Becoming a Center of

Excellence

Becoming a Center of Excellence

Dr. Brashears

DIRECTOR’S LETTER

It is with humility and gratefulness that I present our 2024 Annual Report. 2024 was a year of transition for CMHOC. Lynne Doyle, CMHOC Executive Director, retired after serving for over 20 years in Ottawa County. I would like to thank Lynne for her honorable service to Ottawa County and specifically CMHOC. I have returned to Ottawa County to serve once again as Executive Director/CEO of CMHOC after a thirteen-year absence, and I am honored to serve.

As this report will demonstrate, CMHOC has demonstrated a zeal to maintain “Community” in Community Mental Health. Through various State and Federal grants and County Millage dollars, CMHOC has filled the gap left by inadequate Medicaid funding to ensure high quality mental health services.

I would like to thank our CMHOC employees, Contract providers, and CMHOC Board of Directors for their hard work and support.

MISSION

Community Mental Health of Ottawa County partners with people with mental illness, intellectual/developmental disabilities, substance use disorders, and the broader community to improve lives and be a premier mental health agency in Michigan.

VISION

Community Mental Health of Ottawa County strives to enhance quality of life for all residents.

VALUES

Always act truthfully, honestly, honorably and without deception; seek no favor; and receive no extraordinary personal gain from the performance of our official duties.

Interact with providers professionally, impartially, fairly and consistently; listen to the recommendations and concerns of each.

Treat each consumer as a customer; and do all we can, within the bounds of state and federal laws, regulations, policies and budget, to meet requests for service.

Interact with all people in a dignified and respectful manner.

Interact with each consumer impartially, fairly and consistently; listen and respond to the recommendations and concerns of each.

Each staff member will perform to the highest professional standards and to his or her highest personal capabilities.

Regard each staff member with professional respect, recognizing that each person using his or her trade or vocation makes a valuable contribution; engage each staff member impartially, fairly and consistently; and listen to the recommendations and concerns of each.

Use of public money in the accomplishment of our mission and hold it as a basic value to discharge our stewardship in a responsible, cost-effective manner, always remembering and respecting the source of the Agency’s funding.

How CMHOC Is Working Towards Becoming a Center of Excellence

Community Mental Health of Ottawa County (CMHOC) is actively striving to become a recognized Center of Excellence in mental health care, setting the standard for high-quality services and innovative practices. This commitment is driven by our belief that every individual deserves access to comprehensive, effective care that addresses their unique needs. In this annual report, we identify three key pillars that will guide our journey toward this goal:

#1: Keeping the Community in Community Mental Health

#2: Evidence-Based
Practices

#3: Stewardship

By optimizing our resources and ensuring fiscal responsibility, we can enhance our capacity to deliver high-quality services now and into the future.

Three Pillars of Success

Keeping the Community in Community Mental Health, Evidence-Based Practices, and Stewardship

#1: Keeping the Community in Community Mental Health

The first pillar, Keeping the Community in Community Mental Health, emphasizes the importance of community engagement and collaboration. We recognize that effective mental health care extends beyond clinical settings; it requires strong ties with local organizations, stakeholders, and the individuals we serve. By fostering these connections, we can create a supportive environment where community members feel empowered to seek help and participate in their own care. This pillar also focuses on gathering community feedback to inform our services, ensuring that they remain relevant and responsive to the needs of Ottawa County residents.

#2: Evidence-Based
Practices

The second pillar, Evidence-Based Practices, reflects our commitment to integrating research-driven approaches into our service delivery.

By implementing proven interventions, we aim to enhance the effectiveness of our programs and improve client outcomes. Continuous training and professional development for our staff will ensure that they are equipped with the latest knowledge and skills to provide the highest quality of care. This commitment to evidence-based methodologies not only strengthens our service offerings but also builds trust with the community we serve.

#3: Stewardship

Finally, the pillar of Stewardship underscores our responsibility to manage resources wisely and ethically.

As we strive for excellence, we recognize the importance of transparency, accountability, and sustainability in all our operations. By optimizing our resources and ensuring fiscal responsibility, we can enhance our capacity to deliver high-quality services now and into the future.

This stewardship extends to our relationships with clients and partners, as we seek to build trust and foster a collaborative environment where everyone can thrive.

Together, these three pillars form the foundation of CMHOC's vision for becoming a Center of Excellence. Through this focused approach, we are committed to not only improving mental health care in Ottawa County but also to fostering a healthier, more resilient community.

#1: Keeping the Community in Community Mental Health

#2: Evidence-Based
Practices

#3: Stewardship

PILLAR #1: Keeping the Community in Community Mental Health

Ottawa County Pathways to Better Health—often simply known as "Pathways"—is a vital local initiative dedicated to supporting underserved and vulnerable residents of Ottawa County.

Established through a coalition of community partners, Pathways aims to address key priority areas identified in the 2015 Community Health Improvement Plan (CHIP), focusing specifically on mental health, access to care, and healthy behaviors.

In 2018, CMHOC adopted Pathways in response to CHIP's recommendations to enhance access to care. Currently, CMHOC employs five full-time Community Health Workers (CHWs) who assist adults and families receiving mental health services at CMHOC. Using the Pathways model, CHWs guide individuals through the often-complex health systems, ensuring they receive the care and resources necessary for positive health outcomes.

Tackling the challenges of mental health, access to care, and healthy behaviors is no small feat. Yet, Pathways plays a crucial role in minimizing the barriers that individuals face. CHWs work closely with clients to address various life, environmental, and social factors that hinder their health and well-being. This includes connecting clients to essential resources such as housing, nutritious food, healthcare for chronic conditions, and mental health support.

The impact of the CHW’s is evident, with hundreds of individuals—primarily women, those living in poverty, and individuals with complex physical and mental health needs—enrolled in the program and receiving the assistance they need. Recent data from Pathways highlights significant improvements in clients' overall health, both mental and physical, as a direct result of CHW assistance.

CMHOC remains a proud partner of Pathways, working to connect individuals to community services, treat the whole person, and exemplify how a community can uplift its most vulnerable members.

Pathways by the Numbers

Pathways Data Points: Since 2018

Pathways Opened

579

Social Services Referrals
for Food Assistance, Housing, and Chronic Disease Management

325

Medical Services Referrals for Medical Referrals, Medical Home, Tobacco Cessation, & Health Insurance

224

Other Referrals

30

Total Referrals

681

CMH Consumers

413

Consumers Breakout: 45 MI Adult, 28 Family Services

73

“Pathways  has been the best support system for me on my journey to a better me. It’s been a huge relief passing on some of the mental load to someone I can trust, that has my best interest in mind.”

-Pathways Participant

Community Mental Health of Ottawa County Navigator Program

The navigator program began in 2020 and consists of three navigator specialists and one navigator clinician. The navigator program was created in response to a gap in services, mainly for those individuals who were experiencing an emergent situational crisis that wasn’t severe enough to need inpatient hospitalization.

When someone is in a situational crisis, they often need immediate support and resources to help them overcome the crisis. If left unaddressed, this crisis could rise to the level of needing more intensive services, such as hospitalization. The core goal of the navigator program is to provide resources quickly and efficiently during these crisis situations.

Through this support and selection of resources that best fit a person's needs, the navigators help individuals overcome their crisis and help them to return to their baseline or state prior to the crisis.

The navigators also play an important role in CMHOC’s Zero Suicide program by providing crisis stabilization. The navigators serve as a safety net for those who many need extra support in getting connected to resources. One of the duties of this role is to provide follow-up phone calls to individuals who have been seen by CMHOC’s crisis team. The navigators follow up with the person the next day to assess how they are doing, assess their risk of harm, check out what’s going on, help them get connected to mental health services either through CMHOC or the community, and help with other resources as needed. In addition to the phone calls, they also send a handwritten caring card indicating that CMHOC and the navigators are here for them and can help them if they need or want it. They also provide both follow-up phone calls and caring cards for individuals who are discharging from inpatient hospitalization.

The navigators provide outreach and crisis stabilization to those who are experiencing homelessness. Our navigator clinician works very closely with community partners who work in this area to provide crisis stabilization, support, and resource navigation to those who are experiencing homelessness to help them overcome mental health and substance use barriers that are often confounding factors to their homelessness.

The navigators have a great impact in our community. Here is some data over the last year to show the incredible work this program has done and how impactful it is to the community. The navigators truly show how they continue to “Keep the Community in Community Mental Health.”

PILLAR #2: Evidence-Based Practices

Clubhouse and Assertive Community Treatment and Integrated Dual Disorder Treatment (ACT/IDDT):

CMHOC has actively implemented a range of Evidence-Based Practices (EBPs) to enhance the quality of care for individuals facing mental health challenges. These practices are grounded in research and proven to be effective in improving outcomes for clients. By integrating EBPs into our services, we not only address the diverse needs of the community but also fosters a culture of continuous improvement and accountability in mental health care.

In addition to these therapeutic approaches, CMHOC is committed to ongoing staff training and professional development to ensure that team members are well-equipped to deliver these practices effectively. Regular workshops and supervision sessions are held to deepen staff understanding of EBPs and to share best practices among colleagues.

Clubhouse

Clubhouse International is a model designed to support individuals with mental illness through a psychosocial rehabilitation approach. It emphasizes social integration and empowerment by creating a supportive environment where members can actively participate in their recovery. Evidence shows that participation in Clubhouse programs leads to improved mental health outcomes, enhanced social skills, and increased employment opportunities. The model fosters a sense of belonging and purpose, which are crucial for recovery, by involving members in the daily operations via a work ordered day and decision-making processes of the Clubhouse.

Clubhouse “helped my mental health—to not be lonely and to get out into the community."

Clubhouse Data

Members Supported

49

Lakeside Clubhouse members with  employment assisted
(12% higher employment rate than national average)

27%

hours of social activities in the community organized

1,800

Healthy meals served

2,400

Clubhouse members outreach to support connection and decrease isolation

400

Hours of skill building through collaborative work

17,000

ACT

Assertive Community Treatment (ACT) and Integrated Dual Disorder Treatment (IDDT) are two evidence-based practices aimed at providing comprehensive support for individuals with severe mental illness, often including co-occurring substance use disorders. ACT is characterized by a team-based approach, where mental health professionals deliver personalized care directly in the community, promoting engagement and reducing hospitalizations. IDDT integrates substance use treatment with mental health services, recognizing the interconnectedness of these issues. Research indicates that both ACT and IDDT significantly enhance quality of life, improve treatment adherence, and reduce the incidence of relapses, highlighting the effectiveness of these collaborative, client-centered models in fostering holistic recovery.

ACT Data

In 2024, 10 ACT clients successfully met their treatment goals and were then transferred to a lower level of care.

10

ACT team piloted the use of Goal Scaled Solutions (GSS). GSS is a software that provides access to the Client and treatment provider(s) so progress in specific identified areas can be measured and shared in real time.

By implementing GSS, ACT team has successfully supported many ACT clients in reaching their goals and improve care coordination efforts.

In 2024, two ACT clients were able to obtain adequate housing utilizing CMHOC’s Permanent Supportive Housing program.

ACT clients often experience greater barriers when obtaining housing due to symptoms or legal or functioning issues, so having two clients find housing is a great success!

2

PILLAR #3: Stewardship

Starting in September 2024, CMHOC Chief Executive Officer Dr. Michael Brashears launched an ongoing series called “Did You Know,” aimed at engaging the community and providing a platform for open dialogue. Held at the CMHOC office on James Street in Holland, this series encourages staff, community members, and even the CMHOC Board of Directors to come together and discuss various aspects of CMHOC's work. Topics covered so far include Medicaid Services and funding, State and Local General Fund allocation, CCBHC funding, Millage, and Grants.

Dr. Brashears plans to explore additional topics in the future, such as how individuals can access CMHOC services, diving deeper into the process, and offering more information on CMHOC’s Crisis services so people are aware of the resources available to them.

The goal of this ongoing series is to give Ottawa County residents direct access to CMHOC leadership, allowing them to ask questions in different formats while fostering education and transparency.

Stewardship Data

Individuals Served in 2024

Individuals Served

4,501

Persons with an  Intellectual/ Developmental Disability

707

Adults w/ Mental  Illness

1,827

Children w/ Serious  Emotional Disturbance

917

Adults w/ a  Substance Use Disorder

1,040

Children w/ a  Substance Use Disorder

10

CONTRACTED SERVICES

DIRECT-RUN SERVICES

MENTAL HEALTH AND SUBSTANCE USE DISORDER (SUD) REVENUE

MENTAL HEALTH AND SUBSTANCE USE DISORDER EXPENDITURES

MILLAGE & GRANT REVENUE

MILLAGE & GRANT EXPENDITURES

Goals for 2025

Keeping “Community” in Community Mental Health.

01

Providing services in addition to the Medicaid benefit to the intellectually or developmentally disabled, mentally ill, and substance use disordered population in Ottawa County.

02

Ensure family, legal guardian, and person served input to the Community Mental Health strategic plan.

03

Leverage CMHOC's status as a County Department to ensure collaboration with other county departments and county resources.

Becoming a Center of Excellence

01

Development of a robust outcome measurement system that measures the efficacy and quality of all CMHOC services.

02

Use of best practices and/or evidence-based practices in the delivery of CMHOC services.

03

Development of a utilization management system that ensures consistency in determining the amount, scope, and duration of medically necessary services, and ensures fiscal stewardship of all CMHOC funds.

FY2024 Board Members

Thomas Bird (Secretary)
Donna Bunce
Gretchen Cosby(Chair)
Christian Kleinjans
David Parnin (Vice Chair)
Sylvia Rhodea
Stephen Rockman
Beth VanHoven
Kendra Wenzel
Lucy Ebel
Vonnie VanderZwaag
Terry Goldberg
Jason Monroe
Kyle Parcher
Steven Savage
Robin Wick