Slavonic digs into contracts, payments at Oklahoma mental health agency
Attending his first assembly of the Oklahoma Division of Psychological Well being and Substance Providers Board on Friday, interim Commissioner of Psychological Well being Greg Slavonic supplied a broad replace on his priorities, the company’s ongoing “reorganization” and the necessity to flip over the “the wrong way up” monetary image that portends potential service cuts.
With six weeks on the job following the Legislature’s removal of prior Commissioner Allie Friesen, Slavonic referenced his early conferences with legislative leaders, Gov. Kevin Stitt — who hired a particular counsel in Might to analyze the company’s fiscal points — and ODMHSAS workers members, with whom he met on his first day at work.
“One of many issues I had heard was that we’ve a cultural concern right here, and I didn’t need to get off on the improper foot with them, as a result of this company has had a variety of detrimental information within the press. A lot of it, I believe, was perhaps unfounded however but may very well be thought-about as based,” Slavonic mentioned. “I need to be sure that this company, shifting ahead, all the press that we get is sweet information, and I need to maintain us out of the paper.”
Slavonic missed the board’s prior meeting in June, the place members voted to “reestablish” an Inside Audit Division within the hope of figuring out future points extra shortly and independently.
“To start with, I’d prefer to apologize to the board for my absence final month on the assembly. It was solely my second week, and I didn’t put it on my calendar,” Slavonic mentioned. “However I had a urgent assembly over in Tulsa to satisfy with a health care provider who was going to be a doable participant with serving to us by our consent decree.”
Slavonic, a retired U.S. Navy rear admiral, mentioned “resolving the consent decree” has grow to be his prime precedence. The court-approved agreement stems from a class-action lawsuit filed on behalf of criminal defendants deemed incompetent to face trial. Such defendants have confronted prolonged delays — as much as two years — in receiving competency restoration providers, leaving many languishing in county jails which are under-equipped to supply providers that will be out there on the backlogged Oklahoma Forensic Heart in Vinita.
“As residents of Oklahoma and taxpayers of Oklahoma, we must always all have an interest within the consent decree and it being resolved as shortly as doable, as a result of this will probably be a three- to five-year mission, and the sum of money the state must pay to resolve that is — if we glance again on the Pinnacle Plan, we will type of get a snapshot of how a lot this might probably value the state of Oklahoma,” Slavonic mentioned. “The cash we may save (by resolving these points) would then be capable to — I hope the Legislature may then redirect that cash to this company. That may be my hope.”
In Might, the Oklahoma Legislature adjourned with out crafting a full Fiscal Yr 2026 finances for ODMHSAS. Whereas lawmakers supplied a $27.4 million supplemental appropriation to keep away from projected payroll defaults on the finish of FY 2025, they delayed decisions concerning the company’s full fiscal wants till its proverbial pot of pecuniary pasta may very well be strained and drained.
With the constitution of the reestablished Inside Audit Division accredited by the ODMHSAS Board on Friday, Chairman Hamel Reinmiller praised the route of the company’s reforms.
“I believe it provides an unbiased voice for inside audits on to the board that has by no means existed earlier than,” he mentioned. “That doesn’t suggest that there’s some shielding happening there. That’s not the case. I believe it’s trade normal. I believe having an unbiased voice reporting on to the board is the cleanest and most acceptable approach for inside audits to occur and for trustworthy discussions to occur about how we will enhance our processes.”
Concern renewed about ‘retroactively’ chopping substance use therapy funds
What precisely led ODMHSAS to the brink of payroll default earlier this 12 months stays unclear, though state leaders have publicly mentioned some particulars. For years, the company apparently:
- Paid prior-year Medicaid reimbursements with next-year appropriations;
- Swept unencumbered parts of contractor agreements collectively to make “pended payments” to licensed group behavioral well being facilities (CCBHCs) that serve Medicaid and uninsured sufferers; and
- Prolonged “value-based funds” to substance use dysfunction (SUD) suppliers regardless of the conclusion of federal funding for this system.
Appointed to steer ODMHSAS in early 2024 by Stitt, Friesen sounded alarm bells early this 12 months when she realized the company’s funding hole had derailed its Medicaid obligations. However in doing so, Friesen’s crew blindsided SUD providers with an e mail saying a minimum of two prior quarters of value-based funds wouldn’t be reimbursed for care already supplied. SUD suppliers alerted their legislators to the choice, which stunned lawmakers and intensified criticism of Friesen’s administration because it supplied a string of ever-changing finances gap estimates.
In her closing weeks as commissioner, Friesen indicated the stalled value-based funds could be honored by the company. Nonetheless, that now not seems to be the case.
On July 10, Slavonic despatched SUD suppliers an e mail much like the one which caught them off guard in March. The e-mail mentioned partly:
ODMHSAS is at the moment evaluating its monetary place for each state Fiscal Years 2025 and 2026. We acknowledge lots of you may have questions concerning the standing of the Q3 value-based funds. These funds are usually not contractually obligated, and the federal funding that beforehand supported this initiative is now not out there to the division.
Right now, we can not make any commitments concerning value-based funds. We’ll decide our potential to concern any value-based funds for FY 25 as extra info turns into out there. Our precedence is to align funding and partnerships with the best requirements of accountability and stewardship of state sources.
Janet Cizek, knowledgeable counselor who runs Neighborhood Remedy Integrations in Tulsa and Bartlesville, mentioned Slavonic’s e mail renewed tensions amongst her friends.
“We obtained an e mail notifying us concerning the Division of Psychological Well being’s intention to retroactively lower funds for contracted providers. Clearly, that is regarding,” Cizek mentioned. “We’re persevering with conversations with legislative leaders and the division as we assess one of the best ways to supply look after Oklahomans who desperately want it.”
Requested concerning the value-based cost state of affairs for SUD suppliers Friday, Slavonic deferred remark to ODMHSAS communications coordinator Maria Chaverri.
“Interim Commissioner Gregory Slavonic is conducting a complete evaluation of greater than 800 contracts, which embody the value-based contracts with non-public suppliers,” Chaverri mentioned. “For contracted SUD suppliers, value-based funds have been beforehand supported by a mixture of state and federal funds. With the expiration of that federal help, a accountable reassessment of the VBP mannequin is underway.”
Reinmiller additionally addressed the value-based cost uncertainty after the assembly.
“The Division of Psychological Well being desires to reward contract suppliers which are dotting their I’s and crossing their T’s and delivering good service — to the extent that we will,” Reinmiller mentioned. “There’s a lot that goes into getting our arms across the fiscal place for the Division of Psychological Well being. It’s an enormous group. We clearly have a CFO transition, we’ve a commissioner transition. There’s so much to that, and I believe the commissioner is solely saying, look, we need to reward the organizations that we’re partnered with which are doing good work to the extent that we will, however we’ve received to get our arms round our potential to take action.”
Reinmiller mentioned Slavonic was “simply giving an trustworthy reply” together with his e mail to SUD suppliers.
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“There’s a shifting monetary mannequin with psychological well being,” Reinmiller mentioned. “We’ve received federal funds which are eroding. The state goes to need to backstop greater than we’ve up to now, and that places a squeeze on this division, and we’ve all set to work collectively. That features all of our contracted companions, all people at DMH, all people that’s attempting to supply providers for these in Oklahoma that want it.
“We’ve all set to work collectively to carry prices down and convey income up in order that we will proceed to ship on the degree we’re at.”
For his half, Slavonic mentioned he’s nonetheless studying the lingo and particulars at ODMHSAS.
“This company has worse acronyms than the Navy,” Slavonic joked after Friday’s assembly.
He instructed board members he has confronted a steep studying curve as somebody not beforehand acquainted with many packages and practices.
“That is actually type of an unknown territory for me,” he mentioned. “However I used to be requested by the governor to come back on board and attempt to steer the ship in the proper route, maintain it afloat after which present correction for the company.”
To that finish, Slavonic mentioned he has been provided extra assist by Stitt, who opposed Friesen’s elimination as commissioner and who has criticized the company’s previous contracts with CCBHCs, the nonprofit organizations tasked with making a service security internet for Medicaid sufferers and the uninsured.
“The governor provided up that he would element a CFO to this company to assist us on the monetary facet as a result of the monetary facet of this company is actually the wrong way up, and so we’re working very exhausting to have the ability to make it proper and get it headed in the proper route,” Slavonic mentioned, including a dab of sarcasm. “Though the governor has put out that we’re in want of a CFO from one other company, it has been crickets from different companies. For some purpose, I don’t know why, nobody desires to come back to work right here on the company.”
Moments earlier than Friday’s assembly started, Slavonic encountered Robert McCampbell, the particular counsel employed by Stitt to “examine mismanagement” at ODMHSAS.
“We’re nonetheless going ahead with this investigation?” Slavonic requested McCampbell.
McCampbell, who reviews to the governor’s workplace, replied: “That’s actually my opinion.”
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‘The company has been underfunded for a few years’
Like a brand new plumber who has inherited outdated clogs, Slavonic has no scarcity of messes to handle.
After all, he has expertise mopping a climate deck. From March 2023 by Might 2024, Slavonic served as interim director of the Oklahoma Division of Veterans Affairs, an company going through its personal dysfunction on the time.
On Friday, Slavonic mentioned he not too long ago ended the hybrid remote-work mannequin at ODMHSAS — with choices for exemptions — to return company workers to their workplace assignments after years of pandemic-era flexibility.
“That’s the one approach we’re going to have the ability to do the work that must be carried out to achieve success,” Slavonic mentioned. “The subsequent precedence is altering the tradition right here — working with reorganization. And the third is getting the cash wanted to function this company and our 11 services that we function. I consider the company has been underfunded for a few years.”
To make that time, Slavonic referenced ODMHSAS’ growing old services in Vinita, Norman and elsewhere. Whereas the brand new Oklahoma Psychiatric Care Center in Tulsa (106 beds) is nearing completion to interchange the present Tulsa Behavioral Well being Heart (56 beds), the same hospital mission in Oklahoma Metropolis fell apart amid budgeting blunders, which included a $7 million false begin that expended philanthropic funds and an audible towards including disaster and competency restoration beds at a shuttered St. Anthony building in southwest OKC. The revised mission is pending approval from the Vatican, which desires Oklahoma to lease the constructing whereas it mulls the sale.
One purpose the proposed Donahue Behavioral Well being Hospital mission fell aside in OKC concerned an lack of ability to promote the Griffin Memorial Hospital property in east Norman for the $50 million price ticket state leaders had hoped.
On Friday, the ODMHSAS Actual Property Belief — comprised of the identical members because the ODMHSAS Board — accredited promoting half of a neighboring property to the Metropolis of Norman, which has leased the land for many years to function as Griffin Park. Town can pay about $3.36 million to amass the 156 acres containing its baseball and softball fields, whereas the adjoining 160 acres that Norman leases to function Sutton Wilderness Park would require statutory adjustments to legalize any sale, company officers mentioned.
Board member Hossein Moini requested what the company plans to do with the $3.36 million generated by the Norman property sale. Reinmiller replied, “There’s a listing of (infrastructure) wants.”
In the meantime, ODMHSAS is about to maneuver ahead with the sale of two adjoining properties totaling 10 acres in north Tulsa, which characteristic a 16,000-square-foot constructing wherein Palmer Addiction Recovery Services operates a middle serving girls and youngsters. The property carries an $895,000 appraisal and is to be bought at public sale.
After Friday’s assembly, Reinmiller talked concerning the significance of discovering new income.
“I believe the division is doing a implausible job underneath present management of streamlining waste, fraud and abuse. I don’t imply to say that there was any fraud. I don’t assume that was happening in any respect,” he mentioned. “However I believe there was spending that may very well be tightened up, and making gross sales like that, trimming prices and rising income does nothing however assist the division. In order that’s all we’re attempting to do — trim prices and improve income in order that we can assist the oldsters of Oklahoma that want psychological well being providers.”
Throughout his opening remarks Friday, Slavonic referenced one other “concern” he’s attempting to assist resolve with elected officers in Oklahoma County, which has begun web site work for a new behavioral health center to abut the new jail deliberate for southeast OKC. Slavonic famous that he labored with Oklahoma County Clerk Maressa Deal with in U.S. Sen. James Lankford’s workplace. He mentioned Deal with had inquired about ODMHSAS’ plans for the previous St. Anthony constructing amid the awkward chance that two new behavioral well being facilities is likely to be launched in south OKC on the identical time, probably with completely different operators competing for a similar workers and sources.
Deal with instructed NonDoc that ODMHSAS owes the county $1.5 million of American Rescue Plan Act funding that had been designated to be used on the now-stalled Donahue hospital mission, and she or he mentioned her “relational, brainstorming dialog” with Slavonic.
“As an Oklahoma County Finances Board member, I wished to debate a number of key points, one being the brand new behavioral well being middle the county is constructing with ARPA funds. I used to be excited by listening to his ideas on doable alignment of efforts between ODMHSAS and the county,” Deal with mentioned. “Through the years, the admiral and I’ve efficiently collaborated on numerous tasks. We each care deeply about spending tax {dollars} responsibly and dealing with key companions to seek out efficient options. Psychological well being is a matter I care deeply about, each professionally and personally. No matter whether or not something particular comes because of this dialog, I consider it’s essential that we proceed strengthening our working relationship with ODMHSAS. These sorts of conversations are how progress begins.”
Talking of progress, Slavonic is hoping a gathering held Wednesday with the CEOs of all 13 licensed group behavioral well being facilities will transfer tough conversations ahead about the necessity to reform CCBHC guidelines, necessities and income fashions.
Ten minutes earlier than Friday’s ODMHSAS Board assembly started, Slavonic emailed a handful of legislative leaders and Stitt administration officers to say his crew and CCBHC leaders “got here collectively to strengthen collaboration, enhance transparency and chart a sustainable path ahead.”
For months, CCBHC leaders have been deeply involved concerning the chance that ODMHSAS will finish “pended funds” with out offering various funding for security internet suppliers. On the finish of fiscal years, “pended funds” have been divided amongst CCBHCs as a technique to help their contracts and canopy prices for the uninsured. The cash has traditionally been drawn from in any other case unexpended ODMHSAS contracts.
Uncertainty over the standing of “pended funds” has been exacerbated by September’s anticipated conclusion of CCBHCs’ enhanced Medicaid matching rate. That looming change may require Oklahoma to dedicate about $20 million extra simply to take care of its funding ranges for Medicaid sufferers seen by CCBHCs at the moment, and Slavonic hinted on the important uncertainty in his e mail Friday morning.
“The dialogue acknowledged the monetary realities all of us face, with a shared deal with sustaining and strengthening the CCBHC mannequin inside the constraints of the FY 26 finances,” Slavonic wrote. “As a part of the session, the division introduced plans to herald a nationwide advisor to evaluate Oklahoma’s CCBHC system and supply suggestions aligned with greatest practices. Suppliers have additionally been invited to submit cost-saving methods and assist prioritize the providers most important to behavioral well being providers for his or her areas.”
Slavonic has additionally scheduled a gathering Monday with legislative leaders and Stitt administration members to evaluation ODMHSAS contracts, a contentious matter between trade leaders and the governor, who has lambasted sure CCBHC leaders for taking massive salaries and who has questioned how ODMHSAS contracts were awarded lately.
2025-07-19 05:01:00
