PENDLETON - Umatilla County intends to appeal a decision to decertify its Mental Health Department to deliver services to some 6,500 county residents who are covered by Greater Oregon Behavioral Health Inc. (GOBHI).
The health management organization based in The Dalles contracts with a dozen Oregon counties, funneling Medicaid funds from the state to individual providers, usually county health departments. GOBHI pays Umatilla County about $150,000 a month to provide mental health services.
Losing those funds would force the county to cut at least half of its mental health staff, said Mental Health Director Charles Carnes. It's the county's largest department, with about 80 employees.
Kevin Campbell, CEO for GOBHI, said in his "notice of decertification" that the action is the result of findings by a site review team that identified "significant deficiencies" and that Umatilla County Mental Health "continued to operate in a manner which presents an ongoing risk to the health and safety" of GOBHI clients.
County officials said they were blind-sided by the notice, because exit interviews after the last site visit in May by GOBHI and state reviewers led the county to believe it was headed in the right direction. But GOBHI'S written report from that review wasn't presented until late last week, at the same time it delivered its notice of decertification.
County officials were still reeling from the shock Monday. Commissioner Bill Hansell said the news was like telling a patient who is trying to lose 200 pounds and is half way there that they've failed because they didn't reach their goal.
"We're not trying to hide anything," Hansell said. "We've acknowledged we have problems and we've been trying to fix them. We thought we were progressing."
Campbell said he "would applaud the changes they have made" but that after consulting with the state, GOBHI determined that "while there has been progress, it has not been sufficient."
Since a state review in August 2002, reviewers have been pushing the county to improve its delivery of crisis services, including improving the paper files of its patients to avoid confusion or an incorrect prognosis in an emergency.
Campbell faults the structure rather than the personnel in Umatilla County. "They've hit some institutional barriers that have made it very difficult to deliver the necessary services," he said.
The county received 15 recommendations at the start of the year, some urgent, Campbell said, adding that its "inability to find a different model to deliver and integrate services has been huge."
Umatilla County has been unable to provide consistent services from a psychiatrist, he noted. A part-time hire in March did not work out and the county has continued to try to fill the position.
Connie Caplinger, director of Health and Human Services for the county, said the decertification notice will be appealed to the GOBHI board of directors, who will probably hear it in September.
Regardless, GOBHI will issue a Request for Proposals by Sunday for entities interested in providing mental health services in the county. The earliest a new provider could be hired and "on the ground" is October, he noted.
"If the county appeals, it would be reviewed in a timely fashion, and if the county was to prevail, the RFP would be pulled," Campbell said.
In the meantime, Caplinger stressed that it will be "business as usual" for Umatilla County Mental Health and that clients should be assured that services will continue to be provided as needed.
She expressed confidence in the county staff and the oversight county officials provide.
"I'm in favor of local control, and the local mental health authority is the commissioners," she said.