Contract for Comprehensive Mental Health Care Services for Cuban Entrants at Fort Chaffee, AK

In October 1980, unsponsored entrants from Cuba were consolidated at Fort Chaffee from four camps. When the consolidation arrangements at Fort Chaffee were first announced, mentally ill persons and certain other individuals were not included in the relocation plans. The mentally ill already at Fort Chaffee would remain, and it was estimated that many of the entrants being relocated might become anxious or depressed. Thus comprehensive mental health services with requirements for a bilingual staff had to be developed at Fort Chaffee. The Department of Health and Human Services contracted for the services. Two of three organizations contacted about the contract submitted proposals and were found to be technically equal, thus the award was made on the basis of cost. It became apparent during the transfer that many more of the entrants were mentally ill than had been anticipated. Because of the increased numbers of the mentally ill, the awardee requested increases in services, the number of staff, and the cost of the contract. This request was granted by letter contract.

The many complexities and uncertainties surrounding the entire Cuban entrant situtation, together with the sensitive nature of decisions relating to relocating the mentally ill, made it extremely difficult to plan to provide mental health services to the entrants in an orderly manner. Given the circumstances, the decision to proceed with a letter contract was not unreasonable. However, the director of operations and the chief Public Health Service officer at Fort Chaffee were not full participants in the process of deciding how mental health services would be provided. The salary levels that were established were considerably higher than salaries previously paid for similar services at Fort Chaffee. Per diem allowances to cover the cost of housing were generous in both their amount and duration. The scope of the services to be provided was not clearly defined. The final contract altered the total cost, reduced the base salaries of certain new employees, reduced the amount of per diem, and resolved differing opinions concerning the Public Health Service's approach to psychiatric screening. Regularly scheduled reviews of the mental health staff needed and services provided are held. Tighter administrative procedures to monitor hours worked by contractor staff exist, and better controls exist on expenditures for supplies and equipment. More definitive reporting and documentation requirements exist on the treatment and rehabilitation of the mentally ill entrants.