Fourteen quit mental health clinic in dispute

From The Oregonian, February 16, 1998

More than a dozen high-level staff members have resigned from the Garlington Center for Mental Health Care amid a dispute over management and finances of the nonprofit clinic.

Most of the 14 who have offered resignations left Friday. Others intend to leave within a few weeks or sooner.

The walkout includes three of seven staff directors at the center, based in North and Northeast Portland. Two other director positions are vacant, one of them from the firing of the medical director last week. Others leaving include nurses and program supervisors.

Departing employees and some clients expressed concern for continued delivery of services to clients in the wake of the departures. But the clinic’s chief executive officer and a board member said the clinic is covering client needs with the help of medical staff from other centers that belong to a network of Portland-area clinics.

Ten lose jobs

The departure follows a layoff of 10 staffers in the wake of reorganization to address reduced revenue. The walkout also follows the firing of the medical director, Dr. Nicholas Drakos, a psychiatrist.

The layoffs, in addition to a decision to leave an additional 16 positions vacant, resulted from a need to address reduced revenue, clinic officials said. The revenue reductions stem from a move by the state to pay for services on a managed care basis rather than through a fee-for-service system.

On Feb. 3, 15 staffers, including Drakos , wrote a letter to board president Norm Wyers with copies to other board members. In the letter, the 15, almost all of them program directors or supervisors, accused Phyllis Paulson, the CEO, of “chronically poor management and leadership” that have “led the agency to the brink of nonexistence.”

Paulson, they said, had been autocratic, had made unilateral decisions and had subverted the authority of program directors. Drakos, who had worked at the center nine years, said he was fired the next day.

Board acts

Theresa Williams-Stoudamire, acting board president while Wyers is out of the country, said the board met Feb. 9 with staff members and Paulson. The board sided with Paulson, who was named CEO two years ago.

“We have investigated, we have heard the concerns and issues raised by the 14 people, and we listened to the CEO and to her response,” Williams-Stoudamire said. “After that we gave a full vote of confidence to continued operations of the clinic.” That vote, she said, included a vote of confidence in Paulson as CEO.

Paulson would not reply to allegations of being autocratic and similar complaints. Her only response, she said, was to note the vote of confidence by the board.

Some clients worried about being able to get services at the clinic. One woman, 32, who said she has schizophrenia and manic depression/bipolar disorder, said she called the center Friday to get a refill on medications and was told by a departing nurse that the center could not help her.

“Right now,” she said, “I can’t make good decisions for myself and they can’t help me.”

Paulson said the client “was given incorrect information. We have had a psychiatrist and nurse on duty every day this week. The services have been available.”

Drakos said the center cannot put in “rent-a-docs” and keep up the continuity of complicated care by “a really good group of mental health professionals.”

Paulson and Williams-Stoudamire countered that needs would be covered by qualified medical people from other clinics in the network. “All of the psychiatrists here have worked with this client population for many years,” Paulson said. “A good number of the clients are known to these psychiatrists.”

Clinic serves 500

The center has about 500 clients, Paulson said, and an annual budget of about $3.5 million. It has about 90 employees.

Most of the clients’ treatment is paid for by Medicaid. Money from that federal program goes to the state, which then sends it to Multnomah County, which in turn funnels it to the Garlington Center and similar health-care clinics. Other money comes from state and Multnomah County general funds.

The Multnomah County Community and Family Services Division will monitor finances and care at the Garlington Center, said Gina Mattioda, public affairs coordinator for the division.

In the meantime, she said, “We have been assured by management at the Garlington Center that services will not be interrupted.”

As for the switch from fee-for-service to managed care and its effect on clinic finances, Mattioda said, “There is no reason to believe that the transformation for Garlington Center is any greater than for other agencies” providing similar services.