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Health System Transformation Bulletin
Health System Transformation
SelectedNovember 9, 2015

OHA names External Relations Division director

BethAnne.jpg​The Oregon Health Authority (OHA) has named its director for the new External Relations Division, which comprises legislative and government affairs, communications, the Office of Consumer Activities and the OHA ombudsman.

BethAnne Darby joined the OHA team November 9. She has extensive experience in both government affairs and communication, and has a law degree from Willamette University.

Most recently, she was the assistant executive director for public affairs at the Oregon Education Association. She also served as the executive director for the Oregon Board of Psychological Examiners, lobbyist for the Oregon Board of Chiropractic Examiners and has worked on political campaigns.

BethAnne will create an integrated approach to OHA external relations, as well as increase the internal communications function.

They’re listening: State leadership embarks on tour to hear from people who have experienced Oregon’s behavioral health system

​State Sen. Sara Gelser, along with OHA Director Lynne Saxton, began a listening tour in September. They are traveling throughout the state so that they can listen, first-hand, to individuals who have experienced the Oregon behavioral health (mental health care and addictions) system.

For example, at the first meeting held in Klamath Falls, Gelser and Saxton welcomed more than 100 individuals – children, teens, and adults of all ages – who shared stories about what was working well for them: affordable housing and in-home services; and the challenges: finding permanent employment. In addition to Klamath Falls, where they were joined by Sen. Doug Whitsett, Rep. Gail Whitsett and Klamath County Commissioner Tom Mallams, they hosted meetings in La Grande with Union County Commissioner Jack Howard, and in Bend with Sen. Tim Knopp and Deschutes County Commissioner Tammy Baney.

Participants applauded local law enforcement for their role in supporting and keeping individuals with mental illness or addictions safe when in their care and custody. There was praise for the success of drug courts and peer support services.

Another challenge discussed was learning how to successfully navigate a complex behavioral health system so that a parent could access timely and appropriate services for her child with mental illness. In rural areas, transportation was an impediment to getting to initial appointments or keeping appointments. And in La Grande, they learned there is great local support and additional need for psychiatry services.

Gelser and Saxton will use this information to bring access to better behavioral health care to all regions in Oregon and increase data-driven outcomes. A summary report will be available in January to guide OHA’s behavioral health integration efforts. The meetings will continue in November in Astoria, Albany and Portland. For more information on the upcoming meetings, go to www.oregon.gov/oha/amh/Pages/strategic.aspx

Medicaid client update:

​As of October 19, 2015, there are 1,118,800 people in Oregon who are Medicaid clients, an increase of about 459,700 since December 2013 (pre-ACA).

Oregon Health Plan (OHP) update:

​​The work to prepare the Oregon Health Plan (OHP) eligibility and enrollment system – Oregon Eligibility (ONE) – for implementation is ongoing. We expect eligibility workers to begin to use the system before the end of the year.

We are building from Kentucky’s successful basic system, and want to safeguard system stability. To this end, eligibility workers will use some manual and transitional processes when the worker portal becomes available. System testing has been underway for a number of months and will continue through November.

In addition, OHA requested and received approval from the Centers for Medicare and Medicaid Services (CMS) to pause OHP renewals for up to 90 days while we transition to ONE. This will be very helpful in managing workloads during the open enrollment period, as paper application processing continues. CMS has also given OHA approval to spread out renewals over 2016 in an effort to balance monthly volumes.

In 2016, current OHP members will be asked to renew their coverage through the current paper renewal process. New applicants can expect ONE to become available to them in early 2016. Individuals will be added to ONE as they renew in 2016 or come in as new applicants.

Public Health Division update:

​Retail marijuana is now for sale in Oregon for people 21 and older. OHA’s Medical Marijuana Dispensary Program is overseeing retail sales until the Oregon Liquor Control Commission begins to issue licenses in 2016. OHA’s Public Health Division has created a website: healthoregon.org/marijuana. There, you will also find the required posters and cards that dispensaries must display as well as evidence-based information about how marijuana use can affect the public. More than 60,000 users have accessed the website since October 1.

OHA announces 2015 Dr. Bruce Goldberg Health Equity Champions

​The Oregon Health Authority’s Office of Equity and Inclusion announced three Dr. Bruce Goldberg Health Equity Champions for 2015 during its annual meeting Thursday at the Oregon Convention Center. This year's recipients are state Representatives Alissa Keny-Guyer (D-Portland) and Knute Buehler (R-Bend), and the Oregon Health Equity Alliance.

“We are so fortunate to have partners like these championing health equity in Oregon,” says Leann Johnson, director of OHA’s Office of Equity and Inclusion. “They have worked tirelessly to ensure all Oregonians have access to better health, better care and lower costs."

These champion awards are named for Bruce Goldberg, M.D., OHA’s first director, who led health system transformation in Oregon. More information about the recipients is below:

Rep. Alissa Keny-Guyer – As chair of the Oregon House of Representatives Human Services and Housing Committee and with a background in public health, Rep. Keny-Guyer is deeply committed to health equity and prevention strategies with the greatest returns – from prenatal care to suicide prevention, as well as oral, environmental and public health. She focuses on women, foster children and communities that suffer the poorest health. During the 2015 session, Rep. Keny-Guyer sponsored House Bill 2024, highlighting the important role of traditional health workers in providing culturally appropriate oral health prevention education to address oral health inequities. She works hard to develop bipartisan support and listens carefully to voices in the community.

Oregon Health Equity Alliance – The Oregon Health Equity Alliance (OHEA) is a statewide partnership of more than 40 organizations and diverse health equity advocates, public health entities, and organizations that serve constituents experiencing health inequities. OHEA’s five-year strategic plan is designed to bring about the best community-driven results and motivate policy change for social justice. In the 2015 legislative session, OHEA supported numerous bills that address social determinants of health and equity, including bills known as Ban the Box, End Profiling, Paid Sick Time, Comprehensive Women’s Health, and Cover All Kids.

Rep. Knute Buehler, M.D. – Rep. Buehler’s leadership was instrumental in passing House Bill 2879. This bill, which will become law January 1, 2016, allows pharmacists to prescribe and dispense birth control pills and hormonal contraceptives to women. This law eliminates an obstacle to access and effective use, especially among low-income women. With the passage of House Bill 2879, Oregon now joins California as the only two states that allow women direct access to birth control through a pharmacist prescription.

Oregon’s Coordinated Care Model Summit: Highlighting outcomes and promoting excellence in the coordinated care model

November 17
Oregon Convention Center, Portland

You still have time to register for this one-day meeting hosted by the Oregon Health Authority to:

  • Share outcomes and lessons learned;
  • Support excellence in coordinated care model implementation across sectors; and
  • Inspire future innovation in Oregon and beyond.

Highlights include:

  • Dr. Soma Stout, M.D., of the Cambridge Health Alliance and the Institute for Healthcare Improvement, will talk about opportunities to create healthy communities by addressing the social determinants of health within clinic settings.
  • CCO leaders will tell the stories of how they achieved results.
  • Health care leaders will discuss the future of the coordinated care model and financial sustainability.

    For more details, see the draft agenda.
One-on-one help makes the difference in chronic disease care

Community Paramed_sized for web.jpg

Learning to live with a chronic condition can help prevent at-risk people from developing even more serious health concerns. Many people with diabetes, heart disease, lung disease and other conditions face barriers to good health management. If they're unable to travel to their doctor’s office or don't understand how to properly take their medicine or measure their blood sugar or blood pressure, their conditions can spiral out of control.

Redmond Fire and Rescue’s mobile paramedic program plays an important role in the community health of Central Oregonians by helping high-risk patients avoid preventable health emergencies.

When Doug Kelly, Redmond Fire and Rescue EMS division chief, heard about mobile paramedic programs in Texas and Colorado, he was convinced such a program could make a difference for rural Oregonians. Kelly worked with PacificSource Community Solutions, the coordinated care organization in Central Oregon, and St. Charles Health System to set up the state's first grant-funded mobile paramedic program. The program serves at-risk patients with high needs in Redmond and the rest of Deschutes, Jefferson and Crook counties by providing follow-up care in their own home. It helps keep people with chronic conditions from making unnecessary and expensive ambulance trips to the hospital emergency room.

“Patients who participate in the program will have a better understanding of their illness and what it takes to get better," Kelly says. "The key to what this program does is education. The goal is to help people better understand their disease.”

Dan Cox is the program's man on the ground. A retired firefighter/paramedic, Cox is the community paramedic who works directly with the patients.

“My job is to help people better manage their health," Cox says. "Often I can see what the problem is when I get to their house.”

PacificSource works with its member providers to refer high-risk Medicaid patients to the program. Only those who have been hospitalized with specific chronic conditions such as chronic obstructive pulmonary disease (COPD), heart disease or diabetes and are at risk of being re-admitted to the hospital are included. If a referred patient meets the criteria, Cox gets a health history from their doctor and calls the patient to set up their first visit.

“Some people need help for just a few visits. Others need help for much longer, sometimes even months," Cox says. "One man I worked with had hypertension, and his provider couldn’t figure out how to help him manage his pills. This patient continued to come back for care because he was mismanaging his medication.”

Cox realized the man's medical condition was a barrier.  “He had suffered a stroke that damaged a portion of his brain and he couldn’t make sense of the directions on the pill bottles. Every Monday I would visit him and fill in his pill box and made sure he watched. Later on, I would have him practice while I supervised. Eventually he could do it all on his own and was successfully taking his medication without help. He just needed that extra attention to get him started.”

By focusing on this specific group of people, the community paramedics help them gain a better understanding of their illness and what it takes to get better. Many patients have access problems and don’t qualify for home health care. This program covers that gap.

“I see it as a success when I have graduated a patient from the program and know that they are able to manage their own care," Cox says. "I get to do something not a lot of paramedics get to do, and that is pretty great.” 


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