Clatsop Behavioral Healthcare is trying to stabilize

The Daily Astorian, July 18 2016

The new leader at Clatsop Behavioral Healthcare is working to stabilize the struggling mental health agency and identify the most vulnerable patients to ensure they receive quality care.

Amy Baker, the interim executive director, is trying to reassemble a crisis team weakened by staff resignations during leadership turmoil over the past year. The agency is also hoping to open a crisis respite center in Warrenton later this month that could help relieve pressure on hospital emergency rooms and the county jail.

“We’re never going to have the resources to be all things to all people,” said Baker, who took over in June after top administrators left amid public and internal criticism of the agency’s management. “But our absolute role and necessity is that we know who the most vulnerable are, and that includes both adults and kids.”

Clatsop County contracts with the agency to provide mental health services. The agency is part of Greater Oregon Behavioral Health Inc., which oversees mental health in several counties.

Baker, who was the director of prevention and trauma informed systems at Greater Oregon Behavioral Health, said her immediate priorities are to ensure client safety, improve community relations, open the crisis respite center and boost employee morale.

Crisis respite center

The crisis respite center was scheduled to open in April but was delayed in a dispute over whether the center would have secure rooms. Police and city leaders in Astoria and Warrenton wanted secure rooms so potentially dangerous patients could not simply walk away.

The partnership behind the respite center — the county, Columbia Memorial Hospital, Providence Seaside Hospital and Greater Oregon Behavioral Health — agreed that up to four of the 16 rooms would be secure.

Baker said Clatsop Behavioral Healthcare, which will operate the respite center for the partnership, hopes the facility can open next week. She said the agency is still awaiting state authorization for the four secure rooms, but licensing could come after the state makes an assessment in late August.

“Everybody that I’ve talked to feels like this is going to be certainly better than what we have right now,” Baker said.

Response to critical reviews

Complaints about Clatsop Behavioral Healthcare had circulated on the North Coast for years and, in many ways, were similar to the challenges in mental health care experienced across Oregon and the nation. But after a woman with a history of mental illness jumped off the Astoria Bridge in April 2015 — and it was discovered that she had multiple interactions with police and the agency in the months before her death — the agency came under greater scrutiny.

The agency is on track to respond to a critical Oregon Health Authority review in June that validated many of the public and internal concerns about management and quality of care.

The state review found that the agency will need regulatory oversight “until stability in the community mental health system is reached.”

“I think the things that they identified in that audit are all fixable,” Baker said. “And the challenges with CBH aren’t anything that people don’t already know and have heard about.”

The Oregon Health Authority review was provided to The Daily Astorian by an anonymous source in June. The state formally released the report to the newspaper on Friday in response to a public records request.

A separate internal investigation into Clatsop Behavioral Healthcare’s management was also conducted after the labor union that represents workers at the agency took a “no confidence” vote in the former clinical director.

The findings of the investigation have not been released publicly, and the agency has declined a request by The Daily Astorian to disclose the conclusions. Three top administrators left the agency after the investigation, and two federal lawsuits have been filed over management issues.

Baker said in an email Saturday that the agency is unable to release the internal report “because it contains personal and personnel information subject to attorney-client privilege.

“However, the CBH board took the findings seriously. Existing and newly installed CBH management are in the process of addressing the findings of the report. We have every confidence that the organization will be much stronger moving forward and more effective in partnering with other stakeholders and in serving the behavioral health needs in Clatsop County.”

Clear expectations

County Manager Cameron Moore believes it is important for the county to make clear what the expectations are for Clatsop Behavioral Healthcare going forward.

The county Board of Commissioners could hold a work session in August with Baker, the agency’s board, Greater Oregon Behavioral Health and the Oregon Health Authority to outline responsibilities.

“I think we’re all happy that we’re finally seeing things at CBH move in a positive direction,” Moore told county commissioners Wednesday night. “But I also think it’s very important now that the commission, the CBH board and state agencies make sure that we’re all on the same page going forward.”

Baker has been meeting with civic and law enforcement leaders throughout the county to help restore the agency’s reputation.

“It’s really been to reach out and thank them for their patience, assure them that we’re committed to being a strong, vibrant organization. That we’re open to problems, challenges, criticism,” she said. “We want to address that. We want to be an organization that this community is proud of.”

But she also knows she will be judged by whether the agency improves.

“I don’t expect people to just believe everything that I’m going to say,” Baker said. “They need to see action. So that’s what I’m going to do.”