| Barrier topic | Date submitted | Status | Proposed solution | Response | SOC strategic plan alignment | Resolution date | Region | Regional SOC Coordinator | Original barrier form | Assigned agency | Manager | Owner | Consulted | Single or Multi System | ||||
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| 04/19/24 | Received | Our region needs a day treatment center that can accommodate younger kids, particularly those that are 3-5 years of age. | Pillar 4: Community based | Central Oregon SOC | Dani McCallister | Multi system barrier | ||||||||||
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| 02/02/23 | In process - Working with agency on solution | Develop and fund a secure, dual diagnosis (Substance Abuse and Mental Health) residential facility for youth that can serve ages 12 – 19, including youth who may have an Intellectual and/or Developmental Disabilities. | 4/15/24 OHA has provided trainings for several years through the National Association of the Dually Diagnosed (NADD), to ensure that people working in both the mental health and the I/DD systems have information and competency to serve people with cooccurring needs. All residential programs are mandated to serve youth with I/DD, and any ongoing concerns should be filed through a grievance with the program, through the OHA grievance process, or through the Ombuds office. 2/20/24 OHA has funded several new programs this year; Madrona's co-occurring residential beds for youth with mental health and SUD needs opened in January, Nexus Family Healing is working to open a new SIP program for youth referred through restorative services, and we have funded a new program in the gorge for youth, which is breaking ground now and will provide new PRTF beds for younger children.OHA continues to hold discussions with interested providers. ODDS and OHA are developing a program for co-occurring youth. POPs are being developed for the 2025 legislative session for expansion of residential programs. In partnership with ODHS, OHA issued a memo to the Governor's office regarding PRTF capacity: https://www.oregon.gov/oha/HSD/BH-Child-Family/Documents/2023_OHA%20ODHS%20PRTF%20Capacity%20Memo.pdf 10/4/23 Ongoing coordination continues between ODDS and OHA, including hosting of National Association for the Dually Diagnosed (NADD) trainings in August. OHA continues work to expand residential treatment across Oregon through multiple programs & provide ongoing training for providers. | Pillar 2: Integrated and collaborative Pillar 4: Community based | Tri-County SOC | Selby Stebbins | https://www.oregon.gov/oha/HSD/BH-Child-Family/SOCReports/Tri%20County%20SOCAC%20Submission%20Secure%20Residential.docx | Oregon Health Authority (OHA) | Chelsea Holcomb | Jessie Eagan | Multi system barrier | |||||
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| 01/25/23 | In process - Working with agency on solution | Beds available in our region for youth in need of subacute care that allows treatment for more than 23 hrs. and less than 90 days . Success would look like children in crisis that do not need long term residential care being placed in an appropriate level of care quickly, and not having to wait in an Emergency Department where their symptoms are likely to get worse. It could be an addition to an existing entity such as a hospital or treatment center, or a new one designated for this purpose alone. A successful outcome would be making this possible in the next year to prevent more youth from suffering under the current conditions created by this imperative lack of services in our region | 4/15/24 POP submissions for HSD include funding for residential expansion grants. CFBH continues to recommend expansion of community-based programs to proactively manage youth and family crises prior to the need for residential care; it is possible that Oregon's residential capacity is sufficient to meet the need if more children received proactive care. POPs will be reviewed in the upcoming weeks. CFBH continues to work with counties and CCOs to implement IIBHT and MRSS. 2/20/24 OHA has funded several new programs this year; Madrona's co-occurring residential beds for youth with mental health and SUD needs opened in January, Nexus Family Healing is working to open a new SIP program for youth referred through restorative services, and we have funded a new program in the gorge for youth, which is breaking ground now and will provide new PRTF beds for younger children.OHA continues to hold discussions with interested providers. ODDS and OHA are developing a program for co-occurring youth. POPs are being developed for the 2025 legislative session for expansion of residential programs. In partnership with ODHS, OHA issued a memo to the Governor's office regarding PRTF capacity: https://www.oregon.gov/oha/HSD/BH-Child-Family/Documents/2023_OHA%20ODHS%20PRTF%20Capacity%20Memo.pdf | Pillar 4: Community based | Central Oregon SOC | Dani McCallister | https://www.oregon.gov/oha/HSD/BH-Child-Family/SOCReports/Deschutes%20Barrier%20to%20SAS%2001.23%20-%20v3.docx | Oregon Health Authority (OHA) | Chelsea Holcomb | Jessie Eagan | Single system barrier | |||||
| 5 |
| 12/07/20 | Agency responded with intention for further action | Fund BRS Foster Care in region, expand access for justice involved youth, edit service names to reduce confusion, continue eligibility based on behavioral needs, local control and management of services | 4/15/24 OHA, in collaboration with ODHS and OYA, has started the process of updating rules for Behavior Rehabilitation Service (BRS) and held several community listening sessions. To stay up to date on these efforts please refer to OHA's BRS webpage https://www.oregon.gov/oha/HSD/OHP/Pages/Policy-BRS.aspx or OHP's Notice of Rulemaking webpage: https://www.oregon.gov/oha/hsd/ohp/pages/rule-notices.aspx 12/2/23 OHA has been assigned ownership of this barrier and has provided updated response to challenges posed in original form. 1. Behavior Rehabilitation Services (BRS) is not Treatment Foster Care or Therapeutic Foster Care. While Child Welfare has developed a pilot for TFC, it is not covered by Medicaid in Oregon. It would require funding and a state plan amendment to add it. BRS is not a behavioral health service where TFC is. 2. OHA is updating rule to ensure OHP members can access BRS without needing to first be engaged with Child Welfare or juvenile justice. BRS will also be provided in in-home settings under these new rules. More information about the rule revisions and community listening sessions being convened by OHA can be found at: https://www.oregon.gov/oha/hsd/ohp/pages/policy-brs.aspx 12/21/22 - Sara Fox shared that CMS has finally approved the State Plan Amendment that Oregon had submitted regarding BRS. BRS can now be provided regardless of location of youth - allowing for BRS services to be provided in home. Alex Palm will work on updating formal response letter to IHN and provide additional details about communicating out to SOC. 9/20/21 Response: Memo shared from OHA https://www.oregon.gov/oha/HSD/BH-Child-Family/SOCReports/Linn%20Benton%20Lincoln%20BRS%20Barrier%20summary.sf.pdf | Pillar 4: Community based | Linn, Benton, Lincoln SOC | Jennifer Schwartz | https://www.oregon.gov/oha/HSD/BH-Child-Family/SOCReports/IHN-120720a.pdf | ODHS | Donny Jardine | Amy Gordin | Single system barrier | |||||
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| 01/13/20 | Agency responded with intention for further action | Need for targeted funding | 4/14/24 POP submissions for HSD include funding for residential expansion grants. CFBH continues to recommend expansion of community-based programs to proactively manage youth and family crises prior to the need for residential care; it is possible that Oregon's residential capacity is sufficient to meet the need if more children received proactive care. POPs will be reviewed in the upcoming weeks. CFBH continues to work with counties and CCOs to implement IIBHT and MRSS. 2/20/24 OHA has funded several new programs this year; Madrona's co-occurring residential beds for youth with mental health and SUD needs opened in January, Nexus Family Healing is working to open a new SIP program for youth referred through restorative services, and we have funded a new program in the gorge for youth, which is breaking ground now and will provide new PRTF beds for younger children.OHA continues to hold discussions with interested providers. ODDS and OHA are developing a program for co-occurring youth. POPs are being developed for the 2025 legislative session for expansion of residential programs. In partnership with ODHS, OHA issued a memo to the Governor's office regarding PRTF capacity: https://www.oregon.gov/oha/HSD/BH-Child-Family/Documents/2023_OHA%20ODHS%20PRTF%20Capacity%20Memo.pdf 10/4/23 Ongoing coordination continues between ODDS and OHA, including hosting of National Association for the Dually Diagnosed (NADD) trainings in August. OHA continues work to expand residential treatment across Oregon through multiple programs & provide ongoing training for providers. 8/2/23: Community Counselling Solutions is building a facility in Eastern Oregon. OHA is working with CCS to ensure project completion. | Pillar 4: Community based | Eastern Oregon SOC | Chris Barnes | https://www.oregon.gov/oha/HSD/BH-Child-Family/SOCReports/EOCCO-011320.pdf | OHA | Chelsea Holcomb | Jessie Eagan | Single system barrier | |||||
| 7 |
| 12/11/19 | Agency responded with intention for further action | Revise OARs regarding residential providers, infrastructure investments, increase reimbursement rates, | 4/14/24 POP submissions for HSD include funding for residential expansion grants. CFBH continues to recommend expansion of community-based programs to proactively manage youth and family crises prior to the need for residential care; it is possible that Oregon's residential capacity is sufficient to meet the need if more children received proactive care. POPs will be reviewed in the upcoming weeks. CFBH continues to work with counties and CCOs to implement IIBHT and MRSS. 2/20/24 OHA has funded several new programs this year; Madrona's co-occurring residential beds for youth with mental health and SUD needs opened in January, Nexus Family Healing is working to open a new SIP program for youth referred through restorative services, and we have funded a new program in the gorge for youth, which is breaking ground now and will provide new PRTF beds for younger children.OHA continues to hold discussions with interested providers. ODDS and OHA are developing a program for co-occurring youth. POPs are being developed for the 2025 legislative session for expansion of residential programs. In partnership with ODHS, OHA issued a memo to the Governor's office regarding PRTF capacity: https://www.oregon.gov/oha/HSD/BH-Child-Family/Documents/2023_OHA%20ODHS%20PRTF%20Capacity%20Memo.pdf 10/4/23 Ongoing coordination continues between ODDS and OHA, including hosting of National Association for the Dually Diagnosed (NADD) trainings in August. OHA continues work to expand residential treatment across Oregon through multiple programs & provide ongoing training for providers. 8/2/23: Awaiting finalization of OHA budget. 5/23/2023: Awaiting the end of 2023 Legislative session. 1/12/23: A number of bills related to residential services have been introduced in legislative session including HB2544 and HB2541 12/13/22 : OAR's have not been revised, SOCAC will be hosting a conversation on safety for youth in residential care, reimbursement rates based on approval of 1115 Medicaid waver approved in 2021. | Pillar 4: Community based | Linn, Benton, Lincoln SOC | Jennifer Schwartz | https://www.oregon.gov/oha/HSD/BH-Child-Family/SOCReports/IHN-121119a.pdf | OHA | Chelsea Holcomb | Jessie Eagan | Single system barrier | |||||
| 8 |
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| 9 |
| 11/14/22 | In process - Working with agency on solution | This Process should compete with the onboarding time and wage of the many Oregon DSP providers. -A statewide work committee with ODDS staff that can help smooth these hitches and glitches within this process to make it viable and a true choice. -ODDS oversight and technical assistance that is timely and relative. -Coordinate all paperwork and proof so families have one ‘live’ person to help them navigate this process and agencies. Need a coordinator with all entities where none of the four entities work together. We need real people in real time to work through small ‘hitches’; too many agencies with small glitches equates to many days, weeks, months... -Get support to fix micro-breakdowns so a PSW position is a viable option, again. Now we must rely on provider agencies from outside our area as we bring them recruitment PSW prospects to in turn become DSPs. -Provide, accommodate, and financially support a safe meeting space where these and other issues can be discussed and worked out without bias. | 4/15/24 ODDS is working on a new provider enrollment system that will be a one stop shop for similar worker types, including Personal Support Workers, Home Care Workers and Personal Care Assistant 12/22/23 A work group meeting was held December 12th. ODDS provided updates related to new PSW contract, wage study underway and a new PPL contract that will include metrics related to timeliness. Group also walked thorugh process map and discussed 5 areas of improvement where onboarding process was delayed. ODDS also shared information about a potential "Agency with Choice" legislative concept that may be introduced during the short session. While long term improvements are expected with the universal portal - there are likely additional ways to improve process. ODDS will incorporate feedback from process map and communicate operational changes with staff. | Pillar 2: Integrated and collaborative Pillar 4: Community based | North Coast SOC | Qurynn Hale | https://www.oregon.gov/oha/HSD/BH-Child-Family/SOCReports/DD%20Leadership%20Vetting%20Quesitons%2011.1.22.pdf | ODHS- Office of Developmental Disability Services | Dana Hittle | Chrissy Fuchs | Single system barrier | |||||
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| 09/09/22 | In process - Working with agency on solution | Remove the restriction in Oregon law against parents being paid caregivers to their minor disabled children. Direct the Office of Developmental Disabilities Services to satisfy centers for Medicare and Medicaid Services requirements to allow child Medicaid recipients with in-home provider hours to select their biological or adoptive parents to fill those jobs. | 2/20/24 "SB 1565 is currently being considered in the 2024 Legislative Session. The bill is an update to the paid parent caregiver work at ODHS-ODDS. Specific details of what it will do are best understood by reviewing the base bill and proposed amendments found at the link below: https://olis.oregonlegislature.gov/liz/2024R1/Measures/Overview/SB1565 The Centers for Medicare & Medicaid Services (CMS) will likely review ODDS' application. ODDS expects federal approval of the waiver in the first half of 2024. This is not guaranteed. Rulemaking begins at this time. Rules will be temporary or permanent depending on time constraints. If temporary, the permanent rulemaking process will follow immediately. If approval follows this estimated timeline, the program will launch mid 2024. Further timeline updates will be added to this webpage: https://www.oregon.gov/odhs/idd/pages/sb-91-implementation.aspx#:~:text=Senate%20Bill%2091%20(SB%2091,to%20pay%20parents%20as%20caregivers" 1/19/24 ODDS submitted the new Children’s Extraordinary Needs Waiver to the Centers for Medicare and Medicaid Services (CMS) this week. A few decisions from this process: • At the request of many commenters, we added parental income disregard back into the application. • We also removed the need to document a child’s lack of access to providers from the eligibility criteria. • We kept the cap of 20 hour per week, per child. Many people requested a change to 40 hours. We kept 20 hours to double the number of children this program can serve within its budget. • Because of the program’s limited budget, we anticipate having more applicants than space in the program. We will randomly assign a number to every child who initially applies. Children who do not get a space in the program will keep their initial order on the waitlist. If eligible, they will still have access to nonparent providers through the K Plan and other waivers. As spaces open, the first child on the waitlist will have the option to enter the program, if eligible. When new applicants wish to enter the program, we will add them to the end of the waitlist. 12/22/23 Public comment period closed on December 5th, ODDS will incorporate feedback into final CMS application due end of the year. ODDS expects federal approval of the waiver in the first half of 2024. Approval is not guaranteed. When/if approved, rule making would then commence. Further timeline updates will be added to this webpage: https://www.oregon.gov/odhs/idd/pages/sb-91-implementation.aspx#:~:text=Senate%20Bill%2091%20(SB%2091,to%20pay%20parents%20as%20caregivers | Pillar 1: Youth and family engagement | Douglas County SOC | Cady Lyon | https://www.oregon.gov/oha/HSD/BH-Child-Family/SOCReports/Douglas%20SOC%20Barrier%20Submission-Revised%209.9.22.pdf | Oregon Legislature | Dana Hittle | Caitlin Shockley | Single system barrier | |||||
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| 07/21/22 | In process - Working with agency on solution | 4/14/24 The Dental Director position remains open. Anna connected with the Neelam Gupta, at the Health Care Incentives program at OHA, about incentives for dentists who work with kids with I/DD to learn more about training and financial incentive opportunities. 2/20/24 New OHA director, Dr. Sejal Hathi has been confirmed.. She's getting up to speed and we hope her confirmation will lead to the hiring of an OHA Dental Director who can help us resolve this long-standing barrier. | Pillar 3: Culturally responsive | Coos County SOC | Pamela Huntley | https://www.oregon.gov/oha/HSD/BH-Child-Family/SOCReports/SOC%20Barrier%20Form%20Dental.pdf | OHA | Dana Hittle | Multi system barrier | |||||||
| 12 |
| 07/03/19 | Agency responded with intention for further action | Increase psychiatric reimbursement rates, coverage for alternative treatments, loan forgiveness programs for providers, promotion of Opal-K and Project Echo, fellowships. | 2/20/24 OHA was funded in the 2023 budget and is building contracts to expand the number of developmental pediatricians and child psychiatrists. 10/5/23 Additional funds were approved in the 2023 legislative session for an increase in psychiatric providers. These funds were given to the BH Workforce team, and they are coordinating with providers at OHSU and Samaritan health to expand training for child psychiatrists and developmental pediatricians within Oregon Child Psychiatry "slots" are determined at the national level; Oregon has to apply for additional educational placements. 8/2/23: $3.1 million allocated in the 2023-25 biennium to provide incentives to recruit and increase the number of child psychiatrists and developmental pediatricians to serve children, youth and their families trained in Oregon by providing incentives and funding to attract child psychiatry and developmental pediatrics fellows with priority given to residents with diverse backgrounds, to work in various settings related to child and family behavioral health. | Pillar 4: Community based | Tri-County SOC | Selby Stebbins | https://www.oregon.gov/oha/HSD/BH-Child-Family/SOCReports/HSO-070319.pdf | OHA | Jessie Eagan | Single system barrier | ||||||
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| 06/01/23 | In process - Agency actively working on solution | Ensure access to care and timely coverage when transitioning child in CW custody is being moved to a different CCO or FFS, Consider use of wraparound coordinators to negotiate roles and responsibilities within overlapping CCOs, Ensure front line workers know rules and expectations in care transition and when to follow up when these aren't met. | 6/14/23 - Communication materials being developed for Child Welfare workers on rules and expectations to share with impacted families. Alex S. looking at Child Welfare data to understand how many youth are impacted by these transitions. | Pillar 2: Integrated and collaborative Pillar 4: Community based | Statewide | SOCAC identified barrier related to problems accessing care for youth who move to coverage under a new CCO or into FFS. This often leads to interruptions in care (providers, medications, etc.) and delays in access care (like dental and vision, etc). Challenges related to accountability for "transition to care" rules and contract obligations. EHRs and payment mechanisms also pose barriers. | OHA/ODHS | Rusha Grinstead | Jessica Ickes | Multi system barrier | ||||||
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| 10/13/21 | Agency responded with intention for further action | Improve insurance enrollment process to reduce delays, produce timely enrollment reports, implement IDENTITY, improved outreach to providers, | 6/14/23 - Anna following up with originator of barrier to inquire about outcomes of the IDENTITY pilot 12/13/22 Emailed Alex for update. Initial response: Ongoing tracking and updates to IHN by OHA and ODHS | Pillar 2: Integrated and collaborative | Linn, Benton, Lincoln SOC | Jennifer Schwartz | https://www.oregon.gov/oha/HSD/BH-Child-Family/SOCReports/IHN-101321.pdf | OHA/ODHS | Rusha Grinstead | Jessica Ickes | Multi system barrier | |||||
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| 12/11/19 | Agency responded with intention for further action | Amend FFS to fund full range of services, minimize enrollment disruptions related to eligibility, ensure adequate coverage from private insurers | 9/25/2023. Work continues. 1/12/2023: SOCAC staff revisiting barrier with FFS program at OHA. FFS undergoing transformational improvement project 12/13/22 OHA is addressing FFS expansion. Wraparound FFS will be implemented Jan 2023. MODA is currently offering adequate coverage for privately insured. | Pillar 2: Integrated and collaborative | Linn, Benton, Lincoln SOC | Jennifer Schwartz | https://www.oregon.gov/oha/HSD/BH-Child-Family/SOCReports/IHN-121119b.pdf | OHA | Rusha Grinstead | Jessica Ickes | Single system barrier | |||||
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| 01/04/23 | In process - Working with agency on solution | 1. Need for hourly code for MH respite. Currently, only per diem code. 2. Need for hourly MH respite; need for more varied schedule: 4 hours, 6 hours, 8 hours, etc. Families need flexibility. 3. Need for education from the state on 1915j: How to access this service (20 hour personal care attendant program) for youth with behavioral health needs; 1915i education – what can 1915i cover? How are other counties utilizing funding for respite/relief care? 4. Can DHS use prevention first funding to fund local respite programs? Professional and/or drop in model? 5. How do we build a robust respite provider network (GOBHI model)? Increase payment to providers? How do we increase providers? How do we financially sustain intermittent care? 6. Develop foster homes for mental health so MH foster families can double as respite providers to provide this intermittent service in a more cost-effective manner. Or is there a way to leverage existing DHS and DD homes and providers to serve kids with MH needs? 7. Is it possible to use MH dollars to fund DD provider agencies for MH respite services? 8. Fund a full-time respite home or group home with a staff (Rainbow House in Yamhill County is an example). 9. Despite having some limited respite available as a diversion from hospitalization and youth in MRSS and Wraparound, there continues to be a need for a professional mental health model of respite that serves high acuity and older kids with complex emotional and mental health issues and challenging behaviors. What recommendations are there for developing and funding a respite model for high acuity youth? 10. There is a need for a “Resource Parent's Night Out” model for all families in each county; once a week or once a month for 3-4 hours. Are there examples of flexible funding models to financial sustain this type of program as well as other community based services using Medicaid dollars? 11. In summary, we need to develop a diversity of respite options and broaden the ability of Medicaid to pay for different types of respite (the mental health crisis respite is just part of the solution). | 4/15/24 SOCAC Respite Report was approved by the full council in the April meeting. Report can be found here: at https://www.oregon.gov/oha/HSD/BH-Child-Family/Pages/System-of-Care.aspx SOCAC and OHA are sending report out to key partners throughout Oregon, and SOCAC is reconvening Respite Work Group to prioritize and advance recommendations from the report. OHA is developing a Memo to CCOs on strategies they can undertake now to support/fund respite services in their regions. Currently with Medicaid leadership for review/edits and hope to publish prior to the May SOCAC meeting. CFBH continues to advocate for a 2025 POP for (lifespan) Respite to support waiver development, infrastructure/demonstration sites and staffing resources. Two respite services are under consideration by OHA for a 2025 add to In Lieu of Services - Would require final approval from CMS. 2/20/24 SOCAC hosted workshops with partners (state agencies, providers, respite payers, family members, and youth) to identify top barriers to respite and develop recommendations for overcoming barriers. The SOCAC hosted a feedback loop session which worked with attendees to prioritize recommendations for respite. SOCAC is compiling recommendations and which will be presented at the Council's March 5th meeting. | Pillar 2: Integrated and collaborative Pillar 3: Culturally responsive Pillar 4: Community based | Linn, Benton, Lincoln SOC | Jennifer Schwartz | https://www.oregon.gov/oha/HSD/BH-Child-Family/SOCReports/Barrier-Submission-Form%20SAS%20RESPITE%20IHN-CCO.docx | Christy Hudson | Chelsea Holcomb | Multi system barrier | ||||||
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| 07/11/23 | In process - Working with agency on solution | Explore and/or develop capacity for respite options in Douglas County to support youth between the ages of 8 and 12 years of age | 4/15/24 SOCAC Respite Report was approved by the full council in the April meeting. Report can be found here: at https://www.oregon.gov/oha/HSD/BH-Child-Family/Pages/System-of-Care.aspx SOCAC and OHA are sending report out to key partners throughout Oregon, and SOCAC is reconvening Respite Work Group to prioritize and advance recommendations from the report. OHA is developing a Memo to CCOs on strategies they can undertake now to support/fund respite services in their regions. Currently with Medicaid leadership for review/edits and hope to publish prior to the May SOCAC meeting. CFBH continues to advocate for a 2025 POP for (lifespan) Respite to support waiver development, infrastructure/demonstration sites and staffing resources. Two respite services are under consideration by OHA for a 2025 add to In Lieu of Services - Would require final approval from CMS. 2/20/24 2/20/24 SOCAC hosted workshops with partners (state agencies, providers, respite payers, family members, and youth) to identify top barriers to respite and develop recommendations for overcoming barriers. The SOCAC hosted a feedback loop session which worked with attendees to prioritize recommendations for respite. SOCAC is compiling recommendations and which will be presented at the Council's March 5th meeting. | Pillar 4: Community based | Douglas | Cady Lyon | https://www.oregon.gov/oha/HSD/BH-Child-Family/SOCReports/Respite%20(2).docx | SOCAC | Chelsea Holcomb | Single system barrier | ||||||
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| 03/15/23 | In process - Agency actively working on solution | Creation of a respite program or availability of respite providers in our area that are trained to handle high acuity youth and children. This would be a resource that is not specific only to foster care, but to all youth in need of respite services. | 4/15/24 SOCAC Respite Report was approved by the full council in the April meeting. Report can be found here: at https://www.oregon.gov/oha/HSD/BH-Child-Family/Pages/System-of-Care.aspx SOCAC and OHA are sending report out to key partners throughout Oregon, and SOCAC is reconvening Respite Work Group to prioritize and advance recommendations from the report. OHA is developing a Memo to CCOs on strategies they can undertake now to support/fund respite services in their regions. Currently with Medicaid leadership for review/edits and hope to publish prior to the May SOCAC meeting. CFBH continues to advocate for a 2025 POP for (lifespan) Respite to support waiver development, infrastructure/demonstration sites and staffing resources. Two respite services are under consideration by OHA for a 2025 add to In Lieu of Services - Would require final approval from CMS. 2/20/24 SOCAC hosted workshops with partners (state agencies, providers, respite payers, family members, and youth) to identify top barriers to respite and develop recommendations for overcoming barriers. The SOCAC hosted a feedback loop session which worked with attendees to prioritize recommendations for respite. SOCAC is compiling recommendations and which will be presented at the Council's March 5th meeting. | Pillar 4: Community based | Central Oregon | Dani McCallister | https://www.oregon.gov/oha/HSD/BH-Child-Family/SOCReports/Pacific%20Source%20-%20Central%20Oregon.Respite03.15.22.docx | SOCAC | Chelsea Holcomb | Multi system barrier | ||||||
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| 06/11/20 | In process - Working with agency on solution | Develop and resource infrastructure for respite care. | 4/15/24 SOCAC Respite Report was approved by the full council in the April meeting. Report can be found here: at https://www.oregon.gov/oha/HSD/BH-Child-Family/Pages/System-of-Care.aspx SOCAC and OHA are sending report out to key partners throughout Oregon, and SOCAC is reconvening Respite Work Group to prioritize and advance recommendations from the report. OHA is developing a Memo to CCOs on strategies they can undertake now to support/fund respite services in their regions. Currently with Medicaid leadership for review/edits and hope to publish prior to the May SOCAC meeting. CFBH continues to advocate for a 2025 POP for (lifespan) Respite to support waiver development, infrastructure/demonstration sites and staffing resources. Two respite services are under consideration by OHA for a 2025 add to In Lieu of Services - Would require final approval from CMS. 2/20/24 SOCAC hosted workshops with partners (state agencies, providers, respite payers, family members, and youth) to identify top barriers to respite and develop recommendations for overcoming barriers. The SOCAC hosted a feedback loop session which worked with attendees to prioritize recommendations for respite. SOCAC is compiling recommendations and which will be presented at the Council's March 5th meeting. | Pillar 4: Community based | Lane | Hayley VanHorn | https://www.oregon.gov/oha/HSD/BH-Child-Family/SOCReports/Lane-061120.pdf AND https://www.oregon.gov/oha/HSD/BH-Child-Family/SOCReports/Lane-061120-Narrative.pdf | SOCAC | Chelsea Holcomb | Single system barrier | ||||||
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| 01/25/24 | Assigned to agency | 1) Mobile crisis unit with immediate and short-term crisis assistance for youth experiencing IDD and youth experiencing other behavioral challenges 2) Map existing services for youth with co-occurring mental health, behavioral health, and I/DD diagnoses, noting gaps and thinking through connection between systems, including interdisciplinary training and blended funding. 3) Return of NEMT and/or some other support around safe transport of youth in crisis 4) Trauma informed training expansion/requirement/or addition to law enforcement training 5)Trained, skilled professionals to provide respite options as prevention and short-term intervention which does NOT lead to a youth being removed from the home | Pillar 2: Integrated and collaborative | Marion and Polk SOC | Heather Pascoe | https://www.oregon.gov/oha/HSD/BH-Child-Family/SOCReports/Marion%20Polk.MH_IDD_01252024.pdf | OHA | Chelsea Holcomb | Jessie Eagan | Chelas Kronenberg | Multi system barrier | |||||
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| 10/22/22 | In process - Working with agency on solution | 1) Parents have access to training to help them manage young people with escalated and/or aggressive behaviors. Parents learn how to appropriately respond and recognize red flags and are aware of treatment options for Mental Health. 2) Providers are trained to manage young people with escalated and/or aggressive behaviors. Providers have a tool set of techniques to de-escalate young people. 3) Cross-agency collaboration on providing training to manage aggressive behaviors to parents and cross-agency staff. 4) Agencies are aware of different procedures and have access to different types of training around escalated behaviors. 5) The most effective procedures and training are identified and made available to parents and providers. 6) This type of training is built into the MRSS program and MRSS staff provide training to parents and other providers in the community they serve. 7) Young people have access to supports to help them manage their behavior. 8) Develop incentives for psychoeducational classes for parents (collaborative problem solving, etc.) and skill building. 9) Although Collaborative Problem Classes are available and families are using the service, families are asking for a higher level of training on recognizing and de-escalating aggressive behaviors. 10) Develop and fund more upstream interventions (education, skills trainers, in-home supports, socialization opportunities, respite) | 2/20/24 Registrations have met or exceeded offerings (with exception of a provider training that only secured 36 registrants for 50 openings). Trainees are highly rating this training, building community, and being connected to peer support in both the in-person and online formats. There was concern that the online class would not be as effective as the in-person class, but the online class is exceeding everyone's expectations in terms of engagement, interactivity, peer support, and community building. One final training will be held March - April. 12/22/23 One parent training was completed with 21 registered and one provider training was completed with 52 registered. Parents highly evaluated the class and said they gained crisis intervention skills. Additional parent and provider trainings are scheduled for Q1 of 2024. 10/5/23 Five six-week series of trainings will be held by end of the year (two to providers and three to parents). First parent training gets started this month; 15 people have registered - room for 20. 6/13/2023 SOCAC approved funding to pilot parent and provider training for Lincoln/Linn/Benton SOC. Aim of start up later this summer. 4/20/23 - Pilot proposal submitted to ODHS from IHN. Awaiting response from ODHS and additional information from IHN. Barrier brought to December 2022 SAS meeting. SOCAC staff to convene a small work group to identify training opportunities that could be offered to families. First meeting of work group held January 30, 2023. Second work group meeting scheduled for March 6th. | Pillar 1: Youth and family engagement | Linn, Lincoln, Benton | Jennifer Schwartz | https://www.oregon.gov/oha/HSD/BH-Child-Family/SOCReports/IHN.Training%20for%20aggressive%20behaviors.102222.docx | Christy Hudson | Christy Hudson | Multi system barrier | ||||||
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| 12/30/21 | Agency responded with intention for further action | Medicaid reimbursement rates for Open Card and CCO covered services need to be increased substantially (ideally, they should be doubled to support the needed services) to cover the costs of delivering pediatric developmental diagnostic assessments, to allow for increased funding of clinical staff at organizations that provide assessment services, including the Eugene CDRC. Also, additional billing codes that cover family services should be implemented for families with children who appear to have developmental delays. | 12/22/23 EASY continues to roll out in 2 demonstration sites. OHA is refining service and process, and exploring roll out to other counties, starting with Lane county in early 2024. 11/9/23 39 youth have now been served, and 60% of the referrals have come from parents as the guardian (no ODHS or OYA involvement). 20 youth have been connected to the I/DD system. 10/5/23 OHA has developed a program called EASY (Expedited Assessment Services for Youth) which provides comprehensive psychological testing with an additional focus on supporting identifying possible developmental delays, and in coordination with I/DD intake screening. EASY can also collaborate with other disciplines like a developmental pediatrician to support a thorough assessment. Two demonstration sites in Multnomah and Deschutes Counties have been stood up and OHA is working to expand access. So far, EASY has been provided for 23 youth. Developmental disabilities were identified for 9 youth - and approval for DD services was achieve within 3 weeks of referral. Multiple youth involved with the juvenile justice system had significant changes in the adjudication process due to EASY identifying mental health conditions that were missed (including psychosis). Most importantly, 60% of the youth referred have the parent as guardian in an effort to support youth and families before they get involved with ODHS and Juvenile Justice, as this service is insurance blind. | Pillar 2: Integrated and collaborative Pillar 4: Community based | Lane | Hayley VanHorn | https://www.oregon.gov/oha/HSD/BH-Child-Family/SOCReports/Lane%20SOC%20barrier-12.30.21.docx | OHA | Chelsea Holcomb | john.r.linn@oha.oregon.gov | Single system barrier | |||||
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| 11/09/23 | Received | Additional funding is needed to support the needs of students impacted by SB819 (2023) which has resulted in escalated behaviors among some students who struggle to stay in school for a full day. Schools are ill equipped to meet needs of students, and lack of support is resulting in referrals to higher levels of care. | 12/22/23 Staff from ODE Office of Enhancing Student Opportunities made contact with the district to discuss their concerns, and will be providing technical assistance to them. Although SB819 was identified as the precipitating factor, this situation points to the need for integrated systems of care across youth serving agencies. OESO staff will continue to provide TA as requested by the district and ODE has scheduled a follow up with meeting with the regional SOC January 3rd. | Pillar 2: Integrated and collaborative Pillar 3: Culturally responsive | Central Oregon SOC | Dani McCallister | https://www.oregon.gov/oha/HSD/BH-Child-Family/SOCReports/COSOC.SB819.%2011.10.23.docx | ODE | Grace Bullock | Single system barrier | ||||||
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| 07/11/23 | Resolved - Barrier has been solved, no further action identified | Enable more options for the Peer Support training and certification including offering the training more frequently and by more than one organization. | 11/13/23 PSS training is held by 2 organizations through OHA Contracts: Youth ERA and Oregon Family Support Network (OFSN). The frequency of trainings is set by contract. OHA’s Office of Recovery and Resilience is working to broaden the capability of other organizations to offer this training. We expect this to happen in 2024, providing more options to the community. Although Medicaid billing is only possible once a FSS or YSS is in the Traditional Health Worker registry, other options are open to providers to both increase knowledge and skills over this period. CCOs can provide bridge funding until registration is secured. OFSN can also provide additional technical assistance for this barrier. There has also been a reported backlog/delay in processing of THW registrations. To address this, the THW Commission is moving certification of SUD peers to MHACBO. A new electronic registration system is also being implemented at the commission - which will hopefully alleviate the backlog and speed up certification process. 9/7/23- OHA CFBH and ORR to meet with UHA in October for further conversation. 7/28/23 SAS discussed barrier at meeting this week. OHA ORR will take lead on follow up with the Traditional Health Worker program to resolve barriers in training and delays in PSS certification process | Pillar 4: Community based | 11/09/23 | Douglas County SOC | Cady Lyon | https://www.oregon.gov/oha/HSD/BH-Child-Family/SOCReports/Peer%20Supports%20(2).docx | OHA | Hilary Harrison | Single system barrier | |||||
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| 03/20/19 | Resolved - Barrier has been solved, no further action identified | Additional funding for support of a fellowship program to train additional providers in assessment. | 10/5/23 OHA has developed a program called EASY (Expedited Assessment Services for Youth) which provides comprehensive psychological testing with an additional focus on supporting identifying possible developmental delays, and in coordination with I/DD intake screening. EASY can also collaborate with other disciplines like a developmental pediatrician to support a thorough assessment. Two demonstration sites in Multnomah and Deschutes Counties have been stood up and OHA is working to expand access. So far, EASY has been provided for 23 youth. Developmental disabilities were identified for 9 youth - and approval for DD services was achieve within 3 weeks of referral. Multiple youth involved with the juvenile justice system had significant changes in the adjudication process due to EASY identifying mental health conditions that were missed (including psychosis). Most importantly, 60% of the youth referred have the parent as guardian in an effort to support youth and families before they get involved with ODHS and Juvenile Justice, as this service is insurance blind. 8/2/23: $3.1 million allocated in the 2023-25 biennium to provide incentives to recruit and increase the number of child psychiatrists and developmental pediatricians to serve children, youth and their families trained in Oregon by providing incentives and funding to attract child psychiatry and developmental pediatrics fellows with priority given to residents with diverse backgrounds, to work in various settings related to child and family behavioral health. 6/13/23: OHA launched pilot of Expedited Assessment Services for Youth (EASY) - which provides rapid access to evaluation, assessment and recommendations for complex youth — especially those who are in child welfare custody and placed in temporary lodging, ED boarding, shelter care, county juvenile facilities or the custody of Oregon Youth Authority. More information is here: https://www.oregon.gov/oha/HSD/BH-Child-Family/Pages/EASY.aspx?utm_medium=email&utm_name=holding-hope060123&utm_source=govdelivery | Pillar 2: Integrated and collaborative Pillar 4: Community based | 10/11/23 | Lane | Hayley VanHorn | https://www.oregon.gov/oha/HSD/BH-Child-Family/SOCReports/Lane-032019.pdf | OHA | john.r.linn@oha.oregon.gov | Multi system barrier | |||||
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| 12/07/20 | Resolved - Barrier has been solved, no further action identified | Fund broadband expansion, supports for connectivity, public hotspots, information about hotspots in community | 1/12/23 Oregon Broadband Office is seeking feedback on proposed Program Rules, Handbooks and Support Documents. More information is here: https://www.oregon.gov/biz/programs/oregon_broadband_office/pages/default.aspx Oregon Broadband is also asking for community assistance to build out the National Broadband map:https://www.oregon.gov/biz/programs/Oregon_Broadband_Office/Pages/Broadband_Map.aspx 4/28/21 Letter from Chelsea Holcomb https://www.oregon.gov/oha/HSD/BH-Child-Family/SOCReports/SAS-Barrier%20Response-IHN-Dec%202020-final.pdf | Pillar 4: Community based | 04/28/21 | Linn, Benton, Lincoln | Jennifer Schwartz | https://www.oregon.gov/oha/HSD/BH-Child-Family/SOCReports/IHN-120720b.pdf | OHA | Statewide SOC | Multi system barrier | |||||
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| 09/22/20 | Resolved - Barrier has been solved, no further action identified | Allocate specific funding for travel within rural communities | 10/7/2020 - Letter sent from Nat Jacobshttps://www.oregon.gov/oha/HSD/BH-Child-Family/SOCReports/Response-EOCCO-0920-100720.pdf | Pillar 4: Community based | 10/07/20 | Baker | Chris Barnes | https://www.oregon.gov/oha/HSD/BH-Child-Family/SOCReports/EOCCO-092220.pdf | SOC | Statewide SOC | Single system barrier | |||||
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| 04/14/21 | Resolved - Barrier has been solved, no further action identified | 9/1/21 Analyze funding across FFS and CCOs. Provide information about what is and is not covered by insurance providers. | 2/3/23 - Wraparound is now a covered service for FFS.https://www.oregon.gov/oha/HSD/BH-Child-Family/Documents/FFS%20Wraparound%20Expansion%20Memo%202.1.23.pdf 9/15/21 - Letter sent from Chelsea Holcomb https://www.oregon.gov/oha/HSD/BH-Child-Family/SOCReports/SAS-Barrier%20Response-Yamhill-April%202021FINAL.pdf | Pillar 2: Integrated and collaborative | 09/15/21 | Yamhill County SOC | Sheryl Fisher | https://www.oregon.gov/oha/HSD/BH-Child-Family/SOCReports/Yamhill%20County%204-14-21.pdf | OHA | Statewide SOC | Single system barrier | |||||
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| 02/08/21 | Resolved - Barrier has been solved, no further action identified | Look at provider licensure flexibility for services provided in K-12 settings | Letter sent from Chelsea Holcomb 4/20/21 https://www.oregon.gov/oha/HSD/BH-Child-Family/SOCReports/SAS-Barrier%20Response-Marion%20polk.pdf | Pillar 2: Integrated and collaborative | 04/20/21 | Marion and Polk SOC | Heather Pascoe | https://www.oregon.gov/oha/HSD/BH-Child-Family/SOCReports/Marion%20Polk%20SOC%20Barrier%20Submission.pdf | OHA | Statewide SOC | Single system barrier | |||||
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| 04/01/23 | Resolved - Barrier has been solved, no further action identified | Understand why schools are hesitant to allow MRSS in a crisis. Investigate insurance concerns for school districts and study where school districts do allow and welcome MRSS. Develop statewide communications plan for schools and school districts to clarify service. | 1/9/24 SOCAC convened meeting with OHA and ODE. Neither agencies believe this a system wide problem. ODE and OHA co-co-convene a twice monthly cross-agency meeting to coordinate program design, legislation and funding. MRSS design is included in schools and school districts. 10/5/23 No updates as we're still waiting on PACE legal team for a response | Pillar 2: Integrated and collaborative Pillar 4: Community based | Statewide | SOCAC identified barrier. Reports that some schools were refusing MRSS and or supports from external providers. | SOCAC | Grace Bullock | Multi system barrier | |||||||
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| 10/22/22 | Agency responded with no further actions planned | SAS to partner with a peer-run organization, such as OFSN, Youth Era, etc., to adapt the OHA Minors Rights report into a family-friendly information sheet. | 4/15/24 Current OARs allow for youth to be admitted into inpatient treatment by their parents, even if they do not consent. However, there are programs that are denying admission. There is hesitancy from some providers to force someone into treatment and programs concerned that youth who are not consenting to their admission are more likely to require physical interventions like restraint. OHA is seeking additional consult from DOJ for and are hoping to create clinical guidance for programs, if granted permission to do so. 2/20/24 OHA's Adolescent Health Program hopes to complete youth created materials by summer, 2024. SOCAC has reassigned to barrier back to OHA's Health Systems Division who will be gaining clarity on consent and confidentiality rules for inpatient and residential settings. 11/9/23 FAQ has been approved and posted on OHA website: https://www.oregon.gov/oha/HSD/BH-Child-Family/Pages/FAQ.aspx SOCAC will continue tracking development of youth friendly facing materials happening in OHA's Public Health Division | Pillar 1: Youth and family engagement | 04/17/24 | Linn, Lincoln, Benton | Jennifer Schwartz | https://www.oregon.gov/oha/HSD/BH-Child-Family/SOCReports/IHN.Minors%20Rights.102222.docx | Oregon Health Authority (OHA) | Jessie Eagan | Hilary Harrison | Single system barrier | ||||
