The future of Oregon's addictions and mental health system

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Over the next year, the Oregon Health Authority's Addictions and Mental Health division (AMH) will engage in major health reform to improve the health and well-being of Oregonians.

One task is the integration of physical and behavioral health care for individuals served through the Oregon Health Plan. This is the health system transformation work set forth by House Bill 3650 that includes the development of Coordinated Care Organizations (CCOs). AMH staff are working to ensure that CCOs would provide greater access to integrated health, addictions and mental health services.

System change

In addition to the work to develop CCOs, AMH has undertaken a parallel but separate system change effort with Oregon's county governments to restructure the publicly funded addiction and mental health system for people who are not eligible for the Oregon Health Plan. The goals for this system change work are similar to those of HB 3650 and include:

• Emphasizing early intervention to promote independence, resilience, recovery and health and to avoid long term costs including loss of employment, damage to family stability, increased health care costs, and criminal justice involvement
• Providing flexibility to local communities to enable them to better serve people with addictions and mental health needs
• Improving accountability in the community-based addictions and mental health system
• Ensuring consumer and family involvement in both the planning and ongoing governance of the system
• Reducing reliance on high-cost institutional care
• Over the long term, increasing the availability of high quality community-based addictions services and mental health care 

Flexibility, accountability and local control

These improvements to the addictions and mental health system will be driven by the flexibility afforded by global budgeting, allowing counties the discretion to put resources where they are most needed to serve people in their communities. The budgeting flexibility will be balanced by outcomes-based management that holds counties and providers accountable for the overall behavioral health of the populations they serve rather than just the quantity of services provided or the number of people served.

The work will move forward rapidly, with a target for establishing the framework for global budgeting and outcomes-based management for services not covered by the Oregon Health Plan by July of 2012. 

Charters

• System Design 
• Contract Language Team 
• Finance Team 
• Performance and Outcomes Measures Team 
• Organizational/Change Management Team 
• Advising Activities  

Stakeholder participation and public feedback

To ensure that system change reflects the best thinking from staff, partners, consumers, families and communities, AMH has developed two formal advisory processes.

From July-October of 2011, stakeholders met with AMH staff in a series of Design Advisory Group meetings. Input from each meeting was shared with the AMH teams responsible for different aspects of system change. See below for design advisory group concept papers describing how this input was incorporated into their work.

From October 2011-June 2012, a stakeholder Implementation Advisory Group is meeting monthly to provide intensive advice on the details of system change implementation.

In addition to the formal feedback processes above, AMH requests your ideas, concerns and questions about system change via e-mail at AMH.systemchange@state.or.us.  

Implementation Advisory Group

• Advisory Group Activities Feedback Loop Diagram 
• Advisory Group Membership Roster 

Click a date below for details, agenda and materials for each meeting.

Design Advisory Group

Design Advisory Group overview 

Concept Papers

• System Design Overview 
• Financial Agreements 
• Financing 
• Peer and Family Involvement 
• Performance Measures 
• Quality Improvement and State Oversight 

Click a date below for details, agenda and materials for each meeting.