While Congress continues to debate health-care reform, Lowell A. Keig, the general counsel for a company that provides behavioral health-care services for children and adolescents, says it’s business as usual for his company.
Austin-based Youth and Family Centered Services Inc. (YFCS) is a privately held company that provides health care, educational programs and alternative living arrangements in eight states.
“We treat very troubled and sick kids and kids with disabilities,” he says. The company has facilities in Arkansas, Arizona, Florida, Indiana, Mississippi, Missouri, New Mexico and Pennsylvania that include psychiatric residential treatment centers, acute care hospitals, group homes and outpatient programs. The company serves more than 4,200 children and adolescents each day, Keig says. He says that working for YFCS is “being a part of a business that is doing some real important work.”
Keig says the company offers a broad spectrum of services and that not every facility has the same.
“In some locations we have a community center where kids come in for day treatment — school plus therapeutic care — and then they go home at night,” he says. “Sometimes we go to the home and do services for the kids at the home. Then we also have psychiatric residential treatment facilities.”
As elected federal officials hammer out reform proposals, Keig is writing contracts for payors, such as insurance entities or managed care organizations; contracts for physicians and other professionals; and contracts with vendors for property leases, hazardous waste removal, records storage and office equipment. He also continues to verify that the company’s facilities meet state and federal health-care provider compliance requirements and manages a bevy of outside counsel.
While it is too early to forecast how proposed health-care reform bills will affect the company, Keig says, “We think of the government as more like a partner because approximately 65 percent of our payments are Medicaid.” The company gets the majority of its client and patient referrals from state agencies or from contractors with state agencies, he says. For instance, the New Mexico Children, Youth and Families Department refers clients to the company’s outpatient and residential treatment services in Albuquerque, Keig says.
Keig regularly handles legal matters in labor and employment, medical professional liability, health-care regulations, insurance and general business issues.
“I don’t think there is a day that goes by that I don’t talk to some outside counsel,” says Keig, the company’s only in-house counsel. Keig says he uses nearly 30 outside firms for general business and health-care issues, medical malpractice matters and employment law.
“A big portion of my plate is employment issues when they become legal issues, such as EEOC claims,” he says. Keig tries to handle most employment issues in-house, turning to outside counsel when litigation ensues.
YFCS has more than 3,000 employees, and Keig says he works closely with Maggie Freeman, the director of the company’s human resources department.
“Within the employment area you have everything from employee relations to Department of Labor complaints to EEOC complaints,” Freeman says. “There are claims that have to be reported to various state entities, and since we’re in health care, we have mandated reporting as well. Any issues along those lines, he is intimately involved.”
When Keig needs outside counsel for employment litigation matters he often turns to Bruce A. Griggs, a shareholder in the Austin office of Ogletree, Deakins, Nash, Smoak & Stewart. Griggs says he has been working with YFCS for several years and that that relationship continued when Keig became GC in 2005.
Keig “realizes that [an] outside counsel is kind of on the front line every day, and he does a good job of listening and following advice,” Griggs says. “Lowell is very knowledgeable about labor and employment law, and that is very helpful.”
After graduating from the University of Texas School of Law in 1988, Keig worked as an associate with Elliott Flood, who had an insurance defense firm, The Elliott Flood Law Firm, in Austin at that time.
“I had done some clerking for Elliott while in law school,” Keig says. “He needed more help, the job was there, and so that was great. It was the right place at the right time.”
Keig moved to San Antonio in 1989 when his wife, lawyer Elizabeth J. Keig, accepted a job with Cox & Smith (now Cox Smith Matthews). Keig spent the next 11 years in San Antonio practicing business litigation, employment law, tort litigation and criminal prosecution. He was an employment litigation and insurance defense associate with Smith, Barshop, Stoffer & Millsap for about five years. He did a one-and-a-half year stint as a prosecutor for the Bexar County District Attorney’s Office until June 1994, when he decided to hang a shingle and work as a solo focused on transactions and litigation.
Keig jokingly says he was able to spend time as a prosecutor because his wife was making good money at a large firm.
“I tried lots of DWI cases and misdemeanors and did some pretrial felony work,” he says. “I always had a public service bent, and it was great to be wearing the white hat, as well,” Keig says.
Keig says he left his solo practice in January 1997 when he had an opportunity to join the newly formed, now defunct, firm of former FBI Director Williams S. Sessions and his son Lewis, Sessions & Sessions. Keig was of counsel handling litigation and some business transactions. Keig says he knew William Sessions because they were both active in the San Antonio Bar Association and the William S. Sessions American Inn of Court in San Antonio.
In October 2000, Keig went to work as a fellow in health-care litigation and counseling, where he handled false-claims litigation, for then-Texas Attorney General and now U.S. Sen. John Cornyn, R-Texas.
“He knew me through the bar, and I appeared before him when he was a district judge in San Antonio,” Keig says. When Keig left the AG’s office in 2005 to join YFCS, he was deputy chief of the antitrust and civil Medicaid fraud division.
“I got a lot of experience in many areas of health care there, the enforcement end of things and understanding how the government looks at fraud and abuse,” Keig says. “And I worked very closely with the criminal arm of Medicaid.”
A recruiter had approached Keig about considering the GC position at YFCS, to replace the company’s outgoing GC.
“It sounded like a great new opportunity with a growing company,” he says, adding that it was a good move.
“I have enjoyed practicing law a lot more in-house than in private firms,” he says. “I put it on a par with working in government where there is more collaboration with co-workers.”
But Keig says the reward he gets from working at YFCS is not necessarily from the legal work.
“It’s the look on a kid’s face,” he says.
When he visits the company’s facilities, he says, the children often come up to him and ask who he is and what he’s doing.
“On more than one occasion a kid has come up and said, ‘I’ve worked on my program and am being discharged tomorrow and going back to regular school.’ ” Keig says those conversations are what he enjoys most about being in-house with YFCS.
During his second year with YFCS Keig says the company acquired 11 day-treatment clinics in Arkansas and a home- and community-based center in Florida and refinanced the company at the same time.
“Not only was I doing due diligence on those companies, others were doing due diligence on us for the lenders,” he says. “It was pretty busy that year.”
Although the company is interested in future acquisitions, none are likely during the current economic climate, he says.
“When things turn around, I will be doing deals again,” he says.
Keig describes himself as a “jack of all trades and master of none.” Keig says that his varied legal background has been helpful to him as a GC.
“I’ve done a little bit of each type of practice,” he says. “I manage a whole lot of outside counsel and having a litigation background as well as a transactions background comes in very handy.”
Keig and his wife, now senior vice president for legal and business development with Gerson Lehrman Group, and three children, ages 8 to 16, live in Austin. Keig grew up in Dallas where his father was a civil engineer for the city of Dallas for 33 years.
“The public service bent, I think, was ingrained in me by my father,” Keig says. “The earliest I can remember, sometime during high school, law sounded like a good profession to go into to help people. I didn’t particularly think I would do public service lawyering, but more the general helping of others.”