Pierce County to privatize mental-health services

In a move that's being closely watched, Pierce County will soon be the first in the state to totally privatize its mental-health services.

Earlier this month, OptumHealth — a private company contracted by the state to oversee and administer mental-health services in Pierce County — announced that it would no longer be using the county's own mental-health providers to deliver services to the thousands of residents who need mental-health and crisis treatment.

Instead, the Minnesota-based company chose three new service providers to supply the crisis triage, evaluation and treatment, 24-hour hotline and outreach services that had historically been provided by county workers.

Between 130 and 150 employees with Pierce County Human Services (PCHS) — including case workers, psychologists, psychiatrists and nurses — were recently notified that they would lose their jobs.

OptumHealth said in a news release that it would be looking to hire the laid-off county employees wherever possible.

The experiment on the privatization front is seen as a barometer of how the state may deliver mental-health services to counties in the future and is being closely watched by other county providers and administrators, according to a spokesman with the state Department of Social and Health Services (DSHS).

"Not that the state has a plan to privatize other counties, but that's one of the things that's causing interest and some trepidation among other counties," said spokesman Jim Stevenson.

Critics of the change say the county's human-services department has provided stable care. They worry the change could mean that there will be fewer overall beds available for people who need them.

Among the services and facilities the county will no longer provide is a 30-bed evaluation and treatment center, an 18-bed crisis triage center and a mobile outreach team.

In its place, Recovery Innovations Inc. has been contracted by OptumHealth to provide a crisis triage center using what OptumHealth describes as a more intimate, homelike environment. Another private company, MultiCare Good Samaritan Outreach Corp., and a coalition of local mental-health agencies will provide 24-hour mobile outreach. A16-bed evaluation and treatment center will be provided by Telecare Mental Health Services of Washington.

The new companies, with facilities sited around Pierce County, are scheduled to begin providing services on Oct. 1.

In the meantime, a temporary pod with 45 beds will be established at Western State Hospital to accept people who are in mental-health crisis while the new providers get up and running, OptumHealth said.

The state has assured recipients of mental-health services that they should not notice any interruption in care.

If everything goes the way it's supposed to, it should be as "boring as watching paint dry," said Doug Porter, an assistant secretary with DSHS.

PCHS is housed in a former hospital near downtown Tacoma. One of the department's strengths, according to director Dave Stewart, is that it was able to provide a single, centrally located facility for clients delivered by law-enforcement officers and emergency medical technicians.

Pierce County officials, who worked until the eleventh hour to try to keep the contract, said the loss of county jobs was a blow.

OptumHealth had wanted the county to provide several smaller, 16-bed units instead of the 48-bed unit operated by PCHS in order to maximize eligibility for federal dollars, said Pierce County Executive Pat McCarthy

"But we could not provide that because we would lose our economy of scale," said McCarthy.

Most counties serve as administrators as well as providers of their own mental-health services, using funds provided by the state. However, two years ago Pierce County said that it no longer wanted to serve as an administrator of mental-health services although it continued to be a provider.

The county cited financial problems and also asserted that it unfairly bore the burden of having one of the state's major mental hospitals in its region.

One-tenth of the money received from the state for mental-health services was being spent on court hearings and procedures connected with Western State Hospital, according to Stewart.

The state took over administration of the services until it entered into a contract with OptumHealth earlier this year.

Stewart said there is nothing the county can do now. The change is already in motion.

"This is a devastating loss to us," said Stewart. "But all we can hope for now is that there will be a seamless transfer of services and that people who need help can get it."

Christine Clarridge: 206-464-8983 or cclarridge@seattletimes.com