Plans for detox, crisis intervention facility take shape

Plans are moving forward for a facility that would provide care and medical supervision to people experiencing mental health or substance abuse crises, keeping them out of jail or the emergency room.

Under a tentative framework discussed by county and city officials on Nov. 15, Johnson County would buy and own a building intended to provide sobering, detoxification and crisis stabilization services while the University of Iowa Department of Emergency Medicine would provide day to day management of the facility.

The agreement, although not yet formalized, represents the next stage of discussions for the facility, which has been in the planning stages for months. With details about the ownership and management of the facility close to resolved, county officials will soon be able to move forward with the purchase of a building to be renovated and prepared to house the crisis facility.

The facility is one goal of the county's larger jail alternatives strategy and makes up part of a two-pronged approach, along with crisis intervention training that teaches law enforcement and first responders to deescalate encounters and recognize signs of mental illness and intoxication.

Officials have hosted three 40-hour crisis intervention training sessions this year and have trained about 170 members of law enforcement, including 140 who work in Johnson County, said Johnson County Sheriff Maj. Steve Dolezal at the Nov. 15 meeting.

Without a facility to house and care for people experiencing behavioral health crises, officials say law enforcement have few options but to send someone to jail or the emergency room, which doesn't address the root of their problems with substances or mental illness.

That's why it's important to move forward with a facility where those people can be taken, said Janelle Rettig, chair of the Johnson County Board of Supervisors. Otherwise it's harder to achieve the cost savings and jail diversion benefits that should result from the crisis intervention training.

"Everyone keeps saying to me, 'We’re really glad we have the training, now we still don’t have any options. Our choice is still the emergency room or jail,'" she said.

County officials have not publicly announced a site for the facility, but estimates show the costs to purchase and renovate an existing building would be about $3.2 million, while constructing a new building could cost up to $6.5 million.

Estimates project the facility would cost about $1.5 million annually to operate, and would lose around $375,000 per year.

Under a draft agreement for the facility, Johnson County and Iowa City would each contribute 38.5 percent of the building's initial costs, while North Liberty would chip in 15.5 percent and the remaining cities in Johnson County would provide 7.5 percent. Several city councils intend to discuss the proposal in the coming weeks as they prepare their budgets for the next fiscal year.

The draft document also states that Johnson County would be responsible for funding operational deficits of up to $400,000 annually. If deficits at the facility exceed $400,000 in a year, the draft agreement states that participating cities will provide funding in the same proportion that they contributed to the building's initial capital costs.

Rettig said part of county government's role is to provide social services, and even with the expense of providing a backstop for losses at the new facility, the county would still be saving money on inmate housing at the Johnson County Jail. The population at the jail reached its lowest point in a decade in 2016 and has fallen steadily in recent years due in part to the county's other jail alternatives efforts.

"I have never assumed this project would break even. From my experience, nothing in social services ever pays for itself," Rettig said.

While formal legal agreements still have to be drawn up, Rick Dobyns, a UI representative, said at the meeting that the Department of Emergency Medicine will move forward with plans "as though we're going to be the managing entity." Several local nonprofits would offer services at the building and assist with programming and staffing.

Reach Stephen Gruber-Miller at 319-887-5407 or sgrubermil@press-citizen.com. Follow him on Twitter: @sgrubermiller.