Counties Embark on Mental Health Pilot Project

“Many people are aware there’s been a bit of a firestorm as we expected,” declared Senator Alan Bates (D-Ashland), co-chair of the Ways and Means Subcommittee on Human Services. “We got peoples’ attention and are ready to move forward. We never wanted this to be overly bureaucratic and wanted some action. We believed too big of a step would only lead to disaster. We want to see some limited programs, and have a real opportunity for success.”

 

Legislators approved a budget note on June 8, paving the way for these integrated pilot programs. Harris, who walked away from the Capitol without the requested $2 million to run the program, is confident he can raise enough money from foundations, the federal government and even tap into his $620 million budget. Jefferson County, Multnomah County, Mid-Valley Behavioral Health and a mental health plan in eastern Oregon known as GOBHI have all indicated interest.

 

Harris has whittled the budget down to $1-1.5 million, which will be divided equally for data collection, independent evaluation and start-up costs.

 

After these pilot programs have been evaluated, following a 15-month run, the 2011 legislature may decide to integrate all mental health, addiction and physical health programs throughout the state. It’s too early to make that prediction, Harris said.  

 

Once the pilot programs get under way, some advocates are concerned about how the money will be doled out, which doesn’t surprise Harris. “But this is helping us lay the groundwork for participating in a new healthcare delivery system.”

 

Advocates will realize integration is the best approach, he said. “We’re thinking about more efficient ways to provide services that are more effective. I don’t want us to be left in the caboose. Mental health and addictions are too important to be an after thought.”

 

Eventually the funding stream needs to turn into an outcomes-based system, paying for performance, particularly for addiction services. Currently most physical health plans report penetration rates of 2 percent or lower, while the prevalence rate in the general population is closer to 10 percent. “We need to incentivize a better penetration rate; it’s a matter of educating people to do outreach, not just rely on people to just self-identify themselves. We need to problem solve with the plans and the providers.”

 

Harris was pleased legislators didn’t take a carving knife to his budget. The state hospitals were given another $20 million, while community service projects were cut by $18 million. “Mental health and addiction funds were basically kept even,” he said, and there were no cost-of-living increases. “Legislators minimized the cuts.”

 

Alternatives need to be found to divert people away from institutionalized care and toward community-based services such as mental health courts, he said. “We need to find ways to control the front door because community resources are less expensive. We need to look for a better way to reduce demand for institutional facilities, and use institutions for people who really need them. It’s clear that if you ignore people who get caught up with the justice department, there’s no way to control costs. My goal is to get people a stable place to live, and help them stay out of jails and hospitals.”

 

On the addictions side, the state’s only serving a fraction of the need, about 25 percent, while there’s only enough money to help 40 percent of people with mental health problems.

 

“We cannot serve everyone,” he said. “We should be able to get more services to people in communities and help them stay in their own homes. We need to become more efficient using the resources we have because there aren’t going to be new resources in these troubling economic times.”

 

Harris admitted his new role is rather daunting, having never sat behind a desk before. A clinical social worker, the last 43 years he’s worked in the field, his last role as head of Central City Concern where he was always surrounded by people in recovery.

 

Now vying for the permanent job as director of addictions and mental health, Harris calls it a great opportunity “where the economic crisis forces us to think differently – to find services that are less expensive and just as effective.”