County abruptly ends contract with CFR

Agency didn’t know the change was coming: ‘I noticed we were on the agenda today,’ director says

Webster County has cancelled its agreement with Community and Family Resources, which takes in patients for detox and substance abuse treatment, including involuntary committals, but has not disclosed why.

The county supervisors now plan to sit down and re-negotiate a new agreement for this sort of substance abuse and mental health costs, Supervisor Mark Campbell said Tuesday.

Campbell said services are in place to help those in need until a new agreement is in place.

CFR didn’t know the change was coming, according to Executive Director Michelle De La Riva.

“I noticed we were on the agenda today,” she said at the meeting.

Last year, 122 people from Webster County came through CFR’s medically managed detox program, De La Riva said later. Of those, 58 were funded by the county.

CFR takes in people from all across the state, and has agreements with at least 40 counties, she said.

De La Riva said CFR and Webster County have had an agreement for all of the 13 years she’s worked there. The current form of the agreement was signed in December 2013.

CFR is currently building a new $6.6 million facility in western Fort Dodge to bring multiple programs all under one roof. The center is slated to open in May 2019.

Campbell told De La Riva: “We want to talk to you about re-negotiating the contract. … UnityPoint — Berryhill has been contacted, and other agencies are available to do both detox services and civil commitments until we have a contract successfully negotiated with you guys.”

Campbell said the current agreement was put in place before changes to Medicaid took place in Iowa.

One goal in making this change is to make sure proper insurance is in place, Campbell said, and that the county will only pay for the services if there is no other source of payment.

“I think there were some changes to Medicaid covering detox, where in the past it did not. That is what we have been told,” county Auditor Doreen Pliner said.

“Our old contract does not have an ending date, and all of our contracts should,” Campbell said. “There will be no disruption of services.”

He added, “We have services in place, and will be utilizing them. That may include CFR in the future. We hope to have a contract signed for future services with whoever it may be very quickly.”

De La Riva asked, “If we do choose to discontinue this contract, which is with the county for detox patients as well as civil committals, what is the plan for those who are civil committals to our agency?”

Campbell said she should contact whoever she talks to for billing.

“Whoever you contact with the county before to get approved for services,” he responded.

“We don’t. The judge orders them,” De La Riva said.

The judge orders a person committed, the sheriff’s Department picks them up and drops them off at CFR, which treats them as per the agreement, she said.

“I guess we will see what the judges want to do with that,” Campbell said.

He asked if the county only covers services for those without insurance.

“The county pays not only if they don’t have insurance, but for those who do not meet medical criteria for detox, which is quite a few of them,” De La Riva said. “A person on civil committal is someone that two people have gone to the courthouse in order to commit because they feel they’re a danger to self or others. Oftentimes, those people may come in for the civil committal hold, and they do not meet criteria, which means they are not actively using the substance and testing positive.

“You cannot bill insurance if they do not meet that medical criteria. However, with a civil committal hold, you have to keep them until their court hearing.”