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AllCare, county reach pact

Jackson County and AllCare Health have reached an agreement for the county to keep providing mental health care to AllCare's patients through June 30 — although the help could end earlier as the county continues to lose mental health employees.

The county and AllCare, which serves Oregon Health Plan clients, were unable to agree on financial terms for the county to continue providing mental health services to AllCare patients. With a contract set to expire March 31, Jackson County began hemorrhaging mental health workers.

Workers likely will continue to look for new jobs, despite the Jackson County Board of Commissioners' Wednesday approval of the three-month extension. Remaining county workers will help transition AllCare patients to new providers, including the nonprofit Options of Southern Oregon.

"As of today, we've had 113 people provide resignation notices to the county," Jackson County Administrator Danny Jordan said Wednesday.

Jordan said the county is committed to helping vulnerable mental health patients shift to new providers for as long as it can, but is rapidly losing the employees it needs to help AllCare with the transition.

"We will not have the resources to continue past 90 days — and we may not have the resources to last 90 days," Jordan said.

The extension agreement allows the county to stop providing help with a seven-day notice, he said.

The county has predicted 200 employees, including 180 in mental health, ultimately will be lost as they find new jobs or are laid off.

AllCare and Jackson Care Connect, two coordinated care organizations that manage the physical, mental and dental care of Oregon Health Plan patients in Jackson County, are shifting away from county provision of mental health care. Jackson Care Connect has started a longer, more gradual 18-month transition process to new providers.

The CCOs said the county was not able to provide enough care, and wait times were too long. The CCOs also want to expand mental health care to other settings, such as doctors' offices where people already go for physical health care.

Jackson County was aggressively recruiting and hiring employees amidst a nationwide shortage of mental health workers.

The new extension agreement allows up to $2 million for the county to provide transitional mental health care for AllCare patients for as long as the county is able, up through June 30.

"We are excited they gave us a 90-day extension," said AllCare Vice President of Government Relations and Health Policy Josh Balloch. "We will work with everybody to make the transition as seamless as possible. It's about the community coming together to help people get services they need."

The county and AllCare also reached an agreement for the county to continue providing crisis mental health services through June 30, 2018, for $1 million.

Although the two organizations must cooperate, they continue to blame each other for the breakup of the mental health partnership.

Balloch said Jordan could have saved many of the county employees' jobs by accepting an $8 million offer to provide outpatient services only with a requirement for better outcomes for those patients.

"They chose to walk away," Balloch said.

AllCare previously had paid the county $13 million for assorted mental health services. Balloch said AllCare is committed to spending even more this year on mental health care, but through a variety of providers.

With the $8 million offer, county officials contend they would have had to provide more care for less money and would have had to dip into county coffers to subsidize the shortfall — placing the burden on county taxpayers for AllCare patient services.

AllCare receives funding from federal and state governments to care for its OHP clients.

Jackson Care Connect had been paying the county $15 million per year for mental health services.

Although AllCare settled for the three-month extension agreement with the county, AllCare had offered a one-year transition plan on a fee-for-services model, Balloch said.

County officials have said that created too much financial uncertainty and it was losing too many workers to commit to helping AllCare for a year.

Meanwhile, the continuing loss of workers will make it harder for the county to help Jackson Care Connect with its 18-month transition plan, Jordan said.

County Commissioner Rick Dyer said AllCare's shorter transition is hasty and not well planned. He said mental health patients could be hurt.

"We are doing whatever we can to prevent some very substantial consequences from occurring," Dyer said.

In a statement, AllCare said it is committed to improving access to mental health services for its members in Jackson County.

“We’re working with many different local providers to improve access to mental health care. We’re excited to see new mental health facilities in both north and south Medford opening next month and to see expanding efforts to co-locate mental health providers with physical health providers. These efforts should make it easier for our members to access mental health care,” AllCare said.

The county will continue to provide mental health services it traditionally provided, including indigent care, before it expanded to handle AllCare and Jackson Care Connect patients.

One in three county residents is on OHP.

— Reach staff reporter Vickie Aldous at 541-776-4486 or valdous@mailtribune.com. Follow her at www.twitter.com/VickieAldous.

Jackson County says it can't promise it will be able to provide transition services for the full 90 days as mental health workers continue to leave. [Mail Tribune / Denise Baratta]