Provider warns PacificSource'9s proposed 17% cut could force Crook County to curtail intensive mental-health programs
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Summary
Melissa Thompson of VESTS Care told Crook County commissioners PacificSource is proposing a 17% reduction to the county'9s community mental health contract (about $500,000), a change that could jeopardize intensive services such as ACT, wraparound and in-home behavioral health treatment while providers seek alternate funding.
Melissa Thompson, who identified herself as "chief labor, health officer for VESTS Care," told Crook County commissioners on Jan. 14 that PacificSource has proposed reducing the county'9s community mental health contract by about 17%, a cut she estimated would equal roughly $500,000 for Crook County. "The current proposal that they have proposed would be a 17% decrease, which would be approximately $500,000 less," Thompson said.
Thompson said the contract contains two payment elements: a fee-for-service rate and a per-member-per-month (PMPM) payment. She told the board that PacificSource'9s proposal would cut the fee-for-service rate substantially and reduce the PMPM payments, which together widen the shortfall for providers. "They cut not only the rate by approximately 60%, but they also cut our PMPM," she said, describing an acute budget gap for local services.
She described the immediate program-level trade-offs: programs that serve the highest-need clients, including Assertive Community Treatment (ACT) and wraparound services for children, are the most expensive to operate and are therefore most at risk. "ACT... is meant to treat the folks that are the most severely mentally ill folks... It's not that many people," Thompson said, estimating ACT serves about 20 Crook County residents. "If we are not able to provide that program, all of those other services will feel that."
Thompson said VESTS Care has submitted counterproposals and was awaiting PacificSource'9s response; she described PacificSource'9s current negotiation posture as largely unmoving on rate. She also said the organization intends to apply for certification as a Certified Community Behavioral Health Clinic (CCBHC) when Oregon opens applications later this month; Thompson cautioned, however, that CCBHC payments (if the county is accepted) would not begin to offset losses immediately, saying it could take "approximately 18 months" for payments to start.
Thompson urged the board and regional partners to press PacificSource and the Central Oregon Health Council for explanations and possible interim support. Commissioners agreed to help craft a letter and to feed Thompson bullet points to ensure the council and PacificSource understand local impacts. Thompson said she planned to meet with PacificSource'9s CCO director the next day and to contact Ebony Clark, the behavioral health director at the Oregon Health Authority, after receiving any further counterproposal.
The public-comment exchange ended with Thompson'9s pledge to keep the board updated on the contract negotiations and the CCBHC application. The board noted the county could face compliance risks if services lapse before a contract is finalized and encouraged continued coordination among VESTS Care, the health council and OHA.