By MIKE FERGUSON
Baker City Herald
Baker County Commissioners Wednesday gave Mountain Valley Mental Health a year-long extension on a contract to provide community mental health services.
All three commissioners voted yes.
Mountain Valley's board of directors and other supporters referred to a site review from the Oregon Department of Human Services Addictions and Mental Health Division, delivered this week, as proof that MVMH is meeting its state-mandated requirements.
State inspectors said MVMH exceeded the standards defined by state regulations in the areas of providing services andquot;consistent with evidence based practices,andquot; including peer support services and medication information and education; and productivity and volume of services (MVMH provided services to 35 percent more people in the past year with andquot;relatively the same number of staff,andquot; the report indicated.)
MVMH failed to comply with other standards, according to the inspectors, including: quality assurance requirements; personnel records, where some employees were missing job descriptions and some had no criminal background check; and needed medical services, including some agencies' complaints about MVMH's shift from direct service to teleconferencing, a move that MVMH executive director Vicki Long said was necessary because of rural communities' difficulty in attracting people qualified to provide psychiatric services.
Those non-compliance issues are being addressed already, Long said.
County Commission Chair Fred Warner Jr. said he was andquot;really happyandquot; with the generally positive site reviews by state inspectors and by Greater Oregon Behavioral Health, Inc., an accrediting organization that visited MVMH at the same time state inspectors did, April 16-18.
Warner called for an end to the andquot;fightingandquot; that's gone on for more than a year between the MVMH board and the county's Advisory Committee on Mental Health and Developmental Disabilities.
andquot;It's been a difficult couple of years. We're still fighting over openness,andquot; Warner said of the struggle between the two groups. andquot;Fighting does no good. We need the advisory committee to work with MVMH to decide what are the needs and how do we address them.
andquot;I don't believe Mountain Valley has anything to hide,andquot; Warner added. andquot;I encourage their board to open up as much as possible.andquot;
Mountain Valley asked county commissioners for $12,000 to help re-establish mental health counseling at the Pine-Eagle Clinic in Halfway, a service the agency terminated last year because of financial constraints.
Gary Dielman, chair of the county's advisory committee and a frequent critic of MVMH, asked commissioners to require the agency to submit its financial records as part of the new contract.
andquot;If you don't have the rest of their budget, you don't know if they really need the $12,000,andquot; Dielman told commissioners.
County Commissioner Carl Stiff, a former ex-officio member of the MVMH board of directors, said he frequently reported the agency's financial status to his fellow commissioners.
Larry Levinger, former MVMH board chair, said the board of the non-profit agency had been advised by the state to not submit its budgets to county commissioners. Doing so, he said, would make the budget a public document, and thus available to the media and any member of the public.
As a private, nonprofit agency, MVMH does not have to comply with Oregon's public records law. That law requires public agencies, among them counties and cities, to make available to the public all manner of records, including budgets.
During the most recent fiscal year, which ended June 30, MVMH either broke even or finished slightly in the black, Levinger said, a change from the past few years, when the agency had to spend hundreds of thousands of dollars in reserves to provide needed services.
MVMH accumulated those reserves during the late 1990s when mental health payments from state and federal sources were higher, Levinger said.
The agency's 2007 audit showed a $266,000 loss, according to MVMH's budget message. The year before the loss was $206,000. A significant portion in the losses was andquot;due to attorney fees accrued in 2007,andquot; according to MVMH's 2009 budget message.
andquot;Every attemptandquot; was made to cut expenses in the fiscal year just completed, and productivity has andquot;significantly improved,andquot; the budget message indicated.
In 2008, the agency performed 5,207 of what it calls andquot;client visitsandquot; 3,124 adults and 2,083 children.
andquot;During the last two months, we have worked on the 2009 budget, which was completed last week,andquot; the budget message indicated. andquot;We continue efforts to keep expenses down. The increased GOBHI payments coupled with our high productivity and improved billing should allow for a profitable year.andquot;
Part of that increased profitability will go toward 3-percent pay raises for the MVMH staff, which andquot;has worked exceedingly hard for several years without a significant increase in salaries,andquot; the budget message said. andquot;We used part of the projected 2009 profit to give the staff a well-deserved raise. In spite of this, the 2009 budget will remain positive.andquot;
In addition to re-establishing services at the Pine-Eagle Clinic, MVMH identified these objectives for 2009:
n A 24-hour hold bed for people detoxifying from alcohol or drug use, which would provide andquot;a safe environment for the patient to stabilize so that a proper evaluation could be completed.andquot;
n A therapeutic foster care home for minors that could provide more advanced care than a typical foster home and allow most at-risk children to remain in the community
n More services to seniors.
andquot;Mountain Valley Mental Health has come a long way,andquot; Levinger told commissioners. andquot;We've made a number of changes, we're back, and the state says it's proud of where we are.andquot;
Commissioner Tim Kerns thanked Levinger for his andquot;many years of service to the board.andquot;
But some in attendance Wednesday questioned Levinger's assessment of the progress the agency has made.
andquot;I'm not sure at what point we can believe Dr. Levinger,andquot; said Vickie Valenzuela, a member of the Healthy Mental Health committee, which started after a 2006 state site review uncovered 16 deficiencies at MVMH. andquot;From the beginning he's said that everything's fine. Great progress has been made, but because of past history it's still a concern.
andquot;Healthy Mental Health's agenda all along has been, are mental health services being adequately provided to the community? I'm glad,andquot; Valenzuela added, andquot;that you commissioners recognize your oversight responsibility. Before one dollar of county money is given, the least they should do is provide the county and the people with a budget. Accountability and openness should accompany those dollars.andquot;
Dielman warned commissioners that without careful oversight, andquot;you could wake up one morning to see Baker County in the same situation as Multnomah County,andquot; with its financially troubled mental health provider, Cascadia Behavioral Healthcare.
andquot;It's all but bankrupt, and you don't want to be caught in that kind of situation,andquot; Dielman said.
There's not much chance of that happening, said Mike Durgan, who said he recently spent time with a Cascadia board member. andquot;It's in no way relative to Baker County,andquot; Durgan said.
Durgan identified himself as a client of Mountain Valley Mental Health and said he believes staff there have andquot;a strong desire to help people.andquot;
andquot;They treat clients and each other in a positive, respectful way,andquot; Durgan said. andquot;They've done an extraordinary job addressing real concerns. They're a real gem in our community.andquot;