Mental Health Association of Portland

From the East Oregonian, April 13, 2013

Natalie Sanusi hopes that one day mental illness will have the same acceptance as diabetes, asthma and other physical conditions.

When depression and anxiety struck Sanusi in her 30s, she pushed on, going to work and hiding her symptoms. Her condition finally devolved to the point where she thought about killing herself just to stop the despair.

Natalie Sanusi – Erasing The Stigma Of Mental Illness

When the Pendleton woman eventually shared her situation with others, they often made well-meaning, but inappropriate, comments. Some directed her to try harder or have more faith in God.

Sanusi read between the lines.

“They were saying you should be able to pull yourself up by your bootstraps,” she said. “Your disease is your fault.”

Even in her blackest moments, she balked at that. She realized her problem was largely chemical and did not stem from lack of character or self-discipline.

“You’d never say to a diabetic, ‘If you had willpower, you wouldn’t have diabetes,’” said Sanusi, 43. “You shouldn’t say these things to people with mental illness.”

Actress Glenn Close feels much the same as Sanusi, enough to start a website devoted to erasing the stigma of mental illness called bringchange2mind.com.

“Glenn’s sister, Jessie, was diagnosed with bipolar disorder at the age of 47,” said executive director Pamela Harrington. “Her nephew was diagnosed with schizoaffective disorder.”

In a Huffington Post website video on the website, Close talks about how her nephew lost most of his friends and her sister stayed quiet about her diagnosis, thinking other parents wouldn’t let their children come to her house to play with her children.

“The stigma that surrounds mental illness can be worse than the disease itself,” Close said.

The Academy Award-winning actress, famous for her role of a disturbed woman in “Fatal Attraction,” teamed with director Ron Howard to create a video to ease the stigma. The minute-long video, filmed in Grand Central Station, features people wearing white t-shirts bearing the name of their mental illnesses. Close walks alongside Jessie, clad in a white shirt that says “sister.” The camera pans, showing numerous white shirts dotting the cavernous space, illustrating that one in six adults have a mental illness (a quarter of us will be affected sometime in our lives) and most of the rest know someone who does.

Harrington said she believes mental illness will gradually be normalized. People once whispered about HIV and cancer, she said. Mental illness will also find acceptance.

“It’s a matter of time,” she said. “We’re at the tipping point.”

Kevin Campbell, director of Greater Oregon Behavioral Health, Inc., said shame keeps many people from seeking help in the early stages. Rather, many wait until symptoms ratchet up with a psychotic break or other dramatic downturns. Until then, “they’re all alone trying to deal with their challenges.”

“The earlier we get in front of it, the less damage it will do,” Campbell said.

Sanusi said she got the help she needed and has the support of her mother and close friends. The former teacher can no longer work but medication, exercise and therapy keep her symptoms at bay. She finds fulfillment through art and other avenues.

She urges others with mental illnesses to tell their stories.

“Mental illness has got to be normalized,” Sanusi said. “People need to see mental illness the way they see any other ailment.”

She suspects public perception is skewed by hearing about the most dramatic cases, such as shootings in Newtown, Conn., and Aurora, Colo.

“There’s this idea that the mentally ill are all ranting on a street corner somewhere,” Sanusi said. “That’s not the case.”

From the Medford Mail Tribune, January 27, 2013

Journal entries penned a year before Rachel Rice‘s death tell the tale of a loving mother struggling with serious mental illness, and of a failed mental health care system, her daughter says.

“Many unfortunate local events have stemmed from mental illness, and especially from lack of care,” says Lindsey Rice-Meilicke. “This puts the person suffering in danger and, in extreme cases, others as well.”

Judges, county mental health directors and local police agree and say they are pushing for change.

A fledgling mental health court is taking wing. Properly staffed centers designed to provide wraparound services and a sense of community are in the works to replace those shuttered in recent months. And police are being better trained in handling the mentally ill, as law enforcement officers often are the first responders for those experiencing a mental health crisis, says Stacy Brubaker, the new division manager at Jackson County Mental Health.

The county’s new $28.5 million, 86,000-square-foot, two-story health services complex will handle a caseload that is expected to rise from the current 23,000 clients to 45,000 by the time it opens in 2014. Mental health, alcohol and drug programs, immunizations, vital records, food licenses and disability services all would be available in the new health building, officials have said.

Brubaker was hired as the crisis manager for the county’s Health and Human Services Department in August, and promoted to mental health division manager in mid-November, she says.

“It is really up to us to deliver good services and coordinated care,” Brubaker says. “And I truly believe people are best treated in their own communities.”

Rice-Meilicke is hoping changes are on the way. And that sharing her mother’s story will help take the stigma off of mental illness and persuade legislators and the community to fund and support programs that care for those afflicted. Short-shrifting the mentally ill puts “a huge emotional and financial strain on everyone,” Rice-Meilicke says.

“I wish people would see that. See the realities of what is happening,” she says.

Rachel Rice graduated with honors from Crater High School in 1977. She loved cheerleading, baking, crocheting, making people laugh and being a mother. But for the last two decades of her life, the 46-year-old also battled paranoid schizophrenia. Frightened and delusional when in the grips of her illness, Rice was last seen by a high school friend, walking barefoot on Old Stage Road on Aug. 2, 2005. Moments later she melted away into the Central Point hillside and was lost forever, her daughter says.

“She had a tendency to walk from her troubles when she was scared,” Rice-Meilicke says, adding her mother had a history of running away, but that she was never out of contact for more than a few days.

For seven long years, Rice’s family had little hope she was alive but no closure. Then, on Jan. 5, a miner discovered Rice’s remains in a remote area off Old Military Road. Police found no evidence of foul play. Rice likely died of dehydration and heat exhaustion either around or on that hot summer’s day, Rice-Meilicke says.

“We need to pay more attention to why this is happening and what we can do to help, instead of waiting until things are already happening. And then there’s a crisis that can’t be undone,” she says.

Rice-Meilicke, now 32, was just 7 years old when her mother was diagnosed. Her brother and only sibling, Steve Rice, now 31, was even younger. Before she hit her teens, Rice-Meilicke had learned the hard truth about trying keep her mother safe: There aren’t enough advocates for the mentally ill. Consequently, there aren’t enough beds, there aren’t enough programs, there aren’t enough laws and support systems in place to protect those who need it most. And that needs to change, she says.

“I was about 10 or 12 years old. And I would be in the hospital room with my mother, who would be saying and doing all sorts of crazy things, and they’d be working on paperwork to release her,” Rice-Meilicke says. “How crazy is that?”

Having a mentally ill person civilly committed to care is difficult because of Oregon laws, says Jackson County Circuit Court Judge Lisa Greif. Even when there are good reasons to believe a person would benefit from being placed in a care facility, the legal standard for commitment remains extremely high, she says.

All too often those battling mental illness will end up in the criminal court system — usually not the most appropriate remedy, the former defense attorney says.

“Our options are the state mental hospital, jail or prison,” Greif says, adding the “revolving door” aspects between the mentally ill, police and justice officers had everyone wondering, “What can we do better?”

Rice-Meilicke was disappointed to discover Jackson County’s two client-run, drop-in day centers for the mentally ill, DASIL and Hawthorne House, closed last fall. She had hoped, in lieu of flowers, people might send a check to Hawthorne House.

“She worked in the kitchen and baked cookies there,” Rice-Meilicke says. “People who struggle with mental illness don’t want to focus on that aspect of their lives. They want to have fun and be productive, if they can, and be in a place where they are not judged. They need to have a sense of community.”

Brubaker agreed having to permanently shutter the county-run Hawthorne House was “discouraging.” But plans are in the works to create a better “club house model” area at the new health complex that will be similar to Hawthorne House. It will offer attendees a sense of community in a stable, “peer-supported” manner, and also provide education assistance and job training opportunities, she says.

“We all need a place to be. And when you don’t have a place to be, life gets harder,” Brubaker says.

The county also plans to provide a crisis intervention service center that can care for up to five people at a time, she says.

“It will provide people a chance to feel supported and regroup,” Brubaker says.

Just five months before her final disappearance, Rice was “kicked out of foster home after foster home due to her medications not stabilizing her,” Rice-Meilicke says, adding Jackson County Mental Health workers told her they had “no further options.”

Rice was housed in an apartment and expected to manage her own medication — more than a dozen prescriptions in four or five daily doses, her daughter says.

“It was a recipe for disaster,” Rice-Meilicke says.

Medical records show Rice sought treatment at local emergency rooms half a dozen times in the space of one month. Numerous times, Rice became hysterical and called 911, her daughter says.

“The majority of times when somebody is sick, but not getting the help they need, it puts a huge strain on everyone, including the police,” Rice-Meilicke says.

Brubaker’s goal over the next three years is for every law enforcement officer in Jackson County to receive training in crisis response to the mentally ill. Brubaker and a staff member, along with two Medford police officers and a representative of the Jackson County Sheriff’s Department, will attend a weeklong “empathy-based” training in Utah soon, she says.

The five who attend the February sessions will become trainers for the rest of the county’s law enforcement officers, she says.

All but three members of the Ashland Police Department have received the training, as have several others in departments throughout the valley, she says.

Medford police Chief Tim George says he fully supports the mental health training for his officers. A lack of services because of budget cuts has collided with increased need and burgeoning drug and alcohol issues, he says.

“There’s been a huge snowball effect,” George says, adding mental health calls have jumped 25 to 50 percent in the past two years.

His officers responded to 664 mental health calls in 2012. Of those, 344 were suicide threats or attempts, he says, and officers had to put someone in temporary, protective custody 397 times.

“This can create a serious officer safety issue,” George says. “Any time we can get better training, it helps us get better at what we do. It benefits our officers, and the community we serve.”

There are a dozen beds in the only psychiatric unit in Jackson County. The hospital ward does what it can, but it can only triage those experiencing the most critical mental health crisis. The minimal space available means that often the person whom police brought to the hospital is released before the officer has finished writing up the paperwork on the case, George says.

“We see them walking across the hospital parking lot,” George says. “There’s only so much capacity. When there’s no room at the inn, and someone is having a mental health crisis, what are you going to do?”

George credits the William Moore sobering center at Addictions Recovery Center for providing a stopgap temporary “safety valve.” Dual diagnosis is common in the mentally ill, which brings addiction issues to the fore, he says.

Police officers rely upon the ARC’s sobering services to provide a safe haven for those who cannot be legally or professionally evaluated for mental illness because they also are under the influence of intoxicants, George says.

Sometimes, when that facility also is full, George’s officers have been known to drive mentally impaired citizens around in their police vehicles for a time, or bring them to the police station “for a cup of coffee,” he says.

“It helps us buy time, keep them safe, and try to find a relative or someone who might be able to help,” he says.

Greif, George and others on the county’s public health safety panel have begun identifying “frequent fliers” who are shuttled in and out of the criminal justice system fundamentally because of mental health issues.

With no budget and no formal courtroom, Greif volunteered this summer to perform early morning informal hearings with one woman who was at the top of the list, whom she declined to identify.

“I would definitely consider taking on another individual or two,” Greif says, adding she is hoping to lay a framework for creating a mental health court, similar to the county’s successful family and drug courts, when state and county budgets improve.

“It’s a great start,” Greif says. “And the more we can put our heads together, the better for our whole community.”

The woman, her public defender, her mental health worker, the district attorney and Greif have been meeting regularly. They have created an action plan for her and provided wraparound services to ensure she is getting medical and dental care, and proper housing. The one-on-one attention from a judge and the other collaborators has connected this woman to her community — and changed her life, Greif says.

“She has had no contact with police and no complaints since September,” Greif says.

Rice-Meilicke says she will advocate for the mental health court and the other changes.

“This is all very encouraging,” Rice-Meilicke says.

Rice-Meilicke recently discovered her mother’s journal and a long-lost letter her mother had written to her. Rice writes about being frustrated and afraid, and also about being strong and hopeful, Rice-Meilicke says.

Rice acknowledges she appears to have gone “downhill” to some, countering that she is gaining insights into her own strengths as well, her daughter says.

“She did feel strong,” Rice-Meilicke says. “But she didn’t understand why (her mental illness) had to be happening. She wrote, ‘I’m hoping there’s a reason for all this.’”

TRIGGER WARNING: THE VIDEO BELOW, FROM KTVZ.COM,
SHOWS EXPLICIT TORTURE AND MAY BE TRIGGERING

From KTVZ.com, November 6, 2012

Curtis Hooper of Prineville is suing two counties, the city of Prineville and 15 people in federal court for more than $5 million. Having had frequent run-ins with the law, he says police in Jefferson and Crook county have harassed him for years. But last year, he says, it was taken to a new level.

Hooper is still recovering from what he says a former Jefferson County Jail deputy did to him in May of 2010.

“It’s hard to get over,” Hooper said Monday.

Photos provided to NewsChannel 21 show Hooper’s left hand last May, bloodied and with his fingernails turning black and blue.

“I passed out — as soon as they opened the door, I passed out,” said Hooper.

Information NewsChannel 21 was given confirms deputy Rob Robbins kicked a steel door shut on Hooper’s hand. Eight days later, Robbins was fired. Robbins was charged with assault and later agreed to a plea deal in Wasco County as the case was tried before the district attorney in The Dalles.

“While they did something, it was too little, too late,” said Hooper’s attorney, Andrew Mathers, who filed the suit late last month.

Mathers says Robbins had been reprimanded several other times for bad behavior. He told NewsChannel 21, Robbins had been written up for assaulting another inmate, pulling over a woman while in his own car and civilian clothes while off-duty and out of his jurisdiction, assaulting Hooper once before the steel door incident, and having sexual relations with a woman who was a former inmate.

All of that is confirmed in the information NewsChannel 21 was given.

After Hooper’s fingers were slammed in the steel door in Jefferson County, he was not taken to the hospital. Three weeks after the assault. he finally got X-rays, and found out the bones in two of his fingers were shattered. An auto mechanic by trade, Hooper says he can’t work because his fingers still need surgery.

Hooper grew up in foster care and has had his share of run-ins with the law, mostly misdemeanors. His attorney admits that Hooper has a reputation with police for being mouthy and aggressive.

“He’s got a foul mouth and he swears and yells in anger,” said Mathers.

But Hooper’s attorney attributes his client’s bad attitude to a fear of law enforcement, combined with his mental illnesses.

Hooper was serving a 90-day sentence for violating his parole when Robbins attacked him. That assault wasn’t caught on tape, but Hooper says others were.

Hooper has a hard time watching the video of a Prineville police officer bending his fingers back.

“I hate them — it’s horrible,” said Hooper.

The night that video was taken, Hooper’s friend called 911 thinking, he’d overdosed on pills. Medics arrived and found him to be fine.

But then the police came.

Hooper says he was handcuffed, pepper sprayed in the face and Tased by Prineville police. Later, they took him to a hospital, where he was restrained.

It’s unclear why the officer is touching Hooper in the video in the first place. But it is clear that everyone in the room was made aware the camera was running as one of the people in the room says something to the affect of audio and video are being recorded.

Mathers says what you see in the video of Hooper with Prineville police officers is blatant torture. He added that he was surprised the tape of what happened hadn’t been destroyed.

“That’s a sign to me that they’ve done this before and they feel comfortable doing it,” said Mathers.

Mathers wants not just the officer bending Hooper’s fingers held accountable, but anyone else who was in the room.

“Any officer that was there that witnessed this and did nothing is complicit in the assault and complicit in the torture,” said Mathers. “Any officer that wrote a false police report is guilty of covering up.”

Mathers said he plans to make everyone listed as a defendant on the complaint filed in federal court last week pay for what Hooper says they did.

“I want them to know you can’t do this, you cant assault a defendant,” said Mathers.

The lawsuit lists Sheriff Jim Adkins, Rob Robbins, Troy Siefer, Sandford Beals, Josh Oliveira, Katherine Poland, Melody Sheffield, Bambi Darling, Ron Van Fleet, Shawn Windsor, Tony Lewis and Jefferson County through the Jefferson County Sheriff’s Office. It also lists Bob Dundas, Rob Hartley, and Crook County through the Crook County Sheriff’s Office. Finally it lists Tom Kurtz, Jim O’Daniel through the City of Prineville. The suit demands a jury trial.

We put in calls to Jefferson County, Crook County and the city of Prineville for their reaction. The only call that wasn’t returned was from the lawyer for the city of Prineville. The sheriffs in both Jefferson and Crook County said they cannot comment on pending litigation.

READ – Suspect sues City and County, Centraloregon.com, November 10, 2012

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TRIGGER WARNING: THE VIDEO BELOW, ON YOUTUBE FROM CURTIS HOOPER,
SHOWS EXPLICIT TORTURE BY TASER AND MAY BE TRIGGERING

TRIGGER WARNING: THE VIDEO BELOW,
SHOWS :58 SECONDS OF TORTURE OF CURTIS HOOPER AND MAY BE TRIGGERING

By Teresa Rennick, Guest writer
From the Klamath Falls Herald and News, October 28, 2012

Teresa Rennick taught at Oregon Institute of Technology and at the Oregon Health & Science University at OIT in the Nursing Department for 25 years. She worked at Klamath County Mental Health as a psychiatric mental health nurse practitioner for more than 14 years. She resigned in December 2011. She is currently retired.

I’m no longer at Klamath County Mental Health. Or to quote the new director, Amanda Bunger, in the Sept. 11 Herald and News article, I’m one of those who “got off the bus.”

The reporter was told there were four of us, but in fact there have been more than 20 staff members who’ve resigned, or retired, in the last year and a half. Name changes and altered mission statements don’t change facts. Under this new administration, misinformation has been rampant, staff have been mistreated and the care of clients has been compromised. Some good investigative reporting would be welcome here.

“Unqualified persons writing care plans?” Ironically, these were case managers with bachelor’s degrees and many years of experience who are titled “Qualified Mental Health Associates.”

The state rules changed and master’s prepared staff were required to write the plans. But, check the dates and you’ll find that the changes were made and compliance was in place long before the new director climbed into the driver’s seat.

“Open door policy?” The first person to resign (I think of her as the canary in the coal mine) did so because of a decidedly closed door policy.

No indigent clients? Nobody on Medicare? Telling patients to leave when they had nowhere else to go? These abandonment policies were egregious, and many of us found them unacceptable, both legally and ethically.

“Nineteen mentally ill people working full-time in the community?” Is that true? What about the 13 people with severe and persistent mental illness who lost their janitorial jobs because of this new administration? Was there any financial benefit in hiring a janitorial service to clean our building when the client janitors were doing an excellent job? How do you quantify the loss of self-worth and dignity that came with termination of their employment?

What’s it like to work in a setting where the tone is: “You’re on the bus or off the bus?”

How do you make suggestions? Are you afraid to speak up for fear of reprimand? Will you be targeted, harassed and written up? How many grievances have been filed by KCMH employees in the last year and a half? The commissioners and county human resources will have this information, although concerns and complaints have largely gone unheard or were ignored by them.

“Better money management?” What have the hospitalization rates been under this new administration? Keeping people out of the hospital, when we can, is in the client’s best interest, plus it saves the taxpayers at least $1,200 per client, per day. In our previous administration, under Ann Lynn, our hospitalization days per month were so low that we were often a model in the state.

What’s the comparison between average hospitalization days per month under the old and the new system? Is the new system really saving money?

Under the direction of Ann Lynn, KCMH was productive and well run.

Our motto was “Practice Kindness,” a concept that we took seriously when dealing with clients and co-workers alike. Other supervisors who initially stayed on after Ann retired were equally respected and we were devastated when these wise and kind colleagues were targeted, treated shabbily and finally had no recourse but to resign.

Ask how many years of experience have been lost by the many resignations. Talk to staff who’ve left and hear their stories.

The new director’s metaphor about staying on the bus or getting off the bus continues to puzzle me. Where are the clients in this scene? Are they on the bus? Are they outside trying to get someone’s attention? Is the driver even looking? If the driver has only one thing in mind, “efficiency and productivity,” at apparently all costs, how many people are left waiting by the roadside, or worse, caught under the wheels?

The clients and the remaining staff, who continue to strive to give good care in the present atmosphere, and the citizens of Klamath County deserve better.

From the East Oregonian, October 20, 2012

Sharyn Smith calls herself an extreme parent.

Pendleton Beauty

She quit her in-home childcare job in 2008 to raise her own son, Adam, then 4, whose behavior was so erratic she couldn’t even take him to the library. She and her husband Dan Smith had tried for a year and a half to understand his outbursts before taking Adam to psychiatrist David Conant-Norville.

“You could tell when he’d get this way, he gets a different look in his eye,”? Sharyn said. “It’s almost a feral type look.”?

Conant-Norville diagnosed Adam with bipolar, obsessive compulsive and attention deficit disorders, prescribed him medication and gave Sharyn and Dan tips for managing his conditions.

The family still has to cancel plans because of Adam’s moods, but they don’t face these trials alone. Since November, they’ve worked through their challenges with other parents of children with emotional, developmental and behavioral disorders with Special Needs Families Connect.

The support group’s 20 members offer each other peer counseling, advice and references to resources from insurance to therapists.

Smith said she speaks with someone from the group daily. Group members have monthly meetings, organize play dates for their children and babysit for each other.

“We’re kind of an extended family in a way,”?she said. “It definitely does decrease the amount of trips to the psychiatrist.”?

Conant-Norville said such support groups are one way for Pendleton to leverage its limited mental health resources. The city has three clinical psychologists, and Conant-Norville is its only psychiatrist.

But he said the community can remedy the dearth by capitalizing on the kind of tight-knit connections only small towns have, which can make it easier for people to make referrals to mental health services.

Special Needs Families Connect does this well because it’s overseen by a professional organization. Autism Society of Oregon gives classes on handling special needs children’s behavior, and trained Sharon and Winnie Brunett to lead the support group’s discussions.

Even with these resources, Pendleton is still strained by its lack of mental health professionals. Clinical psychologist Connie Umphred often puts patients on wait lists; the Smiths had to wait a month for their first appointment with Conant-Norville.

“We are full all the time,” Umphred said. “We do take new patients, but we’re very busy.”

Conant-Norville said rural areas commonly lack these resources. The shortage of psychologist and psychiatrists spans eastern Oregon; Terrel Templeman, Ph.D. and Umphred see clients from as far as La Grande and John Day at Psychological Services of Pendleton.

It’s hard to say how many of these professionals the community needs.

Conant-Norville was booked when the city had three other psychiatrists when he worked here full-time from 1987 to 1993. Even if the city had more psychiatrists, many people with mental disorders would go untreated because they don’t have health insurance, he said.

Templeman said two more psychologists would fill his and Stephen Condon, Ph.D.’s practices. Templeman will hire Heather Bacon, Ph.D. when she finishes her year-long residency at his practice and receives a clinical psychology license.

Umphred sends some clients to social workers or marriage and family counselors for therapy if they don’t absolutely need to see a clinical psychologist. This leaves her with the difficulty of deciding which patients need her professional attention.

Some patients’ needs require the expertise of a clinical psychologist, including personality disorders, gender identity issues, and underlying problems people develop from experiences such as being physically, sexually or emotionally abused as a child.

The training, continued education, and licensing clinical psychologists are required to have equip them to perform the diagnosis and assessment these issues demand. Umphred refers patients with less complex issues, such as an adolescent having a hard time adjusting to a new stepparent, to a social workers or marriage and family counselors.

Conant-Norville, who flies in from Portland twice a week and offers video appointments for patients at Mind Matters, P.C. Child & Family Psychiatry, relies on physicians to shoulder Pendleton’s psychiatric case load.

Karen Dunlap, physician assistant at Pendleton Family Medicine, said primary care doctors and physician assistants can make diagnoses and write prescriptions for psychiatric issues including depression, anxiety, bipolar and attention deficit disorders, and bereavement.

Dunlap said she refers patients to psychiatrists if she’s exhausted her treatment resources, but rarely does so because of the city’s lacking mental health resources.

“Some people will not get treatment, or they’ll choose not to get it instead of driving somewhere,” Umphred said. “Those people that do choose to find some type of treatment will further stress the limited resources we have.”

Umphred said psychologists and psychiatrists may not come to Pendleton because they want to work in a bigger city, where they may make more money and have a greater client base. Conant-Norville said he’s tried to recruit another psychiatrist to Pendleton since he started working here in 1987 to no avail.

“They don’t realize that this place has a lot to offer,” Umphred said. “Pendleton doesn’t market itself very well and I think we need to find a way to do that.”

From the Klamath Herald and News, October 20, 2012

Klamath County Mental Health will be fined $325,000 by the state office conducting an audit of the department’s billing practices, according to a draft settlement agreement and draft final order from the Oregon Department of Human Services.

The amount is a negotiated settlement that is lower than the $410,546 the department was to be fined, said Amanda Bunger, director of the mental health department. The lesser amount was allowed because the department has made changes since Bunger took over the office in March 2011.

The county is still working out precisely how it will pay the $325,000.

The draft outlines a payment plan starting with $25,000 due by Nov. 1. The plan then requires the county to pay $37,500 every quarter from January 2013 until October 2014.

Bunger said Friday the commissioners had questions about that plan. She also said the county is still determining where the funds will come from to make those payments.

The settlement is still in draft form and has not been signed by the commissioners.

The audit, done by DHS’s Office of Payment, Accuracy and Recovery, reviewed billing practices between July 1, 2007 and June 30, 2008. Bunger has said in previous interviews the audit discovered medical billing codes, missing patient assessments and outdated treatment plans. The issues have since been remedied, Bunger has said.

Many of the changes Bunger has made in the mental health department to fix errant practices were not instigated until her tenure began in 2011. To ensure no further audits would be applied to the time when the errant billing was still in practice, the draft settlement agreement postpones any future audits until a two years from now.

Specifically, it says there will not be another audit for 24 months after the first quarterly payment, which will be on Jan. 1, 2013.

Bunger said the draft settlement agreement will likely come before commissioners in the next two weeks.

From the Daily Astorian, October 11, 2012

Both Clatsop County Sheriff Tom Bergin and Oregon State Police Trooper Jim Pierce, who answered questions Wednesday night at the American Association of University Women’s candidates forum, care about the mentally ill getting more help when involved with the authorities in Clatsop County.

The two candidates for Clatsop County Sheriff differ, however, on how those mentally ill should be housed, with Bergin wanting a new mental-health center built and Pierce wanting the Clatsop County Community Corrections Transition Center reopened.

They took part in the candidates forum Wednesday night sponsored by the Astoria chapter of the American Association of University Women and hosted by Clatsop Community College.

The transition center, opened in 2006 in Warrenton, was a residential center housing 24 males and six females, providing a holding facility for local offenders and people about to be released back into the community. Members of the facility held jobs, were on work crews and took part in treatments and other mental health services during their stay. It closed April 1, 2011 because of budget constraints.

The county only needs a few rooms, said Bergin, to house people with mental disabilities until their transfer to mental health services elsewhere, and the transition center is too expensive to operate.

Click here to read the rest of this article, originally titled “Sheriff’s race: Status quo under fire”

Press release from the Columbia Pacific Coordinated Care Organization, about August 10, 2012

The Oregon Health Authority approved an application from Columbia Pacific Coordinated Care Organization to take over managing Medicaid mental and health plan services on the North Coast as of Sept. 1.

Columbia Pacific CCO will serve all of Columbia, Clatsop and Tillamook counties, as well as the coastal arm of Douglas County. Each CCO will receive a set budget to manage care for people on Medicaid and work with community-based governing boards and advisory councils to direct spending.

“It basically serves like a health plan function, but it works much more closely with the community,” said Patrick Curran, Columbia Pacific CCO board member and director of business integration for CareOregon. “[CCOs] will grow and change and improve based on the needs of that community.”

The establishment of CCOs around the state is part of the Oregon Health Policy Board’s health care reform efforts, which are centered on the “Triple Aim”:

• Improve the lifelong health of all Oregonians;
• Increase the quality, reliability and availability of care for all Oregonians;
• Lower or contain the cost of care so it is affordable for everyone.

The idea behind CCOs is to improve communication among health care providers, hospitals, health plan and social agencies in order to reduce costs and improve the health outcomes for patients.

“If you look at the population on Medicaid, 20-percent of the people incur 80-percent of the cost,” Curran said.

That additional cost is often a result of preventable visits to urgent care or the emergency room by people with chronic health problems, Curran said.

“If we can better provide those services at an earlier time, we can achieve that triple aim,” Curran said.

Columbia Pacific CCO is a partnership between Greater Oregon Behavioral Health Inc. (GOHBI) and CareOregon, which is one of the current Medicare and Medicaid plans available to Columbia, Clatsop and Tillamook county residents.

Initially, the CCO will combine health and mental services under one insurance plan. By 2014, it will also incorporate dental services.

“By integrating medical care, behavioral health and eventually dental care, CCOs will meet the needs of the whole person, rather than treating mind separately from body and separating primary health needs from specialty and hospital care,” said GOHBI CEO Kevin Campbell.

Most plan members shouldn’t notice any change in service since the benefits and access to doctors won’t change. “The day-to-day will remain undisrupted… I think it’s fair to say that a lot of work will be happening behind the scene,” Curran said.

However, Curran anticipates that the CCO will assign an outreach worker to people with episodic (pregnancy) or chronic (diabetes) health issues to help them manage health issues and identify the best use of insurance funds.

“If you have a more coordinated effort… if you can provide preventative care to this person… the cost differential is tremendous,” said Jeanie Lunsford, communications manager for CareOregon.

“CCOs give communities an unprecedented opportunity to have ownership in the transformation of health care,” Campbell said. “With formation of the Columbia Pacific CCO, we have achieved our goal of making the CCO local enough to be relevant while still large enough to maintain solvency so we can continue to provide excellent health care services into the future.”

Residents in the Columbia Pacific CCO service area with current Medicaid plans will automatically be rolled over into the CCO plan. People with both Medicare and Medicaid coverage (dual-eligiblility) may chose to join the CCO or opt out, Curran said.