Tri-agency audit reveals problems with Mind Springs management
Results of audit presented to county commissioners Thursday
Grand Junction Daily Sentinel
A change in leadership and management structure should address troubling issues surrounding Mind Springs Health, according to an unprecedented audit by three state agencies of the Grand Junction-based mental health provider.
In an exclusive interview conducted by The Daily Sentinel with the executive directors of the three agencies and several members of their staffs, which included an advance copy of the audit’s results, the chief recommendation to curing what ails Mind Springs is in addressing how it is managed.
Much of that is already in the works, in part, due to the resignation of Sharon Raggio, chief executive officer, and Michelle Hoy, executive vice president, in January, when the tri-agency audit was started.
“It’s an audit that shines a light on what needs to be done, but the new leadership and the subsequent leadership, that’s going to make all the difference in the world,” said Kim Bimestefer, executive director of the Colorado Department of Health Care Policy and Financing, which commissioned the audit along with the departments of Public Health and Environment and Human Services.
“When we met with them (the Mind Springs board of directors) in January we asked the recruiter for the CEO to be present at that meeting because they needed to know what to recruit,” Bimestefer added. “More of the same is not going to do it. We needed a new sheriff to come in to meet the needs of the community.”
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A copy of the audit was presented to Doug Pattison early Thursday. Pattison has been Mind Springs’ CFO since 2019 before he took over as interim CEO in January. Results of the audit also were being presented to county commissioners and others in a conference call later that afternoon.
“I fully support this,” Pattison said. “We’re embracing change, and we’re going to work collaboratively with all the departments, and getting all the various measures in place, some of which will take longer than others.”
That will start with a new CEO. Pattison is one of three finalists for that job, with a final selection expected to come soon.
The audit was ordered by the three agencies after nearly 50 complaints, including one whistleblower report over medication management, were filed by county commissioners and community leaders in the 10 counties that Mind Springs serves, including Eagle, Pitkin, Garfield and Mesa counties.
While officials in the three agencies and Rocky Mountain Health Plans, which is contracted by HCPF to coordinate care and handle behavioral health Medicaid claims that conducted the audit, first learned about issues with Mind Springs early last year, the mental health provider was the subject of a recent series of investigative articles by the Colorado News Collaborative, a nonprofit news organization that specializes in in-depth reporting.
In some of that reporting, Raggio was unresponsive to questions about issues surrounding Mind Springs, saying she didn’t want to litigate its problems in the media.
The audit isn’t intended to point fingers at Raggio and other Mind Springs leaders, the executive directors said, but it was highly critical of how its management and its various boards are structured, some of which led to gaps in communication with its own staff and the communities it serves, and a general lack of transparency, particularly over its finances.
“The (Mind Springs Health) board structure is complex, lacks transparency, limits community engagement, excludes specific community board participation, has over-representation in other areas, and is not being leveraged to respond to community needs,” the audit reads.
That “incredibly complex” leadership structure has led to issues in providing needed mental and behavioral health services, for which Mind Springs is contracted with the state and several of the Western Slope counties, Patrick Gordon, chief executive officer at Rocky Mountain Health Plans, told the Sentinel.
“There are no fewer than seven legal entities executing Mind Springs’ various programs and functions, overseen by three distinct, somewhat overlapping boards,” Gordon said.
“That structure, we find, has contributed to sort of a disconnect between the community members who serve on the board and the feedback from the community that Mind Springs is organized to serve,” he added. “Suffice to say that corrective action in this area … would be that the board structure be simplified, to be organized to be much more representative of the community, there would be greater consideration of public input and transparency, greater focus on potential conflicts of interests and, frankly, a much greater focus on holding the senior executives and managers at Mind Springs accountable for their performance.”
The audit also found that, primarily because of those management issues, other problems were created, such as a high turnover rate among staff, patient risks over prescription practices and increasingly limited access to psychiatric and behavioral health services.
One of those involved a whistleblower complaint filed to Rocky Mountain Health Plans by one of Mind Springs’ physicians, who expressed serious concerns about medication management and a lack of peer review and treatment practices for patients.
“RMHP Quality of Care reviewers found that MSH outpatient and inpatient policies and procedures were deficient in describing quality processes specific to the oversight and implementation of quality programs,” the audit says. “MSH’s peer review oversight process as inconsistent. Some reviews met peer review standards, while others did not meet standards. There was no indication that deficient findings were reviewed or acted upon.”
The audit found that Mind Springs’ prescription practices were placing patients’ well-being at risk, in part, because some were being prescribed multiple controlled substances, such as stimulants and sedatives “at high doses.”
The audit includes several recommendations and corrective actions that Mind Springs should do to correct its issues, including creating a better system for prescribing medications, reforming its management and board structure, being far more transparent in its dealing with the state and local communities, and complying with new guidelines in its financial reporting.
The audit also recommends that the three agencies continue to monitor Mind Springs to ensure it complies with those recommendations, and implements those corrective actions.
“This (Mind Springs) board was not touching the community,” Bimestefer said. “To guess whether it was intentional or unintentional is less relevant than we change it. I prefer to not let the past be about why, but let the future be how, and that the corrective action fixes the issue of, whether it was intentional or not, to do things less transparent than they could have done.”