You are viewing this article in the archives. For the latest breaking news and updates in Ann Arbor and the surrounding area, see
Posted on Thu, Apr 4, 2013 : 12:43 p.m.

Washtenaw County moves to hire 39 mental health workers to accommodate growing demand

By Amy Biolchini

Responding to a growing local need for mental health services, Washtenaw County is moving to hire 39 new employees this month.

The workers -- 14 of which will be client services managers -- would all be hired into the Washtenaw County Community Support and Treatment Services department that provides services to adults with severe mental illness, severely emotionally-disturbed children and people with developmental disabilities that live in the county.

The Board of Commissioners voted 6-0 in its Ways and Means meeting Wednesday night to approve the measure. Absent were commissioners Conan Smith, D-Ann Arbor; Rolland Sizemore Jr., D-Ypsilanti Township and Alicia Ping, R-Saline.

“We’re serving 40 percent more people today than we were five years ago, just not with increase in staff,” said Dr. Tim Florence, medical director for CSTS.


Commissioner Felicia Brabec, D-Pittsfield Township, at a March meeting.

Andrew Kuhn | For

As a part of the resolution, the county board also gave its initial stamp of approval to giving CSTS more administrative control over its operations.

The addition of 39 employees will bring the 270-member workforce at CSTS to a level that meets the current demand for service, Florence said.

The new positions will be funded through the Medicaid program and will not require the allocation of dollars from the county’s general fund, Florence said.

The 2013 budget for CSTS is $28.7 million. Under the measure that received initial approval Wednesday night, the department’s budget would be increased to $41.8 million.

Commissioner Felicia Brabec, D-Pittsfield Township, called CSTS an “integral” service to the community.

Board Chairman Yousef Rabhi, D-Ann Arbor, also voiced his support for the measure.


Commissioner Yousef Rabhi, D-Ann Arbor, at a March board meeting.

Andrew Kuhn | For

“There’s so much need in our community that goes unmet,” Rabhi said. “The need to bring staff on is absolutely crucial. It means a better service for people that we support in our community.”

Rabhi added that majority of new positions will be under union contracts.

“It will mean a net increase in union positions, which I am very supportive of,” Rabhi said.

Adding 39 employees to the county’s workforce in addition to the creation of two other new positions in other departments would bring the total number of county employees to about 1,375, said Commissioner Dan Smith, R-Northfield Township.

“That’s the highest headcount we’ll have had since 2008,” Smith said. “I will be supporting (the measure), but I’m cautious and leery about increasing the county’s headcount at this time.”

The Washtenaw Community Health Organization (WCHO) is a freestanding governmental agency created by the Board of Commissioners and the University of Michigan in 2000.

CSTS is the service provider for the WCHO, and is a county department charged with providing all medically necessary services for individuals on Medicaid.

For the 2013 fiscal year, WCHO paid CSTS $24.9 million for services, broken down from the following funding sources:

  • Medicaid - state: $9.2 million
  • Medicaid b(3): $2.8 million
  • Medicaid HSW: $8.5 million
  • State general funds: $3.9 million
  • Adult Benefit Waiver program: $255,900
  • Children’s Waiver program: $163,800
  • Michigan Child program: $84,600

The $24.9 million contract accounts for 18 percent of the WCHO’s $140 million annual expenditures on mental health services.

CSTS supplements the funding from WCHO through grants, contracts, service charges, donations and transfers from Washtenaw County’s general fund. In 2010 that amount was $230,000 and in 2011 it was $215,000. There is no budgeted general fund contribution for 2012 or 2013.

Under the resolution passed Wednesday night, WCHO will be increasing its funding to CSTS by $14.3 million for a total allocation of $38.7 million.

The money comes from existing WCHO funds, Florence said, and was approved by WCHO's board of directors.

Florence said the WCHO board agreed to increase funding to CSTS with no changes to the presented plan.

“I’m very happy that the WCHO board supports this funding choice,” said County Administrator Verna McDaniel. “We’ll be working hard to make sure those positions are filled.”

In addition to the hirings, the changes approved to the CSTS structure will give it more immediate control over its budgetary, finance and administrative oversight. Those functions now are carried out by WCHO -- which is not optimal for CSTS to operate efficiently, Florence said.

Those 76 positions would be reclassified from WCHO positions to CSTS jobs under the resolution the commissioners approved Wednesday.

“Now we’re moving so that CSTS has all the necessary tools and resources to provide those services, and has the administrative functions to monitor them,” Florence said.

Administrative costs for the WCHO total $19.7 million, or 14 percent of its total expenses.

CSTS has one of the highest number of employees -- 270 -- and budget out of all county departments, second only to the sheriff’s office.

Its adult mental health services are housed at 2140 Ellsworth Road in Ann Arbor. It also has a location at 750 Towner St. in Ypsilanti that serves developmentally disabled individuals.

Under the county's 2013 space plan, adult mental health services will move to the county Annex building at 110 N. Fourth Ave. in downtown Ann Arbor.

The move will coincide with the hiring of the 39 workers, Florence said, and will allow CSTS better access to treat their patient population.

The WCHO has 86 employees and serves residents in Lenawee, Livingston, Monroe and Washtenaw counties. It is funded by state program dollars and has a 2013 budget of $147 million -- $140 million of which is dedicated to mental health services.

About 89 percent - or $124 million -- of the WCHO’s funding for mental health services comes from Medicaid.

Less than 1 percent, or about $1.4 million, comes from local and miscellaneous funding sources. The majority -- about $1.1 million -- of that came from Washtenaw County’s general fund.

Should the Board of Commissioners give final approval to the measure at its April 17 meeting, the 39 new positions would be advertised on the county’s website.


Details of the budget of Community Support and Treatment Services from the county's departmental budget summary.

Amy Biolchini covers Washtenaw County, health and environmental issues for Reach her at (734) 623-2552, or on Twitter.



Fri, Apr 5, 2013 : 3:58 a.m.

We are blessed/lucky to have Dr. Tim Florence in charge of CSTS.


Thu, Apr 4, 2013 : 7:36 p.m.

Money well spent.


Thu, Apr 4, 2013 : 7:20 p.m.

I'm happy with this move. Dr. Florence is correct. However, having see the recent publication of the salaries of the non-doctor administrative positions overseeing this agency - tons of money could be saved there. There is not reason to pay those folks that much money.


Fri, Apr 5, 2013 : 3:46 p.m.

I viewed the full list of positions and pay grades for the 39 FTE employees, it does not tell you much being grade levels do not tell you what education is needed for the positions, the the pay may or may not be to high or low. Mental health has been a problem for many who have needed it for years after the state closed all the mental health hospitals.


Thu, Apr 4, 2013 : 6:52 p.m.

I'm surprised Dan Smith actually voted in favor of something even remotely related to improving health care, mental health services, or creating jobs.

Elijah Shalis

Thu, Apr 4, 2013 : 5:59 p.m.

Moving the CSTS downtown will make it harder for patients to get to it as there is no parking. Only the really poor ones or homeless ones will use the bus to get there.


Fri, Apr 5, 2013 : 10:47 p.m.

Getting to uptown A2is miserable. People are going to have a very hardtime getting there to getthe help this is suppose to be helping. Maybe offer a bus service from the Ypsi site.. and elsworth.


Thu, Apr 4, 2013 : 7:39 p.m.

I have no idea who uses these services, but parking is a huge problem in DT AA. Perhaps the patients using DT services can be given a 2 hour credit in the parking garages when they have an appointment.


Thu, Apr 4, 2013 : 5:47 p.m.

Finally - something in the right direction!

An Arborigine

Thu, Apr 4, 2013 : 5:45 p.m.

This should do more to keep guns out of the wrong hands than any "gun control" legislation ever could.


Fri, Apr 5, 2013 : 10:49 p.m.

I know KYle no more..but it was nice seeing a rational debate without name calling and good points made from both.

Kyle Mattson

Fri, Apr 5, 2013 : 3:04 p.m.

Hi all- This rabbit trail has veered pretty far off-track. Rather than me having to block the entire thread let's just leave this debate here and save it for a more relevant story. Thanks.


Fri, Apr 5, 2013 : 1:59 p.m.

Robert, an excellent discussion. I'd paint a slightly larger cast of characters. The closing of intuitions was a unique combination of societal pressure, largely led from the left, mental health professionals themselves, court actions on patient rights, and an idea of saving money in closings. As this article lays out, I wonder if the latter ever had savings. I'm still looking for "common-sense" gun control - arguments on magazine capacity is pointless. Magazines in a double action semi-automatic pistol can be changed in a fraction of a second - whether the magazine has 5, 6, 7, or 13 rounds. It can even be changed with one round in the chamber ready to fire. It would be interesting to hear your common sense ideas. In the meantime, it was announced today that Colorado police were warned a month before the Aurora shootings by the therapist treating the suspected shooter "that he is dangerous". So, a basic question I have is, have we swung the door to open, making warning useless to proper authorities for intervention, and by closing institutions specializing in treatment, have no place for secure placement?

Robert E.

Fri, Apr 5, 2013 : 3:51 a.m.

Ok AC...I agree with some of what you say but you must add clarifications or people who are ignorant regarding mental illness will make massive I said...there is no substitute for common-sense gun control and other strategies are being looked at as well, but it seems abundantly clear to start with guns...also, mental health professionals for the most part, know what really goes on in helping those with mental's not necessarily that they are dominated by the left, its just that they are more in tune with reality and the reality of the challenges faced by those with mental illness...the irony of it all is that the current anti-gun control folks and politicians who are now shocked that these mass murderers weren't somehow "committed" to a mental hospital prior to their terrifying violent acts...or why there isn't more "teeth" as you say, in the law that allows for "admitting" an unstable person to a long-term residential mental health facility or hospital...those people AC, are the same folks and politicians who advocated for and shut-down the VAST majority of long-term mental health facilities in this country and especially in Michigan...there are very few psych hospitals that even exist anymore and due to lack of funding, there simply and literally isn't enough space to place all the people who need fact, Michigan now has the deplorable distinction of being ranked #2 in the country for trying and imprisoning children age 14-17 as adults...and guess what AC? Shockingly...many of them have severe and persistent mental illness ...don't you remember Johnny Engler and how there were way more mentally ill homeless people on the street all of a sudden when he was guvna? That wasn't an accident...and that's part of the reason why mental health professionals and most of the "left" reacts negatively to what clearly seems to be an obvious attempt by the "right" to divert the focus f


Fri, Apr 5, 2013 : 2:36 a.m.

Robert, again - my first sentence: obviously not all mental illness = propensity. I also share your concern on lists, classifications, and isolation. But there is no denying we are having this discussion due to the recent use of weapons by this small subset of the mentally ill and that part of the discussions were to be a full dialog beyond gun control - to include media violence and the mental health processes. You are aware that the mother of the Newton shooter was in the court process for a commital (because the child was 17). I also wish an examination of media violence and the mental health process was looked at with equal fervor as how many bullets can go in a magazine - but seeing as the media and mental health professional fields are dominated by the left - it's become obvious they are not going to go there.

Robert E.

Fri, Apr 5, 2013 : 1:44 a.m.

What kind of isolation? First of all I wasnt even responding to your comment, ArborComment, I was addressing the comment above...a very important distinction needs to be made here...there are millions of people with mental illness that would never even think of picking up a gun...thats a fact...there is a small subgroup of psychotic individuals who do have a propensity for violence but they are far outnumbered by those who dont...general comments regarding the releationship between mental illness and gun violence are dangerous, misleading, and offensive to those who have a mental illness or have a loved one who does...the comments above are of that sort...general proposals to develop lists of people with mental illness have a huge potential to violate the rights of those individuals who have zero propensity for violence...there is no substitute for common sense gun control period...and my family hunts btw...most of the U.S. agrees with me...sadly, many politicians allow themselves to be held hostage by an NRA that is a shell of their former self...they used to focus on hunting and gun they focus primarily on getting people to buy guns for the purpose of killing other people...


Fri, Apr 5, 2013 : 12:23 a.m.

Robert, obviously not all mental illness = propensity. However, recent events did have it in common. 1) Newton shooter's mother was in the process of trying to have the son committed. 2) Colorado shooter had been seen by a mental health professional. 3) Arizona shooters immediate family were alarmed at deteriorating mental health, attempted to hide weapons. Did not know where to turn. We were promised a "complete dialog" about these events, including violence in the media, mental illness and what steps society could take for prevention and if needed, isolation. Instead, we're back on the same treadmill - how many bullets a magazine can hold.

Robert E.

Thu, Apr 4, 2013 : 10:48 p.m.

Are you implying that anyone with a mental illness automatically has a propensity for gun violence?


Thu, Apr 4, 2013 : 6:02 p.m.

Possible. But both recent shooters (east coast and Auroa) were under the "care" of mental health "professionals". This coupled with some teeth back in commitals?