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HomeMy WebLinkAboutMental Health - Same Day Access Process Deschutes County Board of Commissioners 1300 NW Wall St., Suite 200, Bend, OR 97701-1960 (541) 388-6570 - Fax (541) 385-3202 - www.deschutes.org AGENDA REQUEST & STAFF REPORT For Board Business Meeting of January 7, 2013 _____________________________ DATE: January 3, 2013 FROM: Scott Johnson, Director and DeAnn Carr, Behavioral Health Deputy Director Deschutes County Health Services (DCHS) Phone 541-322-7633 TITLE OF AGENDA ITEM: "Board consideration of a new behavioral health assessment process in the Health Services Department". PUBLIC HEARING ON THIS DATE? No. BACKGROUND AND POLICY IMPLICATIONS: DCHS must provide access to behavioral health services to Oregon Health Plan (OHP) members within very specific timelines established by the State of Oregon. These timelines range from 24 hours to 14 days depending upon the acuity of the individual. These timelines are required both by our contract with the Central Oregon Health Board and by Oregon Administrative Rule. In order to meet these requirements we must respond quickly to requests for services. In recent years, the significant increase in OHP members has created challenges in our ability to respond promptly to requests for help. These challenges are common in community mental health programs throughout Oregon, particularly in counties with a high demand for services. Our current system of screening, assessment, referral and treatment can and will be made more efficient and responsive. This issue was identified by the Department and is prioritized as a critical quality improvement priority. The need to improve the process was also noted by David Givans, Deschutes County's Internal Auditor. Recommendations from Mr. Givans include: 1) There should be a plan, additional resources and flexibility so that staff are available to respond to new request for service on a timely basis. 2) Management should be responsible for ensuring adequate staff. 3) The access process should be streamlined. 4) There should be a reduction in the number of days it takes for a person to receive an assessment. DCHS is very appreciative of these recommendations and is taking several actions to improve the process for accessing behavioral health services in Deschutes County, particularly for OHP members. 1) We have increased the number of service providers through expansion of DCHS clinicians and the certification of additional community behavioral health agencies available to serve OHP members, 2) We have established access as a priority in our Department Quality Improvement Plan, 3) We have implemented a new electronic health record in November 2012 to document and facilitate the transfer of essential health information and 4) We have designed a new Access Model and team to complete timely assessment of each person's needs and referral to an appropriate resource. The Department will form a new Access Team to lead this effort and assure timely access to a behavioral health assessment and referral (if needed). Initially, the team will be composed of a new supervisor and four masters-level behavioral health specialists (current positions). The Department is recommending the use of contingency funds and reserves to fund a new supervisor position to lead this team. In addition to being more responsive to the needs of our community and more customer friendly, this process will ensure that DCHS meets our contractual and regulatory requirements. This access model is also intended to reduce the number of "no shows" for assessment appointments. Lastly, more immediate access has been shown to help with engagement in treatment and improved health outcomes. The new supervisor will be critical to our success. The logistics of running an Access Team are complex, requiring a high level of coordination and supervision. The role of the supervisor will include ensuring adequate coverage, arranging coverage for unexpected absences, monitoring and addressing daily fluctuations in demand for access services, supervision of the Access Team staff, coordination with panel providers ensuring up to date information regarding capacity and resources, coordination with PacificSource, collaboration with our Quality Management Team regarding our performance, coordination of internal referral processes, coordination with DCHS supervisors regarding back up systems and community networking. A resolution permitting the hiring of the new Supervisor will be provided through the Finance Department for Board consideration and recommended action. Our goal is to post the position as soon as possible and to form the team in March 2013 for service to the public shortly thereafter. FISCAL IMPLICATIONS: The Access Team will be established primarily with existing resources and personnel. One additional supervisor is requested and will be funded with FY 13 contingency funds, Department reserves and ongoing Oregon Health Plan subcaptitation payments from PacificSource Community Solutions. RECOMMENDATION & ACTION REQUESTED: Board endorsement of this Department action. As a separate action and resolution, the Board is asked to approve the addition of a Behavioral Health Specialist III position to coordinate this team and associated work ATTENDANCE: DeAnn Carr, Behavioral Health Deputy Director and Scott Johnson, DCHS Director DISTRIBUTION OF DOCUMENTS: Kathe Hirschman, Deschutes County Health Services, 2577 NE Courtney, Bend 97701.