Here is the County’s Reorganization Plan for Cascadia (1 MB PDF) assembled document consisting of
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The Cascadia Plan, June 16 2008
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A Memorandum of Understanding between the State of Oregon, Multnomah County and Cascadia Behavioral Healthcare, June 16 2008
Cascadia Behavioral Heath Financial Condition, memo from June 11
Our response to these documents.
1. The reorganization of Cascadia is tantamount to the reorganization of the county mental health system.
2. The goals and outcomes of the plan reflect the interests of county and state government. The outreach and contact the reorganization leaders had with those affected by the system’s change was not sufficient. According to the Surgeon General’s mental health report of 2002, 2.2% of the general population has a severe and persistent mental illness, and each of those persons has 4.5 persons who are closely attached to them – friends and family members. In Multnomah County this equals approximately 15,000 and 67,500 = 82,500. The largest County meeting in the past year about this issue drew less that 1/1000 of this number and the majority of persons at that meeting (at Benson High School) were employees of Cascadia or Multnomah County. The goals and outcomes selected may have been considerably different if those directly affected by the reorganization were brought to the discussion as equal stakeholders.
3. The plan as released is without sufficient background data, such as accounting and clinical measures, and for many items without measurable outcomes.
4. The reorganization still leaves Cascadia in financial jeopardy and other community agencies scrambling to build space and hire staff. The agencies named in the report are mature and capable of growth, but providers for at least two large communities – Gresham and inner N and NE Portland – are to be named later.
5. The plan is ambitious and intrepid but leaves behind the question of whether the County has the capacity to monitor contracts.
Your comments?
Those directly affected by the reorganization were not invited to the discussion because, in spite of plenty of lip service, they are not held to be equal stakeholders.
Consumers were invited as were advocates, but only a small percentage attended the open meetings.
Jamie, how do you mean “they are not held to be equal stakeholders?”
Roy, it’s true that there were meetings, but they were of limited value. Among people I know, the debate has been between those who think the meetings were poorly conceived, and those who think they were intentionally poorly conceived. The purpose for the meetings were announced in advance, but were entirely contradictory, and did not match the actual events. Meetings were announced as being an opportunity to give input on a plan (which was not presented), to allow consumers to weigh in on the decisions (which were not specified), and to speak to the issues of the larger mental health system while at the same time saying that right now we are limiting our process only to downsizing a private, nonprofit company. These are what is know as “waddaya think?” meetings. Lots of talk, but zero opportunity to speak to the specifics which would then be negotiated by the “true” stakeholders behind closed doors and announced to the people most affected after the fact.
Jamie, your descriptions of the three misrepresentations of the meetings with consumers and advocates I agree are true descriptions. I think the meetings were well conceived, from the point of view of the County, because, I believe, the intention was to set up “waddaya think?” meetings. The County never intended to have consumers and advocates weigh in or comment on specifics of the Cascadia plan. Your dead on: doors were intended to be closed.