Medicine Wheel turns to county for help with service contract
As nearly 20 people gathered outside the Columbia County Courthouse Wednesday afternoon, wearing shirts and holding signs in support of Medicine Wheel Recovery Services, county commissioners got a glimpse of what's at stake if the recovery center can't reach a contract deal with the county's mental health provider.
"Forty five days ago, I had no place to live," John Barlow told commissioners during an afternoon work session. "These people took care of me and today I'm clean."
Barlow referred to Pam Daniel and Tana Howtopat, who co-founded Medicine Wheel in 2016.
Since then, the center has been able to serve county residents in need of substance and gambling addiction treatment, including those on the Oregon Health Plan, through a system that requires Medicine Wheel to be reimbursed for their treatment services via Columbia Community Mental Health. After attempts to renew a contract with CCMH last fall stalled, Medicine Wheel staff members say they have no way to get paid for the range of services they provide to many with the OHP.
"Addiction is no respecter of socioeconomic lines," Barlow added. "I had everything."
CCMH said it could not renew its contract with Medicine Wheel at the same prices it offered last year because those rates weren't sustainable.
Medicine Wheel has requested to be paid by CCMH on a fee-for-service basis, but CCMH says that's not the way it receives state funding, and thus, can't reimburse Medicine Wheel every time a client receives service.
"The payment rates in the previous contract weren't set at levels that CCMH can sustain," Henry O'Keeffe, an attorney for Greater Oregon Behavioral Health Inc., explained last week.
Daniel and Howtopat, along with their attorney, Michael Sahagian, met with county commissioners Wednesday to lay out the roadblocks they've run into, and ask for assistance.
"It's gonna take away services from a lot of folks who need it," Sahagian told county commissioners and staff. "Not only can we not do it, [at the rates offered] we won't do it."
Medicine Wheel and Sahagian say the contract rates offered by CCMH don't cover the cost of staff time to provide services.
Commissioner Henry Heimuller said the strict chain of command that dictates the reimbursement cycle is a product of the Coordinated Care Organization, or CCO, that was created when the Oregon Health Plan rolled out.
"This goes back to the CCO's program," Heimuller said. "I was against it when Kitzhaber [put it in place]. It narrowed choices by supposedly creating efficiencies."
Howtopat and Daniel say, by law, OHP recipients must be given options for where to receive care, but if Medicine Wheel can't get paid adequately to serve OHP clients, they can't provide services, thus eliminating options for vulnerable clients.
"I just want to know, how do we get to the point where these folks have a choice?" Daniel asked.
Commissioners made no promises, but agreed to reach out to regional agencies to get more information.