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Nov. 1, 2022
In this issue ...
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Fall is definitely here with the beautiful colors of the trees, the darker days and much-needed rain. I’ve also been reflecting about things that I’m grateful for. They are too numerous to list here, but at the top of my list is my family, the natural beauty of Oregon, BuddhaDoodles and the incredible team that I work with daily.
The Child and Family Behavioral Health (CFBH) team was able to meet in-person last month, for the first time since the start of the pandemic, and although not everyone could join us, it was wonderful to connect and discuss our important goals.
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We are lucky to live in the age of information and technology, which has allowed so many people to be able to work from home and continue to work on our communities' priorities. But I am also grateful when teams can meet in person and not only exchange information but connect and experience our humanity.
Last month some of our team members attended the Oregon Suicide Prevention Conference, which you’ll read about their experiences and insights in the article below. I have so much to be grateful for this year, and I am thrilled to share this season with all of you. Take care and enjoy the crisp, cool days of autumn.
The Oregon Suicide Prevention Conference was held in Ashland, Oregon, Oct. 10-13. Approximately 250 champions for suicide prevention gathered to learn, connect, gather energy and share ideas and inspiration. Representing CFBH were Jill Baker, youth suicide prevention policy coordinator; Shanda Hochstetler, youth suicide prevention program coordinator; and Beth Holliman, intensive community-based services coordinator.
This year’s conference theme was, “Reconnecting to Hope: Growing Responsive Communities.” Throughout the conference, speakers shared examples of how they have held on to hope, even through life’s most difficult challenges. We know that increasing connectedness and sense of belonging in a social network reduces the power that thoughts of suicide have for that entire social group, and that hope can grow and thrive in a network. This is particularly true for young people; connection and belonging are some of the most powerful tools in decreasing suicide risk.
After attending the conference Jill Baker remarked, “Even though there will be bumps in this journey, this web of connectivity around young people’s mental health that we are building is strong and full of beautiful humans who are bringing their best selves to this work.”
 From left to right: Taylor Chambers, Public Health Suicide Prevention Coordinator, Oregon Health Authority (OHA); Jill Baker; Meghan Crane, Zero Suicide Program Coordinator, OHA; Shanda Hochstetler (not pictured: Deb Darmata, Adult Suicide Prevention Coordinator, OHA)
One of the topics discussed at the conference was the Oregon Suicide Prevention Framework, which represents the full spectrum of suicide prevention, intervention and postvention efforts in Oregon. The state's youth and adult suicide prevention plans share this framework. The goal is for different programming efforts to identify where work efforts overlap and discover opportunities for collaboration. Guidance documents about use of the Framework are in development. The Framework is explained in more detail in the Youth Suicide Intervention and Prevention Plan 2021-2025.
Our suicide prevention network in Oregon is strong. We have good reason to invite hope in, to look for hope, to cultivate hope and to recognize hope in ourselves and in each other. May our network be a place where hope grows.
For any questions regarding suicide prevention work, please contact Jill Baker, jill.baker@dhsoha.state.or.us or Shanda Hochstetler, shanda.hochstetler@dhsoha.state.or.us.
In January 2021 Oregon launched a new level of care called Intensive In-Home Behavioral Health Treatment (IIBHT) for Oregon Health Plan (OHP) members age 20 or younger. IIBHT offers a community-based alternative to youth and their families who are struggling with complex mental health challenges. One of the main goals of IIBHT is to help reduce out-of-home placements. Youth referred to IIBHT often have complex challenges, and many have previously been referred to residential treatment. Of the 25 youth served in IIBHT in the second quarter of 2022, 13 reported having at least one emergency room visit and nine had at least one inpatient admission, while 19 had reported a history of suicidal ideation during the prior year.
Beth Holliman, intensive community-based services coordinator in CFBH explains, “Families receive a minimum of four hours of services a week, which are tailored to meet the individual needs of the child and their family. The child and their family work collaboratively with the IIBHT multidisciplinary team to establish treatment goals and a timeline for meeting those goals.” Services in IIBHT may include individual therapy, family therapy, peer-delivered services by a family support specialist or a youth peer support specialist, psychiatric services (including medication management), case management and skills training.
OHA is pleased to report that IIBHT has served 160 youth between January 2021 and October 2022. Of the youth who have discharged from the IIHBT program, 67 percent have been discharged to a lower level of care.
OHA encourages OHP youth and their families to proactively reach out to IIBHT providers for support. IIBHT providers are available 24/7. Staff provide real-time support to youth and their families and can respond to the home as needed. The Oregon IIBHT model was created using the National IIBHT Program and Practice Standards published by the University of Washington.
We want to thank our community partners for helping to build a community-based program during a pandemic and look forward to its continued growth. These include: Adapt, Best Care, Catholic Community Services, Center for Human Development, Clatsop Behavioral Health, Community Counseling Solutions, Coos Health and Wellness, Lifeways, Lincoln County Health and Human Services, Options for Southern Oregon, Wallowa Valley Center for Wellness, Yamhill County Health and Human Services and Youth Villages.
If you have questions about IIBHT, or need more information, contact Beth Holliman at beth.holliman@dhsoha.state.or.us.
The CFBH has welcomed two new members to our team: Christie Taylor and Jeanette Hansen. Christie joins us as the young adult service coordinator and Jeanette Hansen is joining us through May 2023 to coordinate our data needs. We are thrilled to have them on our team and can’t wait to see what they’ll accomplish to better Oregon communities. Let’s meet Christie and Jeanette:
“My name is Christie Taylor (she/her/hers) and I am excited to be joining OHA’s Child and Family team as the young adult services coordinator.
"Clinical background: I am an LMSW (MSW-Portland State University) with a Bachelor's in Sociology and Psychology (Oregon State University). "I have worked with Early Assessment and Support Alliance (EASA) for young adults experiencing early psychosis and other evidence-based/fidelity-model programs in a direct clinical and management capacity since 2014, and most recently from a systemic perspective, as the adult behavioral health system of care program specialist for CareOregon's Columbia Pacific Coordinated Care Organization since 2020.
"My goal is to use my previous program development experience to improve access to, and expand upon existing young adult-specific services, and to help “bridge” child and adult behavioral health services. I hope to be a partner and advocate for the unique needs of young adults, and also for rural/geographically underserved areas, by promoting the voices of those with lived experience.
"As a human outside of work, I have lived in both rural and urban areas of Oregon and California. I have love for animals, music, art, rugby and traveling.”
Christie Taylor pictured with her two dogs
(and sometimes coworkers) Bandit and Pluto.
“My name is Jeanette Hansen (she/her/hers), and I am working with the CFBH Unit through May 2023 as a Hatfield Fellow. This is a program through Portland State University that matches accepted applicants with public sector agencies. I am excited to help the unit tackle their data needs.
"My undergraduate degree is in Child Development, and I recently finished a Master of Public Policy degree at Oregon State University. In my free time, I enjoy reading, eating ice cream, attending dance and classical music concerts, and outdoor activities with my family, such as whitewater rafting, skiing and hiking.”
Jeanette Hansen
Our team is getting prepared for the upcoming legislative session. One important piece of that work is to prepare Policy Option Packages (POP) for needed and requested funding to create or expand services and supports. We have developed several POPs in consultation with youth and families and as a part of our policy vision work are a part of the OHA Agency Requested Budget. Presentation Materials around the POP are available, and the unit was excited to have the support of the System of Care Advisory Council in this ask.
You can find information on OHA’s proposed legislative concepts and POPs on the Government Relations page. This session, we are excited to be able to share and consult on these publicly before the (new) Governor reviews what she wishes to propose in her budget to the Legislature.
A summary list is also available for people interested in possible POPs impacting families with children under 5 years of age.
We look forward to ongoing conversations with all of you on supporting the evolution of the children’s behavioral health system.
Since 2020 the CFBH unit, along with the Children’s System Advisory Council, has been working to create direction, strategic pathways and a roadmap for the children’s mental health system. As we continue this journey, we wanted to take a moment to celebrate some successes.
The 2023 POP includes the following youth and family priority requests identified in the policy vision paper and subsequent conversations and feedback:
- Adding respite services to the Medicaid State Plan
- Expanding the young adult hub model
- Adding more developmental assessment capacity
- The CFBH team has been expanded to create the capacity to focus on implementation of the work
- Mobile Response and Stabilization Services have moved through the Oregon Administrative Rules process and this important new crisis support service will roll out beginning January 2023
- Capacity needs for the psychiatric residential treatment system have been modeled and the process initiated to add more providers and beds
We continue our commitment to this work and the engagement of our community in all that we do.
Community conversation about Applied Behavior Analysis (ABA)
The Oregon Health Authority is seeking community feedback on the topic of ABA. ABA is a therapy-based treatment provided primarily to people diagnosed with autism and is currently an Oregon Health Plan (OHP) benefit. Current administrative rules for ABA address Medicaid payment and provider requirements but do not address oversight or management of ABA programs or facilities.
If you or your family have lived experience with ABA, please consider joining this community conversation. ASL and Spanish interpretation and closed captioning will be provided. If you need other accommodations, please contact Tamara Bavaro at tamara.bavaro2@oha.oregon.gov.
Two meeting options are available: Monday, Nov. 7 from noon to 1 p.m. Wednesday, Nov. 16 from 6 to 7 p.m.
To join by phone:
- Dial 1-669-254-5252 and enter meeting ID: 160 810 3685 and passcode: 340653, or
- Use one tap mobile: +16692545252,, 160 810 3685#
12th Annual We Can Do Better Conference
 Relational Health: Supporting Our Youth at Home, School and in Community.
We Can Do Better views health as a product of many factors. Using their website, social media and community forums, they share creative ways that communities approach health — through affordable and nutritious food, safe biking and pedestrian walkways, housing, equity issues and improving the medical system.
The We Can Do Better Conference occurs Wednesday, Nov. 9, 2022, starting at 9 a.m. Tickets are $25. You can register online. Full or partial scholarships are available upon request, thanks to sponsors PacificSource Health Plans and Pivot Point Consulting.
OHA’s own Chelsea Holcomb, CFBH director, and Dr. Grace Bullock, senior mental health officer at Oregon Department of Education, will be speakers.
Spanish and American Sign Language interpretation will be provided thanks to sponsor Comunidad y Herrencia Cultural.
Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) Certification Training
Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is an evidence-based treatment to help children and adolescents recover after trauma. Research shows that TF-CBT successfully resolves a broad array of emotional and behavioral difficulties associated with single, multiple and complex trauma experiences. This is a structured, short-term treatment model that effectively improves a range of trauma-related outcomes in eight to 25 sessions with the child/youth and caregiver.
Dr. Alicia Meyer, a national trainer in TF-CBT and a global trainer in Parent-Child Interaction Therapy is offering a two-day online training, Jan. 19-20, 2023, from 8 a.m. to 4 p.m. each day, for clinicians to become certified in TF-CBT treatment. The training is free for people sponsored by OHA; for others it is $500.
For more information, including prerequisites and required reading materials, visit Dr. Meyer’s website. The prerequisite TF-CBT course costs $35, offers 11 continuing education units and must be completed prior to the two-day training.
Collaborative Problem Solving
OHA funded The Child Center to help families strengthen positive relationships and build the skills needed for success at home, at school, in the community and throughout life.
Collaborative Problem Solving (CPS) is a philosophy based on the understanding that youth with challenging behaviors may be having delays in the development of skills in five different areas which are needed to adaptively solve problems and make decisions in their lives. CPS works to strengthen existing skills and teach them skills to do better in their environment; the philosophy is that “Kids do well if they can.”
The Child Center:
- Offers free CPS classes to people throughout Oregon. Sessions are once a week for eight weeks.
- Is focused on providing services to seven regions in Oregon that have limited mental health provider resources.
For more information, please visit The Child Center’s website and share widely with families and communities.
Eating disorder treatment training series
Struggling to diagnose eating disorders? Have you ever wondered about options for screening a young person for an eating disorder? Did you know that there are several tools that could be used?
Eating disorders affect 30 million Americans and 95 percent of those affected are between the ages of 12 and 25. To address the lack of knowledge and expertise on this subject among health professionals in Oregon, we have engaged Therese Waterhous, PhD, RDN, CEDRD-S, owner, clinician and trainer at Willamette Nutrition Source, LLC, to offer a seven-month virtual training series. Therese will be joined by two guest speakers to address specific health equity considerations in eating disorder treatment. This training is made available through federal funding and there is no charge to registrants.
The next lecture is November 16 from noon to 1:15 p.m. with Melissa Grossman, MS, LPC. The topic will be “Doing the Work: How Clinicians Can Be of Best Service to Our Clients."
Melissa is a licensed therapist who has been working with eating disorders for 32 years. She acted as the clinical director of an outpatient eating disorder and substance abuse program in San Francisco for 10 years. She works with adolescents, their families and adult clients and specializes in eating disorders, addiction, trauma and issues relevant to people who identify as LGBTQIA+.
For more information, visit our website. You can register for the training series through Eventbrite. The training is open to everyone. There are two training dates left in this series. Check out the resources and links to the previous webinars for more information and consider joining this free series or recommending it to others.
If you have questions from the prior trainings that you’d like answered, send them to Sam Haskins at sam.l.haskins@dhsoha.state.or.us.
If you have general questions about the series or need more information, contact Kathleen Burns at kathleen.m.burns@dhsoha.state.or.us.
Suicide Prevention Trainings
Question Persuade Refer (QPR): QPR Training for Trainers
Virtual training
- Monday, November 7, 9 a.m. to 4 p.m.
- Wednesday, January 25, 9 a.m. to 4 p.m.
Contact QPR@linesforlife.org for more information.
Sources of Strength
Virtual Info Sessions (Elementary and Secondary models):
- December 1, 8 a.m. to 9 a.m.
Elementary Coaches training
- November 14-15 in Sunriver, Oregon
Training for Trainers for Middle, High, and Post-secondary School programs
- February 27 through March 2, 2023, in the Medford area
Register for all sessions and find more information at the Sources of Strength website.
Advanced Skills Trainings (such as DBT and AMSR) for mental health providers serving those struggling with suicidal thoughts, ideation or behaviors can be accessed at no cost by contacting Maria Gdontakis Pos, Association of Oregon Community Mental Health Programs (AOCMHP) at mpos@aocmhp.org.
System of Care Learning Collaborative
Every second Tuesday of the month, from 3 to 4:30 p.m., Oregon Family Support Network, Youth ERA and OHA facilitate a conversation for people involved with System of Care work.
Conversation topics include how to develop skills that center youth and families, how to be culturally and linguistically responsive and how to ensure services and supports are community-based. Bring your questions and a desire to learn and unlearn!
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Meeting ID: 995 6012 8631 Passcode: 947033
Contact Nat Jacobs at nat.jacobs@dhsoha.state.or.us for more details.
A Time for Families
A Time for Families is a weekly drop-in discussion hour for parents and family members hosted by Chelsea Holcomb and Hilary Harrison, System of Care policy coordinator. Join us Thursdays from noon to 1p.m.
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Click here to join the meeting (conference ID 676907) or
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Join by phone:1-669-254-5252 | Meeting ID: 161 993 2307 | Passcode: 676907 | One tap mobile: +16692545252,,1619932307#,,,,*676907#
Warmline
Reach Out Oregon, funded by OHA as part of Oregon Family Support Network, has a warm line at 833-732-2467, a website, a chat room for any family member needing support and a weekly virtual support group.
Capacity in the children’s psychiatric and substance use disorder residential system
The CFBH unit has been closely monitoring capacity at all Oregon Health Plan child behavioral health residential facilities since spring 2021. While significantly delayed due to the COVID pandemic, the goal of this work is to develop a centralized access process, so we know how many children and families need these services. As a result, we can identify where capacity needs to be increased to support people with the right service, at the right time.
Please find below a data table for our Psychiatric Residential and Acute Psychiatric Treatment capacity beds since our monitoring began:
Mobile Response and Stabilization Services ($6.5 million)
Planning for Mobile Response and Stabilization Services (MRSS) continues toward a January 2023 launch date. Currently, the Oregon Administrative Rules (OARs) for MRSS have moved through the Rules Advisory Committee, with guidance and insight from those from traditionally underserved and underrepresented communities, other community members, those with lived experience and crisis response staff. The final public comment period runs from November 1-21 with a public hearing scheduled for November 15. The CFBH unit will update the MRSS web page with additional information on the public comment period and the final public hearing once it becomes available. Public comments will be incorporated into the final version of the rule, which is scheduled to go into effect Dec. 20, 2022.
Additionally, we are working with an actuarial firm to assist in establishing rates for crisis service providers with new billing codes designated for crisis response services.
While awaiting the final comment period of the OAR, the CFBH unit is establishing training sessions for crisis response staff to provide evidence-based assessments and screenings delivered in a clinically, developmentally and culturally appropriate manner. Many of the trainings are identified to address concerns voiced by the community, such as providing care to intellectually and developmentally disabled populations and providing care and crisis services with a trauma-informed approach. OHA is also working in collaboration with the Community Mental Health Programs (CMHP) to apply for a Technical Assistance Grant to help standardize training for the crisis system workforce.
We continue to see a steady increase in calls received by 988, aligning Oregon with the national average of a 40 percent increase in calls compared with volume to the existing National Suicide Prevention Hotline (NSPL). Oregon’s current in-state answer rate is 90 percent, which is above the national average. The use of text and chat is continuing to average a seven-fold increase over NSPL numbers, with 100 percent of calls and texts being answered in-state. Additionally, we are seeing a slow but steady increase in texts since 988 went live in July 2022.
In anticipation of the January launch date for MRSS, OHA holds Learning Collaboratives the second Monday of each month to gather further insight and inform the community about MRSS.
Learn more about 988 in Oregon on OHA’s 988 web page. If you promote the NSPL in your work, consider how you will switch messaging from NSPL over to 988. The NSPL number (1-800-273-TALK (8255)) remains available.
Contact Brian Pitkin at brian.m.pitkin@dhsoha.state.or.us or Beth.Holliman@dhsoha.state.or.us with any questions.
Psychiatric Residential Treatment Services ($6 million)
In 2021, OHA’s Legislatively Approved Budget provided funding to support investment in treatment services for Oregon’s youth and families experiencing an intensive behavioral health crisis.
OHA issued a Request for Grant Applications (RFGA) to support the development of Children’s Psychiatric Residential Treatment Facilities for children with severe emotional disorders. This solicitation closed Sept. 24, 2022, and applications are being reviewed. We will report more on this investment in December.
Young Adult Residential Treatment Homes ($9.2 million)
Developed in collaboration with the Intensive Services, Housing & Social Determinants of Health Unit, the RFGA focuses on Young Adult Residential Treatment programs.
This RFGA focuses on:
- Centering health equity, expanding the Young Adult Residential programs, including up to an additional 20 residential treatment home beds for ages 17.5 through 24 years of age, and
- Developing a 10-bed Secure Residential Treatment Facility for young adults aged 18 through 26 years of age with higher acuity needs.
The RFGA closed Oct. 1, 2022. Applications are currently being reviewed. More information to come after the grant(s) have been awarded.
Contact Jessica Stout at jessica.l.stout@dhsoha.state.or.us with any questions.
Interdisciplinary Assessment Teams ($5.7 million)
We continue to meet with community and system partners to assess the need of the Interdisciplinary Assessment Team (IAT) project and creative ways to move forward. The goal is to provide expedited services early, to avoid the significant fallout that can happen while a youth and their family are waiting lengthy periods for evaluations. While we are developing the IAT to reach its full potential, we have made significant progress with smaller versions of IAT.
Expedited Evaluation Services (EES) provide much-needed support to our communities that are clearly struggling. In some situations, all that may be needed is a full psychological evaluation to help a youth and family get on the right path to the services they need. EES provides quick access to full psychological and assessment services within seven to 10 days of referral. EES includes a full review of clinical documents, determination of need for testing, conducting psychological testing, communication with current clinical providers, and (where appropriate) coordination with local Intellectual and Developmental Disabilities intake screening departments. EES can be mobile and meet the youth in the community, either in person or via telehealth as needed.
We are developing demonstration projects with various system partners and plan to soon have more options available throughout the state.
If you are interested in this work, please contact John Linn at john.r.linn@dhsoha.state.or.us.
For feedback and suggestions for our newsletter and information: kids.team@dhsoha.state.or.us
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