Letter To The Editor: I Knew This Closing Would Provoke Emotions

Editors Note: The views and opinions expressed in this editorial are not necessarily the views or opinions of Oskaloosa News.

July 5, 2017
Dear Editor,
From: Mark Doland

On July 3, 2017 at our board meeting, several concerns were brought out in a letter signed by each of you and read by Laura Buch regarding the closing of case management in Mahaska County. This letter is to try to address all concerns that were brought forward.

Let me begin by assuring you that I knew that this closing would provoke emotions from employees that were involved. I truly appreciate the concerns that are outlined in your letter.

I was elected to the board in January of 2013. At this time, I was assigned to be the designee to the Mental Health Regionalization Board and tasked with transitioning from Mahaska County operating our own mental health system to a regional mental health delivery system. This was required by the newly passed law from the Iowa Legislature.

During this discussion, Supervisor Gordy was a vocal proponent to turn Mahaska County Case Management over to the Iowa Department of Human Services. I weighed the options and decided to convince the board that it was vital to leave the case management as it was, local. It made more sense to keep the people that we supported with the intact relationship that had been developed with their case managers. The rest of the board agreed and we left it as it was.

Last year, the legislature privatized Medicaid by law in favor of three different Managed Care Organizations. In April, 2016 two of those immediately announced that they would be providing case management internally. We decided that we would once again remain local as almost all of our clients signed on with Amerihealth Caritas as a way to keep their local case manager.

In February of 2017 we were notified that the last MCO to offer external case management was now going to bring case management internally. This effectively left us with no option of remaining open. The only determination we had was when we would close.

I personally had conversations with others who were in our same situation. There was a work group that was organized to collaborate for possible solutions for the pending transitions. When the others in this group started to set dates to transition their case management to Amerihealth Caritas, Mahaska County Case Management was one of the last holdouts.

When it had become clear that our case managers were anxious of what their job status would be from day to day and our clients were left in limbo as to when, not if, this unfortunate end would come, our entire board agreed that the right thing to do was to set a definite date to close. If it were up to our board as to if we would continue to provide case management we would undoubtedly still be open.

In reference to the manner in which this decision was made, there was and can be no independent decisions made outside of the Board of Supervisors. We are all charged with the duty to research and collaborate with all vital parties on any situation. Due to the fragility of information referring to employees, it was necessary to consult with our County Attorney to obtain direction. I would hope that the other two board members exercised the same diligence in their research and decision making process. There were no “closed door meetings” that you reference to cause harm to our employees or any of the people that we provided supports and services for.

In reference to your concern regarding the way in which you were notified, I would reference many agendas, minutes, articles, CRI news stories, etc. as this story developed. Laura even attended one of our meetings. I offered her the floor to speak or make comments and she declined. We made a decision to close at a Monday meeting. I followed up with Jim Blomgren to obtain direction to formalize our closure. I researched other counties to inquire about severance packages in similar situations as well as notification time-tables.

It was impossible to give formal notice to our employees before newspaper articles hit the stands, less than twenty-four hours later.

As to your reference to my disregard for persons with disability I take very offensively. I have an entire career that I have dedicated time to help persons with disabilities. My wife and I personally have two special-needs children that I adopted that are two and three years old. We have opened our home to more than a dozen special needs children and adults through foster and respite care. I was an associate manager at a local provider overseeing 24 clients and 20 staff in Home and Community Based Services. I developed life-long relationships that I have maintained even after I left employment there. I have provided mental health and substance abuse counseling at no charge to hundreds of people in Oskaloosa in my time as a resident here.

My family has invested many hours and dollars to help those in our community who struggle with Mental Disabilities. Many do not know of all of the work that we have completed in this arena because we do not trumpet our efforts to be seen by others and take credit for it. It is unfortunate and disappointing that I have to defend a reputation that we have worked so hard to establish and maintain as advocates and champions for people we have supported.

In closing, I would have rather remained an entity that provided services to our clients for case management. The state legislature made the determination to turn case management over to the state. I am as frustrated as you are over this change. I wish that we had a different outcome. I apologize for your situation but there is nothing that I or our board could have done to prevent it.

I wish you all much success and many blessings in your future. You have all been wonderful advocates and voices for our clients that we served over the past 20 years. I thank you for your many years of faithful service.

Best Wishes,
Mark Doland
Mahaska County Supervisor