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Census questions: Staffing levels, patient population uncertain at Caro Center

Just how many people work at the Caro Center?

It depends on who you ask and when you ask, according to Jean Doss.

Doss, of the lobbying firm Capitol Consultants, said Monday she’s been unable to lock down a number for the state psychiatric facility at M-81 and Chambers Road in Indianfields Township. Doss admitted as much while making a teleconference video report to the Tuscola County Board of Commissioners during a Committee of the Whole session (at such sessions the commissioners can discuss issues but can’t take action).

The numbers Doss and her staff have gotten from state officials often change from 390 cited by the Department of Health and Human Services to 406-407 that turns up in studies Doss has done of state employment records for the Caro Center.

“I can tell you that in the governor’s own executive budget proposal,” Doss said, “she took the extra money provided in the supplemental in September for 68 new staff in Caro and her anticipated staffing levels as of March was 542 employees.

“I have never gotten the same answer twice when I ask how many full-time employees there are at Caro.”

Doss’ firm was hired in March by the commissioners in an effort to keep a $115 million, 200-bed state psychiatric hospital in Wahjamega in Indianfields Township. That came just after Gov. Gretchen Whitmer halted construction of a 225,000-square-foot new state psychiatric hospital on 650 state-owned acres at M-81 and Chambers Road in Indianfields Township.  

Whitmer cited the city of Caro’s charge of $2.5 million for water service, staffing shortages, recruitment barriers, finding a permanent staff psychiatrist and the ability of families to be involved in treatment due to the location as reasons for the change in course. She then hired Owings Mills, Maryland-based accounting firm Myers and Stauffer to review the decision to build, even after Tuscola County officials had assured state officials the county could provide water to the new facility for about $1 million by upgrading the well-based water system the Caro Center already was using.

Funding for the larger hospital was part of the state’s 2017 budget, ground was broken in October and nearly $4 million already had been spent on a replacement for the 150-bed Caro Center hospital when work was halted in March by Whitmer.

The review by Myers and Stauffer, which cost the state $277,000, listed four options for the state, three of which called for the state to build the new hospital at the Caro Center. None of them were what state Department of Health and Human Services director Robert Gordon recommended to the governor.

He recommended Whitmer keep the Caro Center open but reduce patient beds by almost 50 percent and renovate, or maybe replace, the aging, unsafe Caro facilities.

“We do have to take a moment and say we won this first stage,” said Doss, “by convincing at least Myer and Stauffer and the DHHS director that Caro needs to stay as part of the state’s system of care for individuals with mental illness.”

Gordon’s recommendation also promises to keep staffing at the Caro Center the same. And that is where the actual number of employees matters. 

“When we talk about preserving and protecting all of the jobs that are currently at the Caro Center,” Doss said, “it is really important to have an agreement, a consensus on how many jobs we are talking about.”

“We hired so many people that the full-time employee number will not match up with the W-2s,” said Matt Campbell of the American Federation of State, County and Municipal Employees. “We hired people on limited-term contracts.”

Right now, he said, they have 50 people hired under such contracts. That means they are hired until they aren’t needed any more and then they will be let go. “When the population at the facility goes down,” Campbell said, “they can be let go tomorrow.”

There are at least 65 limited-term employees at the Caro Center right now, he said. But he also cautioned Doss against trying to get a count of employees.

“You are never going to get that number,” he said. “So I wouldn’t bash your head looking for that number.”

Campbell also questioned the county’s continued push to have the full 200-bed, $115 million hospital built in Tuscola County.

“Do we risk losing the $20 million revamp if we push for a new facility?” he asked. “I am from a small town and a little is better than nothing. How big of a risk is that, if we don’t settle for the $20 million?”

“Something has to be done to the Caro facility,” Doss said. “Doing nothing is not an option.

“I feel we need to continue to push.”

Campbell’s information drew the attention of District 2 commissioner Thomas Bardwell.

“Director Gordon’s memo says $40 million (to renovate the Caro Center),” said Bardwell. “Where did you get the $20 million?”

“I really can’t tell you,” said Campbell. “I get the $20 million from people who have told me they plan on spending $20 million in Kalamazoo (at the Kalamazoo Psychiatric Hospital), throwing $20 million at Walter Reuther (Psychiatric Hospital in Westland) and $20 million on Caro and another $20 million into community mental health.”

He also said the plan is for the patient population at the Caro Center to go as high as 110 beds and stay at that level. Doss said she was told the Caro Center population would rise to 145 again this fall.

The DHHS lowered the patient population at the Caro Center to 84 in April, in the face of a Michigan Occupational Health and Safety Administration investigation. Campbell said MIOSHA was threatening the state with more than $1 million in fines over workplace safety violations.

“They made corrective actions,” he said, “by drastically reducing the census.”

Workers at the Kalamazoo hospital also filed a complaint with MIOSHA. 

“Two different investigators,” Campbell said. “Ours found violations. We had to hire a whole bunch of people. Theirs found no violations and no correlation between injuries and mandatory overtime. So theirs was turned down by the same state agency.

“I think politics came into play.”

The Caro Center is one of five state psychiatric facilities. The Center for Forensic Psychiatry in Ann Arbor, the Hawthorn Center in Northville, the Kalamazoo Psychiatric Hospital and the Walter Reuther Psychiatric Hospital in Westland are the others.

The Caro Center’s roots go back to 1914, when the state opened the Caro Farm Colony for Epileptics. It then served as the only state residential treatment center for individuals with seizure disorders until 1997. It was one of 16 state asylums operated in Michigan since 1850. Starting in the late 1980s, the state began to close many of them, including facilities in Traverse City, Newberry, Ionia, Kalamazoo, Northville, Pontiac, Lapeer and Ypsilanti.

Mark Haney is a staff writer for The Advertiser. He can be reached at haney@tcadvertiser.com

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