Frank Moore, Health Administrator/Mental Health DirectorLinn County Department of Health Services

OSHE Panel Discussion:Improving Mental Healthcare Delivery in Your Community

“Leadership drives change and adapts to uncertainty.”

D. Triebes -2014

“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

MHOsCHMPs

IHN-CCOFCHP

IHN-CCO

LinnBentonLincoln

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 CriteriaDemonstrated needImproved health outcomesReduces healthcare costsLeads to integrationUtilization of EHRCulturally appropriateAddresses disparitiesIncorporates quality improvementCollaborativeHas evaluation built-inSustainableReplicable

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 Council19 Members

Linn Advisory

Committee â

18+ Members

Benton Advisory

Committee â

18+ Members

L incoln Advisory

Committee â

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 AuthoritiesTransparentInclusiveShared Values and VisionShared LeadershipInvested in CommunityInvested in Population – Health and WellnessWillingness to riskBringing diverse interests and resources to the table

What Makes it Work?