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Conference Call Number: 1‐888‐808‐6929 Public Participant Code: 915042#
Oregon Health Policy Board DRAFT AGENDA
July 2, 2019 Yellowhawk Tribal Clinic
46314 Ti'mine Way, Pendleton, OR 97801
* Videotaping or recording of honorary prayer/songs is not permitted.
Next meeting: August 6, 2019 Portland State Office Building 800 NE Oregon St, Room 1C, Portland, OR 97232
# Time Item Presenter Purpose
1 9:00 Tribal Welcome: Opening Song and Prayer (CTUIR Singers) *
Chairman Burke, Confederated Tribes of Umatilla Indian Reservation (CTUIR)
Welcome
2 9:15 OHPB Welcome, Minutes Approval
Rosenda Shippentower, OHPB Member David Bangsberg, OHPB Vice‐Chair
Possible Vote
3 9:20 OHA Report Patrick Allen, OHA Director Informational
4 9:25 Metrics & Priorities Jeremy Vandehey, OHA Health Policy & Analytics Division Director
Information & Discussion
5 9:35 Tribal Health Commission Background
Shawna Gavin, Yellowhawk Health Commission, Chair
Informational
6 9:50 Break
7 10:00 Public Testimony David Bangsberg, OHPB Vice‐Chair Informational
8 10:10 Public Health Division & Yellowhawk Tribal Health Center Partnership
Tim Menza, OHA Public Health Division STI Medical Director Lillian Shirley, OHA Public Health Division Director
Informational
9 10:30 Public Health Accreditation & Community Health Assessment
Courtney Stover, Yellowhawk Public Health Accreditation Specialist
Informational & Discussion
10 11:10 Tribal Behavioral Health Strategic Action Plan
Julie A. Johnson, OHA Tribal Affairs Director
Informational & Discussion
11 12:00 Adjourn
Conference Call Number: 1‐888‐808‐6929 Public Participant Code: 915042#
Everyone is welcome to the Oregon Health Policy Board meetings. For questions about accessibility or to request an accommodation, please call 541‐999‐6983 or write [email protected]. Requests should be made at least 48 hours prior to the event. Documents can be provided upon request in an alternate format for individuals with disabilities or in a language other than English for people with limited English skills. To request a document in another format or language please call 541‐999‐6983 or write to [email protected]
Oregon Health Policy Board DRAFT June 4, 2019
Portland State Office Building 800 NE Oregon St., Room 177, Portland, OR 97232
8:30 a.m. to 12:00 p.m.
Item
OHPB video and audio recording
To watch the video of the OHPB meeting in its entirety click here. Agenda items can be reviewed at time stamp listed in the column below.
Welcome and Call to Order, Chair Carla McKelvey
Present:
Board members present: Chair Carla McKelvey, Vice-Chair David Bangsberg, Brenda Johnson, John Santa, Rosenda Shippentower (phone), Kirsten Isaacson, Zeke Smith, Oscar Arana
All Board members present voted to approve the minutes for May with a clarification about the nature of the discussion in the May minutes regarding health equity outcomes varying across geographic areas.
OHA Report, Jeremy Vandehey, OHA
Jeremy provided a leadership update and reviewed legislative highlights. He noted Medicaid related budget legislation and relayed updates regarding the tobacco tax.
00:02:19
Children’s Care: Health Complexity, Dana Hargunani, OHA, Colleen Reuland, OPIP
Dana introduced the Children’s Health Complexity agenda item and provided background regarding the effort. Coleen reviewed medical and social complexity factors and definitions. She described the process the identify complexity factors including literature review. She described how health complexity indicators were chosen and mapped to complexity factors and described how measurement terms were considered and decided. The Board discussed support for the InCK (Integrated Care for Kids) grant opportunity and chose to support the opportunity unanimously.
00:06:36
OHPB Policy Priority Area Timeline Update, Trilby de Jung, OHA
Trilby briefed changes to the timeline and potential opportunities for OHPB to weigh-in on policy priority areas. Brenda asked about children’s cabinet and their work for alignment. Trilby and Jeremy noted the children’s cabinet scoping work is ongoing.
01:28:10
Oregon Health Policy Board DRAFT June 4, 2019
Portland State Office Building 800 NE Oregon St., Room 177, Portland, OR 97232
8:30 a.m. to 12:00 p.m.
Cost of Care Update, Jeremy Vandehey, OHA
The Board discussed the committee’s makeup, charge, timeline and supervision as well as the effect of the -2-amendment. Brenda suggested that health outcomes be considered in the waste report and John discussed the intersection of waste and quality, e.g. hospital acquired infections. Kirsten noted the importance of price in the discussion.
01:45:53
Health Plan Quality Metrics Committee, Shaun Parkman, Co-Chair, Health Plan Quality Metrics Committee
Shaun provided background on the committee’s make-up, work-to-date and coming work. He focused on the tension the committee struggles with between ensuring least burdensome measures and ensuring accountability while considering innovation. Shaun described the nature of the committee’s charge to develop a menu set for public payers. He noted that federal measures superseded the committee’s ability to consider measures for health plans carried through the exchange. He shared information regarding the 2020 aligned measure menu set and provided a status update regarding the committee’s consideration of various measures.
01:56:05
Legislative Update, Jeff Scroggin, OHA
Jeff gave a brief update regarding HPA legislative priorities including HB 2267, SB 1041, HB 2269, SB 3063. The Board discussed the potential for future legislative action regarding vaccination.
02:58:36
Public Testimony
Ann Kasper provided testimony regarding people with lived experience. She asked that peer support specialists continue to be operated out of the Office of Equity and Inclusion, she asked that someone with lived experience be a part of staff. She described challenges with obtaining civil commitment data and Unity arrest data. She described the need for veteran services and analysis of other systems of care based on models in Italy. She asked that evidence-based care be balanced with the need for innovative care and that howsafeandsecure.com regarding how people feel in care. She noted the need for a safe space for men
01:22:48
Adjourn
Oregon Health Policy Board DRAFT June 4, 2019
Portland State Office Building 800 NE Oregon St., Room 177, Portland, OR 97232
8:30 a.m. to 12:00 p.m.
Next meeting: July 2, 2019 Yellowhawk Tribal Clinic 46314 Ti'mine Way, Pendleton, OR 97801 9:00 a.m. to 12:00 p.m.
June 2019 Page | 1
OHPB Committee Digest
PUBLIC HEALTH ADVISORY BOARD, METRICS & SCORING COMMITTEE, HEALTH PLAN QUALITY METRICS COMMITTEE, HEALTH INFORMATION TECHNOLOGY OVERSIGHT COUNCIL, HEALTHCARE WORKFORCE COMMITTEE, HEALTH EQUITY COMMITTEE, PRIMARY CARE COLLABORATIVE, MEDICAID ADVISORY COMMITTEE, STATEWIDE SUPPORTIVE HOUSING WORKGROUP, MEASURING SUCCESS COMMITTEE
Public Health Advisory Board In June, the Public Health Advisory Board held its meeting in conjunction with the Oregon Transportation Commission, at the Commissions invitation. The meeting focused on a conversation between the Board and the Commission discussing the intersection of transportation, public health, and social equity. The workshop was facilitated by Charles Brown, a national leader in the intersections of health, social equity, and transportation. Transportation is essential to quality of life and the economic health of our state. The public’s health (population health) is shaped by social determinants of health, including experience of adversity, trauma and toxic stress; institutional bias; access to stable housing; living wage jobs and having enough healthy food to eat. The work ODOT leads in Oregon connects people with the resources and opportunities they need to find meaningful work, keep their children in school, and access enough healthy food while maintaining stable housing and supporting people to increase their physical activity. The work contributes to Oregon’s population heath goals. ODOT and OHA-PHD have a signed memorandum of understanding that structures the work done between the two agencies. The boards discussed that data from both the health and transportation spheres describes severe and persistent disparities in health outcomes, and access to best-practice transpiration infrastructure – things like complete streets and accessible sidewalks. The Board and the Commission agreed to look more closely at how we measure the outcomes of our partnership, and the co-work that the agencies undertake and seek to address these disparities through our memorandum of understanding. The Chair of the OTC, Tammy Baney, the PHAB Chair, Rebecca Tiel, requested that ODOT and OHA-PHD staff develop a set of suggestions for how the Board and the Commission can pursue work together, as well as a proposed cadence and purpose of ongoing dialogue between the Board and the Commission. COMMITTEE WEB SITE: https://www.oregon.gov/oha/ph/About/Pages/ophab.aspx STAFF POC: Kati Moseley, [email protected]
Primary Care Payment Reform Collaborative The Evaluation, Metrics, Technical Assistance, and Implementation workgroups continue to convene to further advance the collaborative’s initiative. Each workgroup is working on their respective projects to bring forward updates during the next full collaborative meeting.
June 2019 Page | 2
The workgroups will continue to convene monthly except during the month the full Collaborative convenes. The next Primary Care Payment Reform Collaborative meeting will take place on July 16, 2019, from 9am to Noon in Portland.
COMMITTEE WEBSITE: http://www.oregon.gov/oha/Transformation-Center/Pages/SB231-Primary-Care-Payment-Reform-Collaborative.aspx. COMMITTEE POC: Susan El-Mansy, [email protected]
Healthcare Workforce Committee The Healthcare Workforce Committee will meet July 10. Key Items will include: OHPB Updates: Brenda Johnson will provide an update on Board activity. Primary Care Office Updates: Marc Overbeck will share statistics and activity with the Committee related to the National Health Service Corps program and progress on updating Facility HPSAs. Presentation on Health Care Provider Incentive Program: Joe Sullivan will provide the community a summary of accomplishments and impact of the first 18 months of the Health Care Provider Incentive Program, which began January 2, 2018. Presentation on HOWTO Grant Program: Shelly Ziegler of OHSU will update the Committee on activity and results of the first year of the HOWT Grant Program, which OHSU is administering for the OHPB and OHA. Legislative Update: Jeff Scroggin will provide a session wrap-up for the Committee regarding workforce-related legislation and other major topics of the 2019 Legislature. Other: The Committee will consider adoption of a Conflict of Interest Policy and forms, to be aligned with OHPB policy. COMMITTEE WEBSITE: http://www.oregon.gov/oha/HPA/HP-HCW/Pages/index.aspx COMMITTEE POC: MARC OVERBECK, [email protected]
Health Plan Quality Metrics Committee At the June 13 meeting, the committee welcomed four new members. The new members are: • Charlene Maxwell, FNP, DNP, Multnomah County Health Department Role: Health Care Provider • Ann Tseng, MD, OHSU Gabriel Park Role: Health Care Provider • Erik Carlstrom, Carlstrom Consulting, LLC Role: Representing Health Care Consumers • Jim Rickards, MD, MBA, Moda Health
June 2019 Page | 3
Role: Representing insurers, large employers or multiple employer welfare arrangements At this meeting, the committee also reviewed the Oregon Health Policy Board presentation and discussion on June 4, and the draft work plan for 2019-2020. OHPB will be following up with a summary letter to HPQMC this summer. Discussion of the draft work plan included updating the measure criteria and reviewing the measure menu for alignment with priorities. To hear a recording of the meeting or to review the draft work plan and committee roster, visit the committee’s website at: http://www.oregon.gov/oha/analytics/Pages/Quality-Metrics-Committee.aspx The next meeting is Thursday, July 11, 2019 from 1:00pm – 3:30pm. COMMITTEE WEBSITE: http://www.oregon.gov/oha/analytics/Pages/Quality-Metrics-Committee.aspx COMMITTEE POC: Kristin Tehrani, [email protected]
Metrics & Scoring Committee In June, the Metrics and Scoring Committee began discussions on the 2020 incentive measure set, which will be finalized at its July 19, 2019 meeting. The Committee reviewed a letter from Governor Kate Brown and received written public testimony in support of including the two measures in the health aspects of kindergarten readiness measurement strategy in the 2020 incentive measure set (preventive dental visits for children ages 1-5 and well-child visits for children ages 3-6), and in support of reducing the number of measures in the 2020 incentive measure set. Public testimony provided at the meeting included: support for adding a measure related to HPV vaccinations to reduce incidence of cancer, and support for retiring the emergency department utilization and CAHPS access to care measures. OHA staff presented the agency recommendations for the 2020 incentive measure set. Public comment also included questions related to the measure of timely assessments for children in DHS custody/foster care. The packet of materials provided additional information on each measure under consideration, and public input provided in a survey of stakeholders. The Committee will not make final decisions about the 2020 incentive measure set until its July 19 meeting. There are currently 19 incentive measures for 2019. New measures the committee is considering for 2020 include: adolescent immunizations; initiation and engagement in drug and alcohol treatment; and, the two measures included in the health aspects of kindergarten readiness measurement strategy noted above. The Committee made tentative decisions about the following measures: Tentative Decisions: Measures to Include for 2020 • Kindergarten readiness measure 1 – preventive dental visits • Kindergarten readiness measure 2 – well-child visits • Timeliness of postpartum care • Disparity measure – ED utilization for members with mental illness • Oral evaluation for adults with diabetes • Colorectal cancer screening • Cigarette smoking prevalence Tentative Decisions: Measures to Retire for 2020 • Emergency department utilization • Effective contraceptive use
June 2019 Page | 4
• Weight assessment and counseling for nutrition and physical activity for ages 3-17 • CAHPS – access to care • Diabetes – HbA1c poor control There were conversations about the following measures, though tentative decisions were not reached: • Initiation and engagement in drug and alcohol treatment • Dental sealants for children ages 6-14 • Screening, brief intervention, and referral to treatment (SBIRT) for risky drug and alcohol use • Childhood immunization status • Adolescent immunization status • Assessments for children in DHS custody/foster care The following measures are also under consideration but were not discussed in June: • Depression screening • Developmental screening in the first 36 months of life • Controlling hypertension • Patient Centered Primary Care Home Enrollment • Adolescent well-care visits (ages 12-21) COMMITTEE WEBSITE: http://www.oregon.gov/oha/analytics/Pages/Metrics-Scoring-Committee.aspx COMMITTEE POC: Sara Kleinschmit, [email protected]
Health Information Technology Oversight Council The Health Information Technology Oversight Council (HITOC) had a packed agenda on June 5, 2019. HITOC members weighed in on the health equity definition that the Oregon Health Policy Board’s Health Equity Committee is developing and explored the differences between HITOC’s role and the HIT Commons’ role in supporting health IT in Oregon. HITOC also covered the following in-depth topics: Patient Engagement and Health Information Technology HITOC explored how patients can better engage in their own health care via health IT and heard one patient’s perspective on how health IT changed her health care experience. Members discussed the need to understand what barriers exist for patients to engage with their healthcare through health IT. HITOC will continue to learn more through 2019 and will make decisions about its next steps in future meetings. National Health Information Sharing Work HITOC members received an update on the Trusted Exchange Framework and Common Agreement (TEFCA), a national, voluntary framework for health information sharing/exchange that the Office of the National Coordinator for Health IT is developing, as directed by Congress in the 21st Century Cures Act. TEFCA will likely have a significant impact on efforts in Oregon to connect the many health information sharing networks (“network of networks”). Behavioral Health Confidentiality Toolkit for Providers HITOC members heard an update on a new OHA-created toolkit for behavioral health providers that will provide guidance on sharing/exchange of sensitive patient information. The toolkit will be a living document, retained online and updated as needed. HITOC’s next meeting is on August 1. COMMITTEE WEBSITE: http://www.oregon.gov/oha/HPA/OHIT-HITOC/
June 2019 Page | 5
Committee POC: Francie Nevill, [email protected]
Medicaid Advisory Committee The Medicaid Advisory Committee will meet by webinar on June 26th. The meeting will be primarily informational, with updates on the ongoing Legislative Session and from the OHA ombudsperson. The committee will also discuss plans for its upcoming retreat in July. The committee will also welcome four newly-appointed members: Two Oregon Health Plan members and two members associated with a health care organization: • Daniel Alrick, Self-advocate and Vice Chair of the Oregon Council on Developmental Disabilities • Brandy Charlan, In-home caregiver and Medicaid member • Lavinia Goto, Special Projects Manager with Northwest Senior & Disability Services • Adrienne Daniels, Deputy Director of Integrated Clinical Services for Multnomah County The MAC will meet again on July 24th at the State Library in Salem for an extended meeting/retreat to determine policy focus and priority areas for the next two years. COMMITTEE WEBSITE: http://www.oregon.gov/oha/hpa/hp-mac/pages/index.aspx COMMITTEE POC: Tim Sweeney, [email protected]
Health Equity Committee The HEC did not meet in June. Workgroups are using the month of June to develop their work plans for the next 18 months. HEC will reconvene on Thursday July 11th from 12-2 pm COMMITTEE WEB SITE: https://www.oregon.gov/oha/OEI/Pages/Health-Equity-Committee.aspx COMMITTEE POC: Maria Castro, [email protected]
Statewide Supportive Housing Strategy Workgroup The Statewide Supportive Housing Strategy Workgroups (SSHSW) Recommendations have been incorporated into the Oregon Housing and Community Services (OHCS) Five-Year Statewide Housing Plan (appendices document), released on February 11th, 2019. The report contains recommendations regarding principles to guide permanent supportive housing, recommendations to strengthen cross agency collaboration and coordination, recommendations to expand permanent supportive housing through new and existing housing and service resources and recommendations for training and technical assistance to build permanent supportive housing capacity. OHCS Statewide Housing Plan: https://www.oregon.gov/ohcs/pages/oshp.aspx COMMITTTEE POC: Kenny LaPoint, [email protected]
Measuring Success Committee The Measuring Success Committee of the Early Learning Council met on May 1. The committee completed its process of reviewing the proposed early learning system measures by mapping them across seven identified
June 2019 Page | 6
developmental domains, five sectors, and nine objectives of early learning system strategic plan, Raise Up Oregon. The committee determined that the proposed measures adequately covered the intended areas.
Over the course of the summer, staff will continue to document specific details of the measures and conduct a review to determine whether data can be analyzed by racial/ethnic groups. In addition, the ELD will consult with external stakeholders to conduct an equity review of the measures to determine potential bias in the measures. Further, a small workgroup will work in collaboration with OHA on the revision of the PRAMS-2 to incorporate additional early learning system items. The committee is planning on submitting the measure set to the Early Learning Council in October for consideration.
COMMITTEE WEBSITE: N/A COMMITTEE POC: Thomas George, [email protected]
Public Health Division
June 11, 2019
OHA-PHD and Yellowhawk Tribal Health Center Partnership
Funding In fiscal year 2019, OHA-PHD provided the following funding to Yellowhawk Tribal Health Center:
• Tobacco Prevention and Education -- $53,271
• Tribal Public Health Emergency Preparedness -- $43,220
• WIC Supplemental Nutrition Program -- $27,594
• Tribal Maternal and Child Health Services -- $39,447
• Alcohol and Drug Education and Prevention -- $146,250 Highlights
• Yellowhawk Tribal Health Center completed the tribal public health modernization programmatic assessment and shared their experience with the Public Health Advisory Board earlier this year.
• The Eastern Oregon Public Health Modernization Collaborative includes Yellowhawk Tribal Health Center. Yellowhawk Tribal Health Center also works closely with Umatilla County Public Health.
• New Memoranda of Understanding with OHA-PHD regarding laboratory services, vaccine access, outbreak investigations and disease reporting to strengthen state and tribal capacity to respond to complex communicable disease cases and outbreaks, public health emergencies and other health-related emerging events.
• OHA-PHD and Yellowhawk Tribal Health Center are both recipients of the Garret Lee Smith Youth Suicide Prevention Grant. OHA-PHD staff coordinate closely with Yellowhawk Tribal Health Center and the Northwest Portland Area Indian Health Board on this work.
• Yellowhawk Tribal Health Center representatives participated in the OHA-PHD-sponsored Zero Suicide Academy and 2018 Tribal Summit on Opioids and Other Drugs.
• OHA-PHD is supporting Psychological First and PsySTART training for Yellowhawk Tribal Health Center to strengthen tribal emergency response capacities.
• Yellowhawk Tribal Health Center participates in the Oregon Tribal Public Health Preparedness Coalition.
• Actively sharing information with Lisa Guzman, Tribal Health Director, on current Wallowa Lake Clean Up.
Bacterial sexually transmitted infections among American
Indians/Alaska Natives in OregonTim W. Menza, MD, PhD
Medical Director
HIV/STD/TB Section
Oregon Health Authority
Rates of gonorrhea by county, Oregon, 2017
The rate of chlamydia in Oregon and Eastern Oregon is high and stable
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Oregon
The rate of gonorrhea has dramatically increased in both Oregon and Eastern Oregon in the past five years
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Oregon
The rate of primary and secondary syphilis in Eastern Oregon are significantly lower than the Oregon rate, but climbing
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Oregon
Rates of bacterial STI by race/ethnicity, Oregon, 2017
25.3 5.331.5
10.2
130.3173
448.2
95.2
492.9
564.9
889.2
302.9
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Early syphilis Gonoccal infection Chlamydia
Rate of gonorrhea by county, EOMC, 2014-2018
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**Grant
**Sherman
*Baker
**Wheeler
Union
Hood River
*Harney
*Lake
**Gilliam
Wasco
Regional
Malheur
Umatilla
Morrow
Age Adjusted Incidence Rate per 100,000
Age Adjusted Gonorrhea Incidence Rate:2014-2018
Rates of gonorrhea by race/ethnicity, EOMC and Umatilla/Union, 2017
48.5
128.7
76.6
55.346
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Limitations to surveillance data• Misclassification of race/ethnicity
• Match of surveillance data with the Native Tribal Registry in next year to assess misclassification and estimate more accurate rates of STI among AI/AN people
Support in reducing STI• Capacity building and technical assistance for partner services,
screening, and prevention activities
• Partnerships with WIC, nurse-family partnerships to provide STI education and awareness
• AIDS Education and Training Center trainings that range from large, multi-day events, to one-on-one provider detailing
• Special needs funding to develop local projects or interventions
• For people living with HIV, CareASSIST will cover all medical expenses at any facility
Thank you!
Yellowhawk’s Public Health Accreditation Journey
July 2, 2019
Courtney StoverPublic Health Accreditation Coordinator
Yellowhawk Tribal Health Center
Public Health
Public health is what we do together as a society to ensure the conditions in
which everyone can be healthy.
7/2/2019 2
Public Health Milestones• Vaccines against polio and other preventable diseases
• Decline in tobacco use
• Decline in death from heart disease
• Treatment and early detection of cancer
• Early childhood health and nutrition
• Fluoridation of drinking water and improved oral health
7/2/2019 3
The Evolution of Public Health
7/2/2019 4
Public Health 2.01. Monitor Health2. Diagnose and Investigate3. Inform, Educate, Empower4. Mobilize Community Partnerships5. Develop Policies6. Enforce Laws7. Link to/Provide Care8. Assure a Competent Workforce9. Evaluate10. Research
7/2/2019 5
Public Health 3.0
7/2/2019 6
Public Health Accreditation Board (PHAB)• Non-profit, voluntary public health accreditation organization whose
goal is to advance public health performance by providing a national framework of standards for local, state, territorial, and tribal health departments
• Founded in 2007
• Launched national public health department accreditation in 2011
7/2/2019 7
Public Health Accreditation
7/2/2019 8
PHAB Standards include 12 Domains, the first 10 align with the essential services and the final two focus on
management and leadership.
Domain 1: Conduct and disseminate assessments focused on population health status and public health issues facing the community
Domain 2: Investigate health problems and environmental health hazards to protect the community
Domain 3: Inform and educate about public health issues and functions
Domain 4: Engage with the community to identify and address health problems
Domain 5: Develop public health policies and plans
Domain 6: Enforce public health laws
Domain 7: Promote strategies to improve access to health care
Domain 8: Maintain a competent public health workforce
Domain 9: Evaluate and continuously improve processes, programs, and interventions
Domain 10: Contribute to and apply the evidence base of public health
Domain 11: Maintain administrative and management capacity
Domain 12: Maintain capacity to engage the public health governing entity
Accreditation Activity
7/2/2019 9
Accreditation in Oregon
7/2/2019 10
7/2/2019 11
Yellowhawk’s Accreditation Journey
7/2/2019 12
2012
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2015
2017
2019
2014
2016
2018
Yellowhawk’s Accreditation Timeline
7/2/2019 13
2017
2019
2018
Accreditation coordinator started
OCTOBER
Obtained Letter of Support from Health Commission
NOVEMBER
Submitted application to PHAB
JANUARY
Held first Yellowhawk Accreditation Team Meeting
JANUARY
Attended PHAB training
FEBRUARY
Submit all documentation
APRIL
PHAB conducts completeness review
MAY
Site Visit (estimated)
LATE 2019/EARLY 2020
Awarded Seven Directions’ accreditation readiness grant
FEBRUARY
Compile documentation Prepare for site visit
Awarded NIHB accreditation support grant
SEPTEMBER
Fulfill Accreditation Requirements
1/2019
Organizational Plans and Efforts
15
Cover Page of Yellowhawk’s 2017 –2019 Strategic Plan
• Community Health Assessment
• Community Health Improvement Plan
• Strategic Plan
7/2/2019
Fulfill Accreditation Requirements
1/2019
Departmental Plans and Efforts• Performance Management
System
• Quality Improvement Plan
• Workforce Development Plan
• Planning procedures for Pamanaknúwit
16
Photo of concept mapping exercise completed by Pamanaknúwit team members in March 2018
7/2/2019
The CTUIR Community Health Assessment to Health Improvement
Plan Process
Community Health Assessment Background• Yellowhawk was one of 40+ local
organizations who met monthly as members of Umatilla County Coordinated Health Partnership
• Funded by the CDC Good Health & Wellness in Indian Country
• Completed the CHA process in 2011; and again in 2015
• Generalizable data:– 2011 (139 responses)– 2015 (427 responses)
177/2/2019
Community Health Assessment Background• Shared findings of CHA at Community Gatherings, Commission and
Committee meetings, and through print and other media
• Survey released to rank health priority areas
18
Top Priority Areas:ObesityDiabetesDrug and Alcohol UseMental Health
7/2/2019
Health Priority Focus Groups• Facilitation assistance from the Northwest Portland Area Indian
Health Board (NPAIHB)
• Over 50 individuals attended
• Each session consisted of root cause mapping, brainstorming solutions and setting priorities
7/2/2019 19
Prioritizing Actions
7/2/2019 20
• Based on solutions identified during focus groups, distributed survey to community to assist in prioritizing top actions for each priority area
February 13th Stakeholder Gathering
• Over 30 participants from 15 different programs
227/2/2019
February 13th Stakeholder GatheringAccomplishments
23
• Agreement from stakeholders on CHIP framework
• Participants provided input to revise strategies
• Prioritized top strategies and began action planning
7/2/2019
Priority Strategies
24
1. Mental/emotional wellness curriculum for the whole family. Integrate culturally-adapted emotional and behavioral health curriculum into pre-K, schools, youth programs, adult and elder to compliment/supplement other behavioral health interventions (e.g., Adverse Childhood Experiences (ACE) and suicide interventions).
2. Physical activity opportunities at every age. Identify and implement additional interventions to improve physical activity opportunities and engagement, e.g., increased recess, playtime and organized sports, as well as activities focused on elders and adults.
3. Community design and connectivity. Implement biking/skating/scooting/walking infrastructure that encourages healthier lifestyles and better connects housing, school and work centers. Compliment with increased access to recreation facilities and programs (location, hours, amount of program offerings and high-profile events).
4. Collaboration and information sharing, performance measures, community involvement and reporting. Develop cross-department data tracking, sharing and reporting agreements and systems for (shared) community health indicators and performance measures. Involve the community in identifying issues and solutions and engage in regular outreach and communications about CHIP efforts.
7/2/2019
March 4th Stakeholder Gathering
Accomplishments
25
• Identified collaborating organizations for each strategy area
• Developed action plans for each priority project
• Identified next steps, individual and team roles and responsibilities
7/2/2019
7/2/2019 26
Tribal Behavioral Health Strategic Action Plan, 2019-2024
OREGON
Oregon Native American Behavioral Health Collaborative
Working to improve behavioral health outcomes for AI/AN people in OregonIncludes representatives from:
• The 9 Oregon tribes
• NARA• NPAIHB• OHA
Strategic Planning• Identified vision, strategic pillars, and next steps• Held March 7-8, 2019, at NARA Wellness Center• 45 participants from:
• 8 Oregon tribes• NARA• NPAIHB• OHA• Oregon DHS Office of Tribal Affairs
• Facilitation and written plan development by: Kauffman & Associates, Inc.
Shared Vision
The Oregon Native American Behavioral Health Collaborative envisions healthy Native individuals, families, and communities thriving across Oregon.
We envision a shared, continuous alliance between the state, tribal and urban providers that offer a continuum of fully funded, comprehensive, culturally responsive services, grounded in tribal based practices and intertribal collaboration at the administrative and clinical levels .
Strategic Pillars
Training and credentialing
Tribal-based practices
Efficient data systems
Tribal consultation
Governance and finance
Strategic Outcomes: Tribal-based practices
Establish an accredited tribal learning center approved by Mental Health & Addiction Certification Board of Oregon Establish
Secure funds to develop a qualified tribal workforce to provide a total continuum of careSecure
Create a tribal credentialing system to achieve sustainability for tribal-based behavioral healthCreate
Strategic Outcomes: Tribal-based practices
Create a permanent rule or statute in support of tribal-based practicesCreate
Secure state funding for technical assistance in implementing tribal-based practices Secure
Develop a centralized database of tribal-based practicesDevelop
Strategic Outcomes: Efficient data systems
Conduct an inventory of all baseline behavioral health data from state, federal tribal, and local resourcesConduct
Create and identify culturally relevant, specific tribal behavioral health metricsCreate
Strategic Outcomes: Tribal consultation policy
Establish regular information sharing between the state and tribesEstablish
Provide comprehensive, mandatory annual training for all state employees on how to appropriately engage with tribesProvide
Clarify the relationships and expectations between CCOs and tribes/NARAClarify
Strategic Outcomes: Governance and finance
Ensure adequate tribal representation on regional governance entities, with required metrics and reportsEnsure
Establish a dedicated funding set-aside for tribal and urban programs to provide adequate, flexible fundingEstablish
Maintain the existing tribal billing structure, including encounter rates and the fee-for-service system, and expand reimbursement codesMaintain
Next Steps
• The plan lists action steps for launching the plan, including:
• Timeframe• Person(s) responsible
• Progress updates during the collaborative’s monthly meetings
• Questions, feedback?• Finalize plan and share with OHA
Leadership team.
More Information
To learn more about the strategic plan, contact:
Julie Johnson OHA Tribal Affairs Director
