Report Shines Light on Rural Homelessness

CCOs support housing development, programs for unhoused

A comprehensive report on rural homelessness published by AllCare Health in February highlights the challenges meeting short-term and long-term needs of the unhoused population.

“Finding Home: A True Story of Life Outside” was developed by Julie Akins, Senior Housing Director at AllCare Health, through hundreds of interviews with unhoused people in Josephine, Curry and Jackson counties and research on the root causes exacerbating the crisis.

The report shows some startlingly statistics about homelessness:

  • Between 2020 and 2022 the number of people experiencing homelessness in Oregon rose by 23% or 3,304 people, to more than 18,000, according to the federally mandated point-in-time count.
  • 46% of unhoused persons cited unemployment, low income, and economic reasons such as high rents for their condition of being unhoused. The National Coalition for the Homeless cites: “46 to 60% of unhoused people float in and out of full or part-time work.”
  • Key factors in homelessness remain a reduced housing stock, notably in households earning at or below the average median income, according to EcoNorthwest.
  • The Oregon Department of Education (ODE) reports almost 22,000 children in the 2017-18 school year qualified as homeless students under the ODE definition as they lack a “fixed, regular, or adequate nighttime residence.”

The report has been covered extensively in the media, including the Oregon Capital Chronicle, High Country News, KOBI-TV, and Jefferson Public Radio.

A lack of available and affordable housing is a major factor, especially in rural counties, and AllCare Health is advocating for relaxed zoning restrictions in small communities to allow new housing development.

The Oregon Legislature has approved $576 million the past two sessions to address the housing crisis, but while houses are being built there is a continued need for resources like drop-in services and short-term shelters.

Coordinated Care Organizations are committed to supporting these local services as they advocate for long-term housing solutions.

Southern Oregon Wildfires Show How CCOs Assist in Emergency Response

Read more

State of Reform Conference Focuses on New CCO Workgroup, Measure 110

The annual Oregon State of Reform Health Policy Conference took place at the Hilton Hotel in Downtown Portland on November 14, 2023. The opening session centered on Coordinated Care Organizations, featuring speakers like Seamus McCarthy, CEO of Yamhill Community Care, and Mindy Stadlander, CEO of Health Share of Oregon.

During the legislative panel, Rep. Rob Nosse (D-Portland), Rep. Ed Diehl (R-Stayton) and Thuy Tran (D-Portland) from the Behavioral Health & Healthcare Committee, had a wide-ranging discussion of healthcare policy priorities moderated by Dan Cushing, government affairs director at Yamhill Community Care. Topics included a comprehensive CCO workgroup slated for 2025 and Ballot Measure 110.

2025 CCO Workgroup

During the 2023 Legislative Session, Rep. Nosse began talking about pulling together a comprehensive workgroup in the lead up to and during the 2025 legislative session to discuss the CCO model in Oregon. Prior to the State of Reform panel, the precise focus on this workgroup’s discussion remained vague, despite coming up fairly often in public discussions.

During the panel discussion, Rep. Nosse outlined the following priorities for the workgroup:

  • Outcomes for CCO members and their communities;
  • The regulatory framework that CCOs operate within;
  • CCO finances, with a focus on provider assessments and the medical loss ratio; and
  • The duration of CCO contracts after the next procurement.

With this framework now public, it will be easier to tailor COHO’s activities over the course of the next 18 months to dovetail with these future conversations.

Ballot Measure 110

Reforms to the Drug Addiction, Treatment and Recovery Act (Measure 110) passed by Oregon voters in November of 2020 have been front of mind for anyone having serious discussions about health policy in Oregon. “I think most of you know we are struggling with the rollout and implementation of ballot Measure 110,” Rep. Nosse said during the panel discussion.

Rep. Diehl echoed concerns brought forward by individuals who believe that decriminalization efforts have gone too far and have resulted in unintended consequences. “I think one element of it has to be re-criminalization of possession — not to throw people in jail, but to give some incentive to pursue treatment,” he said.

Some of Rep. Tran’s comments focused upon the behavioral health workforce shortage, which has been simmering for decades. The solutions to this vexing issue need to be home grown. Put succinctly, by Rep. Tran, “it’s just not going to magically appear.”

The COHO government affairs team will be working with their medical and behavioral health directors to establish some nonpolitical guideposts for this reform effort, which will be shared with policy makers early next year.

AllCare Health Uses Local Connections to Support Members During Wildfires

Coordinated Care Organization employed GIS mapping to identify members impacted by wildfire and connect with community resources

In September of 2020, the Almeda Fire tore through the Rogue Valley in Southern Oregon, destroying more than 2,600 homes and creating a health crisis for thousands more – including many members of the Oregon Health Plan. Because of its detailed knowledge of local members and its connections to community resources, AllCare Health was able to quickly deploy help to at-risk residents.

This article from the New England Journal of Medicine Catalyst (November 2022) highlights how AllCare Health, one of COHO’s members, put the promise of the CCO model into practice during the emergency:

Within hours of the fires igniting locally, AllCare Health staff began the planning process for responding to members’ needs. The following day, AllCare deployed ArcGIS (Esri, Redlands, CA), a software tool that brings together geographic information systems (GIS), mapping, and analysis, to identify our members who were living within the fire zones. The tool relies on existing addresses for our members and readily identified those at risk, enabling prompt action during the crisis.

Using internal identification keys, we were then able to initially identify more than 8,300 affected Medicaid and Medicare members, including approximately 700 elderly, 700 disabled, and 51 expectant mothers. AllCare’s IT staff then forwarded the names of affected individuals to other internal staff, who began calling those members to inquire about their well-being and needs. A total of 9,630 affected members were eventually identified.

Read the full article at New England Journal of Medicine Catalyst by Dr. Richard Williams, MD, MBA, FAAFP.

Umpqua Health Delivers Household Air Purifiers to Combat Wildfire Smoke

Douglas County’s Coordinated Care Organization used patient analytics to find at-risk members for proactive outreach

Local care delivery is about more than physical, behavioral, and oral health care. Coordinated care organizations are investing heavily in the social determinants of health (SDoH) to improve health outcomes and achieve health equity.

This article from Healthcare Business Today highlights how one of COHO’s members, Umpqua Health Alliance, is addressing local needs through data and flexible investments:

Earlier this year, Umpqua Health obtained funding that allowed it to obtain 420 air purifiers to proactively distribute prior to the 2022 fire season, but first health system leadership needed to determine which patients had the greatest need for the devices. Umpqua Health used its analytics platform to pinpoint the patients most at-risk for respiratory complications by running a model that predicts an individual’s future risk based on past events and claims data.

The health system then contacted those members via text message to gauge their interest, and then began distributing the purifiers to patients through its transitional care clinics, in addition to home deliveries for homebound patients. So far, 76% of patients contacted have accepted the offer of the air purifiers, and Umpqua Health has distributed 309 of its 420 total allotment.

Read the full article at Health Care Business Today by Dr. Rich Parker, MD, the Chief Medical Officer at Arcadia.

Oregon should protect and enhance the local coordinated care to ensure communities get the most bang-for-buck toward health and health equity.

Advanced Health Steps Up to Save Behavioral Health Unit

Coordinated Care Organization commits to covering funding shortfalls to keep critical service running in rural Oregon

The Behavioral Health Unit at Bay Area Hospital will remain open thanks to funding support from COHO member Advanced Health and other community organizations. The support led to the reversal of an earlier announcement that the unit would face imminent closure due to lack of funding. This story illustrates the important role coordinated care organizations (CCOs) play in their local communities.

Read the June 14 press release: “Community Joins Forces to Keep Behavioral Health Unit Open at Bay Area Hospital.” via Bay Area Hospital.

Oregon’s coordinated care model allows local CCOs the flexibility to meet local health needs through partnerships and investments in health infrastructure.

“Advanced Health is pleased to support this important work,” said CEO Ben Messner. “CCOs are the glue that holds the health system together and prevents people falling through the cracks, particularly in rural Oregon.”

During the pandemic and through natural disasters, CCOs across the state stepped up to help members, providers, and other partners with a range of needs, including behavioral health care. Such actions demonstrate the importance of local control, budget flexibility, and breaking down siloes through strong partnerships.

Advanced Health serves more than 25,000 members of the Oregon Health Plan (Medicaid) in Coos and Curry counties. Its network includes physician clinics, hospitals, county providers, substance abuse, and dental services.

COHO is an association of seven CCOs across Oregon. It advocates for local control, health equity, and preserving the coordinated care model.

AllCare Health Removing Barriers Through Translation Services, Foundry Village

Read more

In Grants Pass, Foundry Village Project Builds Bridge Out of Homelessness

Read more

InterCommunity Health Network CCO Joins Coalition for a Healthy Oregon

CORVALLIS, Oregon – Coalition for a Healthy Oregon (COHO) is pleased to announce that
InterCommunity Health Network (IHN-CCO) has joined its statewide association of coordinated
care organizations (CCOs). COHO members are CCOs that connect members to physical,
behavioral, and dental care in communities across the state. CCOs provide high-quality, locally
controlled health care and wellness services to people who qualify for Medicaid due to low
income or disability.

COHO’s seven CCOs serve more than 282,000 Oregonians, amounting to 39% of CCO members
outside Multnomah, Washington, and Clackamas counties. IHN-CCO serves more than 71,000
Oregonians in Benton, Lincoln, and Linn counties.

“We are pleased to welcome InterCommunity Health Network CCO to the COHO family,” said
Doug Flow, COHO president. “We will all benefit from their unique perspectives and ideas.”
COHO members have been top performers in health quality metrics, which improve population
health while saving taxpayer dollars.

“InterCommunity Health Network shares COHO’s values of advocating for members, fully
funding Medicaid, and maintaining local control,” said CEO Bruce Butler. “COHO is a thought
leader in Medicaid policy, and we will collaboratively continue the hard work of transforming
health care for the benefit of our members.”

IHN-CCO was formed in 2012 by local public, private, and non-profit partners to unify health
services and systems for Oregon Health Plan (Medicaid) members in Benton, Lincoln, and Linn
Counties. IHN-CCO is committed to improving the health of their communities while lowering or
containing the cost of care, coordinating health initiatives, seeking efficiencies through blending
of services and infrastructure, and engaging all stakeholders to increase the quality, reliability,
and availability of care.

COHO has played a key role in the continued evolution of the Oregon Health Plan and health
care policy in Oregon since it was founded in 2005. With the support of its members, COHO is
known for bringing innovative ideas to Oregon health policy.

In the current legislative session, COHO has worked with legislators to advance House Bill 3353,
which asks the federal government for greater flexibility and matching dollars for provider
reimbursement and investments in the social determinants of health. When Oregon faced a
budget crisis due to the COVID-19 recession, COHO was instrumental in providing to state
budget leaders a pathway to maintain Medicaid funding.

About COHO

COHO’s members include Advanced Health (serving Coos and Curry Counties), AllCare Health
(serving Josephine, Jackson, and Curry Counties and parts of Douglas County), Cascade Health
Alliance (serving Klamath County), Trillium Community Health Plan (serving Lane County and
parts of Linn and Douglas Counties), Umpqua Health Alliance (serving Douglas County), Yamhill
Community Care Organization (serving Yamhill County and parts of Washington and Polk
Counties), and InterCommunity Health Network (serving Linn, Benton, and Lincoln counties).
COHO and its partners have helped expand the number of individuals who qualify for the
Oregon Health Plan, promoted primary and preventive care, strengthened wraparound
services, and secured stable health care funding through the passage of provider assessments
and Ballot Measure 101.