TACOMA -- The 15,000 residents of Pierce County who receive mental health services should not experience an interruption of treatment because of a behind-the-scenes change in the way service providers are paid, according to the state Department of Social and Health Services (DSHS).

The change involves DSHS taking over direct payment for services that have been handled in the past by the Pierce County Regional Support Network (RSN) system. The two governments agreed in principle last week to work out the transition by extending the county's RSN contract until January 1, 2008.

DSHS Secretary Robin Arnold-Williams said mental health patients will be DSHS' top priority as the system changes. About 10,000 low-income residents of Pierce County receive their treatment through the federal-state Medicaid program, while another 5,000 are covered with state-only funds.

"Our intent is to make sure that none of these consumers loses eligibility or services as a result of this change," Arnold-Williams said. "We also want to assure providers in the community that they will continue to be paid for their services."

She said she was pleased that the state and county appear to have found common ground to set up the new payment system.

The 13 RSNs around the state were set up in the mid-1990s to coordinate mental health services in a managed care system and to distribute state and federal funds appropriated by the Legislature to cover the cost of mental health treatment for low-income residents, including Medicaid clients.

The state's plan to replace the RSN has several critical features:

• The state will hire a vendor to act as a Pierce County claims processor, taking the claims from mental health providers, adjudicating them and verifying they are correct. The vendor also will pay claims with state and federal money from DSHS.
• A second vendor will be hired to handle inpatient authorization and inpatient and outpatient utilization management – basically, making sure the payments and services are adequate and appropriate.
• The state will have to establish new contracts with community mental health providers and other local organizations for outpatient services as well as local consumer and family education and support services.
• Another set of contracts would continue other vital mental health services in the county, ranging from the county's crisis care center to the county's operation of the Evaluation and Treatment Center at the former site of Puget Sound Hospital.

The change affects only Pierce County. Residents of other counties will continue to receive coverage as they have before, through the RSNs in those areas.

DSHS Assistant Secretary for Health and Recovery Services Doug Porter said Pierce County may want to continue to contract to provide some of the county-operated services. He said the state and the county are in the process of deciding on the best way to supply those services in the future.

Porter said the state is also interested in working with providers and local stakeholders to preserve local planning and community involvement in mental health services. He said the state will continue to meet weekly with providers as well as county and RSN officials to make sure there is broad participation in the transition.

FOR ADDITIONAL BACKGROUND, CONTACT:  Jim Stevenson, Communications Director, HRSA, DSHS, 360-902-7604 (Pager: 360-971-4067).