Local clinic outlines capacity limits, insurance barriers and plans to expand services

PLUMAS COUNTY, Calif. — Irene Wojak, a psychiatric nurse practitioner, told the Plumas County Behavioral Health Commission on Aug. 6 that the Portola clinic operated by Eastern Plumas Healthcare is providing outpatient mental health services but lacks full wraparound capacity for people with serious mental illness.

Wojak said the clinic currently has two primary staff — herself and a case manager nurse — and that they see clients under CalAIMS for "mild to moderate anxiety, depression [and] bipolar disorder." She said the clinic does serve some clients with schizophrenia and those on clozapine and injectable medications, but "that's not really the crux of what we do" because the clinic lacks the staffing and wraparound supports required to sustain high‑intensity services.

Wojak told the commission that the clinic had difficulties getting credentialed through a managed‑care contractor, Carelon, but that credentialing was resolved as of Aug. 1. She said the clinic is not currently providing Suboxone treatment because it lacks specialized support and staffing to manage that program, and noted she has training and certifications relevant to substance use work but cannot operationalize them without more personnel.

Commissioners and staff asked whether the clinic serves patients from other parts of the county; Wojak said they see people from Portola, Quincy and other nearby communities. She described the clinic's referral pathway: patients are typically referred from primary care, which allows clinicians to review other medications and reduce drug‑interaction risks.

Commissioners encouraged Eastern Plumas Healthcare staff to participate in the stakeholder survey and to identify gaps for privately insured patients. Wojak and others said privately insured clients sometimes fall through local service networks because county programs prioritize Medi‑Cal populations and because private insurance billing and contracting can limit referral options.

Wojak said the clinic hopes to add another clinician soon and to expand group therapy options when staffing allows. Commissioners asked about group capacity and noted group therapy plus peer support could help address demand when individual therapist availability is limited.

The presentation underscores local capacity constraints: a small clinic doing a wide range of outpatient work, recent progress on managed‑care credentialing and continued limits to expanding medication‑assisted treatment and high‑intensity SMI care until more staff are added.