From The Oregonian – February 22, 2003, no longer online
Multnomah County notified the Oregon Department of Human Services on Friday that it is terminating its mental health outpatient contract under the Oregon Health Plan because of drastically cut state money.
The decision could mean the end of county-provided help to about 10,000 indigent adults and children on March 25.
County officials say they still hope to renegotiate terms to maintain some level of care. But they say they have been talking unsuccessfully with state employees for several months about modifying the agreement, which has been renewed on an annual basis since January 1998.
“So it’s gonna be really bad, or it’s not gonna happen,” said Peter Davidson, director of the county’s Mental Health & Addiction Services Division. “I’ve never heard of a big city mental health system taking cuts this fast.”
In a letter to Madeline Olson, assistant administrator of the state Office of Mental Health and Addiction Services, county Chairwoman Diane Linn said a series of three state budget cuts in effect Feb. 1 and March 1, plus an expected further reduction this spring make it impossible for the county to comply with the clinical and fiscal provisions of the contract.
Being under contract without enough money puts the county at risk for paying hospital expenses for needy people because they will have nowhere else to turn, and the county’s dwindling budget does not have the money, officials say.
“As long as we have responsibility for the system, we have responsibility for the outcome,” explained John Ball, county chief operations officer.
The contract includes funding for a myriad of services to help keep mentally disabled residents in crises out of hospital emergency rooms and jails. The care includes help through primary care providers and walk-in clinics.
Multnomah County is the only county that has given the state a termination notice or sought modification of this service contract, Olson said.
She said receiving the notice was not a shock, because of the discussions.
“We will continue with contingency plans,” she said, “and come to whatever resolution we can to assure services continue to be available to people covered by the Oregon Health Plan.”
“That’s what we hope, too,” Linn said. “We’re hoping it doesn’t affect anyone,” but people will be feeling the result of human services cuts and the failure of Ballot Measure 28 to restore some cuts.
“Anybody who thought everything was gonna work out OK . . . this is the kind of fallout” on the way.
Davidson thinks that without change, the current money climate with the state will “basically end the adult mental health system in four months.”
The proposed Oregon Health Plan budget “has very little money, if any, for the adult mental health system,” he said.
The county has received $33 million annually in federal Medicaid money under the Oregon Health Plan contract for adult and children outpatient services. Davidson said the budget for adult Medicaid eligible outpatient services at the start of this county fiscal year, July 1, 2002, was $23 million. Federal, state and county cuts this year have reduced that by $11.5 million, including $5.7 million in state cuts in the past five weeks.
The contract is administered through a county program called Verity, which in turn contracts with 60 subcontractors. The largest is Cascadia Behavioral Healthcare, which just announced plans to lay off 180 employees this month and close 10 sites by mid-March. The next largest are Oregon Health & Science University and the Morrison Center.