The Oregon Health Authority (OHA) Lisa Millet, MSH Oregon Health Authority October 2, 2013 Governor’s Task Force on TBI Meeting Oregon Health Sciences University

Agency Story OHA was created by the legislature in 2009, and was launched in July of 2011. OHA brought together agencies that had been part of the Department of Human Services (DHS) and the Department of Administrative Services (DAS) The Division of Medical Assistance Programs (includes Oregon’s Medicaid Program) The Public Health Division The Addictions and Mental Health Division The High Risk Insurance Pool The Public Employees Benefit Board (PEBB) and the Oregon Educators Investment Board (OEBB) The Oregon Office of Health Policy and Research The Oregon Health Policy Board has nine Governor-appointed members and serves as the policy-making and oversight body for OHA an agency providing a spectrum of human services to individuals, families and communities 2

OHA Vision, Mission and Goals Vision: A healthy Oregon. Mission: Helping people and communities achieve optimum physical, mental and social well-being through partnerships, prevention and access to quality, affordable health care. 3

OHA Goals Major focus on transforming the health care system by: Improving the lifelong health of Oregonians Increasing the quality, reliability, and availability of care for all Oregonians Lowering or containing the cost of care so it's affordable to everyone or in short… “Better health, better care, lower costs”.

OHA Org Chart 5

Key Divisions OHA has three major Divisions: The Division of Medical Assistance Programs The Addictions and Mental Health Division The Public Health Division 6

The Addictions and Mental Health Division of OHA (AMH) AMH provides: Substance abuse and problem gambling prevention and treatment services Children and Adult Mental health prevention and treatment services Manages the state hospital system, including custody of persons committed to the state by courts because of mental illness

The Division of Medical Assistance Programs in OHA (DMAP) Administers the Oregon Health Plan (OHP) which provides health care coverage to low-income Oregonians More than 600,000 people each month receive health care coverage through the OHP.    

The Public Health Division of OHA (PHD) PHD is primarily focused on prevention and on fostering environments that promote health rather than providing treatment services to individuals PHD has two goals, each with a set of priority areas: Make Oregon one of the healthiest states Make Oregon’s public health system into a national model of excellence

PHD Priorities for Making Oregon One of the Healthiest States Prevent tobacco use Decrease obesity/overweight Reduce suicide Prevent or reduce heart disease and stroke, and increase survivability Prevent family violence Increase community resilience to emergencies

PHD Priorities for Making Oregon’s Public Health System into a National Model of Excellence Transform the public health system through public health accreditation Support CCOs in achieving community health goals Increase the use of health impact assessments as a tool in communities Establish mechanisms that ensure health in all policies Maintain excellence in epidemiology and surveillance 11

AMH Service Delivery System Outside of the State Hospital system mental health and addictions services are delivered through contracts with community mental health programs, regional organizations and direct service providers. Medicaid pays for many of the treatment services overseen by AMH.

DMAP Delivery System Health care services paid for by DMAP are provided by public and private health care providers around the state. 16 Coordinated Care Organizations (CCOs) are the umbrella organizations that govern and administer care for 90% of OHP members. One budget that grows at a fixed rate Also accountable for health outcomes Metrics for incentive payments

PHD Service Delivery System Some statewide services are administered by PHD Many services are provided in partnership with 34 county health departments

AMH and TBI AMH has begun to develop settings that specialize in treatment and behavioral supports needed by people with TBI Enhanced Care Program (Medford) in partnership with DHS: 16 bed residential care facility Two 5-bed residential treatment homes 15-bed long term care facility due to open in 2014

DMAP and TBI DMAP concussion work

PHD and TBI PHD’s Injury and Violence Prevention Program analyzes data about the incidence of TBI and risk factors for TBI TBI has been highlighted as an issue in the Division’s fall prevention work

Future Direction Support the development of CCOs, and inclusion of robust prevention activities. 18

What are the gaps? Need for a TBI Registry to: Help connect those with TBI to services Provide data to inform policymakers and service and prevention program managers about the annual incidence, injury severity, treatment costs, discharge status, geographic distribution of persons with TBI, and the causes and risk factors for TBI in Oregon 19 19