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As a reminder, OHA has posted a list of due dates for Contract Year 2021 and 2022 deliverables due in Quarter 3.
This communication is a compilation of information previously provided by OHA to
CCOs via contract documents, memos, and emails. Most OHA memos about deliverables are posted on the CCO Contract Announcements webpage. Reporting templates, guidance documents, and/or evaluation criteria for particular deliverables are provided on the CCO Contract Forms webpage or as links on that webpage to other OHA webpages.
Contract Deliverable: Ex. C, Sec. 10, Para. e Annual Minimum Medical Loss Ratio (MMLR) Rebate Report
Original due date: 08/31/2022; New due date: TBD
Notes: OHA has been awaiting review findings from the Centers for Medicare and
Medicaid Services to update the MMLR Rebate Report template for CY 2021. Those findings have not been forthcoming, so OHA is moving towards publication of the template based on information available to date. However, OHA will not be able to
publish the updated template 90 days prior to the current due date. OHA will publish the updated template and communicate the new due date as soon as possible. The new due date will be at least 90 days from the date that OHA provides the updated template to CCOs.
If you have general questions about this communication, please contact Cheryl Henning, CCO Contracts Administrator, at Cheryl.L.Henning@dhsoha.state.or.us.
If you have questions about the MMLR Rebate Report, please contact the Office of Actuarial and Financial Analytics at Actuarial.Services@dhsoha.state.or.us.
State health officials at the Oregon Health Authority (OHA) have announced a plan to distribute a package of $517 million in investments aimed at improving behavioral health services in Oregon. This includes $132 million which will flow to treatment providers starting this week.
The investments will be used to bolster the behavioral health workforce and expand treatment services. The state also will distribute funds to provide housing and other support services to people with mental health and substance use issues.
Key elements of the new grants are designed to eliminate health inequities.
The funding includes:
- Approximately $132 million in one-time grants to stabilize a behavioral health workforce that was severely impacted by the COVID-19 pandemic, which are currently being distributed to treatment providers.
- Approximately $155 million in behavioral health provider rate increases to sustain and support behavioral health services, some of which would begin to take effect July 1, 2022 (pending legislative and federal approval).
- Approximately $230 million for supportive housing and residential treatment programs, which they will begin to receive later this summer.
“We are incredibly grateful to the Legislature and to Governor Brown for providing these critical investments,” Steve Allen, OHA’s behavioral health director said.
“These resources are intended to provide immediate support to behavioral health workers and give programs a sustainable base of funding they can count on to make behavioral health treatment more accessible and equitable in Oregon.”
Workforce
OHA is issuing grants to 159 organizations across the state to recruit and retain employees for behavioral health service providers. These funds are beginning to be distributed directly to treatment programs this week. The funds were allocated by the Legislature through House Bill 4004 to supplement staffing losses exacerbated by the COVID-19 pandemic. The median award is approximately $334,000.
Providers must use at least 75 percent of the funding for wages, benefits and bonuses and the remainder for non-compensatory forms of retention or recruitment. To ensure accountability and that these dollars are spent on bolstering the behavioral health workforce, OHA will get reports about how and where these dollars will be spent. Lean more about the workforce stability grants.
“Rarely does an email bring tears, but this one did,” said Janice Garceau, behavioral health director for Deschutes County Health Services in response to receiving notification of the workforce investments for programs in her county. “This will make a meaningful difference.”
Rate increases
OHA is also proposing increasing provider payment rates to better coordinate access to care, incentivize culturally and linguistically specific services, invest in workforce diversity and support staff recruitment. The legislature allocated $42.5 million last year, which is expected to bring approximately $112 million in matching federal Medicaid funds.
The $155 million in rate increases will not only increase funding for treatment programs, it will also increase access for people who need mental health and substance use treatment. In total, this increase would put an extra $109 per Medicaid member into the behavioral health system.
Under the proposed fee-for-service rate increases for providers:
- Programs providing children with intensive psychiatric treatment would receive rate increases of approximately 37 percent.
- Substance use disorder residential treatment services would receive rate increases of approximately 32 percent.
- Adult residential mental health treatment programs would receive rate increases of 30 percent.
- Some providers will receive an over 20 percent bump for providing culturally and linguistically specific services.
- Adult outpatient mental health treatment programs would receive rate increases of approximately 28 percent.
OHA is working on getting federal approval for these increases, and providers that bill OHA directly through Medicaid on a fee-for- service basis this summer.
These fee-for-service increased payments will be retroactive to July 1, 2022. In addition to the fee-for-service increases, OHA will be providing increases to coordinated care organizations that should be passed along to behavioral health providers beginning Jan. 1, 2023.
Supportive housing and residential treatment
The funding for supportive housing and other residential options includes $100 million in direct awards to Oregon’s counties which will be issued by the end of summer. In addition, a competitive grant program totaling $112 million will expand housing and residential services for mental health treatment and substance use disorders.
These grants follow two earlier rounds of funding.
In the fall of 2021, OHA awarded $5 million in planning grants to 100 community organizations and four Tribes. In addition. OHA awarded $10 million earlier in 2022 to projects that could expand residential treatment capacity in the short-term, resulting in the availability of 70 additional beds.
The $112 million grant program will support longer-term projects, including new construction and renovation to further expand licensed residential and supportive housing services.
The remaining $20 million has specifically been identified to support Oregon’s federally recognized Tribes for funding housing and residential treatment projects. Qualifying programs will receive awards in late summer and funding would continue through spring 2023.
The county funding will be used to develop housing options, expand residential treatment capacity and increase access to low and no-barrier shelter options.
The goal of the competitive grants is to create substantially more capacity in Oregon’s continuum of community-based residential and housing services for people with behavioral health needs, offering culturally responsive, person-centered programming.
This will ensure that people are supported in settings that best meet their needs and will create more equitable and effective housing alternatives for people with serious and persistent mental illness, requiring a higher standard of care.
New funds are separate from M110 grants
These investments are separate from, and in addition to, the Measure 110 grants that are currently being awarded to Behavioral Health Resource Networks (BHRNs) around the state to expand substance use treatment.
To date, the Measure 110 Oversight and Accountability Council has approved BHRN applications in 29 Oregon counties.
2023 incentive measure set finalized
The Metrics & Scoring Committee finalized the 2023 incentive measure set earlier this month, choosing to continue all measures from 2022 into 2023 and adding the new Social Determinants of Health: Screening & Referral for Social Needs measure. The final set is here. The Committee will make final decisions on the Challenge Pool measures, the smaller set of measures potentially worth additional bonus funds, at its July meeting.
June Metrics & Scoring Committee rescheduled
The June Metrics & Scoring Committee meeting has been rescheduled and will now occur from 9am – 12pm on Friday, June 24. This is one week later than the normal cadence, and ensures adequate attendance for a quorum. As in the public comment guide, any written public comment should be submitted at least 48 hours prior to the meeting date (June 22nd, in this case).
Seeking new members for the Metrics & Scoring Committee
OHA is now accepting applications for health measurement experts and CCO representatives on the Metrics and Scoring Committee. We are especially interested in applicants with experience in health equity and/or oral health. We are seeking motivated members with a passion for eradicating inequities and improving health care for people in Oregon, particularly those subjected to historical and contemporary injustices. To apply, please review the application instructions and submit both (i) Part 1 and your resume or bio sketch to metrics.questions@dhsoha.state.or.us and complete (ii) Part 2 of the application by June 20, 2022.
Weekly updates on major Medicaid projects
1115 Medicaid Waiver
The first round of negotiations with CMS concluded on May 12. The 1115 Waiver team expects to receive initial feedback on which proposals are likely to move forward and which may be more difficult by late May or early June.
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Oregon Health Plan Redeterminations
OHA has created a strategic governance structure to align planning for multiple projects related to unwinding the Public Health Emergency (PHE). There is still uncertainty about the date the PHE will end, but OHA is ensuring members, CCOs, stakeholders, and staff are as prepared as possible in advance.
Feedback on engagement
The strategic governance team has asked CCOs to identify primary concerns as the redeterminations work begins and to identify how you want to be engaged in planning. Please share your thoughts with david.g.inbody@dhsoha.state.or.us.
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Healthier Oregon
Letters to members
Healthier Oregon letters and translated versions are available.
Healthier Oregon Office Hours for CCOs
CCOs will be offered the following 3 “office hours” dates in late May/June. Additional sessions may be added if needed or requested. Each session will have members of the Healthier Oregon team available to answer questions and share information.
Wednesday, June 8th, Noon -1 PM
Click here to join the meeting
Or call in (audio only) +1 971-277-2343,,741762849#
Tuesday, June 21st, 12:30 – 1:30 PM
Click here to join the meeting
Or call in (audio only) +1 971-277-2343,,771570543#
Who should attend?
- CCO customer service teams,
- Community engagement leads,
- Case management teams
What is the purpose?
- To share ideas for engaging Healthier Oregon members;
- Discuss strategies for navigating the CCO, benefits, accessing care;
- Tools to address enrollment in case management for those with special health care needs;
- Address any questions for customer service teams.
CCO Vaccination Rates will not be available May 27 or June 3.
Please see updated vaccination rates per county.
May 30, 2022
- State offices are closed in observance of Memorial Day
June 1, 2022
- DCO Contracts and Compliance has been cancelled
June 2, 2022
Please visit the committee and workgroup links below for more information about meetings. You can also view the OHA Public Meeting calendar.
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