Mental Health Integration Sees Light of Day

February 18, 2010 -- A small line item passed by the 2009 legislature could turn into Oregon’s largest mental health integration project.

 

Oregon’s three fastest growing counties are poised to jump start a pilot project in Crook, Deschutes and Jefferson, and have numerous at-risk patients who bounce from clinic to clinic and hospital to hospital.

 

Known as the Central Oregon Integration Project, about100 patients have been identified as potential candidates who drain resources from county clinics and are high users of their region’s hospital system, Cascade Health Care. 

 

“None of the providers are talking to each other, so not only are they getting meds crossed, but when it’s a patient with a mental disability, it’s especially difficult,” said Wendy Miller, behavioral health services specialist at Cascade Health Care.

 

Between October 2008 and September 2009, 15 people with mental health problems visited emergency rooms in Central Oregon 463 times at a cost of $593,920.

 

“We have a lot of downward pressure on the system to serve the uninsured,” said Scott Johnson, director of Deschutes County’s Health and Human Services Department.

 

Integrated pilot programs took their first step when lawmakers approved a budget note last June, however didn’t allocate any funds. Since then the Addictions and Mental Health Division has pieced together a small pot of money for start-up costs, said Jane-ellen Weidanz, integration demonstration project manager.

 

“We’re determining whether to fund these projects on a case-by-case basis,” she said.

Central Oregon has requested $150,000 but no commitments have been made.

 

“We’re still in negotiations, but expect to get it out the door pretty quickly,” Weidanz said. “Our assumption is there’ll be enough savings through integration that we can reinvest into other areas. We’re only meeting about 45 percent of mental health care needs in Oregon.”

 

Johnson would like to keep this project running until 2015. “It’s going to take some time to improve the long-term health of these people,” he said.” We’re hoping to be working in a very different collaborative way by this summer. But it seems like every timeline we’ve established for ourselves has taken longer than expected.”

 

It’s up to the legislature to decide long-term funding, Weidanz said. “We’re very committed to the success of these projects. That’s why we’re working so hard to make them happen.”

 

Three counties in northeast Oregon – Baker, Union and Wallowa – are also interested in doing a pilot project.

 

 

A longtime booster of integration, Sen. Alan Bates (D-Ashland) pledges to continue his advocacy role. “Our safety net clinics have a mental health provider working side by side with primary care physicians. It’s more efficient. They’re doing it with existing funding, but it’s a huge stretch for the already cash-strapped counties.”

 

Reallocating funding involves a shift, he said, but it won’t be dramatic. “This isn’t a revolution; it’s an evolution.”

 

Central Oregon hopes to forge new territory. “We’re doing this without any extra resources, so we’re trying to find time to organize this,” Johnson said. “Sharing of health information takes longer than we’d like, but we’re peeling back the onion by doing one thing at a time.”

 

Such pilot projects can show how mental health services can be delivered in a new and different way, said Gina Nikkel, executive director of the Association of Oregon Community Mental Health Programs. “With backing and credibility from the state, this crucial process could really reach a tipping point for effectiveness.”