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AMH System Change

The Oregon Health Authority's Addictions and Mental Health division (AMH) is engaged in major health reform to improve the health and well-being of Oregonians.

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, similar to those of Coordinated Care Organizations 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

General Information

AMH System Change Advisory Activities

Coordinated Care Organizations

AMH System Change Fact Sheet

AMH System Change FAQ for LMHA's

Biennial Implementation Plan

Flexibility, accountability and local control

These improvements to the addictions and mental health system are 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 is 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.

AMH began the first phase of system change on July 2012 which establishes the framework for global budgeting and outcomes-based management for services not covered by the Oregon Health Plan.

Local Mental Health Authority (LMHA) Agreement Documents




Supporting Documents


Stakeholder Communication