2018-11-02 Meeting with GRBHOMeeting with GRBHO
November 2, 2018
10:48 a.m.
Present: Commissioner Fund, Commissioner Jackson, Commissioner Stamper, Lewis County Prosecuting
Attorney Eric Eisenberg, Public Health and Social Services Deputy Director J.P. Anderson, Public Health
and Social Services Director Danette York (by phone), Great Rivers Behavioral Health Organization
(GRBHO) Chief Executive Officer Marc Bollinger, GRBHO Chief Operating Officer Brian Cameron, GRBHO
Chief Information Officer Todd Broderius, GRBHO Attorney Fred Johnson
Guest: Mike Wilde
Recorder: Rieva Lester
Great Rivers Behavioral Health Organization (GRBHO) Attorney Fred Johnson said GRBHO is considering
a move to an LLC.
Eric Eisenberg said the debate is about what the organization will and/or should be doing if it does move
toward becoming an LLC.
Fred said the group met with Cowlitz County the previous week and that the group discussed becoming
a Behavioral Health Administrative Services Organization (BHASO) or ASO. Fred said that would allow for
the retention of local control and equal representation.
Marc Bollinger said future changes at the state level mean insurance plans will pay for Medicaid services
while crisis services will fall to the ASOs.
Eric said there is no statute outlining the change from a BHO to a BHASO. He said there is a concern that
there’s nothing that addresses whether the entity would be allowed to continue offering the same
services it currently provides if it were to move to a BHASO.
Marc said several counties are moving to his proposed model at the beginning of 2019.
Fred outlined the difference between a BHASO and an ASO.
Marc said GRBHO has roughly $8 million in contracts that go beyond 2020. He said those would have to
be addressed if the group was dissolved.
Marc discussed the governing board has oversight of decisions. Danette York noted that Lewis County
would only have one vote in the draft agreement.
Fred said the agreement is being revised and would be available in the next week or two.
Danette said there are concerns that the ASO or BHASO would expand to take on contracts from other
outside the five counties.
Marc said the group would provide safety net services for its five regions inside those five regions. He
said payers outside the regions could qualify for services but that they would have to receive those
services within those five regions.
Eric asked for language that would indicate services would be provided only within the service area.
Marc discussed Medicaid rules that indicate that services must be provided where it’s most appropriate,
which could include across the street from the five regions’ boundaries, etc.
Eric asked if there could be language saying the group wouldn’t be paying itself for services.
JP Anderson left at 11:29 a.m.
Commissioner Fund said there needs to be a “firewall” regarding being a payer or being a service
provider.
JP returned at 11:30 a.m.
Todd Broderius left at 11:32 a.m.
Eric discussed concerns about the group being a provider. He suggested a change to internal practices
that would make determinations regarding the inadequacy of contracted services so it wasn’t just up to
the BHASO.
Fred said he would work on a revised draft.
Meeting adjourned at 11:49 a.m.