2005-751-Minutes for Meeting March 15,2005 Recorded 5/27/2005DESCHUTES COUNTY OFFICIAL RECORDS ^f C
NANCY BLANKENSHIP, COUNTY CLERK 1~J ~005'~J~
COMMISSIONERS' JOURNAL
05/27/2005 04;15;41 PM
11111111)111111111111111 I 111
DESCHUTES COUNTY CLERK
CERTIFICATE PAGE
This page must be included
if document is re-recorded.
Do Not remove from original document.
~`*1tZC
❑ Deschutes County Board of Commissioners
1130 NW Harriman St., Bend, OR 97701-1947
(541) 388-6570 - Fax (541) 388-4752 - www.deschutes.orc
MINUTES OF DEPARTMENT UPDATE -
MENTAL HEALTH DEPARTMENT
DESCHUTES COUNTY BOARD OF COMMISSIONERS
TUESDAY, MARCH 15, 2005
Commissioners' Conference Room - Administration Building - 1300 NW Wall St.., Bend
Present were Commissioners Michael M. Daly, Tom De Wolf and Dennis R. Luke.
Also present were Mike Maier, County Administrator; and Scott Johnson, Mental
Health Department. Also present were Seth Bernstein and Valerie Davis of ABHA
(Accountable Behavioral Health Alliance). No representatives of the media or
other citizens were present.
The meeting began at 11:00 a. m.
Please see the agenda and backup documentation (copy attached) for information
on the items discussed.
No formal action was taken by the Board at this meeting.
Being no further items addressed, the meeting adjourned at 11:50 a. m.
DATED this 15th Day of March 2005 for the Deschu es County oard of
Commissioners. l
Tom DeWolf, Chair
y, Compfiissioner
ATTEST: Dennis R. Luke, Oommissioner
Recording Secretary
Deschutes County Mental Health
BOCC Monthly Meeting - Proposed Agenda
9:30 -11:00 Tuesday, March 15, 2005 Note Extended Time
Location: County Administration Building (Allen Room, BOCC)
9:30 -10:10, Guest Discussion - Seth Bernstein, Valerie Davis, ABHA
ABHA is asking for meeting time with Commissioners in all 5 counties.
1. Trends in Managed Care - Current Encounters Project
2. 2005-2006 ABHA Budget Process
3. ABHA Response to White Paper
10:10 -11:00 DCMH Monthly meeting
1. $450,000 New Acute Care Funds (includes Jefferson and Crook)
a. Reduce use of EOPC. Invest locally in options to keep people out of hospitals.
2. Sage View Update - Pending BOCC Actions
a. Good progress; update on principles endorsed in December. Handout
b. 5-year service contract ($401,115 through June '06). ALL indigent clients.
c. Van sale pending at our purchase price.
d. All legal documents to Commissioners March 28/30.
3. Criminal Justice - LPSCC priorities (meth and alternatives). Handout: Priorities
a. Jail survey - need alternatives to incarceration. More effective, less costly.
4. Children's System of Care Delay till fall
a. OHP children, high need, significant emotional disturbances
b. Policy: Central Oregon system (w Jefferson and Crook), ABHA support
c. Financing: awaiting actuarials. Risk, maybe no new resources.
5. FAN - Nelson meeting - Update. Critical to keep mental health services in the schools
6. Legislature - Eauityl - Legislative discussions with Burley, Whisnant.
a. Please make this a priority for Linden.
b. Our legislators are supporting parity. Very important
7. 2005-2007 Budget - 3-year budget; continuing to add back staff.
8. Pending
a. Federal grant application: $1.5 m. 3-year, 3-county grant for meth treatment.
b. Federal grant application: $1.2 m 3-year for Family Drug Court. Due April 15.
c. Federal Indirect Rate - critical policy matter. Samhsa examples.
d. Evaluations: Completion of first DCMH evaluation; completion of last CCF eval.
b. Custody evaluations - request for fee adjustment will be coming.
c. Children's services $51,000 grant received - proposal pending.
d. June 2005 Mental Health and Alcohol & Drug State Audits
e. $30,000 state repayment - relocation of manufactured structure; pd by County.
2005 / BOCC monthly January
Cascade Health Community (CHC)
and Deschutes County (DC)
including Mental Health (DCMH)
Sage View (SV) Proposed Agreement
Approved by the Deschutes County Board of Commissioners (BOCC) December 8, 2004
Update March 15, 2005
Background
This past fall, CHC representatives met with County staff and proposed that CHC assume full
responsibility for the ownership of the Sage View facility and operation of the center's programs
and services. The proposal included terminating the existing Limited Liability Corporation.
Pursuant to this proposal, Scott Johnson (Deschutes County Mental Health), Lori Hill (County
Adult Mental Health Program) and Robin Henderson, Leader Manager of CHC Behavioral Health
Services have held a series of meetings to discuss this proposal and, if feasible, negotiate the
terms of this arrangement. This process has included consultation with a number of people
including Mark Pilliod, Susan Ross, Tom Safley (CHC), Cindy Cook (CORHA) and mental health
representatives from Crook and Jefferson Counties.
We have successfully negotiated six primary and essential points of agreement that could serve
as a framework for an agreement. The Board of County Commissioners met on December 8,
2004 and agreed in principle with these six points. The Board also agreed that a final decision to
terminate the Healing Health Campus Limited Liability Corporation (LLC) would be contingent
on successful development of legal documents that assure all of these conditions will be met.
Summary
START UP FUNDS. Yes, as agreed in principle. HHC, LLC will return the start up funds; DCMH
will reserve our portion of these funds. DCMH and CHC will each receive the $290,000 that
each party committed to SV. CHC will take responsibility for all startup funding and cash
flow needs for SV. DCMH will place the Department's portion ($290,000) into a designated
Acute Care Reserve for future use in assisting Sage View clients and for other investments
that prevent or assure needed hospitalizations. HHC, LLC will return the start-up funds it
received from DC and CHC to each partner.
Interest should be defined as "interest earned" through the dissolution date." DC and CHC
agree to direct the LLC to transfer all interest income I to SV to help offset remaining
construction costs including final landscaping and painting.
2. SERVICE CONTRACT. Yes, 5 years as required by BOCC. First 18 months, Sage View will serve
all indigent clients for $401,115. Terms of remaining 3.5 years to be determined in spring of
2006 based on use, need and resources. Sage View will assure compliance with CDBG terms.
DC will provide a service contract to CHC. DCMH will contract with CHC for services.
Investment during the first 18 months will total $401,115. During that period, Sage View will
serve ALL indigent clients from Crook, Deschutes and Jefferson counties who meet the
admission criteria. CHC will document use. ABHA 3 will contract for services for OHP clients
from ABHA member counties (especially Jefferson, Crook and Deschutes).
Amount to date: $3,480 through November, 2004.
3 Accountable Behavioral Health Alliance
Agreement Final BOCC 12.8.04 Page 1 Draft 3/14/2005
The service agreement extends five years to coincide with the CDBG grant assuring CHC
assumes full legal responsibility for all CDBG requirements including 51% service to
low/moderate income individuals. Security assured through a note and trust deed.
Reported on quarterly basis.
3. RATE INCREASES CAPPED. Yes, as agreed in principle. DC expects to contract for services in
future years; CHC rate increases for patients 4 seen at Sage View will not exceed 5%
annually. DCMH will contract with CHC in future years for services to the indigent
population. Growth in the indigent rate will be capped for a minimum of 20 years. It is
agreed that this will be calculated based on a 2005 base rate of $500 per bed day.
4. CHC RESPONSIBILITIES. Yes, as agreed in principle. CHC will own the facility, manage the
grants, and fulfill the intended purposes of Sage View. This includes CDBG responsibilities 5,
$600,000 grant from CDBG and $400,000 loan from DC to help assure service to low income
individuals. CHC agrees to repay the DC loan based on the same provisions (i.e. repayment
over 20 years, no interest, repayment beginning in 2008, penalty clause for late payment)
CHC payments against the $400,000 loan will be placed in the DCMH Acute Care Reserve to
continue benefiting clients with mental health acute care needs.
DC will send a letter to the Northwest Health Foundation (NWHF) verifying the dissolution of
the LLC and requesting that the NWHF grant (i.e. $225,000) be managed by the St. Charles
Medical Center Foundation with CHC fulfilling all grant requirements and expectations.
5. FACILITY USE AS INTENDED MINIMUM 20 YEARS. Yes, as agreed in principle. CHC agrees to
use the facility for the purpose intended including acute crisis care to indigent and OHP
clients from Central Oregon for at least 20 years OR to work with the DC to transfer ownership
to another party for that intended purpose. To that end, County Counsel suggests a
covenant can be recorded against the title.
6. INDIGENT FUNDS NEEDED. Success! State awarding $225,000 annually (05-07) plus $450,000
start up (03-05). We have been successful in securing a commitment of funds to reduce our
use of Eastern Oregon Psychiatric Center. Successful resolution of this issue is essential to the
long-term financial viability of this project.
PARTICIPATION ON SAGE VIEW ADVISORY BOARD. Yes, as agreed in principle. SV will create
and support an Advisory Board of key stakeholders to help guide the development and
operation of SV. DC agrees to designate a DC representative to participate as a member of
the Advisory Board.
Cc Robin Henderson, Cascade Healthcare Community, Behavioral Health Services
Tom Safley, Cascade Healthcare Community, Sr. Vice President, Finance
4 For the purpose of this Agreement, item #3 is a reference to indigent patients who are residents
of Deschutes, Crook and Jefferson counties.
5 CHC will assure that all CDBG terms are met including the federal requirement that 51% of the
clients served in the first five years of operation are low income.
si
Agreement Final BOCC 12.8.04 Page 2 Draft 3/14/2005
Financial Summary - Deschutes County Investments
Current LLC Arran ement
Proposed CHC operation
Investment
Construction
Operating
Construction
Operating
Start u funds
290,000
Interest only
returned
County 20-year loan
400,000
-
400,000
CDBG construction rant
600,000
-
600,000
Deschutes 18-month svice contract
-
401,115
401,115
Add'I one-time cash flow(estimate)
-
300,000
0
ABHA funds OHP clients
200,000
Use based
200,000
Use based
TOTAL NEEDED estimate
$2,318,820
$1,728,320
Agreement Final BOCC 12.8.04 Page 3 Draft 3/14/2005
Deschutes County
Local Public Safety Coordinating Council
Proposed Mental Health Priorities
March, 2005
Mental health and substance abuse treatment and prevention are essential elements of an
effective public safety and justice system in Deschutes County. The Deschutes County Public
Safety Council and its members endorse a long-term community effort to develop and
implement effective prevention and intervention programs and projects that help provide for
public safety, present alternatives alternatives to incarceration and.better serve, treat and hold
accountable individuals with mental illnesses and/or addiction issues.
The Council is currently completing a review of services cyd'trends in Uur community. Our goal
will be to sustain current efforts where effective and to focus on a taryeted agenda for the next
several years. The following priorities are endorsed by- I~the Council, referred to the County
Commissioners for adoption as mental health/public safe:ty priorities and for inclusion in the
County's 2005 Mental Health Strategic Plan and the Deschutes Cr)unty 10-Year Cninmunity Plan.
Proposed 2005-2007 Mental'Health Priorities
• Increase Alternatives to Incarceration - a) Expand Oi' , Deferred Sentencing Program and b)
Create a Drug Court. Expand our County's Deferred Sentencing Program to serve more
people, emphasizing accountability and treatment and service coordination. Create a pilot
Drug Court with sufficient, timely treatment and support.
Improve Local Response to Methamphetarnine - Develop a comprehensive effort to address
our community's growing methanrphetcvnine problem including effective prevention and
treatment efforts. Essential cernponents recornr n~-n(-iQ,(-I ~E)y Deschutes County's human
service related departments ` a) Drug Court, b) treatinent on demand (sufficient for
program size) (i nd infersivf~, case management, c) accountability (jail access), d)
parole/prob(-itIOIi capacity and e) prevention (public education/involvement).
• Institute Crisis Intervention Training - Develop and sustain this evidence-based training to
help first responders in Deschutes County effectively work with individuals in crisis.
• Strengthen Juvenile Sex Offender Treatment - A community planning process is nearing
completion. A report of findings and recommendations on this critical issue will be presented
to the Public Safety Council in the next 90 days.
• Sustain Key Proiects, specifically the Mental Health Bridge Program and Parole & Probation
work with adults with rnen'tal illness or addiction issues. Expand as able.
• Develop Resources - Special emphasis on state financing equity, especially with respect to
addiction treatment, federal, state or county financing to the greatest degree possible and
maximizing billable revenue.
Special note: This agenda should be advanced in a manner that complements the current Jail
Needs Assessment Committee process which includes a goal of creating/expanding alternatives
to incarceration. If other priorities emerge from that process, recommendations will be brought
to LPSCC for consideration.
' Deschutes County: Commission on Children & Families, Health Department, Juvenile Department, Mental
Health Department, Parole & Probation Department.
-TES
L
0 2 "AAA Mental Health Department
2577 NE Courtney Drive, Bend, Oregon 97701
General Information/TDD (541) 322-7500
FAX (541) 322-7565
Scott Johnson, Director
County / Schools / FAN partner to offer mental health services
Since the early 1990s, school districts in Deschutes County and social service agencies
have worked together to develop and support the Family Access Network. This effort
includes referrals, direct services in local schools and financial investment.
• The #1 priority in the County's Comprehensive Plan in 1994.
• Financial support over the years: County General Fund, the Juvenile Dept,
the Commission on Children & Families. A 2005 request is pending.
• FAN is the #1 federal priority for Deschutes County in 2005. We are
making an effort to secure federal dollars to support the system long term.
• FAN funding (Bend LaPine) and school funding (Redmond) supplements
County funding and Oregon Health Plan dollars. We could not sustain this
model across schools without FAN and school help.
Service levels (actual / estimated)
• 32 public schools receive mental health services in the Bend LaPine and
Redmond School Districts.
• 14 mental health therapists have provided 7,556 hours of services from
September 2003 - December 2004. Estimate: 11,800 hours by June.
• Schools with most use in 2003-2004 (hours through December '04):
1.
LaPine Elementary
430 hours
2.
Buckingham Elementary
384 hours
3.
Juniper Elementary
273 hours
4.
LaPine Middle School
273 hours
5.
Mt. View High School
238 hours
6.
Cascade Middle School
237 hours
7.
Redmond High School
227 hours
Why this model is so critical
• Services are brought to students; higher use of services; less no shows.
• Earlier identification of mental health, alcohol / drug issues; prompt service.
• School staff prioritize which children need services (up to our capacity).
• More stable because of blended funding. Schools, County, Health Plan.
This model of services in the schools is only sustainable through a continued partnership.
Contacts: Scott Johnson, Director, County Mental Health, 322-7502, scottj@deschutes.org
Suzanne Donovan, Manager, Child & Family Programs, 322-7583, suzanned@deschutes.org
Adult Treatment Child & Family Program Developmental Disabilities Seniors Program Medical Records
Mental Health, Alcohol & Drug Mental Health, Alcohol & Drug PHONE (541) 322-7554 PHONE (541) 385-1746 FAX (541) 322-7567
FAX (541) 322-7565 FAX (541) 322-7566 FAX (541) 322-7566 FAX (541) 330-4642 (Protected Health Information)
Quality Services Performed with Pride
Oregon Funding of
Alcohol and Other Drug Treatment Services
2003-2005
A & D $
County Per Capita
July '04
Population
% of
Pop.
% Tx.
$
State Grant
AD66
State Grant
AD60 Total
Josephine $17.51
78,600
2.19%
4.57%
$709,609
$666,538 $1,376,147
Morrow / Wheeler
$17.18
13,300
0.37%
0.76%
$228,514
$228,514
Columbia
$16.67
45,650
1.27%
2.53%
$171,060
$590,130
$761,190
Wallowa
$15.52
7,150
0.20%
0.37%
$110,962
$110,962
Harney
$14.91
7,650
0.21%
0.38%
$114,090
$114,090
Grant
$14.53
7,750
0.22%
0.37%
$112,630
$112,630
Lake
$14.52
7,500
0.21%
0.36%
$108,874
$108,874
Multnomah
$13.04
685,950
19.15%
29.68%
$7,627,622
$1,315,618
$8,943,240
Mid-Columbia"
$12.90
48,750
1.36%
2.09%
$471,384
$157,426
$628,810
Malheur
$12.36
31,850
0.89%
1.31%
$393,602
$393,602
Klamath
$12.20
64,800
1.81%
2.62%
$504,008
$286,320
$790,328
Douglas
$11.34
102,350
2.86%
3.85%
$722,950
$437,776
$1,160,726
Baker
$11.18
16,550
0.46%
0.61%
$184,950
$184,950
Umatilla
$11.07
72,250
2.02%
2.65%
$477,568
$322,080
$799,648
Curry
$10.14
21,150
0.59%
0.71%
$214,438
$214,438
Lincoln
$9.29
44,400
1.24%
1.37%
$329,490
$82,790
$412,280
Jackson
$8.85
191,200
5.34%
5.62%
$898,856
$793,332
$1,692,188
Benton
$8.71
81,750
2.28%
2.36%
$439,472
$272,240
$711,712
Yamhill
$8.49
89,200
2.49%
2.51%
$465,574
$291,986
$757,560
State average
$8.41
Marion
$7.62
298,450
8.33%
7.55%
$1,974,856
$300,000
$2,274,856
Jefferson
$7.12
20,250
0.57%
0.48%
$144,132
$144,132
Crook
$6.62
20,650
0.58%
0.45%
$136,620
$136,620
Lane
$6.17
333,350
9.30%
6.83%
$1,761,276
$295,276
$2,056,552
Linn
$5.76
106,350
2.97%
2.03%
$387,852
$224,821
$612,673
Clatsop
$5.61
36,400
1.02%
0.68%
$204,358
$204,358
Washington
$5.56
480,200
13.40%
8.87%
$1,553,346
$1,118,544
$2,671,890
Tillamook
$5.38
24,950
0.70%
0.45%
$134,220
$134,220
Union
$4.86
24,850
0.69%
0.40%
$120,764
$120,764
Clackamas
$4.09
356,250
9.94%
4.83%
$978,268
$477,710
$1,455,978
Coos
$3.78
62,700
1.75%
0.79%
$188,730
$48,114
$236,844
Deschutes
$3.04
135,450
3.78%
1.37%
$411,692
$411,692
Polk
$2.54
64,950
1.81%
0.55%
$165,118
$165,118
County Sub-Total
$8.41
3,582,600
100%
100%
$22,446,885
$7,680,701
$30,127,586
Based on 7/1/2004 certified estimates from Population Research Center - PSU
Mid-Columbia includes Wasco, Sherman, Hood River and Gilliam Counties
S:\Mental_Health\Scott\Substance Abuse\A&D 66 and 60 by County.xls
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