Mental Health Care in Jackson County

Representative Pam Marsh

Dear friends and neighbors,

Many members of our community are understandably worried about losing mental health services. Jackson County Mental Health, the public agency that provided these services to Oregon Health Plan members in the past, has lost its contracts. Clients and their families fear that they must change providers or face a gap in services.

I am certain that we will continue to provide high quality mental health services to residents of Jackson County and expand these services so that more people will get the help they need. Achieving this will require a realistic assessment of our current situation plus a lot of hard work.  We can do both.

First of all, who are the players in this drama? In Oregon, those of us who qualify for federally funded Medicaid health care, including mental health services, are enrolled in Oregon Health Plan (OHP), a public health insurance plan governed by Oregon Health Authority (OHA). OHP assigns a network of Coordinated Care Organizations (CCOs) to manage and pay for these services.  Two CCOs, Jackson Care Connect (a nonprofit) and AllCare (a public benefit corporation) serve residents of Jackson County. 

Last year, after careful study, our CCOs concluded that many Jackson County residents who qualify for OHP and who require mental services are going untreated. Both of these organizations decided to renegotiate their contracts with Jackson County Mental Health. The goal of both organizations was to ensure that more Jackson County residents will receive needed services. 

Obviously the performance of Jackson County Mental Health was a sensitive and politically volatile issue. Nevertheless, AllCare and Jackson County Connect had no choice. They are legally obligated to spend OHP dollars efficiently and to serve as many Jackson County residents as possible. To ignore the very low utilization of Jackson County Mental Health services would have been irresponsible. AllCare and JCC knew that many of our neighbors who need help are going without it. Something had to change. 

The two CCOs adopted different strategies. JCC decided that they would not renew their contract with JCMH. Instead they would build a new relationship with Columbia Care.  AllCare chose to renegotiate its contract with JCMH. Their plan was to contract with JCMH to serve a significant number of clients and to identify providers at other locations throughout the county to serve others.  The County refused this offer, leaving many OHP members in limbo.  The AllCare offer to JCMH is still on the table.

As a legislator representing Southern Oregon, my number one job is to defend the interests of our community at the state level. I have been in regular communication with Oregon Health Authority with regard to the meltdown of JCMH contracts with the CCOs. I am especially concerned about the transition of services to other providers.  Last week, OHA issued letters to AllCare and JCMH strongly encouraging both entities to negotiate a longer, better planned transition.  OHA also stated that it intends to monitor AllCare through this transition to ensure that clients receive proper care.

Fortunately, at this time it looks like the County and AllCare will be able to agree on an extension through June 30. 

I have strongly encouraged AllCare to be fully transparent and available to the public.  In response, the organization held two public meetings last week to answer questions about their plans. I attended both.  The good news is that AllCare is committed to build a strong, decentralized mental health system that will provide care to people in accessible settings such as community clinics, crisis nurseries and other places where mental health clients already receive services.  By distributing providers throughout the community, AllCare is confident that more people will receive services and that all our OHP dollars will be invested wisely.  AllCare has stated that it will spend all the dollars currently directed to JCMH — plus additional money — to fund the decentralized system. 

The termination of the JCMH contracts has created turmoil and anxiety in our community. No one, including clients, providers, the CCOs and County administrators, wanted this to happen. The transition to a new network of providers will require careful planning and close attention to the needs of the individuals who receive services. But we must quickly move beyond the rancor and distrust that resulted from the failure of negotiations between the entities involved. All of them are funded by the public and charged with serving the public interest. Addressing the needs of mental health clients should be their foremost concern.

What happens now? Clearly, we need a longer transition period.  Mediation between the entities could also be very useful. I’m hopeful that pressure from OHA and elected representatives like me can help align the various parties to this unfortunate situation.  Above all, we must continue to focus on the needs of our mental health clients as we create an excellent system of care.

This is an extraordinarily complex issue. I have touched on just a few aspects of it.  Please contact me via phone or email if you wish to offer more thoughts or an alternative perspective. 

Best regards,

Marsh Signature

Capitol Phone: 503-986-1405

Capitol Address: 900 Court St. NE, H-375, Salem, Oregon 97301