October 1, 1997
BOARD OF COMMISSIONERS' REGULAR MEETING
Harris Hall Main Floor - 1:30 p.m.
Chair Cindy Weeldreyer presided with Steve Cornacchia, Ellie Dumdi, Bobby Green, Sr. and Peter Sorenson present. Zoe Gilstrap, Recording Secretary.
1. COMMISSIONERS' ANNOUNCEMENTS
HEALTH AND HUMAN SERVICES
a. APPEALS/Lane County Managed Mental Health Care Contracts.
Rob Rockstroh, Director, Health and Human Services, gave an overview of this item (see material on file). He noted that they are changing to the Oregon Health Plan which is managed mental health. Rockstroh stated that this Request for Proposal (RFP) was similar to others, but, because of the change to managed care, different questions were asked. He explained Section One of the RFP, Management Level, noting that a provider must get a passing score of 70 or they are automatically out. Rockstroh stated that in this process, there was a committee of seven people and that one of their functions was to determine the Program Qualifications sections which included two sections that also required a minimum score of 70%. Rockstroh noted that everyone got through the management qualifications; however, on Level One of the program qualifications, Siuslaw Pacific did not pass and is appealing. Regarding Level Two, Rockstroh stated that Serenity Lane and Siuslaw Community did not pass.
Responding to Cornacchia on why agencies that met the criteria to provide this service for years suddenly did not qualify, Rockstroh stated that questions were asked that had not been asked before. He said he believed that it was the change to managed care that caused the differences.
Debbie Heeszel, Health and Human Service, stated that the RFP asked not only if they could provide the levels of services, but to prove through the proposal that they could provide those levels of service. She said they were not able, as a screening committee, based on Oregon contract law, to assume that because an agency had been providing the service in the past, they should be automatically awarded the proposal. Heeszel stated that these appellants did not write a proposal that showed that they could provide the service and, per Oregon contract law, that is how they have to make their decisions. Heeszel stated that they ran this process like they have run every other RFP, using scoring sheets with screening committee members. She said it was done based on what was presented in the proposal. Heeszel explained that the screening members read and scored the proposals on their own and then came together to put scores together and look at the averages.
Sorenson asked about the consequence of conflict of interest. Heeszel stated that that would be a ground for appeal. She stated that they were not aware of the relationship between Siuslaw Community Connection and Peace Health, noting that they did remove that screening members scores from both Siuslaw Pacific and Siuslaw Community Connection and it no way changed the final decisions because they used averages.
Teresa Wilson, County Counsel, said the ultimate option is to say the entire process was flawed, reject all bids and do it over. She stated that if an appellant has made a case that there was bias or different criteria, the Board could require the screening committee to go back and rescore that proposal.
Heeszel noted that they did have a bidders conference to allow proposers to come forward and ask questions about the proposal, stating that not all applicants chose to attend this conference. She commented that some of the appellants did not attend. She noted that there are other organizations who did not pass all of the levels for which they applied and are not appealing.
Cornacchia stated that one revised Program Qualifications section was mailed to the wrong address. Heeszel noted that the revised proposal was Section Two of the Program Qualifications and that the provider failed on Section One, which had not been changed. She said they had the full time to write Section One. Heeszel stated that the screening committee did not review Section Two because Section One had already failed and the applicant had the same amount to write on the part which they failed as everyone else.
Responding to Dumdi, Heeszel stated that the change, Appendix A, occurred as a result of the bidders conference. She explained that providers did not believe the original request achieved the goal of the RFP because when providers looked at the original RFP, they stated that they were not going to be able to effectively answer the questions nor were the screeners going to be able to make decisions based on what was asked. Heeszel said, at that time, they went back and tried to pinpoint questions that everyone believed would help them reach those decisions.
Weeldreyer noted that ten minutes for appeal would be allowed to each appellant with a total of ten minutes for rebuttal from all selected providers.
Wanda Schutz Urban, Professional Services Coordinator, Serenity Lane, noted that Betty Kellow, Licensed Clinical Social Worker, Rick Klotz, Licensed Psych Associate, and Chris ONeal, Professional Services Director, were also present. She stated that Serenity Lane has been contracting with Lane County to provide chemical dependency treatment services for 11 years. Urban noted that they scored low in Section 2 and distributed a table with a synopsis of each of the questions and the points they wanted to make (see material on file). She stated that when she wrote the appeal, she had a choice of five criteria on which to appeal, noting that the only one she believed they could fit into was bias although she did not believe it was a conscious bias. Urban pointed out that Serenity Lane has been providing mental health services in addition to drug and alcohol treatment for seven years with a unit designed specifically for mental health. She noted that they have contracted with New Standards, which is a national outcome research company to do their own outcomes and would do that for mental health if they receive the contract. Urban stated that their four most senior mental health therapists have a total of 68 years of postgraduate work experience.
Betty Kellow stated that she has been employed at Serenity Lane for almost seven years, working specifically with residential outpatient and Medicaid patients. She noted the benefits of having both mental and alcohol and drug services on site rather than refer clients out to other agencies and private providers. Kellow remarked that the clients appreciate the knowledge, expertise and sensitivity that a mental health counselor can provide to addiction issues with a greater understanding of what they are experiencing. She said they are trained to be aware of the denial system that is part of the addiction process. Kellow commented that they have learned that many patients are under enormous psycho-social stressors and it is difficult for them to manage more appointments at more places and do much better with onsite services. She stated that the counselors and mental health professionals have ongoing communications with easy access to records and staff regarding clients in treatment. Kellow stated that they can provide psychological testing, allowing for quicker assessment and diagnosis.
Steve Chase, Administrator, Siuslaw Pacific Center, stated that on Friday, July 31, 1997, the RFP selection packets were made available, noting that they received notification of this on the following Monday which was the same day for commenting on or protesting specifications that they believe restricted competition. He contended that they were unfairly locked out of this process due to the failure of County officials to give adequate notice and a failure to notify each competitor equally. Chase remarked that contract proposals were due on Wednesday, August 20, and that he hand delivered his proposal to Health and Human Services one day before the due date. He said on the following day, 1½ hours before the cutoff time, he received a phone call from a County official asking if he had received the revised specifications. Chase stated that this call was made to him after she discovered that his proposal addressed specifications in the original packet, not the revised one. He said further discussion revealed that the entire program section specifications had been changed on August 7. Chase stated that they discovered that the revision was mailed to the wrong P.O. Box. He said the result of this mistake by the County was that his proposal did not address the specifications of the new RFP and therefore, they earned a very low program section. Chase noted that on Friday, September 12, they received a fax transmission listing the selection committees recommendation for contract awards, stating that Siuslaw Pacific Center was absent from that list. He remarked that the notice of right of appeal stated that any appeal must be submitted by noon the following Thursday, five days later; however, within the RFP specifications, the County stated that a seven-day period would be allowed and later stated that the Oregon Administrative Rules required ten days. Chase said he attempted to contact County officials on the day he received the committees recommendation to request the information he would need for an appeal. He stated that his calls were returned the following Monday at which time he was told that the information he requested was unavailable. Chase said he was called back later in the day and told that he could get this information if he was willing to pay staff time to retrieve it. He said that afternoon he received a 124-page fax with unlabeled and unorganized random scoring sheets instead of the scoring sheets for his RFP proposal. Chase stated that they believe a serious conflict existed on the selection committee because one member on the panel is an employee of a parent company of a successful competitor and that four panel members are county mental health employees of Lane County which is in a direct business relationship with Peace Health. He said they have provided mental health support services to western Lane County for 11 years with 11 successive contracts with Health and Human Services and have never been out of compliance with the terms of these contracts or with any of the hundreds of regulations that govern mental health providers.
Sarah Seaman, Program Coordinator, Siuslaw Community Connection, stated that the appeal today is not a request to take services away from anyone granted their appeal. She said that she is asking that her agency be allowed to continue providing services to level 3 and 4 adults, as they have been doing since open enrollment began. Seaman stated that mental health services required in isolated rural communities are not distinguished from the services needed and available in Eugene. She remarked that the Community Connection has provided these services in cooperation with other local providers to persons that fall into Levels 3 and 4. Seaman stated that she believed that the evaluation committee evaluated proposals from Eugene-based agencies and their staff without due consideration to local staff in the rural areas and, thus, the evaluation criteria were unfairly applied. She noted that the agencies that were awarded Levels 3 and 4 Adults based their proposals on the services and staff available in the Eugene area. Seaman stated that the Community Connections operates solely out of the Florence area and that while they have some of the most experienced clinicians in the area, they were rated lower in comparison to the agencies based out of Eugene due to a much smaller staff. She stated that they have the overwhelming support of the community, noting that physicians and other providers such as the Learning Center, Florence Police Department and local child and family providers. Seaman noted that they were granted Level 2 clients who are considered the most severe and need the most attention, and, if they can serve these adults, they can serve people not in as severe needs as those in Level 2.
Steve Allanketner, Executive Director, Options Counseling Services, stated that the process that was undertaken was very much the same as other RFPs they have responded to and the same process that Lane County has always conducted. He said the differences were in the questions that were asked because they were being asked to provide services in a very different way than they had in the past. He said all providers struggled with how to respond to these questions. Allanketner noted that Lane County has been very good about having a process of public meetings, giving providers time to think about managed care and to have input into what managed care is going to look like. He addressed the statement made by Siuslaw Community Connection regarding Options ability to provide experienced Florence personnel to serve chronically mentally ill adults, stating that is in an inaccurate statement and noted their Florence staff (see material on file).
Sorenson noted that the criteria for appeals was five items, including a conflict of interest. He stated that there was a conflict and asked if the mere existence of conflict can be grounds for an appeal.
Wilson responded that the issue is how to deal with the conflict and asked if throwing out the scores of those in conflict satisfied them.
Cornacchia stated that they cannot deal with all the issues due to the appeal rules which require that they just look at appeal criteria. He noted that Serenity Lane chose bias, which was not proven and seemed to be a difference of opinion. He said he did not think Siuslaw Pacific made a case on mismailing the material.
Regarding the conflict of interest, Rockstroh stated that they finance virtually every nonprofit agency in town and noted that he does not get involved in the RFP process.
Dumdi voiced concern regarding the geographic rural areas and the assumption that one agency can take care of the entire county.
Sorenson stated that there was conflict of interest and chose Option 2. He said they do not need to establish that they knew about the conflict.
Green and Weeldreyer agreed with Option 1.
b. ORDER 97-10-1-16/In the Matter of Awarding Contracts to Agencies Selected to be on the Lane County Managed Mental Health Care Provider Panel and Delegating Authority to the County Administrator to Sign Contracts.
MOTION: To award contracts and delegate authority to the County Administrator to sign agreements with these agencies.
Green MOVED, Cornacchia SECONDED. VOTE: 3-0. Dumdi and Sorenson dissenting.
13. OTHER BUSINESS
a. Special Law Enforcement District
Sheriff Jan Clements stated that there are inadequate law enforcement services in rural and unincorporated areas of Lane County. He explained that, in the past, there has been county-wide funding from the general fund, heavily subsidized by timber revenue, for the provision of police services in those areas. Clements said that due to cuts in that level of funding there have been subsequent cuts in the Sheriffs office and their ability to provide police services. He remarked that providing enhanced levels of police protection in those areas is problematic for city residents who feel that they already pay for an enhanced level of services because they have their own police departments. Clements stated that the first alternative to that funding mechanism was the failed two-tiered approach which allowed all residents, including those living in the corporate city limits, to vote to raise the taxes on only those people outside those city limits. He noted that this special district alternative addresses the previous funding mechanism problems by creating a special law enforcement district patterned after the rural fire protection districts. Clements said this district would be funded by a permanent tax rate separate from the County general fund. He listed the criteria used to identify a district: that it has to be geographically based with a sense of an identified community; is an area with sufficient assessed valuation to provide for a meaningful police presence; and that the community is involved from the beginning in the decisions to form the district and the level of service that is presented on the ballot. He noted that the Mohawk Valley Fire District, the McKenzie River Fire District, the Blue River Water District and the Upper McKenzie River District are included in the district they are proposing to form.
Clements reviewed the process to research this special law enforcement district, stating that they will engage in numerous meetings with community groups. He said they are presenting three options for discussion: a high level of police presence, a middle road and a lower end level. Clements remarked that they want to hear from residents regarding the level of service they want in return for the taxes they are willing to pay to provide for that service. He noted that the Board of Commissioners has to file an order initiating the formation of a district by November 7, and, if it is approved by the Boundary Commission, citizens will have an opportunity to vote on it in the May election. Clements stated that the biggest hurdle is concern on the part of the citizens who believe they may lose their base level of protection if they pass a measure that finances an enhanced level of police protection. He stated that while this is not his intention, he acknowledged that this current Board cannot bind a future board.
Captain Tom Brett stated that the midstream option will add four deputies and one supervisor to that district and includes the support service at a cost of $1.16 per thousand assessed valuation. He reiterated that this is the midstream figure and is purely an example to generate discussion from the public. He said they are set for seven meetings with different citizen groups in the McKenzie and Mohawk Valleys. Brett stated that the supervisor of such an area would also assume supervision of the initial residencies that are already in place and would be responsible for being a de facto chief of police, noting that the area would be the touch base for all the citizenry complaints, deployment strategy decisions and other community policing activities. He noted from experience that this level of service becomes very effective as a tool to attack the problems in these smaller communities and forges stronger relationships with the public.
Cornacchia asked what the plans for deployment would be if the vote goes down overwhelmingly in the smaller areas but passes in the higher populated areas. Clements responded that because they would be paying the taxes, they all would receive the same level of service. He said after looking at the May 96 and May 97 precinct results, they found a great deal of support all along the McKenzie Valley.
Cornacchia said there is interest these days for community control over police and that people dont necessarily want the Commissioners as their local board because they want to control it in the community. He stated that he has heard loud and clear that many people believe they vote for one thing, only to have the Commissioners change it.
Wilson noted that there will be a local budget committee for this district with the requirement that members be from the district.
Weeldreyer stated that Board needs to create an understanding, knowing that legally they cant bind future Boards, but make a personal commitment to ensure that voters will not be losing their base level of services if this district is formed and there is a shortfall in the future. She said, because of the time frame, they need to have their questions answered in the next few weeks.
There was agreement to have a work session on this matter.
There being no further business, this meeting recessed into executive session at 4:00 p.m.
Zoe Gilstrap, Recording Secretary
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