There are also deadlines. Six months after the provision of any service, the State begins to penalize the entity submitting the claim and pays less than 100%.
Rivera insisted that local DHS health partners had not been affected by backlogs in submitting claims, and she disputed whistleblowers’ claim that those delays resulted in a loss of health. money for the county.
“Zero penalties,” she said when asked.
But the contract problem, Rivera acknowledged, is real. At one point — the outage predated not only Rivera, but also her predecessor, Barbie Robinson, sources say — the county fell behind in signing contracts with its behavioral health partners before July 1, at the start of each exercise.
This created an annual cycle of difficulties. Unwilling to simply stop offering assistance to customers who desperately need it, providers typically operate without a contract for a few months. This means money is spent on space rental, staff hours and supplies, with little return. And until they have signed a contract, organizations are not even sure of the price they will be paid for the services.
“Most nonprofits operate in the red,” said Hempl, director of the Petaluma People Services Center. So what we end up doing is either we have to fundraise or we cut services in another program. Because whatever dollars we earn, we have to analyze them specifically to meet the needs of the community.
His organization has never had to rely on a line of credit to cover a late contract, but many do, Hempl added. And while fundraising comes with the territory, dealing with temporary shortfalls can be exhausting.
“Ultimately, our donors become our bank,” Hempl said. And we have a generous community. But honestly, if you take the number of people living in Petaluma, it comes down to $35 per person in Petaluma to fund what we’re doing. Out of 60,000 people living here, we have to get $35 from each.
Although Rivera spent most of her career in the public sector, she served as the executive director of the Compassion Center, a nonprofit organization in Shreveport, Louisiana. So she understands the challenges created by her department’s long delays, she said.
The biggest obstacle to securing on-time contracts for nonprofits, according to Rivera, has been budget-driven staffing shortages. And the situation only got worse during the COVID-19 pandemic, Rivera said, as workers took on new responsibilities and were forced to deal with their own health issues and, in many cases, child care issues.
“COVID has really brought to light how under-resourced the healthcare system is across this whole country,” she said. And that has exacerbated the mental health crisis. We are now witnessing the exacerbation of a staffing crisis.
DHS responded with temporary relief, Rivera said. And last May, it tried to bridge the gap by redirecting some employees to full-time, in-person work. The order resulted in an immediate pushback from staff who claimed their work environment at DHS was unsafe.
Public health staffing issues are not unique to this region.
“I’d love to say Sonoma is the only county where it’s an issue, but it’s not,” said Karen Larsen, CEO of the Steinberg Institute, a nonprofit that advocates for public policy. stronger on mental health and addictions. Labor is a problem everywhere. I don’t assume that’s a majority of counties in California, but it’s more than a handful where it’s an issue.
Still, Rivera thinks she can bolster her accounting staff where they need to be and straight out of the ongoing contract mess. Funding is starting to come in from both state and federal governments for mental health and addictions services. And, Rivera added, “If I need any additional temporary help, I’ll ask for it.”
It will take work. In October, Rivera said 28 direct behavioral service providers were waiting to perform their 2022-23 county contracts — more than three months after their 2021-22 contracts expired.
At the time, the health director said the goal was to complete the remaining 28 contracts by the end of December.
On Wednesday, Rivera offered an update: Only five of the 28 were still incomplete, she said, and she expected four of those contracts to be completed by the end of the week.
“One vendor is non-compliant due to confidentiality audits and we do not expect this contract to be completed by our target date,” Rivera said in an email. “We hope that, as we continue to work diligently with this supplier, we will resolve their compliance issues by mid-February.”
She said DHS expects to negotiate 2023-24 contracts with behavioral health partners “by late January to early February,” which would put the process on schedule.
“It has been a heavy burden,” Rivera wrote. “I am grateful for the patience of our wonderful vendors who partner with us to provide quality services to our community. I am also very grateful to our tireless staff who have worked long hours to help correct these historical issues that have plagued this procurement process for far too long.
Local organizations hope to see an improvement.
“It’s refreshing that Tina took that call and said there are things that need to be fixed,” Hempl said. “There have been a lot of mistakes in the past, but how do we see the future? How can someone not be allowed to fall through the cracks while struggling with mental health issues?
You can reach Phil Barber at 707-521-5263 or phil.barber@pressdemocrat.com. On Twitter @Skinny_Post.
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