Oregon Office of Rural Health

Rural and Frontier Listening Tour

Rural and Frontier Listening Tour

The Oregon Office of Rural Health coordinates a Listening Tour of rural and frontier health facilities to discuss and share current challenges, and to encourage partner collaboration to address solutions.

2017

2017 Report

The 2017 Listening Tour included 56 rural and frontier health facilities and 25 partners. The goal of the 2017 report is to objectively address one of the challenges consistently raised during the Listening Tour- the lack of available information and clarity on the roles, responsibilities and authority of the various behavioral health providers (e.g. Local Mental Health Authority, County Mental Health Provider, Coordinated Care Organization, Hospital, Clinic). Participating partners were asked to submit information on their efforts to address the identified challenges.

In addition to Practice Sustainability, the following were also identified as 2017 Listening Tour Partner Resources:

2017 Listening Tour Partner Resources

Columbia Pacific Coordinated Care Organization (CPCCO) and Greater Oregon Behavioral Health, Inc. (GOBHI)

Columbia Pacific Coordinated Care Organization has developed a program and payment model to support the ongoing work of primary care clinics to deliver Patient-Centered Primary Care Home model outcomes-based care.

Additionally, Wellness Centers, developed with GOBHI to address chronic pain and opioid addiction, are a referral resource for primary care providers:

Oregon Association of Hospitals and Health Systems (OAHHS)

In 2015, the Oregon Legislature, with support of the Oregon Association of Hospitals and Health Systems, directed the Oregon Health Authority (OHA) to commission a study on the boarding of patients with mental illness in hospital emergency departments while they wait for a bed in an appropriate setting. OHA released the report in February of 2017.

HB 2023 of the 2015 legislative session required all inpatient psychiatric hospitals to develop and follow policies related to assessment, lay caregivers, and discharge. OAHHS developed guidelines to inform hospitals with inpatient psychiatric units on the new provisions in the law and established rules, which hospitals have implemented. Along with the guidelines, OAHHS with the help of National Alliance on Mental Illness (NAMI) and other stakeholders developed a patient-friendly brochure to help the patient better understand what to expect before, during and after the discharge process.

With the passage of HB 3090 from the 2017 legislative session OAHHS will develop and assist hospitals in implementing emergency department policies for the release from a hospital's emergency department of a patient that presents with a behavioral health crisis, including suicide prevention measures. OAHHS will again develop guidelines to assist hospitals to implement the law and rules and will work to develop patient-facing messaging to ensure everyone is aware of the release process.

For more information, contact: Katie Harris, Director of Rural Health &Program Management at kharris@oahhs.org | 503-479-6027

Oregon Health Authority (OHA) Health Policy and Analytics Division, Office of Behavioral Health Policy

The 2017 Listening Tour's most requested stakeholder partner was the Oregon Health Authority (OHA) Division of Health Policy and Analytics' Office of Behavioral Health Policy. Jackie Fabrick, Behavioral Health Policy Analyst provided co-authorship of the 2017 report.

Additional behavioral health resource information from OHA includes:

Behavioral Health Collaborative (BHC)

In 2016, OHA created the BHC to develop future behavioral health system recommendations for Oregon. The BHC is made up of peer support services, advocates, counties, behavioral health providers, courts, Oregon Department of Human Services, Oregon's coordinated care organizations, hospitals, education, law enforcement, and tribal representatives. Following the 2016 BHCC Recommendation Report, six workgroups were formed to address the identified areas for improvement. More information on the workgroups as well as data and mapping tools can be found in the above link.

Certified Community Behavioral Health Clinics (CCBHCs)

Twenty-five million dollars in planning grants were available to states to develop applications to participate in a two-year CCBHC demonstration program. Oregon applied for, and was awarded a planning grant. In December 2016, Oregon was selected as one of eight demonstration states. The above link includes the following:

  • Demonstration Advisory Group information
  • Certification and compliance materials
  • Data collection and analysis resources

Oregon Performance Plan

In response to a 1999 Department of Justice (DOJ) investigation, OHA collaborated with DOJ to create a state performance plan to improve and monitor mental health services for adults with serious and persistent mental illness. More detail on the Plan and data gathering is available at the above link.

2017 Listening Tour Partner Resources

Oregon Health Authority Office of Health Information Technology (OHIT)

Timely access to health information supports providers to improve communications, coordination and efficiencies for patient-centered care, across health care settings. OHIT projects and initiatives strive to serve patients and providers in all areas of Oregon.

The Oregon Common Credentialing Program (OCCP), established by Senate Bill 604  in 2013, will centralize the collection and verification of credentialing information for Oregon health care practitioners via Medversant's ProviderSource and Client Portal. The OCCP will be mandated for use beginning Nov. 4, 2018.

OHA is developing a state-level Provider Directory that will contain the information providers need to securely communicate and exchange patient information. It will also provide a single source of authoritative provider information, such as contact information, clinic affiliations, licensing data, etc. that can support the operations and analytics needs of health care organizations.

    Funding Available for Rural Hospitals to Implement EDIE and PDMP

    To assist Type A and Type B rural hospitals, the Oregon Research & Education Foundation, a 501c3 subsidiary of the Oregon Association of Hospitals and Health Systems, has funding available from OHA for the implementation of Emergency Department Information Exchange (EDIE) and/or Prescription Drug Monitoring Program (PDMP).  Find funding details and application information here.

    Oregon Medical Board (OMB)

    The OMB staff review all incoming license applications for their intended practice location. If the physician or physician assistant indicates an intended practice address that is on the Oregon Office of Rural Health list of rural and frontier locations, those applications are flagged, prioritized and expedited. This helps providers begin practicing in rural and frontier Oregon faster.

    Oregon State Board of Nursing (OSBN)

    Statement from the OSBN:

    While the Board has had multiple discussions related to the Nurse Licensure Compact, which allows nurses to have one multistate license with the ability to practice in their home state and in other compact member states, the Board voted not to endorse the concept as significant opposition was voiced by Oregon Nurses Association without any offsetting voice of support.

    For additional information about the OSBN's work, please visit their website. Resource links include:

    • Licensure applications and certification information
    • Scope of practice information
    • Publications

    Oregon Center for Nursing (OCN)

    The Oregon Center for Nursing facilitates research and resources for Oregon's nursing workforce. Resources on choosing nursing as a career and recent publications such as a 2018 report on Aging Trends in Oregon's Nursing Workforce are available on their website.

    2017 Listening Tour Partner Resources

    Oregon Medical Board (OMB)

    During the past two years, the Medical Director of the OMB has met with rural providers in Redmond, Roseburg, Seaside, and Lakeview to discuss the challenge of treating chronic pain and prioritize making resources available for rural providers and their patients. The Board published a booklet, Cultural Competency: A Practical Guide for Medical Professionals, in 2017 and distributed it to 17,000 licensees in Oregon. The booklet includes sections specific to caring for rural Oregonians, and features additional resources on caring for patients who have varied backgrounds in health literacy, language, ethnicity, race, and religion.

    Oregon Rural Practice-based Research Network (ORPRN)

    Through the Centers for Medicare and Medicaid Services (CMS) Accountable Health Communities Initiative, ORPRN is launching a project on social determinants of health screening in Crook, Curry, Deschutes, Hood River, Jackson, Jefferson Josephine, Wasco and Yamhill counties in 2018.

    2016

    2016 Report

    The 2016 Listening Tour expanded to include all rural and frontier health facilities. Facilities were asked what state partner organizations they would like to attend the visit. Thirty-six partners from 16 organizations participated in the tour. Forty-five facilities participated.

    Four challenge areas were identified:

    • Availability and Affordability of Housing
    • Nurse and Credentialed Medical Assistant Shortages
    • Health Information Technology
    • Patient Access to Primary Care Providers, Specialists, and Acute Care Placement Options

    2014

    2014 Report

    The first Listening Tour brought together state partners that work closely with Oregon's rural hospitals in order to collaboratively learn more about what the hospitals think is important and challenging during a period of health reform. Tour attendees included: Kelly Ballas, then Chief Financial Officer of the Oregon Health Authority, the Oregon Association of Hospitals and Health Systems and ORH. Twenty-seven rural and frontier hospitals participated.

    Five challenge areas were identified:

    • Availability of mental health services
    • Sustainability of health reform
    • Availability of long term care
    • Improving access and quality of care
    • Workforce challenges

    For questions or to request a high-resolution PDF of the 2017 Report, please contact:

    Rose Locklear, Program Coordinator | locklear@ohsu.edu | 503-577-3849