Commissioners pursue 2nd bridge, accept first payment from CCMH, approve union agreement and wage increases
Houghton County Commissioners, Dec. 14, 2021
A Freedom of Information Act request has been filed with the county to obtain:
Summary of accounts payable
Draft letter concerning the possibility of a new bridge
Sheriff’s union agreement
Remonumentation documentation
Summary sheet for the wage increase of appointed and elected officials
and the
Quarterly budget amendments
Meeting Highlights
Bridge “steering committee” formed, seeking feasibility study, letter drafted
County Administrator Elizabeth Bjorn drafted a letter about the funding for a new bridge crossing the Portage Lake waterway. Commissioners Glenn Anderson and Tom Tikkanen are taking the lead on reviewing this letter. The two commissioners also met with several people from KEDA, MDOT, local city managers, and Michigan Tech to discuss the possibility of pursuing a second bridge. They concluded that a feasibility study is a necessary first step. They also highlighted that other waterway crossings such as a tunnel or tube are also possible.
Counties receive first-ever reimbursement for transport from CCMH
Through an agreement that Councilor Tom Tikkanen credited Chairperson Al Koskela for reaching with Copper Country Community Health, the county has received a $46,500 check for the transportation of mental health patients by the county sheriff.
Houghton County considers terms of opioid crisis settlement
If all other involved counties agree, the case will not go to court. Commissioner Glenn Anderson said that the dollar amount of the settlement has not been confirmed yet and that he hopes to learn more specifics at an upcoming meeting.
Commissioners agree to unknown Sheriff’s union agreement
With no public discussion or available draft, the county commissioners voted unanimously to approve an unknown pending agreement. Later in the meeting, in response to a question from County Treasurer Lisa Mattila during public comment, it was revealed that the agreement was part of a third-year reopener, for a $3 per hour raise for 2023, the last year of the deal.
Remonumentation application and progress
In the ongoing effort to place new, modern monuments for establishing property boundaries, the commissioners heard from the remonumentation program representative. The effort has been ongoing since the 1990s, and the representative estimates the county is roughly 30% done. Funding for the effort is tied to property deed registration fees and a state grant calculation.
Commissioners approve raises for appointed and elected county officials
The commissioners voted to approve a wage increase for the appointed and elected offices that is equal to the courthouse union. Administrator Elizabeth Bjorn referred the commissioners to a summary sheet that was not available to the public but said that the raise would be $0.80 an hour for 2022, $0.60 in 2023, and $0.50 in 2024.
Other notes:
The U.S. Coast Guard “explicitly said no” to keeping the Portage Lake Lift Bridge in the down position during morning and evening rush hours.
Tikkanen reports that the DNR expects the trail between Dollar Bay and Lake Linden should be complete by this time next year.
The Michigan Natural Resource Trust Fund has awarded $300,000 to developing the Houghton-Douglas Falls park.
The heating system in the Sheriff’s Department has failed and is expected to take a few weeks to replace.
The commission accepted the sole bid, for $1,000 and cost of removal from the facility, on the cardboard compactor at the county transfer station.
Two members of the CCMH board resigned and were replaced by the board.
Pandemic safety procedures leave some mental health patients feeling abandoned
Teletherapy is popular among many of CCMH's patients, but not all of them find it adequate.
Handling the COVID-19 pandemic has been tumultuous for all of us, involving quick adaptation and frequent discomfort. But for those managing a chronic condition like a mental illness, the pandemic created a fog of uncertainty and new barriers to care that exasperated some issues, despite the best efforts of local workers to mitigate them.
The state deemed mental health services essential, so they could continue under lockdown, but they weren’t specific about what preventative measures providers should or could take.
Copper Country Mental Health, the needs-based, government-supported provider of mental health care in the Keweenaw Area, received some basic guidance from the Michigan Department of Health and Human Services (MDHHS), which they combined with guidance from the CDC and the Michigan Occupational Safety and Health Administration (MIOSHA).
“So we had input from a lot of different agencies and organizations, and then we met as like a safety committee, and that involved our nurses, and we developed the protocols,” CCMH Director Cari Raboin said.
Month by month through the pandemic, the guidance they received changed, and so the committee met repeatedly to update their procedures.
“So it was a moving target,” Raboin said. “It was moving and changing all the time.”
The CCMH staff were also concerned because some studies being released showed that severe mental health disorders could be an increased risk factor for mortality in patients with COVID-19. They felt that the increased risk to the people they’re meant to serve called for a higher level of caution.
Therapy was moved to phone or video interaction. Injected medications were offered in the parking lot by masked and gowned nurses. Even emergency room mental evaluations for people brought — sometimes involuntarily — to the hospital were done over the phone in coordination with emergency room staff and family when available.
“[CCMH] staff would talk with them [the hospitalized] on the phone, too,” Raboin said. “So we got a lot of input, more than just the phone assessment.”
Assertive Community Treatment, which is regular one-on-one activity between a patient-consumer and a CCMH worker and often involves things like making and attending appointments or doing personal shopping, was able to continue with some extra precautions.
But any kind of group social activity had to be ended and didn’t resume for a long time. In the best of cases, these activities moved to a virtual format.
Matt and Nola Olson said that was hard on their adult daughter, who also lost the job shredding paper she had been working a couple of hours per week because of lockdown.
Their daughter doesn’t like cameras and so virtual options don’t suit her.
“When everything shut down and isolation came, you could really see it,” said Nola, their daughter’s full-time caretaker.
This in turn meant Nola had less time for her own work and personal care, which were already limited by the lack of trained, available respite care.
“I had to keep her busy,” Nola said.
Nola felt that the isolation was causing their daughter’s symptoms of schizophrenia to worsen. They felt the first therapist they worked with remotely didn’t understand and wasn’t listening to their concerns.
“We have to deal with it, they don’t,” Matt said. “They’re on the other end of the phone.”
The Olsons were able to change therapists to one they felt took more care to compensate for the shortcomings of telehealth, but still feel their daughter would be better served by in-person therapy sessions.
Raboin said there are pros and cons to using teletherapy. Not being able to read physical cues and body language is definitely a drawback, but she said they got a significant amount of positive feedback from consumers about teletherapy, as high as 70% approval in a survey they sent out. Those who have trouble keeping in-person appointments because of transportation issues, or symptoms of their illness that make going out in public more difficult, found it particularly helpful.
“We hope to be able to continue to provide that as an option,” Raboin said.
It’s currently allowed under special federal and state rules, but may not be in the future. Until CCMH hears from agencies that are above them in authority, they can’t make any long-term plans, either. And not having a plan to offer their patient-consumers keeps everyone apprehensive.
The Olsons said that not knowing what the plan was, and not having any direct contact with therapists or other professionals has left them feeling out of the loop and abandoned.
Raboin said communicating was “definitely” a challenge. They sent out letters, updated their website, and attempted other outreach with each update.
“But the best way we found to communicate with people is one-on-one,” Raboin said.
The most reliable way they found to communicate information was to have someone’s case manager or primary clinician talk with a patient-consumer or their guardian directly about new information or changes.
Whereas transportation to appointments is a barrier to care for some, access to broadband internet or wifi is a barrier for others.
CCMH provided iPads for some consumers who didn’t have a good device for video chatting and bought calling cards for others who had limited minutes on their phones.
The Olsons have to rely on dial-up internet or cell-based internet because of the rural location of their home and their financial constraints, which is another thing that keeps video conferencing from being a good option for their daughter, so they mainly rely on audio-only phone therapy.
“As far as mental health was concerned, it’s all telephone,” Matt said. “And it’s hard to gauge things off a telephone… you’re missing all of the visual cues.”
The Olsons said that the double-standard between physical and mental health was part of what made it so frustrating.
“What burnt me up was the hospital was open the whole time,” Matt said. “Granted you had masks and you had to check for fevers and you know, but if you broke your arm you knew you could go to the emergency room and have your arm dealt with.”
But for mental health issues, there was nowhere open to them.
The Olsons are told their daughter has an illness of the brain and it should be treated as a physical ailment, “but we weren’t treated that way.”
New programs rising to meet young people’s mental health needs
Local school are implementing tiered systems of support to address the needs of school kids early on.
Tiers of mental and emotional support for students from kindergarten up
A survey of parents conducted by the University of Michigan found that 16.5% of youth between the ages of 6 and 17 experienced a mental health disorder in 2016, but about half of those estimated 7.7 million children went untreated.
In much of Houghton County, there is an overlapping and growing network of programs designed to address the mental health issues of youth as early as possible. They don’t meet every need, but several are newly implemented and seeing positive results even during a tumultuous time.
Many schools are also focusing on mental health supports for students without impairments, or any illness or acute needs at all, too. The idea behind these new programs is to support a student’s mental health needs, starting from basic social support and potentially scaled up to 1-on-1 therapies, as necessary.
Multi-tiered Systems of Support
This is based on Positive Behavioral Interventions and Supports and is being rolled out through the Michigan Department of Education and locally through the intermediate school district. MTSS was launched to take a more proactive approach to identify students with greater needs by first taking a schoolwide approach to basic mental health supports. The program is optional.
“School districts can choose whether or not they have tiered levels of support for students in the schools,” Natalie Morgan said.
Morgan is the mental health services coordinator with the Copper Country Intermediate School District.
Not every school district is involved with MTSS. If districts choose to participate, they create a local team that works with Morgan or another CCISD “coach” to develop and execute the details of their MTSS program.
All students in participating districts are screened and school data is assessed three times throughout the school year. Tiers of support can be escalated to meet an individual or group of student’s needs. Parental involvement is also emphasized.
“We try to have as much communication with parents as we can,” Morgan said.
Sometimes the school can call meetings between a student’s parents, teachers, mental health provider, and even an administrator if necessary, but there are other, positive steps taken first.
“Every student throughout the school gets the tier one supports,” Morgan said.
Tier one - School-wide, foundational work to create a generally structured and supportive atmosphere for students.
This can look different in different schools and classrooms. The structure element comes from the expectations of behavior and conduct.
“So the things that are in, like the student handbook,” Morgan said.
Rather than simply having these posted or distributed, the teacher takes time to teach what the expectations of behavior are.
“Then tier two supports are for those students who just need a little extra boost of those tier one expectations,” Morgan said.
Tier two - Group-level interventions that might include a special reading group or study hall.
These groups can offer some students some extra assistance toward catching up with peers on schoolwork or offer social-emotional learning lessons.
“So that could be friendships, it could be talking about empathy,” Morgan said.
After seeing a lot of missing homework in their data, Baraga High School recently had a homework catch-up day that allowed students to catch up on homework.
“They didn’t tell the students about it at first…” Morgan said. “The percentage of homework completion that was done was like, through the roof.”
Tier two might also include regular 1-on-1 check-ins with teachers throughout the day.
“And it’s not, you know, a 10-minute conversation,” Morgan said. “It’s ‘thanks for sitting down and getting your pencil out right away’ kind of thing.”
Tier three - Individual interventions for students who might need support like 1-on-1 counseling.
“We have a whole range of students who are referred for services,” Morgan said.
Sometimes a student can be referred because of truancy or problem behavior in class, other times it can be because of something that happened at home.
“So it kind of depends on what the school is seeing and how they assess that situation,” Morgan said. “And then a lot of times it’s a referral to services here. To the ISD.”
The CCISD has two full-time and two part-time clinicians to meet referred students with mild to moderate needs. Students with extremely high needs can be referred to Copper Country Mental Health or served by CCISD staff under Project AWARE.
Sessions are usually once a week for 30 to 45 minutes.
Project AWARE
A new program to the area, this program is launched with federal grant dollars from the Substance Abuse and Mental Health Services Administration.
“We technically started it in like January, maybe February of this year,” Morgan said.
Along with some money toward supporting youth mental health treatment, it also funds money toward public education and fighting the stigma surrounding mental health treatment.
One program under this umbrella is Youth Mental Health First Aid. The training is for people like youth pastors, team coaches, and other people who regularly interact with youth.
“It can be employers if they’re an employer that employs youth,” Morgan said.
The training helps someone recognize if a youth is struggling with something and get them any needed support.
DEFINING TRAUMA - A quick sidebar
Trauma is often thought of as something that occurs after a violent or sudden event, like a fire, car crash, or physical abuse.
“It can be that car accident or that one event that happened that’s traumatic,” Morgan said.
But it could also be a divorce or death of a close family member or mentor. There are also complex traumas like generational drug and alcohol abuse or poverty.
“When a traumatic experience happens it can shift how your brain absorbs information,” Morgan said.
The traumatic experience becomes a lens through which the entire world is filtered.
“We see that in soldiers who come back from war,” Morgan said. “If they hear a door slam it can trigger their brain into thinking that is, you know, a gunshot or an explosion of some sort.”
For children, different things can be experienced as traumatic.
“We’ll work with students who have adults in their life who have identified a traumatic experience that the student went through,” Morgan said. “We’ll start working with them and they don’t see it as traumatic.”
When that’s the case, Morgan said they don’t pressure the person to see it as a traumatic event. She said it all depends on how the individual is internalizing an experience. If a person feels it is traumatic, and that memory is impacting how they perceive and react to the world, then therapists work to help them.
Therapy under Project AWARE is with Morgan as a therapist and Andy Kalcich or Allie Richmond, CCISD mental health services specialists, for skill-building. Therapy is where a student might work through trauma or practice mindfulness techniques. In the skill-building portion of their work, they talk about things like what coping skills they use, and each’s respective effectiveness for that individual.
Capturing Kids’ Hearts
Capturing Kids’ Hearts is a program launched by the Flippen Group that also relies on some of the same PBIS science in MTSS, but involves more intensive, direct training for the adults in a school than the state has dedicated for MTSS. CKH particularly focuses on building strong relationships between the students and adults within a school.
Calumet, Laurium and Keweenaw Elementary School recently launched their program locally with grant assistance from the Portage Health Foundation, and this year they were recognized nationally as a model school. It’s only the second year they’ve participated in the program. The selection process includes a direct evaluation as well as surveys from students, parents and staff.
“But the biggest thing to hang our hat on,” Julie Giachino said, “is just the culture we’ve created for these children and staff.”
Giachino is the assistant principal at CLK Elementary School, and one of the school’s first participants in the Flippen Group’s 2-day training. She described the culture transformation as “magical.”
Students are individually greeted as they enter the school building and classrooms.
“You’re engaging that student and finding out--What are their needs, right now?” Darren Kinnunen said.
Kinnunen is the social worker at CLK Elementary. He said a student isn’t going to learn well if they have distractions like needing breakfast or having lost something important to them, or other personal issues. These initial, immediate check-ins are a way to discover those needs and address them before they lead to bigger issues during instruction.
Photo provided by Julie Giachino
One of the first things a class does together at the beginning of the year is create their shared social contract.
“It could be viewed as your set of rules,” Giachino said.
The group develops the classroom rules for the year together, with the teacher leading a discussion about how the students want to be treated, and how the teacher should be treated. Involvement in the process empowers kids to check in on each other, as the rules are shared, rather than just the teacher’s own.
“So anytime there’s conflict or anything in the room… we always go back to that social contract,” Giachino said.
The school staff also develops one for themselves at the beginning of the year. In kindergarten classrooms, they call it the ‘classroom promise’ to keep the vocabulary understandable to the young students.
Two examples of social contracts developed at CLK Elementary this year. The one on the left is from a kindergarten classroom, the one on the right is the staff social contract. Photos provided by Julie Giachino.
Kinnunen said that some instruction time is lost to these extra interactions, but by eliminating distractions and stress students can focus more on academics. He said that Horizons Alternative High School has found more classes are being completed since they’ve started spending time implementing Capturing Kids’ Hearts.
“Once you have their heart, their minds are open,” Giachino said.
The concepts of CKH are along the same guidelines at Tier one MTSS supports. The program also dovetails with other programs CLK Elementary has enacted in the last couple of years.
KINGS Time
Through each week, the CLK Elementary School’s social worker, Kinnunen, spends 40 minutes with each class talking about things like problem-solving, developing empathy, understanding your own emotions, and social interaction.
“Some kids are maybe getting it at home, right?” Kinnunen said. “Just because of the household that they have. Some kids aren’t getting it.”
It also helps Kinnunen build a rapport with the kids so that if they come in to see him about an individual problem, they already have the basis of a mentor-mentee relationship.
“For me, it’s just a great opportunity to connect with kids,” Kinnunen said.
These social classes are also very similar to some Tier two MTSS supports, but enacted across the entire elementary school rather than targeted.
Therapy Dogs
Benny the therapy dog and Matt Hampton, CLK Elementary principal. Photo by Joshua Vissers
The CLK district currently has five hypoallergenic therapy dogs that spend their days at the schools. Two are in the elementary school. Sometimes they’re scheduled to be in classrooms, other times they’re in one-on-one meetings.
“He even comes in here once in a while for some of our parent meetings and he’ll jump over there on the chair,” Matt Hampton, CLK Elementary School principal, said. “It really not only puts students at ease but also puts parents at ease.”
Right now the new dogs are training with Hampton and waiting for programs to restart after the pandemic. The dogs that have been in the building longer went through Pet Partners training.
“It’s been a great success for us,” Kinnunen said.
Handle With Care
CLK Schools have coordinated with local police in this state program to increase their awareness of what students are experiencing outside of school.
“We recognized that there are some students in our district that may have been affected by just, trauma, in their life,” Kinnunen said, “and that maybe we weren’t picking up on some of that.”
Kinnunen would sometimes find that students in his office had major events happen in their lives that the school staff was completely in the dark about.
In the Handle With Care program, if police encounter schoolkids when on a call, they inform the school; not of all the details, but simply that the student may be tired from lack of sleep, distracted in class by something that happened, or need extra support temporarily.
“Depending on the circumstance, it might just be a check-in and not really talk about what happened last night,” Kinnunen said. “But just to say ‘Hey, how are you doing?’”
It’s a simple program, conducted via email, and Kinnunen highly recommends it to other districts.
Copper Country Mental Health
In addition to assisting schools with many of the above programs and being directly involved with Project AWARE, Copper Country Mental Health also provides several independent programs.
“We provide a whole array of services, as required by the Michigan Department of Health and Human Services,” said CCMH Executive Director Cari Raboin.
Much of their programs are paid for through Medicaid, which sets a severity condition on the treatment they can offer and requires them to follow other MDHHS rules, too.
Independent referrals go through NorthCare Network. Most children need a parent or legal guardian involved, but there are some limited services available without parental consent to those over the age of 14.
Leslie Griffith is the outpatient program director at Copper Country Mental Health, but spent 17 years of her career focused on early childhood and youth treatment, a segment of the population she says are particularly underserved.
CCMH considers youth to be prenatal to age 21.
Griffith wrote in an email that the goal of youth intervention programs is to reduce problematic behaviors and symptoms to ultimately have “a decrease in functional impairment”. Functional impairment is simply the barriers or limitations an illness places on carrying out a person’s daily life.
Services can be paid for through some private insurance, Medicaid, or MiChild insurance, according to Griffith. Charges are also income-adjusted.
“I’m concerned that people aren’t calling us who are eligible for our services,” Raboin said.
She said anyone in doubt of their need or financial assistance eligibility should call 1-888-906-9060 for a screening.
Parent Support Partner
PSP is a program to help parents with training and support to be caretakers of children with serious emotional disturbances. The goal is to move families to independence from counselors and other interventions through training in how to directly participate in the treatment process.
Youth Peer Support Services
This program pairs youth with a young adult to offer advice and support.
Wraparound
This program helps coordinate the supportive adults in the orbit of a child who has serious emotional disturbance to have a team approach in managing the necessary support. The program is especially effective for those involved with multiple institutions.
A variety of education and training programs.
Dial Help
A local organization originally established to address addiction, Dial Help now offers a variety of support services.
Crisis Line
To talk to someone about available help and resources in the community, Dial Help keeps someone available around the clock. They offer specialized youth services and can make referrals to other experts.
Call: 1-800-562-7622
Text: 906-356-3337
Dial Help supports the local Communities That Care initiative, which uses an evidence-based prevention model to address youth substance abuse, delinquency, and mental health. The organization relies heavily on volunteers.
Pandemic’s impact on youth mental health
“There’s definitely been some ups and downs,” Morgan said.
One of the positives, according to her, is that insurance companies and other institutions have come to recognize the value and effectiveness of teletherapy, which is conducting therapy sessions via video conferencing.
“Some of those students who have been virtual, we’ve done virtual sessions with them,” Morgan said.
She said more people have been able to participate in meetings virtually, too.
On the other hand, the distance has created some problems, too.
“If a student doesn’t want to meet, they just don’t log on,” Morgan said.
Morgan said the pandemic exacerbated the anxiety and depression some students they see were already feeling.
“So it’s just being able to recognize that and really working with students on different coping skills and things that they can use to kind of help get through this,” Morgan said.
The CCISD staff has been approved to keep meeting with students into the summer.
At CLK Elementary, the challenge was how to continue connecting with students when schools went virtual. CLK Elementary was only closed twice in the last school year, both in the fall, but the staff said switching back and forth was difficult.
Social contracts and regular greetings continued, but the venue changed.
Kinnunen said that they tried to maintain what schedule consistency they could so that students could develop new habits.
“We’re all creatures of habit, right?” he said. “Anytime there’s a shift, it just throws your system.”
Kids that didn’t show up for classes got calls from paraprofessionals and other staff from the school to check in on why.
The change to virtual learning also presented some students with issues finding both devices and internet access to participate. Different solutions were found for each, with the Portage Health Foundation assisting with establishing wifi hotspots, too.
Struggling to meet community staffing needs
“It’s mostly just qualified therapists to provide the services,” Morgan said.
Morgan said the CCISD has been fortunate in their hiring, but other ISDs in the UP have struggled just to find qualified people to fill those positions, and keep them there.
Currently, the CCISD has a small staff serving several school districts, with more joining the MTSS program. Morgan said more support from within the individual school districts would be very helpful. Social workers in schools, like Kinnunen, are beginning to be more common.
“If we could have, you know, be able to provide a social worker in every school, that would be phenomenal,” Morgan said.
Griffith wrote that there are “certainly” unaddressed needs in the community, but that families with higher income have access to private practitioners.
Raboin also said staffing is an issue. CCMH covers a four-county area with a small staff that has to be able to do many different things.
“Our staff really have to be jacks of all trades,” Griffith said.
Frequent turnover makes keeping well-trained people on the job difficult. The geographic differences across the state aren’t always accounted for in the requirements they’re placed under, and encouraging needed people to move to the area isn’t always easy, either.
Social workers and therapists have specific educational requirements that have to be met as well. Raboin said CCMH has found success using remote teletherapy for their patients, as then therapists can be non-local.