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Home My WebLink About2009-07-22 Work Session (5)Deschutes County Health Services (DCHS) Memorandum To: Deschutes County Board of Commissioners Dave Kanner, County Administrator From: Scott Johnsoni i -ctor, DCHS Date: July 10, 2009 Subj: Mental Health OHP services (encounters) by zip code Material for BOC work session July 15 Background Deschutes County's adopted Mental Health 2008-2013 Strategic Plan includes a goal related to access to our services. The citation reads "Access — Continue to assess public access to our services, recognizing the transportation difficulties facing our clients. Seek equitable access for indigent and OHP clients in north and south county ...". We have developed a performance measure (see attachment) to examine the proportionate service levels by community (i.e. zip code). This data was the topic of discussion at the June 2009 meeting of our Deschutes County Addictions & Mental Health Advisory Board. Not surprisingly, it has been difficult to efficiently and effectively realize this goal but progress is being made in some areas (e.g. service to OHP children in LaPine). We are hopeful that the expansion of the LaPine Community Clinic (as a Federally Qualified Health Clinic), our efforts at service integration and the eventual addition of a more comprehensive north county service center can help us improve geographic access. Commissioner Work Session July 15 I have been asked to brief you on this topic at your next work session. In preparation, Ray Wingert in our office has gathered the following data for services provided between 7/1/8 — 6/30/9 for our consideration. See data by age group on Page 2. Table No. 1 All Ayes Area served OHP members OHP served % served Bend 11,783 1,214 10.3% LaPine / South County 2,757 266 9.6% Redmond / North County 7,332 538 7.3% Sisters 672 28 4.2% Totals 22,544 2,046 9.1% Page 1 Johnson Memo to BOC re mental health service levels July 10, 2009 — Page 2 Additional Considerations • By contract, we are expected to provide service to Oregon Health Plan members based on medical necessity for covered services. We would never expect the same exact service rate by community and age group. It is a general concept only. • An additional 16 OHP members assigned to our area were also served in 2008-09. • There is no objective way to measure the need of indigent, uninsured clients with a mental illness in different areas of our County. At the same time, if service levels for OHP clients are lower in particular communities, it is quite possible the same situation exists for low income, uninsured residents of those same communities. • Seth Bernstein reports that Mental Health Organizations (like ABHA), on average, have a penetration rate a little over 7%. • We are hopeful that the Legislature's intent to add 105,000 Oregonians (including 80,000 children) to the OHP rolls will increase access for people in our County. • Our Department will continue to work to increase our service levels in North and South County and we hope this data will improve over the next several years. Table No, 2 Children ages 0-17 Area served Bend OHP members 6,856 LaPine / South County Redmond / North County 1,437 OHP served served 506 7.4% 129 9.0% 4,487 Sisters Totals 408 253 15 5.6% 3.7% 13,188 903 6.8% Table No. 3 Adults ages 18-65 Area served OHP members OHP served % served Bend 4,437 671 15.1% LaPine / South County 1,198 126 10.5% Redmond / North County 2,540 270 10.6% 5.4% Sisters 242 13 Totals 8,417 1,080 12.8% Table No. 4 Adults ages 66 and over Area served OHP members OHP served % served Bend 490 75 9.6% LaPine / South County 122 11 9.0% Redmond / North County 305 15 4.9% Sisters 22 0 0.0% Totals 939 73 7.8% C: Members of the Addictions & MH Advisory Board; DCHS Management Team Attachment: Data included in the 2009-10 DCHS Program Budget Page 2 Aitach rnenf Excerpt from DCMH Strategic Plan 2008-2013, 2008-2010 Work Plan .. . • "Access -Continue to assess public access to our services, recognizing the transportation difficulties faced by our clients. Seek equitable access for indigent and OHP clients in north and south county. ...." Program Priorities (from 2009-2010 Program Budget Narrative) County Goal #4 Health Services: Facilitate, invest in and provide a system of services to improve the health of Deschutes County residents Objective #1: Partner and offer leadership on community initiatives Action B: Increase access to health service's in North and South County Performance Measure FY FY FY FY FY 2009-10 Target 2005-06 2006-07 2007-08 2008-09 YTD Percentage of Oregon Health Plan members in each area receiving mental health services CHILDREN >90% of countywide average in ea :h area Bend 106.5% 103.4% 109.6% 107.7% La Pine/South County 90.2% 103.0% 103.5% 129.0% Redmond/North County 95.6% 95.6% 87.5% 83.1% Sisters 69.2% 74.9% 48.3% 44.4% Performance Measure FY FY FY FY FY 2009-10 Target 2005-06 2006-07 2007-08 2008-09 YTD Percentage of Oregon Health Plan members in each area receiving mental health services ADULTS >90% of countywide average in each area Bend 119.0% 118.2% 118.9% 119.0% La Pine/South County 61.7% 67.2% 79.4% 83.6% Redmond/North County 84.7% 85.0% 78.6% 79.2% Sisters 76.4% 69.8% 58.2% 47.9% Performance Measure FY FY FY FY FY 2009-10 Target 2005-06 2006-07 2007-08 2008-09 YTD Percentage of Oregon Health Plan members in each area receiving mental health services SENIORS >90% of countywide average in each area Bend - 142.9% 147.2% 146.6% 128.7% - La Pine/South Count' 15.1% 12.4% 33.1% 69.5% Redmond/North County 62.8% 62.2% 62.1% 73.4% Sisters 111.6% 72.2% 0% 0% \\ZEUS\katheh\MY DOCUMENTS\AMHAB\2009\July\Percentage of OHP receiving services in each are L.doc