PENDLETON - Tina Forman is unhappy with Umatilla County's Mental Health Program services.
A client off and on for 12 years, she said she needs help, but has been unable to get it. The names of her counselors come and go, each time forcing her to retell her story and start at the beginning with therapy. Her paperwork is in disorder, she said, so sometimes she is prescribed medication she is already on.
And when Forman, who is bi-polar, needs immediate attention, she said she finds it difficult to talk with the crisis workers.
"I'm getting sicker and sicker, and I'm very upset that they're not available for me," she said. "I'm really stuck. I don't know what else to do. They're not listening. They're not helping. It's very difficult to live like this."
Stories like Forman's are the reason local health care professionals are flurrying to submit a proposal to form a private, nonprofit organization to replace UCMH.
A group of about 20, representing a mix not only of private and state-employed practitioners but also several former UCMH directors, met with county commissioners last week and said they had lost faith in the county's mental health services program. They contended it was beyond repair and needs to be replaced.
That information came on top of notice that the county's mental health program could be dismantled in less than a month. Both the state and the county's health care manager, Greater Oregon Behavioral Health Inc., recently sent decertification notices to the county. GOBHI's report said the county's practices raised liability concerns too great to continue contracting with the county.
The county's insufficient medical records and lack of timely access to medication management services were identified as significant problems in the reports, as was its lack of a medical director.
In addition, the report said crisis services are not meeting the health and safety needs of the community, a repeat finding from earlier reviews.
Connie Caplinger, executive assistant to the board of commissioners and spokesperson for the program, said the county staff has attempted to resolve issues of concern.
"I'm not saying that we haven't at times made calls off the mark," Caplinger said. "But each time that has occurred we've gone back and debriefed and used it as a learning opportunity."
The county intends to appeal both decertification notices, said Dennis Doherty, chairman of the board of commissioners. The board will meet Tuesday to formally vote on whether or not to appeal its decertification. In the meantime, Doherty said he is waiting to hear from the group of health care professionals who met with him last week to express their concerns.
Without their support, Doherty said it will be difficult to convince the state that the county can make good on a promise to change. Submitting the proposal for the separate organization will effectively be a vote of no confidence, Doherty said.
A proposal is being worked on, said Terry Edvalson, a facilitator from La Grande coordinating the group. In the meantime, the group is consulting with the members' respective agencies and employers to get approval to submit the proposal Wednesday to GOBHI.
Feelings run strong about the county's inability to repair its system, Edvalson said.
"This is something that's been festering, and it just came to a head," Edvalson said. "Umatilla County is blessed as a rural county with resources. When they aren't being used, something's wrong."
The county has been under intense scrutiny by the state and GOBHI since a mental health review in August 2002. It has made a number of changes to its program and thought it was making significant progress in addressing concerns, including recently hiring a medical director to oversee its operations. If given more time, a deep, systematic change can be made to satisfy everyone's worries, Doherty said.
Many of those professionals aren't so sure, however.
"It is apparent to a number of us that for quite some time the services have deteriorated," said Bruce Barnes, who was medical director of the UCMH from 1976 to 1983.
At last week's meeting with the county commissioners, Evelyn Jenson and Joel Rice, also former directors of UCMH, said they feel the county's services are putting people at risk.
Maxine Stone, superintendent of the state-run Eastern Oregon Psychiatric Hospital, said she hears Forman's concerns echoed by clients and family members.
"We're concerned about a tragedy happening in the community," Stone said.
In addition, she said she has seen a high number of Umatilla County residents hospitalized, something that shouldn't occur if the county was providing adequate services.
"Hospitalization should be the last thing," she said. "It's the most restricted level of care."
Barnes said he maintained contact with the county's clients through a private practice he started when he left UCMH. And, though recently retired, he sits as a court-appointed examiner for commitment hearings for the severely mentally-ill. In that position, he has been witness to testimony from clients and family members regarding the quality of care they are receiving in the community.
He said it appears the least trained staff are working with the most severely ill. It's a bigger problem than simply tight budgets and lack of personnel, he said, it's at least in part a problem of allocating what resources there are.
To fix it will take "a major restructuring of services and how they are provided," he said. "I don't have a bias as to how that is done, but it has got to happen and it's got to happen quickly."