Building an accessible and seamless continuum of care

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June 2019

Editor’s note: Welcome to Recovery Report, a monthly email communication to help the state’s behavioral health stakeholders stay up to date on news from OHA. You are receiving this newsletter because you have shown interest in updates from OHA’s behavioral health programs in the past. Please scroll to the bottom for an opportunity to help us improve this newsletter by filling out a brief survey.

In this issue ...

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Director’s message: Building an accessible and seamless continuum of care

Consider your smartphones. Phones these days are more than just communication devices. They are cameras, TVs, shopping malls and wallets. Most importantly, they’re easy to use. Behind the screen, however, smartphones are intricate pieces of coding, chips and cells that work together to create a seamless, user-friendly experience.

This is the kind of behavioral health system that I’d like to help Oregon achieve, and I need your help. If we’re successful, state and local governments, health care and health insurance entities, nonprofits and schools would work together to create a seamless experience for anyone seeking help.

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Before I get much further, let me quickly introduce myself.

My name is Steve Allen, and I’m Oregon’s new behavioral health director. I am from the Midwest, where I started my career as a clinical social worker and where my wife and I raised our two adult sons. While I’m new to Oregon, I am not new to reforming state behavioral health systems. I was introduced to Oregon and its dedicated behavioral health consumers, advocates and policymakers through my previous job with the Council of State Governments. Oregon was one of the 10 states I advised to improve the effectiveness and outcomes of their behavioral health systems.

When the opportunity arose to focus on Oregon full-time, several things compelled me to say yes:

  • The sophistication and passion of Oregon’s behavioral health advocates.
  • The rising swell of momentum in the statehouse for system transformation.
  • And selfishly, the hiking, biking and photography opportunities of this beautiful state.

Since I started on April 29, I've participated in Oregon Family Support Network’s Children’s Mental Health Awareness Day celebration, Peerpocalypse and the Northwest NAMI Walk (that's where the photo above was taken). I met with many local leaders and nonprofit partners.

This summer and through the fall, I plan to travel the state to seek your advice as OHA leaders and I develop a statewide behavioral health strategy. We have a large and diverse state, and I want to understand the challenges and opportunities in your communities. Do you have a recommendation? Or perhaps an invitation to come and meet with you and others? Please email my executive assistant, Julie Earnest. While I can’t promise I can meet with everyone, I’m eager to hear your suggestions.

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OHA, state hospital take action to relieve capacity crisis

The Oregon Health Authority is taking action to alleviate Oregon State Hospital’s capacity crisis, to reduce admission wait times experienced by mentally ill defendants who are unable to aid and assist in their defense.

Since 2012 patients admitted to Oregon State Hospital under an "aid and assist" order by courts have more than doubled. More than 260 patients at Oregon State Hospital were admitted under "aid and assist" orders. Patients under "aid and assist" orders now account for more than four in 10 state hospital patients.

Approximately 40 people are waiting for admission because the hospital is at the maximum capacity at which it can be safely managed for patients and staff. As a result of this capacity crisis, many of "aid and assist" defendants are not being admitted to the hospital within a required seven-day period. On June 4 a Washington County court held the state in contempt for not meeting the seven-day requirement for four "aid and assist" admissions.

OHA Director Pat Allen on June 7 directed OHA and OSH leadership to increase community mental health supports, facilitate timely discharges of patients who no longer need hospital-level care and prioritize patients under aid-and-assist orders for hospital admission.

Yesterday federal district court judge Michael Mosman made “no current finding of contempt” and instructed the parties to return in 90 days for a hearing to update the court on efforts to speed admissions of aid and assist patients to the state hospital. In a statement, OHA said: “The Oregon Health Authority welcomes the court’s ruling. We will continue to work urgently with courts, counties and the Legislature to solve the capacity crisis at the Oregon State Hospital and ensure every Oregonian with mental illness who needs care can have timely access to treatment in their own community or, when necessary, at the state hospital. We look forward to reporting back to the court on our progress.”

For more information, read OHA’s June 7 press release.

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Introducing Oregon’s first recovery high school

OHA is excited to support the state’s first recovery high school, Harmony Academy, in Lake Oswego. Recovery high schools support adolescents recovering from substance use disorders by providing an alternative environment to support their recovery in community with other youths walking the same journey, as well as adults and mentors with lived experience. Harmony Academy is a Lake Oswego School District public charter school located on the previous Marylhurst University campus. It will open to Washington, Clackamas and Multnomah county students Aug. 26. 

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Legislative update: Aid-and-assist bills advance

The Oregon Health Authority has been working with state legislators in the 2019 session to address the rising aid-and-assist population at Oregon State Hospital, protect OSH patients from abuse and further drive the integration of physical and behavioral health services.

Senate bills 24 and 25 seek to amend the laws related to forensic evaluation and restoration of criminal defendants found unfit to aid and assist in their criminal proceedings.

Courts are committing record numbers of defendants to the hospital due to aid and assist concerns. OSH is over capacity, and defendants are waiting in jail for a bed at OSH to become available. SB 24 would help reduce the census at OSH and encourage the treatment of defendants in the community when appropriate, including providing restoration in the community for defendants charged with misdemeanors and municipal violations. SB 24 also makes changes related to forensic evaluations, sharing of forensic reports, and receiving credit for time served in jail. SB 24 is scheduled for a Senate vote June 30.

SB 25 proposes several fixes that will enable OSH Forensic Evaluation Services to be more efficient and better able to serve stakeholders and patients, including a standardized procedure to send orders to OSH, access to records, and electronic filing of evaluation reports. SB 25 is awaiting Governor Kate Brown’s signature.

Other OHA bills of note include:

Senate bill 26 would prohibit the reinstatement of an employee where there has been a substantiated claim of physical or sexual abuse of a patient. SB 26 awaits final approval from Governor Brown.

Senate bill 22 would establish a framework for the Behavioral Health Home program. SB 22 was approved in the Senate Health and Human Services Committee and referred to the joint budget committee.

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