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The Cowlitz County commissioners Tuesday agreed to amend a five-county agreement that makes the Great Rivers Behavioral Health Organization a limited liability company.

The move should give the counties greater say over where Great Rivers offers mental health and substance abuse care for Medicaid patients in Cowlitz, Wahkiakum, Pacific, Lewis and Grays Harbor counties.

“The more local control we have, the better we can provide quality care for rural residents,” Commissioner Dennis Weber said.

The amendment is in preparation for state-level changes next year, when managed care organizations will take over administering services to Medicaid patients.

Under its new role, Great Rivers will continue to provide crisis and involuntary treatment services for all residents, said Gena James, county human services manager.

A county commissioner from each of the five counties — Weber represents Cowlitz County — serves on the organization’s governing board.

Because of concerns that the managed care organizations could consolidate services and leave rural patients uncovered, Weber said the new agreement includes language to give the counties a stronger voice. For example, if the governing board votes on a contract to provide direct behavioral health services, the representative of the county where the services will be delivered must approve.

In other business, the commissioners approved an application for $70,000 in state grant funding for Lower Columbia CAP’s rural Meals on Wheels program after a public hearing. Mortensen opposed the application.

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