Opinion / Editorial from the Tri-City Herald, April 17 2009

For an agency with such an important mission, Greater Columbia Behavioral Health is kind of a mess.

First, the board of directors abruptly stopped the hiring process for a new executive director last month. It turns out that all five applicants were connected to the agency.

Board members rightly worried about the potential for conflicts of interest and wondered whether a search that attracted only insiders was broad enough to reach the best prospects.

So even though the agency was down to the final phase of hiring, the board launched a new search to widen the pool of candidates. The interim executive director will remain in place until further notice.

That was in March.

In April, the board voted to reconsider the makeup of its membership. It currently is composed of county commissioners and behavioral health providers from 11 counties in Eastern Washington.

County commissioners can appoint alternates to serve in their place on the board, which directs the course of the state-funded network.

Many of those alternates turn out to work for mental health agencies that have a financial stake in the board’s decisions.

No matter how well intentioned the participants are today, the potential for abuse under such a lax system raises a huge red flag. The board oversees a $59 million annual budget.

Benton County commissioners are leading the charge to change the composition of the board.

The revised board proposal would require that all Greater Columbia board members be county commissioners, even if they are serving in the role of alternates. No providers would be allowed.

A 7-4 vote has sent the measure back to each of the counties for a vote.

Benton County Commissioner Max Benitz says that having care providers on the board challenges its integrity, whether the potential conflicts of interest are real or only perceived.

Benton County commissioners feel so strongly about the issue that they might pull the county out of the agency altogether if changes aren’t made.

That could inflict serious damage on the altered agency, since its funding is based on population. Benton County is the largest in the network and could contract directly with the state for behavioral health funding.

A report from a Portland consulting firm backs up Benitz’s concerns, advising that no board member, alternate or staff member in a regional support network represent a provider receiving more than 5 percent of the funding.

Including stakeholders who are in the trenches doing the diligent work of mental health care on the board makes some sense. They understand the needs in our region.

County commissioners, on the other hand, are further removed from the work and less attuned to the issues.

But commissioners also are used to being briefed on challenging topics and making financial decisions in the best interest of the public. That is, after all, their job.

One potential solution could be to have an advisory board made up of providers. They wouldn’t make funding decisions, but they could function as a source of expert guidance to the commissioners.

We agree with the Benton County commissioners that it’s a sticky situation to have providers on the board. Real or imagined, it creates a cloud over the agency’s good work.

And given the delays in finding a new executive director, it seems like a good time to make the move.

EXTRA – Map of Greater Columbia Behavioral Health’s services in SE Washington.

OUR COMMENT – It’s important for our community to track mental health agencies from neighboring communities because of the long history of these agencies migrating difficult patients to Portland and Salem.