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HomeMy WebLinkAboutFY25 Annual ReportF Y 2 5 A N N U A L R E P O R T D E S C H U T E S C O U N T Y H E A L T H S E R V I C E S W H E R E W E A R E N O W E x e c u t i v e S u m m a r y , l o o k i n g b a c k a t F Y 2 4 a n d l o o k i n g f o r w a r d t o F Y 2 5 Throughout Fiscal Year (FY) 2024, Health Services has focused on building internal resilience while responding to a number of health threats to the community. Resilience efforts targeted readiness to respond to emergencies, enhancing financial. vitality, and building positive organizational culture aimed at supporting and retaining workforce. Public Health reestablished a Medical Reserve Corps comprised of over 140 public health volunteers poised to respond to needs and emergencies in the community. Public Health also successfully found a home for its innovative Perinatal Care Coordination Program in the regional global health budget, ensuring vital health screening and referral services to new mothers and families are sustained. Behavioral Health achieved a rebased Prospective Payment System (PPS) reimbursement rate, and thus ensured that Certified Community Behavioral Health Clinic (CCBHC) programs will continue to provide critical integrated care to those struggling with co-occurring mental and physical health conditions. Finally, through our partnership on the Kingwood Campus with County Administration, Facilities, Properties and County Commissioners, Health Services expanded the full array of Behavioral Health, Public Health and Intellectual & Developmental Disability services to northern Deschutes County. Resilience efforts included heavy investment in staff as well. Health Services completed an all-staff engagement survey, collaborated with staff on the development of the Health Services Culture Framework, and expanded staff training and development opportunities. Efforts are intended to help create a culture in which staff feel supported, expand interpersonal tolerance and resilience and have access to tools that enhance collaborative problem-solving and effective communication. The goal of this effort is to ensure staff has a high level of satisfaction and effectiveness as they provide the highest quality of care to those we serve. Health Services has very much been on the forefront of many community struggles this year. Many of those we serve are impacted by a changing climate, economic insecurity, decreasing availability of low-income housing and an emerging overdose crisis. We have seen homelessness, substance use related fatalities, and acuity of service population increase, placing added pressure on staff and already stretched community resources. Several developments give rise to hope. Legislative investments following the passage of Measure 110 (M110) expanded outreach, engagement, harm reduction and treatment services to address addiction. M110 reform investments followed, offering additional resources to ensure more effective diversion of people from arrest into treatment. State dollars to address homelessness resulted in additional shelter beds for some of those we serve, and collaborative activities to address encampments helped Health Services staff become more adept at responding to those experiencing homelessness. Finally, Health Services rolled out the non-law-enforcement (LE) Community Crisis Response Team (CCRT) this year, successfully addressing 80 percent of crisis calls without requiring LE presence. In response to the overdose crisis, Health Services stood up an Overdose Surveillance and Response Team, which has completed targeted prevention efforts aimed at youth, adults and families; improved surveillance with real time OD data; and improved our efforts to ensure lifesaving supplies and treatment referrals make their way into at risk communities. We believe these efforts are mitigating the loss of life communities experience while dealing with surging fentanyl presence in the supply. Meanwhile, we are seeing significant improvements in the data with respect to syphilis, a sexually transmitted infection that climbed precipitously last year and is beginning to show a response to Public Health disease management efforts in the form of declining numbers. Against this background, Health Services continues to demonstrate excellence and has been recognized throughout this year for innovative, meaningful practice, bringing increased recognition, revenue and opportunities to train and present on model programs. Some examples include: $1 million award to Behavioral Health to pilot our successful Aid & Assist program, which has outperformed nearly every A&A program in Oregon. Statewide recognition of Public Health Healthy Schools Program, which has been invited to present and consult on this evidence-based model to entities such as Oregon Nurses Association, Oregon Health Authority, other Public Health Departments and the Oregon Department of Education. Award conferred by the City of Redmond Police Department to the CCRT for excellent partnership in service to individuals in crisis. National Health & Human Services Administration for Strategic Preparedness and Response Award for New Medical Reserve Corps (MRC) Leader awarded to the MRC Coordinator (Carissa Heinige) for the achievements of Health Services MRC. These and other achievements are the cumulative reflection of the commitment, expertise, creativity and courage of Health Services staff. I am grateful to have the privilege to write about them this year as every year. Janice Garceau, Health Services Director T A B L E O F C O N T E N T S P A G E 0 3 A l e t t e r f r o m t h e D i r e c t o r .............................................. S t r a t e g i c P l a n .................................................................... O r g a n i z a t i o n a l C h a r t ....................................................... B e h a v i o r a l H e a l t h I n f o r m a t i o n ..................................... B e h a v i o r a l H e a l t h C o n t i n u u m ....................................... B e h a v i o r a l H e a l t h K e y S t a t i s t i c s ................................... B e h a v i o r a l H e a l t h A d m i n i s t r a t i o n ......................... A c c e s s a n d I n t e g r a t i o n , H o m e l e s s O u t r e a c h ........ C o m p r e h e n s i v e C a r e f o r Y o u t h a n d F a m i l i e s ...... C r i s i s P r o g r a m ............................................................ I n t e l l e c t u a l a n d D e v e l o p m e n t a l I n f o r m a t i o n ....... I n t e l l e c t u a l a n d D e v e l o p m e n t a l D i s a b i l i t i e s ......... I n t e n s i v e A d u l t .......................................................... O u t p a t i e n t C o m p l e x C a r e ....................................... M e d i c a l T e a m ............................................................. P u b l i c H e a l t h I n f o r m a t i o n ............................................. P u b l i c H e a l t h K e y M e t r i c s .............................................. P u b l i c H e a l t h A d m i n i s t r a t i o n .................................. C l i n i c a l & F a m i l y S e r v i c e s ....................................... C o m m u n i c a b l e D i s e a s e s , & P r e v e n t i o n M a n a g e m e n t .............................................................. P r e v e n t i o n & H e a l t h P r o m o t i o n ........................... E n v i r o n m e n t a l H e a l t h , P r e p a r e d n e s s & E n g a g e m e n t ............................................................... A d m i n i s t r a t i v e S e r v i c e s ................................................. D i r e c t o r 's O f f i c e ............................................................. P e r s o n n e l H i g h l i g h t s ...................................................... F i n a n c i a l H i g h l i g h t s ........................................................ 2 4 5 6 7 9 1 0 1 2 1 5 1 8 2 1 2 2 2 5 2 8 3 1 3 2 3 4 3 5 3 7 4 0 4 3 4 6 5 0 5 3 5 4 5 5 P A G E 0 4 O R G A N I Z A T I O N A L C H A R T P A G E 0 5 BOARD OF COUNTY COMMISSIONERS LOCAL MENTAL HEALTH AUTHORITY, LOCAL PUBLIC HEALTH AUTHRITY County Administrator Public Health Advisory Board Behavioral Health Advisory Board Local Developmental Disabilities Planning Committee Behavioral Health Services Holly Harris, Director DCHS Compliance Officer Jillian Weiser Health Services Director Janice Garceau Administrative Services Cheryl Smallman, Business Officer Chris Weiler, Operations Officer Jillian Weiser, Compliance & Quality Assurance Officer Public Health Services Heather Kaisner, Director Environmental & Community Health Preparedness & Engagement Prevention & Health Promotion Communicable Disease Prevention & Management Clinical & Family Services Richard Fawcett, MD. Health Officer Intensive Adult Services Comprehensive Care for Youth and Families Medical Team Access and Integration Intellectual/ Developmental Disabilities Sam Murray, MD. Medical Director Outpatient Complex Care Services Crisis Services Business Intelligence Operations Compliance and Quality Assurance Local Mental Health Authority (LMHA) Governance The LMHA appoints a Mental Health Director and designates the Community Mental Health Program County Commissioners and Judges are the Local Mental Health Authority (LMHA) for the CMHPs and Community Developmental Disabilities Program's (CDDPs) in their counties $53.6M Behavioral Health operational Budget 275.82FTE Behavioral Health To Promote and Protect the Health and Safety of Our Community Janice Garceau Holly Harris 4% Budget supportedby General Funds The Community Mental Health Programs (CMHP) is designated by the Local Mental Health Authority (LMHA) to provide services mandated by ORS 430.610. Behavioral Health Director Health Services Director Local Mental Health Authority: County Commissioners - BoCC Local Mental Health Agency (LMHA): Deschutes County Behavioral Health Division is authorized by the BoCC to perform Public Health LMHA requirements and responsibilities on behalf of the county (Behavioral Health is a division of Health Services) Local Mental Health Administrator: DCHS Behavioral Health Director, authorized by the BoCC to oversee the Local Mental Health Agency Local Mental Health Delegations of Authority Community-based Services not Provided Elsewhere such as School Based HealthCenters or Co-occurring Outpatient Mental Health and Substance Use DisorderTreatment, Supported Housing & Employment, Rental Assistance, IntegratedBehavioral & Primary Care, etc. Justice System Related Services and services that impact rights, such as Aid &Assist or Civil Commitment and Psychiatric Security Review Board Monitoring. Mandated Services Core Services Safety Net Services Services Required by Rule/Contract such as Jail Diversion or Housing Supports,Older Adult, and Intensive Services provide by programs like AssertiveCommunity Treatment (ACT), First Episode Psychosis (EASA), Stabilization Center,Wraparound services to children, Crisis Services such as 24/7 Mobile Crisis Teamsetc. What We Do As the designated CMHP, Deschutes County Behavioral Health ensures a system of comprehensive, coordinated, services to meet the mental health needs of the community. We provide accessible, timely, community-based behavioral health services to Deschutes County residents regardless of ability to pay. OAR Behavioral Health Programs How the System is Funded: A 24-hour program that responds by phone or face-to-face. Services may include assessment, intervention planning, information and referral services. In addition, we provide brief crisis stabilization through individual or group treatment. Intervention Planning referral Services Civil Commitment investigation and monitoring 24/7 Crisis Coverage 24/7 Mobile Crisis Services Stabilization Forensic Diversion Co Responders community based intensive treatment supports to adults with an SPMI diagnoses. Exceptional Needs Care Coordination (ENCC) Aid and Assist Rental Assistance Supported Employment Coordination of Residential Spectrum Two Housing Property Support Outpatient SPMI BH Older Adult BH Care Integrated Care with Mosaic Medical Psychiatric Security Review Board ACT CHOICE MODEL Homeless Outreach Services & Harm Reduction Provides intake, referrals, and care coordination for individuals of all ages, in addition, provides training and technology support to clinical staff. Screenings Assessment Referrals Treatment Recommendations Case Management Brief Therapy CCBHC Coordination Rapid Engagement CANS Assessments for DHS Administrative Support for Behavioral Health Teams Individual and group treatment services to adults children and families with mental health and or alcohol and drug concerns. Referral Services for continued care Individual, Family and Group Counseling Integrated Care with Mosaic Medical Co-Occurring Substance Use Treatment Psychiatric Care and medication management Veterans Services Parent Child Interaction Therapy (PCIT) Care Coordination and Skills Training Crisis & Stabilization 44.70 FTE Intensive Adult Services 57.8 FTE Outpatient Complex Care 42.85 FTE Access & Integration 25.25 FTE Intellectual/Developmental Disability Services 48.85 FTE Comprehensive Care for Youth & Families 49.02 FTE Provides specialty mental healthcare for individuals ages 0-25 and their families through an array of integrated, intensive outpatient care teams. Generation Parent Management Training Oregon (GEN-PMTO) Parent Child Interaction Therapy (PCIT) Young Adults in Transition The Drop Behavioral Health Resource Network Affirming Care (True Colors) School Based Health Centers System of Care Early assessment and support alliance Wraparound CCO Coordinated Care Organizations are the Managed Care Entities (MCEs) tasked with managing Medicaid dollars to ensure the provision of required healthcare services to OHP members in their region. CCOs contract with CMHPs for behavioral health services to their members. CCO contracts are negotiated annually, Deschutes County includes Fee for Service Revenue, Capitation and Program Allocation lines of reimbursement. OHA The Oregon Health Authority provides Medicaid and State General Fund dollars to CMHPs through County Financial Assistance Award (CFAA) contracts for services to indigent uninsured and key strategic investments such as block grants or pilot projects. Grants Deschutes County receives local, state and federal grant funds. Most grants are time limited and cover distinct costs. Some grants, such as CCBHC and federal CAHOOTS funding provide enhanced Medicaid payments intended to expand services. Supports people with intellectual and/or developmental disabilities (I/DD), to enable them to live as independently as possible. Services are aimed at greater access to social interaction, community engagement, and employment opportunities. Screening and investigating allegations of abuse for adults with I/DD coordinating protective services to avoid occurrences of abuse Applications and eligibility for services Case Management services- assessment, service plans, authorizing/referring to chosen services and support monitoring authorized services Statutorily or contract required services, grant funded and fidelity programs. ServiceTypes CommonProblemsAddressedCOMMUNITY BEHAVIORAL HEALTH SERVICE CONTINUUMHigh Risk High Need High Complexity Oregon State Hospital St Charles Sageview and/or EmergencyPsychiatric Services (PES) BedsSagebrush Academy Day Treatment Deschutes Recovery Center (DRC) Moderate Risk High Need High Complexity Deschutes County Health Services (DCHS) Behavioral Health24/7 Mobile Crisis Response & Stabilization CenterYouth Villages, Intercept & Intensive In Home Behavioral HealthTreatment (IIBHT) DCHS Specialty Intensive Community-Based Services DCHS Complex Outpatient Care Intellectual/Developmental Disability ServicesPrivate/Non-Profit agency and/or private practice providersLow Risk Moderate NeedModerate ComplexityPrivate/Non-Profit agency and/or private practice providersPrimary Care BH ConsultantsLow Risk Low Need Low Complexity Persons immediate danger due to acutepsychiatric symptoms and risk of harm to self orothers: persons in need of residential care dueto severe mental illness impacting ability to livesafely without supports in community Persons with severe and debilitating mentalhealth conditions often accompanied bypsychosis or co-occurring medical diagnosis orsubstance use disorders; often experiencehomelessness; may have frequent involvementwith law enforcement due to poorly managedacute symptoms. Children with serious emotional disturbance ormental illness and multi-system involvement(foster care, Juvenile Justice); often at risk forloss of home or school placement.Persons with serious mental illness without psychosissuch as Complex PTSD or major depression; history ofpsychiatric hospitalizations, frequent ER visits, co-occurring physical/substance us conditions; may be atrisk of losing housing, employment, or independence. Person with Post Traumatic Stress Disorder, eatingdisorder, moderate depression or anxiety, some familysupport; struggles to maintain high level of daily functioningand compliance with treatment and medications. Self-referred after loss or life circumstance, has familyconnection, sense of purpose in life, history of stability,current functioning decline (job instability due to symptoms,other destructive behavior, poor insight).Life change resulting in trouble sleeping, self-doubt, mild mood changes; no thoughts ofsuicide or self-harm; trouble managing healthdue to stress; takes medications asprescribed.Overall good life satisfaction, goodrelationships, productive and connected toothers; experiencing minor anxiety; talkingwith others helps.Provider Types HospitalsDetoxResidential Community MentalHealth Safety Net ProgramsCommunity Mental Health Safety Net ProgramsNon-Profit Outpatient Specialty CareNon-Profit Outpatient Specialty CareCommunity Outpatient ProvidersCommunity Outpatient ProvidersCommunity Based SupportEntitiesPrivate/Non-Profit agency and/or privatepractice providers Family, Friends, Religious Organizations,Support Groups, etc.P A G E 0 8 B E H A V I O R A L H E A L T H K E Y S T A T I S T I C S S T A T I S T I C S P A G E 0 9 P A G E 1 0BEHAVIORAL H E A L T H A D M I N I S T R A T I O N & C C B H C Th i s p r o g r a m re p r e s e nt s t h e a d m i n i s t r a t iv e a n d m a n a g e r i a l f u n c t io ns f o r t h e B e h a v i o r a l H e a l t h D i v i s io n, a s w e l l c o n t r a c t s a n d t h e b u d g e t a r y l o g i s t i c s o f p as s -t h r u a r r a n g e m e n t s , a n d B e h a v i o r a l H e a l t h F r o n t O f f i c e . P r i m a r y C o n t a c t : H o l l y H a r r i s , D e p u t y D i r e c t or f o r B e h a v i o r a l H e a l t h W e b s i t e : ht t p s ://w w w .d e sc h u t e s .o r g /h e a l t h /p a g e /b e h a v i o r a l -h e a l t h B r oad H e a l t h G o a l s : S a v i n g L i v e s R e d u c e d m or t a l i t y a n d s u i c i d e r a t e s. R e d u c e d s u b s t a n c e a b u s e . R e d u c e d h o s p i t a l i z a t i o n . R e d u c e d in c a r c e r a t i o n . R e d u c e d h o m e l e s s n es s . I n t e n d e d B e n e fi t s f o r C o m m u n i t y M e n t a l H e a l t h E x p a n d a r r a y o f ad di c t i o n s a n d m e n t a l h e a l t h s e r v i c e s . I nt e g r a t e p r i m a r y c a r e s c r e e n i n g a n d c o o r d i n a t io n . R e c e i v e e n h a n c e d M e d i c a i d p a y m e n t r a t e b a s e d o n c o s t s . H ea l t h c ar e I n t e g r a t i o n F o c u s F o c u s o n r ed u c i n g c o s t l y , n e g a t i v e h e a l t h o u t c o m e s u p s t r e a m . I nc r e a s e c oo r d i n a t i o n w i t h p r i m a r y c a r e C o n d u ct r o u t i n e B M I s c r e e n i n g s - h y p e r t e n s i o n , d i a b e t e s , e t c . E n h an c e s y s t e m s t o s ta b i l i z e i n d i v i d ua l s o u t s i de o f e m e r g e nc y d e p a r t m e n t a n d h o s p i t a l t h r o u g h P e e r s , S t a b i li z a t i o n S e r v i c e s , a n d P sy c h i a t r y . P A G E 1 1 FY 24 High lights an d A ccomplishments Implemented a paid internship program and stipends for providing internship supervision. Implemented a 10% differential for south county employees to improve recruitment and retention of south county workforce. Opened the “The Drop” in Redmond to serve youth and young adults in North County. FY 25 Challeng es & Oppo rtunities Continued workforce retention and hiring challenges. Cost of living and housing challenges for new and existing employees. Rising houselessness for our service population. FY 24 Funding Chang es Received $2 million pass-thru funds to support secure residential. FY 25 Program Changes No Changes. FTE Changes and Detail B E H A V I O R A L H E A L T H A D M I N I S T R A T I O N & C C B H C P R O J E C T C O D E : H S B H G E N P A G E 1 2ACCESS A N D I N T E G R A T I O N T h i s p r o g r a m a r e a co ns i s t s o f t h e A c ce s s T e a m an d C l i n i c a l Ad m i n S u p p o r t T e a m (C A S T ). P r i m a r y C o n t a c t : A m b e r C l e g g , P r o g ra m M a n a g e r W e b s i t e : h t t p s ://w w w .d e s c h u t e s .o rg/h ea l t h /p a g e /b e h a v i or a l -h e a l t h -a c c e s s A cc e s s T e a m M a i n e n t r y p o i n t f o r m o s t o f D e s c h u t es C o un t y 's B e h a v i o ra l H ea l t h p r o gr a m s . T h i s t e a m p r o v i d e s s c r e e n i ng , a s s e s s m e nt , p l a c e m e n t r e c o m m e n d a t i o n s , c a r e co o r di n a t i o n , c a s e m a n a g e m e n t , a nd r e fe r r a ls f o r m e n t a l h e a l t h a n d su b s t a n c e u s e d i s o rd e r s e r v i c e s . C l i n i c a l A d m i n i s t rat i v e S u p p o r t T e a m P r o v i d e s c r i t i c a l a d m i n i s t r a t i ve a n d l o gi s t i c a l s u p p o r t f o r d a y -t o -d a y o p e r a t i o ns an d p r o j e c t s , w h i c h r e d u c e s a d mi n i s t r a t i v e b u r d e n f o r c l i n i c a l s t a f f . T h i s T e a m h e l p s m a n a g e a n d r u n r e p o r t s , a s s i s t s w i t h w o r k g ro u p s a n d m e e t i n g s , o r g a n i z e s pr o j e c t s , o ver s e e s f i s c a l p r o c e s s e s , a n d t r a c k s s c h e d u l e s . P A G E 1 3ACCESS A N D I N T E G R A T I O N F Y 2 4 Highlights and Accomplishments F Y 2 5 Chall enges & Opportunities The Access Team participated in and completed the OHA sponsored Rapid Engagement Pilot. The pilot increased awareness of how administrative burden, and lack of flexibility in rules, has negatively impacted clients and clinicians. Advocacy work through this pilot is resulting in some changes to overly prescriptive rules and laws while recognizing there is more work to do. The CAST team met all administrative expectations this year despite staffing shortages and stepping in to help cover other team’s responsibilities, such as, Operations and Front Desk teams when they were short-staffed. Addition of a temporary admin support specialist for our HOST/COAST teams has ensured more equitable distribution of duties and provided needed coverage for the Mike Maier building. Severe staffing shortages affected the Access team’s ability to meet the Access to Care timelines of 7 days consistently in 2023. However, the team is currently staffed at an adequate level, so we anticipate improvements in this metric in FY25. New CCBHC criteria requirements, which will affect clinical and admin staff, will need to be incorporated by January 1, 2025. The CAST team will continue to navigate helping with Front Desk coverage, where needed, due to staffing shortages coupled with an increase in administrative duties due to grant requirements. P A G E 1 4 ACCESS AND INTEGRATION PROJECT CODE: HSACCESS & HSINTEGRAT FY 24 Funding Changes FY 25 P rog ram Changes FTE Changes and Detail No Changes. Access Team- No Changes. CAST Team- TBD. C h i l d , F a m i l y , & Yo un g A d u l t O u t p a t i e n t (C F Y A ) An o u t p a t i e n t t r e a tm en t p r o g r a m t h a t s p e c i a l i z e s i n t h e c ar e a n d t r e a tm e n t f o r c h i l d r e n t h r o u g h y o u n g a d u l t s . S c h o o l B a s e d S e r v i c e s H e a l t h c a r e c l i n i c s t h a t o f f e r a r an g e o f m e d i c a l a n d m e n t al h e a l t h s e r v i c e s l o c a t e d i n a s c h o o l . D C H S o p e r a t e s s e v e n S c ho o l -B a s e d H e a l t h C e n t e r s i n pa r t n e r s h i p w it h L a P i n e C o mm u n i t y H e a l t h an d M o s a i c M e d i c a l . E a r l y A s s e s s m e n t a n d Su pp o r t A l l i a n c e (E A S A ) T h e E A S A t e a m o f f e r s s u p p o r t s e r v ice s t o i n d i v i d ua l s a g e s 1 2 -2 7 , w h o s u f f e r f r o m t h e k i n d o f p s y c h o s i s t h a t w o u l d le a d t o s c h i z o p h r e n i a if l e f t u n t r e a t e d . W r a p a r o u n d (W R A P) C om m u n it y-b a s e d s u p p o r t f o r c h i l d r e n a n d y o u t h w h o s e m e n t a l h e a l t h n e e ds h a v e n o t b e e n m e t t h r o u g h u su a l s e r v i c e s , a n d t h e i r f a m i l i e s . Y o u n g A d u l t s i n T r a n s i t io n (YA T ) T h e YA T t e a m o f f e r s s up p o r t a n d s e rvi c e s f or a g e s 1 4 -2 4 w h o s u f f e r f r o m m e n ta l h e a l t h a nd /o r b e h a v i o ra l c h a l l e n g e s . T r a n s i t i o na l t r e a t m e n t a n d i n t e r v e n t i o n h e lp s y o u n g ad u l t s t o g r a d u a t e s c h o o l , l i v e a h e a l t h y , p o s i t i v e l i f e a n d b e a c o n f i d e n t a n d b e n e f i c i a l m e m b e r o f o u r c o m m u n i t y . Th e D r o p T h e D ro p s e r v e s y o un g a d u l t s a g e s 1 4 t o 2 7 . Of f e r i ng Pee r S u p p o r t , g u e s t s p e a k e r s , g a m e s , d i s c u s s i o n a n d s o c i a l i z a t i o n , a nd l i f e s k i l l s i n t r o d u ct i o n s. Th e B e h av i o r a l H e a l t h Re s o u r c e s N e t w o r k (B H R N ) T e a m P r o v i d e s su b s t a n c e u s e d i s o r d e r t re a t m e n t , pe e r s u p p o r t , h a r m r e d u c t i o n a n d r e c o v e r s e r v i c e s t o Y o ut h a n d Y o u n g a d u l t s . 9 0 1 U N I Q U E C L I E N T V I S I T S A T T H E D R O P C E N T E R 4 6 % P A G E 1 5COMPREHENSIVE C A R E F O R Y O U T H A N D F A M I L I E S C o m pr e h e n s i v e C a re f o r Y o ut h & F a m i l i e s p r o v i d e s s p e c i a l t y m e n t a l h e a l t h c a r e a n d s u b s t a n c e a b u s e t r e a t m e n t f o r i n d i v i d u a l ’s a g e s 0 -2 7 a n d t h e i r f a m i l i e s t h r o u g h a n a r r a y o f i n t e g r a t e d , i n t e n s i v e o u t p a t i e n t c a r e t e a m s : E A S A , Y A T , W r a p a r o u n d , 2 Y o u n g Ad u l t D r o p -i n C e n te r s , 7 S c h o o l B a s e d H e a l t h C e nt e r s , B H R N C o -O c c u r r i n g S e rv i c e s , a n d C h i l d , F a m i l y & Yo u n g A du l t O u t p a t i e n t . P r i m a r y C o n t a c t : S ha n n o n B r i s t er -R a u g u s t , P r o g ram M a n a g e r W e b s i t e : ht t p s ://w w w .d e sc h u t e s .o r g /h e a l t h /p a g e /c o m p r e h e n s i v e -c a r e - y o u t h -a n d -f a m i l i e s P A G E 1 6COMPREHENSIVE C A R E F O R Y O U T H A N D F A M I L I E S FY 24 Highlights and Accomplishments FY 25 Chal lenges & Op portuni ties Expansion of services in Redmond bringing a Drop-In Center, Wraparound, Early Assessment and Support Alliance (EASA), and Young Adults in Transition services to a rapidly growing. Awarded a $250K EASA Stimulus grant which was utilized to contract for shelter care beds with the Bethlehem Inn, resulting in the hospital diversion of 10 encounters through housing stability and intensive care coordination for young people experiencing their first episode of psychosis. Contracted with The Loft, to ensure shelter care beds were available to young adults resulting in diversion of legal involvement, hospitalization, and increased community stabilization. The grand opening of the Kingwood campus in Redmond will see an increase in local support to North County clients. Having Intensive Youth Services in North County will decrease transportation barriers and expand support to Children and Families. Opportunity to create a Comprehensive Child & Family clinic at the Wall Street Services Building by moving staff from Courtney to Wall Street Services. This move will consolidate resources to one primary Bend location, decrease transportation barriers, and maximize resources currently spread between multiple sites. Children’s residential services in Central Oregon continue to be a major gap in our community’s continuum of care. Continued work with Oregon Health Authority and key stakeholders in 2025 is necessary to support this need. P A G E 1 7COMPREHENSIVE C A R E F O R Y O U T H A N D F A M I L I E S P R O J E C T C O D E : H S I N T Y O U T H FY 24 Fund ing Changes FY 25 Program Chang es FTE Changes and Detail August 30, 2024, the 4-year, $4 million System of Care Expansion Grant will end. While this program is fiscally sustainable through the Wraparound Per Member Per Month payment structure, there is an unintended impact to the overall Perspective Payment model as a CCBHC resulting in a loss of income based on a fee for service billings. The PMPM model only funds client with Oregon Health Plan, who are capitated to Pacific Source. There is an opportunity to begin capturing Fee for Service payment for Oregon Health Plan members not capitated billing H2021. This has not been an option in years past, but recently approved under the 2024 Fee Schedule. No Changes. P A G E 1 8CRISIS T h e C r i s i s p ro g r a m p r o v i d e s 2 4 /7 c r i s i s s e rv i c e s i n c l u d i n g f a c e -t o -f a c e e v a l u a t io ns i n t h e c o m m u n i t y a n d c l i n i c , a s w e l l a s d i v e r t s i n d i v i d u a l s w i t h a s e r i o u s a n d p e r s i s t en t m e n t a l i l l n e s s (S P M I ) f r o m t h e h o s p i t a l a n d c r i m i n a l j u s t i c e s y s t e m wh e n a p p r o p r i a t e . P r i m a r y C o n t a c t : A d a m G o g g i n s , Pr o g r a m M a na g e r W e b s i t e : h t t p s ://w w w .d e s c h u t e s .o r g /h e a l th /p a g e /cr i s i s -s e r v i c e s 2 4-H o u r C r i s i s P h o n e L in e A v a il a b l e 2 4 /7 t o a n y o n e w h o is ex p e r i e n c i n g a cr i s i s /n e e d s c r i si s s u p p or t . W a l k -i n C r i s i s S e r v i c e s a n d S t a b i l i z a t i o n S e r v i c e s P r o v i d e s i m m e d i a t e a c c e s s t o i n d i v i d u a l s e x p e r i e n c i ng a c r i si s . B ri e f s t a b i l i z a t i o n o p e n t o p e o p l e o f a l l a g e s . 2 4/7 C o m m u n i t y C r i s i s A s s e s s m e n t T e a m (C C R T) A t e a m t h a t p ro v i d e s c r i si s i n t e r v e n t i o n se r v i c e s o u t i n t h e c o m m u n i t y . C o -r e s p o n d e r P r o g r am A c l i n i c i a n a n d o f f i c e r r e s p o n d t og e t he r t o m e n t a l h e a l t h r e l a t e d c a l l s . C i v i l C o m m i t m e n t I nv e s t i g a t i o n s A C e r t i f i e d C i v i l C o m m i t m e n t I n v e s t i g a t or m o n i t o r s i n d i v i d u a l s p l a c e d o n a t w o -p h y s i c i a n i n v o l u n t a r y h o l d a n d a l l c i v i l c o m m i t m e n t s w i t h i n D e s c h u t e s C o u n t y . C a s e M a n a g e m e n t L i a is e s w i t h t h e h o s p i t a l a n d B r o o k s R es p i t e f o r d i s c h a r g e p l a n n i n g t o h e l p c l i e nt s w i t h b a s i c n e e d s a n d c o m m u n i t y r e s o u r c e s . P e e r S u p p o r t P e er S u p p o r t S p e c i a l i s t s a r e i n d i v i d u a l s w i t h l i fe e x p e r i e n c e o f m e n t a l h e a l th a n d /o r s u b s ta n c e u s e d i s o r d e r s w h o a r e i n r eco v e r y . T h e y o f fe r s u p p o r t a n d e n c o u r a g e m e n t t o i n d i v i d u a l s s t r u g g l i n g w i t h a m e n t a l h e a l t h c o n di t i o n . F o r e n s i c D i v e r s i o n P r o g r a m A t e a m o f P e e r S u p p o r t Sp e c i a l is t s a n d C a s e M a n a g er s d e d i c a t e d t o s u p p o r t i n g i n d i v i d u a l s w i t h a s e r i o u s a n d p e r s i st e n t m e n t a l i l l n es s (S P M I ) wh o ar e f r e q u e n t ly h a v i n g c o n t a c t w i t h l a w e n f o r c e m e n t a n d t h e c r i m in a l j u s t i c e s y st e m . 1 3 4 2 P E O P L E S E R V E D T H R O U G H C R I S I S W A L K -I N 2 9 % 1 2 9 1 N U M B E R O F E M E R G E N C Y D E P A R T M E N T D I V E R S I O N S 1 8 4 % 3 4 0 N U M B E R O F P E O P L E D R O P P E D O F F B Y L A W E N F O R C E M E N T 3 2 % W o r k f o r c e r e c r u i t m e n t h a s been a n o n g o i n g i s s u e f o r o u r d e p a r tm en t . P o s i t i o n s w i l l o f t e n b e l e f t o p e n f o r s e v e ra l m o n t h s a t a t i m e a n d w e w i l l ha v e v e r y f e w c a n d i d a t e s a p p l y f o r a p o s i t i on . T h e C o m m u n i t y C r i s i s R e s p o n s e T e a m (C C R T ) t e a m ’s o p e r a t i o n a nd d e v e l o p m e n t w i l l c o n t i n u e t o b e a p r i o r i t y . Fu n di n g i s a n o th e r c h a l l e n g e a s s e v e ra l o f o u r g r a n t s a r e s e t t o e x p i r e i n F Y 2 5 i n c l u d i n g I M P A C T S , C i t y o f B e n d , a n d C o -R e s p o nd e r G r a n t . W e a r e l o o k i n g f o r w a y s t o r e -a pp l y f o r g r a n ts a n d f i n d i n g s u s t a i n a b l e s o u r c e s o f f u n d i n g . P A G E 1 9CRISIS FY 24 Hi ghlights and Acco mplis hmen ts FY 25 Challenges & Opportunities T h e D e s c h u t e s C o u n t y S t a b i l i z a t i o n C e n t e r w a s a w a r d e d t h e 2 0 2 3 N o r t h w e s t C I T C o m m u n i t y R e s o ur c e o f t h e Y e ar , ce l e b r a te d t h r e e y e a r s o f o p e r a t io n , a n d t h e i r 1 0 ,0 00 t h e nc o u n t e r. T h e C o m m u n i t y C r i s i s R e s po n s e T ea m (C C R T ) t e am w a s l a u n c h e d o n M a y 1 s t , 2 0 2 3 , a n d c o n t i n u e s t o s u c c e s s f u l ly r e s p o n d t o c r i s i s i n t h e c o m m u n i t y w i th o u t l a w e nf o r c e m e n t . A n e s t i m a t e d t o t a l o f 8 3 .5 % o f c a l l s f o r s e r v i c e w e r e r e s o l v e d w i t h o u t la w e n fo r c e m e n t . The civil commitment and investigation program continues to function but struggles with ongoing funding to meet current work demand. At this time, we are underfunded for this mandated service given our current needs. P A G E 2 0CRISIS P R O J E C T C O D E : H S C R I S I S FY 24 Funding Chang es FY 25 Program Changes FTE Changes and Detail The IMPACTS grant has automatically granted an extension through 2025. The SAMHSA co-responder grant will be ending in September 2024. The SAMHSA Co-Responder grant will be coming to a close in September. DHS The Department of Human Services – Office of Developmental Disability Services provides Medicaid and State General Fund dollars to CDDPs (Community Developmental Disability Programs) to provide eligibility determination, case management, abuse investigations, licensing and certification for foster homes for persons with IDD within the community. Case Management: Case management services are provided to all eligible kids and adults. Adult Abuse Investigation: Investigative authority for I/DD Adults in Deschutes, Crook and Jefferson Counties. Foster Home Licensing : Adult and child foster licensing, certification, renewal and monitoring. Case Management Case Management is fully funded when: Rapid Response to changing needs or crisis situations. Services are coordinated with community partners. Assurance that individual needs and goals are being met. Long term relationship with their Service Coordinators. Prevention and protection from abuse and neglect. Timely access to medical supports, employment, and housing. In order to participate in the match program the following must be met: Actual expenses are more than State base rate (FY25 expenses must be >$4,690,825. Reach service goals (# of encounters): 11k encounters per year. Have enough CGF (approximately 41% of A). Have enough CGF for uncovered indirect costs. Match Program $7.8M I/DD OperationalBudget 48.85FTE Intellectual and Developmental Disability Services (I/DD) To Promote and Protect the Health and Safety of Our Community Janice Garceau Holly Harris 12% Budget supportedby General Funds Community Based Care Behavioral Health Director Health Services Director People with intellectual and developmental disabilities (I/DD) often need community- based long term supports and services to support their needs and to live as independently as possible. This includes person centered case management, voluntary choice of services, services that span lifetime, and assistance for clients to access all services they are interested in. How the System is Funded: Core Services IDD Funding Model DHS conducts a “workload model” study each biennium. Study measures the scope, frequency and duration of all tasks performed by (CDDPs) using caseload data paired with forecasting of population growth to determine funding needed. P A G E 2 2INTELLECTUAL D E V E L O P M E N T A L D I S A B I L I T I E S I /D D pr o v i d es s u p p o r t t o p e o p l e w i t h i n t el l e c t u a l an d /o r d e v e l op m e n t a l d i s a b i l i t i e s (I /D D ), t o en a b l e t h e m t o l i v e a s i n de p e n d e n t l y a s p o s s i b l e i n t h e le a s t r e s t r i c t i v e e n v i r o n m e n t . S e r vi ce s a r e a i m e d at g r e a t e r a c c e s s t o s o c i a l i n t e ra c t i o n , c o m mu n i t y e n ga g e m e n t , a n d e m p l o y m e n t o p p o r t u n i t i e s. P r i m a r y C o n ta c t : P a ul P a r t r i d g e , P r o g r a m M a n a g e r We b s i t e: h t t p s ://w w w .d es c h u t e s .o r g /h e a l t h /p a g e /i n t e l l e c t u a l d e v e l o p m e n t a l - d i s a b i l i t i e s -p r o g r a m I n t e l l e c t u a l/D e v e l o p m e n t a l D i s a b i l i t y S e r v i c e s A v a i l a b l e i n De s c h u t e s C o u n t y: I n t a ke , e l i g i b i l i t y d e t er m i n a t i o n , r e f e r r a l Ca s e ma n a g e m e n t a n d s e r v i c e c o o r d i n a t i o n f o r a d u l t s a n d c h il d r e n I n d i v i d u a l i z e d p l a n n i n g a n d s u p p o r t P r o t e c t i v e s e r v i c e i n v e s t i g a t i o n s a n d s u p p o r t (f o r a d u l t s) V o c a t i o n a l s e r v i c e s R e s i d e n t i a l s e rvi c e s F a m i l y s u p p o r t Co m p r e h e n s i v e i n -h om e s u pp o r t s F o s t e r c a r e E m p l o y m e n t F i r s t 1 0 0 % I n d ivi d u a l S e r v i c e P l a n s R e n e w e d o n Time P A G E 2 3INTELLECTUAL D E V E L O P M E N T A L D I S A B I L I T I E S FY 24 Highlights and Accomplishments FY 25 Chal lenges & Op portuni ties The I/DD program completed a diversity, equity and inclusion plan reflective of last year’s self-assessment. The plan includes strategies to improve access to services for our entire I/DD community. Engaged in an ongoing project to analyze all our critical workflows in an effort to assure continued improvements toward the service of our mission. Began transition to a new service location in Redmond to better serve our residents in the northern end of Deschutes County. Continuing and refining community partnerships that will lead to improved access to mental health treatment for individuals with I/DD who experience a co-occurring mental health diagnosis. Continue the analysis and creation of visual workflows for our critical work processes as part of our ongoing quality assurance efforts. Operational adjustments continue as we stand up a new office location on Antler Avenue in Redmond, and a new Bend location spring 2024. P A G E 2 4INTELLECTUAL D E V E L O P M E N T A L D I S A B I L I T I E S P R O J E C T C O D E : H S I D D FY 24 Funding Chan ges FY 25 Program Changes FTE Changes and Detail No Changes. Rebalanced workload-$282 thousand and anticipated 1 FTE Admin Support. P A G E 2 5INTENSIVE A D U L T T h i s p r o g r a m p r o v i d e s in t e n s i v e ou t r e a c h , e n g a g e m e n t a n d c o m m u n i t y - b a s e d t r e a t m e n t a n d s u p p o rt s t o i n d i v i d u a l s w i t h s e v e r e an d p e r s i s t e n t m e n t a l i l l n e s s an d s u b s tan c e u s e d i s o r d e r s . P r i m a r y C o n t a c t : K a r a C r o n i n , P r o g r a m M a n a g e r h t t p s ://w w w .d e s c h u t e s.o r g /he a l t h /p a g e /i n t e n s i v e -a d ul t -s e r vi c e s A s s e r t i ve C o m m u n i t y T r e a t m e n t (A C T ) A C T i s a c o m m u n i t y -b a s e d p r o g r a m t h a t p r o v i d e s i nt e n s i v e c o m m u ni t y b a s e d b e ha v i o r a l h e a l t h t r e a t m e n t t o a d ul t s w i t h S e v e r e a n d Per s i s t e n t M e n t a l I l l n e s s (S P M I ). A C T ’s h i g h i n t e n s i t y s u p p o r t s s e r v e s i nd i v i d u al s w h o a r e mo s t a t -r i s k f o r p s y c h i a t r i c ho s p i t a l i z a t i o n a n d f o r w h o m t r a d i t i o n a l o u t p a t i e n t s e r v i c e s h a v e n o t be e n s u c c e s s f u l . Co m m u ni t y O u t r e ac h a n d S t a b i l i z a t i o n T e a m (C O A S T ) C OA S T is a g r ou p o f s p e c i a l t y p r og r a m s t h a t p r o v i d e s e r v i c e s to i n di v i d u a l s w i t h S P M I d i a g n o s i s . Co m m u ni t y S u p po r t S e rv i c e s (C S S ) C S S O u t p a t i e n t T r e a t m e n t T e a m pr o v i d es a b l e n d of c o m m u n i t y a n d o f f i ce b a s e d s e r v ice s , fo c u s e d o n i n t e n s i v e t r e a t m e n t a n d s u p p o r t s f o r i n d i v i du a l s l i v i n g w i t h a S P M I . H a r r i m a n H e a l t h C a r e - P e e r S u p p o rt S p e c i a l i s t s o n t h e C S S tea m w o r k i n c o o rd i n a t i o n w i th t h e c o -l o cat e d a n d in t e gr a t e d M o sa i c M e d i c a l p r i m a r y c a r e c l i n i c , t o i m p r o v e m e d i c a l a n d beh a v i o r a l h e a l t h o u t c o m e s f o r p e o p l e w it h SP M I . I n t e n s i v e F o r e n s i c S e r v i c e s T h i s p r o g r a m s e r v e s i nd i v i d u al s u n d e r t h e j u r i s d i c t io n o f t h e S t a te P s y c h i a t r i c S e c u r i t y R e v i e w B o a r d . I n d i v i d u a l s r e c e iv e m o n i t o r i n g s p e c i f i c t o t h e c o n d it i o n s o f th e i r c o m m u n i t y r e le a s e a s we l l a s t r e a t m e n t , c a s e ma n a g e m e n t a n d o t h e r s e r v i c e s a s i n d i c a t e d . H o m e l e s s O u t r e a c h S e r v i c e s T e am a n d H a r m R e du c t i o n P ro g r a m H O S T t e a m p r o v i d e s s t r e e t o u t r e a c h a n d c a s e m a n a g e m e n t s u p p o r t t o h o u s e l e s s i n d i v i d u a l s w i t h S e r i o u s M e n t al I ll n e s s a n d /o r S u bs t a n c e U s e D i s o r d e r s . HR P pr o v i d es s y r i n g e e x c h a n g e , N a r c a n a n d o t h e r s u p p l i e s a n d su p p o r t s t o p e o p l e w h o u s e d ru g s , w i t h t h e g o a l o f r e d u c i n g h e a l t h a n d s a f e t y r i s k s a ss o c i a t e d w i t h s ub s t a n c e u s e . P A G E 2 6INTENSIVE A D U L T F Y 24 Highlights and Ac complishme nts F Y 25 Challenges & Opportunities Continue to be a model in the state for Aid and Assist programming and met statewide metrics for community consultation timelines. Launched an outreach psychiatry pilot program – low barrier access for houseless population. Continue to see positive client health outcomes though our integrated and embedded Mosaic Health clinic. Shelter, housing and residential placement options continue to be limited for our clientele. Continue to struggle to support an increasingly acute client population. Staffing hard to fill positions continues to impact services. 1 7 4 O v e r d o s e R e v e r s a l s f ro m D C H S H ar m R e du c tio n Ser v i c e s P A G E 2 7INTENSIVE A D U L T P R O J E C T C O D E : H S A D L T I N T FY 24 Fundi ng Chan ges FY 25 Program Changes FTE Changes and Detail $1 million in state funding dedicated to an aid and assist community navigator pilot program. No Changes. P A G E 2 8OUTPATIENT C O M P L E X C A R E Th e s e p ro g r a m s p r o v i d e e v i d e n c e b a s e d , i nd i v i d u a l a n d g r o u p t r e a t m e n t , i n c l u d i n g c o u n s e l i n g , c a s e m a n a g e m e n t a n d p e e r s u p p o r t s e r v i c e s t o a d u l ts , c h i l d r e n a n d f a m i l i es w i t h m e n t a l h e a l t h a n d /o r a l c o h o l /d r u g c o n c e r n s , wi t h a f o c u s o n i n t e g r a t e d c a r e . P r i m a r y C o n t a c t : Kr i s t i n M o z z o c h i , Pr o g r a m M a n a g e r W e b s i t e : ht t p s ://w w w .d e sc h u t e s .o r g /h e a l t h /p a g e /a d u l t -o u t p a t i e n t -s e r v i c e s Ad u l t O u t p a t i e n t In t e g r a t e d C a r e (A O P I C ) L o c a t e d a t o u r C o u r t n e y C l i n i c i n B e n d , o u r A O P I C t e a m p r o v i d e s o u t pa t i e nt me n t a l h e a l t h c a r e w i t h a f o c u s o n p r o v i d i n g t r e a t m e n t i n pa r t n e r s h i p w it h M o sa i c m e d i c a l t o s e r v e p e o p l e w h o a r e e x p e r i e n c i n g c o - o c c u r r i n g me n t a l h e a l t h , c h r o n i c m e d i c a l , a n d su b s t a n c e u s e c h a l l e n g e s . Ad u l t O u t p a t i e n t C o m p l e x C a r e (A O P C C ) L o c a t e d a t o u r C o u r t n e y C l i n i c i n B e n d , o u r A O P I C t e a m p r o v i d e s o u t pa t i e nt me n t a l h e a l t h c a r e w i t h a f o c u s o n p r o v i d i n g t r e a t m e n t i n pa r t n e r s h i p w it h M o sa i c m e d i c a l t o s e r v e p e o p l e w h o a r e e x p e r i e n c i n g c o - o c c u r r i n g me n t a l h e a l t h , c h r o n i c m e d i c a l , a n d su b s t a n c e u s e c h a l l e n g e s . S o u t h C o u n t y H ub (S o C o ) L o c a t e d i n L a P i ne, p r o v i d e s o u tp a t i e n t m e n t a l h e a lt h a n d s u b st a n c e u s e t r e a t m e n t t o a l l a g e s i n S o u t h D e s c h u t e s C o u n t y a nd N o r t h K l a m a t h C o u nt y. S e r v i c e s i n c l u d e c ou n s el in g , p s y c h i a t r i c c a re , c a s e m a n a g e m e n t , p e e r s u p p o r t , s up p o r ted e mp l o y m e n t , a n d c a r e c o o rd i n a t i o n . O u r S o C o H u b pa r t n e r s w i t h L a P i n e C o m m u n i ty H e al th C e n t e r t o s up p o r t c li e n t s i n m e e t i n g t h e i r h e a l t h a n d w e l l n e s s g o a l s . N o r t h C o u n t y H u b (N o C o ) L o c a t e d i n R ed m o n d , p r o v i d e s o u t p a t i e n t m e n t al h e a l t h a n d s u b s t a n c e us e t r e a t m e n t s e r v i c e s t o p e op l e o f a l l a g e s w i t h a f o c u s on i m p r o v i n g h e a l t h a n d w e l l be i n g . C o m m u n i ty an d o f f i c e b a s e d s e r v i c e s a r e of f e r e d t o r e s i d e nt s o f N o r t h e r n D e s c h u t e s Co u n t y . A m u l t i di s c i p l i n a r y t e a m a p p r o a c h i s u t i l i z e d t o s u p p o rt p e o p l e i n m e e t i n g t h e i r t r e a t m e n t g o a l s . M o s a i c M e d ica l pr o v i des o n s i te m e di c a l c a r e , w o r k i n g i n p a rt n e r sh i p w i t h o ur N o C o s t a f f . P A G E 2 9OUTPATIENT C O M P L E X C A R E FY 24 Highl ights and Accomplishments FY 25 Chal lenges & Op portu nities Our North County Outpatient Clinic moved into a beautiful new building on Kingwood Ave. Mosaic Medical is collocated within, strengthening our integration efforts. Most clinical staff are now dually credentialed and able to provide co- occurring mental health and substance use treatment. Many staff also have specialized training in CPT and EMDR to treat individuals who are living with the impacts of trauma. Our joint AOP and Mosaic client numbers have increased this year from 130 in January 2023 to 167 in December 2023. Continued improvements in care coordination through collaborative consults and process improvements. South County Hub is supported by a new supervisor and is fully staffed after years of staffing issues, this is a major accomplishment. Client access to care has been an ongoing issue due to staffing issues and the number of people who are needing services. High level of acuity and complex needs of the population we serve coupled with a lack of access to needed resources including higher levels of care and housing. P A G E 3 0OUTPATIENT C O M P L E X C A R E P R O J E C T C O D E : H S A D U L T , H S N O C O , H S S O C O F Y 2 4 Funding Changes F Y 2 5 Program Changes FTE Changes and Detail Awarded the Veterans Behavioral Health Peer Support Specialist grant. This grant will provide funding for our VBHPSS to continue outreaching and supporting veterans in our community. Promoting Integration of Primary and Behavioral Health Care (PIPBHC) grant ended December 2023. No Changes. S t r e e t P s y c h i a t ry O u t r e a c h P r o v i d e r s ro t a t e on e t i m e a m o n t h f o r h a l f a d a y p a r t n e r i n g w i t h t h e h o m e l e s s o u t r e a c h t e a m t o b r i n g p s ych i a t r i c s e r v i c e s d i re c t l y t o C h i n a H a t . M u c h o f t h e w o r k i s b u i l d i n g r a p p o r t a n d w o r k i n g t o i d e n t i f y p e o p l e s u f f e r i ng f r o m s e v e r e m e n t a l i l l nes s a n a s s e s s m e n t, m e d i c a t i o n i f i n d i c a t e d , a n d c o n n e c t i o n t o s er v i c e s . Ad d i c t i o n M e d i c i n e P r o g r a m m i n g U s e k n o w l e d g e a n d e x p e r t i s e o f o u r s t a f f t o e n h a nc e o ur S U D S e r v i c e s a g e n c y w i d e . P A G E 3 1MEDICAL T E A M Th i s p r o g r a m i n t e g r a t e s p s y c h i a t r y i nt o a l l D e s c hu te s C o u nt y B e h a v i o r a l H ea l t h c l in i c a l s e r v i c e s a n d s o m e M o s a i c M e d i c a l C l i n i c s . T h e M e d i c a l Te a m c o l l a b o r a t e s w it h p r i m a r y c a r e t o p r o v i d e i n t egr a t e d , h o l i s ti c c a r e a n d s up p o rt s h e a l t h p r o m o t i o n , h e a l t h l i t e r a c y , a n d h ea l t h m a i n t e n a n c e f o r c l i e n t s . P r i m a r y C o n t a c t : C h a nd r a M o l a , P r o g r a m M a nage r W e b s i t e : ht t p s ://w w w .d e s c h u t e s .o r g /h e a l t h /p a g e / FY 24 Highlig hts and Acco m plishmen ts Implemented street psychiatry outreach in partnership with the HOST team. Added a board-certified addiction medicine psychiatrist. Restructured our LMP staffing model to include the leadership of a psychiatrist embedded with all teams by the end of the fiscal year. FY 25 Cha llenges & Oppor tunities Expanding our addiction medicine programing. Anticipate continued staffing challenges for nurses and psychiatric nurse practitioners due to wage gaps compared to community partners. Further integrating services with Mosaic Medical. FY 24 Funding Chang es May request to convert current contract dollars to a 1.0 FTE. FY 25 Program Chan ges Plan to transition current contracted telehealth services to in-person Psychiatrists and Psychiatric Nurse Practitioners. Public Health To Promote and Protect the Health and Safety of Our Community$18M Public Health Operating Budget Budget Janice Garceau Heather Kaisner Prevent, investigate and protect people from communicable diseases. Ensure safe food and water. Promote health and prevent chronic disease and injury. Prepare for and respond to natural or human caused emergencies and emerging health threats. Ensure equitable access to preventive health services. Create and ensure conditions that equitably improve health and well- being for all. Foster policy, systems and environmental change to prevent and reduce unhealthy behaviors and reduce healthcare costs. Convene community engagement to sustainably prioritize change across multiple sectors and systems of care. Local Public Health Authority: County Commissioners - BoCC. Local Public Health Agency (LPHA): Deschutes County Public Health Division is authorized by the BoCC to perform Public Health requirements and responsibilities on behalf of the county (Public Health is a division of Health Services). Local Public Health Administrator: DCHS PH Director, authorized by the BoCC to oversee the Local Public Health Agency. 23% Budget supported by General Funds What We Do Local Public Health Delegations of Authority Public Health Director Health Services Director 95.68FTE Public Health promotes and protects the health of everyone who lives, works, and plays in Deschutes County: Public Health Sections Statutorily or contract required services and grant funded programs How the System is Funded: Provides Environmental Health, Local and Regional Epidemiology. All hazards emergency preparedness and resiliency for emerging health hazards. Provides both direct COVID-19 recovery services, health preparedness education, technical assistance, and equitable community outreach. Lead work with community partners to promote and ensure practices that improve health and well-being and prevent negative conditions that are harmful to our community both socially and financially. Public Health clinical services including family planning and STI testing and treatment. Family-focused services including home visiting nurses, perinatal care coordination and Women, Infants and Children (WIC) nutritional support. Prevention & Health Promotion FTE 17.40 Clinical & Family Services FTE 33.03 Preparedness Engagement & Environmental Health 22.70 Communicable Disease Prevention & Management FTE 12.30 PH Administration FTE 10.25 Provides Public Health Advisory Board (PHAB) Coordination, Ambulance Service Area (ASA) Administration and Legislative Advocacy, leadership, support, and oversight for local public health programs and services and assures statutory, fiscal, and programmatic requirements are met. Works to diversify and leverage resources to meet community health needs and assure the effective and efficient use of resources. Prevent and control the spread of communicable diseases and mitigate health threats through surveillance, education, investigation, outbreak control and immunizations. Include communicable-disease/STD/HIV/TB and Immunization Programs. OHA Grants The Oregon Health Authority provides Federal Grant and State General Fund dollars to local public health authorities through the Intergovernmental Agreement (IGA) for the Financing of Public Health Services. The IGA sets forth the duties, functions and responsibilities of the local public health authority. A limited number of Public Health services collect fees through licensing, birth and death certificates, and insurance billing for clinical preventative services. Deschutes County Public Health receives local, state, and federal grant funds. Most grants are time limited and cover distinct costs and programs. Fee for Service CGF Local resources applied to help cover costs of mandated or other county service priorities not covered by other revenue sources. P U B L I C H E A L T H K E Y S T A T I S T I C S S T A T I S T I C S P A G E 3 4 B r o a d P u b l i c He a l t h G o a l : P r o m o t e a nd p r o t e c t t h e h e a l t h o f p e o p l e i n D e s c h u t e s C ou n t y t h r o u g h : P r e v e n t i n g t h e s p r e a d o f c o m m u n i c a b l e d i s e a s es an d o u t b r e a k s . F o o d a n d c o n s u m e r s a f e t y . C l e a n a n d s a f e d r i n k i n g w a t e r . E n s u r i n g a c c e s s t o e s s e n t i a l p r e v e n t a t i v e h e a l t h s e r v i c e s . H e l p i n g n e w p a r e n t s a n d b a b i e s g e t o f f t o a h e a l t h y s t a r t . E du c a t i o n a b o ut h e a l th y l i f e st y l e s. R e d u c i n g an d pr e v e n t i n g h i g h -r i s k b e h a v i o r s a m o n g y o u t h . R e s p o n d i n g t o p a n d e m i c s , c l i m a te i m p a c ts , a n d o t h e r e m e r g i ng h e a l th t h r e a t s . P u b l i c H ea l t h M o de r n i z a t i o n : A s e t o f f o u n d a t i o na l c a p a b i l i t i e s a n d p r o g r a m s t o e n s u r e a c o r e s e t o f p u b l i c h e a l th s e rvi c e s i s a v a i l a bl e i n e v e r y c o u n t y i n O r e g o n . D e s c h u t e s C o u n t y Pu b l i c H e al th c on t i n u e s to m o v e t o w a r d f u l l i m p l e m e n t a t i on o f P u b l i c H e a l t h M o d e r n i z a t i o n a n d r e c e i v e d i n c r e a s e d S t a t e f un d i n g i n t h e F Y 2 4 -2 5 B i e n n i u m . T h i s p u b l i c h e a l t h t r a n s f o r m a t i o n f o c u s e s o n e n s u r i n g a l l c o m m u n i t i e s h a v e t h e s a m e h e a l t h p r o t e c t i o n s t h r o u g h a s u s t a i na b l e p u b l i c h e a l th s y s t e m r e ad y t o r e s p o n d t o c u r r e n t a n d f u t u r e p u b l i c h e a l t h c h a l l e n ges . P A G E 3 5PUBLIC H E A L T H A D M I N I S T R A T I O N T h is p r o g r a m p r o vi d e s l ea d e r s h i p , m a n a g e m e n t a n d o v e r s i g h t f o r l o c a l p u b l i c h e a l t h (P H ) s e r vi ce s a n d a s s u r e s t h a t t h e c o u n t y m e e t s s t a t u t o r y , f i s c a l a n d p r o g r a m mat i c r e qu i r e m e n t s. P H A d m i n i s t r a t i o n w o r ks t o d i v e r s i f y , l e v e r a g e a n d a s s u r e e f fe c t i ve an d e f f i c i e n t u s e o f r e s o u r c e s t o b u i l d f o u n d a ti o n a l p r o g r a m s a nd c a p a b i l i t i e s a s w e l l a s m e e t c om m un i t y p r i o r i ti e s a n d r e s p o n d t o e m er g i n g p u b l i c h e a l t h i s s u e s . P r i m a r y C o n t a c t : H e a t h e r K a i s n e r , D e p u t y D i r e c t o r f o r P u b l i c H e a l t h W e b s i t e : h t t p s ://w w w .d e s c hu t e s .o r g /h e a l t h /p a g e/p u b l i c -h e a l t h Stable funding for Public Health to prevent and respond to emerging issues and threats continues to be a challenge; especially as COVID funding comes to an end. Continued increase in complicated syphilis cases yet no increase in resources to tackle this growing epidemic. Increased collaboration and coordination among multiple internal teams and external community partners to respond to the growing fentanyl crisis. Recruiting and retaining clinical public health positions, such as RNs and NPs continues to be a challenge. P A G E 3 6 FY 24 Highlights and Accomplishments F Y 25 Chall enges & Opportunities Opened the North County Public Health Campus to provide public health services in Redmond, including Reproductive Health, STD screening, WIC, and Immunizations. Successfully applied and received an increase of 685 thousand in Modernization funding with a total of $2.66 million awarded for the FY 24- 25 biennium. Transitioned the Emergency Preparedness & COVID-19 Recovery Section to a sustainable Preparedness, Engagement & Environmental Health Section focused on core public health foundational capabilities and programs. FY 24 Funding Changes F Y 25 Progra m Cha nges FTE Changes and Detail PE51-03 ending: $176 thousand in FY24. Re-structured Public Health to better align and sustain core programs and services. Moved from five to four Public Health Sections, including: Communicable Disease Prevention & Management. Clinical & Family Services. Prevention & Health Promotion. Preparedness, Engagement, & Environmental Health. P H A D M I N I S T R A T I O N P R O J E C T C O D E : H S P H G E N C l i n i c a l S e r v i c e s P ro v i d e s f r e e o r l o w -c o s t b i r t h c o n t r ol (f o r a l l a g e s & g e n d e r s ), a n n ua l e x a m s f o r w o m e n a n d S T D p r e v e n t i o n , t e s t i n g & t r e a t m e nt f o r a l l . F a m i l y Su pp o r t S e r v i c e s P ro v i d e s d i r e c t n u r s in g s u p p o r t a n d r e f e r r a l s t o p r e g n a n t a n d p o st p a r t u m w o m e n , ca r e g i v e r s , a n d t h e i r f a m i l i e s t o i m p r o v e b i r t h o u t c o m e s , a n d f a m i l i e s o f c hi l d r e n w i t h s p e c i a l h e a l t h c a r e n e e d s t o i n c r e a s e ac c e s s t o h e a l t h s e r v i c e s a n d i m p r o ve f a m i l y r e l at i o n sh i p s . P e r i n a t a l C a r e C o o r d i na t i o n P ro v i d e s p r e g n a n t a n d p o s t p a r t u m i n d i v i d u a l s a c c e ss t o a n d e n r o l lm en t i n p r e n a t a l c a r e , m e d ic a l i n s u r a n c e a p p l i c a t i o n as s i st a n c e , n u t r i t i o n r e s o u r c e s, b e h a v i o r a l h e a l t h a n d d e n t a l c a r e c o o r d i n at i o n , m e d i c a l tr a ns p o r t a t i o n , a n d m a n y o t h e r s e r v i c e s . W o me n , I n f a n t s & C h i l d r e n (W I C ) P ro v i d e s n u t r i t i o n e d uca t i o n , br e a s t f e e d i n g s u p p o r t , a c c e s s t o h e a l t h y f o o d s , a n d r e f e r r al s to o t h e r n e e d e d r e s o u r c e s f o r p r e g n a n t a n d p o s t - p a r t u m w o m e n a n d t h e i r f a m i l i e s . P A G E 3 7CLINICAL A N D F A M I L Y S E R V I C E S T h es e p r o g r a m s a r e f o c u s ed o n p r o v i d i n g s a f e t y -n e t p u b l i c h e a l t h s e r v ic e s t o i n d i v i d u a l s a n d f a m i l i e s s e e k i n g r e p r o d u c t i ve h e a l t h c a r e , p e r i n a t a l e d u c a ti o n a n d c a r e co o r d i n a t i o n , n u r s e h o m e v i s i t i n g , n u t r i t i o n e d u c a t i o n , b r e a s t f e e d i n g s u p p or t , a n d r e f e r r a l s t o ne e d e d r e so u r c e s . P r i m a r y C o n t a ct : A n n e K i l t y N P , P r o g r a m M a n a g e r W e b s i t e : h t t p s ://ww w .d e s c h u t e s .o r g /h e a l t h /p a g e /c l i n i c s -an d -s e r v i ce s P A G E 3 8CLINICAL A N D F A M I L Y S E R V I C E S FY 24 Hig hl ights and Acc omplishments FY 25 Challenges & Opportu nities C li n i c a l & F a m i l y S e r v i c e s s u c ces s f u l l y m o v e d t o t h e n e w N o r t h C o u n t y C a m p u s a n d of f e r s a l l s e r v i c e s i n a b e a u t i f u l n e w b u i l d i n g s e r v i n g n o r t h D e s c h u t e s C ou n t y a n d r e g i o n a l p ar t n e r s . T h e n e w P u b l i c H e a l t h v a n s t a r t e d p r o v i d i ng m o b i l e W I C a n d R e p r o d u c t i v e H e a l t h c l i n i c a l s e r vi c e s , i n c r e a s i n g a c c e ss t o m o r e c o m m u ni t i e s a n d t a r get p op u l a t i o n s . F a m i l y C o n n e c t s O r e g o n e x p an d e d t o u n i v e r s a l , n o -c o s t n u r s e h o m e v i si t i n g t o a l l f a m i l i e s a n d c ar e g i v e r s o f n e w b o r n s . P C C st a f f h a v e r e t u r n e d t o p r e -C o v i d e m b e d m e n t a t l o c a l O B c l i n i c s , o f fe r i n g i n -p e r so n , w a r m h a n d -o f fs f r o m O B s t o P C C s t a f f f o r p e r i n a t a l c ar e c o o r d i n a t i o n . T h e P u b l i c H e a l t h va n w i l l c o n t i n u e t o i n c r e a s e s e r v i c e s a n d e x p a n d t o n e w l o c a t i o n s , i n c r e a s i n g a c c e s s a n d r e v e nu e . P ro v i d i n g f u l l -t i m e f r o n t d e s k s u p p o r t a t t h r e e l o c at i o n s a n d f u l l -t i m e v i t a l r e c or d s s u p p o r t a t t w o l o c a ti o n s w i th 4 .0 F T E F a m i l y C o n n e c t s i m p l e m e nt a t i o n h a s t a k e n l o n g e r t h a n ex p e c ted . W i l l c o n t i n ue w o r ki n g w i t h O H A , S t C h a r les an d c o m m u n i ty p a r t n e r s t o w a r d s f u l l i m p l em e n t a t i o n . P A G E 3 9CLINICAL A N D F A M I L Y S E R V I C E S P R O J E C T C O D E : H S P H D I R E C T & H S C L I N I C A L FY 24 Fundi ng Changes FY 25 Program Changes FTE Changes and Detail N e w f u n d i n g f r o m P a c i f i c S ou rce t o h e l p s u p p o rt P C C t h r o u g h a p e r m e m be r p e r m o n t h r a t e , S t a r t i n g M a r ch 20 2 4 . I n c rea s e d F a m i l y P l a n n i n g r e i m bu rs e m e n t r a t e o f $1 9 5 /f a m i l y p l an n i n g v i s i t f r o m P a c i f i c S o u r c e C o m m u n i t y S ol u t i on s . S t a r t i n g M a r c h 2 0 2 4 . O r g a n i z a t i o na l ch a n g e s i m p l e m e n t e d i n t h e s e c o n d h a l f o f F Y2 4 r e s u l t e d i n P H F r o nt D e s k an d V i t a l R e c o r d s r e p o r t i n g t o A d m i n is t r a t i v e S e r v i c e s – O p e r a t i o n s i n st e a d o f u n d e r t h e P u b l i c He a l t h l e a d e r s h i p b r a n c h o f t h e o r g a n i zat i o n . P A G E 4 0COMMUNICABLE D I S E A S E P R E V E N T I O N A N D M A N A G E M E N T T h e s e p r o g r am s p r e v e nt a n d c o n t r o l t h e s p r e a d o f c o m m u n i ca b l e d i s e as e s an d m i t i g a te h e a l t h t h r ea t s t h ro ug h s u rv e i l l a n c e , e d u c a t i o n , i n v e s ti g at i o n , o u tb r ea k c o n t r o l a n d i m m u n i z a t i o n s . M o r e o v e r , w e a s s u r e a c c e ss t o p u b l i c h e a l t h s e r v i c es a n d c o n d uc t co m mu n i ty o u tr e a ch pr ov idi n g i m m u n i z a t i o ns , i n f e ct i o n p r e v e n t i o n c o n s ul t a t i o n a n d c o mm u ni c a b l e di s e a se t e s ti n g a n d tr e a t me n t . P r i m ar y C on t a c t : R i t a B a c h o , P r o g r am M a n a g e r We b s it e : h t tp s ://w w w .d e sc h u t e s .o r g /h e a l t h /p a g e /c om m u n i c a bl e -d is e a s e - p r o gr a ms C o m m u n i ca b l e di s e a se s (C D ) a r e t h o s e c o n d i t ion s t h at c a n b e s p r e a d to o t h e r s t h r ou g h ai r , t o u c h, o r c on t ac t w it h c o n ta m in a te d b o d y f l u i d s . A t D e s c h u t e s C o u n t y H e a lt h S e r v i c e s , w e w o r k t o p r e v e n t t h e s p r e a d of t h es e di s e a s e s i n ma n y w a y s . T h e C o m m u n i ca b l e D i se a s e Pr e ve n ti o n a n d Ma n a g e m e n t te a m i s m a d e u p o f t h e f o ll o wi n g p r og r a m s : G en er a l C o mm u ni c a b l e D i s e a s e P r og r a m W o r k t o R e d u ce t h e ri s k o f s p r e a d o f C D b y t r a c k i n g i n f e c t i ou s d i s e a s e s t o th e ir s o u r c e a n d n o t i f y i n g p eop le w h o h a v e b e en e x pos e d . I n fe c t io n P r ev e n t i on P r o g r a m W o r k s w it h C o n g r e g a t e c a r e f a c i l i t i es s u c h a s l o n g -t e r m c a re f a c il i ti e s a nd s h e l t e r s t o m i t iga t e t he sp re a d o f i n f e c ti o u s d i s e a s e s t h r o u g h e d u ca t i o n a n d t e c h n i ca l a s s i s t a n ce . E pi d em i o l o g y E v a lu a te s h e a l t h r i s k s w i t h i n o ur c o m m u n i t y t h r o u g h s u r ve i l l a n c e a nd d a t a a n a l y s i s . H I V a n d S e x u al l y T r a n s m i t t e d D i s e a s e P r ev e n t i on P r o g r a m W o r k t o r e d u c e m or b i d i t y a n d m o rt a li t y a s s o c i at e d w i t h H I V a n d s e xu a l ly t r a n s m i t t e d d is e a s e s , a ls o li n k s p e o p l e t o s e r v i c es f o r di s e a s e p r e v e n t i o n a n d m a n a g e m e nt . I m m un i z a t io n Pr og r a m P r e v e n t s d i s ea s e , d i sa b i li t y a n d d e a t h f r o m va c c i n e p re v en t abl e d i s e a s es in i n f a n t s , ch i l d r e n , a d o l e s c e nt s a n d a d u l ts t h r o u gh su r ve i l la n c e , c a s e i n v es ti g a ti o n a n d c o n t r ol m o ni t o r i n g of i m m un i z a t ion l ev e l s , p r o vi s i o n o f v a c c i n e a n d p r of es si o n al a n d p u b l i c e d u ca t i o n . R W C a s e Ma n a g e m en t E m p o we r s p e o p l e l i vi n g w i t h H I V /A I D S t o e f f e ct i v e l y m a n a g e t h e i r H I V a n d i m p r o ve t h e i r o v e r a ll h ea l t h a nd q u a li t y of l i f e . L o c a l c a s e ma n a g e r s h a ve a t h o rou g h un d e r s t a n d i ng o f t h e s e r v i c e s a n d p r o g r a ms av a il a b l e t o h e l p cl i en t s m a n a g e c h a l l e n g e s a n d cr i s e s r e la t ed t o h e a lt h , h o u si n g , t r e a t m e n t , c o v e r a g e f o r h e a l t h c a r e, a n d r e f e r ra l s f o r n ee d e d s e r v i c e s . T u b e rc ul o s i s (T B ) P r o g r am O ve r s e e s , m a n a g e s , a n d f ac i l i t a t e s a c t i v i t i e s a n d i n t e r ve n ti o n s n ee d e d t o i d e n t i fy a n d p r o p e r l y t r e a t a l l i n d i v idu a l s w i th T B t o s t op i t s s p re a d t o o th e r s . P A G E 4 1COMMUNICABLE D I S E A S E P R E V E N T I O N A N D M A N A G E M E N T FY 24 Hig hl ights and Acc omplishments FY 25 Challenges & Opportu nities D e v e l o p e d a n d p r e s e n t e d I n f e c t io n P r e ven t i o n (I P ) t r a i n i n gs (r e s p i r a t o r y p r o t e ct i o n , c l e a n i n g a n d d i s in f e c t i o n , h a n d h y g i e n e a n d o t h e r I P t o p i c s ) t o L o n g T e r m C a r e F a c i l i t ies a n d o th e r c o m m u n i t y o r g a n i z a t i o n s t h a t c a re f o r v u l n e r a b le p o p u lat i o n s . S u c c e s s f u l i n t e g r a t i o n o f t h e R y a n W h i t e P ro g r a m w i t h S T I /H I V i n v e s t i g a t i o n , o u t r e a c h a n d p r e v e n t i o n p r o g r a m m i n g a n d s t a f f . C o n d u c t e d 6 6 o u t rea c h tes t i n g e v e n t s i n C Y 2 3 p r o v i d i n g r a p i d tes t i n g, e d u c a t i o n a n d r e f e r r a l s (3 1 3 H I V , 2 6 0 H e p a t i t i s C & 2 9 9 S y p h i l i s ). 1 0 0 % o f t he 2 0 2 3 s y p h i l i s a n d H I V c a s e s w er e i n t e r v i e w e d a n d o f f e r e d p a r t n e r s e r v i c e s . 9 6 2 t o t a l n o n -CO V ID c o m m un i c a b l e d i s e a s e c a s e s (5 6 7 S T I /H I V ; 3 9 5 C D ) r e p o r t e d a nd m an a g e d in 2 0 2 3 , 6 6 t o t a l o u t b r e a k s m a n a g e d (5 5 C O V I D ; 1 1 n on -C O V I D ). S u c c e s s f u l l y c o m pl e t e d 2 t u b e r c u l o s i s c a s e m a n a g e m e n t i nc l u d i n g d a i l y d i r e c t l y o bs e r v e d t h e r a p y a m o u n t i n g t o 3 3 7 h o u r s o f s t a f f h o ur s . 4 7 2 p e o p le su b s c r i b e d t o t h e r e s pi r a t o r y s e a s o n w e e k l y O P I r e p o r t i n 2 02 3 , c o m p a r e d t o 3 82 i n 2 0 2 2 a n d 3 6 1 i n 2 0 2 1 . I n c r e a s i n g p o p ul a t i o n , i n c r e a s i n g c omm u n ic a b l e d i s e a s e d e m a n d s a n d u ns ta b l e f u n d in g s t r e a m s . R e s p o nd i n g t o t h e u n p r e d i c t a bl e an d g r o w i n g d e m a n d s o f t h e e v e r - c h a n g i ng c o m m u n i c a b l e di s e a s e l a n d s c a p e , i .e . co m p l i c at e d , t i me c o n s u m i n g c a s e s l i k e t u b e r c u l o s i s , s y p h i l i s , H I V . V a c c i n e Hes i t a n c y is a g r ow i n g c h a l l e n g e . D e v e l o p i n g n e w c o l l a b o r a t i v e r e l a t i o n s h i ps w i t h c om m u n it y p a r t n e r s a n d fo s t e r i n g e x i s t i n g o n e s . P l a nn i n g a nd co m m u n i t y c o l l a b o r a t i o n f o r e mer g i n g c o m m u n i c ab l e d i s e a s e s (em e r g i n g v i r u s e s , m e a s l e s, E .c o l i , E b o l a , t i c k -b o r n e d i s e a s e s , e t c .) s o m e o f w h i c h m a y be a s s o c i a t e d w i t h g l o b a l c l i m a t e c h a n g e . P A G E 4 2COMMUNICABLE D I S E A S E P R E V E N T I O N A N D M A N A G E M E N T P R O J E C T C O D E : H S C O M M D I S FY 24 Funding Changes FY 25 Program Changes FTE Changes and Detail O u r P r o g r a m r e c e i v e d $1 3 ,7 5 1 o n e -t i m e s u p p l e m e n t a l f u n d i n g f o r R y a n W h i t e w h i c h h e l p s t o o f f s e t i n c r e a s i n g c o s t s o f t h e R y a n w h i t e p ro g r a m . A c o n t r a c t w i t h J e f f e r s o n C o u n t y t h r o u g h P E 10 e n d e d o n D e c e m b e r 3 1 s t . W e r e c e i v e d o n e -t i m e $4 3 ,1 4 0 i n C O V I D -1 9 B r i d g e f u n d i n g t hr o u g h J u n e 2 0 25 . C O V I D -1 9 v a cci n e a c t i v i t i e s /de l i v e r y h a s t r a n s i t i o n e d t o t h e C o m m u n i c a b l e D i s e a s e P r e v e n t i o n a n d M a n a g e m e n t T e a m . T h e r e g i o n a l E p i d e m i o l o g i s t h a s t r an s i t i o n e d t o t h e C o m m u n i c a b l e D i s e a s e P r e v e n t i o n a n d M a n a gem e n t T e a m . T h e r e w a s a c h an g e i n t h e n a m e o f t h e s e c t i on f r o m P u b li c H e a l t h A d v a nc e me n t & P r o t e c t i on s t o C o m m u n i c a b l e D i s e a s e P r e v e n t i o n a n d M a n a g em e n t . A d o l e sc e n t H e a l t h E d u ca t e s y o u t h , f a m i l ies , a n d y o u t h -s e r v i n g o r g a n i z a t i on s o n a v a r i e t y o f t o p i c s a n d r e s o u r c e s a v a i l a b l e t o i m p r o v e ad o l e s c e n t h e a l t h r e l a t e d t o t o p i c s s u c h a s p e e r p r e s s u r e , r e s o u r c e a c c e s s , s o c i a l m e d i a u s e , s e x u a l h e a l t h , h e a l t h y r e l a t i o n s h i ps , a n d v i o l e n c e p r e v e n t i o n . H e a lt h y S c h o o l s L o c a l p a r t n e r s h i p b e t w e e n D e s c hu t e s C o u n t y a n d B en d -L a P i n e S c h o o l s p r o v i d i n g p u b l i c h e a l t h s e r v i c e s d i r e c t l y w i t h i n s ch o o l s u s i n g c o l l a b o r a t i v e , s y s t e m i c , a n d i n t eg r a t i v e a p p r o a c h e s s o t h a t s t u d e n t s , f a m i l i e s , a n d s c h o o l s ta f f h a v e a c c e ss t o h i g h q u a li t y h e a l th p r o m o t i n g p r o g r a m s . S u b s t a n c e M i s u s e a n d P r o b l e m G a m b l i n g P r e v e n t i o n P u b l i c H e a l t h e x p e r t i s e t o e n s u r e p o l i c i es , s y s t e m s , a n d e n vi r o n m e n t s a l i g n t o p r e v e nt a n d r e d u c e p r o b l e m g a m b l i n g , t o b a cco , a l c o h ol , c a n n a b i s , a n d o v e r t h e c o u n te r o r p r e s c r i p t i o n d ru g m i s u s e a m o n g y o un g p e o p l e a g e s 1 0 - 2 5 y e a r s . Me n t a l H e a l t h P r o m o t i o n a n d S u i c id e P r e v e n t i o n P u b l i c H e a l t h e x p e r t i s e t o e n s u r e p r o a c t i v e p o l i c i e s , s y s t e m s , a n d e n v i r o n m e n t s a r e i n p l a c e i n o r d e r t o p r e v e n t s u i c i d e d e a t h a n d at t e m p ts an d t o p ro m o t e c o m m u n i t y r e s i l i e n c e a m o n g a l l a g e g r o u p s . Y o u t h E n g a g e m e n t P r o g r a m F o s t e r s y o u t h -a d u l t p ar t n e r s h i p s a n d y o u t h -l e d p r o j e c t s t o e n s u r e s t ud e n t v o i c e a n d lea d e r s h i p i n m e nt a l h e a l t h p r o m o t i o n a n d a d v o c a c y f or S c h o o l B a sed Hea l t h Ce n t e r s . P A G E 4 3PREVENTION A N D H E A L T H P R O M O T I O N P r o g r a m s i n t h i s s ec t i o n l e a d w o r k w i t h c o m m u n i t y p a r t n e r s t o p r o m o t e a n d e n s u r e p r a c t i c e s t h a t i m p r o v e h e a l t h a n d w e l l -b e i n g a n d p r e v e n t n egat i v e c o n d i ti o n s t h a t a r e h a r m f u l t o o u r c o m m u ni t y b o t h s oc ia l l y a nd fi n a n c i a l l y . P r i m a r y C o n t a ct : J e s s i c a J a c k s , P r o g r a m M a n a g e r W e b s i t e : W e b s i t e : h t t p s://w w w .d e s c h u t e s .o r g /h e a l t h /p a g e /s t a y in g - h e a l t h y -p re v en t i o n P A G E 4 4PREVENTION A N D H E A L T H P R O M O T I O N FY 24 Hig hlights and Acc omplishments FY 25 Challenges & Opportunities Almost all Bend-La Pine Schools middle and high schools (11 of 14) have begun implementing Sources of Strength, up from one school the prior year. Sources of Strength is a suicide prevention program that also prevents substance use and violence. Opioid Settlement dollars were allocated to support prevention, surveillance, and response to this concerning community threat. An internal response team is monitoring and actively addressing. Addition of a Supervisor to support overdose prevention, surveillance, and response work and substance misuse and problem gambling prevention as well as the overall workload in Prevention and Health Promotion. 100% of health teachers in Bend-La Pine Schools are now using effective prevention programs as a result of the Healthy Schools program services. This is up from 31% in 2021. Prevention requires long-term investment to realize cost savings and improved community health (e.g. reductions in costs for healthcare, criminal justice, education, social welfare, etc.). Funding has historically been stratified across few stable resources and multiple short-term grants. This results in frequent staff turnover, instability of program delivery, and requires staff to spend time on resource development instead of program implementation. Oregon suicide legislation has significant gaps; all legislation are unfunded mandates, specific to postvention legislation it does not include Community Colleges, does not include youth who have parents who have died by suicide, nor youth who have attempted suicide. Overdose postvention legislation has been based on suicide postvention legislation, which has not been evaluated for effectiveness and is also an unfunded mandate. Changes in some OHA program requirements are allowing for integration of service areas across Prevention where prior requirements were very siloing. An example is fiscal support from Tobacco Prevention for Healthy Schools programming. Prevention requires long-term investment to realize cost savings and improved community health (e.g. reductions in costs for healthcare, criminal justice, education, social welfare, etc.). Funding has historically been stratified across few stable resources and multiple short-term grants. This results in frequent staff turnover, instability of program delivery, and requires staff to spend time on resource development instead of program implementation. Oregon suicide legislation has significant gaps; all legislation are unfunded mandates, specific to postvention legislation it does not include Community Colleges, does not include youth who have parents who have died by suicide, nor youth who have attempted suicide. Overdose postvention legislation has been based on suicide postvention legislation, which has not been evaluated for effectiveness and is also an unfunded mandate. Changes in some OHA program requirements are allowing for integration of service areas across Prevention where prior requirements were very siloing. An example is fiscal support from Tobacco Prevention for Healthy Schools programming. P A G E 4 5PREVENTION & H E A L T H P R O M O T I O N P R O J E C T C O D E : H S P R E V E N T FY 24 Fundi ng Changes FY 25 Program Changes FTE Changes and Detail The Garrett Lee Smith Grant sunsets June 2024 without known renewal opportunity. Threats to DCHS-Behavioral Health (BH) reserve funding also threatens Prevention funding as BH has contributed important financial resources for substance misuse and suicide prevention. P A G E 4 6EVIRONMENTAL H E A L T H , P R E P A R E D N E S S & E N G A G E M E N T T h i s p u b l i c h e a l t h s e c t i o n e m b o d i e s a c o m p r e h e n s i v e a p p ro a c h t o m o d e r n i z i ng pu b li c h e a l t h, in c o r p o r a t i n g f o u n d a ti o n a l c a p a b i l i t i e s s u c h a s e m e r g e nc y p r ep a r e d n e s s , e p i d e m i o l o g y , h e a l t h e qu i t y p r o m o t i o n , c o m m u n i t y p a r t n e r s h i p de v el o p m en t , a n d c o m m u n i c a t i o n . T h e s e e f f o rt s c o n t i nu e t o b e i n t e g r a t e d a c ro s s a l l p u b l i c h e a l t h p r o g r a m a r e a s . T h e E n v i r o n m e n t a l P u b l i c H e a l t h P r o g r a m s t a n d s o u t f o r i t s d e d ic a t i o n t o c o m m u n i t y p r o t e c t i o n , e n s u r i n g t h e s a f e t y a n d c l e a nl i ne s s o f v i t a l r e s o u r c e s l i k e f o o d , a i r , a n d w a t e r . Th r o u g h a c o m b i n a t i on o f p r e v e n t i o n e d u c a t i o n i n i t ia t i v e s a n d r e g u l a t o r y i n s p e c t i o n s a t l i c e n s e d f a c i l i t ie s , t h e p r o g r a m a ct i v e l y s a f e g u a rd s p u b l i c h e a l t h , r e f l e c t i n g a c o m m i t m e nt t o p r o a c t iv e h e al t h p r o m o t i o n a n d d i s e a s e p re v e n t i o n . P r i m a r y C o n t a ct : E m i l y H o r t o n , P ro g r a m M a n a g e r W e b s i t e : h t t p s ://w w w .d e s c h u t e s .o r g /h e a l t h /p a g e / E m e r g e n c y P r e p a r e d n e s s a n d R e s p o n s e Mo n i t o r s a n d s t r e n g t h e n s t h e a b i l i t i e s o f D e s c h u te s C o u n t y a n d o u r h e a l t h c a r e s y s t e m s t o p r o t e c t t h e p u b li c ’s h e a l t h i n d is a st e r s i t u a t i o n s , s u c h as d i s e a s e p a n d e m i c s a n d e p i d e m i c s , c h e m i c a l a n d r a d i o l og i c a l r e l e as e s , s e v e r e w e a t h e r , a n d n a t u r a l d i s a s t e r s . A ss e ss me n t an d E p i d e m i o l o g y A s s e s s i n g t h e e f f e ct i v e n e s s o f p u b l ic h e a l t h pr o g r a m s a n d t h e i r o u t c o m e s , a s w e l l a s c on t i n u o u s l y e v a l ua t i n g h e a l th r i s k s w i t h i n o u r c o m m u n i t y t h r o u g h d a t a a n a l y s i s . C o m m u n i t y P a r t n e r s h i p D e v e l o p m e n t a n d O u t r e a c h F o s t e r i n g c o l l a b or a t i v e r e l a t i o n s h i p s a c r o s s d i f f e r e n t s e c t o r s o f t h e co m m u ni t y a n d e n g a gi n g in s t r a t e g i c p l a n n i n g w i t h c o m m u n i t y -b a s e d o r g a n i z a t i o n s a n d p a r t n e r s t o a c h i e v e p u b l i c h e al t h ob j e c t i v e s . H e a lt h R i s k a nd C r i si s C o m m u n i c a t i o n s D i s s e m i n at i n g i n f o r m a t i o n r e g a r d i n g l o c a l p u b l i c h e a l t h r i s k s a n d a d v i si n g i n d i v i d u a l s o n t h e n e c e s s a r y s t e p s t o sa f e g u a r d t h e m s e l v e s a n d t h e i r f a m i l i e s . F oo d S e r v i c e , P o o l a n d T o u r i s t F a c i l i t y L i c e n s i n g a n d R egu l a t o r y I n s p e c t i o n s R e g u l a t o r y o v e r si g ht e n c o m p a s s e s 1 ,1 4 0 f o o d s e r v i c e f a c i l i t i e s, 1 4 9 l o d gi n g e s ta b l i s hm e n t s (i n c l u d in g m o te l s , h o t e l s , r e s o r t s , R V p a r k s , a n d cam p g r o u n d s ), a n d 3 0 1 p u bl i c p o o l s a n d s p a s . I n s p e c t i o n s e m p h a s i z e e d u c a t i o n a n d d i s e a s e p r e v e n t i o n t o e n s u r e s a f e t y s t a n d a r d s a r e m e t . S c ho o l L u n c h I n s p e c ti o n I n s pe c t i o n o f 6 1 s c h o o l f o o d s e r v i ce k i t c h e n s . F oo d H a n d l e r a n d M a n a g e r T r a i n i n g F o od h a n d l e r t r a i n i n g a n d c e rt i f i e d f o o d m a n a g e r t r a i n i n g o f f e r e d t o l o c a l b u s i n e s s o w n e r s a n d t h e i r s t a f f . D r i n k i n g W at e r E d u c a t i o n a n d R e g ul a t o r y M a n a g e m e n t A d m i n i st r a t i o n a n d e n f o r c e m e n t o f d r i n k i n g w a t e r qu a l i t y s t a n d a rd s f o r t h e 1 85 Des c h u t e s C o u n ty p ub l i c w a t e r s y s t e m s . T e s t e d 1 7 1 p r iv a t e w e l l s s in c e 20 2 2 . C h i l d c a r e F a c i l i t i e s I n s pe c t i o n a n d o u t r e a c h o f 1 6 5 C h i l d c a r e f a c i l i t i e s , i n c l u d i n g p re -s c h o o l, H e ad s t a r t a n d P r e -K . P A G E 4 7EVIRONMENTAL H E A L T H , P R E P A R E D N E S S & E N G A G E M E N T FY 24 Hig hl ights and Acc omplishments E s t a b l i s h m e n t o f a D e s c h u t e s C ou n t y M e d i c a l R e s e r v e C o r p s a n d e m p l o y m e n t o f a f u l l -t i m e co o r di n a t o r . E s t a b l i s h m e n t o f e n v i r o n m e nt a l a c t i o n pl a n s a nd a c t i v a t i o n gu i d e s f o r s m o k e , h e a t a n d c o l d w e a t h e r r i s k c o m m u n i c a t i o n s , s h e l t e r s a n d c o o r d i n a t e d s e r v i c e p r o v i de r res p o n s e . T r a n s i t i o n o f C o v i d -1 9 S i t u a t i o n E m a i l s i n t o P u b l i c H e a l t h M o nt h l y N e w s l et t e r w i th a v e r a g e re a d e r s h i p o f ove r 2 6 ,0 0 0 p e r m o nt h . A w a r d e d t h r e e n e w g r a n t s f r om th e F o o d a n d D r u g A d m i n i s t r a ti o n (F D A ) t o m e e t R e t a i l F o o d R e g ul a t o r y p r og r a m s t a n d a r d s , w h ich e v al u a t e s q u a l i ty an d e f f i c a c y o f t h e f o o d i ns p e c t io n r e g u l at o r y p r o g r a m . A s p a r t o f P u b l i c H e a l t h M o de r ni z a t i o n , e n h a n c e d o u t b r e a k i n v e s t i g a t i o n a n d d i s ea s e p r e v e n t i o n c a p a c i ty i n v u l n e ra b l e p o p u l a t i o n s , s u c h a s c o n g r e g a te set t i n g s (e .g . h o m e l e s s s h e l t e r s ), c h i l d c a r e s , a n d A d u l t F o s t e r H o m e s FY 25 Challenges & Opportu nities L o s s o f e n g ag e m e n t s t a f f i n F Y 2 5 – t r y i n g t o m a i n t a i n c o m m u n i t y p a r t n e r s h i p s a n d e n g a g em e n t w i t h l e s s s t a f f a n d n o d e d i c a t e d o u t r e a c h w o r k e r s . M R C c o o r d i n a t o r i s a c ti v e l y ma n a g in g v o lu n t e e r s t h o u g h a c a m p a i g n a n d c o m m u n i c a ti o ns s e r v i c e c a l l e d b l u e -s k y o p e r at i o n s, a nd i s a l s o i n v o l v e d i n t ra i n in g a n d m i s s i o n s e t d e v e l o p m e n t . F e e s a n d r e v e n u e s no t k e e p i n g p a c e wi t h i n c r e a s e d e x pe n s e s ; r e l y i n g i n c r e a si n g l y on T r a n s i e n t R o o m T a x a n d M o der ni z a t i o n f u n d i n g . E x per i e n c e d a 3 5 % in c rea s e i n T e m p o r a r y R e s t a u r a n t L i c e n s e s i s s u ed i n F Y 2 4 a n d a n t i c i p a t in g t h i s t o c a r r y o n i n t o F Y 2 5 . S t a b i l i z a t i o n o f E n v i r o n m e n t a l H e a l t h s t a ff i n g t h i s y e a r by h i r i n g m o r e e n t r y l e v e l E n v ir o n m e n t a l H e a l t h S p e c i a l i s t s ta f f w h o a r e t r a i n e d b y e xp e r i e n c e d R e g i st e r e d E n v i r o n m e n t a l H e a l t h S p e c i a l i s t s (R E H S ). A w a r d e d f o ur m o r e F o o d a n d D r u g A d m i n i s t r a t i o n G r a n t s f o r C Y 20 2 4 t o t a l i n g $5 0 ,0 0 0 , t o c o n t i n u e q u a l i t y i m p r ove men t w o r k a n d i m p l e m e n t b e s t p r a c t i ces . P A G E 4 8EVIRONMENTAL H E A L T H , P R E P A R E D N E S S & E N G A G E M E N T FY 24 Hig hl ights and Acc omplishments C ontinued I m p l e m e n t e d i n d o o r a i r q u a l i t y e v a l u a t i o n s o n H V A C a n d c l e a n a i r s p a c e s f o r v u l n e r a b l e po p u l a t i on a n d b u s i n e s s e s , u p o n r e q u e s t . I m p l e m e n t e d a s a f e d r i n k i n g w at e r p r o g r a m f o r p r iv a t e d o m e s t i c w e l l o w n e r s to e v a l u a t e f or b a s i c b i o l o g i c a l a n d ch e m i c a l h a z a r d s , a n d i den t i f y p o t e n t i a l h a z a r d s a s s o c i a t e d w i t h w e l l l o c a t i o n . A s w e f a c e t h e c o n t i n u e d do w n s i z i n g s o f l i mi t e d d u r a t i o n e m p l o y e e s , w e a r e a c t i vel y r e i m a g i n i n g o u r o u t r ea c h , e n ga g e m e n t, a n d c o m m u n i t y p a rt n e r s h i p d e v e l o p m e n t ef f o r t s , p a r t i c u l a r l y w i t h OH A -f u n d e d C o m m u n i t y -B a s e d O r g a n i z a t i o n s (CB O s ). M a i n t a i n in g t h e p r o g r e s s m a d e i n t h i s a r e a i s c r u c i a l a m i d s t t h e s e c h a n g e s , a n d w e a r e c o m m i t t e d t o f i n d i n g i n n o v at i v e s o l ut i o n s t o e ns u r e c o n ti n u e d m o m e n tu m a nd i mp a c t . W e a r e s h if t i n g o u r i n s pec t i o n f o c u s t o a "R i s k -B a s e d " a p p r o a c h t o c u l t i v a t e a c u l t u r e o f p r e v e n t i o n . B y e m p h a s i z in g r i s k a s s e s s m e nt , w e a i m t o m i n i m i z e f o o d b o r n e i l l n e s s e s w h i l e a l s o g a t her i n g v a l u ab l e d a t a t o f u l f i l l a k e y e l e m e n t o f t h e FD A ’s V o l u n t a r y N a t i o n a l R e t a i l F o o d R e g u l a t or y Pr o g r a m S t a n d a r d s . T hi s s t r a t e g i c s h i f t r e c o g n i z e s t ha t i mp l e m e n t i n g r i s k -b a s e d i n s p e c t i o n s i n f o o d s e r v i c e e s t a b l i s h m e n t s i s a b e s t p r a c t i c e . I t n o t o n l y e n h a n ces f o od s a f e t y b u t a l s o im p r o v e s r e g u l a t o r y co m p l i a n c e . T h i s d e m on s t ra t e s o u r c o m m i t m e n t t o p ro a c t i v e m e a s u r e s t h a t e n h an c e b o t h s a f e t y a n d s t a n d a r d s a d h e r e n c e i n o u r c o m mu n i t i e s . I n c r e a s e d p r e s e n c e i n b e n e v o l e n t o rg a n iz a t i o n s a n d n o n -r e g u l a t e d f a c i l i t i e s t o e v a l u a t e t h e hea l t h a n d s a f e t y o f v u l n e r a b l e p o pu l a t i o n s , c o l l a b o r a t i n g w i t h B e h a v i o r a l H e a l t h a n d C o m m un i c a bl e D i s e a s e t e a m s . P A G E 4 9EVIRONMENTAL H E A L T H , P R E P A R E D N E S S & E N G A G E M E N T P R O J E C T C O D E : H S E M E R P R E P & H S E V I R O N FY 24 Fundi ng Changes FY 25 Program Changes FTE Changes and Detail M R C G r a n t f u n d i n g t h r o u g h M R C s t r o n g g r a n t e n d s J u n e 2 0 2 5 . P l a n n i n g f o r t r a n s i t i o n i n g s t a f f i n g r a n t f u n d e d p o s i t i o n s in t o o t h e r f un d i n g s t r e am s . L i k e l y i n c r e a s e i n f e e s t o c o r r e s p o n d wi t h C o n s u m e r P r i c e I n d e x a s w el l a s p ro p o se d i n c r e a s e d f e e s f o r M o b i l e F o o d U n i t s (M F U s ). C o n t i n u i n g i n c r e a s e s i n T e m p or a r y F o o d V e n d or l i c e n ses . A w a r d e d f o u r h i g h l y c o m p e ti t i v e F D A g r a n t s t o ta l i n g $5 0,0 00 . A pp l i e d f o r t h e A S P I R E G r an t t h r o u g h t h e N a t i o n a l I n s t i tu t e o f E n v i r o n m e n t a l H e a l t h S c i e n c e s t o r e d u c e c h i ld r e n ’s e x p o s ur e t o p a rt i c ul a t e m a t t e r f r o m s mo k e a n d c o n t a m i n an t s d u r i n g w i l d f ir e s e a s o n ($3 9 ,4 9 0 ). P A G E 5 0ADMINISTRATIVE S E R V I C E S P r o v i d e s o p e r a t i o n a l a n d f i s c a l s u p p o r t , a s w e l l a s o v e r s i g h t o f a s s e t s a nd c o m p l i a n c e . Th i s i n c l u de s b i l l i n g , c r e d e n t i a l i n g , c o n t r ac t i n g , f i sc a l s e r v ic e s , h e a l t h i n f o r m a t i o n t e c h n o l o g y , m e d i c a l r e c o r d s e rv i c e s , i n f r a s t r u c t u r e , w o r k fo r c e d e v e l o p me n t , e q u i t y , l a n g u a g e a c c e s s , s a f e t y , c o m p l i a n c e , q u a l i t y a ss u r a n c e , d at a a n a l y t i c s a nd p r o j e c t ma n a g em e n t . P r i m a r y C o n t a ct : C h e ry l S m a l l m a n , B u s i n e s s Of f i c e r , C h r i s W ei l e r , O p e r a t i o n s Of f i c e r & J i ll i a n W e i s e r , C o m p li a n c e a n d Q u a l i t y A s su r a n c e O ff i c e r B u s i n e s s I n te l l i g e n c e C o n d u c t s f i s c a l a n d a n a l y t i c a l a c t i v i t i e s , a s w e l l a s i n i t i a t i v e s a n d q u a l i t y i m p ro v e m e n t e f f o r t s t o i m p r o v e t h e e ff i c i e n c y , e f f e c t i v e n e s s , a n d f i n a n c i a l s ta b i l i t y o f t h e d e p a r t m e nt . F is c a l S e r v i c e s C o n t r a c t S e rvi c e s D a t a a n d A n a l y t i c s A c c o u n t i n g a n d G r a n t M an a g e m e n t O p e r a t i o n s Ma n a g e s a co m p l e x an d d i v e r s e s e t o f b u s in e s s s u p po r t s e r v i c e s a n d e n s u r e s t h e d e p a r t m e n t h a s t h e t o o l s, e q u i p m e n t an d f a c i l i t i e s n e c e s s a r y t o s e r v e t h e c o m m u n i t y s a f e l y . P ro j e c t M a n a g e m e n t M e d i c a l R e c o r d s H e a l th I n f o r m a t i on T e c h n o l o g y D e p a r t m e n t w i d e S a fet y a n d C o n t i n u i t y o f O p e r at i o n P l a n n i n g B il l i n g a n d C red e n t i a l i n g B e h a v i o r a l H e a l t h F r o n t O f f i c e P r oc u r e me n t I n f r a s t r u c t u r e A s s e t M a n a g e m e n t F l e e t V e h i c l e M a n a g e m e n t P H F r o nt O f f ice C o m p l i a n c e a n d Q u a l i t y A s s u r a n c e (C Q A ) C o m p l i a n c e a n d Q u a l i t y As s u r a n c e : P r o v i d e s a u di t i n g a n d o v e r s i g h t o f d e p a rt m e n t w o r k t o a s s u r e e t hi c a l c o n d u c t a n d c o m p l i a n c e w it h l o ca l , s ta t e , f e d e r al , a nd p r o f e s s i o n a l s t a n d a r d s a n d r e g u l a t io n s ; i n c l u d i n g i n c i d e n t r e p o r t s , p o l i c ie s & p r o c e d u r e s , p r i v a c y , l a n g ua g e a c c e s s , d o c u m e n t a t i on t r a i n i n g , c ha r t a u d i t s , a n d d e p a r t m e n t H R s u p po r t . C o m p l i a n c e a n d Q u a l i t y I n c i d e n t R e p o r t i n g L a n gu a g e A c c e s s A u d it i n g P ro t e c t i v e S e r v i c es P o l i c i e s a n d P r o c e d u r e s H R R e s o u r c e P r oc e s ses D E I W o r k f o r c e D e v e l o p m e n t P A G E 5 1ADMIN S E R V I C E S P R O J E C T C O D E : H S A D M I N -H S 1 O T H E R FY 24 Highlights & Accompli shments FY 25 Challenges & Opport unities C o m p l e te d f u ll cr e d e n t i a l i n g w i t h Me d i c a r e f o r 4 0 LP C s a n d L M F T s b y t h e 1 /1 /2 4 s t a r t d at e – n e w p r o v i d e r t y p e s f o r M e d i c a r e . C e n t r a l i z e d d e p a r t m e nt f i n a nci a l t e c hn i c i an s i n t o s i n g l e t e a m , r e s ul t i n g i n i m p r oved p r o c e s s i n g t i m e s a n d c o n s i s ten c y . S t a f f i n g a c r o s s a l l a r e a s o f A d m i n i s t r a t i v e S er v i c e s h a s n ot k e p t p a c e w i t h o t h e r s e r v i c e a r e a s , r e s u lt i n g i n a b so r p t i o n o f wo r k lo a d w i t h o ut a dd i t i o n a l b a n d w i d t h . U n d e r s t a f f i n g a n d t u r n o v e r at b o t h P u b l i c He a l t h a n d B e h a v i o r a l H e a l t h f r o n t d e s k s . R e d u c e d q u a l i t y i m p r o v em e n t a n d p e r f o r m a n c e m an a g e m e n t c a p a c i t y i s r e s u l t i n g i n d i f f i cu l t y t o a n t i c i p a t e, p r e v e n t , a n d i m p r o v e q u a l it y i s su e s . P A G E 5 2ADMIN S E R V I C E S P R O J E C T C O D E : H S A D M I N -H S 1 O T H E R FY 24 Fundi ng Changes FY 25 Program Changes FTE Changes and Detail E n d o f P a c i f i c S o u r c e W or k f o r c e D i v e r s i t y G r a n t (J u n e 3 0 , 2 0 2 4 ). C o m p l e te d b u i l di n g r e n o v a t i o n s : N o r t h C o u n t y a n d W y a t t . R e p u r p o s i n g a S e n io r Q u a l i t y A n a l y s t f r o m c o m p l i an c e o v er s i g h t i n t o p ro j e c t m a n a g e r t o a s s i s t w i t h g a p i n c a p a c i t y f o r s t r at e g i c p l a n n i n g , p e rf o r m a n c e m a n a g e m e nt , a n d q u a l i t y i m p r o v em e n t . FY 24 Hig hl ights and Acc omplishments L a u n c h ed c o m p r e h e n s i v e w o r k f o r c e s t ab i l i z a t i on s t r a t e g i e s : r e o rg a n iz e d l e a d e r s h i p t e a m ; f o r m a l i z e d w o r k f o r c e e n h a n c e m e n t- c h a rt e r e d c o m m it t e e s ; l a u n c h e d s t a f f e n g a g e m e n t s u r v e y , D C H S c u l t u r e i m p r o v e m e n t p r o j e c t , n e w s u p e r v i s o r t r a i n i n g a n d o n b o a r d i n g i m p r o v e m e n t s ; s u p p o r t e d k e y w a g e a n d t u i t i o n r e i m b u r s e m e n t i n c e n t i v e s . A c hi e v e d i n t e g r a te d B e h a v i o r a l & P u b l i c H e a l t h r e s p o n s e t o ur g e n t c o m m u ni t y n e e d s : co l l a b o r a t i o n o n mu l t i p l e p r o j e c ts t o a d d res s a n d e n d h o m e l e ss n e s s i n D e s c hu t e s Co u n t y ; l a u n c h o f D C H S O v e r d o s e S u rv e i l l a n c e , R e s p o n s e , an d C om m u n ica t i o n - H e a l t h I n t e l l i ge n c e B r i e fi n g . S u p p or t e d , l a u n c h e d an d /o r c o m p l e t e d k e y H e a l t h S e r v i c e s i n fr a s t r u c t u r e p r o j e c t s : R e d m o n d C a m p u s , L a P i n e C o m m u n i t y H e a l th I n t e g r a t i o n , W y a t t L e a s e a n d C o u r t n e y a n d W a l l S t r e e t S e r v i c e s c l i n i c r e n o v a t i o n p l a n n i n g . P A G E 5 3DIRECTORS O F F I C E T h i s p r o g r a m p r o v i d e s a g e n c y -w i d e l e a d e r s h i p a n d o v e r se e s p r o g ra m s a n d a c t i v i t i e s w i t h b r o a d p u b l i c , c o m m u n i t y p a r t n e r , i n t e r -a g e n c y a n d c r o s s -j u r i sd i c t i o n a l i m p a c t a n d i n v o l v e m e n t , i n cl u d i n g s t r at e g i c p l a n n i n g a n d c o mm u n ic a t i o n , f i s c a l v i a b il i t y a n d a c c o u n t a b i li t y a n d w o r k f o r c e d e v e l o p m e n t . P r i m a r y C o n t a ct : J a n i c e Ga r c e a u , D i r e c t o r o f H e a l t h S e r v i c e s FY 25 Challenges & Opportu nities K e y C h a l l e n g e s i n c l u d e r e s p o n d i n g to i n c r e a s i n g t h r e a t s t o o u r s e r v i c e p o pu l a t i o n a n d c o m m u n i t y b r o u g h t o n b y a c h a n g i n g c l i m a t e , p o p u l a t io n g r o w t h , a d e a r t h o f a f f o r d a b l e h o u s i n g , p r e v e n t a b l e d i se a s e o u t b r e ak s , an d t h e F e n t a n yl cr i s i s . E m e r g i n g O pp o r t u n i t ies i n c l u d e : C o n t in u e d b e n e f i t s o f i n t e g r a t i o n a n d c o l l ab o r a t i o n a c r o ss s y s t e m p a r t n e r s : P r i m a r y Ca r e I n t e g r a t i o n , c o o r d i n a t e d r e s p o n s e s t o h o m e l e s s n e s s a n d a d d i c t i o n , B e h avi o r a l H e a l t h p a r t n e r s h i p s w i t h l a w e n f o r c e m e n t an d t h e J u s t i c e S y s t e m , a n d c o l l a b o r a t i o n w i t h s c h o o l s t o r e d u c e s u i c i d e a n d s u b s t a n c e u s e r i s k . C o n t in u e d g r ow t h o f n o n -t r a d i t i o n a l w o r k f o r c e : P e e r s a n d T r a d i t i o n a l H e a l t h W o r k e r s , a n d t h e re-es t a b l i s h men t o f t h e P u b l i c H e a l t h M e d i c a l R e s e r v e C o r p s o f v o l u n t e e r s . FTE Changes and Det ail P E R S O N N E L H I G H L I G H T S S T A T I S T I C S P A G E 5 4 4 2 3 T o t a l F T E D i r e c t o r 's O f f i c e 2 .0 0 A d m i n S e r v i c e s 5 3 .5 0 B e h a v i o r a l H e a l t h 2 9 1 .8 2 P u b l i c H e a l t h 9 9 .9 3 1 4 N u m b e r o f p o s i t i o n s r e a l l o c a t e d i n F Y 2 4 3 8 N u m b e r o f n e w p o s i t i o n s c r e a t e d i n F Y 2 4 F I N A N C I A L H I G H L I G H T S F I N A N C I A L S P A G E 5 5 FY24-25 Req uirements FY24-25 Resou rces