A showdown is pending later this month over which agency should oversee how individuals in Lawrence County receive state services for developmental disabilities. The Clark Community Mental Health Center, with offices in Monett, Pierce City and Cassville, has engaged in a rigorous debate with the Lawrence County Tax Board for the Developmentally Disabled over who will manage services locally.
New legislation passed by the Missouri General Assembly has altered the rules on which agency will oversee services going to the developmentally disabled. In the past, the Missouri Department of Mental Health (DMH) oversaw services itself. Local families went to the Department of Mental Health's Regional Center in Joplin for evaluation and obtaining aid.
For the past 10 years, the state agency has been moving to privatize the entire process. Local private agencies have been going to the tax boards for the developmentally disabled, asking for a letter of reference that confirms their ability to handle targeted case management services.
An audit had shown DMH case managers were handling 70 to 100 people each, far more than the federal standard of 40 per caseworker. Providers were asked to bid for territories by county.
The Clark Center and Pathways jointly prepared a 182-page bid for eight counties where both agencies have been providing services for years. The Clark Center was bidding for Dade, Barry and Lawrence counties.
An hour before bids were to be opened in September of 2008, DMH cancelled the process. New legislation was subsequently developed that changed the enabling language. Senate Bill 435 was signed by Governor Jay Nixon on July 9 and becomes effective on Aug. 28.
Under the new law, DMH still awards contracts for targeted case management services, except in counties that have tax boards for the developmentally disabled. Both Barry and Lawrence counties have these Senate Bill 40 tax boards. The law authorizes the tax boards to name the provider.
The Clark Center had dealt exclusively with DMH in territory contracts. The Lawrence County Tax Board for the Developmentally Disabled, on the other hand, had approved several letters of recommendation for vendors who asked for the tax board's blessing in seeking targeted case management work from DMH.
One of those agencies is Community Support Services of Missouri, based in Joplin. Agency head Jhan Hurn approached the Lawrence County Tax Board for a reference in August of 2007.
Hurn worked for DMH in case management from 1974 to 1995 and subsequently worked for Jasper County Sheltered Facilities. He later worked for the Jasper County Tax Board for the Developmentally Disabled when the board formed its own targeted case management agency. Hurn subsequently formed Community Support Services to do the same work.
With the signing of the new law, it appeared Community Support Services was bound to get the Lawrence County contract. George Woodward, the executive director for the Lawrence County Tax Board, said Community Support Services had the only proposal on the tax board's table.
Woodward had served on the panel that helped recommend how the state should privatize its targeted case management services. The directions are posted on the DMH website.
"If you are going to be part of the network, you should be going to the county," Woodward said.
Frank Compton, executive director of the Clark Center, saw no request for proposals issued by the Lawrence County Tax Board. Woodward said there was no reason to seek proposals before the law was signed. Compton feared Woodward, who has known Hurn for years, would guide the tax board into awarding a contract for services to Hurn's agency.
The Barry County Tax Board, which had also previously given a letter of reference to Hurn's company, appeared poised to do the same.
The Clark Center Board of Directors subsequently sent a letter to both the Lawrence and Barry county commissions, not the tax boards. The letter, signed by Board Chairman Patti Holt, asked the county commissioners to look into the decision to award the contract to Community Support Services, asserting the decision "negatively impacts" county residents. County commissioners appoint the tax board members, three of whom would be appointed in each county this year.
Part of Clark's complaint asserted Community Support Services would require clients to go to Jasper County for services the Clark Center could provide locally.
|Woodward subsequently attended a meeting with the Lawrence County commissioners and two members of the Clark board, Joyce Goodman and Carolyn Flummerfelt.||Woodward said he found the letter accusatory. In his view, the Clark Center may not be qualified to do targeted case management for the developmentally disabled, a distinctly different population than the mentally ill.|
|"Frank expressed no interest in talking to us," Woodward said. "We're 23 months into this process. Where was he? We have meetings that others have known about."|
Community Support Services had letters of recommendation from state lawmakers and John Foley, president of Arc of the Ozarks, Woodward said. The Clark Center had not even presented a proposal. Woodward said the Clark Center's bid package may have been good for DMH, but its documentation had not been offered to the tax board.
Woodward said he doubted the Clark Center, as a service provider, could assess whether services were being properly rendered by itself as case manager. He did not know if the Clark Center, as a mental health provider, knew the terminology of the developmentally disabled, and he had reservations about mixing the two client populations.
For his part, Compton said the Clark Center knows the area and is the logical local service provider. Case work has always been part of Clark's mission, whereas Community Support Services focused on running residential programs until 2003.
Both organizations will now get to present their proposals to the Lawrence County Tax Board on Aug. 24. Woodward felt that was the only fair resolution. Any contract awarded would be for one year only, then subject to review.