HomeMy WebLinkAboutRegional Health Authority MemoHEALTH SERVICES
2577 NE Courtney Drive, Bend, Oregon 97701
Public Health (541) 322-7400, FAX (541) 322-7465
Behavioral Health (541) 322-7500, FAX (541) 322-7565
www.deschutes.org
To: Deschutes County Board of Commissioners
Dave Kanner, County Administrator
From: Scott Johnson, Director, Deschutes County Health Services
Date: July 14, 2010
Subj: Regional Health Authority topic: Work Session July 19; regional meeting July 20
We will be meeting in the work session on July 19 to discuss the Regional Health Authority /
Service Integration project in preparation for a regional July 20 meeting with the Jefferson
County Commissioners and the Crook County Court at the Deschutes County Expo Center.
BACKGROUND
With a policy decision to merge two county departments in 2009, Deschutes County is engaged
in efforts to improve health care for County residents. This includes promoting the Triple Aim
(i.e. better health outcomes, greater satisfaction and reduced costs), integrating primary care
and behavioral health in clinics and addressing a State interest in streamlining governance and
accountability, often referred to as “a single point of accountability.” Also noteworthy, the
President has signed the 2010 Affordable Care Act into law and the 2009 Oregon Legislature has
created the Oregon Health Authority. It is a time of change, uncertainty and great promise.
DECISION POINTS – We are approaching several important decisions for our County and
region. I will brief you on each of these on Monday and am seeking Board direction.
1. Regional Health Authority (RHA) – Discussion of the concept of an RHA and an
indication from all three counties of whether you will consider forming an RHA, either
as a 190 organization or through new legislation. County governments would play a
central role in the creation and operation of an RHA. We have received early support
for this from a number of parties including Dr. Bruce Goldberg, Oregon Health
Authority (OHA), Jim Diegel, St Charles Health System and Megan Haase, Mosaic
Medical. Your direction will help us determine whether to move forward in developing
a more specific proposal. If we receive preliminary support, specific questions to
address or features you would like incorporated would be helpful.
Our Mission: To promote and protect the health and safety of our community.
Memorandum to County Commissioners
Scott Johnson July 14, 2010
2. If you support an RHA concept, realignment of OHP contracts through Pacific Source.
We will review current and proposed pathways for contracting OHP funds. Should we
seek a change, one that would eventually fall under the RHA, the State requires a Letter
of Intent to change the contracting through Pacific Source COIHS effective January 2011.
Pacific Source COIHS would receive a comprehensive OHP contract and would
subcontract behavioral health services through ABHA. Undertaking this change in 2011
would require a Letter of Intent by July 22, 2010 and a final decision by September 15,
2010. In indicating we no longer wish to receive a direct State to ABHA OHP contract
for mental health services or a State to Deschutes County OHP contract for chemical
dependency, we recommend the following conditions be realized prior to September 15:
a. A legal agreement by Pacific Source COIHS and the State OHA to move the OHP
contracts and any other public funds of interest to the Central Oregon counties
through the new Regional Health Authority once it is formed and ready.
b. An ability to review the 2011 DHS contract with COIHS and the 2011 COIHS
contract with ABHA, with both found acceptable by ABHA and the Central
Oregon counties prior to September 15.
c. A legally binding document assuring a “reset button” through which the
participating counties can reform a Behavioral Health Organization, either
through ABHA or the Central Oregon counties for as long as Oregon continues
to operate with carve out options for any behavioral health services.
d. DHS, ABHA and COIHS adoption of a document titled DHS Oversight and
Reporting Processes to help ensure administrative efficiency.
e. A written methodology to guide how any financial savings from the new
delivery and administrative model will be shared by participants.
Executing this change by January 2011 will allow easier and more comprehensive care
coordination between providers and a method to finance more integrated clinics
throughout Central Oregon. It will also allow for a more comprehensive local process to
evaluate and monitor health care investments totaling more than $180 million.
3. Important Transitional Board meeting September 9 – Should you support moving
forward with reform efforts as outlined in items 1 and 2, this next meeting will include a
review of progress made on the items listed above, follow‐up on any matters outlined at
the July 20 regional meeting and an early review of a possible legislative concept for a
Regional Health Authority. A final ABHA letter approving the contract change will be
required by September 15.
I look forward to our discussion on July 19 and July 20.