Building a 21st Century Behavioral Health System
Behavioral health touches every Oregonian – children, teens, adults and seniors. While Oregon has made progress related to the behavioral health system, there is still much work to do to integrate behavioral health with the physical and oral health systems in the coordinated care model, and making sure that every Oregonian has access to the services they need.
In 2016 the Oregon Health Authority (OHA) brought together a diverse group of people and organizations called the
Behavioral Health Collaborative. After eight months of work, the collaborative published recommendations designed to help Oregonians get the right support at the right time. These recommendations will help transform Oregon’s behavioral health system from one that is fragmented and unable to serve everyone in need to one that is integrated and providing better health and better care at a lower cost.
To implement the recommendations, OHA created a governance structure and convened workgroups that include people from across Oregon and are supported by OHA staff and subject matter experts.
The Governance and Finance Workgroup has recommended OHA rename the "single point of shared accountability" referenced in the BHC report to Regional Behavioral Health Collaborative (RBHC). This will avoid the possible interpretation that a new entity is required.
- RBHCs will be formed by CCOs, community mental health programs (CMHPs), local mental health authorities (LMHAs), local public health authorities (LPHAs), tribes, individuals with lived experience, and other key system partners in each geographic region of the state to improve individual health outcomes.
- OHA will implement the recommendation by establishing an RBHC in the tri-county Metro area. FamilyCare CCO’s decision to leave the Medicaid market has illuminated the different approaches within this region’s behavioral health system and has identified the opportunity for timely attention to address the region's ongoing behavioral health challenges. Partners in the Metro area are willing and ready to move forward in developing an RBHC.
Tri-County Portland-Metro Area RBHC
The Behavioral Health in Oregon Mapping Tool is a series of maps used to display various dynamic and interactive information about the behavioral health system in Oregon. This mapping tool is an opportunity to showcase the services that are currently delivered across Oregon. Additionally this mapping tool:
- Provides a comprehensive look at Oregon's behavioral health system including identifying behavioral health service locations in each county, the numbers of Oregonians dealing with behavioral health conditions and the state funding being spent on behavioral health in each county.
- Can be used to identify gaps in Oregon's behavioral health system and help the state and local communities begin to find solutions.
- Provides information to local services for Oregonians looking for help.
You can find out more about the key features of the mapping tool by viewing the Behavioral Health in Oregon Mapping Tool page.
Workgroups met between May and August 2017 to recommend system changes that OHA can implement to attain BHC's overarching goal: creating a coordinated, seamless health care system that treats each individual as a whole person and not a collection of problems and diagnosis.
The Data Workgroup comprises stakeholders with expertise in behavioral health and data. This work group will be responsible for:
- Developing an outcome-focused, person-centered behavioral health measurement framework to assess the impact of integrated services and hold regional collaborations accountable for clinical and cost targets.
- Developing a minimum data set to use consistently across facilities, clinics and providers, which reflects all individuals and populations and their unique outcomes.
The Governance and Finance workgroup is a workgroup of the Oregon Health Policy Board. This group is responsible for:
- Developing guidelines for the development of the single-point of shared accountability
- Developing guidelines for approval of single plans of shared accountability
- Identifying the need for OAR (Oregon Administrative Rules) and contract changes
- Recommending a financial incentive structure
The Standards of Care and Competencies Workgroup is being facilitated through the Behavioral Health Planner of the Addictions and Mental Health Planning and Advisory Council. This group is responsible for:
- Establishing core competencies
- Recommending minimum standards for care
- Recommending mechanisms for co-management of individuals who require specialty behavioral health care
The Workforce Workgroup is being facilitated through the Behavioral Health Planner of the Addictions and Mental Health Planning and Advisory Council. This group will recommend standards for a well-trained behavioral health workforce.
The Peer Delivered Services Workgroup is a subcommittee of the Peer Delivered Services (PDS) Core Team. This group is responsible for:
- Developing standards, expectations, and monitoring guidelines for PDS
- Recommending a standardized training model
- Recommending certification for peer supervisors
The Health Information Technology Oversight Council is a committee of the Oregon Health Policy Board. This group is responsible for providing advice on how to advance the use of technology to integrate and coordinate care across Oregon and the behavioral health system. BHC issues will be discussed at regularly-scheduled HITOC meetings.
In late 2015, Senator Sara Gelser (D-Corvallis) and OHA Director Lynne Saxton traveled the state to hear from adolescents, adults and families who have had difficulties accessing mental health and substance use disorder treatment in Oregon. They heard from approximately 550 consumers and family members over the course of seven town hall meetings across the state.
The Behavioral Health Town Hall Report summarizes the main themes that arose during the town hall meetings.