Travel Town – Medical, mental health, and psychiatric services at the Grand Traverse County Jail cost up to $400,000 more than covered by a contract signed by county health support services.
County Manager Nate Alger said the company ran out of money and asked the county for between $100,000 and $400,000, which the county did not provide.
Algeria said CHSS continues to provide services but is incurring a loss.
The contract amount for a CHSS proposal that contains all services under one umbrella using local providers is $709,199, plus a $10,000 start-up fee. The 10-month contract was signed in February and runs until the end of December. CHSS submitted the lowest bid of four.
CHSS, which is not affiliated in any way with the governorate, is owned by Dr. Nizar Abdel Fattah, Medical Director Imad Farhat and Noman Ahmed. It was formed in October 2021 with the specific objective of making a proposal to provide health services in prison.
The company hired Kona Medical Consultants to take care of the end of business, including accounting, payroll, recruitment, start-up, and more. Donovan Misky, Kona’s CEO, made the company’s offer to the county, was the contact person and signed the contract as CHSS’ interim chief operating officer.
When contacted, Miske said Kona’s contract with CHSS had been terminated two months ago.
“They owe large amounts of money to Kona, surgery centers, hospital laboratories, electronic medical records…” said Miski. “The entity that represents CHSS is not paying its bills.”
At one point, Miska said, Kona was paying for inmates’ prescriptions because the CHSS had no cash. Miski said Kona was never compensated.
“This particular group of people is completely incapable of running a business,” Musk said.
Fattah did not respond to an email request for information.
Miske became known to the county when he offered to provide Kona’s services to conduct an audit of a two-year, $163,000 contract between the county and the Northern Lakes Community Mental Health Authority in the spring of 2020. The contract was ultimately not renewed at the end of 2020.
Algeria said that, during a board meeting, he had talked about an audit and that it had been presented to board members because they had to approve purchases over $25,000, which Algeria said would likely cost it.
Miska told Algeria he could do so for much less money.
According to Kona’s audit, the Northern Lakes contract was not perfect and should be rewritten. The report stated that it was difficult to know which inmates were served and when due to the lack of clear documentation, which is “outdated” because it is on paper.
The report stated that there is no follow-up to monitor inmates after discharge from the hospital, and communication is ineffective and rare.
Kona cost the county $1,000 to audit. Less than a year later, the CHSS was incorporated and Kona made a bid for those same services in Grand Traverse County.
Another study conducted by the prison in 2020 by NCCHCC Resources, a national company that sets standards for corrections, found that the program did not reach enough inmates, assessments were not done, and treatment planning was lacking. In addition, nearly half of the prisoners charged with mental health issues were never seen.
The study also found that there was little contact between Northern Lakes and Wellpath, which at the time was providing medical and psychiatric services at the prison.
Algeria said the results were similar to those of KUNA.
RFPs were sent about six weeks ago to another company, with the county receiving two offers from CHSS and Advanced Correctional Healthcare, which provides health services to about half of Michigan’s prisons.
Capt. Chris Barshef said two other companies submitted bids — TrueCare24 and Diamond Pharmacy Services — but neither of them attended a mandatory pre-bid meeting, and therefore were not considered.
A committee made up of the prison, the mayor’s office, and county officials will propose a corporation to the GTC Board of Directors at a special meeting scheduled for 8 a.m. November 14 at the Government Center. The new contract will start on January 1.
Barshef said CHSS got on board with no prison experience and had to learn on the job, while an established provider would have come up with best practices, policies, procedures and a business plan.
He said the company may have needed more time to meet parity.
“Business structure and performance in some areas is not what I want it to be,” Barshef said. “In the amount of time they’ve been here, we haven’t seen them meet our expectations yet.”
It was the idea of a single company providing all services that attracted the interest of Barshef, Algiers, and members of the district’s board of directors.
“We wanted this company because they had a different kind of look that we wanted to try,” Barshef said. The agreement was to renegotiate the contract at the end of this year or the county will seek a different service provider.
Barshef, Algiers, and board members realized it was a risk with an untried company, but it was a risk they were willing to take if it meant better services.
Services under the CHSS contract were to be provided by experienced local providers, many of whom would operate under power of attorney fees. Barshef said services on the medical side were good, but the company was unable to fill jobs on the mental health services side.
Physical assessments were to be conducted for each inmate, but Barshef said these were not done due to dwindling staff numbers. He said mental health assessments are being conducted by prison staff after some assessment tools have been implemented.
In the contract, the company was to appoint a licensed behavioral health professional and a licensed lead social worker, both of whom had to work full time.
The contract also stipulated that a psychiatrist should remain in prison for four hours a week; Barshef said it was increased to 12 hours a week to make up for a lack of mental health services.
A psychiatrist may also review any inmate who is using psychotropic substances to continue taking it or adjust their dosage.
Barshef said psychiatry services are better than under Wellpath, which had the previous decade.
The prison budget for 2022 includes $780,000 for Medicare and $196,000 for mental health services. Crisis services are provided by the six-county Northern Lakes Community Mental Health Authority, which is funded through an annual payment. For 2021 this payment was $682,200.