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Ada County commissioners have spent the last year wrestling with how they want to address the health needs of people experiencing homelessness.

That struggle appeared to be resolved when commissioners signed a new contract on Feb. 8. Three new employees will be hired to handle mental health services in Ada County.

Commissioners initially reduced the amount given to community treatment from $312,000 to $200,000 and then decided the money would no longer go to New Path. Until October, Ada County paid for on-site treatment services provided at New Path, a 40-unit apartment building at 2200 W. Fairview Ave. in Boise that provides permanent supportive housing for people who had been chronically homeless.

One significant change is that these services will no longer only be offered to those experiencing homelessness.

“The intent of the contract is to improve the behavioral health and well-being of the indigent, un-housed, housing insecure, as well as individuals with substance use and mental health needs in Ada County,” Claudia Weathermon, communications director at Terry Reilly Health Services, said in an email to the Idaho Statesman.

The contract gave a total of $200,000 to pay for salaries for three new full-time employees at Terry Reilly Health Services, a community health center that provides care to those who may find it hard to access it at other places.

Weathermon said she assumes most who come in will qualify for full coverage of the services through Medicare, Medicaid or their private insurance. Some who do not have full health care coverage will be charged on a sliding scale. But those who can’t afford that can access Terry Reilly’s established zero-pay patient fund.

The first hire will be a counselor/social worker who will offer therapeutic counseling, substance abuse counseling and connection to supportive services like transportation, job training, child care, food, dental care and housing.

The second will be a patient navigator/community mental health educator who will collaborate with community partners to provide education services. This person will also help patients navigate the health care system, including enrolling in health benefit plans. The county contract stipulated that two courses that this person must provide are “mental health first aid” and “Applied Suicide Intervention Skills Training.”

The mental health first aid training will be an eight-hour education program for the general community about how to identify and respond to mental health and substance use issues. The Applied Suicide Intervention Skills Training will be a two-day workshop for the general community that will teach people how to identify and intervene with individuals at risk for suicide.

The third employee will be a psychiatric nurse practitioner who will provide psychological counseling and medication.

It is unclear how many people the new hires will be able to see, with cases dependent “upon the complexity and individual client needs,” according to Weathermon.

Increased need in community

Weathermon said local population growth and a global pandemic led to an increased need for mental health services. The number of Idahoans who reported having a mental illness in 2019 rose from 22% in 2019 to more than 33% by the end of 2021, according to the Kaiser Family Foundation.

“We’ve been challenged to keep up in terms of the number of providers and ability to get out to people,” Weathermon said. “… And I think we can all agree that stressors and anxiety have increased through COVID. So just in general, there’s a higher need for behavioral health services.”

Ada County isn’t the only one supporting Terry Reilly. Intermountain Healthcare, the largest health care provider in the Intermountain West and parent company of local Saltzer Health clinics, announced on Monday that it had donated an additional $250,000 to Terry Reilly to hire two mental health providers who will specifically assist residents of Canyon and Owyhee counties .

New Path gets help elsewhere

New Path on-site services that Ada County paid for include peer support, medical and health services, outpatient mental health treatment, substance abuse treatment, intensive case management services and life skills education.

Commissioners first expressed hesitancy toward New Path in June, saying they did not like that those with substance abuse issues received housing regardless of whether they were seeking treatment for their addiction.

“I would rather put it to treatment first rather than housing first,” said Rod Beck, chairman of the Ada County Board of Commissioners, in a June budget meeting. “… It puts responsibility on the tenant to do some things, to get off drugs and things like that. It’s treatment first, not housing first.”

The commissioners have since said the goal is to increase the amount of people who can access services.

“Our objective has always been to provide support for as many people as possible,” Beck said in a February news release.

When the county yanked New Path’s funding in October, Boise city officials stepped in to pay $335,000 to keep them going. Some have expressed resentment toward the commissioners, with Council Member Holli Woodings saying they had “left us on the hook.”

Maureen Brewer, Boise’s senior manager of housing and community development, still sees the new Terry Reilly contract as a “net loss in the county’s contributions toward homelessness.” Brewer believes financially supporting Housing First projects would have been the best use of the funds.

“Support for behavioral health is no doubt important,” Brewer said. “To be clear, this effort sits adjacent to homelessness rather than directly addressing it. … Our deepest need is for permanent supportive housing using the Housing First model. New Path is a cost-savings program for county taxpayers.”

A Boise State University study that found New Path had saved the community nearly $2.7 million in the last two years in jail time, paramedic services, mental health and substance abuse services, emergency room care, in-patient hospital stays and arrest costs.

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