Lifeways is not going down without a fight.

Officials with the community mental health services provider are criticizing Umatilla County’s decision to go with Community Counseling Solutions as its central provider for mental health and addiction services and are urging the county to change its mind.

Lifeways, which has served the county for more than 16 years, claims CCS “is underqualified and underprepared to take on the significantly more complex, higher volume work in Umatilla County,” Chief Executive Officer Tim Hoekstra said in a press release. The company argues Community Counseling won’t be able to get up and running in time to provide adequate care for the county’s more than 4,000 patients.

“At the very least, Lifeways hopes its protest draws attention to the gamble the county is taking with its residents’ health,” Hoekstra said. “Their health deserves a thorough and accurate evaluation process. There is no question that the evaluation process conducted and forming the basis of the award to CCS was neither thorough nor accurate because it missed the obvious conclusion that CCS’ lack of readiness is a danger to Umatilla residents.”

But CCS Executive Director Kimberly Lindsay said the Heppner-based provider, which serves four Eastern Oregon counties, is fully prepared to take on the new role and will begin preparations as soon as Lifeways’ appeal is finished. Community Counseling is set to begin offering addiction services in the county in September and mental health services in December.

Lindsay said she has yet to decide if CCS will respond to Lifeways’ claims.

“We’re interested in defending our good name,” she said. “We’re not going to do anything to discredit anyone. That’s not how we operate. But we will do what we need to do to defend our name and our reputation.”

Lifeways plans to stick around, tries to maintain staffing

Lifeways sent a formal protest letter to the county on June 2, which the East Oregonian obtained and reviewed. The board of commissioners, which approved a unanimous recommendation from a five-person committee in late May to go with CCS over Lifeways, is considering Lifeways’ protest and whether or not to maintain their earlier decision, according to Doug Olsen, the county’s legal counsel.

Olsen said there is no specific timeline for an agency — in this case Umatilla County — to consider or rule on a protest, but the decision had to be made “in a timely manner.” Olsen said the commissioners likely will announce their decision “in the next couple of board meetings.”

Regardless if the county changes its mind, Lifeways says it plans to stay in Umatilla County and “is already underway in pivoting its services to retain staff,” Hoekstra said in the statement.

Lifeways Director Liz Johnsen, however, could not provide specifics of what that might look like or what might change for its patients, employees and facilities, but said “we are looking at different business opportunities to continue to serve the residents of Umatilla County in mental health services.”

She said it’s possible Lifeways might pursue contracts or telehealth services with different states or different areas, adding the company is still investigating how its services might change.

Lifeways has 11 facilities in the county

Lifeways has come under scrutiny from officials for its ability to respond when law enforcement requests help during calls for people experiencing mental health issues, and Lifeways in April drew attention for the closure of Aspen Springs in Hermiston. The acute care facility provided the highest level of psychiatric care for individuals experiencing a severe mental health crisis before it closed after being open for just seven months. It reopened in May as a secure residential treatment facility, a lower level of care.

Since July 2020, Umatilla County has paid Lifeways more than $1,484,000 for behavioral health services, according to county Chief Financial Officer Robert Pahl. The provider serves 184 clients with schizophrenic disorders, 491 clients with major depression, 471 clients with post-traumatic stress disorder, 215 clients with bipolar disorder and more than 2,000 clients with adjustment disorders.

The provider has 11 facilities in Umatilla County and more than 120 employees, most of whom are county residents, Johnsen has stated.

The county has allocated $565,000 for school mental health services and almost $1.2 million for mental health administration in its upcoming 2021-22 budget, and county officials in recent months have emphasized that revamping its mental health care is a primary goal.

Without those funds, Johnsen said Lifeways will continue operations “through our innovation, through looking at other contracts, service lines and programming.”

Meanwhile, Lifeways employees have begun contacting Lindsay to discuss their transition should CCS remain as the county’s new provider, Lindsay said.

Johnsen said she’s confident many employees will choose Lifeways over CCS.

“We in no way intend to prevent them from choosing CCS if that’s what they choose to do,” she said, adding, “we have also heard that many of them don’t want to go to CCS.”

Lifeways’ claims, Community Counseling Solutions response

In the protest letter, Lifeways argues the county “failed to evaluate proposals” and “lacked a rational basis” in its decision to go with Community Counseling Solutions after the committee’s unanimous recommendation.

An educator, business person and county employees, including Umatilla County Commissioner John Shafer, served on the committee. Several committee members said they were asked not to comment about their decision until the appeal process is completed.

Lifeways in its protest letter called the country’s decision “arbitrary and capricious” and pointed out Community Counseling does not have any active facilities, transportation services and personnel in Umatilla County. It claims CCS’ proposal “is full of statements indicating its own serious doubt about its ability to become operational in time.”

Lindsay said she doesn’t “recall stating that we had doubts,” adding, “I do think it’s a lot of work, and I’m not minimizing that.”

Lifeways also called out Community Counseling for not having started hiring the more than 100 employees necessary for the company’s new services in the county. That would entail “a three-fold increase in the company’s operations” leading to what CCS itself called “growing pains.”

Lindsay said Community Counseling is waiting to begin hiring employees and finding facilities and transportation services until Lifeways’ appeal process is complete.

“Our plan was to use the time starting from the time of the award to begin contacting entities about places to rent or purchase,” Lindsay said. “We’re kind of grounded right now because of the appeal. That’s not a criticism. Lifeways is entitled to the appeal.”

Lifeways also noted CCS has yet to be Medicare credentialed to provide behavioral health services, saying that “is akin to a medical student saying they are not a licensed doctor yet, but hope to be soon.”

Lindsay said Community Counseling previously decided to not seek the license to bill Medicare “due to the significant amount of paperwork that was involved.” But a year ago, the company changed its mind. Lindsay said CCS should be credentialed within the next month.

The protest letter also claimed CCS has yet to reach out to Lifeways to discuss the transition between providers. Lindsay said that is not true.

On the day the county commissioners voted to award the contract to CCS, Lindsay said she contacted Lifeways Chief Executive Officer Tim Hoekstra to discuss the transition. According to Lindsay, Hoekstra “conveyed that any conversation regarding transitions or next steps prior to the end of the protest process would be premature and he would not be communicating more until then.”

Johnsen clarified that CCS hadn’t contacted Lifeways personnel in Umatilla County specifically.

Should the county maintain its decision to go with CCS, both providers have said they will work with the other in any way possible to promote a smooth transition for patients and to provide care in the county.

And despite the many claims Lifeways has made against CCS and the county, Johnsen said “unfortunately, the politics of this has pitted Lifeways against CCS, and that’s not what this is about. This is about making sure that the breadth and depth of services in Umatilla County are retained to the level that they are now.”

She added: “This isn’t Lifeways versus CCS. This is what is best for Umatilla County, what makes most sense and what is most pragmatic in making this large of a decision.”