisis.”
Fowler acknowledged Sommerfelt’s request, calling them “very interesting comments.”
The diversion center will be under new management next year after the current operating agency said it won’t apply for a new contract.