An outside observer might say that it looked as though things were already headed in that direction, but Matt Eastwood, CEO of Canvas Health, said that he was surprised when he heard that the Minnesota Department of Human Services (DHS) had hired a new contractor to run the state’s crisis text service. His organization had run the suicide prevention service, known as Txt4Life, since September 2011. With a new contractor in place, Canvas Health’s contract with the state will expire March 31.
The shift “was totally unexpected,” Eastwood said. “We were informed sometime last spring or summer that the state would be putting Txt4Life out for bid. We said we were happy to go out and compete.”
Eastwood said that his organization waited for DHS to put out a formal request for proposals (RFP) for Txt4Life.
“Toward the end of 2017, we reached out to the contract manager at DHS and said, ‘Our contract is done December 31. There is no RFP. Unless you are planning to give this to us or re-contract, we are done as of December 31,’ ” he recalled. The contract manager assured him that the RFP was coming, he said, but asked to extend Canvas Health’s contract until the end of March.
In early January, Eastwood said he ran into Assistant DHS Commissioner Claire Wilson at a meeting. “She said,” he recalled, “ ‘I need to talk to you about Txt4Life.’ ” On Jan. 15, Eastwood said he contacted Wilson. The two set up a meeting for early the next morning.
“At 7 a.m. on the 16th she informed me that the state had entered into a contract with Crisis Text Line out of New York,” he said. “Our contract would end as of March 31.”
Changes frees funds
The decision to end the state’s contract with Canvas Health was a smart financial move, Wilson said. Crisis Text Line, a national nonprofit with strong corporate backing, offered to extend its services to Minnesota free of charge.
“Crisis Text Line is an organization that is supported by various funding streams,” Wilson said. “That allows it provide this service free nationwide.”
The transition will be seamless, according to Wilson. Crisis Text Line will take over the service as of April 1: “There won’t be a gap in access to this service,” she said.
The fact that Crisis Text Line’s services will come at no additional cost means that DHS will instead be able to use the $1.125 million that the state Legislature appropriated last session for a crisis text service to beef up regional coordination for statewide suicide prevention efforts, Wilson said. “Within the contract that we currently have, we were only able to reach 54 counties in the state.”
Once Minnesota has entered into contract with Crisis Text Line, she added, those funds are freed up: “The full appropriation can then go to outreach services.”
Outreach services, Wilson explained, are statewide suicide prevention education and awareness efforts. The appropriated money will be used to hire coordinators and outreach workers who will attend community meetings, speak at schools, in businesses and religious organizations. They will also help maintain local resources in a national database for Crisis Text Line counselors to access.
Organizations interested in providing these services are encouraged to submit proposals to the state.
“These funds are going to be used to expand outreach and education resources across the Minnesota,” Wilson said. “A wide range of agencies, including Canvas Health, can propose to offer outreach services.”
On many levels, the partnership with Crisis Text Line is a positive move for Minnesota, Wilson said.
“I don’t see any downside to this switch. The upside is that more people will have access to a lifesaving service, and we’ll have the potential to have much more expanded outreach services. We will be able to educate in all counties of the state about the service.” The new partnership feels like a great opportunity, she said: “We are able to expand our suicide prevention and crisis texting services to cover all of Minnesota, 24 hours a day, day 7 days a week. There is no downside to that.”
Impact of change
Though Wilson says that Canvas Health and Txt4Life did not provide crisis text services to the whole state, Eastwood disagrees. “We’ve been providing crisis text services to 100 percent of the state of Minnesota for many years,” he said. “We’ve never blocked any calls from anywhere or from anyone who texts us. When Txt4Life’s number is entered, no matter where it comes from, it gets a response from our call center in Richfield.” He also disputes Wilson’s claim that this move will save the state money.
“They aren’t saving a dime; they are using the money in a different way,” Eastwood said. “My understanding is that the dollars were allocated by the Legislature to support a crisis text service. I’m assuming DHS’ point is they are able to leverage these state dollars to get full coverage with regional coordinators. There was not enough money in the dollars allocated by the state to run a text center — and to hire enough regional coordinators to cover the whole state of Minnesota.”
Even if he disagrees about the details, Eastwood does believe that the decision to end the Canvas Health contract must be financially motivated. His organization had no indication that DHS was displeased with their work. “I think we ran the service very well,” he said. “We provided the citizens of the state of Minnesota with excellent service on behalf of DHS. I’m unaware of any actual complaints.”
The discontinuation of the state contact means that all of Canvas Health’s text center counselors will have their positions eliminated. “There are about 12 to 15 people who will be directly impacted,” Eastwood said.
Eastwood admits that if he looks at the situation from a dispassionate angle, he can see why DHS made this decision. “If everything were equal I can understand this move from their perspective,” he said. “They don’t think they can get any more money out of the Legislature for this service. They think they can leverage a free service.” But was the move shortsighted? he asked: “The question is, ‘Will they get the same level of service and safety for Minnesota residents from a national crisis text line as they can from Txt4Life staff?’ ”
Because they are locally based, Eastwood argues, his staff understands local services and communication styles. Counselors based in other parts of the country may not understand the way things work in Minnesota. But he hopes his worries are proven wrong.
“We’re a community mental health service,” Eastwood said. “The stakes are too high for anyone in the agency to wish it goes poorly. I hope this goes exactly as the state thinks it will. If it doesn’t, people are going to get hurt. And that would be criminal.”
Beginning April 1, Crisis Text Line will become the state’s sole provider for crisis text services. People seeking suicide prevention text services should text “MN” to 741741. Texters will be connected with a trained counselor who will help defuse the crisis and connect the individual to local resources.