Frank Moore, Health Administrator/Mental Health Director Linn County Department of Health Services OSHE Panel Discussion: Improving Mental Healthcare Delivery in Your Community

“Leadership drives change and adapts to uncertainty.” D. Triebes “Seems that the older I get the faster time goes by.” D. Glazier-2014 Oregon Society of Healthcare Executives Winter Meeting February 4, 2015 Mental Health and the Oregon Health Transformation

In 2011, more than 41 million U.S. adults (18 %) had any mental illness. In that same year, nearly 9 million U.S. adults (4 %) had mental illness that greatly affected day-to-day living, or serious functional impairment. (SAMHSA ) Behavioral health disorders are the leading cause of disability in the U.S. and Canada. (WHO) High Prevalence of Co-morbid Behavioral Health and Physical Disorders:

1993 – 2013 Oregon Health Transformation MHOs CHMPs IHN-CCO FCHP IHN-CCO Linn Benton Lincoln MH Primary Care Medical Chem. Dep. 2013

A health(y) union of private and public interests –Adjoins local government authorities/services and CCO –Leverages additional funding and resources –Builds upon strengths –Enhances and incents integration –Improves access –Enhances community and consumer engagement –Promotes EBPs –Shared risk/reward –Enhances quality –Lowers costs (but not at the expense of providers or consumers and promotes service excellence) –Promotes funding flexibility wherever possible IHN-CCO: A Catalyst for Change

“An estimated $26 - $48 billion can potentially be saved annually through effective integration of medical and behavioral services. “ Economic Impact of Integrated Medical-Behavioral Healthcare. Millman, Inc. April 2014

Regional Planning Council

Pilot Criteria  Demonstrated need  Improved health outcomes  Reduces healthcare costs  Leads to integration  Utilization of EHR  Culturally appropriate  Addresses disparities  Incorporates quality improvement  Collaborative  Has evaluation built-in  Sustainable  Replicable Regional Planning Council ( advised and informed by the Delivery System Transformation Steering Committee and the Community Advisory Council)

Pilots/Innovations –Prevention –Build on strengths –Promote integration –Promote quality –Promote individual and population health Community Engagement (CAC) –Awareness –Education –Health Equity –Health Literacy –Broad Community Input Innovation and Community Ownership

Senate Bill 1580, the responsibilities of the CAC include, but are not limited to: –Identifying and advocating for preventive care practices to be utilized by the CCO; –Overseeing a Community Health Assessment and adopting a Community Health Improvement Plan to serve as a strategic population health and healthcare system service plan for the community served by the IHN-CCO; –Annually publishing a report on the progress of the Community Health Improvement Plan. Community Advisory Council (CAC)

Community Engagement Community Advisory Council 19Members Linn Advisory Committee  18+ Members Benton Advisory Committee  18+ Members Lincoln Advisory Committee  18+ Members - 51+% are OHP members - Ties to pre-existing advisory bodies

Community Health Assessment (CHA)  Community Health Improvement Plan (CHIP) (Produced by CAC)  IHN-CCO Governing Board  Health Impact Areas (HIAs) Across Region –Access to care –Behavioral health –Maternal & child health –Chronic Disease

Medical costs for treating those patients with chronic medical and co-morbid mental health/substance use disorder (MH/SUD) conditions can be 2-3 times as high as for those who don‘t have the co-morbid MH/SUD conditions. The additional healthcare costs incurred by people with behavioral co-morbidities were estimated to be $293 billion in 2012 across commercially-insured, Medicaid, and Medicare beneficiaries in the United States. (Millman, Inc. 2014) High Medical Cost

IHN-CCO works diligently to test innovative methods of transforming the healthcare system through a variety of pilot projects. Successful pilots will be replicated throughout the IHN-CCO region. Funding for pilots comes from IHN-CCO and service provider agreement to set aside a funding pool for pilot project grants. CCO, CAC and Provider Commitment to Innovation

Mental Health First Aid Regional CHA/CHIP Alignment Criminal Justice Interface LEA Connection System Of Change Wraparound Initiative (SOCWI) Senior Mental Health Coordinators for region Parent Child Interactive Therapy (PCIT) Peer Support Providers Leveraged and Complimentary Efforts - “on deck” or underway in behavioral health alone…

The CCO: a catalyst for system change Accessible, Coordinated, Cost Effective Care  A “CCO of the Community”  Local Government Supports and Authorities  Transparent  Inclusive  Shared Values and Vision  Shared Leadership  Invested in Community  Invested in Population – Health and Wellness  Willingness to risk  Bringing diverse interests and resources to the table What Makes it Work?