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William Glanz

Senior Writer

Minnesota Mental Health Clinic Diversifies … and Thrives

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Shauna Reitmeier, CEO at Northwestern Mental Health Center (photo courtesy Northwestern Mental Health Center)

Seven years ago, the Northwestern Mental Health Center saw an opportunity to diversify services in the eight-county area of rural Minnesota that it serves.

Today, their goal to be more things to more people has succeeded – for clients, the community and the clinic.

“We kept hearing these cries from other partners – like our jail – that they needed more and if we didn’t change our model, the needs of the community weren’t going to be met. So, we said, ‘We need to do this,’” said Shauna Reitmeier, chief executive officer at Northwestern Mental Health Center, based in Crookston, Minn.

Shifting from Compliance to Commitment

The Northwestern Mental Health Center, which serves an eight-county rural community of just 70,000 people,  began its transformation from a county-focused facility to a community-focused clinic in about 2012.

At that time, Northwestern Mental Health Center relied heavily on the counties it serves for funding. As a result, it had a limited number of programs for the public.

So Reitmeier began to make deliberate programmatic changes to broaden services. She started by identifying new sources of funding, which reduced dependence on local government revenue.

“I don’t think there’s a health plan that we aren’t contracted with. We opened the door to make sure we had every funding mechanism available to see people who walk through our door,” Reitmeier said.

As a result of the clinic’s efforts to diversify its programs, it can offer clients a significantly broader range of services than it used to provide.

“We’re very flexible. Our staff has more pots of money and we’ve created an a la carte approach to how we provide services. We’ve got staff that are cross-trained, so when a client comes in, we pick a funding stream based on a family’s needs,” she said.

The clinic is also co-located in area hospitals, schools and corrections facilities. And, rather than providing just rehab services, the clinic assists clients through its homelessness program, provide targeted case management or meet clients through its mobile crisis services.

“We put ourselves where the need is,” Reitmeier said.

Northwestern Mental Health Center also embraced innovation. Partnering with InnovaTel, the clinic was the first in Minnesota to begin using telemedicine for psychiatry in the early 2000s. When the clinic lost its child psychiatrist, InnovaTel stepped in to help fill the need. Since then, the clinic expanded its psychiatry program and InnovaTel now provides the clinic with a new Medical Director, which it shares with another mental health agency in the state to reduce duplication of efforts, increase collaboration and consultation between providers for less isolation and continued clinical growth and development.

“In our efforts to continue to focus on our community need, technology has played a key role,” Reitmeier said. “In 2020, it is a priority initiative of our board to implement the use of telehealth beyond psychiatry into our crisis response, therapy and rehabilitation work across our region.”

This diversification of services began before CCBHCs arrived in Minnesota. Then, when Minnesota became one of the eight demonstration states for the CCBHC program, Northwestern Mental Health Center was selected to serve as one of six clinics in the state.

The clinic put itself in position to earn a coveted CCBHC designation because of its efforts to diversify. Earning a CCBHC designation represented a profound achievement for its efforts to provide more service to more people in rural Minnesota.

Quantifying the Transformation

As a result, Northwestern Mental Health Center has experienced explosive growth. Over the past seven years, the number of clients it serves has increased from 2,000 annually to more than 4,200 annually and revenue has doubled from $6 million a year to $12 million.

They aren’t done yet. Reitmeier says the clinic has opportunity for more growth and Northwestern Mental Health Center just hired a staff member who will focus solely on communications and outreach as they work even harder to reach the community and share information about its continuum of care.

While the counties remain strong partners, the funding they provide has fallen drastically over the past seven years. The counties the clinic serves once provided 90 percent of its funding. Now they provide about 10 percent of Northwestern Mental Health Center’s funding.

“It was a win for the counties because they didn’t have to fund us as much. We were maximizing other funding sources, so the counties saw the cost benefit. But they also saw the social benefit,” Reitmeier said.

That’s because more funding meant the clinic could provide more programs and meet more needs.

Helpful Hints, Red Flags

The transformation wasn’t always easy, but Reitmeier offers these tips to clinics interested in broadening services:

  • Broaden your vision.
  • Build partnerships with other organizations in the community.
  • Improve communications, including talking about the role community-wide clinics play.
  • Improve workforce development.
  • Diversify your payer mix.
  • Get staff credentialed/licensed so they can manage numerous health care plans.

At the same time, clinics should be mindful of the broad organizational impact that expanded programs has on the demand for services and be prepared to handle that new demand. In addition, the regulatory burden also grows as programs increase in number.

Despite those hurdles, Reitmeier wouldn’t change a thing about her clinic’s journey and she encourages others to diversify so they can help more people.

“We were going to be really small and in a constant struggle if we didn’t make changes and focus on the needs of the community,” Reitmeier said. “Now we’re in a better place.”

So is the community.

Pictured above: The staff of Northwestern Mental Health Center (photo courtesy Northwestern Mental Health Center).