TCC’s Response to the City of Portsmouth, Ohio
An address by Andy Albrecht, CEO of The Counseling Center, read at the special session of the City Council on April 30, 2022
My name is Andy Albrecht and I am the CEO of The Counseling Center. I have served at TCC in multiple capacities over my 22-year career. It is my pleasure to represent what is one of the most comprehensive, long-standing, non-profit behavioral health agencies in the state of Ohio and I am excited to share our agency’s perspectives and some pertinent data with all of you this morning.
In the 42-year history of TCC, we have navigated a lot of changes in circumstance – regional alcoholism, the opioid epidemic, behavioral health redesign, the ever-growing need for wrap-around treatment, and the overdose crisis, as well as the aftermath impacting families and youth. With that being said, until now, we have had no issues with the behavioral healthcare marketplace, treatment standards, and government legislation or involvement.
TCC is proud of its non-profit status. We are governed by a board of your neighbors and operated by locally-vested natives, individuals who live here and have a great interest in our community and the people who also live here.
TCC is one of the largest employers in the area, employing over 500 individuals, many of whom are in long-term recovery. TCC creates a $22MM payroll and more than $40MM in annual revenue that is brought into the region. All of these dollars are then spent locally every year.
TCC operates as a regional agency with a unique and rare full continuum of care. We place a significant focus on aftercare services, services that include financial literacy, credit restoration, transportation, safe housing, vocational development, and job placement, critical services that are not currently supported by any TCC funding source.
In addition to our clinical services, we are also aggressive community supporters. We regularly champion area events, both in financial donations and in labor. We donate $50K annually to Friends of Portsmouth as a corporate sponsor, and an additional $25K annually to other area agencies and functions including:
- Children’s programming
- Neighborhood cleanup events
- Senior Games
- Race track events
- Local sporting venues
- Local fitness competitions, and,
- The new Children’s Museum
While the proposed legislation by the council is unprecedented, TCC shares many of the area concerns and feels this direction can ultimately be productive. With that being said, we feel our areas of disagreement center on misunderstanding, misinformation, and an attempt to regulate care at the local level rather than leveraging already existing state resources.
In considering misinformation, one narrative is that the local overdose crisis is significantly worsened by clients coming in from other areas, who drop out of treatment and stay here. That is blatantly false – factual first responder data dispels this perspective. In fact, from May 2021 to March 2022, TCC responded in conjunction with the Portsmouth Fire Department to 334 Overdose calls. 320 of those individuals were residents of Scioto County. Non-county residents represented only 4% of all overdoses. Interestingly, that 4% resided in neighboring counties.
Another narrative indicates that crime increases by people leaving treatment and remaining in the area. That is also false. Recent studies suggest that less than 10% of crimes in our community involve individuals residing elsewhere. In many of those instances, the perpetrators are traffickers bringing drugs to or through the region.
Finally, considerable concern exists about individuals being purposefully imported into the area for treatment. TCC believes it is important to understand that Medicaid dollars (and many times, insurance and private pay funds) generally only cover in-state care. Our clients are Ohio residents. With specific reference to TCC, our client population comprises individuals within a 40-mile radius of Portsmouth, which serves as the metro center for this region. Approximately 20% of clients originate from areas between 1 to 2 hours away but are predominantly served by our Stepping Stones Mothers & Children Program, which is a unique service and one of only 3 within the state, and as such is a limited resource in the state and helps a highly vulnerable and underserved population. The remainder of that 20% figure involves individuals stepping down from our region’s Community-Based Correctional Facilities (CBCFs) housed in Athens, Franklin Furnace, and Southwest Ohio. It is important to note that, when a TCC client desires to leave treatment early, they are returned to their home or location of origin at that time, and they are not left to find their way or to walk the streets. If they are a justice referral, law enforcement is engaged immediately.
Unfortunately, the city of Portsmouth has been put in a position to attempt to regulate healthcare. To this point, while access to treatment has continued to grow in our area, and the Ohio Mental Health and Addictions Services Board has continued to certify providers across the state, there have been no local market studies, no needs assessments, and no clear plan for continued oversight past initial certification.
In addition to the OMHAS shortfall, Medicaid has continued to fund services with little oversight. Since 1995, there have been only 12 full Medicaid audits in Scioto County. TCC is the ONLY Behavioral Health Care provider EVER to be fully audited in this area.
OMHAS and Medicaid have been authorized at the state level to allocate funds for treatment, but there has been little expansion to regulate the use of those dollars. Hence the underlying concern today is a concern that is arguably state-wide and likely nationwide.
It is TCC’s belief that the city has available and underutilized resources to address concerns without any new legislation or expense. As a business consideration, the city can issue a mandate, requiring treatment providers to register as businesses with the city; houses and outpatient posts included. For the safety & security of those in housing, landlord laws and life safety codes can be enforced. With 24 Medicaid-funded treatment providers in the county, a readily available approach would be to enforce these existing codes – similar to the health department’s process with the local restaurant, pool, and school operations.
Concerning the quality of care, it is our stance that all providers should additionally inform the local ADAMHS board of their operation. Agencies should pursue CARF Accreditation or other appropriate credentialing. We would encourage the city to openly engage providers to contribute to future conversations that modify or restrict sub-par treatment providers’ ability to render services.
Last, and above all – To the Mayor, the Council Members, citizens, and agencies: if you suspect an individual or entity is being negligent; that they are not fulfilling their agency mission; that human lives are being damaged by their operation – file a complaint with OMHAS and Medicaid. We would be happy to provide information about how official and anonymous complaints can be filed. This serves to form the foundation for involving already existing state resources in this concern.