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Feb. 1, 2023
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Named after a spring-cleaning festival of the time, February was added to the Roman calendar in 713 B.C.E. by Julius Caesar. For the 28 short days of this month, we celebrate Valentine’s Day, Groundhog’s Day, and most importantly, Black History Month.
In 1967 President Gerald Ford officially recognized Black History Month, which was just one week when founded in 1917 by the father of Black history, Carter G. Woodson. Woodson chose the week to coincide with the birthdays of Frederick Douglass, a former slave and prominent leader in the abolitionist movement, and President Abraham Lincoln.
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Woodson chose the week to coincide with the birthdays of Frederick Douglass, a former slave and prominent leader in the abolitionist movement, and President Abraham Lincoln. The second Black American to receive a Ph.D. from Harvard; Woodson was an author, journalist and historian who lobbied for the national recognition of Black stories and perspectives. People can celebrate the month in a variety of ways: the Cascade Festival of African Films, the PDX Jazz Festival, or the Northwest Black Comedy Festival. Learn more by visiting Travel Portland.
Oregon Health Authority (OHA) has some exciting announcements for the new year: Ebony Clarke will be the new Behavioral Health Director and Bessie Scott is our new Deputy Behavioral Health Director. Ebony has more than 25 years of experience working in both the publicly funded and non-profit children’s behavioral health arenas. She most recently served as the Director of Multnomah County’s Health Department, where she led the Health Department’s COVID-19 response. Bessie comes to us from Seattle, where she was, most recently, co-Executive Director for Operations and, before that, Chief of Staff, for the Public Defender Association. Ebony and Bessie are dynamic leaders, community-focused leaders with track records of building collaborative partnerships with key stakeholders and community groups. It’s an honor to have them on our team.
Throughout 2022, OHA partnered with community mental health providers, peers, youth and families, crisis providers and many other interested parties to collaboratively design a new, enhanced set of rules for mobile crisis intervention services that better meet the needs of the community and are rooted in evidence-based practices. OARs are the rules by which state agencies and subunits operate. They are the mechanisms that agencies use to carry out the goals established by the Oregon Revised Statutes (ORS).
Have questions about what’s new in ORS? Here are some highlights:
What has changed:
- Community members can now call or text 988 when experiencing any behavioral health crisis and be connected immediately to trained crisis intervention counselors.
- 988 can help individuals access Mobile Crisis Intervention (MCIS) teams, if an individual or family is needing a face-to-face response.
- These teams consist of two trained mental health staff (which may include a qualified mental health associate, qualified mental health professional or peer) who respond to the location of the individual requesting assistance.
- The teams also have additional training requirements which ensure that staff are trained in best practices for children, youth, young adults and their families, in addition to being trained in how to work with adults.
What is brand new:
- Mobile Response and Stabilization Services (MRSS) is a national best practice for youth and their families and is an important component of the Children’s System of Care in Oregon.
- Community Mental Health Programs (CMHP) are now required to provide children, youth and young adults (from birth through age 20) with Stabilization Services, in addition to providing the initial crisis response.
- Stabilization services can last up to 56 days and include access to a therapist and family support specialist to assist the youth and family to identify ongoing needs and provide brief, time-limited services, while also assisting the family in accessing appropriate ongoing services and support.
OHA is working closely with the CMHPs to provide technical assistance on the new OAR requirements. 2023 will be a transition year as each of the CMHPs work on standing up the new OAR requirements.
CSAC is composed of system partners, youth and family members. Roberta Lincoln is a family advocate and council member who generously offered her insights and perspective of her time serving on CSAC.
As a parent of two special needs young people of color, she noticed a significant gap in the services and supports available to children with developmental delays along with mental and behavioral health issues. She has experienced firsthand not only how to navigate the system, but the challenges and barriers that parents and children face.
When asked why she joined CSAC, Roberta said, “In the midst of crisis and trauma parents can become paralyzed, and when we come out on the other side, it’s our job to help and support those going through those same struggles. I believe it is my responsibility to speak up and help one another.”
Roberta has found CSAC to be a powerful way to learn about the wide variety of advocacy going on in Oregon.
Additionally, she often joins A Time for Families, a weekly drop-in call with Chelsea Holcomb, director of Child and Family Behavioral Health (CFBH), each Thursday from noon to 1 p.m. Her goal in attending these weekly meetings has been to seek assistance in locating resources when things go sideways. Through her participation, she has been able to hear from other advocates and professionals, learn about problems, and people working throughout Oregon to make things better for children and families.
“It’s encouraging to see the work people are doing to support kids and has strengthened my resolve to continue to advocate for Oregon’s children,” Roberta continued. “Every voice counts. Everyone should have access to the help they need. By joining CSAC [and A Time for Families], families, youth and advocates can learn about other work being done in Oregon. Many of the issues dovetail beautifully — but if you are unaware of the work being done in other advocacy areas — you could miss out on opportunities to provide advocacy or make change to the issues for which you have a passion.”
She would like to see the word get out more broadly about the changes being made — and sees A Time for Families and CSAC as a positive force in spreading information and giving families direct access to the supports provided within the CFBH system.
When asked if she had any message of hope to youth and families seeking help, Roberta said, “There’s help out there, and it’s getting easier to find, so don’t give up!”
On Jan. 1, 2023, coverage for Oregon Health Plan (OHP) changed; under the federal Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit, OHA and coordinated care organizations (CCOs) must cover all medically necessary and medically appropriate services for OHP-enrolled children and youth until their 21st birthday. This means that some services for children under 21 that were historically not covered may now be covered if determined to be medically necessary and medically appropriate for the individual child.
One example is conduct disorder, which was not previously funded on the Prioritized List. As of Jan. 1, OHA and CCOs will not automatically deny coverage of conduct disorder for OHP members under age 21. Instead, they now need to review for the medical necessity and medical appropriateness of conduct disorder on a case-by-case basis.
In Oregon, EPSDT constitutes the child and youth benefit within OHP.
- Early: Assessing and identifying problems early
- Periodic: Checking children’s health at periodic, age-appropriate intervals
- Screening: Providing physical, mental, developmental, dental, hearing, vision and other screening tests to detect potential problems
- Diagnostic: Performing diagnostic tests to follow up when a risk is identified and
- Treatment: Control, correct, or make easier to bear any health problems found.
OHA has developed the following materials to share information about this change:
Learn more about EPSDT at OHA’s no-cost provider education sessions:
Overview of Behavioral Health Policy Change: Feb. 15, from 3 to 4:30 p.m.
This session will provide an overview of the EPSDT policy change for OHP members, and its implications for behavioral health (BH) and Behavior Rehabilitation Service (BRS) providers.
- Audience: BH and BRS providers serving children and youth who are OHP members.
- Presenters will include Margaret Cary, MD, MPH, OHP Fee-for-Service (FFS) Medical Director and EPSDT staff. Child and Family Behavioral Health staff will be available for questions.
Ensuring EPSDT access - documenting medical necessity, prior authorization and related processes for Fee for Service patients: Feb. 7, from noon to 1 p.m.
- Audience: Clinicians and practice managers serving children and youth who are OHP members.
- Presenters will include the following OHA clinician leaders: Dawn Mautner, MD, MS, Medicaid Medical Director; Margaret Cary, MD, MPH, OHP FFS Medical Director.
For both sessions:
- Please contact Tom Cogswell (cogswell@dhsoha.state.or.us, 971-304-9642) if you need an accommodation to fully participate in these webinars. Examples of accommodations include American Sign Language (ASL) or language interpretation, and closed captioning.
- Contact Laura Sisulak, sisulak@dhsoha.state.or.us, with any other questions.
OHA is expanding Fidelity Wraparound eligibility to fee-for-service (FFS) for OHP members. This expansion allows:
- Outpatient behavioral health programs to become approved Fidelity Wraparound providers, and
- Existing Wraparound programs to offer Fidelity Wraparound to FFS OHP members.
We have refined the elements of the Policy Vision paper since it was drafted in 2020. We have now published the Roadmap 2020-2024 to set out all the top level strategies and steps, to be sure that everyone can track the work. In the document you will see a progress report written in early January on work to date, and the timeline for each strategy. Our aim is to update this document every six months and we welcome conversation and feedback around its various components.
This Roadmap is mapped through 2024. We will begin revisiting it later in 2023 to ensure that we are prioritizing what youth and families, our partners and community see as the highest needs. The next phase is to add some graphics to help frame the work and this plan.
Please let us know your thoughts, comments, additions at kidsteam@oha.oregon.gov.
If you or another family member is a firearm owner, it is important to consider safe storage practices in the context of suicide prevention.
What we know:
Here are four recommended firearm safety practices:
- Keep a firearm locked.
- Keep a firearm unloaded.
- Lock stored ammunition.
- Store ammunition in a separate location.
Get a free safety kit for your home, including trigger locks, by visiting one of these Project Child Safe locations. Find other options for firearm storage and other child safety products in the Doernbecher Tom Sargent Safety Center.
Please consider following these safety practices in your households and ask about these practices in households where your child or teen frequent. Together, we can save lives.
If you have questions or need more information, contact Jill Baker at jill.baker@dhsoha.state.or.us.
Events, opportunities, trainings and resources may now be found on our website and will also be sent out mid-month. Look for February events in your inbox on Feb. 15.
System of Care Advisory Council seeking youth, Tribal and pediatric representatives
The System of Care Advisory Council has three vacancies:
- A youth member (under age 25, who has been involved in foster care or juvenile justice),
- A Tribal representative (must be a member of one of the nine Federally Recognized Oregon Tribes or a designee of a Tribe), and
- A pediatric physician.
Do you know someone who could serve in one of those seats? These are some of the most vital voices we need to hear from to transform our systems to work for every Oregon child and family. SOCAC staff can support people in applying, attending meetings and learning about the council. Some members are eligible for a stipend, currently set at $157 per day. Please share among your networks!
Email Christy Hudson at christy.j.hudson@dhsoha.state.or.us if you would like to apply or if you have someone to recommend.
Capacity monitoring for Intensive Treatment Services
Intensive Treatment Services remain a critical concern to CFBH. Each week we receive data on capacity for acute care, sub-acute and psychiatric residential, as well as substance use disorder residential programs. OHA monitors these to understand patterns and to offer help in keeping programs operational.
The graph below shows capacity over time. The top line represents the 2020 goal for the system, of having 286 beds available for youth. The line below shows the highest possible capacity that could have been available, given full staffing and removal of all other barriers.
This possible capacity has declined over three years with the closure of two Kairos residential programs in 2020 and the temporary closures of Crystal Creek at Jasper Mountain. The bottom bar chart represents a monthly summary of reported weekly operational capacity, a combination of beds in use and open beds.
 Suicide-related visits for youth to emergency departments and urgent care clinics
Suicide related visits to Emergency Departments and Urgent Care Clinics for youths ages 18 and younger in the first quarter of 2022 were higher than previous years. Further information can be found in the Suicide Surveillance Report for January 2023.
Young Adults in Transition Residential Treatment Homes (YAT RTH)
Young adult residential programs are for young adults (aged 17 through 24 years) who experience complex behavioral health challenges. The programs support them with developing the skills needed for a successful transition into adulthood. Services and supports include but are not limited to: access to therapy and medication management, understanding and managing behavioral health symptoms and skill development around activities of daily living.
OHA has issued a Notice of Intent to Award to Trillium Family Services, to develop a new Young Adult in Transition Residential Treatment Home in Linn County.
OHA will be reposting this solicitation of a Request for Grant Applications (RFGA) in collaboration with the Intensive Services, Housing and Social Determinants of Health Unit that 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 is posted on the Social Determinants of Health page.
YAT RTH referral process changes
Starting Jan. 1, 2023, all referrals for YAT RTH will be submitted directly to the YAT RTH programs. The current application is on the Supports for Young Adults page, under the Young Adult in Transition Residential Treatment Home Section. Contacts for the programs are on page one of the application.
All referrals must include a completed application form, along with supporting clinical documentation (as listed on page two of the application).
Referral sources include, but are not limited to, Oregon Department of Human Services, Child Welfare, Oregon Youth Authority, county mental health programs, community mental health agencies, acute psychiatric units and young adults themselves. Read more about the YAT program in the System indicators portion of this newsletter.
Information regarding which programs are accepting referrals at this time can be found on the dashboard on our website.
Contact Jessica Stout at jessica.l.stout@dhsoha.state.or.us with any questions.
Interdisciplinary Assessment Teams
We continue to meet with community and system partners to assess the needs of the Interdisciplinary Assessment Team (IAT) project and to create ways to move forward. The first goal, set out in Senate Bill 1 (2019), is to provide rapid access to evaluation, assessment and stabilization services for youth - and especially for those who are in child welfare custody and placed in temporary lodging - in emergency department boarding, in shelter care, in county juvenile facilities or in the custody of Oregon Youth Authority.
We are about to launch Expedited Assessment Services for Youth (EASY). 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. EASY provides quick access to full psychological and assessment services within seven to 10 days of referral. EASY includes a full review of clinical documents, determination of need for testing, conducting of psychological testing, communication with current clinical providers and (where appropriate) coordination with local Intellectual and Developmental Disabilities intake screening departments. EASY can be mobile and meet the youth in the community, either in person or via telehealth as needed.
If you are interested in this work, please contact John Linn at john.r.linn@dhsoha.state.or.us.
Screening for adverse childhood experiences increases visits to behavioral health services, Contemporary Pediatrics, Celeste Krewson, Jan. 3, 2023
SAMHSA Announces National Survey on Drug Use and Health (NSDUH) Results Detailing Mental Illness and Substance Use Levels in 2021, Substance Abuse and Mental Health Services Administration (SAMHSA) Newsroom, Jan. 4, 2023
Parents Often Bring Children to Psychiatric E.R.s to Subdue Them, Study Finds, The New York Times
The Intersection of the Social Determinants of Health (SDOH) and Trauma-Informed Care (TIC), Paces Connection Blog, Shenandoah Chefalo, Jan. 5, 2023
For feedback and suggestions for our newsletter and information: kids.team@dhsoha.state.or.us
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