HomeMy WebLinkAbout2014-02-26 Work Session Minutes
Minutes of Board of Commissioners’ Work Session Wednesday, February 26, 2014
Page 1 of 7
Deschutes County Board of Commissioners
1300 NW Wall St., Suite 200, Bend, OR 97701-1960
(541) 388-6570 - Fax (541) 385-3202 - www.deschutes.org
MINUTES OF WORK SESSION
DESCHUTES COUNTY BOARD OF COMMISSIONERS
WEDNESDAY, FEBRUARY 26, 2014
___________________________
Present were Commissioners Tammy Baney and Alan Unger; Commissioner
Anthony DeBone was away on business. Also present were Tom Anderson,
County Administrator; Erik Kropp, Deputy County Administrator; and, for a
portion of the meeting, Judith Ure, Administration; Ed Keith, Forester; Laurie
Craghead, County Counsel; and Scott Johnson and Laura Spaulding, Health
Services.
Chair Baney opened the meeting at 1:30 p.m.
___________________________
1. Grant Request from Mock Trial Group.
Judith Ure presented an application for a grant in the amount of $600 from the
Mock Trial Group. The Commissioners agreed to split it equally.
UNGER: Move approval.
BANEY: Second.
VOTE: UNGER: Yes.
BANEY: Chair vote yes.
2. Consideration of Approval of Grant Applications.
Ed Keith gave an overview of a grant application for the FireFree media
campaign and other outreach. The 5% match can be existing personnel time.
He spoke also about a FEMA Fire Prevention and Safety Grant in the amount of
approximately $100,000.
UNGER: Move approval.
BANEY: Second.
VOTE: UNGER: Yes.
BANEY: Chair vote yes.
Mr. Keith spoke about the Fire Adaptive Community Hub Network. This
involves eight communities around the country; those who exhibit fire adaptive
community activities. Fire plans, defensible space, supportive legislation, and
forest collaboratives need to be in place. They all share information through the
network. There is one conference a year; the rest is done through webinars and
other media. $12,000 is the maximum award, with a 20% match, which could
be personnel time.
This keeps Deschutes County on the national map with its successes, and open
to new ideas.
UNGER: Move approval.
BANEY: Second.
VOTE: UNGER: Yes.
BANEY: Chair vote yes.
Deschutes County was awarded a grant for $10,200 for weed eradication
efforts. The County will match this with personnel time and work being
provided by partners such as the Forest Service.
Representative of Oregon Emergency Management said that FEMA has secured
contactors to start environmental assessments. They meet by the end of March
and will kick off the process then. This will involve the three counties and the
contractor, and they will go over the scope of work and other aspects.
Chair Baney asked about sending them a letter to keep them focused. Every
day that goes by is a day that they can't do all they should for the community.
She wants to make it clear the County is open and available to assist. No one
will care if it was OEM or FEMA or the County causing a backlog if there is
another disaster. Someone needs to keep on top of this, and remind them that
there needs to be forward movement.
Minutes of Board of Commissioners' Work Session Wednesday, February 26, 2014
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Minutes of Board of Commissioners’ Work Session Wednesday, February 26, 2014
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Commissioner Unger said that maybe a Commissioner should attend the
upcoming meeting just to make it obvious there is a lot of interest. Mr.
Anderson voiced concern about there being risk in this; he does not want it to
backfire. Mr. Keith stated that he will let them know the Board is here and
available, if it will help speed up the process. The meeting will be held here,
making it easy for a Commissioner to drop by.
Chair Baney said that she does not want the problems they had before oc curring
again. She hopes everyone learned some lessons and will work better in
partnership.
Mr. Keith stated that they will commit to a timeline and he will check on that on
a regular basis. There are still other processes to be worked out between the
OEM and the County. They have had some of those conversations, and are
trying to remove obstacles to the environmental part first.
Mr. Anderson noted that the Oregon Department of Forestry would be plugged
in this time, since the OEM does not have the cap acity to do much monitoring.
It is likely the OEM will contract with the ODF for the on-the-ground
monitoring part.
___________________________
Commissioner Unger asked about comments made regarding the weed
ordinance. He asked if they should mirror the State language. Ms. Craghead
said they would come back next Wednesday in a work session, with a matrix
and some ideas to discuss.
Chair Baney asked if the website shows what noxious weeds look like. Mr.
Keith replied it is under deschutes.org/weeds. This has the draft ordinance, a
link to a photo gallery of weeds, a booklet that can be downloaded, and other
work the County is doing in this regard.
3. Discussion of Public Health Accreditation Preparation.
Scott Johnson provided an overview of the National Public Health
Accreditation Board site visit coming up. There are two days of meetings, and
a set of national standards to review. It is essential to have a governing board
that is active in public health matters. There needs to be evidence shown that
the local agency does what they say they are doing.
Minutes of Board of Commissioners’ Work Session Wednesday, February 26, 2014
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Once accredited, this allows for further federal grant opportunities. They
review activities on an annual basis, and are re-accredited every five years.
Laura Spaulding attended the Marion County process. A primary goal is to
prepare the Board in response to questions that will be asked. The Board has to
show that it is involved and aware. This time slot is set up for the accreditation
board to talk with the Board of Commissioners; others might be present for
clarification purposes.
Mr. Johnson said he created a packet with the high points. The session is
scheduled for March 11. They want to know there is oversight and the Board is
supportive of the strategic plan and programs.
Ms. Spaulding added that their questions are very generic and meant to deal
with all kinds of agencies.
Mr. Johnson went over the documents: executive summary, health improvement
plan, and the Community Health Assessment and Community Health
Improvement; and the strategic plan for local issues. The plan covers multiple
years, and they have to break it down by year and by priority. It all ties
together.
Ms. Spaulding noted that they are big on regional ideas. Chair Baney pointed
out that they went to the legislature to be able to do things on more of a regional
basis. Mr. Johnson stated they could go bigger on some things, like grant
writing and overlapping issues. They are able to compartmentalize for smaller
issues. They are more interested in the process to handle specific issues, more
than the specific problems.
Ms. Spaulding pointed out that they are okay with whatever is being done or not
being done, as long as the County takes ownership and have reasons why. She
did not know what kind of questions to expect at first. They have had
documents since last summer and some questions were very detailed, so they
did read them.
Mr. Johnson added that they are interested in the work to be done, the
workforce development plan, the full range of recruiting, training, retaining and
recognizing a qualified workforce. This is a big thing in the health care field.
Minutes of Board of Commissioners’ Work Session Wednesday, February 26, 2014
Page 5 of 7
The other aspect is cultural competency, which is something that needs more
attention.
Commissioner Unger said that the Board consistently supports programs with
general fund to bolster them and make them sustainable. Maybe they can show
the funding levels being consistent or rising over the past five years to keep
programs in place, while State and Federal funding has declined in many cases.
Chair Baney asked how they compare to other counties. Mr. Johnson replied
that they are probably in the top five. Ms. Spaulding said they can show it is
funded well here and not so much in other ways. Mr. Johnson added that
performance management is important, as is the Board knowing the funds are
being well utilized. This group will also be interested in public access and
input.
4. Other Items.
Mr. Anderson said there is an evolving discussion regarding whether to prepare
an ordinance that would ban or limit medical marijuana dispensaries.
Nick Lelack provided a handout with a copy of the Polk County ordinance. He
said it is a simple statement.
Ms. Craghead stated that they need more direct language than this. Chair
Baney asked if marijuana is legalized in the future, what do they do. Ms.
Craghead replied they would amend the Code then. Mr. Kropp added that it
could be a State law that trumps the County’s anyway. It does not seem to be
working at the federal level.
Mr. Lelack stated there is a bill in the legislature regarding this type of ban.
They are not stopping cities and counties from doing something on their own.
They can wait for the session to end or, assuming it will die, the County can
prepare an amendment, show it to the Planning Commission, and it can be
withdrawn if the legislature decides local entities can’t ban it.
Chair Baney said she is not trying to limit access to medical marijuana, but she
does not see a purpose for dispensaries outside the cities. It is easy to get a
medical marijuana card. She wants to see the dispensaries limited to inside the
cities.
Minutes of Board of Commissioners’ Work Session Wednesday, February 26, 2014
Page 6 of 7
Commissioner Unger noted that the law allows for this use. This is looking at
the business side of things. He asked about hospice situations. He feels there
needs to be some control and a normal medical or pharmacy type of
environment.
Mr. Lelack stated that Jackson County is watching this as well. He is not sure
whether they should leave it alone and react later. The concern is mostly about
the pharmacy part.
Chair Baney said there could be rural pharmacies, such as the Tumalo
Pharmacy. She asked if they could meet the criteria and do this. It would be
more contained that way. However, to have a store that is open in the middle of
the night, selling Advil and Cheetos and medical marijuana doesn’t seem right.
Ms. Craghead said this would be in commercial zoning in a rural service area.
Mr. Kropp said that he does not think commercial pharmacies can or will
dispense if it is against federal law. (Note: a web search at this time revealed
that pharmacists are licensed through the federal DEA, and are not allowed to
dispense marijuana; or they would lose the ability to prescribe or dispense any
controlled substance.)
Ms. Craghead noted that they could base it on federal rather than state law if I
passes, and prohibit it in all zones. Chair Baney said she wants to make a
statement that this is not a good place to try to do this. They may have to adjust
as things change in the future.
Mr. Johnson stated that this goes more towards anticipating the Colorado or
Washington situations. There is a lot of focus on anything that might impact
youth. Some products are obviously targeting youth.
Chair Baney said that the reality is that this is a recreation -based county, and
she wants to make a statement that this should not be part of the recreation here.
___________________________
Mr. Kropp said that there were 209 applications submitted for Connie Thomas’
position. An interview panel will be convened when they get to that point.
There will be a panel for the 9-1-1 Director interviews, to include at least one
Commissioner.
Chair Baney noted that Mark Pilliod's last day is coming up. They want a good
transition. He asked if the Board feels the new County Counsel, Dave Doyle,
wants Mr. Pilliod here. Mr. Kropp replied that Mr. Doyle said they would talk
first and it may not be necessary.
Being no further items discussed, the meeting adjourned at 3:05 p .m .
DATED this /z-l! Day of ~tPtCIA-2014 for the
Deschutes Couuty Board of commiSSiouer~cl
~~
Anthony DeB one, Vice Chair
ATTEST:
Alan Unger, Commissioner ~~
Recording Secretary
Minutes of Board of Commissioners' Work Session Wednesday, February 26,2014
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1 Deschutes County Board of Commissioners
PO Box 6005, Bend, OR 97701-6005
1300 NW Wall Street, Suite 200, Bend, OR
Telephone: 541-388-6571 Fax: 541-385-3202
Website: www.deschutes.org
DESCHUTES COUNTY
DISCRETIONARY GRANT PROGRAM APPLICATION
Today's Date: Project Name: IC/~SS f'a:Jm ht..J fl-fiJect: \
L..Ig;:':.gQ.~t:J,t:d.~-::::a.....L.J Project End Date: l..dd:zcd 20// \
Amount Requested: Date Funds Needed: I .US /;idly \
Name of Applicant Organization:! C!Ci;S);r(j?fl1 ~.p.~-t'" \
Address:! bta Sa 2da i /l ,52. ,SZJlte /02-I
City & Zip Code:! P()rtlc;C elL q12t>5 I Tax ID#: \q 7... 0 8471cfol
Contact Name(S):\ 1I1l~e-7A ke-llkflljJ Telepbone#: I SLfI-39b-..:5811\
Fax #: ISLfI-633-73ff3 IEmail Address: Iu'W"?h l!!-CJf1~dc:.lee,h~.c()pA I
On a separate sheet(s), please briefly answer the following questions:
1. Describe the applicant organization, including its purpose, leadership structure, and
activities.
2. Describe the proposed project or activity.
3. Provide a time line for completing the proposed project or activity.
4. Explain how the proposed project or activity will positively impact the community.
5. Identify the specific communities or groups that will benefit.
6. Describe how grant funds will be used and include the source and amounts of matching
funds or in-kind contributions, if any. Itemize anticipated expenditures*.
7. If the grant will support an ongoing activity, explain how it will be funded in the future.
Attach:
Proof of the applicant organization's non-profit status.
* Applicant may be contacted during the review process and asked to provide a complete line item budget.
About Us
A non-profit 501 (c )(3) organization since 1983, Classroom Law Project (CLP) has emerged as
Oregon's leader in preparing youth to become active, engaged and informed participants in
democratic society.
We offer innovative programs that are relevant to the diverse needs of Oregon's regions and
communities. Over the past 25 years, we have built an energetic and cost-effective non-profit
organization that unitizes the power of an experienced staff and a large group of committed
volunteers to reach hundreds of teachers and schools and thousands of students each year.
Data collected in Classroom Law Project's Oregon Civics Survey (2006) min'ors disturbing
trends found nationally. The bad news: young people's knowledge and interest in politics and
government is low, particularly at the local level. These surveys show that only 25% of high
school students can name Oregon's two U.S. Senators and 23% think Ted Kulongoski is one of
them. This disengagement is heightened by the belief of many young people that individual votes
do not matter or are "thrown away."
Oregon's legislative system of initiatives and referendums creates an environment in which
every citizen exercises legislative function. The many times that citizens are asked to amend
Oregon's Constitution and statutes requires that they have an even greater awareness of civics
than elsewhere in the country. It is especially crucial that Oregonians be well-informed, take the
time to research the information required to make reasoned, thoughtful, and independent
decisions, and put aside their personal interests to ask, "Is it best for OregonT
Our school systems need help in providing civics education, so CLP works with teachers and
school administrators to create integrated curriculum that meets their needs. And this isn't just
about learning history or how the courts work -CLP's innovative programs can be used to help
young people to develop positive attitudes about authority, justice, and the rule of law~ to prepare
students to think about the common good; and to take action to express their commitment
through voting, volunteerism and petitioning the government for change.
Classroom Law Project has accomplished much in our first 25 years, but much, much more
remains to be done. Our programs reach some 400 teachers and 12,000 students in Oregon. That
is a good thing. But there are] 98 school districts and 20 education service districts in our state,
educating more than 55] ,000 students. That means we are meeting just 2 percent of Oregon's
need for our programs and services. That is both a humbling and motivating number. As we
begin our next 25 years, Classroom Law Project is committed to the teaching and understanding
of civics and democracy in our schools -with your help, we will go forward teacher by teacher,
student by student, and generous supporter by generous supporter.
Annual Mock Trial Competition:
The mock trial has proven to be an effective learning tool for students of all grade levels. It helps
them understand the law, practice critical thinking, and gain greater confidence with public
speaking by assuming the roles of attorneys and witnesses in a fictional criminal or civil trial.
Participants experience first-hand the difficulties that judges, lawyers and juries face in
detennining which facts are relevant and what legal arguments are effective.
High School Competition
Each year. more than 70 teams, totaling some 1.200 students, compete at regional. state and
national levels with support from more than 500 attorneys, educators and other community
representatives acting as coaches. judges and coordinators.
The High School Mock Trial Competition is one ofCLP's most popular and enduring programs.
It begins with more than 70 teams competing in regional competitions across the state and
culminates with the state finals competition in Portland. Students work together with classmates,
teachers and volunteer attomey-coaches on a hypothetical case. They develop and sharpen
critical analysis, public speaking and interpersonal skills. They become more poised and self
confident -and they learn about the U.S. justice system in the process.
Teams of 8-18 students argue a case before 3-judge panels comprised of attomeys and educators
or other community representatives. They will put on the case three times -arguing each side at
least once. The top teams from each region compete in the state competition at the Hatfield
Federal Courthouse in Portland for the Oregon title. Oregon's winning team will send eight
students to the National Mock Trial Championship.
Advancing teams will compete in the State Finals in March each year at the Mark Hatfield US
Courthouse in Portland, OR.
The Case
Teams will receive hard copies of the case once they have completed registration and payment.
This year the case is a civil matter. The cases rotate between civil and criminal matters each year.
A copy of the case has been included in these materials.
How the Funds Will be Used:
The majority ofthe funds will be used to feed the student participants lunch (pizza, & cookies, &
drinks), provide a continental breakfast to the morning judges, afternoon snacks to the afternoon
judges, lunch for volunteer courthouse staff, and volunteer Deputies. It will also cover the cost of
plates, cups, napkins, utensils, and drinks. We can also use 2 large coolers to keep the drink cool
for the students.
Pizza: $300.00
Plates/Napkins/Cups: $50.00
Food for Judges: $75.00
Drinks: $50.00
Coolers: $100.00
Ice: $25.00
Total Budget: $600.00
Deschutes County Health Services: National Accreditation Public
Health Staff will brief the Commissioners regarding Deschutes
County's March 11 and 12 site visit by the National Public Health
Accreditation Board.
The Board of Commissioners will be asked to participate in the
site visit to answer questions and offer perspectives related to the
role of Commissioners as the local public health authority.
For more information: contact Scott Johnson, Director, Deschutes
County Health Services
Public Health Accreditation Board
Meeting with Board of Commissioners
March 11, 2014
Sample questions
1. Describe the relationship of the governing entity with the Health Department.
a. Deschutes BOC is the public health authority for Deschutes County (see enclosed PowerPoint, "What is
Public Health").
b. BOC adopts County policy and Health Services department's operating budget; also adopts the department's
Strategic Plan.
e. BOC is represented on regional WEBCO and the C. O. Health Council (COHC).
d. Health Services department operations managed through the County Administrator and appointed Director.
2. Is there any other way of communication besides meetings? Through work sessions, Board hearings, Friday
BOC briefs, briefings for County Administrator, meetings with Advisory Boards and periodic Directors Report.
3. Describe the working relationship between the governing entity and the community. Weekly public hearings
and community public comment time; appointments to the Public Health Advisory Board; BOC attendance at
community meetings; representation on WEBCO, COHC and numerous nonprofit boards.
4. Do you meet with the smaller government entities regularly or with Public Health specifically? Periodic
meetings between Deschutes County Board of Commissioners and other local jurisdictions. Examples: meetings
with the Sisters City Council discuSSing the school-based health center; meeting with Redmond City Council re: a
government service center in Redmond and a health district in NE Redmond; Robert Wood Johnson Cross
Jurisdictional Sharing project with Crook and Jefferson Commissioners and Public Health.
5. How do you get public input? Community input time at hearings and work sessions; topical surveys (e.g.,
tobacco use and policy in downtown Bend); work through citizen members on Advisory Boards; work with and
through local nonprofit organizations; input from County social media outlets.
6. What was the governing body's role in the creation of the department's Strategic Plan? The BOC received,
reviewed and adopted the Deschutes County Health Services Strategic Plan based on recommendations from
the Board appointed members of the Health Advisory Boards.
7. What is your role in promotion or monitoring of the Strategic Plan? The Strategic Plan forms the basis of the
department's annual priority setting and proposed operating budget. The BOC promotes the plan by supporting
Strategic Plan priorities and by investing resources to help the department achieve the strategiC plan. The BOC
reviews progress, submitted with the annual program budget and through quarterly performance measure
reports.
8. What was your role in developing the Community Health Assessment and the Community Health
Improvement Plan? Both documents are delegated activities with the work prepared by staff, advisory boards
and community stakeholders. The BOC did receive and discuss a presentation of the Community Health
Assessment. By supporting the department's budget, the BOC also supports our contribution to the Healthier
Central Oregon web site.
9. What is the relationship of the health department to the state health system?
a. Director or deSignee participates on both the Conference and Coalition of Local Health Officials (CLHO).
b. Commissioner participation on the Association of Counties Health & Human Services Committee.
c. State Public Health Division funds and oversees local public health including conducting a Triennial Review.
d. Local subject matter experts regularly talk with their counterparts at the State and other local departments.
e. State Public Health Division and CLHO support efforts to prepare for and achieve national PH Accreditation.
10. How does the governing entity make decisions on laws that can affect Public Health? Or when a policy or
public health issue needs to be addressed?
a. Policy or health issues are identified in many ways including community inquiries or concerns.
b. State legislative or Executive Branch recommendations or actions or laws or task forces (e.g., Future of PH).
c. Work sessions or business meetings e.g., tobacco free campus policy.
d. Approval of plans e.g., Strategic Plan, Ambulance Service Area Plan.
11. How do you bring on a new member to the County Commission? What is the orientation process?
a. County College through the Association of Oregon Counties.
b. Department orientations for the new Commissioner.
c. Informal briefings for the Commissioner by the Administrator, Health Director or others.
d. Invitations to attend Advisory Board or all-staff meetings.
12. How do you choose Public Health Advisory Board members? Press releases when we make a broad appeal for
members. Targeted solicitation when we have specific needs (expertise, geographic area). Interviews by
current Advisory Board leadership. Written recommendations from the local Public Health Advisory Board with
candidate information as background.
13. How does the local Public Health Advisory Board communicate with Commissioners? Interaction at Advisory
Board meetings, ability to attend and comment during community input time of Board hearings, individual
conversations with Commissioners, attendance at a BOC work session or the annual budget presentation.
14. What is brought to the Commissioners re: plans? The BOC reviews, discusses and approves certain plans
including the Ambulance Service Area Plan, the Strategic Plan and the County response to the State Health
Division Triennial Review. Other plans including the Public Health Quality Improvement Plan and the Workforce
Development Plan are delegated operating responsibilities assigned to the County Administrator, the Public
Health Director and staff.
15. Do you have questions for the site visitors regarding the Accreditation process?
, 2/25/2014
What is Publi c Health ?
• Public Health is focused on the population
NOT the individual
• Public health is what we, as a society, do
collectively, to assure the conditions in which
people can be healthy.
Institute of Medicine, 1988 : Th e Future of Public Health
He alth Services
The community is our client
• Health Care Providers diagnose & treat individual
patients
• Public health asks: what is the impact to health &
how can this be prevented?
-Assesses the larger picture, monitor trends, identify risk
factors
-Convenes partners to listen, teach, & develop prevention
action plans
-Develops prevention policies & advocates for change
-Evaluates the impact of the strategies &
interventions & disseminates the results
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Top Ten Public Health Achievements of
the 21 st Century
• Vaccine -preventable diseases
• Prevention and control of infectious diseases
• Tobacco control
• Maternal and infant health
• Motor vehicle safety
• Cardiovascular disease prevention
• Occupational safety
• Cancer Prevention
• Childhood lead poisoning prevention
• Improved public health preparedness
and response
State-Local System of Public Health
• Public Health systems are primarily
governmental
• Public health in Oregon is DECENTRALIZED
-Centers for Disease Control and Prevention is the
lead federal agency
-Oregon Health Authority -state agency
-34 local health departments across Oregon (one
district -North Central Public Health District)
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Local Authority and Responsibility
• Boards of County Commissioners are the Local
Public Health Authority according to DRS
431.375
(1) The Legislative Assembly of the State of Oregon finds that each citizen of this state
is entitled to basic public health services which promote and preserve the health
of the people of Oregon . To provide for basic public health services the state, in
partnership with county govern ments, shall maintain and improve public health
services through county or district administered public health programs .
(2) County Governments or h ealt h districts establis hed under ORS 431.414 are the
local public health auth ority resp on si ble for management of local public health
services unless the county contracts with private persons or an agency to act as
the local public health authority or the county relinquishes authority to the state.
If authority is relinquished , the state may then contract with private persons or an
agency or perform the services.
Duties/Requirements of
Local Public Health Authority (LPHA )
• Enforce public health rules/laws
DRS 431.416 -The local public health authority or
health district shall:
(1) Administer and enforce the rules of the local public
health authority or the health district and public
health laws and rules of the Oregon Health Authority;
(2) Assure activities necessary for the preservation of
health or prevention of disease in the area under its
jurisdiction as provided in the annual plan of the
authority or district are performed.
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2/25/2014
"
Required Services of LPHA
• DRS 431.416 (2) continued ...
-These activities shall include but not be limited to:
• Epidemiology and control of preventable diseases and
disorders (Epidemiology -The branch of medicine that deals with the
incidence , distribution, and control of disea ses .)
• Parent and child health services, including family
planning clinics as described in ORS 435,205
• Collection and reporting of health statistics
• Health information and referral services; and
• Environmental Health Services
Minimum Local Public Health Services
in Rule (under DRS 431.416)
• Communicable Disease Investigation and Control
• Tuberculosis case management
• Immunizations
• Tobacco Prevention
• Emergency Preparedness
• Maternal and child health services
• Family Planning
• Women, Infants, and Children services
• Vital Records
• Environmental Health Services
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r 2/25/2014
Statutory requirements cont
• ORS 431.440 -public health administrators have
police powers -"public health administrators
shall possess the powers of constables or other
peace officers in all matters pertaining to the
public health" (ex : Environmental Health)
• 431.530 - in an public health emergency -"the
local public health administrator may take any
action which the OHA or its director could have
taken, if an emergency endangering the public
health occurs within the jurisdiction ..." (ex: Pole
Creek Fire)
Conference of Local Health Officials
IICLHO"
• Shared governance between the local health
officials and the state public health division
• ORS 431.330 Conference of Local Health
Officials is created. (1) The Conference shall
consist of all local health officers and public
health administrators, appointed pursuant to
ORS 431.418 and such other local health
personnel as may be included by the
rules of the conference.
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Emerging Public Health Issues,
Opportunities and Challenges
• National movement toward the accreditation
of local health departments
• Rise and cost of chronic diseases
• Current Fiscal landscape - federal, state and
local
• State Health System Transformation
Accreditation of Local Health
Departments
• What is Accreditation -Recognition for a health
department to meet nationally recognized public
health standards that assure high quality services,
accountability and efficiency.
• Commissioners, as the Local Public Health Authority,
play an important role in the Accreditation process
site visit will require engagement by Commissioners/
Board of Health
• 4 major areas of readiness: Community Health
Assessment, Community Health Improvement Plan,
Strategic Plan and continuous quality improvement
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.. 2/25/2014
Why be an accredited local health
department?
• Training & TA resources available to health departments now
• Potential grant opportunities
• Potential to become more competitive applicant for other funding
opportunities
• Potential for a stronger voice at the table in ceo conversations or
with other partners
• Defines role of Public Health as all these transitions occur
• Focus on efficiency and quality improvement essential in current
economic environment
Central Oregon Regional Efforts
Central Oregon Regional Health Assessment
=D"' Cuidate
C7 Uving Well with Chronic Conditions
Maternal Child Health CCO Initiative
C7 Maternal Mental Health
<7 Nurse Family Partnership
<7 Robert Wood-Johnson Cross-Jurisdictional Sharing Project
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Conclusions :
Public Health landscape is changing:
-Accreditation is currently voluntary but including
opportunities to improve efficiencies
-Less need for public health to provide clinical services since
insurance coverage required for all by 2014. BUT, not
everyone will be covered.
-Rise i n chronic diseases are identified but there are no stable
funding sources to work to address community prevention of
chronic diseases.
-State Medicaid reform will have an impact on public health
and we will have to engage locally with health care partners
-Interest from legislators and Oregon Health Authority in
moving to a regional publ ic health system
A final plug for Public Health ...
Return on Investment =
Cost Avoidance
Research shows that investing just $10 per
person each year in public health efforts can
save the nation more than $16 billion
within five years.
That's a $5.60 return for every
$1 invested . *
·Sou rce: TllI st for Ame rica's Healt h, Jul V 2008
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1
2/24/2014
Change in County Health Ranldngs: Oregon Rank, 2010 & 2011
Health Outcomes
Health Factors
Mortality
Morbidity
Health Behaviors
Clinical Care
Social & Economic
Factors
Phys ical
Envi ronment
2010
14
21
13
16
21
9
Crook
2011
14
...
10 t
21 ...
21
20 ...
...
...
·Only 33 of 36 counties ranked
: State rankin a in 2011 higher th~n 2010
:R ob ~rt W ood John son Foun dofion, County
Health Ranking" Oregon 2010 8. 2011
http ) j",,,,w.coontyh ealthrankings.org
2
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5
2012 Central Oregon Regional Health Report
EXECUTIVE SUMMARY
ABOUT THIS HEALTH ASSESSMENT
The Central Oregon Regional Health Assessment
(CORHA) 2012 is an overview of data related to health in
communities and populations. CORHA 2012 aims to
provide useful data for three Oregon counties
commonly referred to as "Central Oregon" or Central
Oregon's "tri-county region" : Crook, Deschutes and
Jefferson Counties. Recognizing that many factors
impact the health of individuals and communities, a
range of data from multiple sectors are included in the
report .
Th e Ce n tral Oregon
Reg ional Health Assessment
;s not m e ant to answer afl
questions. It is meant to
provoke them.
How to Use
I We acknowledge that the Central Oregon Regional
I Health Assessment, 2012 is not a compendium of all
indicators and analyses applicable in community health
assessment. Thus, we highly encourage readers to dig
deeper, check sources, and pull-in additional
information to help you complete a more in-depth
understanding of our community.
CORHA 2012 is not a static, single point-in-time
document. Instead, it is intended to be a first-step in our
region's effort to continuously assess data in order to :
identify where to celebrate successes, recognize
weaknesses or areas of concern, instigate community
discussions on how to capitalize on strengths and turn
weaknesses into opportunities for positive change.
The CORHA is not intended to answer all questions.
Instead, it should provoke them . We encourage readers
to ask more questions, dig deeper and explore. Many
data reports and fact sheets on numerous relevant
topics exist for our area -check them out! (See the full
report for a list of suggested documents and resources).
This Executive Summary calls attention to a fraction of
indicators and is a companion -not a replacement -to
the full report.
Ask more question s, d ig
d eeper, explore ...
engage in c o nversa t io n s
As you look and dig deeper, consider the
weaknesses and limitations of the data. Engage in
conversations with colleagues, peers, friends,
family, neighbors, community members, and
strangers. Seek-out qualitative, personal and
experiential information to complement the
numbers you see . Only when communities engage
in this process can we draw the map to improved
health and well-being for our neighborhoods, our
communities and our region.
Data
This health assessment utilizes multiple sources of
data. Some of this data is available through the state
of Oregon, some through national government and
non-government agencies, and some from local
organizations. Sources include Centers for Disease
Control and Prevention's Behavioral Risk Factor
Surveillance System (BRFSS), U.S . Census Bureau's
census statistics, Oregon Health Authority
Department of Public Health's public health and
community data, Oregon Department of Education's
school data, and data from local organizations
compiled by Deschutes County Health Services.
A Note About Data: There are many great and widely
used data sources available today. Data sets like these
require significant amounts of labor and resources
before they are made publicly available. This can mean
unavoidable lag-time where data is many months, often
several years old. This lag can present complications
when trying to interpret and apply the information for
the present day. While the data is still very valuable, it is
important to always look at the data sources' dates and
time frames, and to become familiar with what and how
it is measured. For example, the County Health Rankings
is a great and useful public health resource, but data
used to calculate 2012 County Health Rankings can date
as far back as 2003 (with 2010 being the most recent
year). Similarly, several indicators in this health
assessment pre-date the recession. These indicators are
useful, but cannot help us fully understand how difficult
economic times have impacted our region .
3
• • • •
t
Cen1rol Oregon Heollh Report 2012
OVERVIEW
Tabl e 6 County Health Rankings, 2010·20U : Change in Rankln gs
• OREGON COUNTY HEALTH RANKINGS 2010, 2011, & 2012
Change In Robert Wood Johnson Foundation * Oregon Rankings
17 22 13 t • •*Only 33 of 36 counties ranked
•
=Bottom Quartile in State Rank of Counties
= Top Quartile in State Rank of Counties
= State ranking i n 2012 lower than 2010
=State ranking in 2012 higher than 2010
Health
Outcomes
Health Factors
Mortality
Morbidity
I • ..:alth
Behaviors
Clinical Care
Social &
Economic
Factors
Physical
Environment
2010
14
13
16
21
9
Crook Deschutes Jefferson
CHANGE CHANGE CHANGE
FROMFROM FROM
2011 2012 2010 2010 2011 2012 20102010 2011 2012 2010
14 12 t -
21 -
10 10 -
21 9
21 25 t
20 14 t
t
•
S. Kingston, Deschutes County Health Services/Public Health Department, 04/2012
Robert Wood Johnson Foundation , County Health Rankings : Oregon 2010, Oregon 2011 , & Oregon 2011 .
Retrieved from http ://www .countyhealthran kings .org/ranking-methods/ exploring-data
Preliminary Final Draft 10/15/2012 pg_ 1::
2012 Cen lral Oregon Regional Healtll Report
EXECUTIVE SUMMARY
SPECIAL THANKS
To these individu a ls:
Muriel DeLavergne -Brown Crook County Health Department
Jolene Estimo Confederated Tribes of Warm Springs Health & Human Services
Carolyn Harvey Jefferson County Health Department
Ken House Mosaic Medical
Scott Johnson Deschutes County Health Services
Jessica Kelly Deschutes County Children & Families Commission
Sarah J. Kingston Deschutes County Health Services
Thomas Kuhn Deschutes County Health Services
Maggi Machala Deschutes County Health Services
Tom Machala Jefferson County Health Department
Kat Mastrangelo Volunteers in Medicine
Kate Moore Deschutes County Health Services
Emily Ogren
Minda Morton Jefferson County Commission on Children & Families
Hillary Saraceno Deschutes County Children & Fam i lies Commission
Diane Skinner Deschutes County Health Services
Stephanie Sundborg Deschutes County Children & Families Commission
Erin Tofte Let's Talk Diversity Coalition (Jefferson County)
Kate Wells Kids@Heart, St. Charles Health System
And to these organizations:
Central Oregon Health Board
Central Oregon Health Council
Crook Co. Health Department
Deschutes Co. Public Health Advisory Board
Deschutes Co . Behavioral Health Adv isory Board
Jefferson County Health Department
Let 's Talk Diversity Coalition (Jefferson County)
Mosaic Medical
Oregon Health Authority/Dept. of Publ ic Health
PacificSource
Saving Grace
St . Charles Health System
Volunteers in Medicine, Clinic of the Cascades
FO R A DDITIONA L INFORMATI O N,
c onta c t:
Sarah J. Kingston , MPH
Research Analyst
Deschutes County Health Services
2577 NE Courtney Drive
Bend, OR 97701
sarahk [at) deschutes.org
541-322-7462
22
_______
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1"U-"II',illh--!It-'/ Ii :'\,1)1 'l.· TermsofUse ~I),:.... "jo'II,['
·-·",,1:.~1·1"'·1111·:1'11':1""""
2 0 12 -2015
CENTRAL OREGON
HEALTH IMPROVEMENT PLAN
Central Or n
alth
uthority
1
Disparity/I n eq uity
Comparative mortality ratios in areas of Southern Deschutes County and Northern Jefferson County are significantly higher
than state average and this difference is considered a health disparity -geographic area is related to a difference in
mortality. But, the disparity can be considered a health inequity because it could possibly be avoided or unjust. Central
Oregonians are often not surprised to learn that our rural areas have high rates of poverty, less access to services, greater
distances to travel for needed care, and many individuals struggle to meet basic needs. What is often overlooked, however,
is that these systematic barriers needlessly impact individuals' health.
This is just one example of disparity and inequity in our region, but many other disparities exist. Attention must be devoted
to uncover disparities unique to Central Oregon and to determine which must be addressed as inequities. Improving our
population's health will require working toward health equity-communities where all individuals have the opportunity to
attain their full health potential, and no one is disadvantaged from achieving her/his potential because of socially
determined circumstances related to rural or urban living, race, socioeconomic status, education, etc.
Access to Resou rces
The ability to access resources, services or assistance is impacted by numerous factors, such as transportation, distance and
travel time, finances, social and cultural barriers, waiting time, and existing systems of care and program eligibility,
availability, location and capacity . For example, an elderly person living alone with no social support and unable to drive
may have financial means to see a dentist, but limited access due to transportation issues. Similarly, a working single
mother with no car may have access to public transportation, but if she cannot afford taking unpaid time off of work, her
access to service diminishes. Similarly, factors related to access impact rural residents differently than urban residents -an
important point to consider when planning for programs and services -since more than 41% of Central Oregonians live in
unincorporated areas and towns with less than 2,500 people.
Early Childhood Welln e ss
A child's growth begins in pregnancy and continues into adulthood. Interacting Internal and external factors Impact a child's
social, environmental, physical, and cognitive potential. Children in surroundings unable to support their healthy growth or
meet their needs have increased risk for poor health, safety, development and ability to learn. These unmet needs during
childhood pose threats to health long into adulthood and later life. Ensuring early childhood wellness is a short-term
investment for today and a long-term investment for business, health, education and social sectors in decades to come.
Food Insecurity
Crook and Jefferson counties were among the top 5 Oregon counties with highest food insecurity. Deschutes County has the
largest total number of food insecure individuals in Central Oregon. In Crook County, the average cost per meal is nearly $1
higher than in Deschutes County and the rest of Oregon. It is estimated that more than 37% of children in Jefferson and
Crook Counties may be food insecure . In Deschutes County, of all the food insecure adults and children , 45% are not
eligible for SNAP or other federal food programs-a sizeable number of children and adults who may not be able to access
much needed assistance .
19
Oral Health
Oral health Is frequently identified by providers, teachers and community members as an area of concern in Central Oregon .
Existing data systems do not currently support mechanisms to arrive at accurate and timely estimates of the burden poor
oral health causes in the region. Poor oral health can cause pain, discomfort, and disfigurement. It can affect an .ndivldual's
quality of life, ability to eat and to speak, or interfere with opportunities to learn, work, participate, engage and contribute.
What's more, oral health is related to chronic disease in later life. While prevalence and incidence data for the region may
be lacking, community and stakeholder input suggests improving the oral health of all Central Oregonians is important and
necessary.
Safety, Crime & Violence
A community's safety impacts the population's health in numerous ways-from victims of violence to post-traumatic stress,
from psychological distress to exercise and diet. Exposure to violence is known to increase stress, which is linked to
increased hypertension, stress-related disorders and chronic disease. Trauma from violence can have intergenerational
effects . Central Oregon's rates of total crime appear to be on the decline since the late 1990s, and more work should be
done to continue this trend . Deschutes is in the top 5 Oregon counties with the highest rates (unadjusted 2010 rates) of
both total crimes and violent crimes per 10,000. Jefferson County was among the 10 Oregon counties with the fewest
number of police per 1,000 population. Last year, more than 1,450 individuals in Central Oregon called an emergency crisis
line about domestic violence alone . Healthy populations require safe communities to live, work and play where individuals
affected by violence or crime can access necessary support and services to heal.
Chronic Di se ase
In the last 65 years, adult chronic disease has grown into the main health problem for industrialized nations. Cardiovascu lar
disease, cancers, diabetes and chronic obstructive pulmonary disease account for at least 50% of the global mortality
burden . In Central Oregon, chronic diseases are the leading causes of death for each county. Crook's age-adjusted
prevalence of adults with high blood pressure is 46.2%, significantly higher than 25.8% of adults for all of Oregon.
Deschutes' age-adjusted prostate cancer incidence rate is higher than the state, while Jefferson's age-adjusted prevalence
of arthritis is higher than its neighboring counties and the state. Multiple types of exposures, modifiable behaviors and risk
factors are known to playa role in the development of chronic disease in later life, such as personal dietary and exercise
choices, chronic stress, exposures in utero and throughout early childhood, income, genetics, and the built environment to
name a few.
Alcohol, Drug & Tobacco Use
Heavy drinking, drug use and tobacco use is associated with higher rates of all-cause mortality, chronic disease, violence and
abuse. Excessive alcohol and drug use is also a risk factor for motor vehicle fatalities, fetal alcohol syndrome, interpersonal
violence, overdose and sexually transmitted infections. Tobacco use causes mu ltiple diseases such as cancer, respiratory
disease, and other adverse health outcomes. In 2009, more than 19% of adult males in Central Oregon reported binge
drinking in the last 30 days . In Central Oregon, younger adults have higher rates of alcohol dependence (in past 12 months)
than older adults-17% of adults age 18-25 years, compared to 6.8% of adults 26 years and older. Jefferson County has
higher rates of death from alcohol-induced disease and motor vehicle fatalities that involve alcohol. Since 2001 , Crook's
age-adjusted rates of death from drug-induced causes have been higher than Jefferson and Deschutes (Crook -13.7,
Deschutes -10.1, Jefferson -10.5 per 100,000).
20
Central Oregon Regional Health Report 2012
EXECUTIVE SUMMARY ,
Behavioral Health
Around the world, major depression is a major cause of disability. In Deschutes County, suicide is claiming nearly as many lives as
motor vehicle accidents. It is estimated more than 9,000 adults in the tri-county region have serious mental illness. Roughly 1/3 of
Central Oregon 11lh graders reported having a depressive episode in the last year-high depression scores in youth are associated
with poor academic achievement, anxiety, and poor peer and teacher relationships. Central Oregon can improve behavioral health
by working to prevent behavioral/mental health issues at the individual and community level, to identify early risk factors and
warning signs and to ensure the capacity and Infrastructure exists to provide quality, affordable and accessible services for all
individuals in need.
Healthy Environments
There is much to learn about the environmental health characteristics specific to Central Oregon's communities. The ecologies of
individuals, families, communities and regions often determine options available for individuals to reach their full potential.
Environments exist on many scales -individuals, homes, neighborhoods, geographic regions. Environments simultaneously shape
and are shaped by organisms and individuals within them . For example, built and natural environments directly impact human
health, and humans directly impact the built and natural environments. Until recent decades, "environments" in public health
were most often associated with the natural outdoors -woods, streams, rivers and lakes. Growing bodies of research are showing
relationships with environments on other scales to the health of our populations. Locations of stores to purchase affordable fresh
fruits and vegetables impact healthy choices. Safe and affordable alternative commute options impact the behaviors of individuals
to choose alternatives to driving, thus impacting the environment and the often the individual. Safe and easily accessible places to
play outdoors impact the ability of children to play outside, thus impacting their physical activity and health.
Central Oregon lacks current and relevant data on multiple scales of environment to uncover relationships between where people
live, work and play to their overall health and well-being. This knowledge about the region is expected to expand in coming years,
particularly with recent collaborative efforts with local agencies and individuals looking at transportation, commuting options,
healthy housing, farmers markets, and healthy spaces for kids and adults to play and exercise.
21
/
Deschutes Co unty Heal th Services
Strategic Plan 2012-2015
April 11, 2012
, ,
Summary
This Strategic Plan outlines a vision and set of goals to improve the health of our residents,
strengthen our organization and promote community collaboration. It is a plan for action
that capitalizes on national, state and regional reform. It is both ambitious and a realistic
presentation of our focus and planned actions over the next four years. It is rooted firmly in
goals that will lead to better community health, better care and work that will promote
health and lessen society's burden for unnecessary human and financial costs.
This new plan carries forward a commitment of Deschutes County Health Services to use
public health assessment practices and community guidance to frame a clear agenda,
mobilize our resources and act. Through this effort, we will continue to ensure County
government is accountable and helpful to our County's residents and that we fulfill our
mission to promote and protect the health and safety of our community .
Over the past five years, we've acted on past plans, sponsored many projects, expanded our
services and improved access to care. A sampling of those accomplishments is listed in
Appendix iii. In 2009, our department was formed as a consolidation of the County's Public
Health and Mental Health departments with Enviro nmental Health added in 2010.
In 2012, we will help thousands of residents, offering health and human services at more
than 40 locations including schools, clinics, partner agencies and through a variety of
outreach efforts. We will also continue to increase our investment in our economy and the
workers at many local helping agencies.
While we are optimistic and excited by the promise of health reform, a difficult road lies
ahead. All signs point to reductions in public funds and rising costs as well as a need to push
forward with difficult changes in the way we work and the way people are served. Each fall,
with the help of our community advisory boards and the Central Oregon Health Board and
Health Council , we will review our progress, reassess health reform and our community and
regional needs , and update our priorities to remain current and relevant to the work at
hand. With this in mind, we look forward to a healthier Central Oregon in the years ahead.
We hope you will take the time to review the 71 goals in this document, to ask difficult
questions and to join us in this effort. With adoption of the plan we will move forward
immediately on a number of these actions. We do this with gratitude for the work of a
talented and dedicated staff, the thoughtful guidance of our community advisory boards
and volunteers, the help of community partners and the commitment of our Board of
County Commissioners to community health and well-being.
In partnership with our community and region
Scott Johnson, Director
Deschutes County Health Services
Desch tes County Health Services Strategic Plan 2012-2015 4/11/2012
Page 2 of 34
Deschutes County Health Services
2014-2015 Dep artment Go als & Prio rities
Our 2014-2015 goals are based on our Strategic Plan and regional health reform efforts as well as
emerging issues and opportunities facing our County . These priorities will shape our proposed FY 2015
operating budget, our staffing and our focus for the coming year. These priorities have been reviewed
with the Behavioral Health Advisory Board, the Public Health Advisory Board and the Deschutes County
Board of Commissioners. Adjustments may occur based on final budget adoption .
OUR MISSION:
To promote and protect the health and safety ofour community
OUR VALUES:
Advocacy : The pursuit of community health, healthy lifestyles and access to care.
Collaboration : True partnership with our customers, community agencies and coalitions .
Cultural Competence : Awareness and responsiveness to the diversity in our community.
Excellence : A commitment to best practice and high quality service to the public.
Innovation : A willingness to try new approaches to better serve our community.
Professionalism : The highest level of personal integrity, conduct and accountability.
Stewardship : The wise, effective and efficient use of public resources .
Workplace Health : Work sites that promote respectful interactions and healthy lifestyles.
OUR TOP PRIORITIES
• Expand our County services where needed in support of Medicaid expansion .
• Achieve national accreditation through the Public Health Accreditation Board process.
• Strengthen our partnerships with primary care (a COHC 1 priority for primary care/public health).
• Participate in effective integrated clinics or service hubs in La Pine, the Bend Annex, Sisters and
Redmond. Remain open to other opportunities.2
• Create sustainable models for our school-based health centers and maternal child health program.
• Achieve successful leadership transitions including the Department Director, Public Health Nurse
Manager, Behavioral Health Adult Program Manager and Operations Manager.
• Assess health reform in our region and the County's roles and priorities. Update the Strategic Plan
to best reflect services, staffing and priorities for FY 2016 forward.3
• Consistently measure and report our accountability and effectiveness. Assure we have the skills,
capacity and commitment to objectively measure our performance.
• Establish a coordinated and efficient Early Learning Hub childhood service delivery system for the
Central Oregon region.
1 COHC is the Central Oregon Health Council, the community board overseeing PacificSource as our Coordinated Care
Organization in Crook, Deschutes, Jefferson and northern Klamath counties.
2 Potential examples include Volunteers in Medicine, use of the DCHS Courtney building with Reproductive Health .
3 The assessment will be initiated when new leadership is in place and in concert with staff, our Advisory Boards, County
leadership and the Board of County Commissioners.
IIPage
OUR 2014-15 GOALS :
A. Increase Access to Care
1. Assure behavioral health (BH) services for new Oregon Health Plan (OHP) members (i.e., Medicaid
expansion) including use of community behavioral health providers. Meet OHP access standards.
2. Assure sufficient BH Access Team and adult treatment capacity for expansion as well as equitable
geographic access in La Pine, Redmond and Sisters. Note : Includes better BH facilities in Redmond.
3. Increase access and full utilization of our capacity to help people seeking reproductive health services
through improved coordination and collaboration with partner agencies including Mosaic Medical.
4. Assure all school-based health centers have a medical sponsor and sufficient public health and behavioral
health services during the 2014-2015 school year. Strengthen our partnerships with primary care,
behavioral health4, oral health and public health wherever possible.
5. Assure services for people with intellectual and developmental disabilities by increasing our capacity to
implement the Community First Choice State Plan (1915 k) (i.e ., community provider capacity development).
B. Improve Health
1. Advance population-based health improvement programs.
• Annually increase enrollment in the Living Well programs.
• Create a plan to prevent intimate partner violence.6
• Sustain our capacity to improve health via preventive strategies that address:
a. alcohol, tobacco and other drugs;
b. reproductive health;
c. suicide / self harm prevention (with the Suicide Prevention Advisory Council)7; and
d. prevention of child abuse and neglect.
2. Advance critical specialty programs for community members with complex health needs.
• Develop a transition-age youth program for young people age 14-25 including (but not limited to)
behavioral health, reproductive health, maternal child health, well ness and prevention .8
• Strengthen the Assertive Community Treatment (ACT) team including needed staffing and
expanding the use of peers to coordinate care. Oregon Health Authority (OHA) grant pending.
• Increase access to rental assistance for our behavioral health clients as part of supportive housing
and support for independent living. OHA grant pending.
C. Improve Care
1. Implement improvements as directed by our BH Medical Director and PH Health Officer. Ongoing.
• Improve collaboration by easing transitions to / from primary care, referrals, and case consultation with
primary care physicians who treat DCHS clients as well as area public safety agencies.
• Identify and implement consultative opportunities in public health.
2. Expand our use of peer specialists or community health workers; create internal support in the department.
3. Improve BH client engagement and reduce no shows through provision of at least three appointments in the
first month of service. Set a no show reduction target and track performance. 2015 priority
4 Includes implementation of a 2014-15 SBHC expansion grant from the Oregon Health Authority.
5 Living Well is a best practice chronic disease self-management program developed by Stanford University.
6 The plan should focus on the individual, community, agency and policy levels . It should be developed by public and
behavioral health staff by convening an intimate partner violence committee . To be achieved by winter 2015.
7 Includes a 2014-15 grant from the Oregon Health Authority.
8 Includes implementation of a "Young Adult Hub" grant from the Oregon Health Authority.
21Page
.'
4. Develop and implement strategies to increase referrals and use of alcohol and other drugs treatment
services for OHP members based on medical necessity .
5. Improve intensive treatment services for youth enrolled in wrap-around services, reducing psychiatric
residential treatment services and costs.
D. Reduce Cost and Increase Cost Effectiveness
1. Use certified coding staff to review and strengthen our public health billing practices.
2. In collaboration with the County Finance Department, secure an annual indirect cost rate for support
services in compliance with Federal guidelines .
3. Develop an electronic staff training tool to support workforce development .
4. Develop an electronic health record option for our maternal child health home visiting program.
E. Increase Health Integration and Collaboration
1. Strengthen primary care / public health partnerships, a COHC priority.
• With COPA g and Mosaic, develop protocols for coordinating care for shared pediatric clients .
• Based on demonstrated benefit, sustain our regional maternal child health system for high risk
families: a} coordinated care for at-risk pregnant clients with East Cascade Women's Group, b}
CaCoon, and c} Nurse Family Partnership. Note: Item a} requires investment by COHC.
• Construct and open a comprehensive school-based health center in Sisters; center will include a
medical sponsor, school district, oral health, behavioral health and public health participation.
• Develop a plan for potential development of a school-based health center at a Bend high school.
2. Improve the coordination of more comprehensive care and well ness for our clients .
• With Mosaic, remodel and expand the Annex as a health home for people with serious mental
illness including a facility remodel, staff expansion and enhanced programming.
• Streamline the process of cross referrals and case coordination for clients between the Behavioral
Health and Developmental Disabilities programs, including Public Health.
• With regional partners and the Early Learning Hub, develop a five-year plan to ensure children ages
birth through six are safe, healthy and enter kindergarten prepared to learn . Develop protocols and
strategies to coordinate family support and early childhood services.
3. As directed by the Oregon Health Authority, successfully transition health resources and oversight to our
Coordinated Care Organization {CCO} in the areas of a} mental health residential programs {July 2014},
and b} public health targeted case management {January 2015}.
F. Pursue Excellence
1. Achieve national accreditation from the Public Health Accreditation Board. Site visit March 2014.
2. Achieve all State "Quality Improvement Measures" pertinent to DCHS including, at a minimum, a} a
mental health and physical health assessment within 60 days for all children in DHS custody, and b}
outpatient mental health service within seven days of a behavioral health related hospitalization .
3. Identify and implement a BH therapeutic outcomes tool in consultation with WEBCO and PacificSource.
4. Achieve and maintain BH clinical documentation compliance at 90% and assure encounters are fully
documented as close to 100% as is possible based on State Administrative Rules.
5. Successfully implement the Community First Choice State Plan {1915 k} to assure timely services for
people with intellectual and developmental disabilities.
9 COPA refers to Central Oregon Pediatric Associates .
31Page
G. Expand Regional Efforts
1. Assure organizational support and participation in the successful design and implementation of the
region's Early Learning Hub.
2. Complete and begin implementing a cross jurisdictional action plan for emergency preparedness.
3. Within HIPAA guidelines and Exchange protocols, include County client data in a regional Health
Information Exchange
4. Identify and pursue regional resource development opportunities.
H. Strengthen Our Organization
1. Assess health reform in our region and the County's roles and priorities. Update the Strategic Plan
to best reflect services, staffing and priorities for FY 2016 forward.10
2. Develop and implement a comprehensive approach to cultural competence under the leadership of the
DCHS Cultural Diversity Committee and in consultation with our communities.
3. Sustain our capacity to conduct health assessments and update the Regional Health Assessment; with
the region, foster the development and utility of the Healthy Central Oregon web site.
4. Develop and implement a workforce development plan as required by Public Health Accreditation.
5. ConSistently measure and report our accountability and effectiveness. Assure we have the skills,
capacity and commitment to objectively measure our performance.
6 . Improve knowledge of importance of whole-person health-integrating public health, behavioral health,
intellectual and developmental disabilities-in treatment.
7. Meet meaningful use requirements with our electronic health records.
8. Early in 2015, reassess the organization and structure.
9. Continue to pursue training, practices, protocols and drills to support staff safety.
I. Promote Sound Health Policy
1. As opportunities arise, promote and advance policies that support the Triple Aim. Support programs,
services, practices and activities that lead to better health, better care and less cost.
END
2.19.2014
\\ZEUS\katheh\MY DOCUMENTS\PLANNING\STRATEGIC PLAN\Priorities\2014-2015\Priorities 2014-2015 FINAL Feb 19 2014.docx
10 The assessment will be initiated when new leadership is in place and in concert with staff, our Advisory Boards, County
leadership and the Board of County Commissioners.
41 Pa g e
I. The Triple Aim*
Our Vision for A Healthy Central Oregon
BE,!"I'E CA E
Improve our service
quality, access, reliability,
safety and satisfaction
*The "Triple Aim" is a health reform concept developed by the Institute for Healthcare
Improvement, an independent, nonprofit organization helping to lead the improvement of health
care throughout the world. Triple Aim thinking is intended to improve health and health care.
Triple Aim is now part of Oregon law and a founding concept for the Oregon Health Authority. It
has been adopted by the Central Oregon Health Council and Deschutes County Health Services.
4/11/2012Deschutes County Health Services Strategic Plan 2012-2015
Page 5 of 34
Endorsements and Adoption
ry Board.
Deschute County IWttaVllm:I h Advisory rd.
rd
Adop Ap JL 20 by rd of CDmmlC:C,nl1IPrII:
~n U r. Vice CUllr )
\..._
r
Health Services' Reception and Support Staff
Deschutes County Health Services Strategic Plan 2012-2015
Page 3 of 34
4/11/2012
CHAPTER 40 2014
CURFEW, SOCIAL GAMES, TRUANCY and CONTROLLED SUBSTANCES
CURFEW
40.1lO MINORS UNDER 15 YEARS.
No minor under the age of 15 years shall be in or upon any street, highway, park, alley, or
other public places between the hours of 9:30 p.m. and 4:00 a.m. of the following morning,
provided that on and during any night immediately preceding a day upon which the public school
will be closed, such hours shall be lO:OO p.m. to 4:00 a.m. of the following morning. [Ord. 17, Sec. 1]
40.120 MINORS 15 THROUGH 17 YEARS.
No minor of the age of 15 years or over, but under the age of 18 years, shall be in or upon
any street, highway, park, alley, or other public places between the hours of lO:30 p.m. and 4:00
a.m. of the following morning, provided that on or during any night immediately preceding a day
upon which the public schools will be closed, such hours shall be 12:00 midnight to 4:00 a.m. of
the following morning. [Ord. 17, Sec. 2]
40.130 EXCEPTIONS.
The provisions of sections 40.110 and 40.120 shall not apply to any minor accompanied by
a parent, guardian, or any other person 18 years of age or over and authorized by the parent or by
the law to have the care and custody of the minor, or to any minor who is then engaged in a lawful
pursuit or activity which requires his presence in such public places during the hours specified in
sections 40.1lO and 40.120. [Ord. 17, Sec. 3; amended Ord. 95-lO]
40.140 JURISDICTION.
The provisions of sections 40.110 to 40.195 shall not apply to any area within an
incorporated city in this County. [Ord. 17, Sec. 4]
40.195 PENALTY.
Any minor who violates the terms and provisions of sections 40.110 to 40.195 shall be
taken into custody, as provided in ORS 419C.080, 419C.085, and 419C.088, and may be subjected
to further proceedings as provided in ORS Chapter 419C. [Ord. 17, Sec. 5; amended Ord. 95-10]
SOCIAL GAMES
40.310 SOCIAL GAMBLING NOT AUTHORIZED.
Social games are not authorized under ORS 167.121 within unincorporated areas of Polk
County. All forms of gambling, as defined in ORS 167.117, remain subject to prohibition or
regulation under state law. [Added by Ord. No. 92-34]
40-1
TRUANCY
40.400 TRUANCY REGULATIONS.
(l) Except as provided in subsection (2), all minors between the ages of seven and 18 years
who have not completed the 12th grade shall attend regularly a public full-time school, as required
by ORS 339.010. For the purpose of this section, "attend regularly" means to attend school during
those hours for the full-time school which the minor would attend in the school district in which the
minor resides, on any day on which the school is in session.
(2) Subsection (l) does not apply to:
(a) A minor being taught in a private or parochial school in the courses of study
usually taught in grades 1 through 12 in the public schools and in attendance
for a period equivalent to that required of children attending public schools;
(b) A minor who proves to the satisfaction of the district school board that he or
she has acquired equivalent knowledge to that acquired in the courses of study
taught in grades 1 through 12 in the public schools;
(c) A minor who has received a high school diploma;
(d) A minor being taught for a period equivalent to that required of children
attending public schools by a private teacher the courses of study usually
taught in grades 1 through 12 in the public school;
(e) A minor being educated in the minor's home by a parent or legal guardian;
(f) A minor excluded from attendance as provided by law; or
(g) A minor granted an exemption from compulsory attendance by rule adopted by
the State Board of Education pursuant to ORS 339.030(2).
(3) When a peace officer has reasonable grounds to suspect a minor may be in violation of
subsection (1) above, the peace officer may contact the minor and make such investigation as may
be necessary or appropriate to determine if the minor is in violation of subsection (1).
40.401 ACTION TAKEN.
If a peace officer has probable cause to believe a minor is in violation of section 40.400(1),
the peace officer may:
(a) Take the minor into custody and deliver the minor to the minor's school
principal or attendance supervisor, or their designees, or to the minor's parent
or legal guardian; and
(b) Refer the minor to the Polk County Juvenile Department.
40-2
I
40.402 PARENT I GUARDIAN.
Any parent, guardian or person having the care and custody of any minor between the ages
of seven and 18 who has not completed the 12th grade shall take reasonable steps to prevent such
child from violating section 40.400(1), and shall further send such child to and maintain such child
in regular attendance at a public school during the entire school term or comply with the
exemptions set forth in section 40.400(2).
40.403 VIOLATIONS.
Violation of section 40.400(1) or section 40.402 upon a first and second offense shall
constitute a civil infraction. Violation upon a third and subsequent offenses shall constitute a Class
C misdemeanor.
[Truancy Section Enacted Ord. 13-01]
CONTROLLED SUBSTANCES
40.500 CONTROLLED SUBSTANCES
The use of any building, structure, location, premises or land for a medical marijuana
business is not currently enumerated in the Polk County Code of Ordinances or the Polk County
Zoning Ordinance as a permitted use in any zone, nor is the use enumerated as a conditional use
many zone.
[Controlled Substances Section Enacted Ord. 14-02]
40-3
POLK COUNTY COUNTY COUNSEL
POLK COUNTY COURTHOUSE *DALLAS, OREGON 97338-3177 DAVlDDOYLE
(503) 623-8173 *FAX (503) 623-0896
MEMORANDUM
TO: Board of Commissioners
FROM: County Counsel
DATE: February 4. 2014
RE: Chapter 40
RECOMMENDATION: That the BOC enact Ordinance 14~02 providing a single
amendment to Polk County Code of Ordinances Chapter 40.
ISSUE: Should Polk County amend Chapter 40?
BACKGROUND: Polk County Code of Ordinances Chapter 40 addresses Curfew and
Social Games. The Community Development Depru1ment has requested guidance with
regard to the cun'ent medical marijuana dispensary situation (e.g. can they be sited within
unincorporated Polk County?) Staff has determined that due to the uncertain status of
legal preemption arguments that the Board does in fact have authority to disallow
medical marijuana businesses.
ALTERNATIVES:
(1) NOT enact Ordinance 14-02;
(2) Enact Ordinance 14-02
FISCAL IMPACT: none anticipated