Symmetry Care outlines services, contract scope and jail crisis work as county reviews renewal

Symmetry Care representatives briefed the Harney County Court on the nonprofit’s services on Wednesday and said the county-funded contract that covers non‑Medicaid safety‑net behavioral health services must be renewed by July 1.

The presentation described the contract as covering non‑Medicaid crisis and safety‑net services for uninsured or underinsured residents, jail crisis services, civil commitment evaluations and community outreach. Chris Signer, Symmetry Care’s director, said the county contract delegates responsibility for non‑Medicaid services to Symmetry Care and that the agreement is separate from Oregon Health Authority contracts governing Medicaid services.

Signer and other staff outlined recent quality and compliance work: Symmetry Care is a certified community behavioral health clinic (CCBHC) with an OHA certificate of approval; a GOBI (Oregon Medicaid regional behavioral health) audit conducted in 2023 produced four findings that Symmetry Care says it addressed and that the state verified in a November 2024 follow‑up; and the organization reported a 2024 average client satisfaction score of 4.37 out of 5. Ashley Vander Dawson, a psychiatric‑mental‑health nurse practitioner with Symmetry Care, described clinical services performed at the Harney County Correctional Facility, including 24‑hour crisis responses, psychiatric medication management, long‑acting antipsychotic injections and SUBLOCADE (medication for opioid use disorder) administration.

County commissioners and staff asked for clarification on what the county contract does and does not pay for. Signer said the county contract covers non‑Medicaid “safety net” services for people who are uninsured or lose Medicaid while in custody; when a detained person regains Medicaid coverage on release, Medicaid then pays for ongoing services. Signer also said that some jail patients with severe needs are routed to the Oregon State Hospital for inpatient evaluation and restoration; that state hospital access can be limited; and that proposed state legislation could change how Medicaid coverage is handled for people detained in jails.

During public comment, resident Barbara Kennedy raised concerns about Symmetry Care’s use of tax‑exempt housing and about whether Symmetry Care’s staff provide services to people who are intoxicated. Symmetry Care staff answered that their certificate of approval with OHA authorizes care for people with alcohol and drug disorders, that staff provide in‑home and in‑facility services including residential programs, and that roughly 98 percent of Symmetry Care’s clients are Harney County residents. Signer said the organization serves about 500 people for assessments over the course of a year, and that some services are delivered to out‑of‑county visitors or people passing through Harney County.

Signer said Symmetry Care’s current county contract runs through June 30 and that the county and Symmetry Care need to locate, review and sign the updated contract before July 1. He noted a clause identifying a “key person” that would need to be updated because he plans to retire and Emily (first name only in the record) is the incoming director. No formal county vote on the contract occurred at the March 19 meeting.

Symmetry Care staff also discussed community programs the organization operates, including a Fresh Start job‑training coffee program that has helped employees transition to community employment, weekly adolescent groups and community education events. Staff described improved client engagement metrics over 2023–24 and said clinical measures such as PHQ‑9 depression scores improved on average during treatment episodes.

Signer and staff invited further questions and asked the county to locate the existing contract packet for review. Commissioners and staff acknowledged the need to review the contract language (including the key‑person clause) and to complete signatures before the July 1 expiration.

Ending: The county did not take formal action on the contract at the March 19 meeting. County staff and Symmetry Care agreed to locate and circulate the draft contract so the parties can sign an updated agreement prior to July 1.