PROVINCETOWN — The boards of health of Provincetown, Truro, and Wellfleet will meet jointly in December to hear about the health-care needs of the three towns and to consider a combined effort to improve access to mental health services.
The lack of mental health practitioners here — in particular, therapists who accept insurance — is so severe that the towns are considering how to use public money to make mental health and substance abuse care more available.
The three-town meeting is currently set for Wednesday, Dec. 7, according to Provincetown Health Agent Lezli Rowell, who briefed the Provincetown Select Board on Monday.
Provincetown already has its own five-year mental health plan, which officially began in July of 2021. That year’s programming included a barrier elimination fund, which helps people access mental health and substance abuse programs by paying for transportation or child care, and a youth activity fund that pays for transportation or course fees for camps and classes, based on a theory pioneered in Iceland that social engagement helps prevent depression and substance abuse in young people.
The plan is designed to build year over year, and the crux of the plan, both financially and operationally, is the two crisis counselors that were to be funded in the second and third year of the program. They are meant to help address the acute shortage of therapists and mental health practitioners on the Outer Cape.
“This person would be able to see locals, regardless of their insurance status or ability to pay,” then-health director Morgan Clark told the select board in January 2021. “It would be like a stopgap — you could see them until you could get into a relationship with a longer-term mental health clinician.”
In the 2021 plan, the crisis counselors would be paid for by the town but hired and managed by a nonprofit health-care provider on a contract basis. The cost would be $132,000 per year per clinician.
That part of the program has been on hold, however, partly because Clark resigned as health director last October and partly because Town Manager Alex Morse told the select board he wanted to explore regionalizing both the crisis counselor program and the town’s health director position itself.
The health needs assessment that the three towns conducted this summer supports the notion that their mental health needs are similar and acute and could be approached regionally, Rowell said on Monday.
How Is It Paid For?
Select board Chair Dave Abramson asked if the marijuana revenues that were coming to the town were being collated against the mental health expenditures that were going out. Morse said that marijuana revenues go to the town’s general fund, and mental health expenses come from there.
Town staff including Clark and Assistant Town Manager David Gardner have acknowledged the potential connection between the revenue from “community impact fees” on marijuana dispensaries and the town’s new mental health and substance abuse programs. Towns were supposed to demonstrate that they were spending community impact fees on costs related to the presence of marijuana dispensaries — which could include mental health and substance abuse programming, Gardner told the select board last year.
Those community impact fees, however, have now been dramatically curtailed by a new state law (follow this link to see related story by Paul Benson).
Rowell told the select board that the towns are exploring grant programs that could help fund the shared mental health programs. Morse mentioned the possibility of support from a foundation, or from American Rescue Plan Act funds from the county government, that could supplement the town’s resources.
The local option tax on marijuana still exists — and Wellfleet receives local option taxes on marijuana sales as well — but Morse said that a detailed discussion of marijuana revenues would take place at an upcoming meeting.
