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 March Mental health task force calls for major overhaul Multnomah County Commissioners could find themselves wishing they never had appointed a task force to peer into the county's mental health system when they hear its report March 30. First and foremost, there is no accurate data showing how many people receive such services and the cost of such care. All that's known is counselors are saddled with up to 100 clients, people are being turned away from the crisis triage center, local health departments have become a psychiatric dumping ground and the jails are clogged with people needing psychiatric care. "In the absence of good data, it's tough to go to the legislature and ask for more money," said Elsa Porter, task force chair. Nevertheless, Floyd Martinez, manager of the behavioral health division of Multnomah County's Dept. of Community and Family Services, has asked the Mental Health Division for an immediate infusion of $2 million. Division Director Barry Kast is expected to take that request to the April Legislative Emergency Board. Tort reform battle could cost $6 million Supporters of BaHot Measure 81 expect to pay upwards of $3 million to add one sentence to the Oregon constitution: "The legislative assembly by law may impose limitations on the damages that may be recovered in civil actions." Undoubtedly, opponents will retaliate with a similar amount as injury advocates and trial attorneys gear up for the fight with insurance companies and physicians. On March 30, Oregon Health Forum will sponsor a debate on Measure 81. Rep Max Williams (R-Tigard) will defend the measure, while Dr. Thomas Saddoris will speak in opposition. For reservations, call (503) 226-7870. This isn't the first time Oregon has faced a cap on civil suit awards. The 1987 legislature placed $500,000 limit on noneconomic damage awards in tort cases. "At that time, we had a liability insurance crisis," said Scott Gallant, a lobbyist for the Oregon Medical Assn. "Medical care providers could not afford to purchase coverage, or else it was unavailable. We essentially had one insurer in the entire state. In Eugene, three out of five physicians decided to quit providing obstetrics because they couldn't afford the cost of coverage, so women in that area lost access to services. After the legislation went into effect, medical malpractice premiums went down in Oregon by 50%. There was a real effect." Regence, ODS cancel Serenity Lane contracts Serenity Lane has lost its Oregon Health Plan contracts with Regence BlueCross BlueShield and ODS Health Plans. The insurers contend the program designed for criminals with substance abuse problems gobbled up too much money. CareOregon will remain with Serenity Lane, said Deborah Friedman, director of network and business development, but develop a utilization management plan. "There was the feeling Serenity Lane was breaking the bank, but we had good outcomes among the corrections population," said Mary Christiansen, director of professional services. But the insurers insist competing programs - Bridgeway, New Step and Polk County Mental Health - are just as effective and far cheaper. "I am absolutely confidant patients are being properly treated at other centers," Regence spokesman Ken Strobeck told the Salem Statesman-Joumal. His company dropped Serenity Lane because its billings were too high. "Our experience was the services that come from Serenity Lane are more expensive than comparable services elsewhere in the market." ODS spokesman Charlie LaTourette concurred. "It was a pure and simple business decision," he said. Last year, Regence paid for substance abuse treatment for 934 of its 19,000 OUP members. Serenity Lane treated about half of those, and scored highest on a patient satisfaction survey. GOBHI doesn't want Mid-Columbia to leave GOBHI, a mental health contractor for 16 rural communities, hopes to dissuade Mid- Columbia Center for Living from leaving by sweetening the pot. Mid-Columbia wants to terminate its contract with GOBHI and align with Clackamas County Mental Health to enhance its revenue stream. "If it comes down to an issue of being able to provide more services to our members with Clackamas County, then our county commissioners will stick by their earlier decision," said Sharon Guidera, who runs Mid-Columbia in Hood River, Gilliam, Sherman and Wasco counties. Mid-Columbia faced a $45,000 deficit last December, but pulled out of the read after receiving $46,000 in surplus revenue from GOBBI. "Our caseloads have grown, but our funding has essentially stayed the same with GOBBI," Guidera said. Overall, Nfid- Columbia has seen a 40% growth since 1995 from Oregon Health Plan and non-Oregon Health Plan clients. "It's a tough balancing act when you only have control over part of the funds," she said. "We're trying to maximize the service dollars to our members." 10% of Oregonians have no health insurance Oregon's uninsurance rate has reached its lowest level in many years. The latest statistics from the Office of the Oregon Health Plan Policy and Research indicate 326,942 people, representing 10% of Oregon's population, went without health insurance in 1999. The percentages are much higher for the Hispanic population - 19% lacked health insurance in 1999. When this data was analyzed by county, Coos had the highest uninsurance rate, 18%, followed by Malheur, 17%, Lincoln, 16%, Grant, 15%, and Baker, Hamey and Jefferson with 14% of the population having no insurance. The lowest rates were found in Columbia County, 3%, followed by Washington, 5%, Lane 6%, Union and Yamhill, 8%, and Clackamas, Cilliam and Linn, 9%. Multnomah County, the most heavily populated area in the state, had a 10% uninsurance rate in 1999. Despite the good news, officials are preparing to close the doors to the Children's Health Insurance Program (CHW), which will reach its upper limit, 16,800 children, by June, said Hersh Crawford, Medicaid director, On Feb. 26, CHIP had 16,040 enrollees, another 343,000 people were on the Oregon Health Plan - 81,000 adults, couples and new families, 174,000 other Phase I eligibles; and 88,000 aged, blind and disabled. Thousands of children could be left without coverage once CHIP is full, Crawford told the interim Health and Human Services Committee recently. But Sen. Eileen Qutub (R-Beaverton) disputed that idea. "I don't think there wfll be thousands of children waiting since we're trying so hard to get them into the program." Also in this issue...
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