2006-220-Minutes for Meeting March 06,2006 Recorded 3/14/2006DESCHUTES COUNTY OFFICIAL
NANCY BLANKENSHIP, COUNTY
COMMISSIONERS' JOURNAL
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2006-220
CLERK°S U 1006.714
03/14/2006 09;36;23 AM
DESCHUTES COUNTY CLERK
CERTIFICATE PAGE
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Deschutes County Board of Commissioners
1300 NW Wall St., Suite 200, Bend, OR 97701-1960
(541) 388-6570 - Fax (541) 385-3202 - www.deschutes.org
MINUTES OF MEETING
LOCAL PUBLIC SAFETY COORDINATING COUNCIL
MONDAY, MARCH 6, 2006
Commissioners' Conference Room - Administration Building, Second Floor - 1300 NW Wall St..., Bend
Present were Judge Michael Sullivan; Commissioner Bev Clarno; Bend Police
Chief Andy Jordan; Bob Lacombe, Juvenile Community Justice Department; Mike
Maier, County Administrator; Jack Blum, citizen member; Tammy Baney,
Commission on Children & Families Board of Directors; Judith Ure,
Commissioners' Office; and Becky Wanless, Parole & Probation Department.
Also in attendance were Jacques DeKalb, defense attorney; Scott Johnson, Mental
Health Department; Captain Marc Mills, Sheriff's Office; Mike Dugan, District
Attorney; Roger Olson, NAM; Bob Smit, KIDS Center; Tom Kipp and Carl Lewis,
Oregon State Police; and Scott Johnson, Mental Health Department.
Also present were media representatives Cindy Powers of The Bulletin and Eric
Rucker of News Channel 21.
1. Call to Order & Introductions.
The meeting was called to order at 3:35 p.m., at which time the attendees
introduced themselves.
2. Approval of Minutes of February 6, 2006 Meeting.
Andy Jordan moved approval and Jack Blum seconded. The minutes were
unanimously approved.
Minutes of LPSCC Meeting Monday, March 6 2006
Page 1 of 8 Pages
3. Discussion regarding Signature of a Letter of Support for Drug Court
Grant Application.
Judith Ure, the County's grant writer, introduced a letter of support for a grant
to go to the State to request funding for implementing a drug court. (A copy of
the letter is attached as Exhibit C.) She added that there would be a variety of
signatures also required for a memorandum of understanding to be submitted as
well. After a brief discussion, action was taken.
JACK BLUM: Move Judge Sullivan sign as both Chair of LPSCC and the
Presiding Judge of District Court.
MIKE DUGAN: Second.
The vote was unanimously in favor.
4. Discussion of "Alternatives Subcommittee".
Commissioner Clarno said she is on the LPSCC alternatives subcommittee,
which met last week for the second time. (She referred to a handout at this
time, a copy of which is attached as Exhibit D.) She stated that Becky Wanless
has been instrumental in keeping the group on task.
She gave an overview of the issues the group is addressing, including drug
testing by employers. She said that on May 25 these issues would be reviewed
with people who are working in the trenches in order to get a better
understanding of what kind of programs work, and to prioritize a list of
services.
Mike Dugan asked if, during the development of the jail expansion plan,
whether alternative incarceration programs were considered; and, if so, if the
information could be provided to the committee.
Judge Sullivan said that alternative incarceration programs were in fact
considered. There are some programs available now and others that would be
worthwhile; but the main concern is to have continuity and long-term funding
available. He added that the best source of information on the jail plan would
probably be Undersheriff Larry Blanton.
Mike Maier asked who is staffing the group. Commissioner Clarno said that
Becky Wanless and Mary Anderson are handling the work thus far, but
additional help could be used as the data is compiled.
Minutes of LPSCC Meeting Monday, March 6 2006
Page 2 of 8 Pages
5. Follow-up Discussion regarding King County Justice System Information.
Scott Johnson observed that per the King County report, many of their projects
relate to what Deschutes County is doing. It should be possible to merge this
information into the previous report.
Judge Sullivan added that concerning the court system and assisting the
mentally ill, he is pleased with what the community is accomplishing, but
continuity and assured funding are crucial.
6. Discussion regarding Endorsement of Mental Health 2007-09 Biennial
Plan.
Scott Johnson gave a review of the State planning process, which requires that
the Mental Health Department provide a plan for the next biennium. (Copies of
the Biennial Plan and Strategic Plan are attached as Exhibit E.) He then gave
a brief overview of the issues and concerns.
Bob Smit pointed out that the KIDS Center provides medical evaluations in
regard to child abuse situations and also provides medical diagnosis for other
problems as well. He said that they should be listed as a provider.
MIKE MAIER: Move approval of the Mental Health Plan, with the
addition of the KIDS Center being listed.
JACQUES DEKALB: Second.
The vote was unanimously in favor.
7. Discussion regarding Internet Access to Inmate Information.
Jacques DeKalb stated that indigent defense providers in Lane and Multnomah
Counties have access to certain information on the Sheriff's system, and he
would like to discuss this issue. It would result in an enhancement of
efficiency. He would like to address this at the next LPSCC meeting.
Minutes of LPSCC Meeting Monday, March 6 2006
Page 3 of 8 Pages
8. Discussion regarding Supervision of Misdemeanor Offenders.
Becky Wanless noted that this issue was discussed at the last meeting, and
many people are concerned. Prior to 1997, Parole & Probation used to be a
State function. When Senate Bill 1145 went into effect in January 1997, it said
that any Parole & Probation operated by the State would become the counties'
responsibility.
She said in essence, funding keeps being reduced by the caseload continues to
grow. Deschutes County is one of the fastest growing in the country, and the
street crimes units and law enforcement keep making more arrests.
The ideal caseload is around 70. They try to keep sex offenders and family
violence offenders at a maximum of 55. Some time ago, she approached the
Board and County Administrator with a plan not to supervise misdemeanors.
This decision was not taken lightly. The budget picture for next year will not
be any different from the current year. Due to personnel costs of health
insurance and benefits, it will cost an additional $170,000 for the exact same
work.
Bob Smit and Officer Kipp expressed concern about this situation and asked if
other counties provide Parole and Probation; Ms. Wanless said that some do.
Mr. Smith indicated that misdemeanor sex offenders should be supervised but
won't be. This is especially serious because these cases often involve children.
Officer Kipp stated the Juvenile team has grave concerns as they count on
Parole & Probation to be at the first level, where they have the authority to
verify treatment, do home visits and so on. An officer can run in a
misdemeanor offender, but there's no one to keep an eye on the offender.
Offenses such as deviant behavior, contributing the delinquency of a minor,
public indecency, various types of sexual abuse, and sexual harassment are all
still treated as misdemeanors. The State won't provide funding, and monitoring
doesn't help; they really need direct supervision.
Ms. Wanless stated that there should be one parole officer over fifteen
offenders. Mike Dugan recommended that this position be in the budget goals.
He asked if it would be appropriate for LPSCC to make this recommendation.
Jack Blum observed that these misdemeanor offenders will eventually go on to
worse things, leaving behind more victims.
Minutes of LPSCC Meeting Monday, March 6 2006
Page 4 of 8 Pages
Judge Sullivan agreed that this is a troubling situation, but Parole & Probation
has to prioritize felons. Some officers have high caseloads; Chris Bell alone
has sixty. There has been an increase of 300 felons, and a 10% increase in
filings this year over last year. He said that Ms. Wanless looks hard at
recidivism rates.
In regard to family violence cases, many times drug or alcohol problems are
involved. There aren't any good choices in this situation because there are
inadequate resources. It is great to make recommendations, but at any level
there are competing demands. Cuts at the Oregon State Police and the Crime
Lab have also become a big problem.
Office Kipp noted that he doesn't want to ask Ms. Wanless to change how she
runs her department, but feels it is important for the Board of Commissioners to
look at this more closely.
JACK BLUM: I move that LPSCC respectfully request that the Board of
commissioners consider funding for misdemeanor sex offender
monitoring, in the next budget process.
DUGAN: Second.
Andy Jordan stated that he agrees, but is uncomfortable dictating to governing
bodies how to put their budget together. Mr. Dugan explained that LPSCC was
established to advise and make recommendations to local governing bodies,
especially in regard to how to spend 1145 dollars. The recommendation would
be that this position be put into Ms. Wanless' budget. It may not be approved,
but it is important to make the recommendation. Mr. Blum added that it would
make them aware there is a problem.
Commissioner Clarno stated that this would be general fund dollars. She said
they also need to decide on a drug court and other needs, and it is hard to
determine which is the most important.
Mr. Dugan pointed out that years of literature show that the best you can do is
watch these types of offenders as they don't get cured. Commissioner Clarno
said that she understands there is a fine balance. A recommendation would at
least put it on the radar.
Minutes of LPSCC Meeting Monday, March 6 2006
Page 5 of 8 Pages
Mike Maier noted that Deschutes County supported SB 1145 with the
understanding that the State would provide adequate funding to do the job.
That was about ten years ago. About five years ago the County had to fund
$130,000 to prevent layoffs. The State funded a little more the following year,
but it has never been enough. It often takes working with the State as much as
possible and trying to get grants. The County is in good financial shape by not
taking on long-term obligations it can't afford. Also, this year binding
arbitration is coming up that can impact the County budget. The problem is
simply that the State doesn't provide enough dollars.
Officer Kipp pointed out that he just wanted to bring up an issue that involves
the safety of the community's children. Commissioner Clarno asked if this will
be considered during the next legislative session. Mr. Dugan said that they
have repeatedly asked for full funding. The County has considered opting out
as well; whenever this happens, the funding formula is raised to a bare
minimum, but never to a level of what is needed.
Mr. Maier added that the formula doesn't take into account the cost of living
differences throughout the State. It is important to recruit and retain good
employees, and pay what is needed to do so. Mr. Dugan noted that the
alternative to incarceration is supervised probation, and the alternative to that is
unsupervised, which is nothing. The sad part of dealing with misdemeanor sex
offenders is that unless they are given a lot of time, they get out of jail without
any supervision.
Ms. Wanless added that there are some people who are simply unwilling to be
supervised, are dangerous and have to be incarcerated. Community supervision
makes good financial sense. The Department of Corrections says it costs $65 a
day to house a prisoner, but the cost is actually over $80 per day; and it is $10 a
day for community supervision.
At this point the group took action on the previous motion. The vote was
unanimous, with the exception of County Administrator Mike Maier, who
abstained.
9. Discussion regarding Corrections Budget.
Bob Smit indicated that this item was covered during the previous discussion.
Minutes of LPSCC Meeting Monday, March 6 2006
Page 6 of 8 Pages
10. Update regarding Dedicated Courthouse Parking for Law Enforcement
Personnel.
Chief Andy Jordan stated that the City wants a proposal submitted in writing.
A suggestion has been made to having the spaces available only for official law
enforcement use during the hours of 8 a.m. -5 p.m., Monday through Friday;
and all other hours the spaces could be used by anyone. There are many good
reasons to restrict the spaces for official use during working hours, but the
decision is up to the City. LPSCC members are concerned about the safety and
security of law enforcement personnel, those citizens coming to the Courthouse
and people in the courtrooms.
Judge Sullivan said that a representative of the Oregon State Police will put a
proposal together with Court Administrator Ernie Mazorol and present it. He
added that discussion has taken place regarding placing metal poles in front of
the building so that no one can drive up the steps. Chief Jordan stated that the
urban renewal group has indicated they may be able to provide these safety
devices. Mr. Maier stressed that care needs to be taken to make sure they are
not unsightly, especially since the remodeled building looks attractive now.
11. Meeting Schedule: July and September.
Judge Sullivan suggested that because the 4th of July holiday falls on a Tuesday,
and the regular meeting date would be on July 3, and many people will be
taking vacations, perhaps the group should skip the July meeting altogether.
The group unanimously supported skipping the July meeting.
Judge Sullivan suggested that because of the Labor Day holiday, the September
meeting should be moved to the second Monday, September 11. The group
agreed.
12. Other Business and Items for the Next Meeting (Monday, April 3).
No other business was brought before the group.
Minutes of LPSCC Meeting Monday, March 6 2006
Page 7 of 8 Pages
At this point, the only items to be carried over to the Monday, April 3 meeting
are Internet Access to Inmate Information (Jacques DeKalb), and the parking
situation adjacent to the Courthouse.
Being no further items addressed, the meeting adjourned at S: 00 p.m.
Respectfully submitted,
Sk&t"'/
Recording Secretary
Attachments
Exhibit A: Sign-in sheet (1 page)
Exhibit B: Agenda (1 page)
Exhibit C: Copy of a grant application letter and information regarding Drug
Court (2 pages)
Exhibit D: A copy of an Alternatives Subcommittee handout (37 pages)
Exhibit E: A copy of the Mental Health 2007-09 Biennial Plan and Strategic Plan
(110 pages)
Minutes of LPSCC Meeting Monday, March 6 2006
Page 8 of 8 Pages
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{ 1300 NW Wall St., Suite 200, Bend, OR 97701-1960
(541) 388-6570 - Fax (541) 385-3202 - www.deschutes.ore
MEETING AGENDA
LOCAL PUBLIC SAFETY COORDINATING COUNCIL
3:30 P.M., MONDAY, MARCH 6, 2006
Commissioners' Conference Room - Administration Building, Second Floor
1300 NW Wall St.., Bend
1. Call to Order & Introductions
2. Approval of Minutes of Monday, February 6 Meeting
3. Discussion regarding Signature of a Letter of Support for Drug Court Grant
Application -Judith Ure
4. Discussion of "Alternatives Subcommittee" - Bev Clarno
5. Follow-up Discussion regarding King County Justice System Information -
Scott Johnson
6. Discussion regarding Endorsement of Mental Health 2007-09 Biennial Plan -
Scott Johnson
7. Discussion regarding Internet Access to Inmate Information - Jacques DeKalb
8. Discussion regarding Supervision of Misdemeanor Offenders - Becky Wanless
9. Discussion regarding Corrections Budget - Bob Smit?
10. Update regarding Dedicated Courthouse Parking for Law Enforcement
Personnel - Ernie Mazorol, Andy Jordan
11. Meeting Schedule: July and September
12. Other Business and Items for the Next Meeting (Monday, April 3)
March 6, 2006
Scott Johnson, Director
Deschutes County Mental Health Department
2577 NE Courtney Drive
Bend, OR 97701
Dear Mr. Johnson:
The Local Public Safety Coordinating Council (LPSCC) supports and encourages the efforts of
the Deschutes County Mental Health Department and its partners to bring a family drug
treatment court to Deschutes County. Our member agencies have long recognized that excessive
and repeated substance abuse, most specifically involving methamphetamine, is creating a crisis
for families in our community and placing a significant burden on limited public safety, judicial,
and addiction treatment resources. In fact, Deschutes County's classification as a High-Intensity
Drug Trafficking Area (HIDTA) in Oregon is largely due to extensive and pervasive
methamphetamine use, production, and distribution.
At the same time that this problem is growing throughout the region, treatment capacity is
diminishing. Without access to treatment, even those who are willing and eager to break the
chains of abuse for the sake of their children and families are instead likely to find themselves in
a revolving cycle of court appearances, jail time, probation, child custody intervention, and
increasingly perilous circumstances.
The proposed family drug treatment court will help address these issues. Evidence has shown
that, by emphasizing treatment and other wraparound services in an intensive and comprehensive
system, drug courts can reduce addiction, prevent relapse, decrease recidivism, and reunite
families who have been torn apart by drug use. By building upon Deschutes County's already
highly successful family court model, the proposed drug treatment court will enhance the
services available to families in severe crisis who will most benefit from a structured intervention
as an alternative to traditional sentencing.
Many of LPSCC's member agencies have been involved in the lengthy planning process to bring
a family drug treatment court to Deschutes County. You can count on our continued
involvement and support as you pursue funding sources to bring this program to life.
Sincerely,
Michael C. Sullivan
Presiding Judge, Deschutes County Circuit Court
Chair, Local Public Safety Coordinating Council
Druiz Court Implementation and Enhancement Grant Program
$5.5 million
Competitively distributed 2006-2008
TWO GRANT PROGRAMS:
1. Byrne Methamphetamine Reduction Grant Program
Interagency case management, addiction treatment, mental health care and
related essential services for a drug court and/or dependency court supervised
parenting and pregnant methamphetamine-using women, and their children.
1. 25% cash match
2. 2 years maximum
3. 10 programs with $150,000.00 per year
4. renewed based on adherence to grant plans
5. must have funding continuation plan
6. directed primary to drug affected women and children
2. Drug Court Implementation and Enhancement Court Program
Funding for drug court coordinators and drug court supervised addiction
treatment to support the implementation of new drug courts and the
enhancement of existing drug courts serving adults, juveniles and families.
1. no cash match
2. $2.5 million
3. one year grant
4. maximum grant amount $300,000.00
5. must have funding continuation plan
6. directed to enhance or implement drug court
7. must address the 10 key components to a drug court
Application deadlines:
1. Letter of interest to CJC by February 28, 2006
2. Complete grant application must be received no later than April 3, 2006
3-6-06
Alternatives Subcommittee
Suggested Committee Membership: BOCC (Bev Clarno, Subcommittee Chair),
Courts (Ernie Mazorol), District Attorney (Mary Anderson), Sheriff's Office (Larry
Blanton), Mental Health (Scott Johnson), Juvenile Justice (Bob LaCombe), CC&F
Board and Meth Action Coalition (Tammy Baney), Parole and Probation (Becky
Wanless), NAMI (Roger Olson), Chamber of Commerce (Mike Schmidt and Jeff
Neilson).
Preamble: The Local Public Safety Coordinating Council for Deschutes County
recognizes that a continuum of services, programs and facilities is essential in order
to deal effectively with substance abuse issues and those individuals who come into
contact with law enforcement, including those who may be booked into jail and/or
sentenced to a term of local incarceration.
Goal: To identify and prioritize a list of key services and programs that:
✓ promote public safety and personal accountability;
✓ treat and assist special populations in contact with the criminal justice system,
and
✓ reduce recidivism.
Key services and programs will be developed in the following categories:
• Prevention
• Diversion from the system prior to booking
• Pre-Trial diversion, adjudication and sentencing options
• Incarceration
• Assisting in successful reentry
Timeline:
Date
3/6/06
5/25/06
6/1/06
10/11/06
11/1/06
12/1/06
Revised 3/3/06
Item Accomplished
Approval from LPSCC to proceed
Key informants work session
Research and data collected
Draft report completed
Presentation of report to Family Drug Court community partners
BOCC adopts report
Exhibit C)
Page of]_
Alternative Incarceration Programs
Oregon's three alternative
incarceration programs
Both men and women participate in the Summit
Program at Shutter Creek Correctional Institution in
North Bend. Summit stands for "Success Using
Motivation, Morale, Intensity and Treatment." Summit
leads inmates to confront criminal thinking. The pro-
gram encourages and supports new pro-social beliefs
and behaviors. It focuses on cognitive skills, alcohol
and drug education, work skills and ethics. Summit
also teaches inmates how to build and maintain posi-
tive relationships. Inmates learn to accept responsibili-
ty for their criminal behaviors and the harm they
caused others. It includes a personal discipline com-
ponent that is loosely based on a military training
:model. Summit graduates about 225 inmates annually.
Turning Point for women is offered at Coffee Creek
Correctional Facility in Wilsonville. In a learning envi-
ronment, women work to develop the pro-social skills
needed for life outside prison. Inmates in the program
participate in intensive addiction treatment and particle
pate in individual and group counseling. Participants
learn the skills necessary to change their behavior and
increase their personal accountability and responsibili-
ty. They are required to develop healthy daily routines
that involve physical work and exercise. A strong
emphasis is placed on preparing for gainful employ-
ment and successful living in the community. Every
year, Turning Point will serve about 100 women.
New Directions Addictions Program is an intensive
residential treatment program for men at Powder River
Correctional Facility in Baker City. It focuses on devel-
oping.personal accountability and responsibility
through a structured. daily- routine that involves physi-
cal work, exercise, and behavioral- skill development.
Group and individual addiction treatment includes 12-
step and other recovery activities where participants
learn. the skills necessary to.change their behavior and
increase their personal accountability and responsibili-
-ty.'Additional interventions prepare inmates for gainful
employment and teach them how to develop and
maintain pro-social relationships and family skills.
They also learn to identify and change criminal think-
ing errors and develop healthy decision-making skills
and habits for successful community living. About 350
men will participate in New Directions each year.
Eligibility criteria
Qualified inmates must apply to be accepted into any
of the three programs. Summit has specific start
dates for each group. The other two programs have
rolling admissions, which means that new participants
are accepted when there are openings.
Other DOC criteria may apply, but the basic qualifica-
tions are:
• A sentencing order that allows alternative incar-
ceration, transitional leave and time cuts (no
mandatory minimum sentences or sentencing
under another. disqualifying law).
• Minimum-custody classification.
• Enough time remaining in the sentence to com-
plete the 270-day program.,
• No immigration or,felony detainer that would still
be in effect at the time, of transitional leave.
The selection process
All inmates are carefully evaluated when they enter
the Oregon Department of Corrections. Each inmate
receives an individual corrections plan to address
seven key criminal risk factors. Among those factors
is alcohol and-drug abuse. Eligible inmates are priori-
tized based on these risk factors and admitted into
the appropriate programs as space permits.
Active participation required
Inmates may be removed from alternative incarcera-
tion programs at any time for rule infractions, lack of
effort or motivation, poor program progress, or lack of
positive change. Inmates who fail any phase of an
alternative incarceration program or who voluntarily
request-to be removed from the program will return,to
regular incarceration to serve the balance of their
sentences. They are ineligible to participate in alterna-
tive incarceration programs in the.future.
Statutory authority:
ORS 421.502, 421.508, 421.510, 421.512, Chapter
464 (2003 Laws), effective date: January 1, 2004.
For more information, please contact:
Kristi Brandt, Alternative Incarceration Coordinator
Coffee Creek Correctional Facility
PO Box 9000, Wilsonville, OR 97070
(503) 570-6696 or e-mail: kristi.j.brandt@state.or.us
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Page_ of 3
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orn-ative
rce ration
ro gra,ms
"Alternative incarceration" is a phrase that describes intensive prison pro=
grams-offered by the Oregon Department of Corrections (DOC) to select-
inmates who are at risk,of reoffending due to untreated addictions and
criminal thinking.
Oregon's first alternative incarceration program, the Summit Program, began.in 1994 and
continues today. The 2003 Legislature approved additional alternative incarceration pro-
grams: "Turning Point" for women and "New. Directions" for men provide cognitive behavioral
change programs that focus on alcohol and drug treatment.
Alternative incarceration programs prevent future criminal behavior
Many Oregon prison inmates have severe substance abuse problems - a key risk factor con-
tributing to criminal behavior. To reduce the risk that offenders will commit new crimes,.the
DOC designed its alternative incarceration programs around treatment and programs proven
.to be effective in treating addictions and changing behavior. The programs are designed to
_prepare inmates_to._retu.rn_successfully_to_the community after release.-from -prison.
Summit, Turning Point and New Directions all have structured 14 to 16-hour days that require
physical work, exercise and service to the community. Participants live in dedicated
housing units for about six months and participate in programs that stress personal
responsibility and accountability. The curriculum includes preparing for employment,
developing good relationships and family skills, and recognizing and changing
criminal-thinking errors. Participants also focus on healthy decision-making skills
and habits for successful community living. Inmates accepted into Turning Point
and New Directions also must participate in intensive addiction treatment, counsel-
ing, education, 12-step meetings and other recovery activities.
Alternative incarceration programs have three phases: Inmates who successfully
complete the residential phase move into the community. Still considered inmates,
they are supervised for 90 days while practicing the skills and discipline learned in
prison. Those who complete this "transitional leave" phase are eligible to have their prison
Oregon Department of Corrections
is to promote public safety by holding
offenders accountable for their actions
and reducing the risk of future
criminal behavior,
sentences reduced. These time cuts are expected to average about 13 months. After transi-
tional leave, offenders are supervised by parole officers while completing their post-prison
supervision sentences.
Many graduates of these types of programs have gone on to be successful contributing .
members of society. The results of Oregon's alternative incarceration programs are carefully
tracked. Outcomes of each program and a control group will be evaluated to determine the
programs' effectiveness. This information- will be used to guide future policy decisions.
Alternative Incarceration Programs (AIP)
Basic Eligibility Criteria
Taken from the AIP Oregon Administrative Rule (OAR 291-062-0130) effective 8122105
The department in its discretion may accept eligible inmates into an alternative incarceration program based on its determination that the inmate's
participation in such a program is consistent with the safety of the community, the welfare of the applicant, the program objectives and the rules of the
department.
If otherwise eligible under Oregon law, any person sentenced for a. crime committed on or after December 5, 1996, shall be eligible for alternative
incarceration programs only upon order of the sentencing court as directed in the judgment pursuant to ORS 137.750.
An inmate is not eligible to participate in alternative incarceration programs during service of a sentence for conviction of a crime
described in:
• ORS 163.095 (Aggravated Murder)
• ORS 163.115 (Murder)
• ORS 163.118 (Manslaughter 1)
• ORS 163.235 (Kidnapping 1)
• ORS 163.355 (Rape III)
• ORS 163.365 (Rape 11)
• ORS 163.375 (Rape 1)
• ORS 163.385 (Sodomy III)
• ORS 163.395 (Sodomy 11)
• ORS 163.405 (Sodomy 1)
• ORS 163.408 (Unlawful Sexual Penetration 11)
• ORS 163.411 (Unlawful Sexual Penetration 1)
• ORS 163.415 (Sexual Abuse 111)
• ORS 163.425 (Sexual Abuse 11)
• ORS 163.427 (Sexual Abuse 1)
• ORS 163.435 (Contributing to the Delinquency of a Minor)
• ORS 163.525 (Incest)
• ORS 164.325 (Arson 1)
• ORS 164.415 (Robbery 1)
• ORS 137.635 A determinate sentence resulting from a conviction of one or more of ten listed felony crimes (i.e., Murder, including any
aggravated form of Murder, Manslaughter I, Assault I, Kidnapping I, Rape 1, Sodomy I, Sexual Penetration With a Foreign Object I, Burglary 1,
-
Arson land-Robbery-l)~ if the-inmafe-also-has a prior conviction for one or more of-those ten listed felony crimes
• ORS 161.610 (gun minimum) until the inmate completes the minimum incarceration term imposed by the court less earned time under ORS
421.121
• ORS 421.168(1) and ORS 144.108(3)(b) Parole or post-prison supervision violation sanction
• ORS 137.700 or ORS 137.707 until completion of the mandatory minimum incarceration term. For crimes committed on or after December 5,
1996, the inmate is eligible after completion of the mandatory minimum incarceration term only upon order of the sentencing court as directed
in the judgment pursuant to ORS 137.750
• The following ORS committed and convicted on or after April 1, 1995:
o ORS 163.175(1)(b) Assault II
o ORS 163.225 Kidnapping II
o ORS 164.405 Robbery II unless the sentencing court, notwithstanding ORS 137.700 and 137.707, has imposed a lesser sentence
pursuant to ORS 137.712 and (for crimes committed on or after December 5, 1996) only upon order of the sentencing court as
directed in the judgment pursuant to ORS 137.750
• ORS 163.125 Manslaughter II committed on or after October 23, 1999 unless the sentencing court, notwithstanding ORS 137.700 and
137.707, has imposed a lesser sentence pursuant to ORS 137.712 and only upon order of the sentencing court as directed in the judgment
pursuant to ORS 137.750
• ORS 161.725 or ORS 161.737 (dangerous offenders) for a crime committed on or after November 1, 1989
An inmate is not eligible to participate in alternative incarceration programs if:
The inmate has an adult conviction for felony escape which was committed within three years prior to the time of program entry, or has a
conviction for unauthorized departure from the legal and/or physical custody of the Oregon Department of Corrections or its authorized agents
which was committed within three years prior to the time of program entry -
• Serving non-sentencing guidelines prison terms (sentences with crime dates prior to November 1, 1989), unresolved criminal prosecutions,
consecutive county jail terms, or any other circumstance that would conflict with his/her release from prison upon satisfactory completion of an
alternative incarceration program.
• The inmate has a current detainer
• The inmate has less than ten months to serve from the first day of program entry
Other eligibility criteria apply. See OAR 291-062 or contact: Kristi Brandt, AIP Screening Coordinator at 503-570-6461 fo Exhibit
Page _~A_ of _-1
Oregon Department of Corrections
SUMMIT Community Schedule
Community
70
75
80
85
Arrival Date
4/3/2006
2/12/2007
12/24/2007
11/3/2008
SCCI "Graduation"
10/3/2006
8/14/2007
6/24/2008
5/5/2009
Trans. Leave End
12/28/2006
11/8/2007
9/18/2008
7/30/2009
Total Program days:
269
269
269
269
Community
71
76
81
86
Arrival Date
6/5/2006
4/16/2007
2/25/2008
1/5/2009
SCCI "Graduation"
12/5/2006
10/16/2007
8/26/2008
7/7/2009
Trans. Leave End
3/1/2007
1/10/2008
11/20/2008
10/1/2009
Total Program days:
269
269
269
269
Community
72
77
82
87
Arrival Date
8/7/2006
6/18/2007
4/28/2008
3/9/2009
SCCI "Graduation"
2/6/2007
12/18/2007
10/28/2008
9/8/2009
Trans. Leave End
5/3/2007
3/13/2008
1/22/2009
12/3/2009
Total Program days:
269
269
269
269
Community
73
78
83
88
Arrival Date
10/10/2006
8/20/2007
6/30/2008
5/11/2009
SCCI."Graduation"
_4110/2007
__._.211.9/2008___
12/30/2008_..
1.1/10/2009.__
Trans. Leave End
7/5/2007
5/15/2008
3/26/2009
2/4/2010
Total Program days:
268
269
269
269
Community
74
79
84
89
Arrival Date
12/11/2006
10/22/2007
9/2/2008
7/13/2009
SCCI "Graduation"
6/12/2007
4/22/2008
3/3/2009
1/12/2010
Trans. Leave End
9/6/2007
7/17/2008
5/28/2009
4/8/2010
Total Program days:
269
269
268
269
REVISED: 6/17/05
EXCEL/Community S
Exhibit D
Page , of
TREATMENT PROGRAMS AND SENTENCING OPTIONS
AVAILABLE AT DEPARTMENT OF CORRECTIONS
FEBRUARY 13, 2006
State / County Office Building
Barnes Room
Bend,Oregon
1:00pm - 1:30 pm Introduction to Department of
Corrections And Intake Process
Kristi Brandt and Scott Taylor - DOC
1:30 pm - 2:45 pm Treatment Programs Available at the
Department of Corrections
Scott Taylor - DOC
An overview of the treatment programs available inside the
walls at DOC. Who is eligible for those programs, length of
the program and how it affects an inmate's overall sentence.
2:45 pm - 3:00 pm Break
3:00 pm - 4:15 pm Alternative Incarceration Programs and
Structuring of Sentences and Court
Orders
Scott Taylor and Gina Raney - DOC
An overview of the available alternative incarceration
programs. Who iseligible for those programs, length of the
program and how it affects an inmate's overall sentence.
Exhibit
Page of 3~
Scott Taylor
Chief of Community Corrections
Oregon Department of Corrections
Scott Taylor is currently the Chief of Community Corrections. Prior to accepting this
position, he was the Assistant Director of Correctional Programs for four years and the
Assistant Director of Community Corrections for the department for five years.
Mr. Taylor holds a Masters of Public Administration degree from Portland State
University and two Bachelor degrees in Sociology and Police Administration. In
addition, he completed the University of Oregon's Pacific Program for management and
leadership.
Mr. Taylor is a consultant with the National Institute of Corrections, serves on the Board
of the American Probation and Parole Association, and was a past President of the OCJA
and the Western Correctional Association. His professional experience includes:
Regional Manager for Community Corrections, Field Unit Supervisor, Probation and
Parole Officer, Institution Counselor, and Juvenile Institution Group Life Supervisor. In
addition, Mr. Taylor is a former Mayor of Canby, Oregon.
Exhibit
Page `1 of 3--
r
Kri S B r n d-~ -
Kristi Brandt is a native Oregonian and graduated in 2000 with her Associate of Applied Arts
degree in Business Information Systems from Pioneer Pacific College, where she graduated with
Honors and was presented the Outstanding Student Award.
Kristi began her career with the.Oregon Department of Corrections (DOC) in May 2000. Three
of last five plus years, Kristi had been employed in support roles for various administrators in
DOCs central office in Salem. The last two and a half years, Kristi has worked as Screening
Coordinator, developing the Alternative Incarceration Programs (AIP) screening process. The
screening process involves coordinating with several department sections to ensure inmates are
eligible to participate in an alternative incarceration programs per statute, rule, and policy.
Kristi is also the contact person for questions regarding AIP eligibility.
Kristi has been married for 25 years, has three children with one still living at home. She is an
avid walker who has participated in many relay walks, several 1/2 marathons and last October
completed her third marathon.
Gina Raney is a Policy and Technical Program Manager with the Offender Information and
Sentence Computation (OISC) unit of the Department of Corrections (DOC). She has worked
for the DOC for 10 1/2 years, all of which has been with DISC.
The complexity of sentencing laws and sentencing conditions imposed by the courts, together
with changes created by appellate court decisions and new laws leads to a constant need for
legal interpretation so that the DOC can develop policies to implement these sentencing
changes. Gina is the Department's liaison with the Attorney General's office on sentencing
issues. Using the Attorney General's advice Gina develops policy proposals for the DOC's
management to address the on-going changes in sentencing . Gina interacts regularly with a
wide range of criminal justice system professionals to both gather and share sentencing
information as well as develop and revise overlapping policies and procedures.
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Research Issue brief
OREGON DEPARTMENT OF CORRECTIONS
Executive Summary: Preliminary Results
of DOC Alternative Incarceration Programs
Overview
The Oregon Department of Corrections (DOC)
Alternative Incarceration Program (AIP) is a series of
intensive services intended to eliminate criminal
tendencies. The newest AIP is also intended to treat
alcohol and drug addiction.
AIP provides 14-16 hours of intensive programming
each day. Programming occurs seven days each week for
six months. The institutional program is followed by a
90-day "transitional leave," which involves intensive
supervision while in the community. Violators of
transitional conditions are returned to prison to complete
their sentences. Inmates completing the six-month
institutional programming and the 90-day transitional
leave are placed on post-prison supervision and are
eligible for prison sentence reductions averaging
between 12-13 months.
The first AIP - called Summit - began with a
boot-camp model for men and women at Shutter Creek
Correctional Institution in North Bend in 1994. In 2003,
the Oregon Legislature approved an expansion of AIP
focused on inmates with moderate-to-severe substance
abuse problems. These treatment beds serve a higher
proportion of inmates incarcerated for drug offenses,
driving offenses, theft, and burglary.
In January 2004, two new AIPs began to serve higher-
risk offenders willing to accept intensive substance-
abuse treatment. New Directions AlP for men is located
at Powder River Correctional Facility in Baker City. The
program will successfully graduate approximately 200
inmates to post-prison supervision annually. Turning
Point AIP is located at Coffee Creek Correctional
Facility in Wilsonville. The program will successfully
graduate approximately 55 inmates to post-prison
supervision annually.
Does AIP Work?
DOC has 11 years' experience with Summit. However
DOC's experience with New Directions has not been
long enough to adequately measure its effects on
recidivism. Because of this lack of data, direct
comparisons of effectiveness between Summit and New
Directions are not yet possible.
DOC Research and Evaluation did look at preliminary
data on program effectiveness. Using a propensity
scoring analysis, groups of offenders from both
programs who had been released for at least six months
were statistically matched. Control and treatment groups
matched based on time since release and the following
demographic factors: number of prior incarcerations, any
prior theft convictions, revocations from supervision,
age, crime type, earned time, sentence length, ethnicity,
substance abuse risk, and severity of crime.
Comparisons were completed with the following
preliminarX results:
Inmates completing the Summit program at Shutter
Creek showed a small improvement in recidivism
over the comparison group; however the change was
not sufficient to attain the level of statistical
significance.
Inmates completing the New Directions program at
Powder River showed a statistically significant
improvement in recidivism rates over the
comparison group.
Early data shows that the New Directions AIP at Powder
River has a significant effect on reducing recidivism,
particularly in the early post-prison supervision period.
However, it must be stressed that this data is
preliminary.
Exhibit
page of
AddNonalALPresearch on comparison ofattitudes
A soon-to-be released doctoral dissertation by Alexander
M. Millkey, MS, Psy.D., titled: Comparison of Attitudes
Related to Substance Abuse in Male Inmates Following
Treatment in Boot Camps and Therapeutic
Communities, reports that participants in both treatment
conditions were found to have statistically significant
change in attitudes related to criminal thinking and
substance abuse.
His study shows that participants who completed the
therapeutic community at New Directions AIP had
significantly better attitudes regarding substance use
than those who completed the boot-camp model
(Summit). However, the effect sizes associated with
these differences were small.
Summary
Estimate of AIPs' fiscal impact
Inmates successfully completing any AIP and
transitional leave average 385-day reductions in
sentence. The resulting reduced number of DOC beds
saved $4.8 million in the 2003-05 biennium. AIP is
expected to save DOC $6.1 million in the 2005-07
biennium.
Ongoing study
Preliminary results show that PRCF's New Directions
program is effective in reducing early recidivism. Over
the next 24 months, refined research on both the Summit
AIP and the New Directions AIP will study larger
samples and control groups. This will provide more-
definitive results, with data to quantify and compare the
effects of all DOC Alternative Incarceration Programs.
Study results also will better associate changes in
offender attitudes with subsequent reductions in
recidivism, and will help identify the most appropriate
inmates for specific Alternative Incarceration Programs.
Such ongoing improvements in AIPs can improve
effectiveness, reduce the number of future victims of
crime, and save taxpayer dollars.
The mission of the
Oregon Department of Corrections
is to promote public safety by
holding offenders accountable for their
actions and reducing the risk of future
criminal behavior.
Max Williams, Director
(503) 945-0920
Mitch Morrow, Deputy Director
(503) 945-0921
Paul Bellatty, Ph.D.
Research & Evaluation Administrator
(503) 947-1010
Ginger Martin
Assistant Director for Transitional Services
(503) 945-9062
Colette S. Peters
Public Affairs Administrator
(503) 945-9092
Oregon Department of Corrections
2575 Center Street NE
Salem, Oregon 97301-4667
www.oregon.gov/doc
R1-DOC/PA:1/10/06
Exhibit V
Page 23 of 3--j
Dept. of Corrections-291-062 Page 1 of 9
ORE60N SECRETARY UE STATE t
NOME Oo" Oregon State. Archives
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The Oregon Administrative Rules contain OARs filed through December 15, 2005
DEPARTMENT OF CORRECTIONS
DIVISION 62
ALTERNATIVE INCARCERATION PROGRAMS
291-062-0100
Authority, Purpose and Policy
(1) Authority: The authority for these rules is granted to the Director of the Department of Corrections in
accordance with 2003 Or Laws, Chapter 464 and ORS 179.040, 421.500 to 421.512, 423.020, 423.030
and 423.075.
(2) Purpose: The purpose of these rules is to establish special alternative incarceration programs and
establish department policy and procedures for the program's operation and management in accordance
with ORS 421.500 to 421.512.
(3) Policy: Within the inherent limitations of resources, and the need to maintain facility security,
internal order, and discipline, and the health and safety of staff, inmates, and the public, it is the policy
of the Department of Corrections to discharge its statutory responsibilities to establish alternative
incarcerations programs by creating and operating programs that promote inmate rehabilitation during
incarceration and reduce the risk of continuing criminal conduct when the inmate is returned to the
community.
Stat Auth: ORS 179.040, 421.500 - 421.512, 423.020, 423.030 & 423.075
Stat Impl: ORS 179.040, 421.500 - 421.512, 423.020, 423.030 & 423.075
Hist.: DOC 1-2004(Temp), f & cert. ef. 1-14-04 thru 6-12-04; DOC 5-2004, f. & cert. ef. 7-12-04
291-062-0110
Definitions
(1) Alternative Incarceration Program: A highly structured corrections program that includes intensive
interventions, rigorous personal responsibility and accountability, physical labor, and service to the
file:HC:\Documents and Settings\brandis\Local Settings\Temporary Internet Files\OLK11 Exhibit
Page of 3T1
Dept. of Corrections-291-062 Page 2 of 9
community.
(2) Custody Cycle: The time period during which an offender begins incarceration with the Department
of Corrections and/or is under the supervision of community corrections until discharge from all
Department of Corrections and community corrections incarceration and supervision.
(3) Short-Term Transitional Leave: A leave for a period not to exceed 90 days preceding an established
release date which allows an inmate opportunity to secure appropriate transitional support when
necessary for successful reintegration into the community in accordance with ORS 421.148, 421.510
and the department's rule on Short-Term Transitional Leave, Emergency Leaves and Supervised Trips
(OAR 291-063). The department may grant a transitional leave of up to 30 days for inmates who are not
participating in an alternative incarceration program.
(4) Static 99: An actuarial instrument designed to estimate the probability of sexual recidivism among
adults. It is used to determine which offenders will be designated "predatory".
Stat. Auth.: ORS 179.040, 421.500 - 421.512, 423.020, 423.030 & 423.075
Stats. Implemented: ORS 179.040, 421.500 - 421.512, 423.020, 423.030, 423.075
Hist.: DOC 1-2004(Temp), f. & cert. ef. 1-14-04 thru 6-12-04; DOC 5-2004, f. & cert. ef. 7-12-04; DOC
11-2005, f. 8-19-05, cert. ef. 8-22-05
291-062-0120
General
(1) The Department of Corrections has established and operates two types of alternative incarceration
programs. One of the alternative incarceration programs is an intensive cognitive program based in part
on a military model of intervention, and is a maximum of 270 days duration. The other is an intensive
alternative incarceration addictions program that includes intensive addiction intervention and treatment,
and is a minimum of 270 days duration. Each alternative incarceration program includes two
components - a structured institution program and a period of structured short-term transitional leave.
However, the department in its discretion may require individual program participants to complete their
assigned program without a period of transitional leave. Each alternative incarceration program will
require its participants to engage in a minimum of 14 hours of highly structured routine every day for
the duration of the program.
(2) Inmates are required to participate in and successfully complete transition classes offered as a
condition of program graduation. The number and frequency of these classes will be determined by each
facility.
(3) The department in its discretion may grant individual inmates a period of structured, short-term
transitional leave as part of their alternative incarceration program assignment if the inmate has
identified viable self-support options in the community or if the supervising community corrections
agency has approved a temporary subsidy that will allow the inmate to successfully transition in the
community.
Stat. Auth.: ORS 179.040, 421.500 - 421.512, 423.020, 423.030 & 423.075
Stats. Implemented: ORS 179.040, 421.500-421.512, 423.020, 423.030, 423.075
Hist.: DOC 1-2004(Temp), f. & cert. ef. 1-14-04 thru 6-12-04; DOC 5-2004, f & cert. ef. 7-12-04; DOC
11-2005, f. 8-19-05, cert. ef. 8-22-05
file://C:\Documents and Settings\brandis\Local Settings\Temporary Internet Files\OL Ex
Page-25- of 31
Dept. of Corrections-291-062
291-062-0130
Inmate Eligibility
Page 3 of 9
(1) The department will identify inmates eligible to participate in alternative incarceration programs. To
be eligible to participate in the program an inmate must:
(a) Be sentenced to the legal and physical custody of the department and be subject to a term of post-
prison supervision upon satisfaction of a term of incarceration in a Department of Corrections facility;
(b) Be at least 18 years of age at the time of entry into the program, or may be under 18 years of age and
have been convicted of a crime upon remand from juvenile court; and
(c) Be assigned minimum custody status in accordance with the department's rule on Classification
(Inmate) (OAR 291-104) and have no more than 36 months to serve at the time of program entry.
(2) An inmate is not eligible to participate in alternative incarceration programs during service of a
sentence for conviction of a crime described in:
(a) ORS 163.095 (Aggravated Murder);
(b) ORS 163.115 (Murder);
(c) ORS 163.118 (Manslaughter I);
(d) ORS 163.235 (Kidnapping I);
(e) ORS 163.355 (Rape III);
(f) ORS 163.365 (Rape II);
(g) ORS 163.375 (Rape I);
(h) ORS 163.385 (Sodomy III);
(i) ORS 163.395 (Sodomy II);
6) ORS 163.405 (Sodomy I);
(k) ORS 163.408 (Unlawful Sexual Penetration II);
(1) ORS 163.411 (Unlawful Sexual Penetration I);
(m) ORS 163.415 (Sexual Abuse III);
(n) ORS 163.425 (Sexual Abuse II);
(o) ORS 163.427 (Sexual Abuse I);
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(p) ORS 163.435 (Contributing to the Delinquency of a Minor);
(q) ORS 163.525 (Incest);
(r) ORS 164.325 (Arson I); or
(s) ORS 164.415 (Robbery I).
(3) An inmate is not eligible to participate in alternative incarceration programs if the inmate is serving a
sentence under the provisions of ORS 137.635.
(4) An inmate is not eligible to participate in alternative incarceration programs if the inmate is serving a
sentence under ORS 161.610 until the inmate completes the minimum incarceration term imposed by
the court less earned time under ORS 421.121.
(5) An inmate is not eligible to participate in alternative incarceration programs if the inmate:
(a) Has an adult conviction for felony escape which was committed within three years prior to the time
of program entry, or has a conviction for unauthorized departure from the legal and/or physical custody
of the Oregon Department of Corrections or its authorized agents which was committed within three
years prior to the time of program entry.
(b) Is serving non-sentencing guidelines prison terms (sentences with crime dates prior to November 1,
1989), unresolved criminal prosecutions, consecutive county jail terms, or any other circumstance that
would conflict with his/her release from prison upon satisfactory completion of an alternative
incarceration program.
(c) Has a current detainer. Inmates with detainers lodged with the department after they have been
selected and assigned to one of the programs, and the detainer is discovered after the inmate has
completed approximately one-half of the program may be permitted to continue their participation in the
program at the discretion of the superintendent/ designee based on their program performance to date.
(d) Is currently assigned to special security housing for reasons of protective custody, and the inmate's
assignment to the program is otherwise determined by department officials to pose a threat to the safe,
secure and orderly operation and management of the program, including the safety of department staff
and inmates.
(e) Has less than ten months to serve from the first day of program entry. May have nine months to serve
with superintendent's/designee's approval.
(f) Is serving a parole or post-prison supervision violation sanction pursuant to ORS 421.168(1) and
144.108(3)(b).
(6) An inmate is not eligible to participate in alternative incarceration programs if the inmate is serving a
sentence under the provision of ORS 137.700 or 137.707 until completion of the mandatory minimum
incarceration term. For crimes committed on or after December 5, 1996, the inmate is eligible after
completion of the mandatory minimum incarceration term only upon order of the sentencing court as
directed in the judgment pursuant to ORS 137.750.
(7) An inmate is not eligible to participate in alternative incarceration programs if the inmate, on or after
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April 1, 1995, commits and is convicted of
(a) Assault II as defined in ORS 163.175(1)(b) (Intentionally or knowingly causes physical injury to
another by means of a deadly or dangerous weapon);
(b) Kidnapping II (ORS 163.225); or
(c) Robbery II (ORS 164.405); unless the sentencing court, notwithstanding ORS 137.700 and 137.707,
has imposed a lesser sentence pursuant to ORS 137.712 and (for crimes committed on or after December
5, 1996) only upon order of the sentencing court as directed in the judgment pursuant to ORS 137.750.
(8) An inmate is not eligible to participate in alternative incarceration programs if the inmate on or after
October 23, 1999, commits and is convicted of Manslaughter II as defined in ORS 163.125, unless the
sentencing court, notwithstanding ORS 137.700 and 137.707, has imposed a lesser sentence pursuant to
ORS 137.712 and only upon order of the sentencing court as directed in the judgment pursuant to ORS
137.750.
(9) An inmate is not eligible to participate in alternative incarceration programs if the inmate is serving a
sentence under the provisions of ORS 161.725 or 161.737 (dangerous offenders) for a crime committed
on or after November 1, 1989. An inmate shall not be allowed to participate in alternative incarceration
programs even after completion of the required minimum incarceration term (determinate sentence)
even if the Board of Parole and Post-Prison Supervision finds that the person is no longer dangerous or
finds that the person remains dangerous but can be adequately controlled with supervision and mental
health treatment and sets a post-prison supervision release date.
(10) If otherwise eligible under Oregon law, any person sentenced for a crime committed on or after
December 5, 1996, shall be eligible for alternative incarceration programs only upon order of the
sentencing court as directed in the judgment pursuant to ORS 137.750.
Stat. Auth.: ORS 179.040, 421.500 - 421.512, 423.020, 423.030 & 423.075
Stats. Implemented: ORS 179.040, 421.500-421.512, 423.020, 423.030, 423.075
Hist.: DOC 1-2004(Temp), f. & cert. ef. 1-14-04 thru 6-12-04; DOC 5-2004, f. & cert. ef. 7-12-04; DOC
11-2005, f. 8-19-05, cert. ef. 8-22-05
291-062-0140
Inmate Selection
(1) The department in its discretion may accept eligible inmates into an alternative incarceration
program based on its determination that the inmate's participation in such a program is consistent with
the safety of the community, the welfare of the applicant, the program objectives and the rules of the
department. The superintendent/ designee of each facility that has an alternative incarceration program
shall appoint a committee that will be responsible for making recommendations to the
superintendent/designee on the placement of inmates in the program.
(2) An inmate will not be accepted into an alternative incarceration program unless the inmate submits a
written request to participate.
(a) The request must contain a statement signed by the inmate applicant providing that he/she:
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(A) Is physically and mentally able to withstand the rigors of the program; and
(B) Has reviewed the alternative incarceration program descriptions provided by the department and
agrees to comply with each of the requirements.
(b) Otherwise eligible inmate applicants with a physical and/or mental disability will be evaluated
individually by the department to determine whether they may successfully participate in the
fundamental components of an alternative incarceration program.
(c) The department shall make the final determination regarding an inmate's physical or mental ability to
withstand the rigors of the program.
(3) Inmates who score a four or higher on the Static 99 will be reviewed for program entry on a case-by-
case basis.
Stat. Auth.: ORS 179.040, 421.500 - 421.512, 423.020, 423.030 & 423.075
Stats. Implemented: ORS 179.040, 421.500-421.512, 423.020, 423.030, 423.075
Hist.: DOC 1-2004(Temp), f. & cert. ef. 1-14-04 thru 6-12-04; DOC 5-2004, f. & cert. ef. 7-12-04; DOC
11-2005, f. 8-19-05, cert. ef. 8-22-05
291-062-0150
Removal or Suspension From an Alternative Incarceration Program
(1) The superintendent/designee in his/her discretion may remove or suspend an inmate from any
portion of an alternative incarceration program, and may reassign the inmate to another Department of
Corrections facility to serve the balance of the inmate's court-imposed incarceration term(s), for
administrative or disciplinary reasons. The decision to remove or suspend an inmate from the program
will be made in consultation with a committee appointed by the superintendent/designee that is
responsible to review the performance of inmates participating in an alternative incarceration program.
(2) Administrative Removal/ Suspension:
(a) The superintendent/designee in his/her discretion may immediately remove or suspend an inmate
from the program and reassign the inmate to another Department of Corrections facility without a
hearing, for administrative reasons.
(b) An inmate who is not available to participate substantially in the program (e.g., physical and mental
illness, court appearance(s), disciplinary segregation, etc.) for up to 30 days following placement will
have his/her program participation suspended and be evaluated by the committee to determine whether
the inmate will be removed from the program or accepted back into the program at the program level
deemed appropriate by the superintendent/designee.
(c) Any change in status that would cause an inmate to be ineligible to continue participating in the
program as described in OAR 291-062-0130 (e.g., discovery of a detainer), may result in a suspension.
If suspended, the inmate will have 30 days to resolve his/her eligibility status with the department. If the
inmate's eligibility status remains unresolved, the inmate will be removed from the program.
(d) Inmates are expected to participate in all aspects of their program assignment at a level consistent
with the length of time they have been assigned to the program. The superintendent/designee in his/her
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discretion may suspend an inmate from the program for 30 days or more when, in consultation with the
program performance review committee, the superintendent/designee determines that the inmate is not
making adequate program progress. During the suspension, the inmate will be given an opportunity to
come into compliance with established program standards. If the inmate comes into compliance, he/she
will be placed at a program level deemed appropriate by the superintendent/designee. If the inmate fails
to meet program expectations, he/she may be removed from the program. If the inmate is assigned to an
intensive alternative incarceration addiction program, the inmate may have the length of his/her program
extended beyond 270 days.
(e) Administrative Review of Removal for Administrative Removal:
(A) When the superintendent/designee removes an inmate from the inmate's program assignment for an
administrative removal, the inmate will be notified in writing of the reason(s) for the removal decision,
and the opportunity for administrative review of the decision.
(B) To obtain an administrative review of the removal decision, an inmate must send a request for
administrative review in writing to the Assistant Director for Transitional Services/designee, together
with any supporting documentation. The Assistant Director for Transitional Services/designee must
receive the request within 15 calendar days of the date of the notice of the administrative removal. The
review should be completed within 15 days after receiving an inmate's review request. The Assistant
Director for Transitional Services/designee's decision on administrative review shall be final.
(3) Disciplinary Removal/Suspension: An inmate who after a hearing in accordance with procedures
provided in the department's rule on Prohibited Inmate Conduct and Processing Disciplinary Actions
(OAR 291-105) is found to have committed a major disciplinary rule violation may be removed from
the program and transferred to another Department of Corrections facility at the discretion of the
superintendent/designee.
(4) Voluntary Removal: An inmate may elect to remove himself/herself from an alternative
incarceration program; however, to do so the inmate must sign a document requesting removal from the
program to the superintendent/designee. Voluntary removal from the program constitutes a program
failure.
(5) Once an inmate has been removed from an alternative incarceration program as a program failure,
he/she will be ineligible to participate in another alternative incarceration program during the same
custody cycle. If the failure is from an alternative incarceration addictions program, he/she will be
ineligible to participate in any other alcohol and drug treatment program during the same custody cycle
(this does not include dual diagnosis programs).
Stat. Auth.: ORS 179.040, 421.500 - 421.512, 423.020, 423.030 & 423.075
Stats. Implemented: ORS 179.040, 421.500-421.512, 423.020, 423.030, 423.075
Hist.: DOC 1-2004(Temp), f & cert. ef. 1-14-04 thru 6-12-04; DOC 5-2004, f. & cert. ef. 7-12-04; DOC
11-2005, f. 8-19-05, cert. ef. 8-22-05
291-062-0160
Alternative Incarceration Program Prison Management
(1) To the extent that other Department of Corrections rules may conflict with provisions in these rules
(OAR 291-062-0100 to 291-062-0160, such rules are inapplicable to alternative incarceration programs
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and are modified as provided below to reflect the purposes of alternative incarceration programs and the
relatively short period of confinement.
(2) Modified Rules:
(a) Short-Term Transitional Leave, Emergency Leaves and Supervised Trips (OAR 291-063):
(A) An inmate who completes, to the department's satisfaction, all of the requirements of the structured
institution program may be released into the community on short-term transitional leave. Upon
successfully conforming to directed activities while participating in the short-term transitional leave
component of the program, an inmate shall be released into the community on post-prison supervision.
(B) Because alternative incarceration program participants who successfully complete their program will
effectively receive a reduction in their incarceration terms, they will be held to a higher standard of
behavior on transitional leave than other inmates on short-term transitional leave. Therefore, OAR 291-
063 is modified with respect to alternative incarceration program participants to provide that violations
of transitional leave conditions will be addressed in accordance with Department of Corrections rule on
Structured Intermediate Sanctions, OAR 291-058. Additionally, an inmate's transitional leave agreement
will constitute the Department of Corrections expectations for both behavior and programming
compliance. Accordingly, if an inmate violates his/her conditions of transitional leave, he/she will not be
awarded either institutional conduct or programming compliance credit for the period of time while on
transitional leave status.
(b) Hygiene, Grooming and Sanitation (Inmate) (OAR 291-123) and Personal Property (Inmate) (OAR
291-117): The superintendents in the facilities where alternative incarceration programs are provided
may establish separate and distinct standards for personal grooming and hygiene as a means to support
program goals. Canteen operations and purchases, food services and educational requirements for
participants may be modified by those facilities where alternative incarceration programs are offered as
a means of supporting program goals. Each facility may develop internal processes for staff and inmates
outlining the applicable requirements and/or restrictions specific to these programs.
(c) Performance Recognition and Award System (PRAS) (OAR 291-077): Inmates assigned to an
alternative incarceration program will receive a standard number of points for their PRAS award as
determined by the department for work and program participation. Inmates are eligible for special
recognition awards pursuant to the department's rule on Performance Recognition and Award System.
(d) Mail (Inmate) (OAR 291-131): Inmates participating in the military model of intervention alternative
incarceration program may not be allowed to correspond with inmates participating in the same
program, and/or may not be allowed to correspond with other inmates housed in general population at
the facility where the program is operating.
(e) Prison Term Modification (OAR 291-097): Inmates who begin an alternative incarceration program
will be considered to be participating in their primary program plan. If an inmate fails to complete any
portion of the program because of inadequate program performance, disciplinary reasons, or voluntary
removal, the inmate will be considered noncompliant with his/her primary program plan, and will not be
granted earned time credit for programming during that review period.
(f) Assessment, Assignment, and Supervision of Inmates for Work Assignments and Unfenced
Minimum Housing (OAR 291-082): Inmates participating in the military model of intervention
alternative incarceration program and who are otherwise ineligible for outside work crews and unfenced
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minimum housing may participate in outside work crews after reaching red hat status and reside in an
unfenced minimum housing so long as the victim of their crime does not reside in the area.
Stat. Auth.: ORS 179.040, 421.500 - 421.512, 423.020, 423.030 & 423.075
Stats. Implemented: ORS 179.040, 421.500-421.512, 423.020, 423.030, 423.075
Hist.: DOC 1-2004(Temp), f. & cert. ef. 1-14-04 thru 6-12-04; DOC 5-2004, f. & cert. ef. 7-12-04; DOC
11-2005, f. 8-19-05, cert. ef. 8-22-05
The official copy of an Oregon Administrative Rule is contained in the Administrative Order filed at the Archives Division,
800 Summer St. NE, Salem, Oregon 97310. Any discrepancies with the published version are satisfied in favor of the
Administrative Order. The Oregon Administrative Rules and the Oregon Bulletin are copyrighted by the Oregon Secretary of
State. Terms and Conditions of Use
Alphabetical Index by Agency Name
Numerical Index by OAR Chapter Number
Search the Text of the OARS
uestions about Administrative Rules?
Link to the Oregon Revised Statutes (ORS)
Return to Oregon State Archives Home Page
file:HCADocuments and Settings\brandis\Local Settings\Temporary Internet Files\C Exhibit
Page of
Section 6 - Forms, Dates & Deadlines
Make a co o f your records 109
Oregon State Bar MOLE' 5200 SW Meadows Rd. PO Box and 1689,aLakehOsw goaOR 97035-0889
(503) 620-0222 X368 11 1-800-452-8260 X368
Oregon State Bar Minimum Continuing Legal Education
MCLE Form 2. Group CLE Activity Accreditation A lication
Pursuant to MOLE Rule 4.3, sponsors of Group CLE Activities must apply for accreditation no later than 30
pletion of the CLE activity.
Individual bar members may also apply on their own behalf for accreditation of a Grou CL days after the com-
fee is required. P E Activity by using this form. No
The sponsor fee is $40 for a program of 4 or fewer hours and $75 for a program of more than 4 hours. The sponsor fee for a
series of programs not exceeding 3 hours in 3 consecutive months is $40. A sponsor fee is required for each repeat (live or electron
ic) of the programs. (See MCLE Rule 4.3(c).)
-
Name and address of person or organization applying (Please print. This will be mailin label)
C) ~SCh V p Co~ir1-}v J 1 r A~-fp ~S g ) Applying As (check one):
J ySponsor
r►W Bond St.
❑ Individual Member
C4 D C1 7 -7 01 Bar #
Phone:
r~ y 1 _ 1 _ y Contact Person (Sponsors only): [jt Q~d i
Title of CLE Activity: T 1 I f1
C'-~` rTY1efl 1- r r
Name of CLE Sponsor (if not the applicant): ~~jr0.M S gf1C~ Sep Ien Op4ia~sGa fob
lam. ~t DpG
Phone:
Date(s) and Location(s) of CLE Activity
Date(s) Location(s)
Z1) 3 / Q lp (city/state)
gad, oF,
Number of credits requested:
General 3, 2.v)
Practical Skills
Prof. Resp.: Ethics Child Abuse Re
Delivery TOTAL P Diversity
me hod(s):
faculty in room with participants; ❑ telephone to broadcast site~jscus ❑ interactive video; ❑
❑ videotape presentation; ❑ interactive computer/intern broadcast 6 s ion leader present satellite ❑
~this replay?,/ audiotape presentation;
❑ Yes sat No If yes, please identif
Will this program include the use of written material?ogram producer:
Yes ❑ No (If no, please explain)
Total pages:
Describe sponsor's
Sponsors):
application will not be processed unles
OPY of the s the following are enclosed:
C program agenda showing timelines
Biographical information on the program faculty
po
S°P nY orsor sa Fee mple (15-20 pages) of program's written materials - include ethics portion if ap licable
Sponsor P
Member Signature: .
Date:
Denied
*CLE2
Fee Paid:
MCLE Credits
General:
Ethics:
General or Practi,
Total:
Program No.:
Visit the OSB web site for cunentinfortnation. WWWosbarorg
Exhibit
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The Bulletin I Local & State I Program aids family visitation
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Program aids family visitation
County-owned space provides neutral zone for area children
By Cindy Powers / The Bulletin
Counterclockwise from bottom left, Amy Davidson, Robert
Currie, Jodie Gilbert, Gail Bartley, Janet Huerta and
Samantha McConnell, all employees of Mary's Place, a
visitation and exchange program for parents in high-conflict
divorce or custody cases, discuss business during a meeting
Friday evening in the program's Bend office.
Mary's place
What: Mary's Place, a supervised
child visitation and exchange center
Where: 1130 NW Harriman St., Bend
When: The facility is available from 6
to 9 p.m. Monday, Thursday and
Friday and from noon to 8 p.m. on
Sundays.
Contact: Gail Bartley, program
manager, at 322-7460
Page 1 of 4
Children in Deschutes County whose parents share
custody, but have a contentious relationship, can be
free from heated exchanges during pick-up and drop-
off, thanks to a new program designed to help families
with visitation issues.
Mary's Place, which provides a venue for supervised
visitation and child exchanges between parents in high-
conflict relationships, started offering those services in
late January.
The space that houses Munchkin Manor, a Bend day-care center with brightly colored rooms filled with children's
artwork, is taking on another role in the evenings and on weekends. The county-owned space is available Monday,
Thursday and Friday nights and on Sunday afternoons for visitation and exchanges.
And local judges, while unable to comment on specific cases, say it's a program that has been long-needed in the
community.
"There were many instances in which supervised visitation or supervised exchanges were needed and we had no public
provider," said Deschutes County Circuit Court Judge Alta Brady. Brady acted as a liaison between program planners
and the local judiciary during the two-year planning process.
"What the judges had to resort to were public places where a potentially volatile exchange could tl Exh
http://www.bendbulletin.com/apps/Pbcs.dll/article?AID=/20060306/NEWS0107/603060318/100 Page of _
Anthony Dimaano / The Bulletin
The Bulletin Local & State I Program aids family visitation Page 2 of 4
n
continued. "So we ended up with a McDonald's with a playground or a police parking lot, but there was a concern
about what message that was sending to children."
The solution came in the form of federal grants that funded the planning phase for Mary's Place and will pay for its first
year of operation.
The facility, located in the Des-chutes County Resources Building at 1130 NW Harriman St. in Bend, was named in
homage to Mary Offutt, a Bend resident and consummate volunteer since she moved to town in 1985.
That year, Offutt started her 20-year volunteer career with Central Oregon Battering and Rape Alliance, which has
contracted with Deschutes County to operate Mary's Place.
Offutt is now in her mid-80s and had to stop volunteering last year due to health reasons, according to Janet Huerta,
staff and programs director for the alliance. Huerta also serves as project director for Mary's Place.
"We liked the idea of having a name so the child could say 'I'm going to so-and-so's place' and there would be no
stigma attached with the visitation arrangements," Huerta said.
To ensure safe and smooth transitions, two employees of Mary's Place work with each parent at exchange or visitation
time.
The parents park in separate parking lots, come in different entrances and need not see or hear one another, Huerta said.
Mary's Place staff will then take children from one parent to the other or supervise visitation depending upon the
family's circumstances.
Getting ready
About five years ago, a committee dedicated to family law issues in Deschutes County recognized that a facility for
supervised visitation and exchanges between parents was a high priority, according to Ernest Mazorol, Deschutes
County trial court administrator.
"But budgets had been drastically cut so nothing ever came of it," Mazorol said.
Nonetheless, officials kept discussing the possibility of implementing such a program
"We had a number of folks that came to the table from different perspectives: judges, members of the bar, parole and
probation officers and others so when we decided on how to approach things it would be much more workable because
we had input from various people and agencies," said Deschutes County Circuit Court Judge Michael Sullivan.
They just needed to find a way to pay for it.
In 2003, the county sought federal dollars from The Safe Havens: Supervised Visitation and Safe Exchange Grant
Program. The program provides money to communities to support supervised visitation and exchange of children in
situations involving domestic violence, child abuse, sexual assault or stalking, according to the U.S. Department of
Justice Web site.
Deschutes County received a $135,000 planning grant that funded training sessions and visits to facilities in Oregon
and Duluth, Minn. A number of communities have modeled their programs after the Duluth facility, according to
Huerta.
Local planners used some of the dollars to bring a trainer from Duluth who worked with area batterer intervention
providers, employees of the Deschutes County Victim's Assistance program, probation officers and advocates for
battered women.
Exhibit
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The Bulletin I Local & State I Program aids family visitation
Page 3 of 4
Two part-time facilitators also received training on working with high-conflict divorce and custody issues, as well as
diffusing highly tense situations surrounding visitation and exchanges.
While the local program was originally designed for parents facing court-ordered custody arrangements, planners
decided to offer services to any family experiencing conflict when parents exchange children, said Gail Bartley,
program manager for Mary's Place.
"The court is one way, but say someone is on probation and they have parenting time that needs to be supervised, or
they can't have contact with the other person," Bartley said. "A probation officer could refer them, a private attorney, an
advocate from victims assistance or they could self-refer if they feel they need the services."
Two adult probation officers in Deschutes County supervise about 120 family violence offenders, according to Becky
Wanless, director of Deschutes County Adult Parole and Probation.
"My two (probation officers) tell me that the most volatile times, and most difficulties come up, when exchanges occur
because they are right back there in proximity with a person who they may have abused physically or emotionally,"
Wanless said.
Her department recently got the news that they could refer people to Mary's Place, and probation officers have already
discussed plans to use the program.
"They think they will be referring about 60 percent of their caseload to Mary's Place," she continued. "Now (the
probation officers) have the ability to say to the offender'You have to exchange the child with your former partner at
Mary's Place,"' Wanless said.
Helping families
In September 2005, the county received another $175,000 in Safe Havens grants, giving Mary's Place the capital
needed to open its doors.
After finding office space, establishing separate entrances for parents and installing security cameras and panic buttons
for emergencies, Mary's Place opened for business on Jan. 23. It is one of about 70 Safe Havens programs around the
country.
Deschutes County, which owns the space, has donated it to Mary's Place during its hours of operation, according to
Bartley. Grant money pays for salaries and day-to-day operations.
Mary's Place operates on a sliding-scale fee based upon income, Bartley said, with a cost of $5 to $65 per visit. Victims
of domestic violence are not charged for the services.
"We know that the fees are never going to make up a great portion of the budget," said Huerta. "We've already applied
for another grant to fund the program in the future."
In June of 2005, filing fees for divorces increased in Deschutes County, in part to help fund Mary's Place.
Parents who are referred to the program, or who agree to use it, can expect an estimated hourlong intake interview,
according to Huerta. They must agree to give Mary's Place employees access to all court records, criminal history and
any prior treatment or counseling evaluations.
Both parents must agree to use the service unless they are under court order to participate in supervised exchanges or
visitation. Mary's Place is just one option for families under court order. They also may use private supervision
providers or turn to family and friends, if they can agree on one person.
Exhibit Page rnL2 of.
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3/6/2006
The Bulletin I Local & State I Program aids family visitation Page 4 of 4
Sho::ild they decide to use Mary's Place, Huerta said parents can expect a welcoming experience.
"We do our best to explain why we are doing this, the benefits, the rules and guidelines and get to know people and put
them at ease," Huerta said. "Our job is to take the person from being fixated on the (former partner) and start being
involved with the child, and experience the rewards of that parenting relationship."
So far the program has one family enrolled for monitored exchanges, but Huerta hopes to be able to service up to 60
families in the near future.
"Two weeks ago we went to the judges and said we're ready to start taking on more people," Huerta said.
But the ultimate goal is to transition the family toward positive interaction and help them become independent of
Mary's Place.
"It's not anticipated that a couple using these services will need it forever," said Judge Brady. "What I commonly see is
an initial volatile period that leads to the filing of a divorce petition or restraining order and, often as time goes by,
things will calm down. It really is to provide safety for the children and the parents during a really heated period when
the relationship initially breaks up."
And those who are dedicated to working with these families say the program is essential for those who need it.
"Obviously this is part of the extreme side of things and most people won't need our services," Huerta said. "But for the
people who do need us, we want to be here."
Cindy Powers can be reached at 541-617-7812 or at cpowers@bendbulletin.com.
Exhibit
Page , ' of 3-
http://www.bendbulletin.com/apps/pbcs.dll/article?AID=/20060306/NEWS0IO7/603060318/1001&nav ca... 3/6/2006
Deschutes County Mental Health Department (DCMH)
Deschutes County 2007-2009 Biennial Plan
TO: Board of County Coin missioners
Mental Health, Alcohol & Drug Advisory Board
Commission on Children & Families
Local Public Safety Coordinating Council
Patrick Carey, Manager, DHS Service Delivery Area 10
Action Needed: Endorsement of the 2007-2009 Biennial Plan for submission to the
State of Oregon Office of Mental Health & Addiction Services.
Background
Every two years, each county mental health program in Oregon is required to prepare a "Biennial
Implementation Plan" for submission to the State of Oregon. The plan outlines mental health
and addiction related needs and planned services for the next two years, which coincides with the
Legislature's development of Oregon's next budget. In this case, the 2006 plans are used by
OMHAS in developing policy, funding and program proposals for 2007-2009. Based on the plan
guidelines, much of our developmental disabilities work and our managed care work with
Accountable Behavioral I Iealth are not included in the plan.
The link to the Strategic Plan
The proposed Biennial Plan for Deschutes County is based almost entirely on the 2006-2010
Strategic Plan as adopted by our Deschutes County Mental Health, Alcohol & Drug Advisory
Board. There is no area of inconsistency between the two documents. Two sections, Alcohol &
Drug Prevention (managed through the Deschutes County Commission on Children & Families)
and Gambling Prevention and Treatment (managed through DCMH) are spelled out in greater
detail in the Biennial Plan. Both areas are funded by state grants dedicated to those purposes.
Major areas of interest highlighted in both documents include: (not in priority order)
1. Service to the public in a manner that is consistent with our vision, mission and values
and based on recovery principles as developed in our County.
2. Sustainability of local services and the capacity to respond, in partnership with agency
partners, to increasing needs in a growing community.
3. Outpatient services for children and adults with mental health or addiction issues.
4. Implementation of the Children's System of Care Initiative with local partners, providing
local intensive treatment services for children who are primarily members of the Oregon
Health Plan.
5. Continuation of gambling prevention and treatment services for Central Oregon.
Exhibit E
Page of I 1 l~
6. Continued development of our regional acute care system and services with expansion of
services and treatment options where feasible. Includes linkages to the State Hospital
System.
7. An emphasis on and support of alternatives to incarceration including our Bridge
Program, mental health court and proposed family drug court.
8. Expanding emphasis on evidence-based practice in our services consistent with Oregon
law and our ongoing efforts to deliver effective services.
9. Advocacy for equitable public funding of mental health and addiction prevention and
treatment services throughout Oregon with attention to need and the population to be
served. Current Deschutes County interests include alcohol and other drug treatment
funding, mental health treatment and funding of mental health services for seniors.
10. Health care integration including work with Volunteers in Medicine, the Bend
Community Clinic, school health clinics and other primary care physicians.
11. Culturally competent service to all segments of our community.
12. Ongoing quality improvement efforts and implementation of recommendations contained
in the Department's Audit Action Plan which is based on numerous 2005-06 audits
including mental health, alcohol and other drugs, developmental disabilities and our
business systems.
13. Advancement of our interest in improving and integrating our managed care operations,
both through Accountable Behavioral Health Alliance (mental health) and our department
(Chemical Dependency Organization).
14. Work force development to ensure that practitioners and support staff have the skills and
assistance needed to ef[ectively serve the public.
15. State improvements and efficiencies in practices, regulations and technical assistance.
16. Ongoing departmental improvements in our services to the public and methods of
operation.
Contact: For more information contact Scott Johnson, 322-7502 or
Scott Johnson(a)
Attachment: Biennial Plan Cover Letter to Bob Nikkel, Director, OMHAS
S,Ulental Hcahh`Scon,Repon& & Plan,%MUMBOCC et al incmo 03.06 doc
- -
Exhibit
Page L- of 1I d
February 27, 2006
Mr. Bob Nikkei, Administrator
Office of Mental I lealth & Addiction Services
500 Summer Street NE, E86
Salem, OR 97301-1118
Subject: Cover Letter with Deschutes County Mental Health's 2007-09 Biennial Plan
Dear Bob:
We are enclosing the Deschutes County Mental Health 2007-2009 Biennial Implementation Plan. I am
including this cover letter with additional information on our work in Deschutes County and topics of
interest and concern to our Department and County.
First of all, I want to thank your office and you, personally, for your support and assistance on
several matters that affect our community. The 2005 increase in State indigent acute care resources
(SE 24) has allowed us to form the Central Oregon Acute Care Council and to develop a more
comprehensive approach to acute care services for the benefit of Crook, Jefferson and Deschutes counties.
Sage View recently celebrated its first year anniversary and reported significant successes in helping
residents of the region, including OHP members and indigent adults. The new resources have also
allowed us to expand our targeted case management services for diversion and to begin to limit length of
stay to the minimum necessary for effective service and the use of respite alternatives. Mike Morris has
played a key role in this planning and development effort.
In addition, your leadership in advancing funding formulas that balance state resources to all parts
of Oregon has been very beneficial to residents of our area in need of mental health services. The
2004 implementation of mental health equity increased crisis and adult mental health treatment resources
to our area and, at least over the short term, brought us more in line with other areas of our state. It also
allowed us to reopen on Fridays and return to a full five-day schedule for the first time since 2002. The
announcement of a six-year reallocation of funds for alcohol and drug treatment will also make a
significant, though painfully gradual, difference in our area. It is critical that more work be done to assure
that fast growing areas like Washington County and Central Oregon have adequate investments in the
years ahead.
Exhibit
Page _30f T1(-
Mr. Bob Nikkel, Administrator
February 27, 2006
Page 2
Finally, I want to thank you for your collaboration on a regular basis with the Association of
Oregon County Mental Health Programs (AOCMHP). The Association is an excellent resource to
OMHAS, the Governor's Office and the Oregon Legislature. It is also notable that your office combined
our mental health and alcohol/drug site visits for the first time, which has started a process to look
more efficiently and effectively at our work to help people with co-occurring disorders. Lastly, this
Biennial Plan and those of the other 35 counties should be useful in your early efforts to develop
policy and funding plans for Oregon's Governor and the 2007 Legislative Session.
Concerns and Recommendations:
A timely and rational plan for all State mental health investments needs more attention - Our
County is experiencing an influx of close to 8,000 residents annually. Allocations should be
adjusted annually based on the most recent Portland State University demographic data. We are
particularly concerned in four areas: a) mental health, b) alcohol and drug treatment, c) senior
services and d) indigent acute care services. Progress has been made but more is needed. Most
critical is the need for the 2007 Legislature to begin to invest in alcohol and drug treatment in our
state.
2. Services will decline without further investment - Without additional State investment, we will
reduce our treatment services in 2007-2009. In January 2006, our Oregon Health Plan capitation
declined 16 percent. We will exhaust most of our reserves in the next 36 months, experience an
increase of about 25,000 residents and watch the health insurance costs for our employees rise 12-
15% annually. These patterns assure a drop in services without state and local planning and
investment.
Alternatives to incarceration must expand - Our County Commissioners recently received a
report calling for more than doubling the County's jail bed capacity by 2010. A coin prehensive
public safety plan must also include state support of best practices such as mental health court,
drug court and continuation of our federally funded Bridge Program. Funding of the Bridge
Program should not be eliminated in the fall of 2006. Equally important is that the Governor and
Legislature sustain the 2006-2007 Drug Court treatment funds, offset the 2008-2009 loss of
Federal Byrne grant funds and support projects not funded in the 2006 Criminal Justice
Commission process. At a minimum, it would appear that the State needs to invest $6.5 million
in 2007-2009, more if it intends to support areas not helped in 2006.
4. Transformation of the State hospital must also focus on community systems - Essential work is
now under way to design and develop a new and improved State Hospital. It is critical that this
effort included coinplementary community investments that will allow as many people as
possible to receive humane, effective services in community settings with the support and contact
with family and friends.
Exhibit
Page of no
Mr. Bob Nikkel, Administrator
February 27, 2006
Page 3
Children's services are experiencing a difficult transition - We remain in support of the
Children's System of Care Initiative as called for by the Oregon Legislature. There is great
promise in creating more community-based options for children needing higher levels of mental
health care. We support a move away from residential care and traditional day treatment services
toward more home and school based services. We are hopeful that the State's goal of increasing
the effectiveness of the system and helping more children can be realized. At the same time, this
new reform is taxing, our system and could affect other children's services including mental
health services in our public schools and treatment for victims of child abuse.
6. We hope to resume consideration of a Behavioral Health Organization - Several years ago our
County and Accountable Behavioral Health Alliance sought development of a BHO, merging our
mental health managed care work with chemical dependency managed care work for Oregon
Health Plan members. We are hoping to revisit this goal and develop a BHO in the next 2-4
years. We are asking for your assistance in developing a BHO_in the hope that it will benefit
OHP residents in our County and possibly our region.
7. A review and consolidation of the OARS and revamped site visit process arc necessary - We
recently completed certification processes for mental health and alcohol/drug treatment. The
OMHAS plan to review all relevant OARS to simplify and reduce redundancy and confusion will
be very beneficial. In addition, it would be beneficial to develop sample treatment forms and
clear standards or review tools to help local programs be efficient, effective and accountable and
to improve the site visit process.
In closing, we are very appreciative of your work and that of the Office of Mental I lealth & Addiction
Services on behalf of residents of Central Oregon and our entire state. We are hopeful you will consider
these concerns and recommendations as well as the material in all County Biennial Plans as you prepare
for the next biennium and the future of our mental health system in Oregon. We look forward to working
with you in this process.
Sincerely,
Scott Johnson, Director
Deschutes County Mental Health Department
SNMemal HealWScoMRepuns R Plansl?0W1Biennial Plan 07-09 Nikkei Cover.doc
Enclosure
cc: Deschutes County Commissioners Clarno, Daly, Luke
Central Oregon legislators Sen. Westlund, Rep. Burley, Rep. Whisnant
Exhibit
Page of
DESCHUTES COUNTY
MENTAL HEALTH
2007-2009 BIENNIAL IMPLEMENTATION PLAN
Table of Contents
Page
Licensure/Approval
County Planning Process
Cultural Competency and Service to Minority Populations
3
Current Linkages to State Hospital System & Mental Health Acute Care Providers
3
Update to 2005-2007 Plan
4
Nigh Priority Needs
4
Child & Family Mental Health
5
Adult Mental Health
6
Justice System Interface-Alternatives to Incarceration
7
Older Adult Mental Health
9
Alcohol, Other Drug Prevention
10
Alcohol, Other Drug Treatment
10
Problem Gambling Services
1 I
Description Of How Deschutes County Will Allocate And Use OMHAS Resources
11
Allocation Changes and Rationale
12
Proposed Funding Allocations
12
Prevention Plan
13
Gambling Services Plan
17
Children's Mental Health Services Plan
20
Older Adult Mental I lealth Services
20
Attachments
Deschutes County Contact Information
22
1
List of Subcontracted Services
24
2
Board of County Commissioner Review and Approval
25
3-4
Mental Ilealth, Alcohol & Drug Advisory Board Review and Comments
(Combined MH Advisory Board and LAPDC)
26
5
Commission on Children & Families Review and Comments
27
6
County Funds Maintanance of Effort Assurance
28
7
Planned Expenditures of Matching Funds and Carryover Funds
29
8
Review and Comments by the Local SDA Manager, DHS
30
9
Review and Comments by the Local Public Safety Coordinating Council
31
10
Prevention Strategy Sheet
32
Attachments (Additional):
I 1 Referral Proces for ICTS/Wrap-Around Services 33
Deschutes County Mental Health Strategic Plan, 2006-2009
Exhibit E
Page L of I ! b
GENERAL GUIDELINES
1. Licensure/Approval
Deschutes County Mental Health (DCM1I) is certified by the State of Oregon Office of Mental l lealth
and Addiction Services. The current Certificate of Approval for mental health services is valid until
June 9, 2008. The current Certificate of Approval for children's ICES services is valid until
September 28, 2006. A new Letter of Approval for adult alcohol and drug treatment services is
forthcoming and will be valid until June 2008'. We are working with OMHAS staff at the present
time for a Letter of Approval for adolescent treatment services.
2. Minority Services
As noted in the 2005-2007 Biennial Plan, DCMH will seek to maintain alcohol and drug treatment for
ethnic and minority services. We remain on record and actively engaged in the advocacy for
equitable investment in addiction treatment services in Oregon. If and when that issue is addressed,
Deschutes County will be better equipped to expand our capacity and serve priority populations
through our own services and investment in groups such as BestCare Treatment Services, Serenity
Lane, Rimrock Trails, and Pfeifer & Associates. While we recognize more work is needed in this
area, we will struggle to make the improvements that are needed without resources. At a minimum,
we will actively work to attract qualified bilingual/bicultural staff over the next several years as called
for in our Strategic Plan. Any assistance possible from OMIIAS and higher education institutions to
recruit and train qualified professionals will be greatly appreciated.
STANDARD PLAN REQUIREMENTS
1. County Contact Information
See attached County Contact Information form (page 22)
2. County Planning Process
2001-2010 Comprehensive Community Plan --Deschutes County's social service system has a rich
tradition of collaborative and integrated planning and program development efforts between local
agencies, systems and community members. This work is ongoing and occurs within the frame-
work of the comprehensive 2001-2010 Deschutes County Community Plan (available online at:
www.co.deschutes.or.us/index.cfm?objectid=AFF64ADB-9027-D5E6-3D8B8495EAFOB032, pages
31 [AOD] and 34 [MH]) compiled by the Deschutes County Commission on Children & Families
(CCF). Sections of that plan, including those related to mental health and addiction, arc prepared and
incorporated by the logical service, planning and advocacy groups. DCMH and our local (and
integrated) Mental Ilealth, Alcohol & Drug Advisory Board contributed to numerous sections and
had primary responsibility for the mental health and chemical dependency sections of the plan. CCF
also publishes a Report Card every three years reporting to the community on our progress on critical
priorities in the Community Plan.
2006-2009 County Strategic Plan, Deschutes County Mental Ilealth-In the fall of 2004, the
Deschutes County Mental Health, Alcohol & Drug Advisory Board commissioned a Strategic
Planning Committee composed of Advisory Board members, County officials and the DCMH
Final site visit and all corrective actions completed 2/23 with assUrance a new Letter of Approval would be
provided in the very near future.
Deschutes County Mental Health
Page I
2007-2009 Biennial Implementation Plan
Exhibit E
Page -1 of (b
Management Team to develop a four-year Strategic Plan to establish a financial plan and priorities for
the next several years. Information was solicited from numerous groups, both formally and
informally, in the preparation of this document. Previous biennial plans were also used to provide
context and continuity, where warranted. We also formed work groups specifically around Evidence
Based Practice (Strategic Plan, page 46) and Professional Development (Strategic Plan, page 55).
The Strategic Plan was completed in two phases. Phase one was approved by the County
Commissioners in December, 2004. It included a three-year financial plan and an approved staffing
plan that allowed us to increase our access and reopen for services on Fridays. The Department had
reduced staffing levels and days of operation in 2002. Phase Two is included as an attachment to the
Biennial Plan. It was adopted by our Advisory Board in October, 2005, and presented to the
Commissioners for their consideration in January, 2006. The Plan is cited and cross-referenced in a
number of places in this Biennial Plan.
Consumers and Family Members--There are a number of consumers, family advocates and
representatives of NAMI of Central Oregon on our Advisory Board. These individuals were involved
in the development, review and approval of our Strategic Plan. As a result of a recent Mental Health
OMIIAS audit, new appointments to the Advisory Board (January, 2006) have improved
representation by family members with children who need or have received mental health services in
the community.
2007-2009 State Biennial Implementation Plan--This document is a synopsis of ongoing and recent
developments and priorities for our County and the people we serve. Since the Strategic Plan was
completed over the past 15 months, much of that material and priorities is referenced and reflected in
this submittal. The Strategic Plan will continue to be the primary document used to measure our
progress and assist us in prioritizing resources and program development activities. The Department
and our Advisory Board will review and update the Strategic Plan on an annual basis.
MHO Business Plan-Also during 2005, Deschutes County completed an in-depth review of our
participation in ABHA, our five-county managed care mental health organization. The project
resulted in two reports (available upon request). At the conclusion of this planning, the Deschutes
County Commissioners made a decision to remain with ABHA but seek fundamental changes and
improvements in ABHA's operation, with the primary intent of improving services to OHP members
in Central Oregon and administrative support to related providers and jurisdictions. OMHAS staff
provided support and technical assistance to this project.
Professional Advisory Council and Other Stakeholder Groups-By statute, Deschutes County has a
Council composed of more than 20 essential community providers to advise the Commission on
Children & Families (organizer of the Community Plan) and to help coordinate and improve the local
service delivery system. DCMH participates on the Council. DCMH also works closely with many
groups in planning and service coordination. Examples include:
Addiction treatment providers'-
BcstCare Treatment Services and Jefferson County (regional matters)
Cascade Healthcare Community
Consumers and family members
Commission on Children & Families
Local Developmental Disabilities Planning Committee
Juvenile Department
z I3estCare, Pfcifer& Associates, Serenity Lane, Rimrock Trails
Deschutes County Mental Health 2007-2009 Biennial Implementation Plan
Page 2
Exhibit E
Page_ of 1~_
KIDS Center (child abuse assessment and intervention)
Local Public Safety Coordinating Council/public safety officials
Lutheran Community Services Northwest and Crook County (regional matters)
Mental Health, Alcohol & Drug Advisory Board
School districts' and the High Desert Education Service District
Seniors and People with Disabilities
Service Delivery 10 Manager (Patrick Carey) and staff
Cultural Competency and Service to Minority Populations
DCMH currently houses El Programa de Ayuda at our main clinic in Bend. This small organization
is making an effort to serve the Latino community, a growing segment of our community. Our goal is
to increase.our work with this group and identify ways to improve our services and accessibility.to
minority populations. Strategic Plan references follow:
"Increase the public's access to services and the quality of our services for County residents
who face language or cultural barriers.
1) Bilingual staff-Develop a bilingual (Spanish speaking staff) capacity within all
department programs, including reception staff. Long-term goal, resources may be
required.
2) Coordination with El Programa do Ayuda-House this agency to better serve the
Spanish-speaking community. Request assistance and guidance.
3) Translation of Materials-Complete translation of all print and web information into
Spanish.
4) Poverty issues-Training for staff in understanding the impact of poverty."
3. Current Linkages to State Hospital System & Mental Health Acute Care Providers
We are fully committed to a high level of coordination between Deschutes County Mental Health and
acute care services for consumers who are residents of Deschutes County, particularly for indigent
clients and members of the Oregon Health Plan.
New Central Oregon Acute Care Council-The Council was formed in 2005 to help develop and
support an expanding regional acute care system for the benefit of residents of Crook, Deschutes and
Jefferson counties. The Council includes representatives from Cascade Healthcare Community,
OMHAS, ABHA, the three CMHPs, NAMI, a local public safety official and other community
representatives. This group also oversees use of our SE 24 resources to assist indigent mental health
consumers needing help in Central Oregon.
Sage View-This Bend sub acute residential facility for adults needing stabili7.ation and short-term
treatment for mental health issues was opened in February, 2005, by Cascade Healthcare Community,
our largest hospital system in Central Oregon.
Central Oregon Hold Rooms-Deschutes County residents benefit primarily from expanded hold
room capacity in Bend at St. Charles Medical Center (February, 2006, expansion from two beds to
five beds) and from a transport hold room at the system's Redmond hospital. In bend, consumers
with acute mental health needs are placed in St. Charles. Once stabilized, transfer to Sage View will
occur.
'Bend-La Pine School District, Redmond School District, Sisters School District
Deschutes County Mental Health
Page 3
2007-2009 Biennial Implementation Plan
Exhibit--E.__
Page _ of
l 1 r~
Blue Mountain Recovery Center and Other Out of Area Facilities-Central Oregon counties continue
to access Blue Mountain on a limited basis. DCMH staff work with Blue Mountain in the areas of
consumer intake and discharge planning. Staff conducts phone conferences with Blue Mountain
medical and social work staff in order to assure that hospital treatment and discharge planning are is
well coordinated. In receiving additional SE 24 resources in 2006, the Central Oregon system is
making every effort to reduce our use of Blue Mountain acute care services by 50 percent. Additional
data is needed from OMHAS on prior utilization to help us determine our success in reaching this
shared objective.
Utilization Management Improvements-The Central Oregon region has a utilization manager hired
by ABI1`A as our shared mental health organization. The manager oversees, authorizes and helps
coordinate services, admissions and discharges for indigent and OHP consumers at any acute or sub
acute facility serving our consumers. DCMH staff are actively involved in this process as well,
including care coordination and transition planning.
Other Services and Changes Since 2005-2007-Regrettably, development of Sage View also
necessitated the loss of Park Place in 2004. While the general system has seen notable improvements,
the loss of this lower level of care is missed. We are currently developing other step-down and
respite options as well as intensive case management support for certain acute care clientele.
A note of caution: Indigent resources provided through OMHAS, while increased, may still be
inadequate to meet acute care needs in our region over the next several years. Our three-year
investment plan for these resources is not sustainable, requiring selection of our more effective
strategies or additional investment by the State of Oregon at levels comparable to some other parts of
the state.
Update to 2005-2007 County Plan
4. Iligh Priority Needs
• General-The Strategic Plan, page 13, provides an analysis of environmental trends and
challenges facing DCMH and our community. They arc numerous. Many are difficult to address
given our limited resources and the demands for our services. See also a "SWOT" analysis on
page 16 of the Strategic Plan documenting our strengths, weaknesses (internal), opportunities,
and threats (external).
1. Acute care resources/indi ent-The added investment in 2005 was essential but still falls
short of the level of support in some other parts of Oregon. The current program and
financial plan for Central Oregon is not sustainable without additional investment.
2. Audit relief and technical assistance-Recent certification processes for mental health and
adult alcohol and drug treatment expire in 2008. It is hoped that OMHAS will be successful
in consolidating and streamlining the administrative rules by 2008. We are also interested in
state authorized treatment forms that are efficient and effective to use in the treatment process
and clear tools to prepare for the site visit process.
3. Evidence based practice (Strategic Plan, page 46) --Ability to sustain and build on current
EBP efforts. Given the progress that has been made by our Department in recent years, it is
most important to continue to the development of work on efforts such as DBT, Assertive
Community Treatment, treatment of co-occurring disorders, development of our mental
Deschutes County Mental Health 2007-2009 Biennial Implementation Plan
Page 4
Exhibit=
Page ~t~ Of
health court, supported housing, supported employment and consumer run clubhouse model.
With state support, development of a Family Drug Court will also take form in July, 2006.
4. I-Told rooms in the region-Cascade Healthcare Community is expanding hold room capacity
in Bend in 2006. At the same time, the availability of beds is uncertain at best in Redmond,
Prineville and Madras.
Measuring results (Strategic Plan, page 52)-Deschutes County is instituting a performance
measure system to better document and report on the effectiveness and benefit of our public
services. In addition, printed inserts are appearing throughout the year to report on the results
of the social services provided through Deschutes County. We would welcome any State
effort to compare and contrast county services with those available in other parts of Oregon,
particularly if it can include technical assistance to improve our performance in any service
that may be lagging behind other areas of our state.
6. Professional development and sustaining a skilled work force (Strategic Plan, page 55)--This
report is part of our continuing efforts to train and sustain a capable work force at DCMH.
Electronic Medical Records-"The Strategic Plan calls for the development of EMR over the
next several years. "In cooperation with Information Technology, form a work group to
study the feasibility of acquiring and using a new electronic system for medical records.
Develop findings and recommendations including a preferred package, financing and
transition plan. Emphasize case for clinicians and utility for treatment, planning and billing.
Acquire a system by 2007-08."
• Child & Family Mental Health (Strategic Plan, page 27)
1. Alcohol and Other Drug (AOD) Certification-Reinstatement of AOD Letter of Approval to
assure AOD services are available as needed for OHP members and indigent clients. We will
be engaged in this process during Spring, 2006, and need a letter by July, 2006.
2. Schools-Sufficient funding to assure mental health and addiction services are available in
Deschutes County schools at least one day per week. Currently, availability is declining and
the number of public schools continues to increase due to population growth.
3. System Balance-Continuing effort to assure community-based outpatient services at a level
that will limit wait list, assure we meet a growing community need and reduce the need for
higher cost residential and hospital placements in the coming years.
4. CSCI-PRTS and ICTS resources sufficient to finance service needs of Levels 4, 5, and 6.
Development of a realistic wrap-around model and care coordinator role given limited
resources. Resources for care coordination as currently practiced are inadequate to be
sustainable beyond June, 2007, primarily for Level 4 clients.
5. CSCI Providers and-, Services-Financially viable providers (i.e., primarily Cascade Child
Center and Trillium Family Services of Central Oregon) capable of offering ICTS services.
We remain active in partnership with "Trillium, Crook and Jefferson counties, and ABHA in
trying to sustain a small PRTS program in Central Oregon.
6. Services to victims of abuse and neglect-Continuation of treatment services at the KIDS
Center at a level that will limit wait list and assure help for victims of abuse.
Deschutes County Mental Ilealth 2007-2009 Biennial Implementation Plan
Page 5
Exhibit E,
Page i_ of~
• Adult Mental Health (Strategic Plan, page 29)
1. Community Support-Sustain case management and treatment for clients with a serious
mental illness. Operate within a framework of Assertive Community Treatment and
Strengths Based Case Management capable of providing frequent contact with highest need
clients, outreach, support, case management and treatment services.
Acute Care-Work to create and sustain an effective system of acute care and intensive
service options for adults experiencing significant emotional distress. Resources-
Effectively invest new State funding to develop essential acute care, case management and
respite services. Continue to advocate for an equitable share of State funds for acute care.
Regional Council and System-Participate actively in the development of a high-quality
regional system of care. Develop and sustain service options including Sage View (including
access for indigent individuals and OHP members), actively manage inpatient costs and
resources, and monitor services and cost trends. Oregon State Hospital and Blue Mountain
Recovery Center-Represent the interests of Central Oregon in planning for changes at the
State Hospital and downsizing of acute care at Blue Mountain Recovery Center. Utilization
Managerent-Dedicate staff time (through our managed care organization) to care and
resource management for 014P and indigent clients. Routinely track services and funds and
review exceptional cases to assure we are managing risk and making the best possible use of
available resources.
Outpatient Treatment-Address access for mental health, addictions and gambling treatment.
Assure that clients meeting service priorities are seen in a timely fashion and decrease no-
show rates. Expand services in Redmond and La Pine. Continue to support and develop the
Dialectic Behavioral Therapy program for high-need clients. Continue to support a brief
treatment model for appropriate clients. Maintain a utilization management process to assure
clients get the appropriate level of care and assist clinicians to manage caseloads with
increasing demands for services.
4. Groups-Continue to support and expand group treatment services and move toward more
targeted focus. Identify target populations and diagnoses that are best treated by group
services and increase the use of evidence based practice models.
5. Employment (Supported)-In cooperation with clients, local employers, and the State
Department of Vocational Rehabilitation, increase our capability and capacity to offer
supported employment opportunities to people with mental illness.
6. Housing (Supported)-Develop additional partnership(s) with CORHA to create short-term
or permanent housing units in Redmond and Bend for people with mental illness. Seek
County or City assistance in securing land for acquisition and grant funds for construction.
Dedicate sufficient department staff to provide necessary case management and support
services.
Medication Mana ement-Monitor available resources for access to prescriber appointments
and evaluate the need to allocate additional resources to this service. Continue to explore the
most effective and efficient use of these limited resources and expand alternative methods of
service delivery such as group medication management. Increase coordination with primary
care providers for ongoing medication management. Expand use of evidence based practices
within accepted department prescribing practices such as use of medication algorithms and
standardized assessment/documentation formats. New resources may be needed.
Deschutes County Mental IIealth
Page 6
2007-2009 Biennial Implementation Plan
Exhibit el
Page ~2 of lIB
• Justice System Interface-Alternatives to Incarceration (.Strategic Plan, page 32)
1. Alternatives to incarceration-Develop a lasting and formal partnership through the Local
Public Safety Coordinating Council to address the criminalization of the mentally ill and to
plan and carry out core strategies and programs. Emphasize a systems approach to
improvements in programs, services and practices used to address the issues associated with
mental illness and addictions.
2. Diversion In Lieu of Booking
• Crisis and Intensive aitreach-Reduce unnecessary hospitalizations and incarceration
through prevention and early intervention. Sustain the County's Community Assessment
(Crisis) Team for assessment and crisis intervention and the Community Support
Services Team for intensive wrap-around services to high-need clients (includes
treatment and connection to programs and supports).
• Coordination and Referral to Hospital-Work closely with Cascade Healthcare
Community and other hospital systems to assure appropriate referrals and coordination of
services. Increase justice system awareness of hospital roles, services and capacities.
• Sage View—-Assure successful operation and availability of this secure (short-term) crisis
stabilization and treatment center for eligible individuals including OHP members and
indigent individuals.
• Hold Rooms at St. Clharles Medical Center-Expand access to short-term stays at the
hospital for assessment and stabilization.
3. Jail Bridge Pro ram-Sustain and expand services to adults with co-occurring disorders
within the jail and the community corrections system in Deschutes County. Goals include
reducing recidivism and improving functioning in the community through housing and job
assistance, treatment, medication management and other community supports.
4. Crisis Intervention Training (CIT)-Over the next two years and in cooperation with local
law enforcement agencies and the local chapter of NAMI, develop and implement CTT as an
evidence based practice which increases the ability of first responders to work with people
with mental health or addiction issues. NAMI is launching a nationwide campaign in support
of this training. Establish a method to assure ongoing training for new employees. Include a
train-the-trainer approach with law enforcement, jail and mental health professionals.
Coordinate project with Sheriff and Police Chief.
5. Family Drug Court and Dngg Court-in partnership with the courts and treatment providers,
provide County leadership to help secure treatment resources to develop and implement a
comprehensive family drug court. Develop a work group to design the court process and
referral system. Coordination to occur through the Circuit Court.
• Family Drug Court-Prioritize families with minor children. Reestablish a work group
to begin operational planning to begin a Family Drug Court in 2006. Treatment
resources must be secured through pending federal grant applications, the meth initiative
of the 2005 Oregon legislature (through the Criminal Justice Commission), and/or
Deschutes County Mental Health
Page 7
2007-2009 Biennial Implementation Plan
Exhibit E
Page 13 of 116
Oregon Health Plan funds where applicable. Pilot program size: 10 families (estimate)
with one assigned judge.
• Evaluation-Conduct an evaluation of Family Drug Court to determine benefit and
opportunities for improvement and/or expansion.
• Expansion Long-Term-Expand the Family Drug Court to serve appropriate individuals
in need of addiction treatment. Decision on whether to focus expansion on a juvenile
court or adult court would occur at a later date.
6. Mental Health Court.-With courts and program partners, sustain and expand this deterred
sentencing program as an effective treatment alternative for County residents with a mental
illness who commit (primarily) non-person misdemeanors. Deschutes County Mental Health
services: assessment, treatment, case consultation.
7. Jail Services-Services performed by jail staff include assessment, medication and
stabilization, particularly of seriously and persistently mentally ill population. Challenges:
cost of medication. County mental health is available for after-hours, crisis assistance.
Needed hospitalizations are accomplished cooperatively between jail and mental health staff.
Juvenile Services--(This section was provided by Juvenile Community Justice). The use of
secure detention'for young people between the ages of 12 and 17 is a serious tool for ensuring
public safety and youth accountability, not undertaken lightly and strictly outlined within
Oregon statute. Any detention decision is the result of serious contemplation and often
consultation between the various amts of the juvenile justice system and is always ultimately
monitored and approved by the Court.
Sex Offending Youth Offenders-We have anecdotal and increasing empirical evidence
that post-adjudicatory youth with sex offending charges are sometimes held for long
periods of time in detention, without benefit of treatment, due to long waiting lists at non
close-custody residential treatment facilities and lack of local resources to treat this
population. We aim to avoid this use of detention and increasingly are looking at
developing resources to create a local/regional residential treatment program with
appropriate safety, treatment and transition/reintegration elements.
Youth Offenders With Serious Mental Health Issues and Substance Abuse We have
anecdotal and increasing empirical evidence that youth with serious mental health issues
and substance abuse challenges in need of residential/inpatient treatment are sometimes
held for long periods of time in detention, without benefit of treatment, due to long
waiting periods and lack of local resources. We aim to avoid this use of detention and
advocate for development of local and other group and individual transition homes for
youth offenders with mental health disorders who are facing setbacks in existing mental
health treatment/residential placements, waiting for placements and reintegrating home
from placements.
9. Supervised Housing-As recommended by Adult Parole & Probation, seek resources to
develop and offer transitional, supervised housing for people with mental illness who are
diverted from the justice system or are seeking to re-enter the community. The goal is to
offer safe, stable housing for clients and to prevent recidivism. This need became more
apparent with the 2004 closure of Park Place.
Deschutes County Mental Health
Page 8
2007-2009 Biennial Implementation Plan
Exhibit F_
Page of O
10. Psychiatric Security Review Board (PSRB)
Greater Awareness-Seek State assistance in training jail staff and others on the PSRB
process and guidelines, clarify process to differentiate mental illness issues from criminal
acts, and the County's role in revocations. Establish a method to better inform jail staff of
PSRB individuals residing in Deschutes County. Note: Deschutes County has 12
individuals under PSRB supervision (September, 2005) including seven adults in foster
care and five others living in the community.
Aid and Assist-Expedite the aid and assist process for PSRB clients to reduce
unnecessary jail days awaiting processing. Arrange training for assistant district
attorneys and defense attorneys on PSRB and the aid and assist process.
11. Addictions Treatment-Long term, work to expand alcohol and other drug treatment services
for people involved in the justice system.
• Older Adult Mental Health (Strategic Plan, page 30)
1. State Funding Advocate for the restoration of State funds for mental health services for
seniors (progress made). In addition to the restoration, work toward an allocation of
additional State funds (comparable to other counties with senior programs) based on need and
a commitment to support high-quality programs for this population.
2. Senate Bill 781 Implementation (2005 lcgis<ation~--ln recognition of the passage of this new
Oregon law, participate in State efforts to implement the law and increase state and local
programming for seniors.
3. Enhanced Care Outreach Services-Expand the Enhanced Care Outreach Services program
by increasing the number of clients served. This expansion would allow for additional staff
hours which would ensure more individualized services to clients and better distribution of
staff hours over the seven days a week the program operates.
4. Training-Expand the array and quantity of mental health services available to seniors by
increasing staff skills in providing more group work.
Service Expansion-Develop a new project that uses a coordinator to recruit, train and
supervise volunteers and student interns. Many of the clients could benefit from more
frequent contact with friendly visitors along with their other mental health treatment.
6. Expand Service Locations-Explore opportunities for co-locating services in senior centers
or medical settings whcre clients might be more comfortable receiving services.
7. Addition to Strategic Plan: Increase Staff Capacity-Any ability to close the gap between
the need for treatment and support services for seniors with mental illnesses and our current
capacity (quantified as 2 FTE QMHP and 1 FTE QMHA).
Deschutes County Mental Health 2007-2009 Biennial Implementation Plan
Page 9
Exhibit E
Page - k of ~Q
• Alcohol, Other Drug Prevention-Deschutes County remains committed to a comprehensive
Prevention Office through the Deschutes County Commission on Children & Families. For
information on our high priority AOD needs, contact Robin Marshall, Deschutes County's
Prevention Coordinator at 541-3224802 or robin_marshall@co.deschutes.or.us.
Alcohol, Other Drug Treatment (Strategic Plan, page 30)-Developed in cooperation with
Deschutes County's treatment providers including Best Care, Serenity Lane and Pfeiffer and
Associates.
Establish Guiding Principles-a) Collaboration-Our community is best served through
collaboration, a common focus and mutual support between Deschutes County Mental
Health, other County departments, and private prevention and treatment agencies and
coalitions. b) Investment-'T'reatment resources available to Deschutes County should he
invested in a manner that assures the maximum amount of high-quality services. c) Results-
Services must be based on evidence based practices and consistently report measurable
outcomes that demonstrate effectiveness.
2. Comprehensive Approach-Work with the community to develop a system with a full
continuum of services to prevent substance abuse and to assure access and engagement of
those in need of addictions treatment. Resources needed.
Co-Occurring Disorders-Retain primary responsibility for the treatment of co-occurring
mental illness and addiction issues by Department clinicians. Assure qualified, well trained
professionals are offering these services.
4. Equity-Advocate with the State for a fair and equitable investment of treatment resources
for Oregon residents, regardless of their county of residence. Eliminate current inequities that
exacerbate social problems in our community through an inadequate level of treatment
services for County residents. Resources needed.
5. Family Drug Court-In partnership with the courts, provide leadership in securing treatment
resources to develop and implement a family drug court. Offer treatment of co-occurring
disorders directly by Department staff while using one or more private agencies for the
delivery of chemical dependency treatment.
6. County Leadership---Convene treatment professionals at least quarterly to address planning,
advocacy, service coordination and program development priorities and issues. Promote and
bring visibility to chemical dependency issues.
7. Methamphetamine Coordinated Response-Participate actively in the Meth Action Coalition,
supporting a comprehensive approach focused on prevention, treatment and public safety.
Seek resources to expand treatment. Resources needed.
8. Oregon Health Plan Members-Assure
treatment services to Oregon Health Plan
Chemical Dependency Organization.
availability of timely, high-quality addiction
members through operation of the County's
9. Prevention-Support the substance abuse
Commission on Children & Families (CCF).
by CCF. Support evidence based projects
prevention work of the Deschutes County
Invest public funds through projects sponsored
that reduce at-risk youth behavior and support
Deschutes County Mental Health 2007-2009 Biennial Tinpleinentation Plan
Page 10
Exhibit
Page 1~_ of
healthy family functioning. a) Increase partnerships with treatment providers. b) Reduce
adolescent alcohol use in Deschutes County. c) Conduct analysis of beer and wine tax money
distributed in Deschutes County. d) As able, reinvest funds from the Chemical Dependency
Organization in projects that prevent substance abuse.
10. Priority Populations-For the foreseeable future, the Department will focus its limited
treatment resources by prioritizing service to specific groups in our community. a) Youth-In
an effort to stem the spread of substance abuse in our community, we will focus on the
prevention and treatment of adolescent alcohol use. b) Adults-Focus on four populations:
OHP members, families with minor children (child welfare concerns), people with a
methamphetamine addiction, and/or individuals in the justice system (effective alternatives to
incarceration and opportunities to prevent recidivism). c) As restricted resources become
available, other populations in our community will receive assistance within those grant
guidelines.
• Problem Gambling Services
1. Sustaining current efforts in outlying areas-An ability to sustain our planned expansion of
prevention and on-site problem gambling treatment services in Jefferson and Crook counties.
The service expansion is scheduled for spring of 2006.
5. Description of How Deschutes County Will Allocate And Use OMHAS Resources
The following information is preliminary, subject to County Budget processes scheduled for the
spring of 2006, 2007 and 2008. The nature of the County process and the work of the Mental Health,
Alcohol and Drug Advisory Board are such that changes may occur in amount or use of County
General Fund Resources which could in turn affect our deployment of OMHAS resources and
priorities.
Reductions, adjustments and limitations--Ve are mindful of the reported Department of Human
Services shortfall of $172 million and any potential loss of resources to our services or those of our
community partners that might occur as a result. In addition, in January 2006, we experienced a 16%
reduction in our OHP outpatient capitation which reduces our service levels (primarily due to an
impact on personnel). This will necessitate a greater focus on our encounters, assuring the accuracy
of our service cost rates, and potentially a reduction in service capacity to indigent clientele or the
variety or degree of offerings to members of the Oregon Health Plan. Lastly, increases in costs
associated with health insurance for our employees, PERS, and County support services will affect
our service levels.
Allocation and Use of Resources-Resources will be allocated within the SE requirements and
limitations coupled with the priorities in our Strategic Plan. No significant changes have been
planned and scheduled for implementation thus far. It is difficult to determine if any will be on the
horizon in 2007-2009.
Evidence based practices-DCMH has already employed many evidence based programs and
practices in our work as documented in the Strategic Plan, page 46. This is an essential part of our
continuing efforts as evidenced currently in our work to develop a Family Drug Court in Deschutes
County with AOD treatment elements heavily influenced by EBP. Similarly, we are initiating a new
County group, chaired by a County Commissioner, to look at EBP Alternatives to Incarceration to
complement plumed jail expansion in our County.
Deschutes County Mental Health
Page I I
2007-2009 Biennial Implementation Plan
Exhibit E
Page of 1/0
Two DCMH Program Managers have been assigned responsibility for monitoring our progress in this
area and assuring we are giving it full attention. DCMH intends to remain in full compliance with the
intent of SB 267 to the best of our ability and within our financial resource limitations and the unique
characteri sties of our community.
Allocation Chantses And Rationale
SE 22, Child and Adolescent Mll Services-Historically, DCMH Child & family Program
personnel have been deployed primarily in two clinic settings, at the KIDS Center and in
numerous public schools. As of April 2006, we will have a limited, part-time presence in 20
schools. We are currently meeting with the school districts to determine how we should approach
the 2006-2007 school year. It is even less certain how and to what degree this work will continue
during the 2007-2009 Plan years. County funds were used (on a one-time basis) to supplement
state dollars in 2005-2006; it is unclear if that will continue in 2006-2007. We remain confident
that school-based services help assure integration and increase access to services. Unfortunately,
the loss of federal dollars (from prior years), the limited State and 01IP funds and the increase in
the number of public schools (due to growth) will make it difficult to sustain our current efforts.
SE 24, Regional Acute Care Inpatient-These resources are managed through Deschutes County
but benefit Jefferson, Crook and Deschutes counties in consultation with the Central Oregon
Acute Care Council. A significant segment of these resources will continue to be dedicated to
Sage View. We are also working with the Council and OMHAS staff to identify other staff
options, diversion opportunities and step-down services that might be available and
complementary of Sage View. This work is continuing. It is important to note that the level of
S1 24 funding does not make all current and planned investments sustainable. It is critical that
additional dollars be made available in the next 2-3 years, or some program investments will have
to be reduced or eliminated.
Subcontractors-There are no immediate plans for any changes in subcontractors although work is
underway to add a Child Psychiatrist (part time) position to our Child & Family team.
6. Proposed Funding Allocations
FINANCIAL ASSI
STANCE AWARD
SERVICE ELEMENT
REPORT 1-A
REPORT 1-B
TOTAL
1 Local administration health sv
289,968
289,968
20 Nonresidential adult MH serv
832,162
122,351
954,513
22 Child & adoles MH services
331,627
114,562
446,190
24 Regional acute psych inpatient
846,819
846,819
25 Comm crisis--adult & child
584,866
584,866
28 Residential Treatment Services
993,405
993,405
30 PSRB tinnt & supervision
81,023
81,023
31 Enhanced care services -
297,708
297,708
34 Adult foster care MHS
494,966
494,966
35 Older/disabled adult MH svcs
17,550
17,550
36 PASARR MHS
_
_ _
18,802
18,802
39 CSS Homeless
_ 48,625
-
48,625
66 Continuum of care
411,692
411,692
70 Prevention services
294,804
_
294,804
80 Problem gambling prevention
_
27,922
27,922
81 Problem gambling treatment
41,109
41,109
201 Non-res Designated Svcs MIIS
53,640
53,640
Deschutes County Mental Health 2007-2009 Biennial Implementation Plan
Page 12
Exhibit C
Page 1 of / r
PREVENTION PLAN
Deschutes County prevention efforts are effective due to the strong community-based input received.
Oversight by the Mental Health, Alcohol and Drug Advisory Board, and Commission on Children
and Families and the input of the Deschutes Prevention Partners and rural coalition members have
allowed a melding of separate community plans and needs uito one comprehensive county plan. The
Deschutes County Prevention Team has been involved in all aspects of local Partners for Children
and Families planning and fund allocation process. The Prevention Coordinator assists in the
decision of allocation of monies in order to fund prevention projects through SB 555.
The current Deschutes County Ten-Year Community Plan cites reduction of eighth grade ATOD use
as one of the long-term outcomes. The projects within the All#70 plan have been developed to affect
the long-term ATOD rates in our county. The logic model submitted to the State OCCF for eighth
grade ATOD use outlines expectations of our parent training programs to address this outcome.
Parent training programs are funded in our county with other dollars and are a part of the larger
continuum of prevention services. As state dollars dwindle, we will be unable to sustain our
continuum of prevention efforts at current levels.
Community mobilization will be conducted through support to local prevention teams. The vast
majority of funds needed to support these adult and youth teams comes through the Drug Free
Communities grant and the Safe and Drug Free Schools state dollars, however we will use a small
portion of AD#70 funds to assist the rural coalitions with prevention focused projects and activities.
These rural prevention coalitions, supported by Prevention Team Staff, conducted a needs assessment
of their communities in 2001-2002 and update their strategic plans on an annual basis. Individual
rural prevention teams have identified priorities and implemented strategies to reduce adolescent
substance abuse and address the community's needs.
Deschutes County will keep focus on social and health consequences of underage drug use through
the implementation of the evidence-based program, Project Towards No Drug Abuse, public
awareness of the issues (on a countywide basis), support of local surveillance operations, and youth-
led projects.
Public awareness about ATOD issues will continue to be woven into all prevention work within the
county. In the past the Prevention Team has sponsored various trainings on issues surrounding
ATOD and will continue to do so as funding is available. Although this is not a major component of
our plan, we will continue to educate the community through our local prevention teams, press
releases, town halls and trainings.
Deschutes County currently uses the following SAMHSA programs. These programs are coordinated
through several different agencies and not necessarily funded through AD#70 or prevention funds.
Model:
Effective:
Promising:
Communities Mobilizing for Change on Alcohol
Guiding Good Choices
Incredible Years
Life Skills Training
Project Towards No Drug Abuse
Second Step
Strengthening Families
Big Brothers/Big Sisters
Friendly PEERsuasion
Nurturing Parenting Program,
Preschool and ToddL.r
School-Aged Children
Families in Recover,.
Spanish Families
Making Parenting A Pleasurt
Deschutes County Mental Health 2007-2009 Biennial Implementation Plan
Page 13
Exhibit C
Page N91_ of ( n
The support and advocacy for implementation and continuation of Life Skills Training will be
continued. We have been fortunate recently to have the assistance of Americorps volunteers in this
project. The goal is to sustain current sites using LST and offer to assist in implementation at other
sites. By providing the curriculum and free training to the sites we have found it has been easier for
the schools to implement the program.
The Youth Conference will be held annually in the winter at the local Fair and Expo Center. Past
conferences have each hosted over 350 youth and advisors who spend the day attending prevention-
focused breakout sessions; a school-team debrief meeting to assist in integrating the day's message
into a prevention-focused project with action plan. Youth teams are given an opportunity to work
together as a school-based group to complete team-building activities. Teams are asked to submit
their prevention project plans, and in recent years over 70% of teams completed their projects! The
planning for the conference is a collaborative effort and includes local agencies, businesses, fraternal
organizations and community volunteers. A small amount of AD#70 funds is used to support the
conference with over 75% of the needed revenue received through community donations.
The county will continue to use a portion of the AD#70 funds to support AOD assessments for
school-aged youth. By providing assessments to youth within the school system or in their local
community, we have broken down one of the many barriers to identification and referral services.
Youth completing the assessments are tracked to keep data on the percentage of youth following the
recommendations received based on the assessment.
Deschutes County contracts with El Programa de Ayuda, which is a telephone and face-to-face
information referral service. They also provide oral and written translation service to individuals
and programs throughout the county. Through partnerships with community programs, cultural
awareness activities and Cultural Competency trainings are organized and provided by El Progratna
de Ayuda.
Each contractor receiving CCF, JCP, AD#70 or county funds is encouraged to attend cultural
competency training each fiscal year. All local programs are notified of cultural competency
trainings as they are trade available.
As state and federal funds shift, the ability to continue on-going professional development for staff
will become more available. Staff will be attending the two mandatory Prevention Coordinators
meetings at the state level, National CADCA conference for our Drug Free Communities
Coordinator, as long as federal funds are available, and will continue to attend the statewide
prevention conferences as they are available. The county will also keep in mind the WestCAPT
internet classes and other free or inexpensive trainings that may be available in the future.
The quarterly meetings of the Deschutes Prevention Partners, the blending of efforts through
CCF/JCP/OHD tobacco/AD#70, and the many other collaborative efforts underway within our
community facilitate coordination of prevention efforts within the county. It is because of these
important linkages that we are able to effectively examine and respond to issues around substance
abuse, violence prevention and healthy lifestyles in Deschutes County.
Deschutes County Mental Health
Page 14
2007-2009 Biennial Implementation Plan
Exhibit
of II
Page (2.0 -
AD #70 Budget 2007-2009
Personnel
$31,700
Project TND
29,500
Community Coalitions
16,500 See detail below.
Life Skills
6,000
Youth Conference
3,500
Professional Development
300
$87,500
Provider Name
Approval/
Service
OMHAS Funds
Specialty Service
License Ill
Element
in Subcontract
Number
Redmond
93-1314045
A.D70
$ 5,500
Ongoing development of
Community Action
community coalitions
Team
La Pine Community
93-1 3 1 4045
AD70
$ 5,500
Ongoing development of
Action Team
community coalitions
Community Action
93-1314045
AD70
$ 5,500
Ongoing development of
Team of Sisters
community coalitions
$16,500
2007-2009 Prevention Funding Plan Baseline Budget Narrative
The following explanation is based on an annual budget. Budget numbers for 2007-2008 and 2008-
2009 will remain the same.
Personnel/Staff ($31,700 annually) will cover the project coordination for the youth conference,
oversight of Life Skills Training in Deschutes County, Project Towards no Drug Abuse in Deschutes
County and school AOD assessment services. Personnel dollars will fund a portion of the salaries of
the County Prevention Coordinator, Robin Marshall, and the A&D70 Program Contact, Candy
Freiboth.
Contracts/Consultants ($29,500 annually) includes the contract for $24,000 with Deschutes County
Mental Health to provide Project TND and AOD assessments, and education in the Sisters and
Redmond communities.
Community Coalitions ($16,500 annually) will be divided equally between and used to support three
separate rural coalitions in the communities of La Pine, Sisters and Redmond. These funds will be
used to further advocate for and implement research-based prevention programming at the
community level.
Professional Developlnent/Training ($300 annually) will be used to allow attendance at two DHS
sponsored meetings per information in Baseline Funding Guidelines, item #2.
Other ($9,500 annually) will be used to purchase curriculum and supplies for Life Skills Training
sites ($6,000) and for the Youth Conference to contract for AOD prevention speakers and other
general costs necessary for an effective youth prevention event ($3,500).
Deschutes County Mental Health 2007-2009 Biennial Implementation Plan
Page 15
Exhibit F. (t ~
Page of
2007-2009 Prevention Funding Plan Baseline Funds - Signature Page
I have read the attached Prevention Funding Plan and agree that it addresses or complements the priorities
in the County's Comprehensive Plan.
Lco Mottau, Vice-Chair (Date)
Mental Health, Alcohol & Drug Advisory Board
31a
Scott Jr n. rector (Date)
Deschutes Col y Mental Health
Tammy Baney, Chair (Date)
Commission on Children & Families
Deschutes County Mental Health 2007-2009 Biennial Implementation Plan
Page lb
Exhibit
Page of I -GO
GAMBLING SERVICES PLAN
Gambling Prevention for Central Oregon is administered as a Tri-County Region made up of Crook,
Deschutes and Jefferson counties. Services are provided by Deschutes County Mental Health. The
2007-2009 plan is basically a continuation of the 2005-2007 revised plan which was updated in
September, 2005, when increased prevention dollars were received by the region. At that time,
services were increased to rural, underserved counties of Crook and Jefferson. Rased on the
continued availability of funding, the plan will continue to focus on expanding services to Crook and
Jefferson counties (with the goal of increasing referrals from and treatment services in these areas), as
well as to expand the provision of dual diagnosis and wrap-around services through the use of
treatment enhancement dollars.
Deschutes County Mental Health 2007-2009 Biennial Implementation Plan
Page 17
Exhibit
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Exhibit -F
Page 2 of 116
GAM BUNG PREVENTION AND TREATMENT
Problem Gambling Service Region Designation
Please designate the name of the county or agency that serves as the regional contractor for providing
problem gambling services to your county:
Crook County hereby authorizes Deschutes County to obtain DHS distributed funds for the provision of
problem gambling services to Crook County residents.
Nancy yler, ran Col it rty Ser NW
Director, Crt County en Health
Jefferson County hereby thorizes De es County to obtain DHS distributed funds for the provision
of problem gambling services to efferson County residents.
Rick Trel av n, Best Care Treatment Services
Director, Jefferson County Mental Health
For those counties serving as the regional contractor, please use the table below to determine level of
Problem Gambling Flex Fund availability.
Region: Central Oregon Crook, Deschutes and Jefferson counties
Total Annual Problem Gambling Flex Funds !Available: $49,679
Deschutes County Mental Health 2007-2009 Biennial Implementation Plan
Page 19
Exhibit
Page , of
CHILDREN'S MENTAL HEALTH SERVICES PLAN
Service offerings are continuing in a manner generally similar to the 2005-2007 plan. Major elements
of our work are detailed in the Strategic Plan on pages 27 and 28 and include school based services in
the majority of public school in the County, treatment services at KIDS Center, the local Child Abuse
treatment center, service at two clinic sites (Bend and Redmond) and regional Children's System of
Care services, primarily through Trillium Family Services of Central Oregon and Cascade Child
Treatment Center in Redmond.
The process is detailed on Attachment 11, Referral Process for Intensive Community Treatment
Services (ICTS)/Wrap-Around Services. Upon initial determination of need for intensive treatment
services, the therapist sends a packet of information (including the CASIT and mental health
assessment) to the Care Coordinator. After obtaining any relevant additional information from the
therapist or schools, the Coordinator presents the case to our Central Oregon Review Committee for
prioritization and a determination of eligibility as well as a decision on available resources.
The Coordinator works closely with the family to develop a wrap-around team. The meeting includes
a look at the family's strengths (through an assessment) and any concerns. The Coordinator convenes
the team and facilitates any team meetings. Note: DHS is the convener and facilitator when the child
is involved with that system. The therapist remains involved as needed and appropriate.
The team develops the wrap-around plan including priority services. The Review Committee
authorizes services. With approval, the Coordinator, related providers and the family work to put the
services into action. The wrap-around team is reconvened periodically and as needed, particularly at
times of transition from one level or type of service to another. The family is involved in all aspects
of the process, from initial intake to wrap-around meetings to case planning.
Local services: Cascade Child Center and Trillium Family Services of Central Oregon currently
provide intensive treatment services for Jefferson, Crook and Deschutes counties. BestCare also
provides 1CTS services to children in Jefferson County. Trillium also provides residential services,
emphasizing local placements whenever possible.
OLDER ADULT MENTAL HEALTH SERVICES
Deschutes County has one of the few dedicated mental health teams for older adults in the State of
Oregon. It is estimated that the program will help approximately 475 seniors in 2005-2006, but far
more would benefit from service. During a 2005 OMHAS audit, the state auditor identified the
program as a strength in our Department and one of the best programs of its kind in the state.
This five-member team of professionals conducts outreach activities, assessment and evaluation
services, case management, and short-term intervention and treatment services for Deschutes County
seniors at high risk for a variety of mental health problems. The program assists the community
helping system with training for other senior providers and consultation with residential providers.
The program also includes Pre-Admission Screening and Resident Review evaluation services. Staff
also operate an Enhanced Care Outreach Services (ECOS) Program. Primary emphasis is placed on
seniors who reside in out-of-home placements and who, because of mental and emotional disorders,
are at risk of psychiatric hospitalization.
Deschutes County Mental Health 2007-2009 Biennial Implementation Plan
Page 20
Exhibit t,
Page 2LQ_ of I I Q
Recently, the program has expanded our efforts to help the community by focusing on the
recruitment, training and supervision of volunteers and student interns. As we are able to add
capacity, we are confident that clients will benefit from more frequent contact with friendly visitors
along with their other mental health treatment.
Priorities in the Strategic Plan are outlined on page 30. They include 1) equitable funding of county
programs based on need, demographics and a commitment to senior services, 2) an active role in
statewide SB 781 implementation, 3) added capacity for ECOS, 4) expansion of group work by staff,
5) our interest in finding opportunities to co-locate mental health services where seniors congregate,
and 6) expand the program to serve all seniors with mental illnesses.
Workforce development help needed-Expansion in staff capacity including 2 FTE QMHP and 1
FTE QMHA.
Deschutes County Mental Health 2007-2009 Biennial Implementation Plan
Page 21
Exhibit l_'
Page 2--1 of
Deschutes County Contact Information
county Contact Information
County: Deschutes County Mental Health
Address: 2577 NE Courtney Drive
City, State, "Zip: Bend, OR 97701
Person(s) authorized to represent County in negotiations and sign Agreement(s):
Name: Scott Johnson Title: Director, Deschutes County Mental Health
Addiction Treatment Services Contact Information
Name:
Lori Hill, Adult Treatment Program Manager
Agency:
Deschutes County Mental I Iealth
Address:
2577 NE Courtney Drive
City, State, Zip:
Bend, OR 97701
Phone:
541-322-7535 Fax: 541-322-7565
E-mail:
lori_hill@co.deschutes.or.us
Prevention Services-Con tact Information
Name: Robin Marshall, Prevention Coordinator
Agency: Deschutes County Commission on Children & Families
Address: 1130 NW Harriman, Suite A
City, State, Zip: Bend, OR 97701
Phone: 541-385-1717 Fax: 541-385-1742
E-mail: robin_marshall@co.deschutes.or.us
Mental Health Services Contact Information
Name:
Scott Johnson, Director
Agency:
Deschutes County Mental Health
Address:
2577 NE Courtney Drive
City, State, "Zip:
Bend, OR 97701
Phone Number:
541-322-7502 Fax: 541-322-7565
E-mail:
scott_johson(o)co.deschutes.or.us
Gambling Treatment Prevention Services Contact Information
Name:
Fred Doolin
Agency:
Deschutes County Mental Health
Address:
2577 NE, Courtney Drive
City, State, Zip:
Bend, OR 97701
Phone Number:
541-322-7507 Fax: 541-322-7565
E-mail:
fred-doolln@co.deschLites.or.us
Deschutes County Mental Health 2007-2009 Biennial Implementation Plan
Page 22
Exhibit E.
Page of
State Hospital/community Co-Management Plan Contact Information -
Name:
Lori Hill, Adult Treatment Program Manager
Agency:
Deschutes County Mental Health
Address:
2577 NE Courtney Drive
City, State, Zip
Bend, OR 97701
Phone:
541-322-7535 Fax: 541-322-7565
E-mail:
lori_hill@co.deschutes.or.us
Deschutes County Mental Health 2007-2009 Biennial Implementation Plan
Page 23
Exhibit L
Page _ of I Llb_
Office of Mental Health and Addiction Services
Attachment 1
LIST OF SUBCONTRACTED SERVICES FOR DESCHUTES COUNTY
For each service element, please list all of your treatment provider subcontracts on this form. In the far
right column indicate if the provider delivers services specific to minorities, women, or youth.
Provider
Approval/License
Service
OIVIHAS Funds in
Specialty Service
Name
ID Number
Element
Subcontract
Central Oregon Extended
93-1019081
20, 25, 30,
$ 45,408
Adolescent outpatient
Unit for Recovery, Inc.
35
services
Marc Williams
MD22829
20, 25, 30,
$360,000
Psych assess, med
35
mgmt, therapy, corm
ed
Don McFerran
081046617N6
20, 25, 30,
$140,000
Patient assess, need
35
mgmt, staff consult
Joseph A. Barrett
MD24477
20, 25, 30,
$ 90,000
Psych assess, med
35
mgmt, therapy, comn,
ed
Gavle Woosley
200050099NP
22, 25, 30
$130,000
Patient assess, med
mgmt, staff consult
Best Care Treatment
93-1220297
66
$ 80,000
Indigent funding
Services
Pfeiter & Associates
93-1254885
66
$80,000
Indigent funding
Commission on Children
93-6002292
70
$294,805
Substance abuse
& Families
prevention
Heating Health Campus,
61-1465299
24
$526,820
Support operations tier
LLC
Sage View
Lifestyles Living Center
41-2134705
24
$ 60,000 est.
Crisis respite services
Trillium Family Services,
93-0386966
22
$114,562
Residential and
Inc.
community based
children's services
Deschutes County Mental Health
Page 24
2007-2009 Biennial Implementation Plan
Exhibit E
Page of (l b
Office of Mental Health and Addiction Services
Attachment 2
BOARD OF COUNTY COMMISSIONERS
REVIEW AND APPROVAL
Deschutes County
In accordance with ORS 430.258 and 430.630, the Board of County Commissioners has reviewed and
approved the mental health and addiction services County Biennial Implementation Plan for 2007-2009.
Any comments are attached.
Name of Chair:
Address:
"Telephone Number:
Signature:
Dennis R. Luke
1300 NW Wail Street
Bend, OR 97701
541-388-6570
Deschutes County Mental Health
Pave 25
2007-2009 Biennia] Implementation Plan
Exhibit E-
Page of ( 10
Office of Mental Health and Addiction Services
Attachinents 3 and 4
MENTAL HEALTH, ALCOHOL & DRUG ADVISORY BOARD
(Combined Local Alcohol &llrug Planning Committee and Local Mental Health Advisory Board)
REVIEW AND COMMENTS
Deschutes County
See attached roster.
In accordance with ORS 430.342, the Deschutes County Mental Health, Alcohol & Drug Advisory Board
(LADPC) recommends the state funding of alcohol and drug treatment services as described in the 2007-
2009 County Implementation Plan. Further comments and recommendations are attached.
The Deschutes County Mental Health, Alcohol &llrug Advisory Board, established in accordance with
ORS 430,630(7), recommends acceptance of the 2007-2009 biennial County Implementation Plan.
Name of Chair:
Address:
Telephone Number:
Becky Wanless
63360 Britta Street Bldg 2
Bend, OR 97701
541-383-4383
Signature:
Re. c)y Gt/aN /c° fs
Deschutes County Mental Health 2007-2009 Biennial Implementation Plan
Page 26
Exhibit
Page !!20
- of ( Q
MENTAL HEALTH, ALCOHOL & DRUG ADVISORY BOARD
2006
Name/Address
Phone Number/E-Mail
Term Ends
Becky Wanless, Chair
383-4383
12/31/2006
Adult Parole & Probation
becky_wanless®co.deschutes.o
63360 Britta Street Building 2
r.us
Bend, OR 97701
Leo Mottau, Vice Chair
312-4487
12/31/2007
60780 Currant Way
cell 953-0351
Bend, OR 97702
mot tauf&yahoo.com
Daniel Blake
389-3250
12/31/2007
1875 NE Purcell Blvd #9
Bend, OR 97701
Howard Denhartog
529-8083
12/31/2007
14833 Crupper
hdh(F4bendhroadhand.com
Sisters, OR 97759
Dolores Ellis
617-5901
12/31/2007
19492 Sugar Mill Loop
cde.llis2gearthlink.net
Bend, OR 97702
Chuck Frazier
617-1020
12/31/2008
1363 NW City View Drive
cfraziere3bcndcable.cUm
Bend, OR 97701
Karinda Hedlund
318-0123 (H)
12/31/2008
P.O. Box 1605
330-8507 (W)
Bend, OR 97709-1605
kazinda@hasson.com
Glenda Lantis
385-8645 (H)
12/31/2008
2534 NE Jenni Jo Court
318-3753 (W)
Bend, OR 97701
glantisgcocc.edu
Alison Lowe
548-5578
12/31/2007
2190 NW Canal Blvd
a1irivPr@;P.arth.1ink.net
Redmond, OR 97756
Robert Marble
318-8299
12/31/2006
2273 Wintergreen Drive
cell 390-7810
Bend, OR 97701
bpmarb1c2®bendbroadband.com
Mary Martin
385-6879
12/31/2007
60823 Windsor Drive
mmarLinga-bendcable.com
Bend, OR 97702
Exhibit t
Page~ of
Name/Address Phone Number/E-Mail Term Ends
Ken Mathers 385-1738 12/31/2007
Juvenile Community Justice kennm(alco.deschutes.or.us
63360 Britta Street Building 1
Bend, OR 97701
Jennifer McKague 504-0083 12/31/2007
2325 NW Antler Court jsamckague~dbcndbroadband.com
Redmond, OR 97756
Beth Quinn 419-6521 12/31/2007
61247 King Solomon Lane bquinnnbendhroadband.com
Bend, OR 97702
Karren Ruesing
388-6317
12/31/2006
DHS S PD
karren.ruesing@state.or.us
1300 NW Wall Street Suite 102
Bend, OR 97701
Liz Sabatella
923-4856 (W)
12/31/2007
826 NE Providence Drive
318-6112 (H)
Bend, OR 97701
Lindsay Stevens
389-9496 (H)
12/31/2007
21585 Stub Place
388-6962 (W)
Bend, OR 97701
ljstevenswbendcable.com
Bert Swift 617-8754 12/31/2008
64750 Saros Lane swif.ts@bendbroadband.com
Bend, OR 97701
Pat Tabor 383-4385 (W) 12/31/2007
Adult Parole & Probation 617-1255 (H)
63360 Britta Street Building 2 pat_taborcwco.deschutes.or.us
Bend, OR 97701
Exhibit- E
Page 11 of 11 b
Office of Mental Health and Addiction Services
Attachment 5
COMMISSION ON CHILDREN & FAMILIFS
REVIEW AND COMMENTS
Deschutes County
The Deschutes County Commission on Children & Families has reviewed the alcohol and drug abuse
prevention and treatment portions of the county's Biennial Implementation Plan for 2007-2009. Any
comments are attached.
Name of Chair: Tammy Baney
Address: 1130 NW Harriman, Suite A
Bcnd, OR 97701
"Telephone Number: 541-385-1742
Signature:
Deschutes County Mental Health
Page 27
2007-2009 Biennial Implementation Plan
Exhibit
Pagel of AA-Q--
Office of Mental Health and Addiction Services
Attachment G
COUNTY FUNDS
MAINTENANCE OF EFFORT ASSURANCE
Deschutes County
As required by ORS 430.359(4), I certify that the amount of county funds allocated to alcohol and drug
treatment and rehabilitation prograins for 2005-2007 is not lower than the amount of county funds
expended during 2003-2005.
4AWII~
Scott. ohn. n irector
Deschutes County Mental Health
February 24, 2006
Deschutes County Mental Health
Page 28
2007-2009 Biennial Implementation Plan
Exhibit=
Page , Of kV)
Office of Mental Health and Addiction Services - Attachment 7
PLANNED EXPENDITURES OF MATCHING FUNDS (ORS 430.380)
AND CARRYOVER FUNDS
Deschutes County
Contact Person: Greg Canfield
Matching Funds
Source of Funds
-None applicable
Carryover Funds
OMHAS Mental Health Funds
Carryover Amount from 2003- Planned Expenditure
2005
New resources for the Central f Sage View and other acute
Oregon acute care system I care services 2005-2009
n Area
Service Element
SE 24
OMHAS Alcohol & Drug
Funds Carryover Amount
from 2003-2005
None applicable
Deschutes County Mental Health 2007-2009 Hietmial Implementation Plan
Page 29
Exhibit F,
Page of
Planned Expenditure Service Element
Office of Mental Health and Addiction Services
Attachment 8
REVIEW AND COMMENTS
BY THE LOCAL SERVICE DELIVERY AREA MANAGER,
DEPARTMENT OF HUMAN SERVICES
Deschutes County
As Service Delivery Area Manager for the Department of Human Services, I have reviewed the 2007-
2009 Biennial County Implementation Plan and have recorded my recommendations and comments
below or on at attached document.
Name of SDA Manager: Patrick Carey
Signature:
Date:
Deschutes County Mental Health
Page 30
2007-2009 Biennial Implementation Plan
Exhibit F
Page- of_
Office of Mental Health and Addiction Services - Attachment 9
REVIEW AND COMMENTS
BY THE LOCAL PUBLIC SAFETY COORDINATING COUNCIL
Deschutes County
The Local Public Safety Coordinating Council has reviewed the 2007-2009 Biennial County
Implementation Plan. Comments and recommendations are recorded below or are provided on an
attached document.
Name of Chair:
Address:
Telephone Number:
Signature:
Date:
Judge Michael Sullivan, Presiding Judge
I Ph Judicial District
1100 NW Bond Street
Bend, OR 97701
541-388-5300
March 6, 2006
Deschutes County Mental Health
Page 31
2007-2009 Biennial Implementation Plan
Exhibit
Page _ of
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Exhibit
Page 4 1)_ of RD-
_7
Attachment 11
Referral Process for
Intensive Community Treatment Services (ICTS)/Wrap-Around Services
1) Child is referred to the Deschutes County Mental Health Department from a variety of referral
sources.
2) A mental health therapist is assigned and completes the mental health assessment. Based on the
assessment and as needed:
a) A CASII is completed
b) A Release of Information for ICTS/Wrap-Around services is signed by the guardian.
c) A Release of Information is signed for the school district by the guardian. The therapist will
request school records.
3) When a CASII reaches Level 4, 5 or 6, an internal referral is made for a wrap-around planning
meeting. An assigned senior staff member from our County will prioritize cases to be referred to the
Central Oregon Regional Care Coordinator (Level 5/6) or the Deschutes County Care Coordinator
(Level 4).
4) The therapist will complete the "Central Oregon Children's Intensive Services" referral form and give
the form to the appropriate Care Coordinator with other required paperwork.
5) The Care Coordinator will contact the primary liaison for the school to receive additional verbal
information.
6) The Care Coordinator will complete the "Review Committee" referral form and present the term to
the Committee for a determination of priority. The Committee will meet weekly.
7) The Review Committee will prioritize referrals to the Care Coordinator(s) and will make
recommendations for service funding.
8) If a recommendation for residential placement is being made, referral will go to Karen Weiner, the
CSCI Manager, and Dr. Jack Kaczmerick, ABHA, for final determination.
Deschutes County Mental Health
Page 33
2007-2009 Biennial Implementation Plan
Exhibit
C
Page of 1 ~ f ~
Deschutes County
Mental Health
Strategic Plan
2006-2009
October, 2005
Our mission
To provide high-quality and integrated client-centered
services that will enable those we serve to strengthen their
lives and roles in the community.
Adopted by the Mental Health, Alcohol & Drug Advisory Board
October 19, 2005
Adopted by the Strategic Planning Committee
August 31, 2005
The purpose of this Strategic Plan is threefold:
1. To strengthen our organization for the benefit of our community;
2. To focus our efforts on projects and services that will benefit the people we serve; and
3. To inform and enlist the support of the public and our community partners.
Deschutes County Mental Health Strategic Plan DRAFT October, 2005
Page 1
Exhibit
Page 4-'7- of 11 b
ACKNOWLEDGEMENTS
With gratitude to
The staff of the Deschutes County Mental Health Department and the Department's contractors
and community partners for their dedication to the clients we serve.
The Deschutes County Board of Commissioners
Tom DeWolf 2005 Chairman
Michael M. Daly Commissioner, Mental Health Department Liaison
Dennis R. Luke Commissioner, 2005 Budget Officer
Members of the Strategic Planning Committee
Mike Maier
Deschutes County Administrator
Bob Marble
Advisory Board Member MHADAB *
and NAMI Representative
Leo Mottau
Advisory Board Member MHADAB *
and NAMI Representative
Karren Ruesing
Advisory Board Member MHADAB *
and Staff, Or. Dept. of Human Services
Liz Sabatella
Advisory Board Member MHADAB *
and Counselor, Redmond School District
Lindsay Stevens
Advisory Board Member MHADAB *
and LDDPC
Becky Wanless
Chair, MHADAB * and Director, Des. County Adult Parole & Probation
Marty Wynne
Deschutes County Finance Director
and Treasurer
Contributing Staff Members
Greg Canfield Business Services Manager
Kathy Drew Developmental Disabilities and Seniors Program Manager
Suzanne Donovan Child & Family Program Manager
Lori Hill Adult Treatment Program Manager
Kathe Hirschman Senior Administrative Secretary
Scott Johnson Director
Special thanks
to the many staff, volunteers and community partners
who also contributed their time and ideas to this plan.
MHADAB Deschutes County Mental Health, Alcohol & Drug Advisory Board
NAMI National Alliance for the Mentally III
LDDPC Deschutes County Local Developmental Disabilities Planning Committee
Deschutes County Mental Health Strategic Plan
Page 2
DRAFT October, 2005
Exhibit E,
Page '43 of~
TABLE OF CONTENTS
Page
A.
Executive Summary
4
B.
Overview
6
C.
Our Vision, Recovery Tenet, Mission and Core Values
10
D.
Environmental Trends and Challenges
13
E.
Summary of (Earlier) Phase One Plan
15
F.
2006 Priorities
17
G.
Longer Term Recommendations 2006-2009
19
1. Consumer and Family Involvement
19
2. Organizational Development
20
3. Business Services
24
4. Program Development (General)-Quality, Access, Services and Productivity
25
5. Child and Family Services
27
6. Adult Mental Health Treatment and Support Services
29
7. Seniors' Mental Health Services
30
8. Chemical Dependency
31
9. Justice System Services and Alternatives to Incarceration
32
10. Developmental Disabilities Services
36
Ap
pendices
A. Audit Action Plan
37
B. Financial Plan 2005-2008
44
C. Evidence Based Practice Work Group Report
46
D. Measuring Results Work Group Report
52
E. Professional Development Work Group Report
55
F. Comparative Analysis with President's New Freedom Commission Report
58
G. Governor's Mental Health Task Force 2004 Final Report,
"A Blueprint for Action" (Summary)
60
H. Eligibility for Services (2005)
62
Deschutes County Mental Health Strategic Plan DRAFT October, 2005
Page 3
Exhibit
Page of 1 b
Deschutes County Mental Health
2006-2009 Strategic Plan
A. EXECUTIVE SUMMARY
Deschutes County offers essential services to the residents of
Oregon's fastest growing county. County sponsored health,
human services and public safety programs benefit children,
families and people challenged by a disability, mental illness,
or addiction. Deschutes County's Mental Health Department
is on the front line of this effort to help local residents in need.
This Strategic Plan for the Mental Health Department clarifies
as many as 7,350
Deschutes County
adults and 3,150
children may need
mental health services
in 2006."
our vision, mission and values. It also includes our program
priorities for the next four years. It is an ambitious agenda in uncertain times. Our ability to
be successful in carrying out this plan will depend on the talent of our staff, the support of our
County Commissioners, State and Federal funding and the help of our community partners,
advocates and clients themselves.
How great is the need for our services? Our Department helps more than 5,000 County
residents annually-adults with mental illnesses, children with emotional problems, people
with disabilities, people challenged by depression or crises in their daily lives.
The President's New Freedom Commission estimates 5-7% of adults have a serious mental
illness and 7-9% of children have a serious emotional disturbance. Based on those estimates,
as many as 7,350 Deschutes County adults and 3,150 children may need mental health
services in 2006. Many more will need addiction treatment services or support and
assistance with a developmental disability. Some will get private or public help; far too
many will receive nothing at all.
Our County government and its community partners will become increasingly challenged
trying to respond to this need in a growing community. Difficult choices lie ahead. Who will
be eligible for services? Which services are most beneficial? What can we afford to do?
How can we change to be more effective and efficient in our work?
Our services provide a lifeline for people on the fragile Oregon Health Plan, people with
disabilities or mental illnesses and people of limited means. At best, our services stabilize and
strengthen people, offering dignity, hope, self-sufficiency-a better quality of life. Cutbacks
in services risk hopelessness, crises, costly hospitalizations, incarceration and even suicide.
"The public mental health system in Oregon has serious problems I The Governor's 2004
A Blueprint for Action cites many profound shortcomings. They include a public stigma
against mental illness, significant under funding, fragmented services, an inappropriate
reliance on jails and prisons, lack of community resources, insufficient use of early
intervention services and a costly State Hospital in crisis. These seemingly overwhelming
challenges are compounded by calls at the Federal level for cuts in Medicaid funding, the
critical underpinning of the Oregon Health Plan (OHP), including mental health and
addictions treatment for OHP members in Deschutes County.
Page 7. A Blueprint for Action, Governor's Mental Health Task Force, September, 2004.
Deschutes County Mental Health Strategic Plan
Page 4
DRAFT October, 2005
Exhibit
Page of 1 l b
Exhibit
Page Pof
For more information, please contact:
Scott Johnson, Director
Deschutes County Mental Health Department
2577 NE Courtney Drive, Bend, Oregon 97701
541-322-7502 or Scott iohnson@co.cleschutes.or.us
Deschutes County Mental Health Strategic Plan DRAFT October, 2005
Page 63
Exhibit
Page of Q
4~ 011-",
Exhibit
Page eIr
17of
APPENDIX H: Eligibility for Services (2005)
Deschutes County Mental Health has a ranking structure to prioritize client eligibility for service.
Service priorities are based on medical necessity, acuity and contractual agreements and may
be adjusted according to program capacity and availability of resources.
Priority Ranking:
1. Crisis
• Immediate risk of hospitalization due to a mental or emotional problem or
• Need for continuing services to avoid hospitalization/crisis respite due to a mental or
emotional problem or
• Hazard to the health or safety of self or others due to a mental or emotional problem
or
• For A&D clients: In need of detoxification; a pregnant woman who is actively using
alcohol or drugs; IV drug use within the past 7 days; or behaviors consistent with a
grave medically disabling condition related to substance usage. These individuals
will at a minimum receive a screening and referral to appropriate services and will
receive ongoing services at DCMH based on capacity.
2. Serious mental illness as defined by OAR (schizophrenia, serious affective and paranoid
disorders, other chronic psychotic disorders) which significantly impact a person's ability
to function in everyday life and no other available resources for treatment.
3. Oregon Health Plan coverage and in need of routine MH and/or A&D services.
4. Contractual obligation referrals:
• Adult contracts (AFS, Gambling)
• Child & Family contracts
5. Uninsured clients-sliding fee scale. Preference given to referrals from partner
community agencies based on capacity.
6. Private insurance.
All clients meeting priority criteria 1-4 (crisis, SMI, OHP, contracts) are eligible to receive services
at DCMH regardless of ability to pay. Clients meeting priority criteria 5 and 6 (uninsured, private
insurance) will receive services only if there is program capacity and availability of resources.
Clients who report that they have applied for OHP will be screened as non-OHP until coverage is
approved.
Any client screened as not meeting criteria for service eligibility will be given referral information
about other potential providers within the community.
Deschutes County Mental Health Strategic Plan DRAFT October, 2005
Page 62
Exhibit
Page A~Iof
Exhibit
~Q_ Of
Page f
3. The Superintendent of the Oregon State Hospital and Executive Director of the PSRB will
continue their effort to better communicate and collaborate and will together with Local
Mental Health Authorities create a rolling three-year plan for the construction and operation
of community facilities to serve the individuals under the jurisdiction of the PSRB.
4. The Department of Corrections and Sheriffs operating local jails will implement
administratively the recommendations of the Bazelon Center for pre-release planning, to the
extent possible without additional legislation.
Funding
Consistent with its charge, the Task Force took into account existing funding restraints when
developing its recommendations. However, the Task Force did conclude as part of its
identification of System Problems facing Oregon's public mental health system that the system is
significantly under-funded. The impact of this under-funding is compounded by the effects of
cuts in other State services needed by people with mental illness who are poor. Accordingly,
the Taskforce recognizes that some recommendations can be accomplished without additional
resources. Others would require resources that may not be available given fiscal realities for
2005-07 and will impact the degree to which some recommendations can be fully implemented.
Deschutes County Mental Health Strategic Plan DRAFT October, 2005
Page 61
Exhibit -
Page (5_ of
Exhibit E
Page~_ of /I()
APPENDIX G: Governor's Mental Health Task Force 2004 Final Report, "A Blueprint for Action"
Executive Summary
The 2004 Governor's Mental Health Task Force has prepared a full report which identifies
systemic problems in Oregon's public mental health system, makes additional findings, and
offers numerous recommendations for improvement. While every one of the recommendations
listed in the full report is critical, this Summary focuses on the 10 recommendations identified as
priority items for the Governor, the Legislature and state agencies in 2005-07. These priority areas
were identified based on the charge from the Governor in the Executive Order creating the Task
Force, focusing on systemic problems the Task Force identified and relating to recommendations
to improve communication and coordination between the State and community providers of
mental health services, including the criminal justice system.
2005 Legislative Session
1. The Legislature should pass legislation requiring private insurers to provide parity coverage for
mental health and substance abuse services provided to consumers voluntarily.
2. The Legislature should appropriate sufficient funds to permit the orderly restructuring of
Oregon State Hospital and the construction and operation of community facilities to support
populations of individuals who will no longer be hospitalized.
3. The Legislature should expand the Oregon Prescription Drug Program established in ORS
Chapter 414 (SB 875).
Interface between the State and Community Mental Health Providers
1. The State will complete and implement a business plan to reinvent the Oregon State Hospital
in Salem as a "focus of excellence facility."
2. The State will implement programs which provide funding and incentives to counties and
community providers to achieve community-based System of Care services.
3. Local mental health authorities with support from OMHAS will continue to accept increasing
responsibility for assisting individuals to leave acute care and State hospitals, including
individuals subject to PSRB jurisdiction.
Criminal Justice System
1. The State and local mental health authorities will develop and offer training for courts, district
attorneys, defenders, correction officers and police (i) to identify and property respond to
persons with mental illness and (ii) to understand and use community mental health and
substance abuse programs.
2. OMHAS will work with counties (individually or regionally) to create 24/7 acute care crisis
centers to permit individuals to be diverted prior to arrest and to receive individuals upon
diversion from jail or court.
Deschutes County Mental Health Strategic Plan DRAFT October, 2005
Page 60
Exhibit
Page 5a of N
w
Exhibit E
Page 'A of ! I n
Early mental health screening, assessment and referral services are common practice.
Promote the mental health of young children.
Improve and expand school mental health
Sustain and expand school based services for
programs.
Health Plan members and other children in
need of assistance. All public schools.
2005-2006 schools served: 26; not served: 11.
Screen for co-occurring disorders and link with
Sustain current emphasis and capacity to treat
integrated treatment strategies.
co-occurring disorders.
Screen for mental disorders in primary health
_
Continue development of reciprocal
care, across the lifespan and connect to
arrangements with Bend Community Clinic
treatment and supports.
and Volunteers in Medicine. Seek resources to
offer mental health at La Pine School Clinic.
Excellent mental health care is delivered and research is accelerated.
Accelerate research to promote recovery and
Monitor research and reports as part of our
resilience, and ultimately to cure and prevent
work on evidence based practice.
mental illness.
Advance evidence based practice
Implement recommendations adopted in
evidence based practice report; monitor new
developments on an ongoing basis.
Improve, expand work force providing
Implement recommendations (as above)
evidence based services and supports.
Develop knowledge base in four understudied
_
areas: mental health disparities, long-term
effects of medications, trauma, acute care.
'Technology is used to access mental health care and information.
Use technology and telehealth to improve
access and coordination of care especially for
underserved populations and remote areas.
Develop and implement integrated electronic
Acquire and develop an electronic medical
health record and personal health information
record system by 2008.
_systems.
Deschutes County Mental Health Strategic Plan DRAFT October, 2005
Page 59
Exhibit F
Page S5 of HG_
Exhibit
Page of
APPENDIX F: Comparative Analysis With President's New Freedom Commission Report
Deschutes County Mental Health--Developing Methods to
"Achieve the Promise" of the President's New Freedom Commission on Mental Health
President's Commission Deschutes County
Recommendations Recommendations
Americans understand that mental health Is essential to overall health.
National campaigns to reduce stigma of
Support NAMI and consumer implementation
seeking care and revent suicide.
of "In Our Own Voice."
Address mental health with the same urgency
Advocate for parity in Oregon law. Seek
as physical health.
methods to link mental health care to school
based health clinics, Volunteers in Medicine
and the Bend Community Clinic.
Mental health care is consumer and family driven.
An individualized plan of care for every adult
Adopt as a goal. Dedicate resources to
with serious mental illness and child with serious
training. Set as a performance measure in
emotional disturbance.
relevant staff evaluations. Monitor as part of
_
Quality Management Plan.
Involve consumers and families in orienting the
Adopt recovery as core tenet. Form an
department and community system toward
advisory group to study the concept and lead
recovery.
changes in program and practice.
Align federal programs to improve access and
_
accountability for mental health services.
Create a comprehensive State Mental Health
Oregon has completed. Strategic Plan will be
Plan.
aligned with state plan as much as possible.
Protect and enhance the rights of people with
Adopt a set of recommendations titled
mental illnesses.
"Consumer and Family Involvement" as part of
the Strategic Plan. Seek recommendations,
endorsement from NAMI and Consumer Board.
Disparities in mental heath services are eliminated.
Improve access to care that is culturally
Recommendation to add Spanish speaking
competent.
staff to each team (over time). Provide for
required training for staff and contractors
_
biennially. Identify improvements in practice.
Improve access to quality care in rural and
Base services in La Pine, Redmond and Sisters.
geographically remote areas.
First priority: expansion in La Pine. Offer school
based services (with School District support) in
_
north and south county.
Deschutes County Mental Health Strategic Plan DRAFT October, 2005
Page 58
Exhibit
Page_ of~~
On a more positive note, the limitations of our public treatment system and the urgent need
for an overhaul of our State Hospital have received the attention of the Oregon Legislature,
the media and the public. The accomplishments of the 2005 State legislature included
insurance parity to treat mental health issues, passage of a comprehensive
methamphetamine initiative, and the first steps in an overhaul and reinvention of the State
Hospital and further development of our community based service system.
The good news also included a decision by our County Commissioners to enable the
Department to again offer services to the public on Fridays. This return to full service hours
made more than 80 clinicians, therapists, social workers, and support staff available to help
the public five days a week. We have added back these hours through a combination of
new revenue and a plan to put much of our reserves to work helping the community over
the next four years.
In summary, this Strategic Plan provides a framework for our work over the next four years.
Many of the recommendations can be accomplished through current resources; others can
be accomplished only with new revenue. In any case, we are confident that the
improvements and ongoing efforts outlined in this Plan will be highly beneficial to our
community. We invite you to become involved in this process. Your suggestions are
welcomed.
Becky Wanless, Chair
Deschutes County Mental Health,
Alcohol and Drug Advisory Board
APPROVED this day of
Board of Commissioners.
Tom DeWolf, Chair
Michael M. Daly, Commissioner
Dennis R. Luke, Commissioner
ATTEST:
Recording Secretary
Scott Johnson, Director
Deschutes County
Mental Health Department
2005 for the Deschutes County
Deschutes County Mental Health Strategic Plan DRAFT October, 2005
Page 5
Exhibit -
Page of
B. OVERVIEW
The Deschutes County Mental Health Department has developed this Strategic Plan under
the guidance of the Deschutes County Board of Commissioners and the Department's
Mental Health, Alcohol and Drug Advisory Board. This planning effort began in October of
2004 and concludes with adoption of the Plan in the fall of 2005. The Plan extends from
January, 2006 through December, 2009. It includes recommendations that are designed to
improve the Department's effectiveness and benefit to the residents of Deschutes County.
This Strategic Plan and related activities are multifaceted. The Plan addresses a variety of
topics that affect our value to the community, the benefit of our services and the health of
our Department. As a strategic document, it includes recommendations related to our
services, productivity, work environment and finances. It charts our course for the future to
help us better serve residents of our County.
Critical Background Information
Given the dynamic nature of the mental health field, public financing and community
trends, a variety of information was taken into consideration including:
• Results of the 2005 Oregon Legislative Session, both policy and financial;
• Results of the 2005 Deschutes County Budget Process;
• The emphasis on Evidence Based Practice (SB 267, 2003 Oregon Law);
• The 2003 President's New Freedom Commission Report on Mental Health;
• The Governor's Mental Health Task Force 2004, "A Blueprint for Action";
• Staff suggestions, including results of the 2004 Employee Opinion Survey;
• Recent State, County and managed care audits of our operations;
• The 2005 opening of Horizon House, transitional housing for people with mental illness;
• The 2005 opening of Sage View and plans to improve local acute care options; and
• The October, 2005 implementation of the Children's System of Care Initiative.
Strategic Planning Committee
A work group of fourteen individuals has met over the past year to help develop the
Strategic Plan. This group includes representatives of the Mental Health, Alcohol and Drug
Advisory Board, the Local Developmental Disabilities Planning Committee, Central Oregon
NAMI, the County Finance Department, the County Administrator and several department
staff.
Deschutes County Mental Health Strategic Plan DRAFT October, 2005
Page 6
Exhibit F
Page zER- of 11
Work Groups
In addition to the Strategic Planning Committee, we formed three worts groups with
responsibility for preparing key elements of the Strategic Plan. The following chart shows
these three groups and their charge. Reports from each group are also referenced.
Group
Core Question
Pages
Evidence
How can Deschutes County Mental Health ensure that every
Based Practice
reasonable effort is made to offer programs, services and
46-51
educational opportunities that coincide with documented
evidence based practices and programs?
Measuring
As part of our efforts to be accountable to local taxpayers,
Results
our clients, funders and community partners, how can
52-54
Deschutes County Mental Health best measure and report
on our productivity and the quality of our services?
Professional
Recognizing that our staff (including contractors) is our most
Development
valuable resource, what are the core features and
55-57
components of a professional development program that
supports our staff and maximizes the benefit of their work?
The Essential Elements of the Plan
On October 20. 2004, the Deschutes County Mental Health, Alcohol and Drug Advisory
Board endorsed development of a Strategic Plan. The Advisory Board directed that this
planning process include the following seven essential elements:
1. Reaffirming our mission and values as an organization. See pages 10-12.
2. Assuring greatest possible access to core services. This includes
gradual expansion of hours of operation. See page 8.
3. A financial plan that assures core services are sustainable for a
minimum of three years. See page 24.
4. Program development priorities based on evidence based practices See page 21.
5. A report card with measures of program performance. See page 17.
6. Methods to encourage client and family involvement. See page 19.
7. A staff development program. See page 22.
Deschutes County Mental Health Strategic Plan
Page 7
DRAFT October, 2005
Exhibit L
Pageipo of jin
Critical Questions
Phase One of the Strategic Plan was adopted in December, 2004. It included questions that
should be answered in the Strategic Plan. The questions and our conclusions follow:
1. Staff Capacity: Can we return more staff to full-time, 40-hour status? Answer: Yes
(accomplished July, 2005). The County Budget Committee approved returning staff to
full-time status by using operating revenue and reducing our reserves over three years.
2. Financial Health: How will we balance our budget long-term? Answer: By increasing
operating revenue, by seeking more cost effective delivery models and, if needed, by
gradually reducing staffing levels through attrition. We project that reserves will be
reduced to a level equivalent to one month's operating costs by 2007-08.
3. Our Value: How will we measure program effectiveness? Answer: Through organization-
wide commitment to our quality management system, including reporting and public
review of significant, comparative and reliable data. See page 23. The department is
committed to measuring the value (i.e., productivity and quality) of our services.
4. Purchasina Community Services: Are we adequately monitoring our contracts for
program effectiveness and contract compliance? Answer: No, the County Auditor
recently concluded that "contract files are incomplete and unorganized" and that
"oversight of service providers could be improved." Hiring a contracts specialist was the
Department's top priority in the 2005-2006 County budget process. The Budget
Committee did not fund this position. It remains a critical issue; resources are needed.
5. Evidence Based Practices and Proarams: Are we operating programs based on best
practice and in compliance with Senate Bill 26727 What specific improvements should
we make? Answer: We currently use numerous evidence based programs. See Work
Group report (pages 46-51) for additional recommendations. The Department must
remain abreast of current research to assure that we are providing effective services.
6. Professional Development: What are our current strengths? What specific improvements
can we make? Answer: See the Work Group report (pages 55-57). Our commitment to
staff must include a multifaceted, affordable professional development program to help
retain staff, sustain a healthy and productive working environment and assure beneficial
services to the public. A survey of staff will be conducted at least biennially to assess
strengths and areas for improvement.
7. Salaries: Do we provide fair staff compensation In the marketplace? Answer: Under
review. Deschutes County Commissioners have contracted for an independent review
of this question for several county positions including six classifications in the Department.
Non-exempt positions are addressed through the collective bargaining process.
Competitive recruitment and retention are high priorities for Deschutes County.
2Senate Bill 267, signed into law In 2003, requires local governments and other organizations using State funds to assure
that an increasing proportion of those funds (757. by 2009) are used to support evidence based programs and practices.
Deschutes County Mental Health Strategic Plan DRAFT October, 2005
Page 8
Exhibit
Page of
8. Manacled Care: Are we participating in the best possible managed care organizations,
thereby serving Oregon Health Plan members in need of mental health and addiction
services? Answer: Under review. Deschutes County is currently evaluating our
involvement in Accountable Behavioral Health Alliance, our five-county mental health
managed care organization with Benton, Crook, Jefferson and Lincoln counties.
9. Business Practices: What improvements should we make in our business practices?
Answer: The County Auditor completed his report in 2005; recommendations are
included in the Audit Action Plan (pages 37-43) and will be addressed over the next
three years.
10. Revenue: What methods are available to increase revenue? Answer: Resource
development is referenced in many places in the Strategic Plan. There is no simple
answer; the work is ongoing. A few elements are listed below:
• Better documentation of costs and services to OHP members;
• Competitive grant applications to State, Federal and private sources;
• Improvements in our information system to identify and track billings;
• Advocacy for more equitable statewide funding of treatment services; and
• State funding of policy changes related to retooling the State Hospital.
11. Oraanizational Structure: What improvements are needed in our structure and functional
assignments? Answer: This is the next step in the planning process. Adoption of the Plan
will confirm our priorities and functions; we'll then review our structure and resources to
determine how best to support the work. Resolution is also needed on whether we will
remain a member of Accountable Behavioral Health Alliance or seek an alternative
managed care structure. This has implications for the organization of the Department
and assignment of duties.
vescnures county mental Health Strategic Plan
Page 9
DRAFT October, 2005
Exhibit
Page AiZ_0fM__
C. OUR VISION, RECOVERY TENET, MISSION AND CORE VALUES
Our Vision for 2015
"Help is available for everyone in Deschutes County with a mental illness, developmental
disability, addiction, or short-term crisis, regardless of income, culture or where you live in
the County. Help can be found here, in Central Oregon, close to family and friends.
Local government and private agencies work together well and offer a system of
affordable, accessible and integrated services. For our part, Deschutes County Mental
Health is regarded as one of the most effective and helpful county mental health
programs in Oregon.
Dramatic strides continue to be made on a national and state level in helping to
prevent, treat or limit the effects mental illness, addiction, emotional distress or a
disability. Locally, we are familiar with these new developments and the most effective
programs and practices. We continue to improve our services and offer training to help
local practitioners in their work.
All our services are based on the concepts of recovery, resilience and self-sufficiency.
People are supported in living as independently as possible, with the assistance of
families, friends and, when needed, public and private service agencies. Supported
housing and employment projects continue to expand and prosper."
Note: Our vision statement includes language and concepts expressed in other
documents, most notably the President's New Freedom Commission Report, "Achieving
the Promise: Transforming Mental Health Care in America" (July, 2003).
Deschutes County Mental Health Strategic Plan
Page 10
DRAFT October, 2005
Exhibit Fil
of
Page to-
Our Commitment to Recovery, Resilience and Self-Sufficiency
Special Note: The Deschutes County Mental Health, Alcohol and Drug Advisory
Board has joined with the State of Oregon and national experts in promoting
"recovery." Over the next four years, our Department will work to more fully
define this concept and reflect it in ALL our decisions, services and practices.
Given our diverse clientele and services, we are expanding the recovery concept
to include the concept of "resilience." We recognize that we are working to
help people acquire the skills and fortitude to become more resilient, to be able
to overcome short-term crises or personal challenges that would otherwise
compromise their ability to participate fully in community life.
Similarly, the concept of "self-sufficiency" is included, reflecting a value that
people should live as independently as possible in pursuit of their personal goals
and interests and with the support of family and friends and, when needed,
community helping programs.
Sample references
"It is recommended that Deschutes County Mental Health adopt a recovery based
philosophy as the core and foundation of services and evidence based practices
provided to clients in all areas-thus the underpinning to the client relationship. This
needs to involve a process that ensures this philosophy is not limited to a statement or
piece of paper but truly embodied in all services that are provided to clients. it will need
to involve staff training, regular discussions, ongoing supervision and ways to measure the
inclusion (of recovery) in the orientation, treatment planning and ongoing treatment
processes for clients."
Evidence Based Practice Work Group Report
"Recovery can be defined as a process of learning to approach each day's challenges,
overcome our disabilities, fears skills, live independently and contribute to society. This
process is supported by those who believe in us and give us hope."
Ruth Ralph, Ph.D., 2000
'The process in which people are able to live, work, learn, and participate fully in their
communities. For some individuals, recovery is the ability to live a fulfilling and productive
life despite a disability. For others, recovery implies the reduction or complete remission
of symptoms."
- President's New Freedom Commission Report, 2003
Recovery is supported by the power of consumer choice.
For more information or to become involved in this work, please contact
Kathy Drew, 322-7557 or kathy_drew@co.deschutes.or.us
Deschutes County Mental Health Strategic Plan DRAFT October, 2005
Page i 1
Exhibit
Page of
Our Mission .
To provide high-quality and integrated client-centered services that will enable
those we serve to strengthen their lives and roles in the community.
Our Core Values
Our clients
We believe those we serve should be involved in directing the course of the
services we provide as a component of a holistic approach to the betterment of
their lives. We believe our clients should have access, voice and ownership.
Our staff
We believe our staff is a valuable resource, and we promote the personal well-
being and professional development of each individual. Through continuing
education, peer review, and teamwork, we support each other in our efforts to
deliver compassionate, accountable services of the highest caliber. We value
trust, professionalism, integrity and mutual respect in all we do.
Our services
We believe mental health services are an integral part of a healthy community
and that comprehensive care is best provided through service integration,
interagency collaboration, and partnerships with other service agencies.
Our community
We believe mental health services should be visible and available to those in
need and that public awareness and education are key elements in community
wellness. We strive to make our services visible to the community and to deliver
them in an effective and efficient manner. We encourage feedback and use a
strategic planning process proactively to address the needs of our community.
Deschutes County Mental Health Strategic Plan DRAFT October, 2005
Page 12
Exhibit
of (10
Page Lp
D. ENVIRONMENTAL TRENDS AND CHALLENGES
The following items represent many of the trends and factors that affect our work and our
effectiveness. All need to be taken into consideration as we plan for the future.
1. Acute Care Capacity-Cascade Healthcare Community is expanding some critically
important services in our area. This is very beneficial but carries inherent costs and
requires a high level of case coordination, collaboration and financial planning.
2. Alcohol and Drug License-We have a provisional license for addiction treatment
through December, 2005. We will need to complete training, technical assistance and
paperwork improvements to the satisfaction of the State auditor.
3. Audits-We have participated in six external reviews in the past year and have dozens of
recommendations to address. We have developed an action plan to address these
over a manageable period of time and with attention to the most urgent priorities.
4. Behavioral Health Integration-There is growing recognition that co-occurring disorders
are common and should be treated in an integrated fashion. Administratively, there is
merit in linking our Chemical Dependency and Mental Health organizations if feasible.
5. Children's System Reform-All managed mental health care organizations in Oregon are
changing the nature of services to children with significant mental health needs. This is
an important but difficult transition for private agencies and counties.
6. Contracting: Accountability and County Policies-Greater accountability is needed for
contracted services, and County policy requires attention to detail in the preparation
and execution of contracts. Greater monitoring is also needed to assure performance.
7. Documenting Services-Billing and assuring continued Oregon Health Plan funding
sufficient to help our community depends on our ability to fully document delivered
services. This documentation will affect the next actuarial calculation for Oregon MHOS.
8. Electronic Medical Records-There is an increasing trend toward the use of information
technology, reduced paper and greater efficiency. This is encouraging but carries
inherent costs, training needs and adjustments for staff.
9. Equity-Population growth, limited resources and an unwillingness to reallocate State
funds has meant our fast-growing region has not received a fair share of State resources,
particularly in the area of addiction treatment services for low income people.
10. Evidence Based Practices/Programs (EBP)-Our services must continually evolve based
on research and improvements in behavioral health care practice. We will need to
adapt as circumstances warrant. Documentation of our EBP work is required.
11. Finances: Indirect Charges-Charges to the Department for County services affect our
resources for direct services and the amount of care we can provide. Controlling these
costs wherever possible is critical to our future.
12. Health Care Integration-Our community is benefiting from improvements in health care
for low income individuals including Volunteers in Medicine and the Bend Community
Clinic. Cross referrals are critical, and our current ability to respond is very limited.
Deschutes County Mental Health Strategic Plan DRAFT October, 2005
Page 13
Exhibit -
Page of 1 D
13. Health Insurance-Rising costs affect the amount of service we can provide. The most
significant cost increase for our Department is the rise in health insurance for County
employees, up 17%3 annually over the past five years.
14. Inpatient Costs-With improvements in our acute care system, we are incurring greater
costs for inpatient services. A more proactive management of the use of these services
will be needed if we are to control these costs and the impact on other services.
15. Managed Care----Change is inherent in managed care. Locally, we have been
encouraged to look at the feasibility of operating our own mental health managed care
orgonization. Regardless of the outcome, we need to maximize local decision making,
resources for County residents and the benefit of the MHO to our County.
16. Medicaid-Funds to help Oregon Health Plan members have declined in recent years,
and further cuts are being called for in Federal Medicaid funding. We need to monitor
the national debate and stay in contact with Federal officials and the County lobbyist.
17. Oregon State Hospital--Change will occur in the configuration of State hospital services
and the physical plant. Questions will need to be answered as to how to develop and
finance the best possible local helping systems.
18. Paperwork-Our clinicians raise legitimate concerns about the required paperwork and
the associated time demands. Efforts are ongoing to meet governmental regulations
and reporting requirements while asking staff to maintain a high level of direct service
time.
19. Population Growth and Need-With an annual population increase of 5,000-6,000
people, it is increasingly difficult to meet the needs in the community. This concern
affects most if not all human service programs in Deschutes County.
20. Public Confidence and Results-All publicly financed services are facing increasing
pressures to perform and to demonstrate that funds are used effectively. We are seeking
better ways to inform the public about the benefit of our work.
21. Recovery-There is a national movement to promote "recovery" in the design and
delivery of services. The goals are to engage clients as full partners in the treatment
process and to develop services that promote healing, independence and support.
22. Regional Work-Many of the more challenging community issues and service needs are
best addressed in partnership with Crook and Jefferson counties. Examples include
acute care and intensive children's mental health services.
23. Seniors (Senate Bill 781)-Deschutes County is recognized throughout Oregon for our
seniors' mental health services and the work of this team. With changing demographics,
our staff face increasing demands and are in need of greater support and assistance.
24. Transportation Problems-The region's inability to solve public transportation problems for
our residents rneans services must be offered in each community in Deschutes County.
Some progress has been made by the Department; more is needed.
3The 17% reflects the actual increase for Deschutes County Mental Health.
Deschutes County Mental Health Strategic Plan DRAFT October, 2005
Page 14
Exhibit
Page W-1 of (I D
E. SUMMARY OF (EARLIER) PHASE ONE PLAN (Adopted December, 2004)
Phase One of the Strategic Plan was completed in December, 2004. It was adopted by the
County's Mental Health, Alcohol and Drug Advisory Board and the Deschutes County Board
of Commissioners. A summary of several key findings and recommendations follows:
1. The 2003 reduction in Department hours was beneficial over the short term. The County's
2003 decision to operate the Department on a 36-hour, 4-day work week was a
temporary solution to weather cuts in public funding and retain highly qualified, well-
trained, dedicated employees. The strategy was successful in that layoffs were limited
and all programs were maintained on some level.
2. Department staff excel but face significant, extended challenges. Department staff
carry large work loads and provide very valuable services to the public. Staff report that
it is increasingly difficult to meet public requests for service and documentation
requirements while maintaining service quality.
3. Access to services must increase. As resources allow, it is in the best interest of the
community to increase services to meet public requests for help. For the purpose of this
Plan, our actions can and would include returning some staff to a 40-hour work week,
reopening on a scaled back level on Fridays, and adding temporary help where
possible. This is consistent with recent actions by the County to return both the Health
Department and Adult Parole & Probation to 40-hour, 5-day operations.
4. Recruiting for positions Is challenging. It is becoming increasingly difficult to compete for
qualified candidates for the department's vacancies. We have a concern that the
perceived tenuous nature of our operation may result in candidates questioning the
viability of the organization. County plans to review positions and compensation will also
be beneficial.
5. Reopening on Fridays and increasing staff hours is affordable and sustainable. The
department has developed financial projections through June, 2007. Based on
conservative and reasonable revenue and expenditure assumptions, the availability of
additional crisis and adult treatment dollars, and use of a portion of department reserves,
the department can open on Fridays and return 46 employees to 40-hour positions.
6. SWOT Analysis. An analysis of our department's Strengths, Weaknesses, Opportunities
and Threats is underway as part of this planning. A draft (Table No. 1) was prepared by
the department's Management Team and appears on the following page.
Development of this analysis will continue. Suggestions are appreciated.
ueschutes County Mental Health Strategic Plan DRAFT October, 2005
Page 15
Exhibit
Page (p
2~ - of l-
Table No. 1 SWOT Analysis Strengths, Weaknesses, Opportunities and Threats
This table was developed to assist in our planning and analysis. It was created to help us
understand areas to be sustained and supported, others that may require our attention and
challenges or problems that must be addressed or overcome.
Strengths
• Committed, knowledgeable, trained and
motivated staff
• Community partnerships with many
government and nonprofit groups
• A cohesive Management Team
• Improvement in staff morale
• An understanding of core services within
staff teams
• Community and school based services
• Involved and supportive Advisory Board
Opportunities
• ABHA examination, strengthening our
managed care work
• Using our experience with the DD system
to improve our MH system
• Greater stability through a sustainable
business plan and long-range planning
• Evidence Based Practices; local work on
practices we deem most beneficial
• New partnerships for individualized, wrap-
around services for children
• Input in rewriting Oregon's Administrative
Rules
• A trend toward delivering services
differently (e.g., group work, Children's
System of Care reform)
• Any opportunity to eliminate "silos" or
restrictive funding streams
• Revenue opportunities
• Programming to help people with mental
illness in criminal justice system
Weaknesses (internal)
• Extended waiting list for services
• High need and service demand
• Not enough staff to meet needs nor
support staff help for clinicians
• A need to embrace gradual change
aimed at improvements
• A need to improve organizational
systems, policies, and protocols
• Contract monitoring and reporting
• Greater confidence in billing system
• Chart and scheduling requirements
consistently met
• Staying well connected as we grow
• Use of panel providers
Threats (external)
• Instability and reductions in State and
Federal funding
• Greater responsibilities associated with
the County infrastructure
• State documentation requirements
resulting in excessive paperwork for
direct service staff
• Health care costs and the impact on
our cost of doing business
• PERS resolution in the Courts; the
ongoing cost of Retirement System
• Uncertainty that the State will make
the necessary changes and provide
sufficient support
• ABHA changes in the near term
• Insufficient transportation system for
clients
uescnutes county Mental Health Strategic Plan
Page 16
DRAFT October, 2005
Exhibit E
Page Coq of ~Q_
F. 2006 PRIORITIES
1. Recovery Based System; Client and Family Involvement-We will encourage people to
take control of their lives and participate fully in the community4. We will involve clients in
services, program development, evaluation, education and advocacy.
a. Recovery Model-Promote recovery, resilience and self-sufficiency for our clients.
b. Participation and Leadership-Seek participation of clients and family members on
decision making committees5. Promote and support consumer leadership6.
c. Evaluation-Emphasize consumer involvement and progress measures in our quality
improvement system7.
d. NAM[-Collaborate with NAMI of Central Oregon on projects of mutual interests.
2. Accountability, Access and Public Benefit-We will strive for excellence in our work by
emphasizing quality improvement and productivity, evidence based practices and the
use of technology. We will act on priorities in our Audit Action Plan, provide outreach,
offer local services and reduce wait lists and no shows wherever possible.
a. Contracting-Improve our contracting process to prepare and monitor 50+ contracts
with private practitioners and agencies. New resources needed.
b. Community Report Card-Produce and distribute a new publication that will serve as
an annual report on our services and our performance (Spring, 2006).
c. Productivity and Quality Review-Every three months, review data on performance
against measures of our effectiveness and productivity. Address critical issues.
d. Access in Outlying Areas-Open an office in the La Pine Service Center. Assure
convenient services in Redmond. Sustain school services in Redmond and La Pine.
Track service levels to North and South County residents.
e. Electronic Records, Paperwork-Consider acquiring a new information system to
support treatment, reduce paperwork, document services and secure revenue.
Short-term, strengthen our current system. New resources needed.
3. Sustainability, Stewardship and Resource Development-We will sustain core services and
meet the needs of a growing community whenever possible. We will manage resources
wisely and balance our budget while meeting our legal and contractual obligations.
a. Sound Financial Management-Balance the 2005-06 budget, prepare a sound 2006-
07 budget supporting the Strategic Plan and maintain a three-year financial plan.
b. Encounters Documented-Set a high standard of agency-wide documentation of all
services; help assure continued funding and services. Goal: increase encounters 11%.
4Paraphrased from Partners in Crisis, an advocacy and education group seeking to improve services for people with
mental illness at risk of contact with the justice system.
$For example, the Mental Health Alcohol & Drug Advisory Board, Children's System of Care Advisory Board and Local
Developmental Disabilities Planning Council.
6For example: Clubhouse, thrift store, our managed care organization. Support consumer positions in each setting.
IrPrimary measures include the ABHA Consumer Satisfaction Survey, the Oregon Change Index, evidence of significant
consumer involvement in treatment planning, consumer suggestions and the complaint process.
81'otential priorities: Crisis Intervention Training; In Our Own Voice public education effort.
Deschutes County Mental Health Strategic Plan DRAFT October, 2005
Page 17
Exhibit
Page -10 of-U()
c. New Funding-Seek new resources in at least three areas: (1) school based mental
health, (2) addiction treatment and (3) alternatives to incarceration.
4. A Healthy Work Force and Work Place-We will recruit, train and support highly qualified,
motivated and effective staff. We will involve staff in developing and improving our
organization and our services. We will fairly and consistently evaluate performance and
work to maximize productivity, professionalism and effectiveness. We will continually
strive for a healthy work place with mutual respect and support.
a. Staff Survey-Implement a new biennial staff survey designed to gather specific
suggestions to strengthen our organization while helping our clients and community.
b. Trainin -Dedicate time and money for staff training with an emphasis on our
evidence based practice priorities. Reduce costs through State and ABHA
sponsored trainings where feasible. Survey staff regarding training needs.
5. Program Priorities-We will continue to promote and support program development in
several areas this coming year. Areas that will require greatest attention in 2006 include:
a. Acute Care-Develop a regional system of high-quality, cost effective local services.
Reduce placements out of our community. New resources secured, more needed.
b. Help for Children-Develop a regional system of local care for eligible children with
significant mental health needs; using best practices, reduce use of residential and
day treatment services. Oregon Health Plan funds. Offer custody evaluations to
benefit divorcing families with a minor child. Courtfees.
c. Alternatives to Incarceration-With the Local Public Safety Coordinating Council,
expand addiction treatment, start a Family Drug Court; and prepare to offer Crisis
Intervention Training to first responders in 2007. New resources needed.
d. Chemical Dependency-Work with local providers to improve and expand services.
New resources needed. Support the work of the Meth Action Coalition.
e. Integration with Health Care-Coordinate services with the Bend Community Clinic,
school clinics, Volunteers in Medicine, and Sage View whenever possible.
6. Help for Oregon Health Plan Members-Assure access to services, document encounters
and participate fully in our mental health and chemical dependency organizations,
a. MHO Business Plan-Follow the direction of the County Commissioners in participating
in the preferred mental health managed care organization (MHO). Seek the
greatest efficiency and effectiveness possible.
b. Chemical Dependency Organization (CDO)_-Develop the CDO in a manner that is
compatible and integrated with the MHO (above), assuring treatment services to
OHP members.
Deschutes County Mental Health Strategic Plan DRAFT October, 2005
Page 18
Exhibit
Page -7 1 of ~
G. LONGER TERM RECOMMENDATIONS 2006-2009
1. Consumer and Family Involvement-Actively involve clients and family members, where
appropriate, in the course of treatment, case plans, the design and development of new
services and projects, community planning and advocacy.
a. Individualized.. Plans of Care-Develop individualized written plans of care for adults
with serious mental illness and children with serious emotional disturbances.
1) Each plan will reflect and address the expressed needs and preferences of the
individual and his/her family and community support system.
2) Each plan will support the individual in his/her recovery.
3) Each plan will be holistic, integrating the planning and delivery of services and
support available from various agencies, programs and natural supports.
b. Satisfaction-Implement an assessment and satisfaction policy and process through:
1) Outcome analysis (through the Oregon Change Index);
2) An annual satisfaction survey conducted by ABHA9;
3) A feedback form available to clients and caregivers at all program locations;
4) Review of complaints and grievances; and,
5) Full participation on all advisory boards and committees.
C. Recovery-Convene discussion groups to explore methods to better orient the local
mental health system toward recovery. Dedicate staff time to help lead this effort;
recruit family members and consumers to share responsibility.
d. Representation eek consumer and family involvement on all advisory, planning,
evaluation and policy boards/committees. Consistent with values and 2005 audit.
e. Community Awareness-Support and help promote NAMI's implementation of "in
Our Own Voice" to increase understanding and reduce stigma in Deschutes County.
f. Forums-Periodically cosponsor discussions of service and system changes that are
needed to better address consumer and family centered needs and preferences.
g. Leadership-Support opportunities for consumer operated and directed services and
projects (e.g., clubhouse, thrift store, supported employment) as well as assistance
with the development and stability of consumer run organizations.
h. NAMI Local Chapter-Collaborate with the local chapter of NAMI, supporting the
chapter's goals to the greatest degree possible. Meet with NAMI representatives on
a regular basis. Make clients and family members aware of the support offered by
NAMI and introduce family members to NAMI's Family-To-Family education program.
i. Client and Family Advocates -Seek resources to create Department positions to help
assure consumer and family needs are represented in our system and services.
9Accountable Behavioral Health Alliance, our five-county mental health managed care organization.
Deschutes County Mental Health Strategic Plan DRAFT October, 2005
Page 19
Exhibit E
Page--1!2 of /in
2. Organizational Development (See also Business Services.)
a. Audit Action Plan-Begin implementing the recommendations contained in the
various 2004 and 2005 audits of Deschutes County Mental Health. See the Audit
Action Plan Summary in Appendix A, page 37-43. Resources needed to address
some recommendations. The Action Plan summarizes all recommendations
contained in the following audits:
1) 2005-2006 Quality Improvement Work Plan
2) 2005 Deschutes County Review of Business and Contracting Practices
3) 2005 State Mental Health Site Visit and Certification Review
4) 2005 State Alcohol and Drug Site Visit and License Review
5) 2005 ABHA Encounter Data Study for Deschutes, ABHA-wide review pending
6) 2004 State Developmental Disabilities Client File Review
7) 2004 ABHA Site Review
b. Resource Development-Increase funding to support our priorities:
I ) Encounters-Increase documentation of encounters (i.e., services provided) for
Oregon Health Plan (OHP) members. ABHA is proposing an increase in
documented encounters by at least I I% by July, 2006. This target percentage
may change when ABHA completes the study.
2) Acute Care-Work to limit crises and the need for acute care. Seek State funds
at a level sufficient to assure acute care for indigent and OHP residents of our
County. Continue to develop preventative, transitional and acute care
services]O. New resources needed.
3) Equity: Adequate Funding to Meet Needs-Advocate for State funds for mental
health and addictions treatment at levels comparable to other counties. New
resources needed.
4) Third-Party Revenue-Maximize collection of revenue for services delivered.
5) State and Federal Priorities-Participate in the County process to establish
priorities for the County's Federal lobbyist and biennial Oregon legislative session.
6) Grants-Secure grants to support program priorities (with County grant writer).
Priorities are set annually based on the Strategic Plan and current needs".
7) Interns and Volunteers-Market opportunities for student interns and volunteers in
the department and its programs when there is a clear service benefit.
tai"he State has committed $450,000 (2005-07) to develop and improve a Central Oregon's acute care services.
112005 priorities have included methamphetamine treatment, addictions treatment in general, school-based mental
health services, drug court and continuation of the Jail Bridge Program.
Deschutes County Mental Health Strategic Plan DRAFT October, 2005
Page 20
E h
Page of ILO- ,
8) Federal Indirect Rate-Continue to advocate that Deschutes County establish a
rate to include in federal grants to offset administrative costs.
C. Cultural Competency-Increase the public's access to services and the quality of our
services for County residents who face language or cultural barriers.
1) Bilingual staff-Develop a bilingual (Spanish speaking staff) capacity within all
department programs, including reception staff. Long-term goal, resources may
be required.
2) Coordination with El Programa de Ayudo-House this agency to better serve the
Spanish-speaking community. Request assistance and guidance.
3) Translation of Materials-Complete translation of all print and web information
into Spanish.
4) Poverty Issues-Training for staff in understanding the impact of poverty.
d. Evidence Based Practices (ED s)-Continue the Department's commitment to
identify and implement proven, promising practices that are highly likely to benefit
our clients and assure compliance with Oregon law. See full report on pages 46-51.
1) Recovery/Strengths Based Model-Adopt this approach in all treatment services.
Includes adapting the model to children's services and developmental
disabilities, emphasizing resilience or maximum degree of independence.
2) Motivational Interviewing-Incorporate motivational interviewing, counseling and
enhancement in treatment services. The goal is to provide effective help to
unmotivated and mandated populations.
3) Timely Access to Help-Identify and implement the most effective ways to
reduce wait lists and assure prompt service for eligible clients.
4) Support Current Evidence Based Practices (EBP)-Continue current use of proven
practices (below). Assure ongoing training and supervision as needed. Use
standardized modules or fidelity scales. Monitor outcomes.
• Dialectical Behavioral Therapy
• Supported Employment
• Supported Housing
• Consumer Run Clubhouse
• School based children's services
• Dual diagnosis services
• Intensive, strengths based case
management
• Jail diversion /Mental Health Court
5) Improved Training/Development in the Following EBP areas:
Children's System of Care (2006
Priority)
Family Drug Court (2006 Priority)
Brief Solution-Focused Treatment
(added training and structured
format)
Group therapy-identification of
target populations and problems.
Increased use of EBP modules.
Family Psycho Education
Use of Medication Algorithms and
standardized prescribing practices
Deschutes County Mental Health Strategic Plan DRAFT October, 2005
Page 21
Exhibit
Page -L
4-Of
I to
6) Work with ABHA and the State to develop an improved list of practices for
populations that are not seriously and persistently mentally ill.
e. Staff Development and A Healthy Work Force--Recruit, train and actively support
highly qualified, motivated and effective staff, thereby strengthening our programs
and our benefit to the community. See full report on pages 55-57.
1) 2006 Work Force Development Priorities:
• Fall, 2005, survey of staff to identify training needs for 2006.
• Training as needed to support our Evidence Based Practice priorities.
• Calendar of informal peer trainings by staff.
• Designated day quarterly to assure paperwork is current and complete.
• Better use of clinical supervision and team meetings to process difficult
situations with clients including second-hand trauma and critical incidents.
2) 2006 Routine Training Priorities:
• Orientation for new clients (weekly).
• Strengthen orientation for new employees (scheduled regularly) 12.
• Volunteer training(s) (annually for the Advisory Board, key volunteers).
• HIPAA compliance (annual).
• Mandatory abuse reporting (annual).
3) Expertise-Increase support to staff by documenting and informing staff of
special skills, expertise and training of all staff members. Staff recommendation.
4) Library-Offer a comprehensive library of training/education tapes and videos for
use by staff, volunteers, clients and agency partners. Staff recommendation.
5) Staff Survey-Develop an instrument; solicit staff feedback on our operations,
including opportunities for improvement. Conduct survey in 2005, 2007 and 2009.
6) Recognition-Develop methods to recognize staff for their work on behalf of
clients and Deschutes County. Staff recommendation.
7) Team Development-Support team building activities at least annually; organized
by program teams. Staff recommendation.
12Staff Development Work Group recommends organization chart, mentoring program, list of acronyms, other aids,
procedure and policy manual, introductions to other staff, email introduction).
Deschutes County Mental Health Strategic Plan DRAFT October, 2005
Page 22
Exhibit_t- ,
Page of
f. Measuring Our Performance (See full resort on pages 52-54.) Operate a quality
improvement system and process to measure our productivity and effectiveness.
1) Adopt and implement an annual Quality Improvement Plan, including
performance measures for productivity and quality.
2) Convene quarterly public meetings of the Quality Management Committee13 to
review performance data. Prioritize areas for improvement.
3) Publish an annual Community Report Card to inform County residents about our
services and effectiveness including strengths and areas for improvement.
Include comparative data whenever possible.
g. Oregon Health Plan Member Services-Create and support the administrative
structure necessary to meet our managed care responsibilities. Provide high quality,
accessible behavioral health services for any Oregon Health Plan members residing
in Deschutes County who need covered services.
1) Chemical Dependency Organization-Addiction treatment and support.
2) Managed Health Organization-Mental health treatment and support, currently
offered through Accountable Behavioral Health Alliance, our five-county MHO.
3) Potential For Future Integration-Explore feasibility of integrating these
organizations and forming a behavioral health managed care organization.
h. Structure and Capacity-Critically evaluate the Department's structure to support
the Strategic Plan and the Department's services in an effective, accountable and
efficient manner. Complete by Spring, 2006. Resources needed. Current
challenges:
1) Contract development/monitoring capability (currently insufficient). Audit finding
2) Supervisor to direct service ratio (sufficient clinical supervision across the
Department). Note: September, 2005, ratio is 9 clinical supervisorsl4 to 57.1 clinical
staff.
3) Support staff: sufficient help for direct service staff to maximize clinical hours.
Direct service to program support ratio (emphasis on direct service with sufficient
support). Note: September, 2005, ratio is 57.1 clinical staff to 4.5 clerical support
staff.
4) Medical Director: sufficient psychiatric time for prescribing and administrative
oversight.
5) Prescriber time: sufficient time for prescribing and medication management.
13The County's Mental Health, Alcohol and Drug Advisory Board serves as the Quality Management Committee.
74Advlt Treatment has 3.0 supervisors to 24.18 clinical staff. Child & Family has 1.6 supervisors to 17.25 clinical staff. DD
has 0.75 supervisors to 13.05 clinical staff. Seniors has 0.25 supervisor to 4.55 clinical staff.
Deschutes County Mental Health Strategic Plan DRAFT October, 2005
Page 23
Exhibit C
Page ~~of_l1b
3. Business Services
a. Sustainability-Sustain key services and maintain our financial viability. Offer high-
quality, publicly funded services. Sustain services to priority populations: maintain
core services and supports to meet growing community needs.
b. Three-Year Financial Plan-Maintain a financial plan based on current revenue,
expenses, trends, and priorities in the Strategic Plan. See Appendix B, pages 44-45.
Work to sustain current operations through 2007-08 by using operating revenue and
significantly reducing reserves. New resources, greater cost containment needed In
2008.
c. County Indirect Charges-Seek methods to assure that County indirect charges do
not increase at a rate greater than operating revenue unless County general funds
are available to offset such increases] 5. New resources needed if this can't be done.
d. Sustainable Personnel Costs-By 2008, set the number of staff at a level that can be
supported exclusively with operating revenue. Adjust staff levels as needed, primarily
through attrition. Note: On average, about 10-15 positions are vacated each year.
e. Contracting Process and Support-Improve our contracts management process as
recommended by the County's Internal Auditor. Assure we can effectively develop
and monitor Department's contracts, thereby meeting risk management and legal
requirements while investing wisely and fully in private agencies and their services.
Audit recommendation. Resources needed.
f. Financial Management-Continue to operate our financial billing and fund
management system in compliance with County standards and practices.
1) Sound Management-Assure sufficient resources to maintain a balanced budget
and fund core services. Operate within the annual adopted budget and three-
year financial model. Adjust the three-year budget at least semiannually.
2) Contingency Fund Policy-Invest the majority of our reserves in services over the
next two to four years while operating within this new policy. Assure that the
Department retains sufficient reserves to remain in compliance with this policy.
g. Medical Records--Assure this critical system is operating efficiently within Department
guidelines and requirements. Emphasize efficiency, capacity, benefit, compliance
with State and Federal requirements and adherence to Department policies and
procedures. Note: Includes all programs and remote locations.
h. Electronic Medical Records-In cooperation with Information Technology, form a
work group to study the feasibility of acquiring and using a new electronic system for
medical records. Develop findings and recommendations including a preferred
package, financing and transition plan. Emphasize ease for clinicians and utility for
treatment, planning and billing. Acquire a system by 2007-08. Audit
recommendation and staff recommendation. Resources needed for feasibility study
and system development.
151ndirect charges reflect Department payment for the cost of County support services including Legal
Counsel, Personnel, Building Services, Finance, Information Technology and County administration.
uescnutes County Mental Health Strategic Plan DRAFT October, 2005
Page 24
Exhibit_ F.
Page 1 of~
i. Reception Sup port (Main Bend Clinic and Bend Annex
1) Centralized Scheduling-Work with information Technology and clinical staff to
assure use of the centralized electronic scheduling system.
2) Reception-Continue to adapt and enhance reception staff's role in new client
orientations and handling of crisis and screening telephone calls.
j. Fiscal Support
1) Audit Findings-Implement internal auditor recommendations, where practical.
2) Fees-Modify client fee setting process to ensure accurate information is
obtained and appropriate fees are being set.
3) Billing-With help of Information Technology, move to an all electronic billing
system and increase frequency to bi-monthly. Goals are to save staff time and to
improve collections.
k. Capital Acquisition and Minor Equipment-Provide the necessary equipment to
support work of staff and volunteers.
1.) Computer Replacement-Acquire and maintain sufficient hardware to support
staff work; acquire less costly WBTs (Windows-based terminal) whenever practical.
2005 inventory: 26 PCs, 70 WBTs, 9 laptops and 24 printers.
2) Vehicles-Budget funds for replacement and acquisition of enough vehicles to
support our services. It is our goal to reduce new purchases over the next three
years in recognition of the current age of the Department fleet. This will reduce
replacement costs during that time period. 2005 inventory: 22 vehicles.
3) Video Equipment-Assure acquisition and replacement of dependable, high-
quality equipment for groups and training. Staff recommendation.
4. Program Development (General)-Quality, Access, Services and Productivity
a. Recovery-Department Mission and Values-Establish an explicit emphasis on
"recovery" as a foundation for all Department programs. Review and amend as
needed the current mission and values. Affirmed by Advisory Board in spring, 2005,
work session,
b. Improved Access to Services-Seek methods to provide timely access to services for
eligible County residents.
1) Appointments-Increase access by reducing "no shows," particularly at time of
intake. Reduce waiting list to a maximum of two weeks for non-urgent care.
Increase access through appointment reminders, piloting of a drop-in
appointment process, and reducing the time delay between calling for and
getting an appointment.
uescnutes county Mental Health Strategic Plan DRAFT October, 2005
Page 25
Exhibit
_S
Page of
2) Scheduling-Use the computer scheduling system consistently and routinely to
schedule appointments, generate service tickets to document services, track
charts, manage cancellations and reschedule appointments when needed.
3) Geographic Proximity-Assure loc4 access to services in La Pine and Redmond
proportionate to projected need. Emphasis on residency of Oregon Health Plan
members and eligible indigent clientele. Work with the community of Sisters to
determine need for local services. Based on this determination, offer local
services to Sisters area residents no later than 2007. Resources may be needed.
C. Client Chart Review Process-Strengthen the formal chart review process to assure all
staff receive periodic reviews. The goal is to have all staff meet Department
standards. Technical assistance and additional reviews will be focused on staff
needing more assistance. Staff recommendation.
d. Client Treatment Charts-Meet information and documentation needs required by
Oregon law and Administrative Rules to document critical client and service data.
1) Critical Review and Change-Convene a work group to recommend specific
changes that would begin reducing paperwork, increasing productivity (service
hours), increasing automation (using technology), assuring regulatory and grant
compliance and increasing our efficiency. Nearing completion fall, 2005.
2) Forms---Update our intake assessment and treatment plan forms to streamline
documentation to the greatest degree possible while assuring compliance with
Oregon Administrative Rules and effective use of best practice techniques.
3) State Review-Consult with the State's Office of Mental Health and Addiction
Services to assure the updated forms meet State documentation and reporting
requirements.
4) Training-At least annually, train staff on use of the forms for quality control,
documentation and treatment planning.
e. Group Practice-Continue commitment to offer the group modality for a variety of
treatment and support services (both successful and cost effective for many clients).
1) Continuation of Group Practice-Sustain and expand (where feasible) current
offerings. Offerings September, 2005: 42 Child & Family; 26 Adult and Seniors.
2) Parent Groups-Offer group treatment services for parents of minor children.
Staff recommendation.
3) Physical Space-Increase group rooms at the main clinic. (Note: Three rooms
available in 2005). Note: Additional room scheduled for fall, 2005. Staff
recommendation.
Deschutes County Mental Health Strategic Plan DRAFT October, 2005
Page 26
Exhibit -
Page '7C? of
f. Health Care Inte ration-Seek opportunities to integrate mental health services with
physical health care in our local communities.
1) Care for Low income Individuals-Collaborate with the Bend Community Clinic
and the Volunteers in Medicine Clinic to assure appropriate referrals and services,
where feasible, for low income individuals and families in the community.
2) FQHC in La Pine-Long-term, support community efforts to develop a Federally
Qualified Health Clinic to serve the La Pine community.
g. Network of Care-Monitor Lincoln County's development of the California-based
Network of Care, recommended by the President's New Freedom Commission. This
internet based system is multifaceted and offers comprehensive information on
mental illness, evidence based practices and services in the local area. Consider
implementing the system in 2007.
5. Child and family Services
a. School Based Services-Expand our current service capacity to assure mental health
and addiction prevention/early intervention services are available in all public
schools in Deschutes County at least one day per week. Resources needed.
Current capacity: 26 schools, 70 % of 37 public schools in 2005-06; 32 schools, 546
children in 2004-05. Resources are needed or service levels will be reduced.
b. KIDS Center-Sustain and expand mental health services at the KIDS Center as part
of a multidisciplinary assessment and treatment system. This is a critical community
service and program priority. There were 235 children served in 2004 with total hours
of 2,902. Oregon Health Plan (OHP) funds are essential, community or foundation
resources are needed to offer services to other children and families or therapy
services will be reduced.
c. Children's System of Care-(NEW) -Implement Oregon's new Children's System of
Care Initiative for the benefit of Deschutes County children (and their families) with
more serious mental health needs. Early emphasis on OHP child members with serious
emotional disturbances. Goals include local options, coordination with other service
systems and active family involvement. OHP funds are essential, there are limits to
our capacity to help high-need children.
I ) Central Oregon Region-Help develop the Central Oregon Advisory Council,
develop the regional care coordinator position(s), use an approved assessment
instrument and manage available resources.
2) System and Service Development-Develop high-quality, evidence based,
services to meet the needs of local children and families. Through our managed
care organization, provide or contract for individualized services through private
children-serving agencies based in Central Oregon. Invest in services through
Trillium Family Services and Cascade Child Center if feasible.
3) Maximize Services. Accurate Recording (Encounters) -Consistently document all
encounters to assure availability of Medicaid resources.
Deschutes County Mental Health Strategic Plan DRAFT October, 2005
Page 27
Exhibit E-
Page $C) of k \ 0
d. Mediation-Sustain mediation services to divorcing families with minor children. Long
standing program will continue to be offered in collaboration with the Circuit Court.
There were 75 mediations in fiscal year 2004-2005. Domestic filing fees are essential.
e. Custody Evaluations-(NEW)-Initiate a new service to benefit divorcing families with
a minor child and the Court during divorce proceedings. Receive referrals through
the Court; offer high-quality services. Projecting a maximum of 50 evaluations in 2006
but anticipating between 24 and 50. Domestic filing fees are essential.
f. Youth Suicide Prevention-Work with schools, agencies, and the community to
support suicide prevention strategies and treatment options. Participate actively in
the Suicide Prevention Coalition, supporting the coalition's priorities. Note: in 2003
there were 63 documented youth suicide attempts in Deschutes County and 922 in
Oregon. Resources needed to support priorities.
g. Early Childhood-Provide staff with supervision, consultation and training to assess,
diagnose and develop appropriate treatment planning and wrap-around services
for young children with mental health needs. Increase staff awareness of services
provided by other community agencies and work with these other agencies to
develop joint treatment planning to meet the needs of young children with mental
health needs. OHP and State funds essential.
h. Home Visits (2005 OMHAS Audit Recommendation-Provide periodic training
opportunities for staff to allow for home visits with families (where needed and within
our capacity) as part of the therapeutic and farnily support process. Funding
considerations are unknown at this time.
i. Collaboration With All Children's Systems Promote a value that our staff work closely
with other children's helping systems including Juvenile Justice, Courts, Child Welfare
and education. Dedicated time of existing staff.
j. Local Access in Outlying Areas-Expansion of services in North and South County in
response to access issues, community population growth and an emphasis on
outreach to Oregon Health Plan members and indigent families. Includes local
services in Sisters at some point in the future. New resources needed to meet growth
in these communities. May require redeploying resources currently located in Bend.
2004-05 Service Levels
Area
Est. 2004 Total
Population
Est. Number of
_ Children's
Number of Children
Served
Bend
65,210
15,976
861
La Pine
5,799
1,421
132
Redmond
18,100
4,434
283
Sisters
1,490
- 365
28
Number of Oregon Health Plan members in each area varies; services to OHP
members will remain a priority,
I6Popvlation statistics used are from the Portland State University Population Research Center. Children (ages 0-171
make up 24.5% of Oregon's total population, and that percentage was used to calculate Deschutes County's child
population.
Deschutes County Mental Health Strategic Plan DRAFT October, 2005
Page 28
Exhibit_ E
Page ? of ~ b
b. Adult Mental Health Treatment and Support Services (See also Chemical Dependency
and Justice System)
a. Community Support-Sustain case management and treatment for clients with a
serious mental illness. Operate within a framework of Assertive Community Treatment
and Strengths Based Case Management capable of providing frequent contact with
highest need clients, outreach, support, case management and treatment services.
2005 case load: 185.
b. Acute Care-Work to create and sustain an effective system of acute care and
intensive service options for adults experiencing significant emotional distress.
1) Resources-Effectively invest new State funding to develop essential acute care,
case management and respite services. Continue to advocate for an equitable
share of State funds for acute care.
2) Regional Council and System-Participate actively in the development of a high-
quality regional system of care. Develop and sustain service options including
Sage View (including access for indigent individuals and OHP members), actively
manage inpatient costs and resources, and monitor services and cost trends.
3) Oregon State Hospital and EOPC-Represent the interests of Central Oregon in
planning for changes at the State Hospital and downsizing of acute care at Blue
Mountain Recovery Center (formerly Eastern Oregon Psychiatric Center or EOPC).
4) Utilization Management-Dedicate staff time (through our managed care
organization) to care and resource management for OHP and indigent clients.
Routinely track services and funds and review exceptional cases to assure we are
managing risk and making the best possible use of available resources.
c. Outpatient Treatment-Address access for mental health, addictions and gambling
treatment. Assure that clients meeting service priorities are seen in a timely fashion
and decrease no-show rates. Expand services in Redmond and La Pine. Continue to
support and develop the Dialectic Behavioral Therapy program for high-need clients.
Continue to support a brief treatment model for appropriate clients. Maintain a
utilization management process to assure clients get the appropriate level of care
and assist clinicians to manage caseloads with increasing demands for services.
d. Groups-Continue to support and expand group treatment services and move
toward more targeted focus. Identify target populations and diagnoses that are best
treated by group services and increase the use of evidence based practice models.
e. Employment (Supported)-In cooperation with clients, local employers, and the State
Department of Vocational Rehabilitation, increase our capability and capacity to
offer supported employment opportunities to people with mental illness.
f. Housing (Supported)-Develop additional partnership(s) with CORHA to create short-
term or permanent housing units in Redmond and Bend for people with mental illness.
Seek County or City assistance in securing land for acquisition and grant funds for
construction. Dedicate sufficient department staff to provide necessary case
management and support services.
Deschutes County Mental Health Strategic Plan DRAFT October, 2005
Page 29
Exhibit-
Page-Z2, of 11
g. Medication Management-Monitor available resources for access to prescriber
appointments within the department's system and evaluate the need to allocate
additional resources to this service. Continue to explore the most effective and
efficient use of these limited resources and expand alternative methods of service
delivery such as group medication management models. Increase coordination with
primary care providers for ongoing medication management. Expand use of
evidence based practices within accepted .department prescribing practices such
as use of medication algorithms and standardized assessment/documentation
formats. New resources may be needed.
h. Crisis Team-Support development of a "crisis bag" for each member of the
Community Assessment Team and on-call workers. Staff recommendation.
2004-05 Service Levels
Area
Est. 2004 Total
Population
Est. Number of
Adulis17
Number of Adults
Served
Bend
65,210
49,234
1,449
La Pine
5,799
4,378
181
Redmond
18,100
13,665
455
Sisters
1,490
1,125
45
Number of Oregon Health Plan members in each area varies; services to OHP
members will remain a priority.
7. Seniors' Mental Health Services
a. State Funding-Advocate for the restoration of State funds for mental health services
for seniors (progress made). In addition to the restoration, work toward an allocation
of additional State funds (comparable to other counties with senior programs) based
on need and a commitment to support high-quality programs for this population.
b. Senate Bill 781 Implementation 12005 legislation)-In recognition of the passage of this
new Oregon law, participate in State efforts to implement the law and increase state
and local programming for seniors.
c. Enhanced Care Outreach Services-Expand the Enhanced Care Outreach Services
program by increasing the number of clients served. This expansion would allow for
additional staff hours which would ensure more individualized services to clients and
better distribution of staff hours over the seven days a week the program operates.
d. Trainina-Expand the array and quantity of mental health services available to
seniors by increasing staff skills in providing more group work.
e. Service Expansion-Develop a new project that uses a coordinator to recruit, train
and supervise volunteers and student interns. Many of the clients could benefit from
more frequent contact with friendly visitors along with their other mental health
treatment.
17Population statistics used are from the Portland State University Population Research Center. Adults (18 and older)
make up 75.5% of Oregon's total population, and that percentage was used to calculate Deschutes County's adult
population.
Deschutes County Mental Health Strategic Plan DRAFT October, 2005
Page 30
Exhibit
Page -&3 of 11 O
Expand Service Locations-Explore opportunities for co-locating services in Senior
Centers or medical settings where clients might be more comfortable receiving
services.
8. Chemical Dependency
a. Establish Guiding Principles
1) Collaboration-Our community is best served through collaboration, a common
focus and mutual support between Deschutes County Mental Health, other
County departments, and private prevention and treatment agencies and
coalitions.
2) Investment-Treatment resources available to Deschutes County should be
invested in a manner that assures the maximum amount of high-quality services.
3) Results-Services must be based on evidence based practices and consistently
report measurable outcomes that demonstrate effectiveness.
b. Comprehensive Approach-Work with the community to develop a system with a full
continuum of services to prevent substance abuse and to assure access and
engagement of those in need of addictions treatment. Resources needed.
c. Co-Occurring Disorders-Retain primary responsibility for the treatment of co-
occurring mental illness and addiction issues by Department clinicians. Assure
qualified, well trained professionals are offering these services.
d. Equity-Advocate with the State for a fair and equitable investment of treatment
resources for Oregon residents, regardless of their county of residence. Eliminate
current inequities that exacerbate social problems in our community through an
inadequate level of treatment services for County residents. Resources needed.
e. Family Drua Court-In partnership with the courts, provide leadership in securing
treatment resources to develop and implement a family drug court. Offer treatment
of co-occurring disorders directly by Department staff while using one or more private
agencies for the delivery of chemical dependency treatment.
f. County Leadership-Convene treatment professionals at least quarterly to address
planning, advocacy, service coordination and program development priorities and
issues. Promote and bring visibility to chemical dependency issues.
g. Methamphetamine Coordinated Response-Participate actively in the Meth Action
Coalition, supporting a comprehensive approach focused on prevention, treatment
and public safety. Seek resources to expand treatment. Resources needed.
h. Oregon Health Plan Members-Assure availability of timely, high-quality addiction
treatment services to Oregon Health Plan members through operation of the
County's Chemical Dependency Organization.
Deschutes County Mental Health Strategic Plan DRAFT October, 2005
Page 31
Exhibit
Page ?,e4_ of
i. Prevention-Support the substance abuse prevention work of the Deschutes County
Commission on Children & Families (CCF). Invest public funds through projects
sponsored by CCF. Support evidence based projects that reduce at-risk youth
behavior and support healthy family functioning.
1) Increase partnerships with treatment providers.
2) Reduce adolescent alcohol use in Deschutes County.
3) Conduct analysis of beer and wine tax money distributed in Deschutes County.
4) As able, reinvest funds from the Chemical Dependency Organization in projects
that prevent substance abuse.
j. Priority Populations-For the foreseeable future, the Department will focus its limited
treatment resources by prioritizing service to specific groups in our community.
1) Youth--In an effort to stem the spread of substance abuse in our community, we
will focus on the prevention and treatment of adolescent alcohol use.
2) Adults-Focus on four populations: a) OHP members, b) families with minor
children (child welfare concerns), c) people with a methamphetamine addiction
and/or d) individuals in the justice system (effective alternatives to incarceration
and opportunities to prevent recidivism).
3) As restricted resources become available, other populations in our community will
receive assistance within those grant guidelines.
9. Justice System Services and Alternatives to Incarceration
Special note: This section of the plan is being constructed in collaboration with the
Deschutes County Local Public Safety Coordinating Council. The work on this issue is
ongoing; additions and adjustments to these priorities are expected.
Mental health and substance abuse treatment services and prevention strategies are
essential to an effective public safety and justice system. It is the collective goal of
mental health professionals, the courts, corrections and law enforcement in Deschutes
County to ensure access to quality treatment, prevention and support services for youth
and adults with mental illness who impact the criminal justice system.
"People with 'mental illness or 'co-occurring disorders' exact a high to[/ on the justice
system. Revenue spent on their care while incarcerated pulls scarce resources away
from the justice system's primary function-prosecution of criminals. Besides:
• Individuals with mental illness stay in jail longer,•
• They are more expensive to maintain;
• Without proper treatment, they pose a high risk of re-offending; and
• They are at high risk for suicide while incarcerated."
- Oregon Partners in Crisis
Deschutes County Mental Health Strategic Plan DRAFT October, 2005
Page 32
Exhibit
Page $5 of
The Deschutes County Local Public Safety Coordinating Council and its members
endorse a long-term community effort to develop and implement effective early
intervention programs and projects that provide for public safety; present alternatives to
incarceration; and better serve, treat and hold accountable individuals with mental
illnesses and/or addiction issues. We need to develop and sustain system improvements
and initiatives,
a. Collaboration-Develop a lasting and formal partnership through the Local Public
Safety Coordinating Council to address the criminalization of the mentally ill and to
plan and carry out core strategies and programs.
b. System Development-Emphasize a systems approach to improvements in programs,
services and practices used to address the issues associated with mental illness and
addictions.
c. Diversion In Lieu of Bookina
1) Crisis and Intensive Outreach-Reduce unnecessary hospitalizations and
incarceration through prevention and early intervention. Sustain the County's
Community Assessment (Crisis) Team for assessment and crisis intervention and
the Community Support Services Team for intensive wrap-around services to high-
need clients (includes treatment and connection to programs and supports).
2) Coordination and Referral to Hospital-Work closely with Cascade Healthcare
Community and other hospital systems to assure appropriate referrals and
coordination of services. Increase justice system awareness of hospital roles,
services and capacities.
3) Sage View-Assure successful operation and availability of this secure (short-term)
crisis stabilization and treatment center for eligible individuals including Oregon
Health Plan members and indigent individuals,
4) Hold Rooms at St. Charles Medical Center-Expand access to short-term stays at
the hospital for assessment and stabilization.
d. Jail Bridge Program-Sustain and expand services to adults with co-occurring
disorders within the jail and the community corrections system in Deschutes County.
Goals include reducing recidivism and improving functioning in the community
through housing and job assistance, treatment, medication management and other
community supports.
e. Crisis Intervention Training (CIT)-Over the next two years and in cooperation with
local law enforcement agencies and the local chapter of NAMI, develop and
implement CIT as an evidence based practice which increases the ability of first
responders to work with people with mental health or addiction issues. NAMI is
launching a nationwide campaign in support of this training. Establish a method to
assure ongoing training for new employees. Include a train-the-trainer approach
with law enforcement, jail and mental health professionals. Coordinate project with
Sheriff and Police Chiefs.
uescnures county mental Health Strategic Plan DRAFT October, 2005
Page 33
Exhibit
Page '&a of
f. Family Drug Court and Drug Court-In partnership with the courts and treatment
providers, provide County leadership to help secure treatment resources to develop
and implement a comprehensive family drug court. Develop a work group to design
the court process and referral system. Coordination to occur through the Circuit
Court.
1) Family Drug Court-Prioritize families with minor children. Reestablish a work
group to begin operational planning to begin a Family Drug Court in 2006.
Treatment resources must be secured through pending federal grant
applications, the meth initiative of the 2005 Oregon legislature (through the
Criminal Justice Commission), and/or Oregon Health Plan funds where
applicable. Pilot program size: 10 families (estimate) with one assigned judge.
2) Evaluation-Conduct an evaluation of Family Drug Court to determine benefit
and opportunities for improvement and/or expansion.
3) Expansion Long-Term-Expand the Family Drug Court to serve appropriate
individuals in need of addiction treatment. Decision on whether to focus
expansion on a juvenile court or adult court would occur at a later date.
g. Mental Health Court-With courts and program partners, sustain and expand this
deferred sentencing program as an effective treatment alternative for County
residents with a mental illness who commit (primarily) non-person misdemeanors.
Deschutes County Mental Health services: assessment, treatment, case consultation.
2005 capacity: 14 at one time.
h. Jail Services
Services performed through jail staff include assessment, medication and
stabilization, particularly of seriously and persistently mentally ill population.
Challenges: cost of medication. County mental health is available for after-hours,
crisis assistance. Needed hospitalizations are accomplished cooperatively between
jail and mental health staff.
As an immediate priority, DCMH will convene a meeting with representatives of the
Courts and the jail to develop a plan for managing the care and custody of alleged
mentally ill persons (AMIP) who are in custody of law enforcement agencies. To be
completed by spring, 2006. (MH audit requirement)
Juvenile Services-(This section was provided by Juvenile Community Justice). The
use of secure detention for young people between the ages of 12 and 17 is a serious
tool for ensuring public safety and youth accountability, not undertaken lightly and
strictly outlined within Oregon statute. Any detention decision is the result of serious
contemplation and often consultation between the various arms of the juvenile
justice system and is always ultimately monitored and approved by the Court.
The Department of Juvenile Community Justice is in the process of analyzing data
and practices related to detention and will be asking for assistance from the Casey
Foundation's well-respected "Juvenile Detention Alternatives Initiative" project in
2006. This will involve discussion and consensus of all community players in this
important arena. At this time, we have identified the following challenges and needs
related to detention of youth offenders with specialized treatment needs:
Deschutes County Mental Health Strategic Plan DRAFT October, 2005
Page 34
i~~of
1) Sex Offending Youth Offenders-We have anecdotal and increasing empirical
evidence that post-adjudicatory youth with sex offending charges are
sometimes held for long periods of time in detention, without benefit of
treatment, due to long waiting lists at non close-custody residential treatment
facilities and lack of local resources to treat this population. We aim to avoid
this use of detention and increasingly are looking at developing resources to
create a local/regional residential treatment program with appropriate safety,
treatment and transition/reintegrotinn elements.
2) Youth Offenders With Serious Mental Health Issues and Substance Abuse-We
have anecdotal and increasing empirical evidence that youth with serious
mental health issues and substance abuse challenges in need of residential/
inpatient treatment are sometimes held for long periods of time in detention,
without benefit of treatment, due to long waiting periods and lack of local
resources. We aim to avoid this use of detention and advocate for
development of local and other group and individual transition homes for youth
offenders with mental health disorders who are facing setbacks in existing
mental health treatment/residential placements, waiting for placements and
reintegrating home from placements.
j. Supervised Housing-As recommended by Adult Parole & Probation, seek resources
to develop and offer transitional, supervised housing for people with mental illness
who are diverted from the justice system or are seeking to re-enter the community.
The goal is to offer safe, stable housing for clients and to prevent recidivism. This
need became more apparent with the 2004 closure of Park Place.
k. Psychiatric Security Review Board (PSRB)
1) Greater Awareness-Seek State assistance in training jail staff and others on the
PSRB process and guidelines, clarify process to differentiate mental illness issues
from criminal acts, and the County's role in revocations. Establish a method to
better inform jail of PSRB individuals residing in Deschutes County. Note:
Deschutes County has 12 individuals under PSRB supervision (September, 2005)
including seven adults in foster care and five others living in the community.
2) Aid and Assist-Expedite the aid and assist process for PSRB clients to reduce
unnecessary jail days awaiting processing. Arrange training for assistant district
attorneys and defense attorneys on PSRB and the aid and assist process.
1. Addictions Treatment-Long term, work to expand alcohol and other drug treatment
services for people involved in the justice system.
Deschutes County Mental Health Strategic Plan DRAFT October, 2005
Page 35
Exhibit
Page CZ>of ~kh
10. Developmental Disabilities Services
a. eXPRS System-Locally implement the new statewide service authorization system for
the approval and financing of services for clients with developmental disabilities. This
will require close coordination with the State and local providers. Develop expertise
to assist other department programs which may be asked to move to this new system
in subsequent years.
b. Case Management, Family Suraport and Crisis Resolution-Continue to work with
statewide councils and advocacy groups to maintain and improve services to
individuals with developmental disabilities and the families that support them.
Advocate for increases in the Regional Crisis Program to develop more residential
resources in our community for high-need clients. We currently serve 415 clients.
There is no wait list for case management as we are required to serve all clients who
meet the eligibility requirements and address all crisis needs for eligible clients. Family
support serves 46 families; at least 35 more are waiting for that service.
c. Community Resources-Increase the number of choices available to people with
disabilities to remain in their homes and in their community and have their needs met.
Recruit, train and monitor more foster home options for adults and children. Develop
a new residential resource in the community.
d. Brokerage Services-Work with other partners to assure continued and increased
State support for Staley Settlement Brokerage services. Continue to work closely with
the Brokerage to maintain individualized supports to clients. Currently 113 people
receive services from the Brokerage; 45 more are waiting.
e. Lifespan Respite Services (Regional Proqr am1-Identify additional resources to
expand the Lifespan Respite Program. This program not only improves the quality of
life for our clients and their families, but also helps to delay or prevent costly out-of-
home placements. Resources are needed for increased staff time to recruit and train
more providers and to access grants and other resources to increase the availability
of stipends for families to access needed respite services. We have served 135
families in the past year and have 35 providers who have completed the criminal
history check and are available to provide service. Resources needed.
f. Client and Family Self-Advocacy-Support self-advocates in their efforts to make the
community more accessible to people with disabilities. Continue to facilitate training
and discussion opportunities for these individuals to increase their self-advocacy skills
and to identify problem areas and generate solutions.
g. System Coordination (Regional)-Advocate with the State for continued and
expanded support for the Regional Services Program. We work with Crook, Jefferson
and Lake and Lane counties to respond to the short- and long-term crisis needs of
adults and children with disabilities. Foster care recruitment, training, licensing and
monitoring are also handled on a regional basis. We will now begin working on
developing new residential resources through the Staley Settlement. As a region we
will identify residential needs and develop these resources in parts of the region that
will most benefit our clients.
Deschutes County Mental Health Strategic Plan DRAFT October, 2005
Page 36
Exhibit E,
of~1b
R Page
APPENDIX A: Audit Aetinn Ptnn
PROBLEM pouRCQ
SOLUTION
WHO/WHEN DONE
LACK OF CLINICAL SUPERVISION, OR
Sign-in sheet for group supervision.
Elisabeth Huyck X
LACK OF DOCUMENTATION (Requirement
. Documentation of scheduled and
Joe Marcea
is 1 hour individual and 1 hour group
drop-in individual supervision.
Suzanne Smither
supervision) IA&D audit)
Karen Tamminga
DocumentatiQn to Sheryl for clinical
Sheryl Hogan
supervision log.
Community Treatment add A&D specific
- -
Karen Tamminga X
supervision group.
_
August 1
CS
A&D peer supervision group.
CSS Team X
August
Elisabeth will get her CADC license.
-
Elisabeth Huyck
- -
-
December 1
-
&F A&D peer supervision group----d---------
an
---a---
C&F Tem X
clinical supervision group each meet one
Joe Marcea
_
hour each month.
"NONMEDICAL" DIRECTOR
. Job description
(A&D nvdit)
• Time
• Training
• Evaluation
ADVISORY COMMITTEE-INCLUDE
Recruitment process for new members will
MHADAB
ADDITIONAL PARENTS OF CHILDREN &
occur as needed.
Nominating Com.
ATTENDANCE BY C.M.P.
Each recruitment
(MM audit)
cycle
CONTRACT WITH SAGE VIEW MUST MEET
Send copy of contract to State MH
Kathe Hirschman
X
OARS AND LAY OUT HOW ALL THREE
auditor.
COUNTIES MEET THEIR RESPONSIBILITIES.
(M H audit)
Auditor found contract to be thorough
and to meet requirements.
C.M.H.P. HAS THE RESPONSIBILITY TO
_
Work with Sheriff & Jail Commander on
Terry Schroeder
PROVIDE SERVICE FOR ALLEGED
process.
January 2006
MENTALLY
ILL PERSON IN JAIL
-
-
.
(MHaudit)
NEED MORE INFORMATION
Keith Breswick
PERSONNEL RECORDS-CRIMINAL
Send list of all staff and date of approved
Kathe Hirschman
X
HISTORY CHECKS.
criminal history checks to State.
MH audit
COMBINED INSURANCE AND CLIENT
Improve internally developed billing
Greg Canfield
PAYMENTS EXCEEDED AMOUNT OF
software to identify any overpayments.
David Givans
SERVICE.
'
MORE INFORMATION NEEDED.
July 2006
Givans
audit
PAPERWORK
Revise forms.
Paperwork Com.
• ASSESSMENTS
Ron Fisher
• TREATMENT PLAN
Keith Breswick
• RELEASE OF INFORMATION
September
t
PROGRESS NOTES
Compare new forms with Ron's findings to
-
Lori Hill
• NOTIFICATION OF MEMBER RIGHTS
make sure findings are addressed in the
Karen Tamminga
• CRISIS PLAN
forms.
September 1
(A&D audit) -
-
(ABHA audit 2004)
Training for clinicians. Sheryl and
Supervisors
supervisors will complete sample charts for
Sheryl Hogan
the training.
Ron Fisher
Keith Breswick
-
September 26
_
•
Implement new forms.
-
October 1
Deschutes County Mental Health Strategic Plan DRAFT October, 2005
Page 37
Exhibit
Page o_ of \ \ b
PROBLEM (SOURCE)
SOLUTION
WHO/WHEN
DONE
FEW ENCOUNTER CODES BEING USED
Each team will review codes to identify
Jean Tonsfeldt
RELATIVE TO TOTAL AVAILABLE
appropriate code for each service
Lori Hill
(Encounter dots study)
provided.
Tim Malone
Karen Tamminga
Elisabeth Huyck
Terry Schroeder
October 2005
IN-HOME SUPPORT PLAN NOT SIGNED
Plan has been corrected
Virginia Mayhill
X
(DD audit)
October 2004
MISSING INFORMATION ON INDIVIDUAL
_
Training on completing the information
Virginia Mayhill
X
INFORMATION SHEETS
sheet.
April 2005
DD avdit+
CASE NOTES
Make recommendation for improvement
Virginia Mayhill
X
(DD audit)
of progress note process.
Aril 2005
NO DOC, THAT REFERRAL INFO. WAS SENT
Transfer of record for individuals moving
_ _
Virginia Mayhill
X
TO GRANT COUNTY WHEN CLIENT
out of Deschutes County will be
TRANSFERRED SERVICES
documented.
DD audtt
NAME OF TEST ADMINISTRATOR NOT
Current provider will schedule another test.
Virginia Mayhill
X
DOCUMENTED; NO CURRENT ELIGIBILITY
EVALUATION
DD audit
NO DETERMINATION OF ADULT ELIGIBILITY
Exam to determine that diagnosis is
Virginia Mayhill
X
WAS FOUND IN FILE
appropriate will be scheduled.
DD audit
NO DOC. OF FINANCIAL STATUS
Verification of financial status added to
Virginia Mayhill
X
(DD audit)
_
the intake process.
FAMILY SUPPORT PLANS LACK REQUIRED
Family Support plans written too globally.
Jean Mendenhall
INFORMATION AND NOT DEVELOPED
Will correct as new plans are written
Ongoing
ACCORDING TO REQUIREMENTS
annually.
DD audit
NO DOC OF SERVICE COORDINATOR
CDDP will ensure documentation in file,
Virginia Mayhill
DESIGNATED WITHIN REQUIRED TIMELINE
including dates on application for services
Ongoing
DD oudtt
NO NOTIFICATION (OR DOC THEREOF) OF
All coordinators will comply with OARS
Virginia Mayhill
CHANGE OF SERVICE
regarding notification and documentation
Ongoing
DD audtt
PRINCIPALS FOR PLANNING
CDDP will comply with OARs regarding
Virginia Mayhill
(DD audit)
ringi als in planning.
Ongoing
INDIVIDUAL SUPPORT PLAN
_
Will document that plans are discussed
Virginia Mayhill
IDD audB)
with individuals.
Ongoing
DISCREPANCIES BETWEEN PLAN FOR
Not a system issue but a clerical CPMS
Virginia Mayhill
X
CRISIS RESPITE CARE AND ACTUAL
billing error. Corrected,
BILLINGS
D audit
PROTOCALL AND OUTPATIENT CRISIS
En
counter services provided at hospital
Terry Schroeder
X
SERVICES AT HOSPITAL & SAGE VIEW NOT
and Sage View.
BEING ENCOUNTERED
(Encdunierdata study )
- - - ----t-o-
Protocol) is working capture their
-----(3-1-1/-
ProtocABHA
encounters.
Ongoing
CAPTURE BRIEF ENCOUNTERS, ESPECIALLY
Develop complete list of services not
PHONE SERVICES
being captured. NO ACTION AT THIS TIME.
-
-
{Encounter data study)
-
forp--------aperwo--r--k-to------
Reduce time
neede
d
capture brief encounters.
'Ticket" clinicians can fill out for phone
Karen Weiner
calls. Provide training to clinicians.
October 2005
Deschutes County Mental Health Strategic Plan DRAFT October, 2005
Page 38
Exhibit ~Ll
Page qi: of_
PROBLEM (souacii)
SOLUTION
WHO/WHEN
DONE
BILLING DEPT. NOT FULLY CAPTURING
Printed reference number on service
Kelli Parks-Friesen
SERVICE TICKET DATA
tickets will provide accountability.
Therapists
IEncounicrdata study)
NO PROCEDURES TO ACCOUNT FOR ALL
January 2006 (or
SERVICE TICKETS.
when current stock is
(Glvans' audit
depleted)
NO CONSISTENCY IN HOW INDIVIDUALS
KEEP TRACK OF THEIR TIME PRIOR TO
• -C&F will pilot use of Accuterm
Therapists
FILLING OUT SERVICE TICKETS. NO
scheduler for all services provided, to
October 2006
CENTRAL RESOURCES HAVE BEEN
be entered each week.
PROVIDED TO ASSIST CLINICIANS
• Adult Tx will enter all appointments into
(Encounterduto study)
Accuterm scheduler and turn in all
NO SYSTEM FOR EASY DOC. OF SERVICES
service tickets within 7 days of service.
OUTSIDE AGENCY
Seniors will complete and turn in
(Encounter data study))
service tickets within 7 days of service
SERVICE TICKET DATA ENTRY NOT
.
SUFFICIENTLY SUPERVISED.
(Givons' audit)
CENTRALIZED SCHEDULING.
(MH audit)
CLINICIANS' FAILURE TO USE
Consider asking ABHA to conduct another
-
October 2007
COMPUTERIZED BUSINESS SYSTEM.
time study at some future date.
(Givans' audit)
-
Pilot having clients at clinic stop at
Karen Tomminga
reception on way out for next
Joe Morceo
appointment.
Suzanne Smither
September 2005
Review pilot. If successful, implement.
Kelli Parks-Friesen
_
December 2005
LACK OF ENCOUNTER DATA TRAINING
Provide encounter code and PEO code
Jean Tonsfeldt
(Encounter data study)
DIRECT SERVICES BY CLINICIANS AS
training for managers and line staff
Michele Shanklin
MEASURED BY BILLED SERVICES SEEMS
(videotape). EFFORTS TO CAPTURE MORE
Lori Hill
LOW
ENCOUNTERS SHOULD INCREASE BILLED
Sheryl Hogan
.
(Givans'audit)
SERVICES.
September 26
CONFUSION ABOUT P.E.O. CODES
ABHA contract with GOBHI to provide
ABHA (Sheryl to
(Encounter dato study)
training for DCMH
contact)
January 2006
QCMH staff to provide ongoing training for
Supervisors
new staff, with test
Ongoing
ABHA adapt GOBHI manual, keep current
ABHA (Sheryl to
and disseminate to counties.
contact)
-
January 2006----------
Work with Dale Jarvis to understand legal
ABHA
use of PEO codes and communicate any
TBD
changes to counties
MANY LOGISTICAL ISSUES RELATED TO
THE DIFFICULTIES ARE OUTWEIGHED BY THE
SERVICES IN SCHOOLS
BENEFITS OF PROVIDING SERVICES IN
IEncounterdata study) _
SCHOOLS.
ACCOUNTING FOR TRAVEL TIME
Travel time will be included in determining
Greg Canfiefd
(Encounter data study)
our cost to provide service.
ABHA
TBD
ABHA to seek State variance for travel
ABHA
-
time
TBD
CLINICIAN TOLERANCE FOR
DULY NOTED.
_
ADMINISTRATIVE TRAINING IS LIMITED
Encounter data stud
Deschutes County Mental Health Strategic Plan DRAFT October, 2005
Page 39
Exhibit_
Page LVZ_ of 1 `o
PROBLEM (souact)
SOLUTION
WHO/WHEN
DONE
C.P.M.S. OPENINGS AND CLOSINGS
ABHA continue to work with State to
ABHA
IMPACT ENCOUNTERING
streamline requirements.
TBD
Encounter data study)
RECEIPTS NOT DEPOSITED TIMELY OR
All money received is deposited daily.
Loretta Gertsch
X
RECONCILED TO FINANCE RECORDS
Givans' audit _
STAFF RESPONSIBLE FOR BILLING AND
We will implement segregation of duties
Greg Canfield
WRITE-OFF SHOULD NOT BE RESPONSIBLE
procedures related to billing/collections
November 2005
FOR COLLECTING & RECEIPTING MONEY
process.
(Givans' audit)
SEGREGATION OF DUTIES IN COLLECTION
Supervisor will perform periodic reviews.
Greg Canfield
SYSTEM COULD BE IMPROVED.
November 2005
(Givans' and t)
We now post unidentified receipts to
Loretta Gertsch
X
temporary suspense account.
CLIENTS NOT REQUIRED TO PROVIDE
Documentation of informalion used to
Maggie Adsit
X
SUPPORT FOR REDUCED FEES.
IGivans'oudltl
establish reduced client fees is required.
Ongoing
-
Clients granted a reduced fee should be
Maggie Adsit
X
re-evaluated annually or when a client
Ongoing
indicates a change in income level.
-
Clinic fee schedule is updated annually.
Greg Canfield
X
BOCC
On oin
WRITTEN ACCOUNTING POLICIES AND
Document accounting policies,
Greg Canfield
PROCEDURES CONCERNING DUTIES OF
procedures, roles and responsibilities.
July 2006
STAFF ARE INSUFFICIENT.
(Givans' audit)
COMPUTERIZED BUSINESS SOFTWARE
IT Programmer test to make sure changes
Dave Petersen
REQUIRES MORE OVERSIGHT.
'
are operating as planned. Other IT staff
Greg Canfield
(Givans
audit(
review code and changes to ensure IT
Ray Wingert
policies and procedures are being met.
-
July 2006
- - - -
Explore transition to information
Gre Canfield
management system.
Ray Wingert
December 2006
If current software continues to be used,
Ray Wingert
develop an operations manual.
TBD
CLINICIAN SUBMITS INVOICES ON BEHALF
County staff will not originate documents
Ron Tamminga
X
OF VENDORS.
'
for other entities. County staff will not
*ivans
audit)
authorize documents they prepare.
ASSIGNMENT OF REVENUE RECEIPT
Revise software so that receipt numbers
Ray Wingert
X
NUMBERS SHOULD BE CONTROLLED.
are controlled, not reissued, and deletions
(Givans' audit)
MANUAL RECEIPTS DO NOT CONFORM TO
can be monitored by supervisory
COUNTY POLICY.
personnel.
(Givans' audit(
A/R clerk should not have authority to
Greg Canfield
delete receipts.
Ray Wingert
November 2005
- -
Receipts conforming to County policy will
Loretta Gertsch
be used for all receipts.
-
November 2005
raC the receipts to assure monies have
Further discussion
been received for all receipts issued.
November 2005
LACK OF SECURITY AWARENESS OVER
Reinforce computer security policies. WE
Kathe Hirschman
COMPUTERS
'
NEED INFORMATION ABOUT PASSWORD
IT
(Givans
audit(
SCREEN SAVERS.
September 2005
uescnures county Mental Health Strategic Plan
Page 40
DRAFT October, 2005
Exhibit
Page C~ of \
PROBLEM souitcE)
SOLUTION
WHO/WHEN
DONE
DEPARTMENT DOES NOT HAVE
Obtain formal resolution for cash used in
Greg Canfield
APPROPRIATE APPROVALS FOR CHANGE
operations. Supervisor periodically
December 2005
AND PETTY CASH FUNDS
account for cash.
Givans' audit)
NEW COUNTY POLICY REQUIRES WRITTEN
Response was sent
X
RESPONSE (to ABHA's 2004 audit).
November 2004
lUvons' auditl
COORDINATED EFFORT NEEDED TO
Collection guidelines will be developed
Greg Canfield
COLLECT ON SERVICE BILLINGS.
'
July 2006
Givans
audit
FREQUENCY OF INSURANCE BILLINGS
Establishing guidelines for the frequency of
Greg
COULD BE IMPROVED.
billings.
November, 2005
(Givans' audit
RECOVERY FROM MEDICARE MAY BE
Require appropriate clinicians and
Kelli Parks-Friesen
IMPROVED.
prescribers to obtain Medicare provider
October 2005
(Givans' audlt)
number. Support and encourage
unlicensed clinicians (MSWs) to obtain
Identified clinicians
licensing and get Medicare provider
July 2006
_ number.
Consider assigning licensed clinicians to
areas serving Medicare clients. NOT EVER.
Assign Medicare clients to the clinicians
Supervisors
with Medicare provider numbers.
Ongoing
INPUT INEFFICIENT FOR SOME SERVICE
Improve computerized business system to
Greg Canfield
PROVIDER (CDO) CLAIMS BEING
allow more efficient data entry. MORE
David Givens
PROCESSED.
INFORMATION NEEDED
(Givani audit)
SERVICES BY CLIENT NOT PROPERLY
Post all payments and adjustments. by
Greg Canfield
MAINTAINED.
service line. Review older services, identify
David Givens
(Givans' audit)
and correct unbalanced service lines.
MORE INFORMATION NEEDED
OREGON HEALTH PLAN CLIENT WITH
Identify other self-pay clients that were
_
Kelli Parks-Friesen
CAPITATED SERVICES WAS CHARGED.
OHP standard and received benefits as of
October 2005
(Givans' audit)
8/l/04.
MEDICARE CARD SUPPORT NOT
Reception staff will ask for insurance
Reception Staff
OBTAINED.
'
information at every visit.
September 2005
(Gvans
oudiq
PARK PLACE BILLINGS SUPPORT NOT
When these programs are developed,
ORGANIZED,
procedures should be in place to
(Givans' audit)
accumulate services provided by date
and by procedure.
_
DULY NOTED.
LEASE DEPOSITS NOT USED AT END OF
Property and Facility Director to follow up
Greg Canfield
X
LEASE TERM,
on recovery of these monies from the
(Givans audit)
lessor.
C - over-- ---s--h-eet----in-- lease-- --fill--es-iden-----ti- - -fying-ite - - ms---
Greg----------------------
-
to be resolved before, during or at end of
September 2005
lease. _
USE OF COMPUTERIZED BUSINESS SYSTEM
Develop procedures to provide oversight
REPORTS NEEDS IMPROVEMENT.
of activities as maintained in the
(Givans oudit)
computerized business system.
NO ACTION BEING TAKEN AT THIS TIME DUE
TO LIMITED RESOURCES
SHOULD FLEX FUND MONIES BE LOANED?
'
We operate within the guidelines for use of
Scott Johnson (will
(Givans
audit)
flex funds. repayment occurs when
talk with Seth)
ossible. NO FURTHER ACTION REQUIRED.
Deschutes County Mental Health Strategic Plan DRAFT October, 2005
Page 41
Exhibit
Page-of
PROBLEM (souRCE)
REASONS FOR WRITE OFFS OF INSUR
SOLUTION
WHO/WHEN
DONE
ANCE
Develop collection procedures identifying
AND CLIENT RECEIVABLES SHOULD BE
the extent of collection efforts.
REVIEWED.
ADDRESSED ABOVE
(Givans'audlt)
------i-----------------------------------------
-
entfy the main reasons why insurance
Ray Wingert
and customers do not pay.
Kelli Parks-Friesen
- - - -
November 2005
Write-offs to be reviewed periodically by -
Greg Canfield
fiscal and clinical supervisory personnel.
Clinical supervisors
November 2005
COORDINATED OVERSIGHT NEEDED
OVER
Develop a performance standard for
PROFESSIONAL SERVICE PROVIDERS
prescribers. Develop reports by physician
(prescribers),
'
and nurse practitioner covering
(Givans
and;t)
performance standards. PRODUCTIVITY
REPORT HAS BEEN IN PLACE FOR SOME
TIME. NO ACTION REQUIRED AT THIS TIME
LACK OF COMMUNICATION ON
.
Personnel Dept. copy MH payroll staff on
Personnel Dept
X
PERSONNEL/PAYROLL ISSUES,
(Givans'audit)
any personnel changes.
-
.
Ongoing
the department, communicate
- - -
Supervisors
changes
changes to the payroll staff.
Kathe Hirschman
October 2005
PRIVACY OFFICER SUGGESTS USE OF
Follow Privacy Officer's and Legal's
Mike Viegas
BUSINESS ASSOCIATE AGREEMENTS.
Gi
'
guidance in agreements to assure HIPAA
July 2006
)
vans
audit)
compliance.
OVERSIGHT OF SERVICE PROVIDERS
Visit with providers t censure performance
Scott Johnson
COULD BE IMPROVED.
Ic"°"~ audit)
in accordance with contract. Detail
Lori Hill
documentation required for payment.
Greg Canfield
Obtain certification of client's completion
of the program. Review billings before
additional monies are paid.
CONTRACT FILES ARE INCOMPLETE
AND
Master log of all contracts with the
Greg Canfield
UNORGANIZED.
(Glvanvaudit)
department. Maintain all contracts in
AS FUNDS ARE
central location with checkout system.
-
AVAILABLE
SERVICES CONTINUE AFTER EXPIRATION OF
- -
Monitor expiration dates of contracts.
Greg Canfield
CONTRACTS.
Include one-year extension clause in
July 2006
(GNans' audit(
contracts.
COUNTY INSURANCE REQUIREMENTS NOT
-
V61 -fill-- all in--ance------require------------ments-- --and
ALWAYS FULFILLED BEFORE CONTRACTS
maintain insurance certificates in the
ARE IN PLACE.
contract file. WE WILL ESTABLISH A
Givans'audit
METHOD TO ASSURE COMPLIANCE.
ASSESSMENT OF CLIENT CULTUR
AL AND
Tie demographic information to cultural
Ongoing
X
DIVERSITY NEEDS
(ABHA audit 2004)
and diversity needs. Cultural consultations
for clients who do not come from
-
dominant cultures.
-
- - -
Intake assessment and treatment plan will
Paperwork
include categories for cultural diversity
Committee
and spiritual strengths and needs..
September 26
ADDITIONAL SITE REVIEW AREAS
:
The QIS work plan includes monitoring and
Sheryl Hogan
X
PERFORMANCE INDICATOR VALIDATION
enhancing:
(ABHA audit 2004)
. Access to Care Standard
• Treatment Planning Standard.
• Discharge after Hospitalization
Standard.
11-1111 all ultlyiu rlan DRAFT October, 2005
Page 42
Exhibit
Page C Of AQ-
PROBLEM (soURCE)
SOLUTION
WHO/WHEN
DONE
CONSISTENT IMPLEMENTATION OF OCI USE
_
OCI batches are reviewed for missing
Tiffani Ossig
)ASHA audit 2004)
information before being sent to ABHA for
Ongoing
tabulation.
&F requires staff to ask their clients to
x
complete the OCI.
-
CS,F are now pre-printing service tickets
x
that include the OCI.
-
eception staff issue the OCI to clients
Reception Staff
x
prior to appointment.
- -
Pre-print treatment goals on the OCI.
She--I Ho-an
-
Ray Wingert
- - -
January 2006
Service Service tickets are being revised. Training
Sheryl Hogan
of clinical staff will occur.
September 26
ADULT CONSUMER SATISFACTION SURVEY
-
RESULTS:
Aggregate Score 72.6% (75.7% in 2003)
Access 76.9% (82.5% in 2003)
Quality 80.8% (78.4% in 2003)
General Satis. 85.3% (86.07o in 2003)
Outcome 53.3% 62.9% in 2003
_
YOUTH AND FAMILY CONSUMER
SATISFACTION SURVEY RESULTS:
Aggregate Score 75.6% (80.4% in 2003)
Access 82.5% (83.4% in 2003)
Quality 83.8% (85,2% in 2003)
General Satis. 80.5% (85.7% in 2003)
Outcome 55.9% 68.8% in 2003
Deschutes County Mental Health Strategic Plan DRAFT October, 2005
Page 43
Exhibit E,
Page Q p of
APPENDIX B: Financial Plan 2005-2008
Actual FY Adopted FY Projected Projected
Account Description 2004/05 2005/06 FY 2006/07 FY 2007/08
86.65 FTF R3 /LS FTF Al LS CTc
BUDGETED AND ACTUAL REVENUES
Beginning Net Working Capital 1,634,080 2,658,399 2,573,195 1,790,853
State Grant
Equity Funds-State Grant
ABHA
Other State, Grant & Patient Revenue
General Fund
Other Transfers in
FUND RESOURCES TOTAL
7,935,679
7,847,352
2,908,735
2,908,735
677,985
338,993
338,993
338,993
2,183,768
2,426,727
2,624,230
2,624,230
1,968,626
1,647,554
1,725,979
1,756,679
1,040,132
1,115,022
1,193,074
1,276,589
400,000
611,430
-
_
15,840,270
16,645,476
11,364,204
10,696,078
BUDGETED AND ACTUAL EXPENDITURES
PER50NNEL SERVICE
5,537,265
6,289,388
6,543,316
6,795
733
COMMUNITY CONTRACTS
6,105,492
6,480,758
1,596,623
,
1,628
555
COUNTY INDIRECTS
642,896
718,577
786,636
,
861
141
MATERIALS & SERVICES
746,217
668,559
731,775
,
687
638
CAPITAL OUTLAY
5,000
5,000
,
5
000
TRANSFERS OUT-PROJECT DEVELOP
150,000
150,000
150,000
,
150
000
Contingency
-
_
,
FUND REQUIREMENTS TOTAL
Beginning Working Capital Carryforward:
Historical Underspending vs. Budget on Personnel
Services and M&S:
Projected Revenue (loss) for Period:
Ending Net Working Capital
Restricted Working Capital:
13,181,871 14,312,282 9,813,351 10,128,068
1,634,080 2,658,399 2,573,195 1,790,853
240,000
240,000
240,000
1,024,319 (85,205)
(782,341)
982,844
2,658,399 2,573,195
1,790,853
808,010
50,000 50,000
50,000
50,000
Unrestricted Working Capital:
2,608,399 2,523,195 1,740,853 758,010
Deschutes County Mental Health Strategic Plan DRAFT October, 2005
Page 44
Exhibit
Page of D
Notes and Assumptions
A. Additional revenues from DHS of approximately $225,000 which in a full year will be spent 100% on
personnel and support, but for this fiscal year only about $110,000 will be spent due to late hiring of
needed personnel.
B. Restoration of OHP Standard Mental Health and A & D benefits will result in about $80,000 of
unanticipated revenue for FY 2004/05.
C. Assumes County General Fund contribution increases of 7% for fiscal years 2005/06, 2006107 and
2007/08, and an increase in indirect charges of 9.5% from the prior year indirect level for each year in
projection.
D. Annual salary increases are calculated using a 4% annual increase: 2% is the anticipated COLA
increase, and the other 2% is Mental Health's average annual step increase. Actual step increases are
4% but MH has 32 staff currently at the highest step and another 10 who will reach the highest step
within two years.
E. Other than adding 3.675 FTE as a result of new dollars discussed in "Note C;" projected budget adds NO
NEW FTE at any time. Budget also assumes an average annual 3.5 FTE vacancy, which results in
approximately $192,000 of annual savings.
F. DCMH was notified shortly after beginning the new budget year that some of the reserves held at
ABHA would be available to the member counties in 2004/05 as augmentation dollars. DCMH's share
of these dollars is $139,657 and can be used in budget year 2004/05 as long as used to add services.
These dollars will be seen initially as revenue in Fund 270 and then transferred to the operating fund,
which is Fund 275. It is likely that these funds would be transferred from Fund 270 to 275 in fiscal year
2005/06, unless needed in 2004/05.
G. These projections include the DHS State Contract increase resulting from equity adjustments. The
biannual equity related increase for DCMH is $453,049, which begins with fiscal year 2004/05. Although
the contract amendment will not be executed until midway through the fiscal year, the full biannual
amount of $453,049 will be paid to DCMH, which provides retroactive payment back to July 1, 2003. It
is DHS's intent that this be permanent funding.
H. "Other Transfers In" represents funds transferred from Mental Health's other two County budgeted funds
(Funds 270 and 280). This account has traditionally been used for the transfer of excess dollars from
Fund 270 and 280. Fund 270 is the depository fund for all our OHP dollars received through ABHA
(recommended government budgeting practices from the GFOA), and Fund 280 is where we budget
and administer our CDO. When developing our annual budgets we use a conservative estimate of
how much income will be available to fund operations in Fund 275, and as a result excess dollars can
build-up in these two funds.
1. It is our intent to keep the unrestricted fund balance equal to or greater than the amount needed to
pay for one month of operations.
I State Grant and Administrative Fee are increased 2% each year, except where specifically otherwise
noted.
K. With the intent of remaining conservative in forecasting, PIERS contributions are maintained at the
current rate of 19.6% for all years.
L. No additional expenditures have been included in projections for any impact resulting from the salary
study the County is planning.
Deschutes County Mental Health Strategic Plan DRAFT October, 2005
Page 45
Exhibit f-'
Page C~~ of ~1 b
APPENDIX C: Evidence Based Practice Work Group Report
Prepared by Lori Hill, Kathy Drew, Mike Kwiatkowski
INTRODUCTION
In our efforts to promote the use of Evidence Based Practices (EBP) at Deschutes County Mental
Health (DCMH), our goal was to create a process that had staff involvement. The state presents
some guidelines as to current EBPs as well as a mandate that increasing amounts of dollars are
spent on EBP in corning years. However, we also believe it is crucial to create an environment
where EBP is viewed as something that makes sense to do, as opposed to merely something the
State mandates that we do. Staff value high-quality, effective services, and it is this value that
must be the basis and core for our EBP plan.
In order to assess where we were as a clinic with Evidence Based Practices and where we
wanted to go, the EBP committee met with each team or representatives from each team
within the Community Mental Health Program-this included Adult Program, Child & Family
Program and Seniors. We introduced ourselves as the early members of the committee and
gave a basic explanation of Evidence Based Practices and how the State was planning to
increase the use of EBPs. In addition to the requirements by the State, we attempted to share
why we thought EBPs were a good idea to improve our services both in quality and quantity and
to improve the job satisfaction of our staff.
In our discussions we found the staff to be open to the idea of increasing our use of Evidence
Based Practices. They are very willing, even excited, to learn new ways to improve services as
they could easily identify areas that needed improvement. It appeared that systems change
was initiated with staff inclusion in the discussion and process. While there was no resistance to
this concept, there was a clear recommendation that we proceed with caution. There was a
strong feeling that we should start small and whenever possible involve therapists who have an
interest in a particular EBP. They encouraged us to be able to measure the outcomes so we
could make adjustments and assure that each practice is producing the desired results. The
staff appreciated the recognition that we are already using some EBPs and that there are some
practices that we're using that warrant consideration as EBPs. They were able to identify
problems with our current service delivery system and recommend changes for improvement.
CURRENT STRENGTHS AND PRACTICES:
After meeting with each team/program, it is evident that DCMH is currently providing an array of
services that clinicians feel are effective. Some may be based on established EBP models while
others, although felt to be effective, may need more exploration of related EBP research. These
are provided through a combination of individual, group, medication, or consultation services
and available to a variety of consumer populations. We found that some practices span
different teams, while others are specific to a population served by an individual team or
program.
Agency-Wide Practices:
1. Dialectical Behavior Therapy (DU : DBT is one of the most widespread practices,
included in varying degrees in Adult, Child and Family, Crisis and Seniors treatment
programs. Regular peer supervision is also available as part of this program, and regular
staff trainings have been provided in this area. The process for implementation and on-
uescnutes County Mental Health Strategic Plan DRAFT October, 2005
Page 46
ExhibitE
Page g A of k\N
going support of the DBT program could be considered a model to review for
implementation of other practices in the clinic.
2. Integrated Co-Occurring Disorders Treatment: This is another practice that is fairly wide-
spread across programs.
3. Group Therapy: This mode of treatment has increased significantly across both the Child
and Family and Adult programs. Groups are presented in a variety of treatment areas.
There is recognition that it may be helpful to identify better which types of diagnosis or
problem best respond to group modalities.
4. Co nitive-Behavioral Therapy: This is felt to be widely used across teams as part of an
individual treatment approach. However, there is not formal, standardized
implementation, and CBT is being utilized more as a component of individual practice.
Practices by Team:
Child & Family Team:
1. School-Based Services: The majority of services provided by the Child and Family team
are provided in the schools, which is a model that has an evidence basis.
2. Children's System of Care: Scheduled to be implemented October, 2005. Targeted at
children with the most severe disorders.
3. Duke University OCD Program
4. COPING-CAT
5. Mass Life Skills Training: To be implemented
6. Family and Parenting Education
7. Play Therapy, Sand Therapy and EMDR: These are felt to be effective but may lack
sufficient documentation to be considered EBP.
Adult Community Treatment: Evidence Based Practices for the non-chronic adult population are
less well documented, but the following practices are felt to be effective.
1. Assessment Tools: Use of structured assessment tools such as Beck, Bi-polar measurement
scale, etc., in treatment.
2. Anger Management for Women
3. Community collaboration: Services provided on-site at other agencies.
4. Relapse Prevention for both A&D and MH clients
5. Medication Management and Education Group for Bi-Polar Disorder (done jointly with
doctor and therapist)
6. Dialectical Behavioral Therapy for Alcohol and drug related clients
Deschutes County Mental Health Strategic Plan DRAFT October, 2005
Page 47
Exhibit
Page of \1 (l
7. Brief/Solution-Focused Treatment (though would recommend more structured format
and training)
Adult Community Support Services:
1. Supported Housing: DCMH provides on-site case management at two housing
complexes and three foster care homes and provides intensive housing assistance for
those individuals living in independent living.
2. Consumer Run Self-Help Groups
3. Clubhouse Program: A strengths based program promoting consumer empowerment.
Currently has one staff assisting consumers in daily operations with a plan for transition to
fully consumer run with paid consumer positions.
4. Consumer Run AA/Dual Diagnosis Support Group
5. Homeless Outreach: Outreach and community based service with dedicated position
for outreach to the homeless.
6. Supported Employment
7. Jail Bridge Position: Focuses on treatment engagement and jail diversion for individuals
involved in the corrections system.
8. Intensive Community Treatment for individuals at risk of hospitalization.
9. Skill based groups such as Symptom Management.
Crisis Services:
I . 24/7 community response to hospitals, jail and juvenile detention
2. Deferred Sentencing Program as component of jail diversion services
3. Psychiatric Security Review Board (PSRB) monitoring: This program spans both the Crisis
and Community Support teams.
4. Safe Schools Risk Assessments
Seniors Menfal Health:
1. Community outreach and partnerships with the medical community
RECOMMENDATIONS:
The EBP team found the meetings with individual clinical teams to be an extremely valuable
experience. While processing and recognizing the importance of input from a variety of staff, it
is also recognized that we are unable to represent all the ideas of individual staff. Therefore, we
focused on finding common threads to help guide us in making recommendations for the
Deschutes County Mental Health Strategic Plan DRAFT October, 2005
Page 48
Exhibit E,
Page 101 of A ~ t7)
development of an EBP plan for the agency. There were several themes that became apparent
and seem to be represented across teams.
First, there were clear underlying concerns about the difficulties in dealing with mandated or
unmotivated clients as well as those that cycle frequently through our system. Second, there
was also the clear recognition that research identifies a positive relationship between client and
clinician as one of the most important factors in favorable outcomes. Third, there was
recognition that a long wait for service has a significant impact on client treatment and on the
system.
Recommendation 1: Recovery Based Philosophy
It is recommended that DCMH adopt a recovery based philosophy as the core and
foundation of services and EBP provided to clients in all areas-fhus the underpinning to the
client relationship. This needs to involve a process that ensures this philosophy is not limited
to a statement or piece of paper but truly embodied in all services that are provided to
clients. It will need to involve staff training, regular discussions, on-going supervision and
ways to measure the inclusion in the orientation, treatment planning and on-going treatment
processes for clients.
Recommendation 2: Motivational Interviewing
It is recommended that motivational interviewing be an integral part of all treatment
services. This will need to involve training for all clinicians and inclusion as an integral part of
the treatment process. There must be clear identification of stages of change in the
assessment process as well as type of treatment provided linked to the appropriate stage of
change. The goal will be to link better with all clients, and especially to address the
unmotivated and mandated populations.
Recommendation 3: Improved Access Strategies
It is recommended that we explore various ways to address the access issue. This may
involve looking at some access models for quicker access, re-evaluating service priorities
and the numbers of clients that are being offered services, looking at most cost-effective
ways to provide treatment services (i.e., in-house versus subcontracting).
It is also clear from our conversations with staff that there are many EBPs currently being
provided, and that a primary goal needs to be to assure that we provide adequate support to
existing programs. This involves adequate training and support, attention to fidelity scales and
improved attention to outcomes. Practices that have been identified by staff can be divided
into two categories: 1) Models of treatment services, and 2) practices that are being utilized on
a more individual basis by clinicians (e.g., DBT has been adopted more as a model while
Cognitive Behavioral Therapy (CBT) would be considered to be an individual practice). The
following recommendation aims to focus more on the over-arching models of services that are
currently being implemented.
Recommendation 4: Support for Specific Treatment Modalities
It is recommended that DCMH continue to support the following treatment modalities.
Support will need to assure that there is a plan for on-going training and supervision in each
of the areas, as well as attention to use of standardized modules and/or fidelity scales if they
exist or working with the State for assistance if there is not a clearly identified fidelity scale for
a certain practice. There should also be attention to a plan to monitor outcomes in each of
the areas. The lack of adequate outcome measurements to determine effectiveness of
treatment was, again, a broad theme across programs.
uescnutes county Mental Health Strategic Plan DRAFT October, 2005
Page 49
Exhibit -C
Page \C)o of
• Dialectical Behavioral Therapy Program
• Dual Diagnosis Services
• Brief/Solution-Focused Treatment (with additional training and structured format)
• Consumer Run Clubhouse Program
• Intensive Case Management utilizing Strengths Case Management
• Supported Housing
• Supported Employment
• Jail Diversion including Deferred Sentencing and Jail Bridge programs
• Community-Based Model of Services for Seniors Mental Health
• School-Based Services for Child and Family
• Children's System of Care
• Group therapy with improved identification of target populations and problems.
Increased use of EBP modules in groups that are provided.
• Family Education
• Outreach to SPMI population
• Medication Management group treatment done jointly with prescribers and
clinicians
It is suggested that Recommendations 1-4 be the major focus for the DCMH system before new,
large-scale changes are undertaken. Having stated this, it is also recognized that there may be
interest by individual clinicians to add new types of services they are providing, such as groups.
In this context, it would be recommended that the clinicians move to utilizing structured,
module-based curricula in groups to the largest extent possible. This should be taken into
consideration whenever possible when new groups are being planned.
Based on feedback received in our EBP survey, it is recommended that the following areas be
considered as future areas for EBP implementation. Each would need research into any existing
EBP model or curriculum identification.
• Increased use of Strengths Based Case Management. This includes more focus on
wellness models (including nutrition, stress reduction/management) and recreation,
leisure and social skills.
• Standard Relapse Prevention Planning for alcohol and drug and mental health
• Experiential programs for adults
• Chronic Pain
• Skills teaching for symptom management-suggest use of Illness Management and
Recovery Program
• Standardized prescribing practices for medication management services
• Standardized assessment tools
• Matrix Model
• Enhancing DBT use with alcohol and drug clients
• Corrections-specific treatment groups
• Anger Management for Adolescents
• Domestic Violence and Cycle of Abuse Treatment with Adolescents
• Treatment for adolescent gang participation
• Physical/mental health interconnection
• Mobile Crisis and improved linkage with law enforcement
All staff were clear that there were several essential elements that need to be taken into
account when new practices are implemented: Time, training, adequate supplies and support,
adequate research. The following recommendation is in line with these concerns as well as with
system change training guidelines. The extent to which these steps are used will be based on
Deschutes County Mental Health Strategic Plan DRAFT October, 2005
Page 50
Exhibit F
Page b of D
the type of change. One clinician implementing a group will be simpler than changing a system
(i.e., implementing recovery based philosophy).
Recommendation 5: Effectively Manage Change & New Developments
Use the following guidelines when implementing any change:
• Implement one new practice at a time. In a large organization such as DCMH, this
could be limited to one change at a time per team or per group of staff. The goal is
that the same staff are not trying to implement multiple new practices at the same
time.
• Identify the problem: Be sure to be clear what problem or issue we are trying to
address by implementing a new practice.
• Organize a learn to address the problem: The team should include a change
leader-someone with enough influence to effect the change. The team should
consist of several key staff or stakeholders who have an interest in planning and
implementing the change. All need to have adequate time allotted.
• identify the desired outcome: It is recommended that the goal of the new practice
be clearly identified as well as how this outcome will be measured.
• Assess the organization and system: Identify knowledge, skill and resources that are
needed. Identify supports and barriers. This will include identifying who will be
impacted by the change, training needs, etc.
• Design an action and maintenance plan: Maintenance plan should include on-
going supports such as peer supports and training as well as tools and supports for
clients to use.
• Pilot test a plan whenever possible with smaller group and evaluate before adopting
agency-wide.
• Based on any needed revisions, proceed to larger scale implementation if
appropriate.
• Identify on-going supports needed to sustain the improvement.
uescnutes county Mental Health Strategic Plan DRAFT October, 2005
Page 51
Exhibit
Page pC.lr of~
APPENDIX E: Professional Development Work Group Report
Prepared by: Suzanne Donovan, Karen Tamminga, Fred Doolin, Mike Doster, Linda Cady,
Anne Muir, Sally Crowe
"We believe our staff is our most valuable resource,
and we promote the personal well-being
and professional development of each individual..,"
Summary
This Staff Development Committee was assigned responsibility for preparing this report for
inclusion in the Strategic Plan. The Committee was headed up by Suzanne Donovan and Karen
Tamminga. In addition five staff members from several different teams also participated: Fred
Doolin (Adult/Gambling Services), Mike Doster (Seniors Program), Linda Cady (Medical
Records/Support Staff), Anne Muir (Community Assessment Team) and Sally Crowe (Child &
Family Program).
Initially it was decided by the members of this committee to focus on a broader spectrum than
just staff development and training. In addition to training needs, they were concerned also
with improving staff morale issues as well as improving system processes.
The focus of our discussions and planning fell into three broad areas:
1) Professional Development - including clinical training, supervision and licensure.
2) Internal Development - including supporting improved internal informal processes and
trainings that would generate improved business/organization.
3) Morale and Communication - Supporting improved morale and communication within
the agency.
The overlap of these areas was quickly noted - and everyone agreed that as improvements
were made in one area it would impact the others. By doing the things that improve
professional development and informal processes - both morale and communication will
improve - they build on one another- and this will give hope that both morale and
communication within the agency can keep on improving.
What is currently working: What's been done in the area of Staff Development?
a. ABHA provides clinical trainings for staff - 6x year
b. Clinic pays for specific outside trainings for staff
c. Supervision is available towards licensure
d. Personnel Department has a good orientation for new staff
e. Child & Family Team has developed a procedure/policy manual for their staff
f. Periodic all staff meetings can be useful/helpful
g. Supervision/ Peer support is helpful with difficult clients or situations
h. DBT clinicians group supports therapists involved with our most difficult clients
i. Annual Team Retreats are beneficial
Deschutes County Mental Health Strategic Plan DRAFT October, 2005
Page 55
Exhibit -
Page jjCE> of
Action Plan: - Suggestions for Improvement
a. Survey staff on what they need for training
b. Ask staff to keep the clinic informed of trainings other community agencies are offering
c. Provide in house training using existing staff and expertise, with CEUs available from
NASW or ACCBO (these could be 2hr, 4hr, all day or even multiple day trainings
depending on topic/levels of expertise) when cost effective
d. Paperwork Day - One day a month - have a designated paperwork day, this day could
also include less formal trainings by staff members(2-hr), with pot-luck lunch for those
interested in networking
e. Trainings on topics such as
I ) Improve your processes (i.e. paperwork skills)
2) "People centered teams" training (SCMC)
3) improve Organization & Time management skills,
4) Coping with Change - Changing our paradigm/philosophy to cope better with
change in our agency, the field, and State/Fed. requirements
5) Effective ways of working with angry/difficult clients,
6) Improve people and interpersonal relationships skills
7) Effective ways of working with stress and burnout
8) Annually updated training(s) on policy around safety issues, i.e., panic buttons,
emergency response, etc.
f. Team retreats 1-2x a year
g. Better use of clinical supervision and team meetings to process difficult situations with
clients including second hand trauma and critical instances
h. Provide a follow up on the Staff survey
i. Develop an orientation/training process for all new staff:
I) Better orient new staff (provide map, agency organization chart, list of acronyms
or other cheat sheets)
2) . Assign a buddy /mentor for new staff to help train, answer questions, etc.
3) Procedure/Policy Manual for new Staff - for each team
4) Help new staff feel welcome (introduce new staff, welcome with an email),
Key concepts and/or Agency Values
a. ABHA/ DCMH needs to provide trainings on Evidenced Based Practices as identified by
the EBP Committee
b. DCMH would like to better utilize expertise of current staff for training others
c. Acknowledge Staff efforts more - (through awards, use of humor, acknowledging what
works, finding positives)
d. Utilize a central person to acknowledge birthdays
e. Improved communication can happen through phrasing statements in what the agency
can do or can provide instead of the negative what cannot be done, or cannot be
provided
f. Focus on helping staff feel heard, valued, etc
Other Ideas or Items that staff would hike to have clarified/ more communication about
a. What is the Agency Training Policy?
b. What is the policy reimbursement for costs of annual licensure?
c. What is the policy on clinical supervision for licensure?
d. Review or provide access to the county policy on taking college classes
e. Review the policy for panic buttons, emergency response, etc.
Deschutes County Mental Health Strategic Plan DRAFT October, 2005
Page 56
Exhibit-
f-1-Page _V(Jp of
APPENDIX D: Measuring Results Work Group Report
Prepared by: Sheryl Hogan, Scott Johnson
L Suggestions or questions should be directed to Sheryl Hogan, Quality Improvement
Specialist at DCMH. Ph: 322-7571 or sheryl_hogan@co.deschutes.or.us
Our mission is to promote and provide quality services." Our values include work with
community partners and client involvement. They also include concepts of effectiveness,
efficiency, professional development, and community feedback. The purpose of our Quality
Improvement System is to focus on measuring our quality, productivity and effectiveness. How
can we assure ourselves, our clients and our community that we are successful? The proposed
measures (draft) on the following page will be finalized as part of our Strategic Plan. Suggestions
are welcomed.
CRITERIA FOR SELECTING OUR PERFORMANCE MEASURES
The measure and the related data must be.
a. Meaningful it captures a significant aspect of our work;
b. Reliable the data is collected routinely and accurately;
c. Comparable we can compare over time and/or with others;
d. Easy to capture collection is manageable;
e. Linked to QM Plan ...fits with our overall plan and managed care plan.
BENEFITS OF OUR QUALITY IMPROVEMENT SYSTEM
a. Promotes excellence.
b. Recognizes our staff and contractors for the work they do.
c. Helps our Quality Management Committee evaluate our work.
d. Allows us to celebrate our accomplishments and areas to improve.
e. Informs taxpayers and other stakeholders through an annual Community Report.
f. Supports our grant writing and community education efforts.
g. Meets County requirements for performance measurement.
Deschutes County Mental Health Strategic Plan DRAFT October, 2005
Page 52
Exhibit
Page 1 0-1 of 11 b
Deschutes County Mental Health Performance Measures (Draft)
MHO
Public
Category
Measure
Report
Report
Count
1. Access *
a. Timely access to care
x
X
X
b. Reduce "no show" ratesh
x
c. Alternative accessiii
x
d. Help for North and South County clientsiy
x
e. Outreach to Oregon Health Plan membersv
x
2. Quality
a. Consumer-driven treatment planningv!
X
of Care "
b. Use of evidence based practices°ii
X soon
x
c. Children's System Change Initiativev1i
X soon
d. High level of productivity by cliniciansix
3. Integration,
a. Timely follow-up after inpatient discharger
x
Care
b. Coordination with primary health care
x
Coordination *
during and after treatment x'
4. Prevention
a. Increase public awareness, education xn
Education and
b. Community partnerships, collaboration A
X
Outreach
5. Outcomes *
a. Improvement through treatmentpv
X
X
b. Client satisfaction.-
X
X
6. Workforce
a. Staff survey of satisfactionxA
X
development
b. Staff development resourcesxvu
c. Training opportunitiesxvr~
7. Alternatives to
a. Effective Deferred Sentencing Programxlx
-
Incarceration;
b. Successful Jail Bridge Program-
X
hospitalization
c. Local alternatives to EOPC placements-'
d. Drug Court xxu
8. Consumer;
a. Significant consumer role in treatment
X
family involved
b. Participation on all committees/boards-x i
c. Community resources for consumer and
x
famil su ortxxiv
9. Priority projects
a. Successful job placementsxxv
x
b. School based children's servicesm'
c. Help for homeless eo le-il
10.A healthy
a. Balanced three-year budget plan -R
business
b. Adequate reserves for emergenciesxxix
c. (Billing measure)xxx
*R
equ~red as part of our Oregon Health Plan/managed care responsibilities. Other information
for periodic reports: number of people served; units of service provided, cost per client.
Deschutes County Mental Health Strategic Plan DRAFT October, 2005
Page 53
Exhibit E
Page (DR Of
T_ mely access to care-Urgent emergency: telephone response in 15 minutes. Emergency: contact within
6 hours. Urgent: contact within 24 hours. Routine Non-Emergency: appointment within two weeks.
iiReduce "no-show" rates-Reach and sustain a 70% show rate for intake appointments.
i"Alternative Access-Increase client access to services by offering an alternative. Explore same day
scheduling for Fridays.
"Help for North and South County-Number of children and adults served in North and South County as a
percentage of the population.
Outreach to Oregon Health Pian members-The % of Health Plan members receiving mental health
and/or chemical dependency service by calendar quarter. Measure of encounters in mental healthy
'Consumer-driven treatment planning-90% of reviewed charts indicate client/family involvement
(signature, progress notes, and/or completion of Oregon Change Index)
"Use of evidence based practices-Creation of measure that meets or exceeds requirement in SB 267
(2003 Oregon law)
viiiChildren System Change Initiative-To be determined.
ixHiah level of productivity by clinicians-55% of clinician time is direct service with client or collateral
helping agencies or supports.
xTimely follow-up after discharge-Timely coordination with at least 95% of clients having a follow-up
appointment scheduled within one week of discharge from an inpatient facility.
xiCoordination with primary health care during and after treatmeni-90% of reviewed charts document
coordination with a primary care provider (OR documentation of refusal by client). 90% of charts
reviewed for terminated clients show medication coordination at termination.
AIncrease_public awareness and education-Mental health services should be visible and available.
Increase the number of community presentations about mental health and the services the department
provides through the measurement of PEO service hours.
14Community partnerships and collaboration-(CSCI?) Enhance community partnerships and collaboration
to reduce the number of clients that "fall through the cracks." Pool resources in order to ensure the
complex needs of clients can be met.
wvlmprovement through treatment-Oregon Change Index tool to measure outcomes.
-Client satisfaction-Annual survey of client satisfaction. Increase the response rate and overall
satisfaction of participating clients.
xviataff survey of satisfaction-Annual improvement using Cascade Employers Association instrument
established in 2004 or an alternative instrument.
xvO i1aff development resources-At least - percent of annual salary costs.
xu11Training opportunities-Training or staff development activities for at least 50% of staff annually.
AxEffective Deferred Sentencing Program-50% increase in number of DSP clients and successfully
completing treatment, with no recidivism for (time).
xxSuccessful Jail Bridge Program-To be determined.
xx'Local alternatives to EOPC placements-50 % reduction in use of acute care beds at Eastern Oregon
Psychiatric Center
XXQLga Court-To be determined.
xx"Particigation on Committees and Board Consumer and family member representation on at least 90%
of DCMH committees and governing boards.
WvCommunity resources for consumer and family support-Department participation quarterly at NAMI
board meetings, regular meetings with Crook and Jefferson representatives. Consumer and family
resource distribution at intake of local NAMI and other support services.
-Successful 'ob placements-Number of individuals with supported employment and percentage in
stable employment for minimum of six months.
xx,"School-based children's services-Ability to offer mental health services based in Deschutes County
public schools (at least four hours per week). Percentage of schools.
%XVO e-1p for homeless-Measure to be determined.
xxviBalanced three-year budget plan-To provide more services in a cost efficient manner.
xxxAdequate reserves for emergencies-Maintain reserves equal to at least 10% of monthly payroll costs.
xxxBillina measure-To be determined.
Deschutes County Mental Health Strategic Plan DRAFT October, 2005
Page 54
Exhibit
Page of~
Responsible Individuals for Staff Development Process
• Suzanne Donovan will make sure all staff receives policies on agency training,
reimbursement for annual licensure, reimbursement for individual licenses for those doing
supervision or when licenses are required, County policy on taking college classes. In
addition she will monitor and keep Program Managers informed of the budgetary
limitations/abilities within each program.
• Karen Tamminga will develop and send out a survey to staff requesting their interest in
trainings and inform staff of trainings other community agencies are offering. Karen will
also set a schedule and organize the "paperwork day" and informal trainings by staff
members along with CEUs when appropriate, and the potluck.
• Each Program Manager will be responsible for retreats and the organization of clinical
supervision/team meetings to process difficult situations and work on and system to
acknowledge staff efforts more.
• Suzanne and Karen will share responsibility for contacting trainers to present to staff.
• Kathe Hirschman will direct individual programs in their orientation process including
getting all programs to develop a staff Policy/Procedure Manual. Kathe will set up a
system to acknowledge birthdays. In additional she will in conjunction with the
Management Team determine a schedule for All Staff meetings.
uescnures c=ounty Mental Health Strategic Plan DRAFT October, 2005
Page 57
Exhibit F
Page \D of \ \