March 6, 2013 – The status of a former member of Health Share of Oregon's Community Advisory Council who resigned last month as the director of the Housing Authority of Clackamas County was the subject of heated discussion when its Community Advisory Council met last week.
Trell Anderson served on the council since its inception but was apparently asked to reapply for membership, a process that could take months. Sam Chase, a council member and director of the Coalition of Community Clinics, made a motion to recommend to the executive council that Anderson be remain as a member without having to go through that process.
“I felt that without more information it was compromising the integrity of the council,” said council member Amy Anderson. “He was asked to resign by Clackamas County. It just kind of came out after the meeting he had attended.”
“I can understand that concern. I would share that concern. Clackamas County has had some extremely conservative changes as far as their council,” Chase said. “To me, those are separate from the importance of the work we're doing here.” Chase then withdrew his motion, saying the conversation about the process had been productive.
The discussion about retaining Anderson came after a short presentation by community engagement coordinator Jacob Figas, who talked about the coordinated care organization's efforts to recruit more members in general and those representing Clackamas County in particular. Figas clarified that the advisory council is intended to represent all three counties in the CCO but there are no requirements that representation be distributed a particular way (for instance, there do not have to be an equal number of representatives from each county).
During her presentation, CEO Janet Meyer talked about the requirement that CCOs incorporate mental health and addiction services by July. “We're concerned that the addictions system has been underfunded for years,” she said. “Pushing an underfunded system into the CCOs is concerning.”
Meyer also noted that 90 percent of the beds that provide mental health and addiction services in Oregon are in Health Share's coverage area, meaning many people from around the state will come to the Portland area to get treatment.
Where previously, patients could be disenrolled if they left their coverage area to seek treatment, that option went away under the CCO legislation. “That's good because it will ensure continuity. The complicating factor is, if a Health Share member goes to Baker for treatment, Baker will need to provide care,” Meyer said.
Meyer also commented on the CCO's efforts to recruit staff, acknowledging that so far Health Share's staff is not as diverse as it could be. In addition to posting job listings to Indeed and Craigslist, Health Share runs ads in publications geared toward minority groups, she said.
“It's not always clear when you get a resume how somebody identifies,” Meyer said, but Health Share does receive a large number of resumes from out of the state.
Government and regulatory affairs manager Ashlen Strong gave a legislative update to the council, saying the government relations workgroup has developed a framework of three principles, adopted by the governing board, around which its political advocacy is built: fully funding the governor's budget, maintaining existing statutory framework for CCO governance, and allowing CCOs to build their provider networks.
“Health Share really needs to focus on the business of the system. We can't do that if the structure is a constantly moving target. If the state keeps coming in and telling us to change the structure we can't focus on the real work,” Strong said.
Asked if there was a way advisory council members could be informed of legislation that might affect the Oregon Health Plan population and provide feedback to the government relations workgroup, Strong said she would happily share the list of bills she is tracking and encouraged input from the community, but did not think there would be time to provide detailed analysis on all the relevant bills.
“I don't know that we have frankly the staff resources to do the analysis for each issue that affects the OHP population,” Strong said. “I do have a tracking list that I'd be happy to share with everybody. I have a list of 50 or 60 bills that maybe might one day affect the population.”
One bill that concerned the committee, Strong said, would require the community advisory council to approve the business plan for the CCO, which “sounds, at first blush, like a great idea” but could affect the makeup of the council and undermine the governing board.
“We really feel like the best body to make those kinds of decisions in the governing board,” Strong said.
Lee Girard, community services manager for Multnomah County Aging and Disabilities Division, also made a presentation on the role of CCOs in providing long-term care. She mentioned a pilot program in Multnomah County that is looking at reducing costs among seniors and people with disabilities, particularly those living independently, to ensure they are not, for instance, re-hospitalized after one visit.
“On the health side, they don't always know when the person that they're working with has a long-term care manager,” Girard said. “On our side, we don't always know when a client has been in and out of the hospital.”
