Oregon’s Behavioral Health System · 2017-10-30 · Oregon’s Current Behavioral Health Status 3...
Transcript of Oregon’s Behavioral Health System · 2017-10-30 · Oregon’s Current Behavioral Health Status 3...
Oregon’s Behavioral Health System:
An Action Plan for the
21st Century
Royce Bowlin, OHA, Behavioral Health Director
Jackie Fabrick, OHA, Behavioral Health Policy Analyst
October 30, 2017
Behavioral
Health Collaborative (BHC)
What will be covered?
1.Behavioral Health Collaborative (BHC) Overview
2.Accountability Structure
3.BHC Work Group Deliverables & Status Update
4.Timeline & Communication Plan
5.Questions
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BEHAVIORAL HEALTH POLICY
Health Policy and Analytics
Oregon’s Current Behavioral
Health Status
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36% of
teenagers
perceive no risk
from smoking a
pack of
cigarettes a day
14.6%Of teenagers
experienced a
major
depressive
episode in the
last year
Suicide is the
2ndleading
cause of death
for young
adults in
Oregon
4.5% of
adults had
serious
thoughts of
suicide last
year
Oregon ranks
4th
nationally in
opioid use
Illicit drug use
among
teenagers is
2.5% higher
than national
average
Binge drinking
among
teenagers is
2.5% higher than
national
average
35.8% of
teenagers
perceive no risk
from smoking a
pack of
cigarettes a day
Only 46% of adults who
receive mental
health help, say
it helps
7%Of Oregonians
over 12
experience
alcohol
dependence or
abuse
11% of
Oregonians
dependent on
illicit drugs
receive
treatment
Only 45%of youth who
had a major
depressive
episode receive
treatment
Oregon is
ranked 14th
nationally in
youth suicide
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Going forward: A behavioral health system
that works for all Oregonians
Priorities
• Improve behavioral health outcomesfor consumers
• Improve equitable access to effectiveservices in every part of the state
• Improve efficiency and cost-effectivenessin services
• No wrong door approach
• Mental health and substance services areseamlessly tied to all aspects of care
• Focus on prevention and health promotion
• System-wide accountability forimproved outcomes
BHC Recommendations Overview
Recommendations will transform behavioral health system so that all
Oregonians (both Medicaid and non-Medicaid) will be served by a
coordinated care model for behavioral health needs.
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• Focused on person and family
• Fully integrated behavioral health
with physical and oral health
• Build on existing efforts and
complement, not duplicate
• Reduce administrative burden and
system complexity
• Shared financial risk
• Outcomes that are measurable and
sustainable
BHC Recommendations
Recommendations will transform behavioral health system
so that all Oregonians (both Medicaid and non-Medicaid)
will be served by a coordinated care model for behavioral
health needs.
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1. Governance and Finance:
Regional governance model for
behavioral health
2. Standards of Care and
Competencies
3. Workforce
4. Information Exchange and
Coordination of Care
BEHAVIORAL HEALTH POLICY
Health Policy and Analytics
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BEHAVIORAL HEALTH POLICY
Health Policy and Analytics
BHC Work Group
Deliverables & Status
Updates
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Health Policy and Analytics
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Governance and Finance Work Group
Deliverables:
(Completed 8/31/17)
• Define Single Point of Shared Accountability and define elements of
Single Plan of Shared Accountability
(To be completed Sept/Oct 2017)
• Identify incentives Risk / Benefit sharing
• Ensure alignment of contracts
BEHAVIORAL HEALTH POLICY
Health Policy and Analytics
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Governance and Finance Work Group
Update
Four phased approach to development and implementation of the
regional behavioral health Single Point of Shared Accountability
(SPOSA):
Phase 1: Letter of Intent (LOI)
Phase 2: Community-based priorities and rationale
Phase 3: Action Plan
Phase 4: Performance and Reporting
BEHAVIORAL HEALTH POLICY
Health Policy and Analytics
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Standards of Care and Competencies
Work Group
Deliverables:
(Completed 8/31/17)
• Established core competencies for providers
(To be completed Sept/Oct 2017)
• Established minimum standards of care, stateside standards for
assessment, placement and billing criteria.
• Established minimum standards for care coordination and payment
mechanisms are in place for care coordination to meet the minimum
standards.
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Health Policy and Analytics
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Standards of Care and Competencies
Work Group Update
• Core competencies for providers
• Endorsed existing standards from the Substance Abuse and Mental
Health Services Administration (SAMHSA) and the University of
Colorado Eugene Farley Center.
• Minimum Standards of Care
• Statewide standards for assessment, placement and billing criteria.
• Care Coordination
• Establish minimum standards for care coordination.
• Ensure payment mechanism is in place for care coordination to meet the
minimum standard, including travel time.
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Health Policy and Analytics
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Workforce Work Group
Deliverables:
(Completed 8/31/17)
• Recommend recruitment and retention strategies.
(To be completed Sept/Oct 2017)
• Recommend standards for a well-trained behavioral health
workforce, inclusive of certified, licensed and unlicensed, peer
support specialists and community health workers throughout the
state.
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BEHAVIORAL HEALTH POLICY
Health Policy and Analytics
Workforce Work Group Update
• Workforce assessment
– Farley Center
• Retention and recruitment
– Loan repayment programs
– Outreach efforts
– Trainings
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Health Policy and Analytics
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Peer Delivered Services Work Group
Deliverables:
Completed 8/31/17
• Establish system standards and expectations for Peer Delivered
Services (PDS) workforce.
• Establish the certification/licensure program for becoming a PDS
supervisor.
• Minimum standards and ongoing training requirements for peer
support specialist competence and training.
• Monitor for effective and appropriate use of employing peer
services.
• Research methodologies to establish target ratio of PDS to
members.
– PDS Core Team will be submitting recommendations on target
ratio of peer support specialist to member based on setting.
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BEHAVIORAL HEALTH POLICY
Health Policy and Analytics
Peer Delivered Services Work Group
Update
• System Standards
• Standardized Training Model
• Supervision
(Enter) DEPARTMENT (ALL CAPS)
(Enter) Division or Office (Mixed Case)
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Health Information Technology
Workgroup
Deliverables:
• Advance the implementation of technology to further care
coordination across the state and behavioral health system.
• Identify ways for the state and regional collaborations to support the
continued adoption and utilization of electronic health records and
information sharing across payers and platforms.
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Health Policy and Analytics
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Health Information Technology Update
• Completed environmental scan of Health Information Technology
(HIT) use by behavioral health agencies
– Preliminary results
– Key informant interviews underway
• In December, the Health Information Technology Oversight
Committee will review report on behavioral health and HIT
– Identify gaps and opportunities
– Additional recommendations for supporting behavioral health
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Health Policy and Analytics
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Commercial Health Plans
Deliverables:
• Work plan will be developed upon completion of Parity Policy
Academy.
• Will include technical assistance from OHA’s Transformation
Center to educate providers about parity.
• OHA will work with Department of Consumer and Business
Services and commercial payers to identify the states collective
authority to integrate commercial and publicly insured behavioral
health efforts to produce results, efficiencies and parity
compliance.
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Health Policy and Analytics
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Data Work Group
Deliverables:
Work to begin October 2017
• Develop an outcomes-focused, person-centered behavioral health
measurement framework to assess the impact of integrated
services.
• Align outcomes measurement with identified standards for
behavioral health.
• OHA will work with its current systems to coordinate information and
track progress and outcomes across the state.
• Work group will submit recommendations to the Health Plan Quality
Metrics Committee for metrics to hold the CCOs accountable.
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Health Policy and Analytics
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Transformation Center
• Series of webinars
– Data sharing
– Organizing local structures around shared outcomes
– Blended funding models
– Using data to improve services
– Ensuring equity and transparency within the governance model
• Learning Collaborative
– One day event
– Hiring, retaining and using peer delivered services
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BHC Timeline
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Implementation Timeline
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Phase Four
• OHA Core Team
• Contract changes for CMHPs and CCOs
• Oregon Administrative Rule changes
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Questions?