0
Beyond the Safety Net:
Behavioral Health in an Integrated Setting
Pam Martin, Ph.D., ABPP
Director, Addictions and Mental ...
2
3
World Health Organization
High Income Middle Income Low Income
Cardiovascular Disease
(heart disease/stroke)
Cardiovascula...
6
7
2013-15 Legislatively Adopted Budget
Community mental health investments
•$21.8M – Children’s mental health
•$46.3M – Comm...
Implementation of community investments
9
• Implementation teams establishing timelines for roll out
• Review existing rep...
10
11
Patient-Centered Primary Care Homes
• Currently 385 recognized PCPCH in Oregon
• Standards for Care
– Accessible
– Account...
Peer Delivered Services in Oregon
• 26 counties have Recovery Community Centers
• 6 counties provide addiction recovery me...
Traditional Health Workers
• Community Health Workers
• Peer Wellness Specialists
• Personal Health Navigators
• Doulas
• ...
Japanese Kids
15
American Kids
16
Partners in Health
• Office of Consumer Affairs
• Health Literacy
• Social Media
• Electronic Medical Record
• Health Tool...
18
Why integrate health care?
Individuals with a severe
mental illness have a 25 year
difference in average life
expectancy c...
Co-Morbidity: Mental/Medical
20
Co-Morbidity: Medical/Mental
21
Integrated Care Models
• Coordinated Care Organizations (CCOs)
• Patient-Centered Primary Care Homes
(PCPCHs)
• Assertive ...
Coordinated Care Organizations
• Integration of behavioral, physical and dental health
• Focus on chronic disease manageme...
Coordinated Care Organizations
• Local networks of all types of health care providers
working together as one entity to de...
Coordinated Care Organizations
• Currently 15 CCOs operating in communities around Oregon
• 90% of OHP clients are covered...
Partnerships : Consumers +
• Law Enforcement
• Families
• Detention Centers
• Providers
• Prisons
• Schools
• Public Healt...
Working Together
28
29
What is changing in Oregon
Income limits increasing
Today the limit is 100% or below
the Federal Poverty Level (FPL).
B...
Cover Oregon is an online marketplace where Oregonians
can apply for health care coverage, comparison-shop for
plans and a...
31
One house, one door
Individuals
and
Families: OHP
and commercial
Small
Employers
Get involved
OHA and Cover Oregon are working together to administer an outreach
and enrollment program for hard-to-reach,...
Get involved – be a community partner
Help Cover Oregon reach and serve people with
addictions and mental health.
• Volunt...
Evolution of health care
34
35
Thank you!
36
LEARN MORE AT COVEROREGON.COM
EMAIL COMMUNITYPARTNER@COVEROREGON.COM
37
Pam Martin
Director, Addictions and Mental Health ...
Pamela A. Martin, PhD : Beyond the Safety Net: Behavioral Health in an Integrated Setting, at the OHSU auditorium on Augus...
Pamela A. Martin, PhD : Beyond the Safety Net: Behavioral Health in an Integrated Setting, at the OHSU auditorium on Augus...
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Pamela A. Martin, PhD : Beyond the Safety Net: Behavioral Health in an Integrated Setting, at the OHSU auditorium on August 1 at 7 PM. 2013

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Transcript of "Pamela A. Martin, PhD : Beyond the Safety Net: Behavioral Health in an Integrated Setting, at the OHSU auditorium on August 1 at 7 PM. 2013"

  1. 1. Beyond the Safety Net: Behavioral Health in an Integrated Setting Pam Martin, Ph.D., ABPP Director, Addictions and Mental Health Oregon Health Authority 1
  2. 2. 2
  3. 3. 3
  4. 4. World Health Organization High Income Middle Income Low Income Cardiovascular Disease (heart disease/stroke) Cardiovascular Disease (heart disease/stroke) Cardiovascular Disease (heart disease/stroke) COPD COPD COPD Cancers Cancers Lung Infections Diabetes Dementia TB Dementia HIV/AIDS HIV/AIDS Complications of Pregnancy and Childbirth Malaria Traffic Accidents Traffic Accidents Diarrheal Diseases
  5. 5. 6
  6. 6. 7
  7. 7. 2013-15 Legislatively Adopted Budget Community mental health investments •$21.8M – Children’s mental health •$46.3M – Community mental health capacity • $5.7M – Supported employment, supported housing and peer delivered services •$7.6 M – Community mental health provider cost of living adjustments •$5.5 M – Case management – assertive community treatment Addictions treatment investments •Increases room and board rates for adolescent alcohol and drug residential treatment from $30 to $90 per day •Funding “set aside” for potential rate increases in room and board for adult alcohol and drug residential system 8 43 % increase in total funds for Oregon’s community mental health system
  8. 8. Implementation of community investments 9 • Implementation teams establishing timelines for roll out • Review existing reports and recommendations from past workgroups • Gather baseline data • Align goals with health system transformation efforts and collaborate with CCOs • Form community advisory groups and engage existing consumer advisory groups • Communicate on progress
  9. 9. 10
  10. 10. 11
  11. 11. Patient-Centered Primary Care Homes • Currently 385 recognized PCPCH in Oregon • Standards for Care – Accessible – Accountable – Comprehensive – Continuous – Coordinated – Patient and family centered • www.PrimaryCareHome.oregon.gov 12
  12. 12. Peer Delivered Services in Oregon • 26 counties have Recovery Community Centers • 6 counties provide addiction recovery mentor services through the Access to Recovery (ATR) grant • Oregon Family Support Network (OFSN) provides statewide support and training for family members of children and youth with behavioral health issues • Youth M.O.V. E. provides services for young adults (18- 25) in recovery from behavioral health concerns • Iron Tribe provides support for people transitioning out of the prison system 13
  13. 13. Traditional Health Workers • Community Health Workers • Peer Wellness Specialists • Personal Health Navigators • Doulas • Peer Support Specialists (will be added to the permanent rule) 14
  14. 14. Japanese Kids 15
  15. 15. American Kids 16
  16. 16. Partners in Health • Office of Consumer Affairs • Health Literacy • Social Media • Electronic Medical Record • Health Tools (There’s an app for that!) (Enter) DEPARTMENT (ALL CAPS) (Enter) Division or Office (Mixed Case) 17
  17. 17. 18
  18. 18. Why integrate health care? Individuals with a severe mental illness have a 25 year difference in average life expectancy compared to the general public. 19
  19. 19. Co-Morbidity: Mental/Medical 20
  20. 20. Co-Morbidity: Medical/Mental 21
  21. 21. Integrated Care Models • Coordinated Care Organizations (CCOs) • Patient-Centered Primary Care Homes (PCPCHs) • Assertive Community Treatment (ACT) • Behavioral Health Homes (BHH) 22
  22. 22. Coordinated Care Organizations • Integration of behavioral, physical and dental health • Focus on chronic disease management • Focus on primary care • Get better outcomes: – Health fairness – eliminate health disparities – Prevention • Community based health workers/traditional health workers 23
  23. 23. Coordinated Care Organizations • Local networks of all types of health care providers working together as one entity to deliver care for people on the Oregon Health Plan – Physical health care – Addictions treatment – Mental health care – Dental care • Care is coordinated at every point – from where services are delivered to how the bills are paid 24
  24. 24. Coordinated Care Organizations • Currently 15 CCOs operating in communities around Oregon • 90% of OHP clients are covered by a CCO • Benefits and services are integrated and coordinated • One global budget that grows at a fixed rate • Metrics: standards for safe and effective care – Alcohol or other Substance Misuse (SBIRT) – Developmental Screening in the First 36 Months of Life – Follow-up after Hospitalization for Mental Illness – Follow-up Care for Children Prescribed Attention Deficit Hyperactivity Disorder (ADHD) medication – Screening for Clinical Depression and follow-up Plan • Local accountability for health and budget • Local flexibility • More information: www.Health.Oregon.gov 25
  25. 25. Partnerships : Consumers + • Law Enforcement • Families • Detention Centers • Providers • Prisons • Schools • Public Health • Faith Based • Advocates • Hospitals • Emergency Depts. • Legislators • City Government • County Government 27
  26. 26. Working Together 28
  27. 27. 29 What is changing in Oregon Income limits increasing Today the limit is 100% or below the Federal Poverty Level (FPL). Beginning January 1, 2014, the limit will be up to 138% FPL. That’s about $15,800 a year for a single person or $32,500 a year for a family of four. Now Jan. 1
  28. 28. Cover Oregon is an online marketplace where Oregonians can apply for health care coverage, comparison-shop for plans and access financial assistance. Oregonians, regardless of income, can apply through Cover Oregon at www.coveroregon.com to see if they qualify for Oregon Health Plan, Healthy Kids or tax credits for private insurance. 30 Cover Oregon
  29. 29. 31 One house, one door Individuals and Families: OHP and commercial Small Employers
  30. 30. Get involved OHA and Cover Oregon are working together to administer an outreach and enrollment program for hard-to-reach, non-English speaking, geographically isolated, and underserved populations. Community partners and providers: •Reach out to and provide enrollment assistance to Oregonians accessing public and private health insurance coverage •Develop local outreach campaigns tied to the overall Cover Oregon marketing effort •Provide assistance with eligibility, enrollment, appeals, and coverage renewals •Collaborate with other community partners as well as insurance agents 32
  31. 31. Get involved – be a community partner Help Cover Oregon reach and serve people with addictions and mental health. • Volunteer and grant opportunities will be available to providers and community organizations for outreach, enrollment assistance and public education. • Training is available for community partners to provide outreach and enrollment assistance. • Learn more at CoverOregon.com • Or email communitypartner@coveroregon.com 33
  32. 32. Evolution of health care 34
  33. 33. 35
  34. 34. Thank you! 36
  35. 35. LEARN MORE AT COVEROREGON.COM EMAIL COMMUNITYPARTNER@COVEROREGON.COM 37 Pam Martin Director, Addictions and Mental Health Division Oregon Health Authority 500 Summer Street NE, E86 Salem, OR 97301 503-945-5879 pamela.a.martin@state.or.us
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