Lack of staff squeezes county clinic’s services

HUDSON–Mental Health Clinic Open Access modifications, upcoming retirements, coronavirus, outpatient services and staffing shortages received attention at the Columbia County Community Services Board (CSB) meeting February 26 and its Intellectual and Developmental Disabilities (I/DD) subcommittee meeting February 25. Staffing shortages affect both the Mental Health Clinic and outside services. Help is wanted from master’s degree-level mental health clinicians and behavioral health specialists to respite workers.

The Columbia County Mental Health Clinic has Open Access hours Monday through Thursday from 8:30 to 10:30 a.m. During these hours, it “historically, would accept every [county resident] who came in,” whether for a one-time consultation or to start something longer term, said Dan Almasi, director of clinical services for the Columbia County Department of Human Services. Sometimes as many as 13 people would come in a morning.

But now, Mr. Almasi reported, the clinic has reduced this service, due a lack of professional staff. People can still come during Open Access hours, but now the staff screens them to determine who needs immediate attention and put the others on a waiting list. “This was not an easy decision,” Mr. Almasi said. “It goes against the grain of our mission.”

“I want to emphasize that this is temporary until we hire more people,” Mr. Almasi continued. But the clinic is “three full-time clinicians down,”, he said, and efforts to recruit new staff have not produced a lot of resumes. Meanwhile, some current clinicians are headed toward retirement. And the clinic gives priority to those clients already in its system.

Also headed toward retirement are two key Human Service executives: Michael Cole, county director of human services, retiring near the end of this summer; and Beth Schuster, executive director of Twin County Recovery Services and co-chair of the CSB, who is retiring at the end of the year.

To find Mr. Cole’s successor, Ms. Schuster and Supervisor Matt Murrell (R-Stockport), chair of the Columbia County Board of Supervisors, are forming a search committee.

Regarding the coronavirus, Mr. Cole said, “We’re making plans in case it becomes pandemic.” Goals, he said, include finding places to hold quarantined individuals in and determining “how people who show symptoms will be treated.”

Also at the meeting, Julie Valliere of Columbia Memorial Health gave an overview of a behavioral health program the effort to educate doctors whose care the program aims to supplement. In this program, a primary care physician can determine that a patient might benefit from behavioral health treatment and contacts the Behavioral Health staff. The staff then assesses the patient and sends suggestions to the primary care physician, who uses this information to help assign a diagnosis and advise the patient.

Triggers for the primary care physician to contact Behavioral Health include a patient showing signs of “anxiety” or not taking recommended drugs. Recommendations for the patient could range from going on psychotropic medication, to getting weekly consultation with a psychiatrist, to seeing a Behavioral Health specialist for training how to cope with their illnesses and conditions. The behavioral health team sees “a lot of people who never thought of seeing a therapist.” Recently, a plurality of its new patients needing “coping skills” have been people who have diabetes.

Right now the Behavioral Health team has four specialists and is “looking to hire seven or eight” more. A psychiatrist oversees their work.

At the February 25 meeting Kathi Greif of Life Plan, which defines itself in its brochure as “a parent-led coordination organization that serves people with intellectual and developmental disabilities,” said that respite care is the most common service families requested. But, “it’s really hard to find respite workers for families. There’s a lot of turnover. There are issues with finding respite workers. Everything is so spread out. And most respite work is on evenings and weekends,” she said. In addition, qualifying to be a respite worker for some organizations does not necessarily qualify one to be a respite worker for Life Plan.

Also at the February 25 meeting:

• The meeting heard that not only residents but also the staff of homes for people with disabilities would benefit from public transportation. Locations with such homes include Kinderhook. Mr. Cole recommended specifying a bus route, finding out how many people would take it at what times of the day, and passing the information on to Supervisor Michael Chameides (D-Hudson, 3rd Ward), who has asked for proposals for pilot test bus routes

• Coarc, which provides services for people with disabilities, is renovating a space in the Staples Shopping Center for adult day habilitation and planning to move its preschool, the Starting Place, to the basement of the Hudson Area Library. The basement is under reconstruction for that purpose, and land across an alley can become its playground.

• An attendee the Salvation Army’s move was regrettable because its current location on Third Street in Hudson is so walkable.

The next meeting of the CSB I/DD subcommittee will take place Tuesday, March 24, at 4:30 p.m. at 325 Columbia Street in Hudson. The next meeting of the full CSB will be a dinner Wednesday, March 25, at 5 p.m.

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