We are incredibly excited to share the third feature of our health equity series! Last Month, Cascade Health Alliance announced a significant investment in Klamath & Lake Community Action Services (KLCAS), a nonprofit that assists individuals who have been financially impacted by the pandemic. KLCAS’ services to Oregonians include assistance with rental paymentsutility paymentsparenting supports, and more.

Cascade Health Alliance has long been dedicated to breaking down barriers that cause health inequities by focusing programmatic investments on the social determinants of health. These determinants, like stable housing, food security, access to transportation, connection to support systems and community, fit a new idea of what “health” is. This idea of health truly encompasses the full systemic view of a person’s life, and how other factors affect their health.

We know that across Oregon, hundreds of thousands of people have been laid off or furloughed without pay, and therefore have lost their health insurance. Additionally, they may have medical bills from contracting COVID-19, which leaves little to no room to continue to pay rent, buy groceries, and afford basic necessities. Even worse, our unemployment system is falling behind due to the staggering number of claims, leaving many without unemployment insurance for months. In a message from Director Pat Allen of the Oregon Health Authority, he shared that the COVID-19 pandemic has had disproportionate impacts on Black and African American communities, Asian and Pacific Islander communities, Native American communities, and Latino, Latina, and Latinx people in Oregon. When our communities are hurting, it is our job to ensure that they are cared for.

Because Cascade Health Alliance knows that health is more than just ensuring you see your doctor at regular intervals, they made the decision to invest $50,000 in KLCAS so they could continue to provide basic necessities to Oregonians who may not be able to afford them right now. The donation provided by Cascade Health Alliance was used as matching funds by KLCAS to secure an additional $198,738 for rent relief funding through COVID-19 CARES Act funding.

Tayo Akins, Cascade Health Alliance CEO, stated, “There is a tremendous need for organizations like Klamath & Lake Community Action Services right now. With more of our neighbors losing their jobs and uncertain about their futures, now is the time to step up and support agencies that extend a firm hand of relief. KLCAS had been one of them for a long time, and we appreciate their hard work to help those most in need.”

This dedication to dismantling health inequities before, during, and after COVID-19 does not just benefit Oregonians receiving rental assistance, utility assistance, childcare assistance, as well as stellar health care coverage. When we provide the support that Oregonians need to keep them safe and healthy, we save the state and all Oregonians money, because fewer people end up in the Emergency Department.

Have you been wondering how COHO CCOs are able to make quick decisions on dynamic investments in key areas across the State, while still focusing on the needs of their community? COHO CCOs all have strong, aligned, policy priorities that include their dedication to decreasing barriers and discrimination in health care. These policy priorities guide not only our government affairs teams in working with legislators and other public officials on passing legislation that protects Oregonians on the Oregon Health Plan (OHP), but also guides our CCOs in making programmatic investments. We look forward to continuing our health equity series, in which we share the stories of our CCOs working together across the state, to ensure that OHP members are getting the care that they need on the ground, and the advocates they need at the Legislature.

Thank you, Cascade Health Alliance, for continuing to lead the effort in building and maintaining healthy communities! To read Cascade Health Alliance’s press release on the topic, click here.

This Monday, two members of the Coalition for a Healthy Oregon testified to the Senate Health Care Committee on their provider support strategies during the COVID-19 pandemic. Dr. Jeanne Savage, Chief Medical Officer of Trillium Community Health Plan, and Will Brake, the Chief Operating Officer of AllCare Health represented our association to the Senate Health Care committee, sharing succinctly the many different innovative solutions our CCOs have dreamt up to help keep provider doors open through this crisis.

Dr. Savage testified on her perspective as a physician herself, sharing that her role as a provider helped her see the needs in the community, because she saw them in her own practice. She detailed some of the many investments Trillium has made in their community to ensure that providers were able to maintain staffing capacity and see OHP members. Will Brake followed Dr. Savage, detailing the interpreter services delivered by AllCare, and putting an incredible fine point on the fact that AllCare (like many CCOs) also pay providers a monthly rate instead of per-member reimbursement for services.

A few days before the committee hearing, Brian Neuubert, the Legislative Policy and Research Office (LPRO) Analyst for the Senate Health Care Committee reached out to request COHO’s help in finding members of our CCOs to testify on CCO provider supports.

COHO got to work brainstorming a representation that would share both an urban and rural perspective, so legislators could have a clear understanding of what is happening on the ground. Trillium Community Health Plan was excited to share the many ways they have been aiding providers, and identified Dr. Jeanne Savage, both the CMO and a provider that serves Trillium as the perfect person to deliver our message.

AllCare Health was equally excited to join in on the conversation, and helped us determine that Will Brake, the COO and member of the Metrics and Scoring Committee run by OHA, would be another amazing messenger.

Thank you for your willingness to participate, and your wonderful representation of both rural and urban CCOs.

To read more about investments made by Trillium Community Health, click here. To read more about investments made by AllCare Health, click here.

Trillium

AllCare

At the outset of Oregon’s coronavirus outbreak, Gov. Kate Brown issued sweeping executive orders to help “flatten the curve” and preserve health system capacity. One of these orders was a ban on non-urgent medical procedures, which has since been lifted.

Gov. Brown and her medical experts have encouraged people to seek the health care they need. Nevertheless, the volume of activity has not returned to normal (this could be for a variety of reasons, such as folks worrying about contracting COVID-19 or spreading it to others). While necessary in the early weeks of the pandemic, the ongoing slowdown has meant a major decline in revenue for many providers. Most importantly, there are concerns that deferred care could lead to worsening of certain health conditions.

In the months ahead, health care professionals expect a surge in demand for preventive care, dental care, elective surgeries, and other services. This begs the question: what effect will this have on our Medicaid system?

Throughout the pandemic, CCOs have been helping providers, clinics, and other health care providers keep their doors open and maintain capacity by delivering financial support. However, CCOs’ global budgets do not necessarily take into consideration the multi-month global pandemic we are currently going through.

Many of the providers who serve Medicaid patients are reimbursed through sub-capitated payments (per member per month). These payment arrangements could help level off the peaks and valleys of utilization, as well a potential future surge in demand. Nevertheless, there is little reason to believe the decline in utilization during the second quarter will lead to any real “savings” by the CCOs. This is especially true when considering the potential spike in activity and the progression of certain conditions due to the interruption in care.

In order to responsibly plan for the medical surge that may lie ahead, CCOs are focused on coordinating care for members and keeping their partners, the provider community, in business. It remains to be seen how the system will be impacted in the long run, but CCOs are well positioned to handle these irregularities while providing excellent health care to Oregon Health Plan members.

All our member CCOs are doing a fantastic job ensuring that their members get the care that they need during this crisis, and this week we decided to highlight the work of a CCO that is not currently in our membership. Yamhill CCO is constantly innovating for the Oregonians living in their service area, and we wanted to share a heart-warming story of how our friend, Yamhill CCO, is aiding its community.

As the first waves of COVID-19 hit our state, Yamhill CCO was working to keep their members connected to the services they needed. As Yamhill’s team brainstormed, they realized that their Non-Emergent Medical Transport (NEMT) contracted service, which had taken a downturn, could be utilized to take members important places that are not traditionally covered under this service.

Yamhill gave their NEMT contractor the go-ahead to take their OHP members to health-related services: meaning that members could now utilize NEMT to travel to food pantries, grocery stores, the employment office, the bank.

Yamhill’s innovation will allow OHP members to safely travel from their home or shelter to essential services that they may otherwise not have had access to. These safe, clean, and free rides are incredibly helpful for vulnerable Oregonians as well, as members using the services will only have contact with only a single person during their ride, decreasing their risk of exposure.

This will also provide income to local Oregonians who make their earnings through the NEMT service that Yamhill has contracted with.

This initiative was set up as a Community Benefit Health-Related Services expense in less than two weeks from conception to fruition, and Yamhill CCO invested about $50,000 to jumpstart the program.

Yamhill does not intend to shut this program down when our State reopens, though. They’re hoping that with the kickstart to this program already completed, that they will be able to continue funding this service for their OHP members. As Yamhill gains insight into how COVID-19 has affected their budget and if this is a service that OHP members will need after the pandemic, they can begin making plans to continue this program as permanent.

Thank you, Yamhill CCO for your amazing investments in our communities, and your dedication to serving Oregonians. We look forward to working with you again in the future!

Prior to the Revenue Forecast, which was released to the public this past Wednesday, Oregon Legislators and Governor Brown were staring down a budget shortfall of unknown proportions. In preparation for the Revenue Forecast, and to shore up potential budget holes before the end of the year, Governor Brown asked every agency to put together recommendations for large cuts across the board.

Now that the budget forecast has been released, we know that there is an estimated $2.698 billion shortfall for the 2019-2021 biennium, as shortfalls in the next two biennia that total $4.384 billion and $3.381 billion, respectively.

However, the Revenue Forecast was not all bad news. We know agencies have a positive ending fund balance that when added together totals about $1 billion. We also have about $1.586 billion held in the State’s “Rainy Day Fund.”

Even with the ending balance budget, and the large reserves that Oregon carries, we may still be short on shoring up the budget, meaning that agencies will most likely have to make cuts. Last week, the Oregon Health Authority (OHA) told Coordinated Care Organizations (CCOs) that in their worst case scenario, there could be up to a 2.38% cut to the Oregon Health Plan (OHP) funding.

While 2.38% certainly does not feel like a big number, it gets much larger when you begin considering the high federal match that Medicaid dollars bring in from the federal government. If we include the match dollars in that percentage, the cuts for OHP will look more like 6%. Last year, CCO budgets totaled $6 billion dollars. If this 2.38% cut is instituted, the Oregon Health Plan will lose $142.8 million dollars, and Oregonians will lose $360 million dollars in vital health and health related services.

While we recognize the difficult position our State Legislature and Governor are in with deciding how to balance the budget, we believe that continuing to preserve the federal match dollars we receive through our Medicaid program will enable our state to recover economically, while still allowing Oregonians access to vital programs.

At a time when we expect a surge of new enrollment due to job losses, the best way to support the health care safety net is by fully funding Oregon’s Medicaid program, the Oregon Health Plan.

All our member CCOs are doing a wonderful job of ensuring that Oregon Health Plan (OHP) members are getting all their needs met during COVID-19, and this week, we decided to highlight an exciting new initiative by Advanced Health.

Out in Coos and Curry Counties, Advanced Health CCO is looking to increase access to telemedicine by creating what they call the “Telehealth Access Fund.” This fund is specifically geared toward providing funds to health care providers so they have the financial bandwidth to improve or install technology that allows them to visit patients virtually.

Essentially, any health care provider in Coos or Curry County can apply for dollars through Advanced Health CCO, sharing information on how much financial support they need, what they intend on purchasing, and a few other details. Then, Advanced Health runs these applications through its board and Clinical Advisory Panel (CAP). Once applications are approved, these dollars go straight to the provider to invest in telehealth.

While Advanced Health is accepting applications from all network providers across their service area, they are working to ensure that small, independent health care practitioners, especially those in behavioral health and substance use treatment, know about this program and have the information they need to apply for it.

Advanced Health has been interested in launching a program like this for quite some time. Because the service area they work in is incredibly rural, Oregonians often must drive long distances to get to an appointment. Increasing providers that utilize telehealth will be positive during COVID-19, so no one risks exposure, but the effects of this fund are much more long-lasting than that.

During the pandemic, health care providers utilizing telehealth can use a wider range of platforms than usual, including Zoom, FaceTime, Skype, etc. However, once COVID-19 is a thing of the past, providers will need to return to HIPPAA-compliant technology to deliver telehealth. By providing these dollars to local providers, Advanced Health is ensuring that those providers will be able to offer telehealth to everyone in their area, even after the COVID-19 pandemic has ended.

Advanced Health is not stopping there with their efforts to increase access to telehealth during this pandemic. On a case-by-case basis, they are working to get much-needed technology to those who may not have access to a computer or smart phone, so that they can continue their regular health care.

Thank you, Advanced Health, for your dedication to ensuring your community has the resources they need during the pandemic. These investments will reap positive outcomes for years to come. Your innovation is impressive!

All our member CCOs are doing a fantastic job at ensuring that their communities have their needs met throughout this crisis, and this week we are featuring some investments made by Trillium Community Health Net.

Trillium has been focused on investing in community partners to respond to needs related to the crisis, and we are here to detail all the amazing investments that Trillium has made in their community right here in Oregon, including the tens of thousands of dollars to expand food distribution programs in metro and rural area school districts, specifically targeting schools that have a 50% or greater free and reduced lunch participation.

These investments, made from their parent company’s COVID-19 Community Relief Fund, are intended to provide financial support to areas of social determinants of health that are becoming even more prevalent now that hundreds of thousands of Oregonians are laid off work, and potentially can’t afford basic necessities.

Trillium partnered with their Community Advisory Committee (CAC), which is made up of board members, community members, and at least one Oregon Health Plan (OHP) member to decide what their priorities should be within the community, and continue to have conversations about how to best aid their members and providers on a weekly basis.

Through this collaboration, Trillium decided that the most important needs for their members were food resources, access to high-speed broadband connectivity, and providing key health and educational products to those in need.

Not only did Trillium invest in the metro food distribution program, they also provided support to a local nonprofit by matching donations at a local food drive, and investing directly into the nonprofit to ensure that families have immediate access to food.

Finally, Trillium donated 500 Walmart gift cards to organizations that provide assistance to houseless and other marginalized populations. These gift cards were distributed among eleven different organizations across Trillium’s entire service area, to ensure that Oregonians are getting the help they need. This investment specifically allows individuals experiencing houselessness to buy necessities such as diapers, tents, and hygiene products.

Thank youTrillium for you wonderful investments in your community! We can’t wait to see what you do next!

Oregonians have successfully flattened the curve enough to have most counties move into phase one of the Governor’s plan to reopen the state. Last week in a press conference, Governor Brown announced that all counties would be able to apply to reopen, and approval would depend on whether or not they were prepared to meet social distance, testing, contact tracing,  and hospital capacity requirements to execute a safe reopening.

In a press conference on Thursday, Governor Brown announced that 28 counties met the requirements and would be able to open today, May 15. By the end of the day, that number had increased to 31 counties.

That means in these counties, some nonessential businesses like restaurants, bars, gyms and salons in those counties can open as long as social distancing and protective measures are followed. Gatherings can also increase to 25 people.

Two counties, Marion and Polk, applied to reopen but did not meet the Governor’s criteria. Clackamas, Multnomah, and Washington counties have not yet applied. In response to a question about whether people from closed counties can travel to counties that are now open, OHA Director Pat Allen said, “Reopening is a team sport. It is not going to work if some people follow the rules and others don’t. We need everyone to do their part.”

In addition to reopening nearly all of Oregon’s counties, the Governor issued new guidelines for all counties, even those who have not been approved to enter phase one. Those guidelines include:

  • Grocery stores, pharmacies, banks and credit unions, and gas stations are all open.
  • Restaurants are open for take-out service only.
  • Stand alone retail operations are open provided they meet required safety and physical distancing guidelines. Indoor and outdoor malls are closed.
  • Local outdoor recreation activities are open, including many state parks.
  • Non-emergency medical care, dentist offices and veterinary care are open and operating, provided they meet required safety guidelines.
  • Local cultural, civic and faith gatherings are allowed for up to 25 people provided physical distancing can be in place.
  • Local social gatherings over 10 people are prohibited and those under 10 people must use physical distancing.
  • Personal care services such as salons and barbers, as well as gyms, are closed.
  • Child care is open under certain restrictions, with priority placements for children of health care workers, first responders, and frontline workers.
  • Public transit is open under certain restrictions, and must be sanitized often and enforce 3 feet of space between passengers
  • Summer school and camps

For more information about the reopening, as well as guidelines for businesses in open counties, go to https://govstatus.egov.com/reopening-oregon#countyStatuses.

On Thursday, Governor Kate Brown detailed the next phase of her plan to reopen Oregon. This followed her announcement on May 5 that some state parks, outdoor recreation facilities, and areas across Oregon would have limited opening for day use.

Oregon’s COVID-19 infection rate is the fourth lowest in the U.S. The social distancing measures that Oregonians have been adhering to since March have resulted in successfully flattening the curve, and now the Governor’s efforts are turning toward safely and slowly reopening each part of our society and economy.

In Thursday’s press conference, Governor Brown detailed the prerequisites to gradually opening the state, which includes a decrease in symptoms, cases, and hospitalizations for at least 14 days. Businesses should be prepared to record customers’ contact information for contact tracing, and counties must be able to trace 95 percent of contacts within 24 hours. As well, counties must have the capacity to adequately test 30 people per 10,000 residents per week.

Other requirements include adequate testing capabilities and personal protective equipment for hospitals. Hospitals must have 20 percent of their beds available.

Counties throughout Oregon can apply to reopen beginning Friday, May 8, and if they meet the criteria, some counties may be able to reopen as soon as Friday, May 15. Pat Allen, director of the Oregon Health Authority, said he expects most counties in Oregon to be able to meet the criteria to begin the first phase of the Governor’s plan to reopen the state.

Under Phase One, restaurants, bars, and retail businesses can reopen, as long as they are able to follow Occupational Safety and Health Administration guidelines. As well, personal care businesses, such as salons, barbershops, gyms, and other businesses will be allowed to reopen. Childcare, summer school, and youth programs will also be allowed to resume.

“We are not returning to business as usual. We are venturing into uncharted territory,” said Director Allen. To watch the full press briefing, click here.

All our member CCOs are doing a stellar job caring for their communities during this crisis, and this week, we will be highlighting the efforts of AllCare Health to ensure that everyone in Curry, Josephine, and Jackson counties have access to culturally appropriate information about this public health crisis, in a language that they can read.

Even prior to this public health crisis, AllCare Health maintained a robust interpreter program in which they provide language assistance services to members and providers alike. But now, when local public health agencies do not have access to meaningful interpreter services to get vital information to communities, AllCare is stepping in to make sure that translation and interpretation services are happening.

From big picture initiatives, such as partnering with local public health agencies to distribute language-specific health information, to meeting individual member needs, such as purchasing iPads for deaf OHP members so they can access provider services via telehealth, AllCare is on it. They are currently in collaboration with Josephine and Jackson County Public Health and are providing American Sign Language (ASL) and Spanish speaking interpreters, as these two languages are the highest utilized among residents in that area other than English. In Curry County, AllCare Health is offering free interpretation and translation to any nonprofit organization over the phone!

In every decision that AllCare has been making regarding how they spend their Social Determinants of Health and Equity (SDoH-E) dollars, language access is always a consideration, especially during a pandemic. Now, those who are deaf, hard of hearing, or are not English language speakers will have access to the information they need. And, in some cases, members may even be given the technology they need to access that information. Plus, with AllCare utilizing interpretation services at such a high rate, interpreters who were laid off or had their hours cut will have a source of income.

AllCare also serves Oregonians who might not have received stimulus checks for reasons including their marital status to an undocumented Oregonian. Because AllCare knows many of their members could be suffering from lack of income and resources, they also donated $25,000 in gift cards to grocery stores directly to their Regional Health Equity Coalition (R-HEC) to be distributed to those most in need. The R-HECs are collaborative, community-led groups that work regionally to identify and address health equity issues, and they work with CCOs to create and operationalize projects that combat health inequities based in race. With the R-HEC’s expertise in these health inequities, paired with AllCare’s deep knowledge of the community, the hope is that the hardest hit communities will be covered.

The list of investments AllCare has made in their communities is extensive, including investing $10,000 in Unete, a Farmworkers Advocacy Group, as well as $5,000 to each Community Advisory Committee (CAC) to be invested in pilot programs that they deem the community needs. The CAC is made up of members of the community, including at least one OHP member, as well as board members.

Are you curious about what other amazing things AllCare Health is spending their dollars on? Click here to view the Community Support page of AllCare’s website, which is updated to reflect all of the investments AllCare Health is making in their community!

Thank you AllCare Health for your deep dedication to cultural responsiveness as well as language access during this pandemic, and for working so hard to care for your members!