Loading...
2019-161-Minutes for Meeting April 09,2019 Recorded 5/23/2019BOARD OF COMMISSIONERS 1300 NW Wall Street, Bend, Oregon (541) 388-6570 Recorded in Deschutes County CJ2019-161 Nancy Blankenship, County Clerk Commissioners' Journal 05/23/2019 4:45:25 PM 1111111111111111111111111111ii FOR RECORDING STAMP ONLY BOCC TUESDAY MEETING MINUTES 2:00 PM TUESDAY, April 9, 2019 ALLEN CONFERENCE ROOM Present were Commissioners Phil Henderson, Patti Adair, and Anthony DeBone. Also present were Tom Anderson, County Administrator; Erik Kropp, Deputy County Administrator; David Doyle, County Counsel; and Sharon Keith, Board Executive Assistant. Several citizens and representatives of the media were in attendance. CALL TO ORDER: Chair Henderson called the meeting to order at 2:07 p.m. ACTION ITEMS 1. Staff Report on Request of PacificSource for Memoranda of Understanding Health Services staff Hillary Saraceno and Janice Garceau presented the item and reported Health Services is recommending the partnership with Pacific Source that relates to the Coordinated Care Organization application. The documents will be included on tomorrow's Board meeting for consideration of signature. BOCC TUESDAY MEETING APRIL 9, 2019 PAGE 1 OF 4 2. Marijuana Code & Law Enforcement Update Community Development Staff Nick Lelack, Lori Furlong, and Angela Haviear along with Sheriff's Office staff Joe DeLuca, Todd Kloss, Laura Conard presented case history over the past three years regarding enforcement of the County's marijuana land use regulations. There were a total of 89 complaints and investigations were documented by Community Development Department from the years 2016 to present. Annual inspections are scheduled within the next few weeks. Mr. Kloss reported on the last six months law enforcement activity regarding marijuana incidents. 31 cases were referred to the Sheriff's Office by CDD. Mr. Kloss reported on the issue of illegal exportation of marijuana. There are 954 medical marijuana grow operations in Deschutes County with the majority not being inspected by the Oregon Health Authority. For the Sheriff's Office to acquire a search warrant is time consuming and necessitates 20 - 40 people on site to gather evidence. The Sheriff's Office was awarded a grant to fund a criminal analyst position to research data on property complaints. 3. New Neighborhood - Groundwater Protection, Transferable Development Credit/Pollution Reduction Credit, Sewer Loan Community Development Department Director Nick Lelack and Planning Manager Peter Gutowsky presented the history and concept of the New Neighborhood in South County. A copy of the presentation is attached for the record. Four property owners that were in the audience approached the Board and presented their request to simplify this program to allow development in that neighborhood. RECESS: At the time of 4:36 p.m., the Board took a recess and the meeting was reconvened at 4:43 p.m. BOCC TUESDAY MEETING APRIL 9,2019 PAGE 2OF4 4. Planning Commission Joint Meeting Recap & Next Steps Community Development Department staff Nick Lelack and Peter Gutowsky presented this item to review the follow-up from the joint planning commission and Board of Commissioners meeting of March 21, 2019. Commissioner Henderson expressed interest in forming a group to have discussions on housing. Commissioner DeBone commented on the challenges of zoning. Mr. Gutowsky reported on upcoming community meetings. Mr. Lelack recommended a discussion on the cost of land use, provide a summary of other counties going through the same housing concern, and what are the other options that we could look at. The Board recommended holding a joint meeting with the Planning Commission with the next meeting to be held after the legislative session. Mr. Lelack reported there are two planning commissioners up for reappointment on July 1st. Both members expressed interest in reappointment. Mr. Lelack also reported there is interest by the Historic Landmarks Commissioner to increase the amount of ex -officio members. 5. Committee Appointment Selection logistics for the Public Safety Coordinating Council, Audit Committee, Investment Advisory Committee, and Cohesive Strategy Steering Committee This item will be moved to the agenda of Wednesday, April 10. EXECUTIVE SESSION: At the time of 5:18 p.m., the Board went into Executive Session under ORS 192.660 (2) (e) Real Property Negotiations. The Board came out of Executive Session at 5:37 p.m. and directed staff to proceed as discussed. BOCC TUESDAY MEETING APRIL 9, 2019 PAGE 3 OF 4 At the time of 5:38 p.m., the Board went back in Executive Session under ORS 192.660 (2) (e) Real Property Negotiations. The Board came out of Executive Session at 5:50 pm and directed staff to proceed as discussed. At the time of 5:50 p.m., the Board went back in Executive Session under ORS 192.660 (2) (d) Labor Negotiations. The Board came out of Executive Session at 6:44 p.m. OTHER ITEMS: None reported COMMISSIONER UPDATES: None reported ADJOURN Being no further items to come before the Board, the meeting was adjourned at 6:44 p.m. DATED this ( Day of Commissioners. BOCC TUESDAY MEETING 2019 for the Deschutes County Board of PHILIP G. H NDERSON, CHAIR PATTI ADAIR, VICE CHAIR ANTHONY DEBONED COMMISSIONER APRIL 9, 2019 PAGE 4 OF 4 Deschutes County Board of Commissioners 1300 NW Wall St, Bend, OR 97703 (541) 388-6570 - www.deschutes.org BOCC MEETING AGENDA DESCHUTES COUNTY BOARD OF COMMISSIONERS 2:00 PM, TUESDAY, APRIL 9, 2019 Allen Conference Room - Deschutes Services Building, 2ND Floor - 1300 NW Wall Street - Bend CALL TO ORDER ACTION ITEMS 1. 2:00 PM Staff Report on PacificSource's Request for Memoranda of Understanding -Janice Garceau, BH Deputy Director 2. 2:30 PM Marijuana Code & Law Enforcement Update - Lori Furlong, Administrative Manager 3. 3:00 PM New Neighborhood - Groundwater Protection, TDC/PRC, Sewer Loan - Nick Lelack, Community Development Director 4. 4:00 PM Planning Commission Joint Meeting Recap & Next Steps - Nick Lelack, Community Development Director 5. 4:15 PM Committee Appointment Selection Logistics for the Public Safety Coordinating Council, Audit Committee, Investment Advisory Committee, and Cohesive Strategy Steering Committee OTHER ITEMS These can be any items not included on the agenda that the Commissioners wish to discuss as part of the meeting, pursuant to ORS 192.640. COMMISSIONER'S UPDATES Board of Commissioners BOCC Meeting Agenda Tuesday, April 9, 2019 Page 1 of 2 EXECUTIVE SESSION Executive Sessions under ORS 192.660 (2) (e) Real Property Negotiations and ORS 192.660 (2) (d) Labor Negotiations At any time during the meeting, an executive session could be called to address issues relating to ORS 192.660(2)(e), real property negotiations; ORS 192.660(2)(h), litigation; ORS 192.660(2)(d), labor negotiations; ORS 192.660(2)(b), personnel issues; or other executive session categories. Executive sessions are closed to the public; however, with few exceptions and under specific guidelines, are open to the media. ADJOURN Board of Commissioners BOCC Meeting Agenda Tuesday, April 9, 2019 Page 2 of 2 , 1 _, Agency -1.-1 \ 41lik et! P (---, 4.4 -,- ) (7.2. —;-- .,-- - .)--- . , VLL Ci2t1rtoy1 5L,.,txrvt61011, ) .,,,...... \ -7- ------7.-- Work Session (P/ease Print) Ii -----.._ '.• \I 0 . --<, ,--- ,—,si ‘ y 2 0 aq 3 r 4 'l -.• ....,3:- - ' 1.- 's."•••• s ? „.,/ . ....„), Page # of Pages Please return to BOCC Secretary. Deschutes County Board of Commissioners 1300 NW Wall St, Bend, OR 97703 (541) 388-6570 - Fax (541) 385-3202 - https://www.deschutes.org/ AGENDA REQUEST & STAFF REPORT For Board of Commissioners BOCC Tuesday Meeting of April 9, 2019 DATE: April 2, 2019 FROM: Janice Garceau, Health Services, TITLE OF AGENDA ITEM: Staff Report on PacificSource's Request for Memoranda of Understanding RECOMMENDATION & ACTION REQUESTED: Health Services supports PacificSource's application to be the CCO for Central Oregon and requests review of the Memoranda of Understanding before signature by the Board of County Commissioners, as the LMHA and LPHA for Deschutes County. BACKGROUND AND POLICY IMPLICATIONS: The Oregon Health Authority has released the request for applications (RFA) that lays out the requirements applicants must meet to serve Oregon Health Plan members for the next five years of coordinated care contracts (2020-2024), also known as "CCO 2.0." The RFA advances the policy recommendations approved by the Oregon Health Policy Board in October, which addressed Governor Kate Brown's four priority areas for improvement: • Improve the behavioral health systems and address barriers to access to and integration of care. • Increase value and pay for performance. • Focus on social determinants of health and health equity. • Maintain sustainable cost growth and ensure financial transparency. Responses to the RFA are due April 22 by 3 p.m. OHA expects to announce the awards for the CCO contracts in July. PacificSource Community Solutions, Inc., intends to submit an application to the Oregon Health Authority to be awarded a contract to act as the Coordinated Care Organization (CCO) for the Central Oregon region (Crook, Deschutes and Jefferson counties, and specific ZIP codes in north Klamath County). The application process requires that PacificSource describe the applicant's status for obtaining Memoranda of Understanding (MOUS) with Local Public Health and Local Mental Health Authorities (LPHA and LMHA, respectively) for the purpose of detailing system coordination agreements regarding CCO members receiving health services. The MOUs do not establish payment terms, only that the parties will enter into negotiations to contract with DCHS to provide services to CCO members in the region. The MOUs also serve as a way to document the parties' commitment to work together on health promotion activities and planning efforts, shared behavioral health system planning, and provision of clinical services to OHP members. New to the MOU is the requirement of the CCO to collaborate with the Local Public Health Authority on the creation of the Regional (Community) Health Assessment and Improvement Plan. This coordination has already been occurring in Central Oregon. Health Services staff are currently reviewing the underlying Request for Applications from OHA and the proposed PacificSource MOUs as well as consulting with other LMHAs and LPHAs in Oregon. County Legal staff are currently reviewing the MOUs. FISCAL IMPLICATIONS: There are no direct fiscal implications. However, the MOUs set out principles and guidelines that may indirectly impact contract negotiations. The MOUs outline which clinical services the CCO's members would be eligible to receive; a contract with the CCO will be needed for authorization of payment for those services which are provided by DCHS. The MOUs do not establish the payment terms, only that the parties will enter into negotiations as part of the contracting process in the event that PacificSource is awarded the CCO contract for the Central Oregon region. ATTENDANCE: Health Services staff: Janice Garceau, Behavioral Health Deputy Director; Hillary Saraceno, Public Health Deputy Director AGENDA REQUEST Deschutes County Board of Commissioners 1300 NW Wall St, Bend, OR 97703 (541) 388-6570 - Fax (541) 385-3202 - https://www.deschutes.org/ AGENDA REQUEST & STAFF REPORT For Board of Commissioners BOCC Tuesday Meeting of April 9, 2019 DATE: April 2, 2019 FROM: Janice Garceau, Health Services, TITLE OF AGENDA ITEM: Staff Report on PacificSource's Request for Memoranda of Understanding RECOMMENDATION & ACTION REQUESTED: Health Services supports PacificSource's application to be the CCO for Central Oregon and requests review of the Memoranda of Understanding before signature by the Board of County Commissioners, as the LMHA and LPHA for Deschutes County. BACKGROUND AND POLICY IMPLICATIONS: The Oregon Health Authority has released the request for applications (RFA) that lays out the requirements applicants must meet to serve Oregon Health Plan members for the next five years of coordinated care contracts (2020-2024), also known as "CCO 2.0." The RFA advances the policy recommendations approved by the Oregon Health Policy Board in October, which addressed Governor Kate Brown's four priority areas for improvement: • Improve the behavioral health systems and address barriers to access to and integration of care. • Increase value and pay for performance. • Focus on social determinants of health and health equity. • Maintain sustainable cost growth and ensure financial transparency. Responses to the RFA are due April 22 by 3 p.m. OHA expects to announce the awards for the CCO contracts in July. PacificSource Community Solutions, Inc., intends to submit an application to the Oregon Health Authority to be awarded a contract to act as the Coordinated Care Organization (CCO) for the Central Oregon region (Crook, Deschutes and Jefferson counties, and specific ZIP codes in north Klamath County). The application process requires that PacificSource describe the applicant's status for obtaining Memoranda of Understanding (MOUs) with Local Public Health and Local Mental Health Authorities (LPHA and LMHA, respectively) for the purpose of detailing system coordination agreements regarding CCO members receiving health services. The MOUs do not establish payment terms, only that the parties will enter into negotiations to contract with DCHS to provide services to CCO members in the region. The MOUs also serve as a way to document the parties' commitment to work together on health promotion activities and planning efforts, shared behavioral health system planning, and provision of clinical services to OHP members. New to the MOU is the requirement of the CCO to collaborate with the Local Public Health Authority on the creation of the Regional (Community) Health Assessment and Improvement Plan. This coordination has already been occurring in Central Oregon. Health Services staff are currently reviewing the underlying Request for Applications from OHA and the proposed PacificSource MOUs as well as consulting with other LMHAs and LPHAs in Oregon. County Legal staff are currently reviewing the MOUs. FISCAL IMPLICATIONS: There are no direct fiscal implications. However, the MOUs set out principles and guidelines that may indirectly impact contract negotiations. The MOUs outline which clinical services the CCO's members would be eligible to receive; a contract with the CCO will be needed for authorization of payment for those services which are provided by DCHS. The MOUs do not establish the payment terms, only that the parties will enter into negotiations as part of the contracting process in the event that PacificSource is awarded the CCO contract for the Central Oregon region. ATTENDANCE: Health Services staff: Janice Garceau, Behavioral Health Deputy Director; Hillary Saraceno, Public Health Deputy Director MENTAL HEALTH MOU: * Final version * Accepted redline * Proposed redline * Final Version PacificSource Community Solutions PacificSource Community Solutions PO Box 5729, Benc, OR 97708-5729 (800) 431-4135 CommunitySolutions.PacificSource.com MEMORANDUM OF UNDERSTANDING This Memorandum of Understanding ("MOU"), by and between PacificSource Community Solutions, an Oregon non-profit corporation ("PCS"), and a Local Mental Health Authority, the Board of County Commissioners of Deschutes County, Oregon ("LMHA"), (PCS and LMHA, together, the "Parties"), is made and effective on , 2019 for the purpose of documenting Parties' commitment to work together to support and improve health through shared behavioral health system planning and provision of clinical services. WHEREAS PCS intends to submit an application (the "Application") to the Oregon Health Authority ("OHA") to be awarded a contract to act as a Coordinated Care Organization ("CCO") for Deschutes, Crook and Jefferson Counties in Oregon (the "Region"). WHEREAS the Parties seek to identify the roles and responsibilities of their respective organizations to work towards a health care system in Region that achieves cost containment, improved member experience, better health care outcomes, and stability, adequacy, and well-being in the Region's health care workforce. WHEREAS PCS acknowledges LMHA's responsibility to develop a system of services for insured and uninsured individuals, and LMHA acknowledges PCS's responsibility to administer Medicaid funds for those enrolled in CCO. WHEREAS the Parties agree that the overall health of the community will be enhanced by PCS and LMHA collaboratively developing, where possible and practicable, a system of publicly funded mental health and substance use disorder services for both uninsured and insured individuals that is mutually supportive, coordinated, and funded. THEREFORE this MOU sets forth the Parties' understandings and expectations with regarding to PCS' potential contract to serve as the CCO for the Region and the Parties' commitment to each other. 1. Term. The understandings and commitments made by the Parties pursuant to this MOU shall remain in effect until the Parties enter into an agreement that supersedes this MOU, until December 31, 2019 if PCS is notified by OHA that PCS has not been awarded a CCO contract in Region for 2020, or until December 31, 2024, whichever occurs first. 2. Understanding. It is mutually agreed upon and understood by and among the Parties to this MOU that: a) PCS shall be the legal entity submitting a Letter of Intent and Application in response to RFA# OHA-4690-19. b) The Parties support and approve of PCS' submission of the Application. c) In the event PCS is awarded a contract to act as the CCO for the Region, the Parties agree to undertake the obligations outlined in Section 2(d) through 2(i) below. d) Behavioral Health Plan: PCS shall coordinate with the LMHA and its designated Community Mental Health Program on the development of a comprehensive Behavioral Health Plan for the Region as described in RFA# OHA-4690-19, Exhibit M, Section 3a(7) —Sample CCO Contract, and the LMHA shall participate in the Behavioral Health Plan development. The plan shall include without limitation goals to improve health outcomes and increase access to services. i) Structure. The Behavioral Health Plan developed by the Parties shall seek to: (1) Describe priority actions, accountable parties for those actions, and timeline for action and assessment; (2) Create structures for communication across systems, coordination of services to individuals, and feedback processes to improve functioning of behavioral health system; (3) Prioritize best -practice and evidence -based strategies where available; (4) Use a community-based, multisystem approach that engages a wide range of economic, governmental, and social service organizations and institutions serving residents of the Region; and Employ data from a population based needs assessment, using a range of data sources including the Community Health Assessment and Community Health Improvement Plan if available, including ethnic, age, cultural and diversity needs of the population. (5) ii) Goals of Plan. The Behavioral Health Plan developed by the Parties shall aim to: (1) Improve health in Region through access improvement and system redesign for behavioral health services; (2) Improve service delivery and coordination among service providers; (3) Maximize resources for CCO enrollees and increase utilization of funds from sources other than state general fund and Medicaid payments to support local services; (4) Coordinate services among the criminal and juvenile justice systems, adult and juvenile corrections systems, child welfare, schools, and local mental health programs; (5) Address local housing needs for persons with mental health disorders; and (6) Address local behavioral health workforce needs and training opportunities. iii) Process, Dates, Milestones: (1) The CCO's Behavioral Health plan will be completed by 12/31/2020. (2) The Behavioral Health Plan development process will be facilitated by CCO or designee, with the approval of a written plan and execution of written commitments from participating parties prior to 12/31/2020. (3) The Behavioral Health Plan development process will include periodic meetings, every 1- 2 months, with interim work by individuals, groups, and organizations. iv) Community Partners. The Behavioral Health Plan shall be developed by PCS through seeking input and participation from LMHAs and Community Mental Health Programs serving the Region and the following community partners in the Region: (1) Behavioral health services organizations and/or professionals; Memorandum of Understanding Page 2 of 7 (2) Local mental health advisory committee; (3) Behavioral Health system consumers, advocates, and families; (4) Representatives of early childhood and K-12 education; (5) Representatives of Oregon Department of Human Services' child welfare division; (6) Members of the local public safety coordinating council including criminal justice/corrections institutions, law enforcement, and first responders; Providers of dental and physical health services, including hospitals and public health; and (7) (8) Providers of social supports, including but not limited to housing, employment, and/or transportation. e) Community Health Assessment and Improvement Plan: PCS and LMHA shall collaborate in the creation of the Community Health Improvement Plan ("CHP"), as described in ORS 414.627. The Parties commit to jointly developing and submitting a CHP for the Region to the Oregon Health Authority on or before June 30, 2021 or a later date if permitted by the CCO Contract because of an existing CHP developed by the Parties. The Parties will coordinate the development of the CHP with the creation of the LMHA's local plan. f) Local Plan: PCS shall support the LMHA in the creation of LMHA's local plan as described in ORS 430.630(9), included here as Attachment A and as later amended, which is attached hereto and incorporated herein. By January 1, 2020, LMHA shall request in writing from the Oregon Health Authority a determination as to the nature of the local plan required of LMHA and the date by which it must be completed. This determination shall be provided to PCS within 30 days of its receipt. Within 60 days of a written request from LMHA to PCS, the Parties will convene and shall use best efforts to develop a data sharing plan to include data from the CCO Community Health Assessment and any necessary written agreements and to establish a written agreement as to the responsibilities and engagement of each in the creation of the local plan. Clinical Services Contract: PCS and LMHA acknowledge that the services listed below are the responsibility of LMHA. Once awarded a CCO contract for the Region, PCS will enter negotiations to contract with designated Community Mental Health Program(s) in the Region to provide services to CCO members assigned to the Region. Such contract(s) shall include payment terms adequate to cover reasonable costs for providing these services at a level proportionate to CCO members' use of the services. PCS shall use its best efforts to execute a mutually agreeable contract that includes services in the following categories with the LMHA-designated Community Mental Health Program in the Region: g) i) Management of children and adults at risk of entering or who are transitioning from the Oregon State Hospital or from residential care; ii) Care coordination of residential services and supports for adults and children; iii) Management of the mental health crisis system; iv) Management of community-based specialized services, including but not limited to supported employment and education, early psychosis programs, assertive community Memorandum of Understanding Page 3 of 7 treatment or other types of intensive case management programs and home-based services for children; and v) Management of specialized services to reduce recidivism of individuals with mental illness in the criminal justice system. h) Provision of Clinical Services: LMHA shall at all times cause to be in place a Community Mental Health Program competent and qualified to provide services as described above. i) LMHA Duties: LMHA shall adhere to and comply with the applicable requirements detailed in Attachment A. 1) LMHA acknowledges that additional contracts and agreements, as contemplated herein, shall provide for the provision of services to CCO enrollees who may reside outside of Deschutes County. LMHA agrees to provide services under such contracts and agreements to CCO enrollees residing in zip codes 97731, 97733, 97737, and 97739. LMHA further agrees that it shall enter into any necessary intergovernmental agreements in order to provide services to CCO enrollees residing outside of Deschutes County. 3. Non -Exclusive. This MOU does not create an exclusive arrangement between PCS and the LM HA or its designated Community Mental Health Program, and PCS may enter into agreements with other parties for similar or the same services or participation. 4. Governing Law. This MOU shall be governed by and construed in accordance with the laws of the State of Oregon, without regard to conflict of laws principles. 5. Counterparts. This MOU may be executed in two or more counterparts, each of which shall be deemed an original, but all of which together shall constitute one and the same instrument IN WITNESS WHEREOF, the parties hereto have executed this MOU on the day and year first above written. PacificSource Community Solutions Deschutes County, Oregon By: By: Name: Name: Title: Title Date: Date: Memorandum of Understanding Page 4 of 7 Attachment A Local Mental Health Services Plan 430.630 Services to be provided by community mental health programs; local mental health authorities; local mental health services plan. (9)(a) As used in this subsection, "local mental health authority" means one of the following entities: (A) The board of county commissioners of one or more counties that establishes or operates a community mental health program; (B) The tribal council, in the case of a federally recognized tribe of Native Americans that elects to enter into an agreement to provide mental health services; or (C) A regional local mental health authority comprising two or more boards of county commissioners. (b) Each local mental health authority that provides mental health services shall determine the need for local mental health services and adopt a comprehensive local plan for the delivery of mental health services for children, families, adults and older adults that describes the methods by which the local mental health authority shall provide those services. The purpose of the local plan is to create a blueprint to provide mental health services that are directed by and responsive to the mental health needs of individuals in the community served by the local plan. A local mental health authority shall coordinate its local planning with the development of the community health improvement plan under ORS 414.627 by the coordinated care organization serving the area. The Oregon Health Authority may require a local mental health authority to review and revise the local plan periodically. (c) The local plan shall identify ways to: (A) Coordinate and ensure accountability for all levels of care described in paragraph (e) of this subsection; (B) Maximize resources for consumers and minimize administrative expenses; (C) Provide supported employment and other vocational opportunities for consumers; (D) Determine the most appropriate service provider among a range of qualified providers; (E) Ensure that appropriate mental health referrals are made; (F) Address local housing needs for persons with mental health disorders; (G) Develop a process for discharge from state and local psychiatric hospitals and transition planning between levels of care or components of the system of care; (H) Provide peer support services, including but not limited to drop-in centers and paid peer support; (I) Provide transportation supports; and (1) Coordinate services among the criminal and juvenile justice systems, adult and juvenile corrections systems and local mental health programs to ensure that persons with mental illness who come into contact with the justice and corrections systems receive needed care and to ensure continuity of services for adults and juveniles leaving the corrections system. (d) When developing a local plan, a local mental health authority shall: (A) Coordinate with the budgetary cycles of state and local governments that provide the local mental health authority with funding for mental health services; (B) Involve consumers, advocates, families, service providers, schools and other interested parties in the planning process; (C) Coordinate with the local public safety coordinating council to address the services described in paragraph (c)(J) of this subsection; (D) Conduct a population based needs assessment to determine the types of services needed locally; Memorandum of Understanding Page 5 of 7 (E) Determine the ethnic, age-specific, cultural and diversity needs of the population served by the local plan; (F) Describe the anticipated outcomes of services and the actions to be achieved in the local plan; (G) Ensure that the local plan coordinates planning, funding and services with: (i) The educational needs of children, adults and older adults; (ii) Providers of social supports, including but not limited to housing, employment, transportation and education; and (iii) Providers of physical health and medical services; (H) Describe how funds, other than state resources, may be used to support and implement the local plan; (I) Demonstrate ways to integrate local services and administrative functions in order to support integrated service delivery in the local plan; and (J) Involve the local mental health advisory committees described in subsection (7) of this section. (e) The local plan must describe how the local mental health authority will ensure the delivery of and be accountable for clinically appropriate services in a continuum of care based on consumer needs. The local plan shall include, but not be limited to, services providing the following levels of care (A) Twenty -four-hour crisis services; (B) Secure and nonsecure extended psychiatric care; (C) Secure and nonsecure acute psychiatric care; (D) Twenty -four-hour supervised structured treatment; (E) Psychiatric day treatment; (F) Treatments that maximize client independence; (G) Family and peer support and self-help services; (H) Support services; (I) Prevention and early intervention services; (J) Transition assistance between levels of care; (K) Dual diagnosis services; (L) Access to placement in state -funded psychiatric hospital beds; (M) Precommitment and civil commitment in accordance with ORS chapter 426; and (N) Outreach to older adults at locations appropriate for making contact with older adults, including senior centers, long term care facilities and personal residences. In developing the part of the local plan referred to in paragraph (c)(J) of this subsection, the local mental health authority shall collaborate with the local public safety coordinating council to address the following: (A) Training for all law enforcement officers on ways to recognize and interact with persons with mental illness, for the purpose of diverting them from the criminal and juvenile justice systems; (B) Developing voluntary locked facilities for crisis treatment and follow-up as an alternative to custodial arrests; (C) Developing a plan for sharing a daily jail and juvenile detention center custody roster and the identity of persons of concern and offering mental health services to those in custody; (D) Developing a voluntary diversion program to provide an alternative for persons with mental illness in the criminal and juvenile justice systems; and (E) Developing mental health services, including housing, for persons with mental illness prior to and upon release from custody. (f) Memorandum of Understanding Page 6 of 7 (g) Services described in the local plan shall: (A) Address the vision, values and guiding principles described in the Report to the Governor from the Mental Health Alignment Workgroup, January 2001; (B) Be provided to children, older adults and families as close to their homes as possible; (C) Be culturally appropriate and competent; (D) Be, for children, older adults and adults with mental health needs, from providers appropriate to deliver those services; (E) Be delivered in an integrated service delivery system with integrated service sites or processes, and with the use of integrated service teams; (F) Ensure consumer choice among a range of qualified providers in the community; (G) Be distributed geographically; (H) Involve consumers, families, clinicians, children and schools in treatment as appropriate; (I) Maximize early identification and early intervention; (J) Ensure appropriate transition planning between providers and service delivery systems, with an emphasis on transition between children and adult mental health services; (K) Be based on the ability of a client to pay; (L) Be delivered collaboratively; (M) Use age-appropriate, research -based quality indicators; (N) Use best -practice innovations; and (0) Be delivered using a community-based, multisystem approach. (h) A local mental health authority shall submit to the Oregon Health Authority a copy of the local plan and revisions adopted under paragraph (b) of this subsection at time intervals established by the Oregon Health Authority. [1961 c.706 §40; 1973 c.639 §3; 1981 c.750 §3; 1985 c.740 Memorandum of Understanding Page 7 of 7 * Accepted Redline PacificSource Community Solutions PacificSource Community Solutions PO Box 5729, Bend, OR 97708-5729 (800) 431-4135 CommunitySolutions.PacificSource.com MEMORANDUM OF UNDERSTANDING This Memorandum of Understanding ("MOU"), by and between PacificSource Community Solutions, an Oregon non-profit corporation ("PCS"), and a Local Mental Health Authority, ("LMHA"), (PCS and LMHA, together, the "Parties"), is made and effective on 2019 for the purpose of documenting Parties' commitment to work together to support and improve health through shared behavioral health system planning and provision of clinical services. WHEREAS PCS intends to submit an application (the "Application") to the Oregon Health Authority ("OHA") to be awarded a contract to act as a Coordinated Care Organization ("CCO") for,iood River and Deleted: Wasco Counties in Oregon (the "Region"). WHEREAS the Parties seek to identify the roles and responsibilities of their respective organizations to work towards a health care system in Region that achieves cost containment, improved member experience, better health care outcomes, and stability, adequaand well-being_in the Region's health care workforce. WHEREAS PCS acknowledges LIMiHA'sresponsibility to develop a system of services for insured and uninsured individuals and LMHA acknowledges PCS's responsibility to administer Medicaid funds for those enrolled in CCO. WHEREAS the Parties agree that the overall health of the community will be enhanced by PCS and LMIHA collaboratively developing, where possible and practicable, a system of publicly funded mental health and substance use disorder services for both uninsured and insured individuals that is mutually supportive, coordinated and funded. THEREFORE this MOU sets forth the Parties' understandings and expectations with regarding to PCS' potential contract to serve as the CCO for the Region and the Parties' commitment to each other. 1. Term. The understandings and commitments made by the Parties pursuant to this MOU shall remain in effect until the Parties enter into an agreement that supersedes this MOU, until December 31, 2019 if PCS is notified by OHA that PCS has not been awarded a CCO contract in Region for 2020, or until December 31, 2024, whichever occurs first. 2. Understanding. It is mutually agreed upon and understood by and among the Parties to this MOU that: a) PCS shall be the legal entity submitting a Letter of Intent and Application in response to RFA# OHA-4690-19. b) The Parties support and approve of PCS' submission of the Application. c) In the event PCS is awarded a contract to act as the CCO for the Region, the Parties agree to undertake the obligations outlined in Section 2(d) through 2(i) below. Commented [KM]: Application will not be available for advance review. MCCFL may ask to strike this section if prefers not to make statement of support. d) Behavioral Health Plan: PCS shall coordinate with the LMHA and its designated Community Mental Health Program on the development of a comprehensive Behavioral Health Plan for the Region as described in RFA# OHA-4690-19, Exhibit M, Section 3a(7) —Sample CCO Contract, and the LMHA shall participate in the Behavioral Health Plan development. The plan shall include without limitation goals to improve health outcomes and increase access to services. i) Structure. The Behavioral Health Plan developed by the Parties shall seek to: (1) Describe priority actions, accountable parties for those actions, and timeline for action and assessment; (2) Create structures for communication across systems, coordination of services to individuals, and feedback processes to improve functioning of behavioral health system; (3) Prioritize best -practice and evidence -based strategies where available; (4) Use a community-based, multisystem approach that engages a wide range of economic, governmental, and social service organizations and institutions servingresidents of the Region; and Employ data from a population based needs assessment, using a range of data sources including the Community Health Assessment and Community Health Improvement Plan if available, including ethnic, age, cultural and diversity needs of the population. ii) Goals of Plan. The Behavioral Health Plan developed by the Parties shall aim to: (1) Improve health in Region through access improvement and system redesign for behavioral health services; (2) Improve service delivery and coordination among service providers; (3) Maximize resources for CCO enrollees and increase utilization of funds from sources other than state general fund and Medicaid payments to support local services; (4) Coordinate services among the criminal and juvenile justice systems, adult and juvenile corrections systems, child welfare, schools, and local mental health programs; (5) Address local housing needs for persons with mental health disorders; and (6) Address local behavioral health workforce needs and training opportunities. iii) Process, Dates, Milestones: (1) The CCO's Behavioral Health plan will be completed by 12/31/2020. (2) The Behavioral Health Plan development process will be facilitated by CCO or designee, with the approval of a written plan and execution of written commitments from participating parties prior to 12/31/2020. (3) The Behavioral Health Plan development process will include periodic meetings, every 1- 2 months, with interim work by individuals, groups, and organizations. iv) Community Partners. The Behavioral Health Plan shall be developed by PCS through seeking input and participation from LMHAs and Communis Mental Health Programs serving the Region and the following community partners in the Region: (1) )3ehavioral health services organizations and/or professionals; (5) Memorandum of Understanding Page 2 of 7 Deleted: <#>PCS, LMHAs from Region, and Community Health Programs serving the Region;¶ (2) Local mental health advisory committee; (3) Behavioral Health system consumers, advocates, and families; (4) Representatives of early childhood and K-12 education; (5) Representatives of Oregon Department of Human Services' child welfare division; (6) Members of the local public safety coordinating council including criminal justice/corrections institutions, law enforcement, and first responders; (7) Providers of dental and physical health services, including hospitals and public health; and (8) Providers of social supports, including but not limited to housing, employment, and/or transportation. e) Community Health Assessment and Improvement Plan: PCS and LMHA shall collaborate in the creation of the Community Health Improvement Plan ("CHP"), as described in ORS 414.627. The Parties commit to jointly developing and submitting a CHP for the Region to the Oregon Health Authority on or before June 30, 2021 or a later date if permitted by the CCO Contract because of an existing CHP developed by the Parties. The Parties will coordinate the development of the CHP with the creation of the LMHA's local plan. f) Local Plan: PCS shall support the LMHA in the creation of LMHA's local plan as described in ORS 430.630(9) included here as Attachment A and as later amended. By January 1 2020, LMHA shall request in writin• from the Ore on Health Authority a determination as to the nature of the local olan re•uired of LIMEIA and the date by which it must be completed.,This determination shall be provided to PCS within 30 days of its receipt Within 60 dusof a written request from I_iVIHA to PCS, the Parties will convene and shall use best efforts to develop a data sharing plan to include data from CCO Community Health Assessment and any necessary written agreements and to establish a written agreement as to the responsibilities and engagement of each in the creation of the local plan. g) Clinical Services Contract: PCS and LMHA acknowledge that the services listed below are the responsibility of LMHA. Once awarded a CCO contract for the Region, PCS will enter negotiations to contract with designated Community Mental Health Program(s) in the Region to provide services to CCO members assigned to the Region. Such contract(s) shall include payment terms adequate to cover reasonable costs for providing these services at a level proportionate to CCO members' use of the services. PCS shall use its best efforts to execute a mutually agreeable contract that includes services in the following categories with the LMHA-designated Community Mental Health Program in the Region: i) Management of children and adults at risk of entering or who are transitioning from the Oregon State Hospital or from residential care; ii) Care coordination of residential services and supports for adults and children; iii) Management of the mental health crisis system; iv) Management of community-based specialized services, including but not limited to supported employment and education, early psychosis programs, assertive community Memorandum of Understanding Page 3 of 7 Deleted: By July 1, 2020 or at least 180 days prior to the expiration of the existing local plan, whichever is later Deleted: . By the same date, the Parties will Commented [KD2]: PCS requests that MCCFL specify the additional services that MCCFL requests be added to this list and source. PCS believes that this list is an accurate representation of ORS 414.153 treatment or other types of intensive case management programs and home-based services for children; and v) Management of specialized services to reduce recidivism of individuals with mental illness in the criminal justice system. h) Provision of Clinical Services: LMHA shall at all times cause to be in place a Community Mental Health Program competent and qualified to provide services as described above. i) LMHA Duties: In accordance with ORS 430.630(9), LMHA and its designated Community Mental Health Program shall collaborate with the local public safety coordinating council to address the following: Commented [KD3]: Performing on these statutory requirements is important to success of other public i) Training for all law enforcement officers on ways to recognize and interact with persons stakeholders and CCO. PCS does not accept MCCFL's with mental illness, for the purpose of diverting them from the criminal and juvenile justice request to remove this section. systems; ii) Developing voluntary locked facilities for crisis treatment and follow-up as an alternative to custodial arrests; iii) Developing a plan for sharing a daily jail and juvenile detention center custody roster and the identity of persons of concern and offering mental health services to those in custody; iv) Developing a voluntary diversion program to provide an alternative for persons with mental illness in the criminal and juvenile justice systems; and v) Developing mental health services, including housing, for persons with mental illness prior to and upon release from custody. 3. Non -Exclusive. This MOU does not create an exclusive arrangement between PCS and the LMHA or its designated Community Mental Health Program, and PCS may enter into agreements with other parties for similar or the same services or participation. 4. Governing Law. This MOU shall be governed by and construed in accordance with the laws of the State of Oregon, without regard to conflict of laws principles. 5. Counterparts. This MOU may be executed in two or more counterparts, each of which shall be deemed an original, but all of which together shall constitute one and the same instrument IN WITNESS WHEREOF, the parties hereto have executed this MOU on the day and year first above written. PacificSource Community Solutions [LMHA] By: By: Name: Name: Title: Title Date: Date: Memorandum of Understanding Page 4 of 7 Commented [KD4]: MCCFL requests removal. PCS does not agree. This is a provision of the CCO-related statute to which this MOU responds. Attachment A Commented [KOS]: Added per MCCFL request in Local Mental Health Services Plan comments in References document. 430.630 Services to be provided by community mental health oragrams; local mental health authorities; local mental health services pian, (91(a) As used in this subsection"local mental health authority" means one of the following entities: (A) The board of county commissioners of one or more counties that establishes or operates a community mental health programa pa The tribal council, in the case of a federallyrecognized tribe of Native Americans that elects to enter into an agreement to provide mental health services; or (C)_. A regional local mental health authority comprising two or more boards of county commissioners. (b) Each local mental health_ authority tha rovides mental health services shall determine the need for local mental health services and adopt a comprehensive local plan for the delivery of mental health services for children, families, adults and older adults that describes the methods y which the local mental health authority shaljprovide those services. Thgpurpose of the local plan is to create a blueprint toprovide mental health services that are directed by and responsive to the mental health needs of individuals in the community served bythe local plan. A local mental health authority shall coordinate its local planning with the development of the community health improvement plan under ORS 414.627 by tthe coordinated care organization serving the area. The Oregon Heaith Authoritymay require a local mental health authority to review and revise the local plan periodically, (c) The local olan shall identify ways to: (A) Coordinate and ensure accountability for all levels of care described in paragraph le) of this subsection; (3) Maximize resources for consumers and minimize administrative expenses; (Cj_Provide supported employment and other vocational opportunities for consumers; (D) Determine the most approj7riate service provider among„a range of qualified providers; co Ensure that appropriate mental health referrals are made; (F) Address local housing needs for persons with mental health disorders; (G) Developa process for discharge from state and local psychiatric hospitals and transition planning between levels of care or components of the system of care; (_)j Provide peer support services,, including but not limited to drop-in centers andp_eidpeer support; al Provide transportation supports and (i) Coordinate services amongthe criminal and juvenilejnustice systemstaduit and juvenile corrections systems arid local mental health programs to ensure that persons with mental illness who come into contact with the justice and corrections systems receive needed care and to ensure continuity of services for adults and juveniles leavi_n the corrections system. i_dj,_Whendeveioping a local plan, alocal mental health authority_shall: (A) Coordinate with the budgetary cycles of state and local governments that provide the local mental health authority with funding for mental health services; ) Involve consumers, advocates families, service providers. schools and other interested parties in the Alarm rocess; (C)Coordinate with the local public safety coordinatingcouncil to address the services described in ap ragraph (c)(1) of this subsection; (D) Conduct a pppulation based needs assessment to determine the tvoes of services needed locally Memorandum of Understanding Page 5 of 7 (E) Determine the ethnic, age-specific, cultural and diversitvneeds of theoppuiation served by the local plan; (F) Describe the anticipated outcomes of services and the actions to be achieved in the local plan LW Ensure that the local olan coordinates planning, fundinpand services with: (ft The educational needs of children, adults and older adults, (ii) Providers of social supports, including but not limited to housing, employment, transportation and education; and (iii) Providers of physical health and medical services; (H) Describe how funds other than state resources, may be used to support and implement the localolan; (ilDemonstrate ways to integrate local services and administrative functions in order to support integrated service deliver_y_inthe local plan; and (J) Involve the local mental health advisory committees described in subsection (7Jof this section. le) The local plan must describe how the local mental health authority will ensure the delivery of and be accountable for clinicaUyappropriate services ina continuum of care based on consumer needs. The local pllanshall include but not be.limited to,services proviiiding_the following levels of care: (A) Twenty -four-hour crisis services; (B) Secure and nonsecure extended psychiatric care; (L' Secure and nonsecure acut psychiatric care; (P) Twenty four-hour supervised structured treatment (E) Psychiatric day treatment; (F) Treatments that maximize client independence; LG) Family and peer support and self-help services; (H1 Support services] (1) Prevention and early intervention services] .� Transition assistance between levels of care (K) Dual diagnosis services; fit Accessto_piacement in state -funded psychiatric hospital beds M Precommitment and civil commitment in accordance with ORS chapter 426; and LN)„ Outreach to older adults at locations appropriate for making contact with older adults,. nclu (J t senior centers, longterm care facilities and personal residences. (f),_ In developingthepart of the local plan referred to in paragraph (p() of this subsection, the local mental health authority shall collaborate with the localpublicsafety-coordinating council to address the following; (A) Training for all law enforcement officers on ways to recpgnize and interact with persons with mental illness, for theouroose of diverting them from the criminal arid juvenile justice systems; LBLDevelooing voluntary, locked facilities for crisis treatment and follow-up. as an alternative to custodial arrests]• (c) Developing a plan for sharing a daily Ali and juvenile detention center custody roster and the identity of persons of concern and offering mental health services to those in custody, , Developinga voluntarvdiversion program top„rovide an alternative for „persons with mental illness in the criminal and juvenile justice systerns_Land (,_) Developing mental health _ervicesjinclrading housing,_forgersons with mentaiiilness.rrior_ to and upon release from custody.. Memorandum of Understanding Page 6 of 7 (g) Services described in the local plan shall: LZ Address the vision, values and guidingorinciples described in the Report to the Governor from the Mental Health Ali•nment Work,rou. Januar 20011 LB) Be provided to children older adults and families as close to their homes as possible; culturallyapprooriate and competent; (0) Be, for children, older adults and adults with mental health needs, from providers appropriate to deliver those services, (g)___Be delivered in an integrated service delivery system with integrated service sites or processes and with the use offintegrated service teams:, (F) Ensure consumer choice among a range of qualified providers in the community; (_GLBedistributed geographically;_ LH Involve consumers, families,clinicians, children and schools in treatment as appropriate; (1)_ Maximize early identification and early_iintervention; (J) Ensure appropriate transition planning between providers and service delivery systems,, with an emphasis on transition between children and adult mental health services; (K) Be based on the ability of a client to pay; (t) Be delivered collaboratively (M) Use age-appropriate research -based quality indicators; (N) Use best -practice innovations; and (0) Be delivered using a communitrybased, multisystem approach. (h) A local mental health authority shall submit to the Oregon Health Authority a copy of the local .plan and revisions adopted under paragraph (b) of this subsection at time intervals established by the Oregon Health Authority. 11961 c.706 §40; 1973 c.639 §3; 1981 c.750 §3; 1985 c.740 Memorandum of Understanding Page 7 of 7 * Proposed Redline PacificSource Community Solutions PacificSource Community Solutions PO Box 5729, Bend, OR 97708-5729 (800) 431-4135 CommunitySolutions.PacificSource.com MEMORANDUM OF UNDERSTANDING This Memorandum of Understanding ("MOU"), by and between PacificSource Community Solutions, an Oregon non-profit corporation ("PCS"), and a Local Mental Health Authority, ("LMHA"), (PCS and LMHA, together, the "Parties"), is made and effective on 2019 for the purpose of documenting Parties' commitment to work together to support and improve health through shared behavioral health system planning and provision of clinical services. The purpose of this Agreement is to assure that a system of publicly funded mental health and substance use disorder services are coordinated and funded through Pacific Source, in its role as a Coordinated Care Organization ("CCO"), in collaboration with the Deschutes County Board of County Commissioners, in its role as the Local Mental Health Authority ("LMHA"). In addition, this Agreement identifies the roles and responsibilities of Pacific Source and LMHA to effectively and efficiently work together towards achieving the Triple Aim; coordinate services and efforts to meet the mental health and substance use disorder needs of Pacific Source members, potential Pacific Source members, and the greater community; maintain the behavioral health safety net available to all; achieve improved behavioral and physical health outcomes; facilitate advantageous use of the system of publicly funded behavioral health care and services available through Pacific Source and LMHA; and create cost savings through care coordination and collaboration. Pacific Source acknowledges Deschutes County LMHA's responsibility to develop a system of services for insured and uninsured individuals and Deschutes County LMHA acknowledges Pacific Source's responsibility to administer Medicaid funds for those enrolled in the Oregon Health Plan (01 -IP). The parties agree that the overall health of the community will be enhanced by Pacific Source and Deschutes County LMHA collaboratively developing, wherever possible and practicable, a system of publicly funded mental health and substance use disorder services, for both the insured and uninsured that is mutually supportive, coordinated, and funded WHEREAS PCS intends to submit an application (the "Application") to the Oregon Health Authority ("OHA") to be awarded a contract to act as a Coordinated Care Organization ("CCO") for Counties in Oregon (the "Region"). THEREFORE this MOU sets forth the Parties' understandings and expectations with regarding to PCS' potential contract to serve as the CCO for the Region and the Parties' commitment to each other. 1. Term. The understandings and commitments made by the Parties pursuant to this MOU shall remain in effect until the Parties enter into an agreement that supersedes this MOU, until December 31, 2019 if PCS is notified by OHA that PCS has not been awarded a CCO contract in Region for 2020, or until December 31, 2024, whichever occurs first. Commented [JG1]: These paragraphs added to the preamble. Captures edits proposed by Hood River CMHP (Mid -Columbia Center for Living — MCCFL) and I believe accepted by PS liaison to MCCFL, Kristen Dillon, as useful/positive additions. 2. Understanding. It is mutually agreed upon and understood by and among the Parties to this MOU that: a) PCS shall be the legal entity submitting a Letter of Intent and Application in response to RFA# OHA-4690-19. b) The Parties support and approve of PCS' submission of the Application. c) In the event PCS is awarded a contract to act as the CCO for the Region, the Parties agree to undertake the obligations outlined in Section 2(d) through 2(i) below. d) Behavioral Health Plan: PCS shall coordinate with the LMHA and its designated Community Mental Health Program on the development of a comprehensive Behavioral Health Plan for the Region as described in RFA# OHA-4690-19, Exhibit M, Section 3a(7) — Sample CCO Contract, and the LMHA shall participate in the Behavioral Health Plan development. The plan shall include without limitation goals to improve health outcomes and increase access to services. The Behavioral Health Plan shall be developed i) Structure. The Behavioral Health Plan developed by the Parties shall be consistent with the guidelines laid out for LMHAs in ORS 430.630 (see Attachment A) and shall seek to: (1) Describe priority goals actions, accountable parties for those actions, and timeline for action and assessment; (2) Create structures for communication across systems, coordination of services to individuals, and feedback processes to improve functioning of behavioral health system; (3) Prioritize best -practice and evidence -based strategies where available; (4) Use a community-based, multisystem approach; and (5) Employ data from a population based, multi -source needs assessment, using the Community Health Assessment and Community Health Improvement Plan (in Central Oregon known as the Regional Health Assessment/RHA and the Regional Health Improvement Plan/RHIP) if available, including ethnic, age, cultural and diversity needs of the population. ii) Goals of Plan. The Behavioral Health Plan developed by the Parties shall aim to: (1) Improve health in Region through access improvement and system redesign for behavioral health services; (2) Improve service delivery and coordination among service providers; (3) Maximize resources for CCO enrollees and increase utilization of funds from sources other than state general fund and Medicaid payments to support local services; (4) Coordinate services among the criminal and juvenile justice systems, adult and juvenile corrections systems, child welfare, schools,,local mental health and physical health _ _ _ programs,- - - - - -_ _ _ _ _ (5) Address local housing needs for persons with mental health disorders; and (6) Address local behavioral health workforce needs and training opportunities. iii) Process, Dates, Milestones: Memorandum of Understanding Page 2 of 8 Commented [JG2]: 1 think this is an important anchor to statutory guidelines already in place that support planning for the delivery of MH services and guide LMHAs engaged in these processes, Deleted: and Deleted: (1) The CCO's Behavioral Health plan will be completed by 12/31/2020. (2) The Behavioral Health Plan development process will be facilitated by CCO or designee, in collaboration with the LMHA or its designee with the approval of a written plan and execution of written commitments from participating parties prior to 12/31/2020. The Behavioral Health Plan development process will include periodic meetings, every 1- 2 months, with interim work by individuals, groups, and organizations. iv) Community Partners. The Behavioral Health Plan shall be developed by seeking input and participation from the following community partners in the Region: (1) PCS, LMHAs from Region, and Community Mental Health Programs serving the Region; (2) Behavioral health services organizations and/or professionals; (3) Local mental health advisory committee; (4) Behavioral Health system consumers, advocates, and families; (5) Representatives of early childhood and K-12 education; (6) Representatives of Oregon Department of Human Services' child welfare division; (7) Members of the local public safety coordinating council including criminal justice/corrections institutions, law enforcement, and first responders; (8) Providers of dental and physical health services, including hospitals and public health; and Providers of social supports, including but not limited to housing, employment, and/or transportation. e) Community Health Assessment and Improvement Plan: PCS and LMHA shall collaborate in the creation of the Community Health Improvement Plan ("CHP" — in Central Oregon known as the Regional Health Improvement Plan/RHIP), as described in ORS 414.627. The Parties commit to jointly developing and submitting a CHP for the Region to the Oregon Health Authority on or before June 30, 2021 or a later date if permitted by the CCO Contract because of an existing CHP developed by the Parties. The Parties will coordinate the development of the CHP with the creation of the LMHA's local plan. f) Local Plan: PCS shall support the LMHA in the creation of LMHA's local plan as described in ORS 430.630(9) (see Attachment A). By July 1, 2020 or at least 180 days prior to the expiration of the existing local plan, whichever is later, or when the state of Oregon indicates one is due the Parties will develop a data sharing plan to include data from CCO Community Health Assessment and any necessary written agreements. By the same date, the Parties will establish a written agreement as to the responsibilities and engagement of each in the creation of the local plan. g) Clinical Services Contract: PCS and LMHA acknowledge that the services listed in ORS 430.630 (9)(e) and those listed below are the responsibility of LMHA. Once awarded a CCO contract for the Region, PCS will enter negotiations to contract with designated Community Mental Health Program(s) in the Region to provide services to CCO members assigned to the Region. Such contract(s) shall include payment terms adequate to cover reasonable costs for providing these services at a level proportionate to CCO members' use of the services. PCS shall use its best efforts (3) (9) Memorandum of Understanding Page 3 of 8 Commented (.163]: Added b/c the list below is not inclusive of all services for which the LMHA is responsible. to execute a mutually agreeable contract that includes services in the following categories with the LMHA-designated Community Mental Health Program in the Region: i) Management of children and adults at risk of entering or who are transitioning from the Oregon State Hospital or from residential care; ii) Care coordination of residential services and supports for adults and children; iii) Management of the mental health crisis system; iv) Management of community-based specialized services, including but not limited to supported employment and education, early psychosis programs, assertive community treatment or other types of intensive case management programs and home-based services for children; and v) Management of specialized services to reduce recidivism of individuals with mental illness in the criminal justice system. h) Provision of Clinical Services: LMHA shall at all times cause to be in place a Community Mental Health Program competent and qualified to provide services as described above. i) LMHA Duties: In accordance with ORS 430.630(9), LMHA and its designated Community Mental Health Program shall collaborate with the local public safety coordinating council to address the following: i) Training for all law enforcement officers on ways to recognize and interact with persons with mental illness, for the purpose of diverting them from the criminal and juvenile justice systems; ii) Developing voluntary locked facilities for crisis treatment and follow-up as an alternative to custodial arrests; iii) Developing a plan for sharing a daily jail and juvenile detention center custody roster and the identity of persons of concern and offering mental health services to those in custody; iv) Developing a voluntary diversion program to provide an alternative for persons with mental illness in the criminal and juvenile justice systems; and v) Developing mental health services, including housing, for persons with mental illness prior to and upon release from custody. 3. Non -Exclusive. This MOU does not create an exclusive arrangement between PCS and the LMHA or its designated Community Mental Health Program, and PCS may enter into agreements with other parties for similar or the same services or participation. 4. Governing Law. This MOU shall be governed by and construed in accordance with the laws of the State of Oregon, without regard to conflict of laws principles. 5. Counterparts. This MOU may be executed in two or more counterparts, each of which shall be deemed an original, but all of which together shall constitute one and the same instrument IN WITNESS WHEREOF, the parties hereto have executed this MOU on the day and year first above written. Memorandum of Understanding Page 4 of 8 PacificSource Community Solutions [LMHA] By: By: Name: Name: Title: Title Date: Date: Memorandum of Understanding Page 5 of 8 Attachment A Local Mental Health Services Plan 430.630 Services to be provided by community mental health programs; local mental health authorities; local mental health services plan. (9)(a) As used in this subsection, "local mental health authority" means one of the following entities: (A) The board of county commissioners of one or more counties that establishes or operates a community mental health program; B The tribal council in the case of a federal) reco:nized tribe of Native Americans that elects to enter into an agreement to provide mental health services; or (C) A regional local mental health authority comprising two or more boards of county commissioners. (b) Each local mental health authority that provides mental health services shall determine the need for local mental health services and adopt a comprehensive local plan for the delivery of mental health services for children, families, adults and older adults that describes the methods by which the local mental health authority shall provide those services. The purpose of the local plan is to create a blueprint to provide mental health services that are directed by and responsive to the mental health needs of individuals in the community served by the local plan. A local mental health authority shall coordinate its local planning with the development of the community health improvement plan under ORS 414.627 by the coordinated care organization serving the area. The Oregon Health Authority may require a local mental health authority to review and revise the local plan periodically. (c) The local plan shall identify ways to: (A) Coordinate and ensure accountability for all levels of care described in paragraph (e) of this subsection; (8) Maximize resources for consumers and minimize administrative expenses; (C) Provide supported employment and other vocational opportunities for consumers; (D) Determine the most appropriate service provider among a range of qualified providers; (E) Ensure that appropriate mental health referrals are made; (F) Address local housing needs for persons with mental health disorders (G) Develop a process for discharge from state and local psychiatric hospitals and transition planning between levels of care or components of the system of care; (H) Provide peer support services, including but not limited to drop-in centers and paid peer support; (I) Provide transportation supports; and (J) Coordinate services among the criminal and juvenile justice systems, adult and juvenile corrections systems and local mental health programs to ensure that persons with mental illness who come into contact with the justice and corrections systems receive needed care and to ensure continuity of services for adults and juveniles leaving the corrections system. (d) When developing a local plan, a local mental health authority shall: A Coordinate with the bud eta c cles of state and local governments that provide the local mental health authority with funding for mental health services; (8) Involve consumers, advocates, families, service providers, schools and other interested parties in the planning process; (C) Coordinate with the local public safety coordinating council to address the services described in paragraph (c)(J) of this subsection; (D) Conduct a population based needs assessment to determine the types of services needed locally; Memorandum of Understanding Page 6 of 8 (E) Determine the ethnic, age-specific, cultural and diversity needs of the population served by the local plan; (F) Describe the anticipated outcomes of services and the actions to be achieved in the local plan; (G) Ensure that the local plan coordinates planning, funding and services with: (i) The educational needs of children, adults and older adults; (ii) Providers of social supports, including but not limited to housing, employment, transportation and education; and (iii) Providers of physical health and medical services; (H) Describe how funds, other than state resources, may be used to support and implement the local plan; (I) Demonstrate ways to integrate local services and administrative functions in order to support integrated service delivery in the local plan; and (J) Involve the local mental health advisory committees described in subsection (7) of this section. (e) The local plan must describe how the local mental health authority will ensure the delivery of and be accountable for clinically appropriate services in a continuum of care based on consumer needs. The local plan shall include, but not be limited to, services providing the following levels of care: (A) Twenty-four-hour crisis services; (B) Secure and nonsecure extended psychiatric care; (C) Secure and nonsecure acute psychiatric care; (0) Twenty-four-hour supervised structured treatment; (E) Psychiatric day treatment; (F) Treatments that maximize client independence; (G) Family and peer support and self-help services; (H) Support services; (I) Prevention and early intervention services; (1) Transition assistance between levels of care; (K) Dual diagnosis services; (L) Access to placement in state-funded psychiatric hospital beds; (M) Precommitment and civil commitment in accordance with ORS chapter 426; and (N) Outreach to older adults at locations appropriate for making contact with older adults, including senior centers, long term care facilities and personal residences. (f) In developing the part of the local plan referred to in paragraph (c)(J) of this subsection, the local mental health authority shall collaborate with the local public safety coordinating council to address the following: (A) Training for all law enforcement officers on ways to recognize and interact with persons with mental illness, for the purpose of diverting them from the criminal and juvenile justice systems; (B) Developing voluntary locked facilities for crisis treatment and follow-up as an alternative to custodial arrests; (C) Developing a plan for sharing a daily jail and juvenile detention center custody roster and the identity of persons of concern and offering mental health services to those in custody; (D) Developing a voluntary diversion program to provide an alternative for persons with mental illness in the criminal and juvenile justice systems; and (E) Developing mental health services, including housing, for persons with mental illness prior to and upon release from custody. Memorandum of Understanding Page 7 of 8 (g) Services described in the local plan shall: (A) Address the vision, values and guiding principles described in the Report to the Governor from the Mental Health Alignment Workgroup, January 2001; (B) Be provided to children, older adults and families as close to their homes as possible; (C) Be culturally appropriate and competent; (D) Be, for children, older adults and adults with mental health needs, from providers appropriate to deliver those services; (E) Be delivered in an integrated service delivery system with integrated service sites or processes, and with the use of integrated service teams; (F) Ensure consumer choice among a range of qualified providers in the community; (G) Be distributed geographically; (H) Involve consumers, families, clinicians, children and schools in treatment as appropriate; (1) Maximize early identification and early intervention; (J) Ensure appropriate transition planning between providers and service delivery systems, with an emphasis on transition between children and adult mental health services, (K) Be based on the ability of a client to pay; (L) Be delivered collaboratively; (M) Use age-appropriate, research -based quality indicators; (N) Use best -practice innovations; and (0) Be delivered using a community-based, multisystem approach. (h) A local mental health authority shall submit to the Oregon Health Authority a copy of the local plan and revisions adopted under paragraph (b) of this subsection at time intervals established by the Oregon Health Authority. (1961 c.706 §40; 1973 c.639 §3; 1981 c.750 §3; 1985 c.740 Memorandum of Understanding Page 8 of 8 PUBLIC HEALTH MOU PacificSource Community Solutions PacificSource Community Solutions PO Box 5729, Bend, OR 97708-5729 (800) 431-4135 CommunitySolutions.PacificSource.com MEMORANDUM OF UNDERSTANDING This Memorandum of Understanding ("MOU"), by and between PacificSource Community Solutions, an Oregon non-profit corporation ("PCS"), and a Local Public Health Authority, ("LPHA"), (PCS and LPHA, together, the "Parties"), is made and effective on , 2019 for the purpose of documenting Parties' commitment to work together to support and improve health through health promotion activities undertaken by Parties and provision of clinical services. WHEREAS PCS intends to submit an application (the "Application") to the Oregon Health Authority ("OHA") to be awarded a contract to act as a Coordinated Care Organization (the "CCO") for Counties in Oregon (the "Region"). THEREFORE this MOU sets forth the Parties' understandings and expectations with regarding to PCS' potential contract to serve as the CCO for the Region and the Parties' commitment to each other. 1. Term. The understandings and commitments made by the Parties pursuant to this MOU shall remain in effect until the Parties enter into an agreement that supersedes this MOU, until December 31, 2019 if PCS is notified by OHA that PCS has not been awarded a CCO contract in Region for 2020, or until December 31, 2024, whichever occurs first. 2. Understanding. It is mutually agreed upon and understood by and among the Parties to this MOU that: a) PCS shall be the legal entity submitting the Application in response to RFA# OHA-4690-19. b) The Parties support and approve of PCS' submission of the Application. c) In the event PCS is awarded a contract to act as the CCO for the Region, the Parties agree to undertake the obligations outlined in Section 2(d) through 2(f) below. d) Community Health Assessment and Improvement Plan: PCS and LPHA shall collaborate in the creation of the Community Health Improvement Plan ("CHP"), as described in ORS 414.627. The Parties commit to jointly developing and submitting a CHP for the Region to the Oregon Health Authority on or before June 30, 2021 or a later date if permitted by the CCO Contract because of an existing CHP developed by the Parties. The Parties will develop the CHP in alignment with the LPHA's obligations under public health accreditation or similar standards or requirements. e) Clinical Services Contract: Once awarded a CCO contract for the Region, PCS will enter negotiations to contract with each designated public health department and/or district in the Region to provide services to CCO members assigned to the Region. Such contract(s) shall include payment terms adequate to cover reasonable costs for providing these services at a level proportionate to CCO members' use of the services. To the extent that the following services are included in the health care benefit package administered by the CCO, PCS shall use its best efforts to execute a mutually agreeable contract that includes services in the following categories with each public health department and/or district in the Region: i) Immunizations; ii) Sexually transmitted diseases; iii) Other communicable diseases; iv) Family planning; v) Human immunodeficiency virus and acquired immune deficiency syndrome prevention; vi) Maternity case management; vii) School-based clinic services; and viii) Other health care services as mutually agreed. f) Provision of Clinical Services: LPHA shall at all times cause to be in place a public health department or district competent and qualified to provide services as described above. LPHA acknowledges that additional contracts and agreements, as contemplated herein, shall provide for the provision of services to CCO enrollees who may reside outside of Deschutes County. LPHA agrees to provide services under such contracts and agreements to CCO enrollees residing in zip codes 97731, 97733, 97737, and 97739. LPHA further agrees that it shall enter into any necessary intergovernmental agreements in order to provide services to CCO enrollees residing outside of Deschutes County. 3. Non -Exclusive. This MOU does not create an exclusive arrangement between PCS and the LPHA or its designated public health department or district, and PCS may enter into agreements with other parties for similar or the same services or participation. 4. Governing Law. This MOU shall be governed by and construed in accordance with the laws of the State of Oregon, without regard to conflict of laws principles. 5. Counterparts. This MOU may be executed in two or more counterparts, each of which shall be deemed an original, but all of which together shall constitute one and the same instrument g) IN WITNESS WHEREOF, the parties hereto have executed this MOU on the day and year first above written. PacificSource Community Solutions [LPHAJ By: By: Name: Name: Title: Title Date: Date: Memorandum of Understanding Page 2 of 2 Legal Authority: Mental Health PacificSource Community Solutions, Inc. PO Box 5729, Bend OR 97708-5729 PacificSource 541.382.5920 800.431.4135 Community Solutions CommunitySolutions.PacificSource.com Requirements relating to Local Mental Health Authorities and Coordinated Care Organizations March 11, 2019 Required Elements for CCO Application Submission and CCO Operation 1. Exhibit G, Section 4 Cooperative Agreements with Publicly Funded Programs Report (Next due July 1, 2020; page 204) Report by July 1 of each year the status of formal agreements with publicly -funded entities, including local mental health authorities. 2. RFA Attachment 7, Section 1.d. (Due with Application April 22, 2019; page 324) (1) Describe the Applicant's status for obtaining MOU(s) or contract(s) with LMHAs and CMHPs throughout its proposed service area. (2) If MOUs have not been executed, describe Applicant's efforts to do so and how the Applicant will obtain the MOU(s) or contract(s). 3. RFA Attachment 7, Section 12.c. (Due with Application April 22, 2019; page 335) Submit table listing publicly -funded programs with which Applicant has agreements to pay for point - of -contact services and for cooperation with the local mental health authorities unless cause can be demonstrated that such an agreement is not feasible. Oregon Revised Statutes ORS 414.153 Services provided by local health departments (4) [...the state shall...] Recognize the responsibility of counties under ORS 430.620 (Establishment of community mental health and developmental disabilities programs by one or more counties) to operate community mental health programs by requiring a written agreement between each coordinated care organization and the local mental health authority in the area served by the coordinated care organization, unless cause can be shown why such an agreement is not feasible under criteria established by the Oregon Health Authority. The written agreements: (a)May not prevent coordinated care organizations from contracting with other public or private providers for mental health or chemical dependency services; (b)Must include agreed upon outcomes; and (c)Must describe the authorization and payments necessary to maintain the mental health safety net system and to maintain the efficient and effective management of the following responsibilities of local mental health authorities, with respect to the service needs of members of the coordinated care organization: (A)Management of children and adults at risk of entering or who are transitioning from the Oregon State Hospital or from residential care; (B)Care coordination of residential services and supports for adults and children; (C)Management of the mental health crisis system; (D)Management of community-based specialized services, including but not limited to supported employment and education, early psychosis programs, assertive community treatment or other types of intensive case management programs and home-based services for children; and (E)Management of specialized services to reduce recidivism of individuals with mental illness in the criminal justice system. ORS 430.620 Establishment of community mental health and developmental disabilities programs by one or more counties. (1) The county court or board of county commissioners, or its representatives designated by it for the purpose, of any county, on behalf of the county, may: (a) By contract with and subject to the rules of the Department of Human Services, establish and operate, or contract with a public agency or private corporation for, a community developmental disabilities program. (b) In conformity with the rules of the Oregon Health Authority, establish and operate, or contract with a public agency or private corporation for, a community mental health program. (c) Cooperate, coordinate or act jointly with any other county or counties or any appropriate officer or agency of such counties in establishing and operating or contracting for a community mental health program or community developmental disabilities program to service all such counties in conformity with the regulations of the department or the authority. (d) Expend county moneys for the purposes referred to in paragraph (a), (b) or (c) of this subsection. (e) Accept and use or expend property or moneys from any public or private source made available for the purposes referred to in paragraph (a), (b) or (c) of this subsection. (2) All officers and agencies of a county, upon request, shall cooperate insofar as possible with the county court or board of county commissioners, or its designated representatives, in conducting programs and carrying on and coordinating activities under subsection (1) of this section. 430.630 Services to be provided by community mental health programs; local mental health authorities; local mental health services plan. (9)(a) As used in this subsection, "local mental health authority" means one of the following entities: (A) The board of county commissioners of one or more counties that establishes or operates a community mental health program; (B) The tribal council, in the case of a federally recognized tribe of Native Americans that elects to enter into an agreement to provide mental health services; or (C) A regional local mental health authority comprising two or more boards of county commissioners. (b) Each local mental health authority that provides mental health services shall determine the need for local mental health services and adopt a comprehensive local plan for the delivery of mental health services for children, families, adults and older adults that describes the methods by which the local mental health authority shall provide those services. The purpose of the local plan is to create a blueprint to provide mental health services that are directed by and responsive to the mental health needs of individuals in the community served by the local plan. A local mental health authority shall coordinate its local planning with the development of the community health improvement plan under ORS 414.627 by the coordinated care organization serving the area. The Oregon Health Authority may require a local mental health authority to review and revise the local plan periodically. (c) The local plan shall identify ways to: (A) Coordinate and ensure accountability for all levels of care described in paragraph (e) of this subsection; (B) Maximize resources for consumers and minimize administrative expenses; (C) Provide supported employment and other vocational opportunities for consumers; (D) Determine the most appropriate service provider among a range of qualified providers; (E) Ensure that appropriate mental health referrals are made; (F) Address local housing needs for persons with mental health disorders; (G) Develop a process for discharge from state and local psychiatric hospitals and transition planning between levels of care or components of the system of care; (H) Provide peer support services, including but not limited to drop-in centers and paid peer support; (I) Provide transportation supports; and (J) Coordinate services among the criminal and juvenile justice systems, adult and juvenile corrections systems and local mental health programs to ensure that persons with mental illness who come into contact with the justice and corrections systems receive needed care and to ensure continuity of services for adults and juveniles leaving the corrections system. (d) When developing a local plan, a local mental health authority shall: (A) Coordinate with the budgetary cycles of state and local governments that provide the local mental health authority with funding for mental health services; (B) Involve consumers, advocates, families, service providers, schools and other interested parties in the planning process; (C) Coordinate with the local public safety coordinating council to address the services described in paragraph (c)(J) of this subsection; (D) Conduct a population based needs assessment to determine the types of services needed locally; (E) Determine the ethnic, age-specific, cultural and diversity needs of the population served by the local plan; (F) Describe the anticipated outcomes of services and the actions to be achieved in the local plan; (G) Ensure that the local plan coordinates planning, funding and services with: (i) The educational needs of children, adults and older adults; (ii) Providers of social supports, including but not limited to housing, employment, transportation and education; and (iii) Providers of physical health and medical services; (H) Describe how funds, other than state resources, may be used to support and implement the local plan; (I) Demonstrate ways to integrate local services and administrative functions in order to support integrated service delivery in the local plan; and (J) Involve the local mental health advisory committees described in subsection (7) of this section. (e) The local plan must describe how the local mental health authority will ensure the delivery of and be accountable for clinically appropriate services in a continuum of care based on consumer needs. The local plan shall include, but not be limited to, services providing the following levels of care: (A) Twenty -four-hour crisis services; (B) Secure and nonsecure extended psychiatric care; (C) Secure and nonsecure acute psychiatric care; (D) Twenty -four-hour supervised structured treatment; (E) Psychiatric day treatment; (F) Treatments that maximize client independence; (G) Family and peer support and self-help services; (H) Support services; (I) Prevention and early intervention services; (J) Transition assistance between levels of care; (K) Dual diagnosis services; (L) Access to placement in state -funded psychiatric hospital beds; (M) Precommitment and civil commitment in accordance with ORS chapter 426; and (N) Outreach to older adults at locations appropriate for making contact with older adults, including senior centers, long term care facilities and personal residences. In developing the part of the local plan referred to in paragraph (c)(J) of this subsection, the local mental health authority shall collaborate with the local public safety coordinating council to address the following: (A) Training for all law enforcement officers on ways to recognize and interact with persons with mental illness, for the purpose of diverting them from the criminal and juvenile justice systems; (B) Developing voluntary locked facilities for crisis treatment and follow-up as an alternative to custodial arrests; (C) Developing a plan for sharing a daily jail and juvenile detention center custody roster and the identity of persons of concern and offering mental health services to those in custody; (D) Developing a voluntary diversion program to provide an alternative for persons with mental illness in the criminal and juvenile justice systems; and (E) Developing mental health services, including housing, for persons with mental illness prior to and upon release from custody. Services described in the local plan shall: (A) Address the vision, values and guiding principles described in the Report to the Governor from the Mental Health Alignment Workgroup, January 2001; (B) Be provided to children, older adults and families as close to their homes as possible; (C) Be culturally appropriate and competent; (D) Be, for children, older adults and adults with mental health needs, from providers appropriate to deliver those services; (E) Be delivered in an integrated service delivery system with integrated service sites or processes, and with the use of integrated service teams; (F) Ensure consumer choice among a range of qualified providers in the community; (G) Be distributed geographically; (H) Involve consumers, families, clinicians, children and schools in treatment as appropriate; (I) Maximize early identification and early intervention; (J) Ensure appropriate transition planning between providers and service delivery systems, with an emphasis on transition between children and adult mental health services; (K) Be based on the ability of a client to pay; (L) Be delivered collaboratively; (M) Use age-appropriate, research -based quality indicators; (N) Use best -practice innovations; and (0) Be delivered using a community-based, multisystem approach. (h) A local mental health authority shall submit to the Oregon Health Authority a copy of the local plan and revisions adopted under paragraph (b) of this subsection at time intervals established by the Oregon Health Authority. [1961 c.706 §40; 1973 c.639 §3; 1981 c.750 §3; 1985 c.740 CCO 2.0 Request for Applications Attachment 11— Behavioral Health C. MOU with Community Mental Health Program (CMHP) (recommended page limit 6 pages) Applicant will enter a MOU with Local Mental Health Authority that will be enforced and honored. Improved health outcomes and increased access to services through coordination of safety net services and Medicaid services. 1. Describe how Applicant plans to develop a comprehensive Behavioral Health plan for Applicant's Service Area. Please include dates, milestones, and Community partners. 2. Describe how Applicant plans to collaborate and coordinate with the Local Mental Health Authority in the development of the CHP. Please include dates and milestones. 3. Describe how Applicant plans to collaborate and coordinate with the Local Mental Health Authority in the development of the local plan. Please include dates and milestones. 4. Does Applicant expect any challenges or barriers to executing the written plan or MOU extension with the Local Mental Health Authority? If yes, please describe. Sample 2020 Contract Exhibit M 3.a Care Coordination (6) Contractor shall enter into a written memorandum of understanding (MOU) with the local community mental health program (CMHP) in Contractor's service area by January 1, 2020. The MOU shall include: (a) A formalized agreement that the Contractor will coordinate with the CMHP on the development of a comprehensive Behavioral Health Plan for Contractor's service area; and (b) All the requirements identified in ORS 414.153. (7) Contractor shall develop a comprehensive Behavioral Health plan for Contractor's service area in collaboration with the local mental health authority and other community partners (e.g., education/schools, hospitals, corrections, police, first responders, child welfare, DHS, public health, peers, families, housing authorities, housing providers, courts) (12) Contractor shall work collaboratively with OHA and CMHPs to develop and implement plans to better meet the needs of Members in less institutional community settings and to reduce recidivism to emergency departments for Behavioral Health reasons. (13) Contractor shall work collaboratively with other providers in the health care continuum to improve services for adult Members with SPMI. (14) Contractor shall coordinate and collaborate on the development of the community health improvement plan (CHP) under ORS 414.627 with the local community mental health program (CMHP) for the delivery of mental health services under ORS 430.630. (15) Contractor shall work with SRTFs to expeditiously move civilly committed adult Members with SPMI who no longer need placement in an SRTF to a community placement in the most integrated setting appropriate for that person. Discharge shall be to housing consistent with the individual's treatment goals, clinical needs, and the individual's informed choice. The individual's geographic preferences and housing preferences (e.g., living alone or with roommates) shall be reasonably accommodated in Tight of cost, availability, and the other factors stated above. (16) Contractor shall work with local law enforcement and jail staff to develop strategies to reduce contacts between Members and law enforcement due to Behavioral Health reasons, including reduction in arrests, jail admissions, lengths of stay in jails and recidivism. (17) Contractor will work with local jurisdictions to share information with jails regarding the Behavioral Health diagnosis, status, medication regimen, and services of Members who are incarcerated Exhibit M 2.6 Crisis, Urgent, and Emergency Services (3) Contractor shall establish written policies and procedures for a quality improvement plan for the emergency response system. Exhibit N —Social Determinants of Health and Health Equity 2. Community Health Assessment (CHA) and Community Health Improvement Plan (CHP)... b. To the extent practicable, Contractor shall include in the CHA and CHP a strategy and plan for: (1) Working with the Early Learning Council, Early Learning Hubs, the Youth Development Council, Local Mental Health Authority, oral health care providers, the local public health authority, community-based organizations, hospital systems and the school health providers in the Service Area/region... Prepared by Kristen Dillon Legal Authority: Public Health PacificSource Community Solutions PacificSource Community Solutions, Inc. PO Box 5729, Bend OR 97708-5729 541.382.5920 800.431.4135 Comm unitySolutions.PacificSource.com Requirements relating to Local Public Health Authorities and Coordinated Care Organizations March 11, 2019 Required Elements for CCO Application Submission and CCO Operation 1. Exhibit G, Section 4 Cooperative Agreements with Publicly Funded Programs Report (Next due July 1, 2020; Consolidated RFA page 204) Report by July 1 of each year the status of formal agreements with publicly -funded entities, including local public health authorities. 2. RFA Attachment 7, Section 12.c. (Due with Application April 22, 2019; Consolidated RFA page 335) Submit table listing publicly -funded programs with which Applicant has contracts to pay for point -of - contact services. 2017 Oregon Revised Statutes ORS 414.153 Services Provided by Local Health Departments In order to make advantageous use of the system of public health care and services available through local health departments and other publicly supported programs and to ensure access to public health care and services through contract under ORS chapter 414, the state shall: (1)Unless cause can be shown why such an agreement is not feasible, require and approve agreements between coordinated care organizations and publicly funded providers for authorization of payment for point of contact services in the following categories: (a)Immunizations; (b)Sexually transmitted diseases; and (c)Other communicable diseases; (2)Allow members of coordinated care organizations to receive from fee-for-service providers: (a)Family planning services; (b)Human immunodeficiency virus and acquired immune deficiency syndrome prevention services; and (c)Maternity case management if the Oregon Health Authority determines that a coordinated care organization cannot adequately provide the services; (3)Encourage and approve agreements between coordinated care organizations and publicly funded providers for authorization of and payment for services in the following categories: (a)Maternity case management; (b)Well-child care; (c)Prenatal care; (d)School-based clinics; (e)Health care and services for children provided through schools and Head Start programs; and (f)Screening services to provide early detection of health care problems among low income women and children, migrant workers and other special population groups; and Sample 2020 Contract Exhibit B, Part 4 Providers and Delivery System 10. b. Contractor shall promote communication and coordination with state and local government agencies and culturally diverse community social and support services organizations, including early child education, special education, Behavioral Health and public health as critical for the development and operation of an effective delivery system. 12. Health Promotion and Prevention Contractor shall provide evidence -based care in a culturally responsive and linguistically appropriate manner that supports prevention, contains cost, and improves health outcomes and quality of life for their Members. Contractor shall report to OHA Contract Administration Unit on health promotion and disease prevention, describing the means by which Contractor will accomplish the following tasks. Contractor shall:... e. Demonstrate evidence of partnership with health promotion, racially, ethnically and linguistically diverse community, and local prevention leaders and professionals, including local public health authorities. f. Contribute to local public health and health promotion planning efforts j. Assure full compliance with disease reporting to the public health system Exhibit B, Part 10 — Quality, Transformation, Performance Outcomes and Accountability 9. Quality Performance Improvement Projects b. Contractor shall commit to improving care in at least 4 of the following 7 focus areas... (2) Addressing population health issues (such as diabetes, hypertension and asthma) within a specific geographic area by harnessing and coordinating a broad set of resources, including Traditional Health workers, public health services, and aligned federal and state programs... 12. Quality Pool i. Contractor shall offer correlative arrangements with Participating Providers (including Social Determinants of Health & Health Equity partners, public health partners, and other health- related services providers as appropriate), providing monetary incentive payment arrangements with Providers that reflect priorities which align with the Quality Pool program for achieving the outcome and quality objectives. Contractor shall report these arrangements and amounts paid to OHA annually, on Exhibit L and submitted in conjunction with the 4th Quarter reporting period (See Exhibit L)... k. Contractor shall create a distribution plan for Quality Pool and Challenge Pool earnings. The plan should include: (1) an overview of the methodology and/or strategy used to distribute quality pool earnings to participating providers, including Social Determinants of Health and Health Equity (SDOH- HE) and public health partners, that provides information related to the contractor's process of evaluating the contributions of participating providers and connecting those evaluations to distribution of funds; . (2) data on the expenditure of quality incentive pool earnings and whether the distribution considers payments made previously to participating providers (such as up front funding to a clinic or non -clinical partner that is intended to help the contractor achieve metrics related to the quality pool); (3) information to help participating providers (including SDOH-HE and public health partners) understand how they may qualify for payments, how contractor distributed funds in the most recent year, and how they may distribute funds in future years. Exhibit M - Behavioral Health 3. Care Coordination and Integration a. Care Coordination... (7) Contractor shall develop a comprehensive Behavioral Health plan for Contractor's service area in collaboration with the local mental health authority and other community partners (e.g., education/schools, hospitals, corrections, police, first responders, child welfare, DHS, public health, peers, families, housing authorities, housing providers, courts) Exhibit N — Social Determinants of Health and Health Equity 2. Community Health Assessment (CHA) and Community Health Improvement Plan (CHP)... b. To the extent practicable, Contractor shall include in the CHA and CHP a strategy and plan for: (1) Working with the Early Learning Council, Early Learning Hubs, the Youth Development Council, Local Mental Health Authority, oral health care providers, the local public health authority, community-based organizations, hospital systems and the school health providers in the Service Area/region... Prepared by Kristen Dillon Deschutes County Board of Commissioners 1300 NW Wall St, Bend, OR 97703 (541) 388-6570 - Fax (541) 385-3202 - https://www.deschutes.org/ AGENDA REQUEST & STAFF REPORT For Board of Commissioners BOCC Tuesday Meeting of April 9, 2019 DATE: April 3, 2019 FROM: Lori Furlong, Community Development, TITLE OF AGENDA ITEM: Marijuana Code & Law Enforcement Update RECOMMENDATION & ACTION REQUESTED: Discussion item. BACKGROUND AND POLICY IMPLICATIONS: CDD has coordinated with the Deschutes County Sheriff's Office (DCSO) since 2016 to enforce the County's marijuana land use regulations. This discussion will provide an update on both marijuana code and law enforcement activities. This discussion may inform the Board's review of the marijuana text amendments. FISCAL IMPLICATIONS: None. Enforcement activities are included in current budgets. ATTENDANCE: Lori Furlong, Angela Havniear, Nick Lelack, Todd Kloss, Laura Conard, and others. Deschutes County Community Development Department Planning Building Safety Environmental Soils Code Enforcement P.O. Box 6005 117 NW Lafayette Ave., Bend, OR 97703 MEMORANDUM TO: Board of County Commissioners FROM: Lori Furlong, Administrative Manager Angie Havniear, Administrative Manager DATE: April 8, 2019 SUBJECT: Marijuana Enforcement Update Telephone: 541-388-6575 www.deschutes.org/cd PURPOSE The purposes of this work session are to present and discuss: • An update on marijuana related Code Enforcement cases, including key issues, resolution of cases, status of pending cases, and the nature of the complaints/issues (e.g., odor); • Coordination among code and law enforcement with the Central Oregon Drug Enforcement (CODE) team and Deschutes County Sheriff's Office (DCSO) to achieve compliance; CODE and DSCO staff will also provide updates on marijuana -related law enforcement activities; and • A proposed FY 2019-20 project to update the Code Enforcement Policy & Procedures Manual to reflect the Board's direction on marijuana enforcement, among other Manual updates. CODE and DCSO staff will also attend and participate in this work session. Subsequently, on April 22, CDD will schedule a second work session with the Board to discuss annual administrative inspections of approved marijuana production and processing facilities (to be conducted in spring) to verify compliance with land use decisions. BOARD DECISION / DIRECTION Staff is not seeking a Board decision or direction at this meeting. ATTACHMENT(S) Marijuana Code Enforcement Statistics 2016 -present. Table 1: Marijuana Complaints / Cases / Investigations, Marijuana Complaints and Investigations 2016 2017 2018 2019 Total Notes Total Investigations By Year 5 57 56 2 89 Unfounded Marijuana Production 2 22 26 50 Marijuana Odor 2 2 4 Marijuana Lighting 1 1 Complaints - Resolved RV Occupancy at proposed grow site 1 1 Marijuana Greenhouse Lighting 1 1 2 Marijuanan production 3 12 5 20 Marijuana odor 2 2 Marijuana Noise 1 1 Violation of Conditions of Approval 1 1 Court Hearing (Hearings Officer Hearings) Marijuana Production 1 1 Non -conforming OMMP Grow Odor violation - CE prevailed in hearing and fines issued. Pending Marijuana odor 1 1 CE prevailed at hearing - fines issued. Marijuana production 1 1 Referred to DCSO. Marijuana Production 1 1 Alteration of OMMP grow without approval Violation of the Conditions of Approval 1 1 Water delivery correction required, conditions of approval need to be modified Under Investigation (DCSO) Marijuana Production 2 2 Pending investigation by DCSO. Referrals to DCSO 16 15 -2- Deschutes County Board of Commissioners 1300 NW Wall St, Bend, OR 97703 (541) 388-6570 - Fax (541) 385-3202 - https://www.deschutes.org/ AGENDA REQUEST & STAFF REPORT For Board of Commissioners BOCC Tuesday Meeting of April 9, 2019 DATE: April 3, 2019 FROM: Nick Lelack, Community Development, 541-385-1708 TITLE OF AGENDA ITEM: New Neighborhood - Groundwater Protection, TDC/PRC, Sewer Loan BACKGROUND AND POLICY IMPLICATIONS: The presentation provides background on La Pine's New Neighborhood, the TDC/PRC Programs, and loan to the City of La Pine for sewer system improvements. FISCAL IMPLICATIONS: To be determined based on Board direction. ATTENDANCE: Nick Lelack, James Lewis, Peter Gutowsky CU i GJ> 0 v ra ra . E o 0 in groundwater. r5 C CO 1 vi. Oregon DEQ finds increasing nitrate levels out of La Pine 7,000 Tots remained undeveloped Ampunos sal anw amnbs High water table h unbuildable a 5 r0 4.- 4...) —w c4-- • — D U LI--- .-§- v) 0L._ (13 U v -a -0 ° 0,6 70 i c (0 s..... 0 Cl. 0 o ° ._ -0 C)-- .5 — c 00 _0 >, C 0 E tIns- ro E c 0 E co E 0- 0 -63S.- L-- . - 2 2 0L-- >a) .0 0 › a) (-0 x 46 (1) a) 0- x o a) LU _ 0 ,„„ Lack of evacuation routes w c 0) a) B: E 0 V a ce 0 aJ cu u ct5 Mu0-492 Ms4' �v) v)-0 (13L - 0_N u SCJ 1 Y a) cu CL >75 iii 2 trim E 5 v q, � ® ��v7 ® vim® � V� in C 73 Ln 0 00 t U cou 0_ �� L) ,�� C > 1?-• Csj m"--rC (j)J ul� ®c H vrt0 76 o 4.4 alCccm o 674(5 4jj1 wzro • • H L aJ u a,• �' V) (13 • ct3� -• 0 rt3 04 �c a) E aJ tan(13w >-0 ®a.0� a) a_ o gyri O.413 u Cl)0 8 MGM CII CO fti +., VI O +� ' *�j Q CII CI) fa N v CI v co v +- cd Sa. A O° v c4 *- C/I 75O O „�, ' , ;--. 7 Cal -u 4-, ca f -,E b A. v 4 ✓ ca rd R,, o a) O d 0 ,� a ^iZ -0 al pg 4vo �n0 0ov� oa�i�`4� a'ag-4- CO 0 ull 4.3 v�O ,—.4 +) v �.rli 4-, v ra a v o O Icv F O 0) 0 0 0 XI g CI) CD 1-)4 a PC) :13 '..r3(4 i Q0 -o .,1.,0. c(I r0 O �'�,4ao,"vJco 0 a)*ti0+v.,•mow.+cc ,_ 0 •�•�'r+ 0 t"),.. rn 0 v 0� a M co C/2 G.~ O N vI�w�O 4-,Cvv� ww2 A I 0� • a'CUal0�4-1gga+a)b0`Z.,-1 cn "'v��llflui °N C)v.�a CZ t) c U�0 Cil CD o°�lad 0 "a0ro��W c.)•VPCO00U � co W+a /,,, riU.44°,.4.r, 0 U A E O 0 u u CD Lr Expanded La Pine UUC Boundary TDC Program Goals Keeps Rural areas rural. Purchases private property rights. Provides opportunity for a range of housing types. Meets Community Facility needs. 2 Proximity to La Pine Industrial Park. Accommodates population growth. Transportation: 8Trip lengths shortened. E to.0 a .4-• a) L V c a) E C2. 0 a) a) 0 • w w w u o 1_ a) 0_ a) 4--) > rCI S-. 4-, E (13 c E 0 a) 0 4-- (0 0 s.._ U 0 W V) U 0 - 1:t n 0 a) C Lri u ..613 3 ....., > c '5 • — .. • — u S.- E 0) D n ro (0 sm (il a_ c ....... 0_ ci > v) c 1.... 00 4) >, a) L-su >> (I) (1) 0 0 —0 U N Pa u SENDING AREA 43 TDCs from private property owners (35 lots) 97 TDC from County owned lots (76 lots) Restrictive covenants recorded on 111 lots r0 >, (1) r3 c CU 4-) • -- E cu 4, ct3 s_ 4-) 0 LJ RECEIVING AREA 106 TDCs assigned to Quadrant 2c (Pahlisch) a -la ri 1. 73 > E Ts E (13 >r13 E bz ktz o 0 ro ,„ a) L.... ... „.. a) c a)v) 4.-- < v)v) u I E vi 75 t Lo _ cu E a) cu -1--.) a) 0 — -E.T. 0 . Sti U a 7,01.0 4...04-j° 4-j>cZ3 7:3C1' 00.0(1) L-- L.... ' °E O 4-$ E .c. -5,a) (13 ro 5 .6.) s..6.0. tat) E o..., v) E: D v) a) -o cu E cu (3 a) o E-0 cuc r:L.--) E4...) &,... 4...) Cl C v) C1)a) 75 06 0 0 >1 E CU 73 73- ro OL0 cc, 4— 73 CU C 0 E c 0 >°' cl- E bsov) c E° --o co 0 ro E Eu r(3 0(1 '4= -5 b,() 47' (1) > 0 D L13 00 4�OV) C u 73 O CU a) 0... Z v) s_ c/ a) U ct ate a Pollution orked with lo co E c E u wINJ E 0) E u wirsJ CD c v E u a. 0 HEIN l'62 On In 0 -0 C ..2 2 KM 40 -0 w ISMS • MIM 0 E 7;5 0 0. 0 0 c 7.79 .4:0 0.3 .0 7; . w ro .. ...c to = • RFSOLU f ION tJ O 'tea O G.v C '5 v' a E.no v c '� o i a 'I:" c 4 - "vGv 2 v V E •Q a- .ac`C LO c. u24. u - °«'co� _..e cC � eCnae:sgi=�' E.5 'no upoycu VO a 0u. V:zv,O 6G L...',0 vc "t, a 3� 2 - e uv U'g ci S t>"" } .E i- c'.. - J E u c[ r v w H c.E E uL c Gp yG 0c a. E ,,.2 -iii -I� Uv2c i.u. Cu,cs E� v'=-' U ... g43 E F J w c w.5 S a.5 f o v ,E U .3 ='$ $. c 5 Eq1 c o 'c O E � f o •,!:�^111If'E G C 7 ra uU r s v .w O g E2 `3 m ax E —17.1 EtalFV y u yi m ' 1,. 1 ..! c ra. UW 6GV 7 1w re, _ • V u u 6 au u'a ': O, u• 0• - r p x '" .0 2 t y , .2 x v• u F a • 5g° %,�w 3,,5 3v c ;o . 3' a q ? v' , E O 4 V U^ o .F. o v s L .2 2' E. O ra c 9 u E z h � c O u � ro � o e n c p U 2 a E E 2E. E g c 0 O >, N:i G 0. 0 vi (13 N. c4-) p^11 -0 0 a) '4...., C c tgisgas ma C cu U �-- E. ro aJ ® v1 s.....® .� � : � L. c® ®b in 0 Q .- 0. ®) t®� ._� -0>��— ® –0Ca) --oE ® v� 0a, >C0. v)r� LE ® CC ®a) a) 4-1 tisam �°..., L( a) 0_ N0 rE3L) 0(13 0 6. in c L.r) a , › , 0 .4...) 0 T c c 4, U `U r0 OCL . RS 0 cu n 4-J ta0 On C .c W CU c r\J 1 Pahlisch has PRCs for its quadrant. m 0 0 8 ..0 ... w 2 Undeveloped, not platted 55 acres, previously zoned Forest Use c &..... o a) 4-) V) V) 4-) CO 0 Cri 0 >1 (1)c) cu a) mr- — -0 71-5 c) 0 E ••••• •C C " •E c\I 2 a_ n D 0 c 0_ 0 V E° 6- 61) (D •FE +c-juc a) > a.) o 8 >, C CL a) n u 4---J rt3 Q a) E u-0 0- -E C ••C0 0-0 :Ju .4_, 0c 4-3 s-CU1/4-'0><E s.... 4••••) 4-) -0 U a) a) o_ (1) 0 0 n (Ths- taiO-C C E s,... ...., •- •1_•-) — ....0 co a) HWEc-9- ' U a) U to > 0 2 -acru.coru r coc 0.... E z c la -0 s.... _C - 0 E -0 4.) D -...... 0 06 a) I a) >-,'473 c " 1 E S.- (13 0 0... (13 C u c -6 •c5 0 ...2 N V) 47,5 V) 1._ 0 0 Ca. a:5 o ro L.....E5 o_. • w z 0 u c,.., u 0 <,J ...- • o • CTCR Y WAY OJ u 40J 0 0 Assumed by City of La Pine) - Sewer District Loan La Pine Specia r--" '1- 00 LO C)CO 00 'q 00 CD N L.r) Cns (NI m06 c'00 oo c) C--- in 00 CO Capitalized Interest Repayments through SDC's Balance 12/31/18 Full Faith and Credit Series 2012 - Refunding 2003 Buildings, Facilities & Radio Systems - 2.86% r04J C V) CU .0 o 0.) c a) cL 0_ 0_ Sewer Loan & County La Pine Special Sewer District Funding for Newberry Neighborhood Sewer: Deschutes County Loan - $1,109,801 - 4.5% Sewer Loan Repayment Terms: The first 300 units, SDC's are discounted $1,446 (EPA Grant $433,700) As of Dec. 2018, 194 remaining SDC discounts available Obligation to repay loan through SDC revenue only Obligation to repay loan terminates in 50 years (Contract 2004-092) County Bond Details: Series 2003 - Full Faith & Credit Obligation - $1,022,783 - 4.49% Series 2012 Refunding 2003 - Full Faith & Credit Obligation - $840,321 - 2.86% La Pine Sewer SDCs 0 C\1 4J T"' i ral _..... S.:. 111 4..) 0 C) ek4 VI 0 ON „E >•., v) 4t E a) (3, a ci cp ,"-- ..., m i 4..?,, cncr)c(c) r— ra) N Ni r— NI N N C r-- %--- N 0 0 0 CD CD W CD 0 0 CD 0 N N N N N s.. n N N N N N --..., -.., .....„ -..., .., 0 .— l'-', r•-• 4-1 U- U a 'a a a a r.-- r•-• •,-.-- r-,.. .,.....- r, cN N N CflCr) 00 0 CNI k.C1 - Cr) `1" Lfl DLDWLO 4% -EA- -taq U =-o E rO E 2 ' 0 -CU CU LI_ tg) 4.-- —0 ) 4-1 4J fl3 *E rO Ci.) a) a) c 76 b.)3 a Ln n 4--a a) o 0 tn U .c D a. c co 0 4.?°,, a --J s- • 4--) E n (1) g) 7:3 D 0 cn " cu 0 if; 0 o D (4-- V) (1) (1 4..>:, .) a) V) L., 0.. 4--) 4-J a.) E rt3 Eo. n ur) -E (13 0 o OU - x k,..) c u n cu < u_ 0 Newberry Neighborhood Fund (297) o L(.2, 10 3 a V) a) En c0 bO 0 0 0) CI) b.f3 E 0 a) 2> rC5 ro c0 4-) (f) a) 4-, c• Reimburse property owners up to $3,750 to off -set costs to install or upgrade an onsite system. - County has provided 60 rebates totaling $213,750 to qualified property owners since 2010. Non -Conforming Loan Program with Neighborimpact 0 0 .4= co CT) u Cll _SD _C CI) s__ tz-Cf3 o rE5 0 c(f) ro b0 0 -- a) ro E c o c Fe) o cu 0>0) C 0 ° C t) rt3 0 4— 0 LI) ) (.1) res CT 0 0 00 ro 0 CU 60 o ro • --v) cirC3 vi C c 2 om o c 0- 4J 0tfl Vi L.- §" a.)E U %-• ro u b.0 • 0 o (1.) > 4-, n r0oc 0 o E (13 0 L. 0 V) 2 4— LI) CS= c a) a) ro tn 0) c 0 4, 0 2 r- I Deschutes County Board of Commissioners 1300 NW WaII St, Bend, OR 97703 (541) 388-6570 - Fax (541) 385-3202 - https://www.deschutes.org/ AGENDA REQUEST & STAFF REPORT For Board of Commissioners BOCC Tuesday Meeting of April 9, 2019 DATE: April 3, 2019 FROM: Nick Lelack, Community Development, 541-385-1708 TITLE OF AGENDA ITEM: Planning Commission Joint Meeting Recap & Next Steps BACKGROUND AND POLICY IMPLICATIONS: The purpose of this meeting is to follow-up on the Board's joint meeting with the Planning Commission on March 21, 2019, and discuss next steps. FISCAL IMPLICATIONS: None. ATTENDANCE: Nick Lelack, Peter Gutowsky Deschutes County Community Development Department Planning Building Safety Environmental Soils Code Enforcement P.O. Box 6005 117 NW Lafayette Ave., Bend, OR 97703 MEMORANDUM TO: Board of County Commissioners FROM: Nick Lelack, AICP, Director Peter Gutowsky, AICP, Planning Manager DATE: April 9, 2019 SUBJECT: Joint Meeting With Planning Commission Follow -Up Telephone: 541-388-6575 www.deschutes.org/cd The purpose of this agenda item is to recap and follow-up on the joint meeting with the Planning Commission to discuss: • Perspectives on the joint meeting. The Planning Commission discussed their perspectives of the joint meeting last week. The meeting video is available online at: http://deschutescountyor.igm2.com/Citizens/SplitView.aspx?Mode=Video&MeetingID=2317&F ormat=Agenda. Planning Commissioners shared their perspectives of the joint meeting beginning at about the 1 -hour mark of the meeting. • Follow-up on next steps, such as establishing a committee to evaluate/consider rural affordable housing options. • Establish a future meeting schedule with potential dates. The Planning Commission is also interested in establishing such a schedule going forward, including potentially meeting a couple of times per year. • Discuss Planning Commission and Historic Landmarks Commission appointments.