Nebraska probation office failed to pay some mental health care providers for months

The rollout in January of a new payment portal for mental health care providers treating Nebraskans on probation came with technical challenges that went undetected for more than two months and left some health care providers unpaid for longer.

The state Office of Probation Administration spent seven years rebuilding its voucher payment processing portal, which thousands of mental health and substance use care providers across the state have used since 2006 to seek payment for care they provide to clients on probation, according to the office.

Nebraska’s probation office pays around $50 million each year to state service providers that evaluate, treat, counsel and sometimes house probationers who otherwise could not afford the treatment.

And the office spent months last year preparing the hundreds of organizations and thousands of individual providers with email blasts, trainings and town hall sessions for the January launch of the new payment portal, said Gene Cotter, the deputy administrator of the office’s operations division.

But when the new portal went live Jan. 1, each provider had to register for the new system all at once — a process that required more support from probation office employees than the state had anticipated — while a breakdown in the new system halted payments to some providers for months, Cotter said.

Though the system worked flawlessly for some providers, others submitted payment requests that went unfulfilled for nearly four months, leading to a backlog of approximately 1,500 unpaid bills at its peak, Cotter said.

It’s not clear exactly how much money the state owed providers when the backlog peaked, Cotter said, but from April 21-27 the office processed 1,215 vouchers that amounted to nearly $2 million in payments, many of which were backlogged from weeks or months prior.

The payments the office processed over that period — which totaled $1.94 million — were paid to 260 separate health care and house providers, for an average of about $7,400 per provider.

For some providers, the months-long delay in payments — which generally took about 14 days to process under the previous system — caused intense financial stress, as payroll and other business expenses have continued to stack up while payments from a once-reliable funding source stopped coming.

Dameon Gilfillan, who operates the for-profit treatment provider Alcohol & Drug Solutions with his mother, Jody, said the probation office owed their company approximately $100,000 as of Tuesday — with some of that money still due from services they had provided in January.

Gilfillan, who also operates New Life Place, a transitional living facility that he said relies nearly entirely on probation vouchers to operate, said the state requirement to staff the living facility around the clock didn’t waiver, even as the state failed to deliver payment.

“I’ve told them — literally — I may have to close my doors,” Gilfillan said recalling his dealings with the probation office that date back months. “I am at stake of not making payroll. ‘Could you please just get a couple vouchers paid out this week?’”

“And that’s just bulls***,” he added. “And it’s embarrassing. It’s embarrassing. I shouldn’t have to sit there and email another colleague and say, ‘Hey, can you please give us some money?’ when it’s already ours, in my opinion. It’s already owed to us.

“I’m not asking for a loan or an advance. I’m asking for payments from January, for Christ’s sake.”

Jody Gilfillan said the probation office had paid out a few of their company’s vouchers in the first four months of 2023, but the Gilfillans were still waiting for payment for most of the services they have provided to clients on probation.

At times, she said, she has resorted to paying New Life Place’s bills out of the separate bank account for Alcohol & Drug Solutions.

And at least once, she said, she had dipped into her personal savings to make payroll.

She said the whole ordeal — which had not been resolved when the Gilfillans each spoke to the Journal Star on Tuesday — had caused her to pause as Alcohol & Drug Solutions kept receiving client referrals from the same office that owed her company thousands.

“Any time I get a referral that’s a voucher client, I get kind of a knot in my stomach thinking, ‘Eh, we need to take them — ethically, we need to take them into treatment,'” she said. “‘They meet criteria. They need help.’

“But yet, I don’t want to wait three or four months for payment with this client.”

No providers who spoke with the Journal Star reported that the payment delays prevented them from offering services to probationers or any other clients.

Topher Hansen, the CEO of the nonprofit service provider Centerpointe, said the probation office owed his organization approximately $6,000 as of late April — and the office hadn’t provided a timeline for when the continued delays might be resolved.

And a spokesperson for an Omaha-based residential facility said the state owed their organization more than $60,000 in unfulfilled voucher payments.

The delays haven’t been universal.

Tina Arsiaga, a Lincoln-based counselor who operates the addiction recovery practice Connecting Links, said her organization “has experienced timely payment” for services rendered to clients on probation in recent months — just as the organization always has over nearly two decades as a provider for probationers, she said.

And Donny Larson, the executive director of the Norfolk-based Women’s Empowering Life Line, said the probation office “has been an integral partner” of the organization for years.

“As a funding source, they have been consistent and timely in reimbursements for as long as we have partnered with them,” Larson said in an emailed statement. “Any deviation from consistent payments should in no way be represented as a pattern of behavior or an ongoing concern for providers.”

More than a dozen treatment and transitional living providers either declined to comment on the payment delays or did not return to phone calls or emails seeking comment.

The drawn-out nature of the delay has been a point of particular friction for the Gilfillans, who said the probation office had provided vague updates on the payment issues as providers faced mounting financial worries.

“Do they … give you a time frame? No,” said Jody Gilfillan, who has been a counselor in Lincoln for more than 40 years and who started her own practice in 2010.

“Do they apologize for it? No,” she said.

Cotter, the deputy administrator, said that the probation office wasn’t notified of the widespread payment delays until early March, and even then did not realize the full scope of the issue.

“The more apparent it becomes, the more vigorously we apply resources to it,” said Cotter, who said the probation office had hired or reassigned 25-30 staff members to process payment vouchers in March, but that it took weeks longer to train and credential those new hires.

Meanwhile, Dameon Gilfillan said, providers who were owed money were not given a clear answer on when the issue might be resolved.

Emails obtained by the Journal Star seem to support Gilfillan’s account of the office’s messaging to providers, which he said amounted to: “(We’re) pretty much being told that, ‘Don’t worry. Help’s on the way.’”

That help finally arrived last week for many providers, according to Cotter, who said the probation office had reduced its backlog from 1,500 pending vouchers to 626 as of Thursday.

Cotter attributed the breakdown in part to issues registering all of the state’s care providers into the new payment portal — a process that remained ongoing Friday — and generally to “growing pains and a new IT system.” 

In a phone interview Friday, Cotter said probation staff would work through the weekend to make continued headway on the backlog of unpaid vouchers, more of which arrive each day.

The probation office, Cotter said, hopes to clear the backlog by mid-May — 4½ months after unpaid vouchers began to mount.