US Department of Justice/Oregon Health Authority OREGON PERFORMANCE PLAN Empowering adults with severe and persistent mental illness to live, work, and thrive in their communities. JULY 2016

Oregon Performance Plan Aggressive three-year timeline: 7/1/16 – 6/30/19 7/1/2016 6/30/2017 6/30/2018 6/30/2019 Tailored to meet the needs of the Behavioral Health Collaborative. Data will be reported to USDOJ Quarterly.

Oregon Performance Plan Right Treatment Right Time Right Setting Adults 18 and over experiencing serious and persistent mental illness Improve transitions of people to integrated settings from higher levels of care. Increase number of people who are supported in the community, and avoid incarceration and unnecessary hospitalization. Expand services and supports that enable people to live successfully integrated into the community.

Plan Highlights Increase Community Integrated Treatment Crisis Services (Mobile Crisis) Assertive Community Treatment (ACT) Supported Housing Peer Delivered Services Supported Employment Criminal Justice Diversion Decrease Institutional Care Secure Residential Treatment Facilities Emergency Departments Acute Psychiatric Care Oregon State Hospital (OSH) The services outlined here are in a different order than they appear in the performance plan. We’ve organized this presentation to better communicate the areas where we will integrated treatment and those where we will decrease institutional care 10 specific topic areas within the Performance Plan. Will be sharing some highlights, the Performance Plan is much more comprehensive. Includes: Metrics with Targets Metrics without Targets Processes

Sustain or further increase Mobile Crisis Increasing availability will help prevent hospitalization and incarceration through early intervention and treatment. Requirements: response times, track/report dispositions. 3,500 served 3,700 served Mobile Crisis Statewide Sustain or further increase 7/1/2016 6/30/2017 6/30/2018 6/30/2019 There are additional requirements around response times specific to frontier, rural and metro areas.

Assertive Community Treatment (ACT) Assume people can transition from OSH into their own home without going to residential care. 1,050 served by ACT 2,000 served by ACT Sustain or further increase 7/1/2016 6/30/2017 6/30/2018 6/30/2019 Develop more ACT programs statewide Ensure that all individuals with SPMI appropriate for ACT receive ACT

Supported Housing Stable housing is important for overall health and stability. It provides community connections in ways that residential care cannot. People with mental illness have the right to live in the community. 835 in supported housing 1,355 in supported housing 2,000 in supported housing 7/1/2016 6/30/2017 6/30/2018 6/30/2019

Peer Delivered Services Vital for a recovery-oriented system. Eases transitions into the community. Provides valuable lived experiences. 20% increase from baseline Additional 20% increase from baseline Sustain or further increase 7/1/2016 6/30/2017 6/30/2018 6/30/2019

Supported Employment Data collection for people in Supported Employment services. Deliverables Track/report number of people who receive services and reemployed in competitive integrated employment. Track/report number of people who maintain competitive integrated employment without receiving services.

Criminal Justice Diversion Increase diversions, expand Sequential Intercept Model statewide, monitor arrests and dispositions. Deliverables Reduce contacts between adults with severe and persistent mental illness and law enforcement due to mental health reasons. Track/report number of adults receiving services and the number of diversions pre- and post-arrest. Expansion of the Sequential Intercept Model

Secure Residential Treatment Facilities Reduce length of stay 10% reduction in length of stay 20% reduction in length of stay Sustain or further increase 7/1/2016 6/30/2017 6/30/2018 6/30/2019 Most restrictive level of residential care Need to rethink how resource is utilized

Emergency Departments Reduce admissions and readmissions 10% reduction from baseline 20% reduction from baseline Sustain or further reduce 7/1/2016 6/30/2017 6/30/2018 6/30/2019 Unnecessary ED use makes it harder for individuals to remain stable in their communities and drives costs up for everyone For individuals with two or more admissions to ED within a six month period, an individualized plan will be required.

Acute Psychiatric Care A plan is needed for people with two or more readmissions within a six month period. Housing needs must be considered prior to discharge. 60% receive warm handoff 75% receive warm handoff 85% receive warm handoff 7/1/2016 6/30/2017 6/30/2018 6/30/2019 Housing is an important consideration in the discharge planning. All partners need to work together to ensure housing needs are met prior to discharge Discharging patients to a shelter, a motel, or the street increases the chances they will be re-hospitalized Discharging patients to a stable living environment promotes health, stability, and community diversity. A “warm handoff” discharge helps the patient connect to community treatment resources, helps them gain stability in the community, and reduces the likelihood of readmission A warm handoff discharge is defined as linkage to a community case manager, peer bridger, or other community provider prior to discharge

Oregon State Hospital Reduce Length of Stay: Once a patient is deemed Ready to Transition (RTT), they must be discharged (preferred discharge is within 72 hours of RTT). 75% discharged within 30 days 85% discharged within 25 days 90% discharged within 20 days 7/1/2016 6/30/2017 6/30/2018 6/30/2019 Keeping people in OSH longer than necessary violates their civil rights; discharge planning must begin at admission. Average length of stay should be no more than 120 days. Preferred discharge is within 72 hours of RTT.

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