Though she said she and her colleagues at Neighborhood Involvement Program (N.I.P.), the 47-year-old Minneapolis health clinic for the uninsured, “tried their hardest” to keep their mental health programs alive, in late December Patsy Bartley, program CEO/president, had to announce that N.I.P.’s Counseling Center would be shut down effective Dec. 31, 2014. N.I.P.’s medical clinic closed on Aug. 29, 2014.
Bartley explained that N.I.P. staff tried to help clients adjust to the Counseling Center’s closure.
“Therapists from our Counseling Center worked with their individual clients to help them find a place for to go,” Bartley said. “We are also referring some people to the Walk-In Counseling Center in Minneapolis. They take uninsured clients there, and we still do have a significant number of those.” The N.I.P. Counseling Center served between 800-900 patients each year.
While Bartley and the N.I.P. board of directors believe that health-care reform has been good news for uninsured and underinsured Americans, the Affordable Care Act (ACA) has meant that N.I.P.’s client base dropped, first with the expansion of Medical Assistance, and then later, when full implementation of the ACA meant that many of their former patients were now able to buy insurance.
Partner search
Though N.I.P.’s mental health clinic did accept insurance, thus protecting it to some degree from ACA threats, the board of directors still made the decision to shut the program down at the end of 2014. Bartley and her colleagues searched for a mental health partner that could “wrap in” N.I.P. Counseling Center services and clients with existing programming, but failed because of the significant number of uninsured clients they served.
“Our marching orders from the board were to look at what partnerships we could establish,” Bartley said. “We needed to do that by year end.”
Some N.I.P. programs found new homes. One program that fell under the umbrella of the program’s mental health services is the Rape and Sexual Abuse Center (RSAC), which operates a 24-hour help line and legal advocacy services for victims of sexual assault. A partnership has been formed with Cornerstone Advocacy Service, a 30-year-old Bloomington-based nonprofit serving victims of violence. All RSAC programs were transferred to Cornerstone effective Jan. 1.
“This was a very good strategic match for us,” Bartley said. “For the time being, our 24-hour crisis center is going to stay in the N.I.P. building. They are planning to still provide therapy for rape and sexual abuse victims.”
The two legal advocates employed by N.I.P. already occupied offices at the Hennepin County Attorney’s office, Bartley said. They were hired by Hennepin County at the beginning of the year: “They were our employees one day and Hennepin County employees the next. From a client standpoint they should not be able to see a difference.”
The N.I.P. Seniors Program formed a partnership with Senior Community Services, a west-suburban agency designed to meet the needs of older adults and their caregivers. Seniors Program participants were transferred to Senior Community Services on Jan. 1.
“Senior Community Services provides services to seniors in the west metro counties but they wanted to move into Minneapolis proper,” Bartley said. “It was a great match. Our core funders were in support of this. They have hired three of our staff.”
N.I.P. wasn’t able to find a home for its dental services program.
“It breaks my heart,” Bartley said. “There are not a lot of good places to go for people who need dental services who are uninsured. The ACA doesn’t really address dental except for kids. There is still a huge ongoing need for that.”
Next steps
Shutting down a program that’s been operating since 1968 takes time.
N.I.P. owns their building at 2431 Hennepin Avenue. As it became increasingly clear that all elements of program would be shut down, the board began to quietly get the word out to potential buyers that the building was available for sale. A buyer quickly emerged for the prime piece of real estate, and a purchase agreement is now in place.
Bartley said that both parties are in the due-diligence stage of the purchase, but there is hope that the rape and sexual abuse center can remain in the building.
“Part of our understanding is we want to make the services as accessible as possible and as seamless as possible for continuity,” Bartley said. “We’re hoping RSAC will be able to negotiate with the person who is buying our building so that they can sustain a long-term lease.”
Health records are available for all former N.I.P. clients. Bartley said that patients should call the clinic at 612-374-3125 and request files. A request form is available online. Then they will need to come to the clinic with a valid picture ID to pick them up.
“Any of our client health records will be made available to people,” Bartley said. “We are preparing client files to be transferred to a record retention group.”
Bartley will remain at N.I.P to assist with clinic shutdown, audit closure and final reports to funders until mid-May, but then she will be on the job market.
“It’s the end of an era, but I love to work,” Bartley said. “I love to do meaningful work, so pretty soon I’ll be looking for a new job.”
Progress
Is it possible that the clients of this agency voted with their feet? When a range of options became available to them they chose not stick with the one they had been compelled to use but instead went to other providers because the availability, quality of care, etc was better.