Mental Health Service Disparities of Latino Oregonians: A Qualitative Analysis (2017)
by Diana St. Amour
Western New Mexico University
Oregon Commission on Hispanic Affairs
Oregon Department of Human Services
Oregon Department of Health
In this study participants were asked about individual and systemic barriers for Latinos and ways
to improve mental health services delivery to the Latino population. Their responses were
compiled and analyzed into themes in order to inform policy and improve service delivery.
The information provided by participants is summarized in three key areas. Firstly, there is an
overview of barriers. These barriers are divided into systemic and individual barriers. Secondly,
the key findings concerning these barriers are highlighted and discussed. Lastly, ideas for
improving mental health delivery are presented and future policy recommendations are
discussed. A description of the study and the methods used are also included in this report.
Youth Suicide Intervention and Prevention Plan – 2016-2020
Oregon Health Authority
Multnomah County Mental Health System Analysis – June 28, 2018
Multnomah County released a new report today on its mental health system that finds the county has many elements of a modern system with an array of services that use progressive, evidence-based practices, peer support and culturally responsive approaches.
But the 130-page “Multnomah County Mental Health System Analysis” also finds a disconnect between the system’s aims and how the system is experienced by a significant number of stakeholders. Other key challenges include an overworked, underpaid workforce; a shortage of supportive housing and multiple agencies providing funding and oversight can make those who need help the most unable to find it. Researchers, who interviewed hundreds of community members and attended public listening sessions, said some of the largest barriers are faced by people who are homeless or have both mental health and substance use issues.
“We know there are gaps. As an emergency room doctor, I’ve seen those gaps first-hand,” said Multnomah County Commissioner Dr. Sharon Meieran. “Now we have a much clearer idea of how we can improve the quality of care and access for people who are most vulnerable and least able to navigate these complexities.”
A Consumer-Operated Case Management Program – June 1992
Robert E. Nikkel, M.S.W., Garrett Smith, M.P.A., David Edwards, B.S.
This article describes the Mind-Empowered SEEDS project.
Oregon State Court – Juvenile Justice Mental Health Task Force
Report and Recommendations – January 2016
Oregon State Court Juvenile Justice Mental Health Task Force
Oregon State Court Juvenile Justice Mental Health Task Force Report (Summary) – January, 2016
Behavioral Health Collaborative Report – (2016)
Oregon Health Authority
Integrated Service Array Progress Review Data Analysis – January 2011
Oregon Health Authority – Addictions and Mental Health Division
Oregon Addictions and Mental Health Division
Cultural Competency Plan – 2007
Oregon Community Addiction Services Investment Strategy – 2008
This report reflects the voices of more than 150 Oregonians from communities across the
state who shared their top priorities related to addiction prevention, treatment and recovery
services. This effort represents the most comprehensive look ever taken at Oregon’s needs
in addiction services. These priorities, supported by data from the State Epidemiological
Outcomes Workgroup (SEOW) report, demonstrate that the need for addictions prevention,
treatment and recovery services in Oregon exceeds the resources and service availability made
possible by current funding.
The Unheard Voices in the Conversation about Behavioral Health in the Portland Metro Area
AFSCME – 2016
Report to Management- MHASD Claims Processing
Multnomah County Auditor – April 2015
This report covers claims processing by the Mental Health and Addiction Services Division which handled about 350,000 claims payments in each of the two years we reviewed. Because of the volume both in number and dollars, as well as the susceptibility of improper billing with medical‐related claims, it qualified as an area of “significant risk.” We found instances of likely overbilling along with errors and inconsistencies in the data.
Mental Health Jail Diversion Feasibility Study
Multnomah County Feasibility Assessment – Executive Summary
Multnomah County – 2015
The Mental Health Jail Diversion Project was prepared in response to a Multnomah County Board of Commissioners fiscal year 2015 budget note to investigate the need and feasibility of enhancing diversion opportunities for people in county jails with mental illness to reduce criminal justice system costs, reduce recidivism, and better treat the mental health needs of the individuals. The project consisted of interviewing stakeholders, reviewing literature, summarizing jail data, convening a stakeholder group to review the materials and prioritize recommendations, and exploring cost information. The report was completed by Lore Joplin Consulting in collaboration with Ann Sihler and recommendations were made to the County Board of Commissioners in February 2015.
Mental Health and Addictions Services: Consultation on Managed Care and Local Mental Health Authority Roles
June 2014
Multnomah County Department of Human Services, Division of Mental Health and Addiction Services
Technical Assistance Collaborative
Annual Medicaid Quality Report – 2014
Multnomah County
Poverty in Multnomah County – 2014
Department of County Human Services – Community Services Division
Mental Health and Addiction Services: Managing Risk in a Changing Environment
Multnomah County Auditor – 2014
Healthcare transformation brings with it both great opportunities and great challenges. For
years there have been efforts to more closely align the business of mental health service
provision with the business of healthcare. The development of comprehensive care
organizations (CCOs) is the most significant healthcare transformation to date.
Multnomah County has operated a mental health insurance plan for some time. However, it was
operated in an environment as part of an integrated mental health system that included community
health services, including crisis response and commitment monitoring. While this integration
was done with efficiency in mind, it blurred the separation between the insurance plan functions
and other parts of the system. In the new environment, with a new CCO inserted between
the state and the County’s insurance operations, it is critical that the County be able to clearly
differentiate costs associated with Medicaid covered expenses and the costs for other services that
the County has determined to be valuable aspects of a comprehensive mental health system.
Transforming Services for Persons with Mental Illness in Contact with the Criminal Justice System
Multnomah County, Oregon Sequential Intercept Mapping and Taking Action for Change
April 13 and 14, 2010
Washington County Mental Health Practice Guidelines – 2013
These practice guidelines were developed to assist Washington County network providers in identifying approaches to working with clients who have been diagnosed with a mental health disorder. Each section identifies both the Oregon Department of Human Services Addictions and Mental Health Division’s approved Evidence Based Practices and best practice alternatives for a variety of diagnoses. Neither the list of diagnoses nor the practice interventions are considered complete; they will be continually developed over time. Interventions are listed in no particular order, they are simply grouped into Evidence Based
Practices and best practice alternatives.
Practices are briefly defined at the end of this document. Providers should ensure that they have received adequate training to implement the approach as designed. Similarly, providers are expected to continually strive for the highest level of fidelity possible for any of the listed Evidence Based Practices that they utilize.
Portland Police Bureau – Community Mental Health Resource Guide – 2017
SAMSHA Behavioral Health Barometer – Oregon, 2015
Oregon Health Authority Behavioral Health Strategic Plan – 2015-2018
This strategic plan represents a shared vision for building and expanding an integrated, coordinated and culturally competent behavioral health system that provides better health, better care and lower cost for all Oregonians. This plan grew out of a collaboration between the Oregon Health Authority, consumers and families, advocates, peer organizations, health providers, county and city governments, tribes, local law enforcements, community mental health programs, coordinated care organizations, and many other stakeholders. Through a series of town hall meetings, these interested parties discussed how to best align behavioral health services with Oregon’s health system transformation efforts.
Multnomah County Utilization Guidelines – a Manual for Utilization Review, Staff and Health Share of Oregon Providers – Multnomah County Mental Health and Addictions Services Division, 2015
Medicaid managed care organizations are required to adopt practice guidelines that are based on valid and reliable clinical evidence, consider the needs of our individuals, and are adopted in consultation with our participating providers. Decisions for utilization management and coverage of services should be consistent with these guidelines.
Health Share of Oregon-along with the Risk Accepting Entities (RAEs)-Clackamas, Multnomah and Washington County has adopted a definition of medical necessity criteria and a set of practice guidelines as a resource for both providers and our staff. It should be noted that these guidelines are administrative in nature; they are not clinical practice guidelines. Clinical practice guidelines reflect practice standards for the management and treatment of specific conditions. Administrative guidelines describe the criteria for authorization for specific types of service. This document incorporates both Health Share of Oregon Regional Behavioral Health services, as well as services only available through Multnomah Mental Health.
The primary purpose of these guidelines is to assist providers in selecting the appropriate level of care for clients, and to inform providers of the criteria used by the RAEs in authorizing services.
Behavioral Health CCO 2.0 Policy Development Proposed Work Plan – Proposed Work Plan – 2018
OHA has convened an internal Behavioral Health CCO 2.0 team with members from Health Policy and
Analytics (HPA) and Health Systems Division (HSD). Members were invited to participate based on their
particular subject matter expertise to develop a comprehensive and integrated behavioral health plan.
Regional Behavioral Health Guidelines for Clackamas, Multnomah, and Washington Counties – Health Share, 2018
Behavioral Health Collaborative Report – 2016
Oregon Behavioral Health Collaborative – Recommendations for a 21st Century System of Care
Every day Oregonians experience the “behavioral health system” with a mixture of hope, reluctance, disappointment and success. Every one of us has a friend, a loved one, or a neighbor who has experienced a mental health issue or substance use disorder – and many of us experience these challenges ourselves. While we have made significant progress in Oregon in recent years, and have led the nation in innovation in some important ways, we have much work to do in our transformation of our behavioral health system. And we know we
must serve Oregonians better.
That is why during the summer of 2016, the Oregon Health Authority (OHA) created the Behavioral Health Collaborative (BHC) to develop recommendations that would build a 21st century behavioral health system in Oregon. The BHC is made up of nearly 50 Oregonians from peer support services, advocates, counties, behavioral health providers, courts, DHS, Oregon’s coordinated care organizations, hospitals, education, law enforcement, a representative from an Oregon Tribe, and an urban Indian organization came together over the past eight months to develop the recommendations included in this report.