By Aileen Hymas
For Columbia Gorge News
THE DALLES — The Wasco County Board of Commissioners on Jan. 7 unanimously approved a letter urging PacificSource Coordinated Care Organization to reverse course on what Mid-Columbia Center for Living (MCCFL) leaders described as a roughly 30% reduction in funding for many behavioral health services, cuts they warned could destabilize crisis-response programs for some of the county’s residents who need it most.
Al Barton, executive director of Mid-Columbia Center for Living, told commissioners the organization’s current negotiations with Pacific Source involve reducing most services, and that at least three intensive programs would become unsustainable, even though they’re required by law.
These programs include clinical teams functioning like a standing emergency service for the most severe mental health crises.
“We think about it like the fire station, right?” he said. “We don’t pay the fire station by how many fires they put out.”
The costs of funding uncertainty
On Jan. 13, many behavioral health providers across the country voiced concern after the Department of Health and Human Services abruptly moved to terminate hundreds of Substance Abuse and Mental Health Services Administration (SAMHSA) grants, threatening nearly $2 billion for mental health and addiction treatment programs. After roughly two days, the federal government reversed these cuts amid political and public backlash.
In the interim, AP News reported clinics and nonprofits experiencing “mass chaos” as they prepared for layoffs, canceled services and began shutdown paperwork, only to receive a formal notice later that the terminations were rescinded. The episode underscored how quickly funding shocks can ripple down to local safety-net systems, even when the cuts are ultimately restored.
Barton warned that if Mid-Columbia Center for Living’s programs shrink or disappear, the costs won’t vanish; they’ll shift to jails, emergency rooms and law enforcement.
“Without a diversion, or not someone checking on them day to day,” he said, “they tend to come to law enforcement’s attention. They tend to come to the hospital’s attention.”
Barton said PacificSource had warned that if Mid-Columbia Center for Living did not accept the proposed agreement, “they’re going to end our contract,” which he described as “dramatic” and “destabilizing.”
Under the existing arrangement, Barton told commissioners, PacificSource makes regular payments that function as a financial cushion for expensive programs. Without that structure, he said, the organization could be reduced to “just another provider,” paid only for services delivered: a model he suggested would not sustain high-intensity programs.
Asked if another provider could step in immediately, Barton said, “No. It’s taken us years to build the infrastructure and recruitment and build the staffing.”
PacificSource has its own funding problems
Springfield-based nonprofit PacificSource provides the Mid-Columbia Center for Living’s contract through its Coordinated Care Organization (CCO). CCOs are a regional health plan structure that receives state and federal Medicaid dollars to coordinate physical health care, behavioral health care and dental care for people on the Oregon Health Plan, typically by contracting with local providers and managing services across the community; 356,000 Oregonians are covered by PacificSource’s Community Care Organization, according to the Lund Report.
The insurer has struggled financially in recent years, pulling out of Washington State in 2024 and laying off 300 employees last October, a sixth of its workforce.
Barton told commissioners that PacificSource had recently sent a message indicating there would be no counteroffer.
“This is the deal,” he said, adding that the contract could end March 21 under the timeline discussed.
County advocates for mental health services
In the approved letter, commissioners wrote that Wasco County, as the Local Mental Health Authority, is responsible for coordinating with PacificSource to ensure local services are developed and implemented, citing state statutes.
The letter describes counties as “the safety net,” noting that Mid-Columbia Center for Living is the region’s community mental health program under a three-county intergovernmental agreement.
“We need MCCFL to have a sustainable budget,” the county board wrote, pointing specifically to base payments meant to maintain the mental health services.
The letter highlights concerns that people could enter the justice system “without true criminal conduct” if programs such as Assertive Community Treatment for adults and Youth Wraparound are not properly funded, and if peer support is not available to medically eligible residents.
At the county board meeting, commissioners questioned whether a letter alone would move the company. Commissioner Phil Brady said he supported signing it but worried it would become “some other piece of paper on his desk.”
Barton urged two escalations: aligning with other counties that contract with PacificSource, and pressing the Oregon Health Authority, which oversees CCO contracts statewide, for intervention.
The approved letter similarly warns it would be “disappointed and concerned to hear of any unilateral, no- cause termination,” and asks PacificSource to resolve the 2026 contract amendment “in a way that protects the safety net.”
The board voted unanimously to approve the letter of support.
“These are very important programs, and it takes a lot to hold them together, and they make a positive impact in our community,” Brady said. “It’s hard to know the details of what’s going on inside PacificSource, except they are financially stressed at this time. But even when you’re stressed, you can move things around.”
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