Oregon launches effort to transform behavioral health system
Behavioral health touches every Oregonian. Everyone has a friend, a loved one, or a neighbor who has experienced a mental health issue or substance use disorder — and many Oregonians experience these challenges themselves.
While Oregon has made progress related to the behavioral health system, there is still much work to do integrating behavioral health with the physical and oral health systems in the coordinated care model, and making sure that every Oregonian has easy access to the services they need.
The Oregon Health Authority convened the Behavioral Health Collaborative last summer to develop a set of recommendations by building on Oregon’s coordinated care model to identify and address the system and operational barriers that prevent individuals and their families from getting the right support at the right time.
On Wednesday, OHA released the BHC recommendations. OHA is also unveiling a new interactive mapping tool that provides a comprehensive look at Oregon’s current behavioral health system. Together, the agency said, these resources will help transform Oregon’s behavioral health system.
“We can and we must treat behavioral health the same way we treat physical health — with compassion, quality care and an understanding that behavioral health needs must be addressed,” said Lynne Saxton, Director of the Oregon Health Authority. “The recommendations from the BHC and the behavioral health mapping tool provide Oregon with a blueprint for a behavioral health system that works for all Oregonians, and can with appropriate planning, execution and investment produce the results we need.”
Oregon’s tribes are reviewing the BHC recommendations and working with OHA to create recommendations specific to behavioral health services for the nine federally recognized tribes of Oregon and the urban Indian Health Organization.
Behavioral Health Collaborative
The BHC comprised nearly 50 members from throughout the state that represent every part of the behavioral health system. With leadership from the Eugene S. Farley, Jr. Health Policy Center, the BHC worked for more than six months to develop a set of recommendations that will transform Oregon’s behavioral health system, move toward a coordinated care model, and create a financially sustainable, results-driven model. The four recommendations include:
Recommendation 1 — Governance and Finance: A single point of shared responsibility for local communities through a regional governance model. This will help transform the behavioral health system so that all Oregonians will be served by a coordinated care model for their behavioral health needs.
Under this recommendation, all organizations in a community that are responsible for behavioral health — everything from community mental health organizations to hospitals to law enforcement to schools and physical health care — will be included in the governance structure to ensure that local resources are being used in the most effective way and there is coordination of care with measurable results for the identified investment.
Recommendation 2 — Standards of Care and Competencies: A minimum standard of care for all behavioral health workers. There are currently inconsistencies in practice throughout the behavioral health system. This recommendation would develop minimum standards so that all Oregonians receiving behavioral health service will have consistency.
Recommendation 3 — Workforce: A needs assessment of current workforce and a comprehensive plan that results in a well-trained behavioral health workforce, inclusive of certified, licensed and peer support specialists and community health workers throughout the state.
Recommendation 4 — Information exchange and coordination of care: Strengthen Oregon’s use of health information technology and data to further outcome-driven measurement and care coordination across an integrated system; and develop an outcomes-focused, person-centered behavioral health measurement framework to assess the impact of integrated services as well as hold the regional collaborations accountable for clinical and cost targets.
When taken together, these recommendations will help transform Oregon’s behavioral health system from one that is fragmented and unable to serve everyone in need, to one that is integrated and providing better health and better care at a lower cost.
Behavioral health mapping tool
Thanks to the work of the Farley Health Policy Center, the behavioral health mapping tool is a series of maps used to display interactive information about the behavioral health system in Oregon. This mapping tool:
— Provides a comprehensive look at Oregon’s behavioral health system, including identifying behavioral health service locations in each county, the numbers of Oregonians with behavioral health conditions and the state funding being spent on behavioral health in each county.
— Can be used to identify gaps in Oregon’s behavioral health system and help the state and local communities begin to find solutions.
— Provides information to local services for Oregonians looking for help.
Behavioral Health Maps:
Behavioral Health Profiles: http://oregonhealth.maps.arcgis.com/apps/webappviewer/index.html?id=1ebfba48c2bc4c5ea012be22a7d44457
County Mental Health & Substance Use Disorder Services: http://oregonhealth.maps.arcgis.com/apps/webappviewer/index.html?id=71f24af58ffd42af8d4e5e44d68b64e7
Medicaid, State and Local Funding: http://oregonhealth.maps.arcgis.com/apps/webappviewer/index.html?id=abe9de62913847159a8d1ab494ea44c4
Oregon Mental Health Service Areas: http://oregonhealth.maps.arcgis.com/apps/webappviewer/index.html?id=b2f00085dea24598af9a1fc60e43e705
You can find out more about the key features of the mapping tool and can access the maps on the Behavioral Health Collaborative website at http://www.oregon.gov/oha/bhp/Pages/Behavioral-Health-Collaborative.aspx.
BHC members in their own words:
“There is no debate that the so-called Oregon ‘behavioral health system’ is fragmented and underfunded. It is also complex and involves many moving parts,” said Bob Joondeph, executive director, Disability Rights Oregon. “To find a way forward, the Oregon Health Authority brought together experienced representatives of the various sectors that make up this system. The resulting recommendations manage to be both pragmatic and aspirational. If they succeed, behavioral health services will be more integrated with physical health services, focus more on prevention and health maintenance, have a quality work force, and a financial structure that incentivizes local innovation, achievement of public health goals and prudent use of funds. The result will be better overall health services for Oregonians.”
“The Behavioral Health Collaborative recommendations put us on the path to improve behavioral health for all Oregonians,” said David Hidalgo, Director of Multnomah County’s Mental Health and Addiction Services Division. “The work from these statewide partners will improve outcomes and accountability, and equip us to better manage investments in our community’s behavioral health.”
“The recommendations of the Behavioral Health Collaborative will help ensure that a single plan of shared accountability will improve access and outcomes for ALL Oregonians in need of mental health and addiction services exists in every region of our State,” said Mary Monnat, president and CEO of Lifeworks Northwest. “We will now have a unified system of care everywhere to help our most vulnerable members. There will be no wrong door to care as each system coordinates within the larger plan to deliver care that is effective and efficient and improves the health of all Oregonians.”
“The Behavioral Health Collaborative moves us toward a system focused on prevention. Paying attention to the whole person — connecting mind and body — and having a system that supports wellness as well as treating symptoms is what people have said they want and need,” said Maggie Bennington-Davis, chief medical officer of Health Share of Oregon. “This sort of system requires a change in our fundamental thinking, including a workforce that incorporates people with lived experience and incentivizing outcomes beyond symptom control. People in a system such as this one will focus on what makes and keeps them well.”
Dwight Holton, CEO, Lines for Life: https://youtu.be/gnQzQjaRueg
