The Eugene Register-Guard published four stories in Spring 2010 about the challenges facing the community center run mainly by mental health consumers in Springfield, Oregon, known as SAFE, Inc. Also known as Wonderland, they ran a mental health clinic Valia. Lane County shut down the program, and SAFE, Inc. sued. Below are the Register-Guard stories in chronological order. (Forwarding this news is not necessarily an endorsement of accuracy.)
Coverage by The Register-Guard, Eugene, Oregon, of SAFE, Inc.’s conflict with Lane County:
6 June 2010:
Mental health agency loses suit against county
BY JACK MORAN
Appeared in print: Sunday, Jun 6, 2010
A jury has determined that Lane County did not improperly break its contract with a Springfield mental health agency that the county stopped funding last year.
A trial in Lane County Circuit Court resulting from SAFE Inc.’s lawsuit against the county wrapped up last week with the jury’s verdict. SAFE, a nonprofit agency, operated Valia Health Resources, which served about 150 people with schizophrenia and other mental disorders.
Attorneys representing SAFE filed the lawsuit in April 2009 after county officials announced they would discontinue the agency’s Medicaid coverage after two years of alleged mismanagement at Valia. Lane County government administers the federal Medicaid program, which, among other things, pays for mental health services for low-income individuals in Lane County.
The nonprofit agency ac-knowledged making billing errors but said the Medicaid reimbursements it had received were appropriate and that the county’s review of Valia had numerous errors. In its lawsuit against the county, the agency accused the county of breaching the parties’ contract by refusing to provide a pre-termination hearing.
During the trial, county officials argued that they did provide the required hearing and acted in good faith throughout the contract. The jury agreed with the county on both claims, county officials said.
“We are very gratified by this verdict,” said Karen Gaffney, the county health department’s assistant director. “It aptly reflects our view of both the facts and the law on the issues the jury was asked to decide.”
Valia was one of the first full-service, peer-run mental health providers in Oregon funded by Medicaid. More than half of its dozen or so employees had previously been treated for mental issues.
The county discontinued Medicaid coverage to the agency after saying that regulators found repeated instances of client assessments that lacked documentation, inadequate clinical supervision and treatment goals that did not address issues that qualified for Medicaid reimbursement.
County officials said that although the jury determined that SAFE breached its contract with the county, the jury declined to award monetary damages to the county.
11 May 2010
County, agency try to reach agreement
Valia Health Resources is putting its lawsuit against the county on hold for now
BY MATT COOPER
Appeared in print: Monday, May 11, 2009, page B1
A Springfield mental health agency and Lane County are in talks over the county’s intent to close the facility, an attorney for the agency said late last week.
Valia Health Resources, which serves about 150 people with schizophrenia and other disorders, sued the county for breach of contract April 27 after the county said it will discontinue the agency’s Medicaid coverage after two years of alleged mismanagement.
“Valia is holding off on proceeding forward with its civil lawsuit while the parties attempt to come to an agreement,” Valia attorney Margaret Wilson said. “I’m not dismissing (the lawsuit).”
The county sought to end the federal reimbursements April 30, saying it found repeated instances of client assessments lacking documentation, inadequate clinical supervision, treatment goals that did not address issues reimbursable by Medicaid and other problems.
The agency acknowledged billing errors but said Medicaid reimbursements were appropriate and that the county’s review of Valia had numerous errors.
The county postponed termination of Medicaid coverage while the parties try to resolve the dispute. Valia clients do not need to change providers at this time, the county said.
In its lawsuit, Valia said the county breached the parties’ contract by refusing to provide a pre-termination hearing.
Termination of the contract would cost the agency $96,000 in damages for services that would not receive Medicaid reimbursements, Valia said.
Valia is one of the first full-service, peer-run mental health providers in Oregon backed by Medicaid. More than half of its dozen or so counselors, therapists and other employees have recovered from disorders.
Valia said in its lawsuit that Lane County employees “have exhibited a pejorative and insulting attitude toward (Valia) because many of (Valia’s) employees and directors have received mental health treatment themselves.”
Wilson said she hopes for resolution of the dispute in the coming months. If the suit goes to trial it could take almost a year, she said.
Liane Richardson, county counsel, did not return a call seeking comment.
29 April 2010
Mental health provider disputes county’s effort to stop payments
The county accuses the agency of mismanagement and poor record-keeping
BY MATT COOPER
Appeared in print: Wednesday, April 29, 2009, page B1
SPRINGFIELD Medicaid- supported services at a Springfield nonprofit mental health provider will continue past their previously expected end on Thursday while the agency challenges Lane County government’s effort to discontinue the payments, a county official said Tuesday.
The county plans to end its contract with Valia Health Resources because of Valia’s mismanagement, poor record-keeping and other concerns, said Rob Rockstroh, director of Health and Human Services.
Valia has said some of the county’s concerns are inaccurate and others are relatively minor and easily addressed.
The agency is “hoping to demonstrate to the county that ours is a good-faith effort to meet and exceed the requirements, as well as continue to improve our internal management processes,” Valia operations coordinator Drake Ewbank said.
Valia clients do not need to change mental health providers while the matter remains unresolved, the county said. Those who have switched providers can return to Valia or remain with the current provider, the county said.
Valia serves about 150 people with schizophrenia, post-traumatic stress disorder, trauma and other mental health disorders.
The agency is peer-run, with more than half of its dozen or so counselors, therapists and other employees having recovered from disorders, Ewbank said.
The county in 2007 approved Valia for Medicaid coverage, giving Valia a stable source of funding to pay for its staff.
25 April 2010
Mental health agency heads to court to keep doors open
The county plans to cut off funding for Springfield’s Valia Health Resources, citing a host of management problems
BY MATT COOPER
Appeared in print: Saturday, April 25, 2009, page B1
SPRINGFIELD A Springfield mental health agency will go to court Monday to try to stop its closure by Lane County government that could put 50 clients in “serious risk” some even facing life-threatening situations, an agency official said Friday.
But the county says consistent mismanagement at Valia Health Resources is to blame for the county’s decision to stop federal Medicaid reimbursements. Clients can shift to other local agencies for treatment, the county said.
Medicaid coverage for Valia will end Thursday, following the non-profit agency’s failure for two years to maintain the documentation, records and oversight necessary to receive the federal payments, said Rob Rockstroh, director of county Health and Human Services.
Valia serves about 150 people with schizophrenia, post-traumatic stress disorder, trauma and other mental health disorders. The agency is peer-run, with more than half of its dozen or so counselors, therapists and other employees having recovered from disorders, operations coordinator Drake Ewbank said.
Valia prides itself on being one of the first full-service, peer-run models in Oregon backed by Medicaid. Some of Valia’s clients are passionate supporters who say other mental health providers won’t help them.
Valia counselors “nurture you, like you’re part of a family,” said Dianne Holmes, a 53-year-old recovering drug user with a learning disability. Without Valia, she said, “I’ll be a shut-in. I’ll go crazy. I need somebody there to talk to me.”
Revocation of a Medicaid certificate is a rare occurrence among the 130 certified outpatient community mental health providers in Oregon, and speaks to comparatively serious problems at Valia, said Mike Morris, a manager with the addictions and mental health division of the state Department of Human Services.
The county approved Valia for Medicaid coverage early in 2007, which meant the promise of stable federal funding that would allow the agency to pay for a staff that serves clients disenfranchised from the existing mental health system, Ewbank said.
But officials with LaneCare, the county agency that contracts with 14 mental health providers, soon found what it called continuing and serious problems with Valia’s operation.
In visits during 2007 and 2008, LaneCare found client assessments that lacked documentation supporting diagnoses and other important information; failure to meet time lines for assessment reviews; misfiled notes; absence of documentation for treatment goals and more.
LaneCare voiced concerns about inadequate clinical supervision, treatment goals that did not address issues reimbursable by Medicaid and goals that appeared to be beyond the skills of the Valia employee working toward them with clients.
LaneCare questioned “large amounts of time” reported by Valia for taking a client out of town to go antique shopping; holding a ladder to help a client paint a home; socializing; helping a client move a travel trailer; and going to a gym with a client and her daughter.
“There were concerns regarding program quality and while we found no indication of fraud, there were questions of possible abuse” of coverage for service, LaneCare officials Mari Jones and Dr. Michel Farivar wrote in January, in recommending termination of the Valia contract.
Ewbank acknowledged “paperwork billing errors” but said the Medicaid reimbursements were appropriate because the services helped clients receive treatment and live independently.
There are more than 20 “material errors” in the county’s review of Valia and many of the concerns are relatively minor and easily resolved, Ewbank said.
Ewbank also blamed the county and the state for failing to provide the help necessary for Valia to collect reimbursements during the first six months of operation in 2007. That left the agency unable to hire for positions that would have helped with concerns including record-keeping and client files, Ewbank said.
The county “never bought in to providing the support and interest that would allow the peer model to survive,” he said. “They have never bothered to come out and even ask or listen to us when we try to explain what we’re doing.”
A Valia attorney will file a restraining order Monday in Lane County Circuit Court to prevent the county from canceling the contract without cause, Ewbank said.
Rockstroh said the county will provide temporary funding to help other agencies serve Valia clients, but that not all clients will receive the peer-run services that Valia has offered.
Many of the 100 or so people who attended a recent local public meeting on mental health services with state Sen. Bill Morrisette said the peer-run model is the only approach that works for them, said Don Bishoff, an aide to the senator.
Morrisette, a Springfield Democrat with long-standing interest in mental health issues, said Friday that he’ll seek funding through foundations or the federal stimulus package to sustain the agency’s peer-run services regardless of whether Valia is the provider that delivers them.
“The alternative is extremely expensive and bleak, because (clients) will go to the emergency room or they will go to jail,” Morrisette said. “We have to try to do something to keep them safe and out of trouble.”
Valia is a branch of Safe, Incorporated, a Springfield-based nonprofit founded in 1994 that provides mental health services.