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Health System Transformation Bulletin
Health System Transformation
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SelectedAugust 19, 2015
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Oregon ranked ninth in the nation for number of NHSC participants
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​Oregon recently was ranked ninth nationally in the number of providers who participate in a national health care workforce recruiting program, both statewide and in rural areas.

A total of 298 Oregon providers participate in the programs of the National Health Service Corps (NHSC). According to a recent report, Oregon is in ninth place among all states and territories for the number of health care providers receiving funds from NHSC's loan repayment, scholarship and state loan repayment programs.

Last year, Oregon was ranked 14th in the nation.

Oregon's current improved ranking  demonstrates that we are improving access to health care for Oregonians in underserved communities by helping stabilize the health care workforce in these areas, says Marc Overbeck of the OHP Primary Care Office (PCO).

Overbeck and his team serve as the state liaison for the NHSC health care workforce recruiting programs in Oregon.

NHSC programs help improve access to health care in underserved areas of the state through loan repayment and scholarship programs for providers who commit to practicing in NHSC-approved clinics.  Such clinics are located in federally designated Health Professional Shortage Areas (HPSAs). There are more than 300 NHSC-approved clinics in Oregon.

As the state liaison, Overbeck and his team ensure clinics and clinicians around the state are aware of the opportunities of these programs, and maximize the opportunities for NHSC resources to come to Oregon providers.

Oregon also ranked ninth nationally for NHSC program participants in rural areas. This means the PCO is effectively providing outreach and support to health care providers outside of Oregon's urban areas, both directly and through its work to promote the NHSC through partner organizations.

  
OHA to host a one-day Fall forum
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"Engaging Beneficiaries with Medicaid and Medicare and Long-Term Services and Supports (LTSS): Strategic Approaches and Partnerships," Friday, September 25, at Lane Community College Center for Meeting and Learning.  

The fall forum will focus on building innovative, strategic approaches and partnerships to serve high-need Medicaid and Medicare, multicultural and LTSS populations. The program will highlight best practices for continued health care transformation work in Oregon and strategies to improve outcomes for high-need beneficiaries. 

Who should attend:  This event is designed to support Oregon health reform work and create opportunities to share and learn about strategies, partnerships and innovative approaches for addressing:

  • high-needs Medicaid and Medicare members;
  • unique challenges facing dual-eligible populations;
  • members with long-term services and supports needs;
  • addressing the unique needs of multicultural populations across Oregon; and
  • supporting members with disabilities.

The event is suitable for coordinated care organization staff and health care providers, Medicare Advantage Plan and Dual Special Needs plan staff, the Oregon long-term services and supports community, and advocates. 

Highlights of the event include:

  • Targeted member engagement and activation
  • Trauma-informed approaches
  • Strategies to improve disability access and care
  • Strategies to address dual-eligible populations with severe persistent mental illness (SPMI)
  • Improving integration of behavioral health for high-needs members
  • Care coordination and care transitions
  • The ACA, Person-Centered Planning, and Olmstead Act
  • Organizational assessment tools
  • Community partners and resources
  • Health equity and multicultural outreach
  • Assistive technology and more

A registration link will be available at the Transformation Center’s Complex Care Collaborative site. For more information, contact Jennifer Valentine at Jennifer.B.Valentine@state.or.us.


  
Patient finds ‘hope’ as clinic combines behavioral, primary care
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​The Willamette Family integrated care clinic helped Bud James Perry get his life back under control after 14 years of active alcoholism that left him homeless on the streets of Eugene.

As Bud tells it, he wasn't washing himself or his clothes and was barely eating any food. As soon as he woke up he started drinking until he passed out again.

That finally changed on August 18, 2014, when he moved into Buckley House to undergo detox in order to receive residential services at Carlton House. The houses are part of the integrated services offered by Willamette Family, a provider in the Trillium Coordinated Care Organization that serves Oregon Health Plan members in Lane County.

It was a long, hard road for Bud, who is also diabetic and had very high blood sugar and blood pressure. He hadn't been taking his insulin or blood pressure meds for at least two months, but with assistance from the team of primary care practitioners, mental health specialists, addiction therapists, peer counselors and more, he stabilized his condition. Bud says he now feels "blessed."

Trillium is one of several CCOs that received federal and state funding through the Oregon Health Authority's health system transformation to pay startup costs to integrate primary health care providers with those who treat behavioral health needs – mental illness and substance abuse disorders. Half of Trillium's eight innovation grants went to existing medical clinics that brought in behavioral care providers; the remaining four including Willamette Family, were behavioral health clinics that brought in primary care providers. (Trillium pays for ongoing expenses of this "integration incubator project" from other internal funding sources.)

Willamette Family's core services in downtown Eugene include primary care, behavioral care, a walk-in evaluation center, alcohol and drug treatment services, outpatient DUI services and peer support mental health services. They also have nurse practitioners who visit the men's and women's residential centers.

"The goal with the clinic is to treat their medical issues but also get them to a place where they want to treat their behavioral health issues, and we've been quite successful with that," says Colleen Smith, the senior program manager. "We want to provide seamless service with the least amount of barriers and have them be empowered in their own health care. That's the heart and spirit of what we're doing, and having them feel like they're the most important person that just walked into the clinic."

Since officially opening in January 2015, the center has treated nearly 1,000 individuals for behavioral or urgent care needs, and diverted more than 300 from local emergency rooms, Smith says. Many of their walk-ins need detoxification service but aren't eligible for it unless they are "medically stable." Willamette Family's services help them get on track with the medications they need for diabetes, asthma and other common disorders, and deal with housing and transportation issues required for successful detox, Smith says.

"We have been instrumental in being able to quickly treat these people for their medical issues so that they can engage in the services they need right away," she says.

Bud, who says he was sober for 17 years before he started drinking again in 2000, says he was never treated so well even when he had a job and private insurance. He credits his primary care provider, nurse practitioner Jin Park, with making the difference.

"I've never had a physician who has treated me with such respect," he says. "When I have questions she explains it to me in a way a lay person like me can understand.

"The biggest thing – and I really mean this – that I've acquired or been blessed with is hope," Bud says.

Colleen Smith says the experience of helping people like Bud has affected her, too.

"It has been an amazing and profound experience," she says. "We're getting to touch people in all aspects of their life and really truly make a difference in our community – we're able to treat the whole person."

  
High touch, low tech: Silverton Health has a person-first approach
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Treating the whole body, including the mind, is an important part of how health care is changing in Oregon. Mental health issues affect 21 percent of people in our state, and these health needs are often not addressed. Silverton Health is working to change this statistic by bringing together teams of mental and physical health care providers to treat the entire person.

Silverton Health created these high-risk care teams to help patients experiencing both a physical and mental health crisis navigate a potentially confusing system. Teams usually include a nurse, social worker and two health navigators. Together, they are able to help ease the transition from the hospital to primary care, explain how patients need to take their medications, do home checks, and assist patients with making and attending behavioral health appointments.

Patients are referred to the program through either their primary care physician or by a computer analytics program that helps identify at-risk or rising-risk patients who may benefit from this type of hands-on care coordination. This program is able to help Medicaid patients - who may be facing some other significant barriers to care such as homelessness - address both their physical and mental health issues and work together with their doctor to gain a better quality of life.

"The focus of the program is not on enabling patients, but instead on educating them how to better manage their health," says Sarah Fronza, chief executive officer of Silverton Health, "The team is in place to help make sure that these at-risk patients have one point of contact to answer questions and help them navigate their care. We take a high touch, low tech approach."

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