Walla Walla County explores contracting out for mental health services

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WALLA WALLA — The county is looking at going back to putting mental health services for Medicaid clients in the hands of a private contractor — a move that would reverse a decision nearly a decade old.

County commissioners Perry Dozier, Greg Tompkins and Jim Johnson voted Monday to study a contracting plan.

Harvey Crowder, county Department of Human Services interim director, told commissioners it makes more sense at this time to have a private provider handle crisis response teams, housing for formerly homeless mentally ill people and behavioral health assessment and counseling.

“Change is coming,” he said, referring to measures under the federal Affordable Care Act being implemented. Now is the time to look for providers who can deliver mental health in primary care settings, he added.

About 40 Human Services employees working in mental health care will lose their county jobs if the county contracts out services, Crowder said, but he expects a contractor to hire back the same people.

“It’s hard to find well-trained and coordinated staff,” he said. “If the contractor wants to deliver, he’s going to need qualified staff.”

Finding an independent provider to deliver services is not about saving money or cutting services, Johnson said, but a way to improve options. Walla Walla County spends $4,073,276 yearly for all its mental health programs.

The idea surfaced when the county underwent the laborious process of trying to hire a psychiatric nurse practitioner, Crowder said last week.

“We asked, ‘Do we need to do this at all? Or are there options that allow contractors with more flexibility?”’

Nearly 10 years ago the county had contracted with Inland Counseling Network for several years to provide services. But a state financial audit unearthed deficiencies in the management. Worsening financial and personnel conditions added to problems and Inland Counseling eventually closed.

Since 2004 mental health care for Medicaid clients has been delivered at the county Department of Human Services office at 1520 Kelly Place, where a number of nonprofit social-service agencies do business.

Yet it was never the intention to keep Walla Walla County in that care loop, said Tompkins. The plan was to return to the contracted model when capable agencies were in place.

“It’s taken longer than we expected,” Tompkins said Monday. “It’s been a rough road.”

Nowadays the community is better positioned and more providers are available, he said, adding that under Crowder’s leadership, commissioners are getting a clearer picture of what mental health care is costing.

While any change is in exploratory mode for now, one possible element Crowder noted is that an outside provider may be able to expand its coverage to include non-Medicaid patients, which the county can no longer offer.

Since 2005 federal rules forbid states and their counties to use leftover Medicaid funds to serve non-Medicaid clients. Before that, many states used that funding to serve people who had no way to pay for health care.

Crowder also anticipates an incoming provider would want to continue to use the same space where services are now delivered. “The set up here is ideal, it’s associated with a lot of the helping agencies, too.”

The money generated by a one-tenth of 1 percent sales tax would continue to go to mental health care through the county, Crowder told commissioners. The only real eventual savings would be a little less overhead costs, he added.

Expected savings are estimated to be about $715,000, said Christine Roberts, fiscal and operations manager for Human Services, this morning.

“I think in the long run, this is the best thing in the community, to have more mental health in the community than this system currently can offer,” Crowder said.

Sheila Hagar can be reached at sheilahagar@wwub.com or 526-8322.

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