CCO Highlight: Trillium Community Health Net

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!

/by

Reopening Oregon

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.

/by

Governor Brown’s Plan to Reopen Oregon

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.

/by

CCO Highlight: AllCare Health

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!

/by

E-Board Meets, Announces COVID-19 Funding

Last Thursday, the Joint Emergency Board of the Oregon Legislature met to discuss the possibility of providing funds to several key industries that are struggling across the state of Oregon. On the docket for the E-Board meeting were discussions about general housing, funding for businesses, emergency housing for domestic violence, establishing an Oregon Worker Relief Fund, creating a critical-access hospital loan program that we discussed last week, among many others.

Below is a breakdown of how Oregon legislators allocated the funding:

Safe Shelter and Rental Assistance – $12 million

This funding will provide rental assistance and safe shelter alternatives for individuals who have lost their income due to COVID-19. It will also provide shelter for people at risk of infection or health problems due to inadequate shelter or housing. $3.5 million will be allocated to purchasing hotel vouches for homeless individuals and farmworkers, and $8.5 million will be allocated for rental assistance for Oregonians who make less than half of the median income and lost wages from the pandemic.

Oregon Worker Relief Fund – $10 million

This funding will provide payments to workers who are ineligible for traditional unemployment, either because they do not have access to traditional unemployment insurance programs or are ineligible due to their immigration status.

Small Business Assistance – $10 million

This funding will establish an assistance program for small businesses with no more than 25 employees impacted by COVID-19 economic restrictions that have not received support from the federal CARES Act. The $10 million small business assistance program will include $5 million from the Emergency Fund matched with $5 million from existing funds in the executive branch’s Business, Innovation and Trade Division.

Domestic Violence Housing Support – $2 million

This funding would provide emergency housing for victims of domestic and sexual violence.

“We have all be hit hard by this pandemic,” said Sen. Peter Courtney, D-Salem. “Today, Legislators from across the state came together to support Oregonians.”

/by

CCOs Brainstorm on Houselessness

The Coalition for a Healthy Oregon (COHO) has begun meeting on a weekly basis during the pandemic to share ideas, concerns, and solutions that we have found to work in our own communities. From food resources and security solutions to leveraging current resources to meet new needs, we have worked to gather and enact comprehensive ways CCOs can aid their communities during this time.

One health-related concern that is especially hard to tackle is securing housing for OHP members who are currently unhoused our will become houseless throughout the pandemic. We know that many may lose their housing due to interpersonal violence, loss of a job, or other factors.

For these reasons, COHO CCOs put their heads together on policy solutions and ideas, as well as other on-the-ground tips to tackle houselessness, especially during times of crisis.

CCOs across the state are working to leverage their current global budget and put money allocated towards Social Determinant of Health & Equity (SDoH-E) spending toward housing assistance for OHP members. This includes rental support for those have housing but may have lost a job. In some cases, hotel rooms have been utilized for survivors of domestic violence and high-risk individuals experiencing houselessness. This tactic works in well-populated and urban areas, as there are many hotel rooms that can be rented.

Some CCOs that serve areas in more rural areas of Oregon do not always have this luxury. Some areas of Oregon have one or two motels or hotels, but often these do not have the capacity to house the number of OHP members that need to be sheltered. Another catch for utilizing the Medicaid dollars that make up the CCOs’ global budgets is they may not be used for brick and mortar. This means that CCOs must contract with other businesses and organizations if they need to build housing to shelter their members.

Big cities like Portland have begun utilizing spacious entertainment centers, that have a plethora of showers/locker rooms, like the MODA center in order to shelter Oregonians. Because the Metro regional government owns this center, it was fairly easy to use this space as a shelter. Again, not all rural towns and cities across Oregon have access to large stadiums.

However, the cities and towns across Oregon all own something, right? Some plot of land, some tennis courts, a school, even? Big spaces that have lots of bathrooms and showers could serve this purpose while they are closed due to the pandemic. Schools would be especially convenient, as they have dedicated places for consuming meals, recreational activities, and the like. Sports facilities, like indoor tennis courts, or university/community college sport’s facilities would be another place Oregonians could safely be housed through this pandemic. If the land, sports facility, or school is owned by the city or county, realistically, that city or county can grant access to CCOs to utilize during pandemics.

These are complex issues with no easy answers. We welcome the community’s input as we continue to do everything possible to support our members.

/by

CCO Highlight: Umpqua Health Alliance

All our member CCOs are doing a stellar job meeting OHP members’ needs and keeping folks out of the hospitals! This week, we are highlighting Umpqua Health Alliance for their incredible work and investment in a local domestic violence advocacy center, Peace at Home.

The rate of domestic violence is already quite high in the United States, with someone experiencing violence at the hands of their partner every 20 minutes. Across the nation, we have seen spikes in domestic violence since social distancing measures began, giving us a clue at what it must be like to be quarantined in a violent situation with no reprieve, for a period of time that is completely undetermined. In fact, one of Peace at Home’s 22 community-integrated advocates shared that every day last week, they interviewed someone who had been strangled by an intimate partner.

Umpqua Health Alliance (UHA) knows and believes that safety during this pandemic also means safety from violence in the home, and relief is about more than just economic relief. So, UHA reached out to a local domestic violence advocacy center in Roseburg to see how they could help.

Peace at Home currently offers incredible emergency services to its community like a 24-hour crisis line, peer counseling, safety planning, assistance with securing food, door lock changes, and most importantly of all, emergency shelter.

Before this collaboration, Peace at Home was already running two shelters for those experiencing family violence, sexual assault, and human trafficking. These shelters were communal living, meaning that people in the shelters often shared quarters and had less independence.

Working together, Peace at Home and UHA concluded that the community most needed more shelter room or capacity to meet the increased demand for safe space during COVID-19. By using dollars from UHA’s COVID-19 Relief Fund, Peace at Home now had the ability to move currently sheltered Oregonians from the communal shelters into rooms of their own where they can self-isolate and be more independent.

This incredible investment by Umpqua Health Alliance has also freed up all the space in the communal shelter, which can now go to other Oregonians living in unsafe situations during this pandemic. UHA did not just make an investment and leave it there—instead, leadership at UHA has continued to reach out to Peace at Home to learn how they can better serve their members who are survivors of violence at home, as well as better understanding the help those Oregonians need.

Thank you, Umpqua Health Alliance, for your dedication to safety and relief during the COVID-19 pandemic, and your desire to help those experiencing violence at home. We look forward to sharing more about what UHA is doing with the remainder of their COVID-19 Relief Fund.

/by

OHA Submits Waiver for COVID-19 Relief

The Oregon Health Authority (OHA) shared late last week that they submitted a Section 1115 Waiver to the Centers for Medicare and Medicaid Services (CMS) to request a COVID-19 Disaster Relief Fund. This waiver, like the one that OHA previously submitted (detailed here), are generally used during emergencies like the current COVID-19 pandemic.

In OHA’s waiver request, they reference that while Oregon is lucky to have a lower COVID-19 caseload then other states, our adherence to aggressive social distancing and the cancellation of elective procedures is creating a huge financial strain on our health systems. This move would increase flexibility for how federally matched payments can be used with Medicaid being the payer of last resort. While this could bring in federal resources for some COVID-19 spending, the Oregon Health Plan faces a budget shortfall that General Fund dollars may not be able to fill.

This waiver, submitted by the state’s Medicaid Director, Lori Coyner, is dated April 17, but as far as we know, the state has not yet received approval from the Federal Government.

Without federal dollars to help our health systems, we will lose our ability to preserve access to care. CCOs have done a great job keeping people out of the hospitals, but the cancelation of nonemergency procedures has led to decreased revenues for hospitals and other providers.

At the same time, hospitals are incurring new costs related to COVID-19, including telehealth platforms, bed reconfiguration, off-site screening venues, and quarantine/post-acute care sites. The result is a need to cut costs, including staff reductions, which poses a threat to Oregon’s health care delivery system.

It is common knowledge that other medical technology like ventilators, respirators, and personal protective equipment (PPE) is in high demand and very short supply. OHA expressed doubts as to whether CARES Act funding would meet specific needs of Medicaid providers, so the Disaster Relief Fund is needed to help cover critical expenses.

Under the proposal, health systems would likely need to first seek support through other public and private means, so that Medicaid is the payer of last resort, and any dollars paid out would be subject to audit.

We will keep you updated on the status of this request.

/by

CCO Highlight: Cascade Health Alliance

All our member CCOs are doing a wonderful job filling gaps and providing services to their members, and this week we are focusing on Cascade Health Alliance of Klamath Falls, Oregon.

Late last week, Cascade Health Alliance (CHA) got an email from Basin Transit, alerting them to the fact that starting now, no one will be allowed on public transit in Klamath Falls without a face mask. This could be detrimental to some OHP members if they do not have the ability to buy or make their own face masks, as many OHP members travel using public transit.

This concern over their member’s safety while using public transit was a catalyst for CHA. They sprang to action to ensure that their OHP members, employees, and their employees’ families have access to face masks—especially those being made and sold locally.

Because so many Oregonians are currently out of work, CHA’s team started looking for a local supplier so the money they spend on face masks could go directly back into the community and help other Oregonians pay their bills.

With some luck, a lot of hard work, and a couple community asks, CHA was able to find a local supplier of face masks who used to run a different small business. This community member re-tooled her shop to make and sell reusable, COVID-19 safe facemasks to those who need them. With the income earned from selling masks, the local supplier was able to hire three more neighbors who had also been laid off due to COVID-19.

To be sure the masks were COVID-19 safe for their members, Cascade Health Alliance had a trusted provider of 25 years, Dr. Raul Mirande, a general surgeon, check that the masks were up to snuff.

Once they got approval from Dr. Mirande, CHA was thrilled to collaborate with these amazing Oregonians who were already making masks for their neighbors and friends! Cascade Health Alliance commissioned 2,500 masks from their community partner, which is the largest order the small business in Klamath Falls had ever received!

These face masks will be delivered weekly to OHP members and CHA employees through no-contact delivery, or during a non-emergent medical transport.

Now, while running errands, riding the bus, or going to work, OHP members served by the Cascade Health Alliance, and CHA employees will be able to keep themselves safe.

People of Klamath Falls, we have good news! Cascade Health Alliance literally has you covered!

Thank you CHA for your hard work and commitment caring for people in the Basin and for quickly and thoughtfully addressing this problem.

/by

Provider Interview: On the Frontlines during COVID-19

In Portland every night at 7:00 p.m., Oregonians gather on their porches and front lawns to bang together pots and pans, play their drums or other instruments, and cheer for health care providers working to keep our communities safe during this pandemic.

Do health care workers and providers hear our cheers and thanks? What do they think about the state’s response to COVID? Do they need more Personal Protective Equipment (PPE)? Do they have any advice or thoughts about what regular people like you and I should be doing?

Most importantly: if we could speak with a health care provider about what it’s like to be working during COVID-19, what would they say?

We had the opportunity to sit down with a Certified Nurse Assistant (CNA) named Emily who works for an Oregon-based company that provides daily medical assistance and other necessary health services to folks on Medicaid and Medicare.

In a normal shift, Emily cares for Oregonians in hospice care, may be paraplegic, have at least one underlying health issue, if not several, and need help with daily tasks. She is responsible for helping her patients with wound care, personal hygiene, and grocery shopping.

When asked about what PPE she has access to daily, Emily shared that she has a single surgical mask that does not have the ability to stop the novel coronavirus the way an N95 mask would— and she reuses it every shift. Gloves provided by her company are either not available or they rip. She tries to keep a personal stash of gloves but says they are nearly impossible to find.

We talked about how it feels as a frontline health care worker to help her clients with wound care when her medical education tells her that the efficacy of her mask decreases by the hour.

Not only is Emily serving her community as a CNA, she is only weeks away from graduating nursing school, and taking the NCLEX. Unfortunately, the novel coronavirus has also thrown a wrench into completing the NCLEX for her license, because completing it is impossible while social distancing.

Despite all the challenges and lack of PPE, Emily shared with me that she is happy to be helping in the face of a pandemic. She knows that the State of Oregon is working hard to ensure that frontline workers have access to PPE and expanded testing to keep her and her patients safe.

When asked how she felt the state was responding to this crisis, she shared that the expansion of unemployment benefits, Oregon Health Plan (OHP) benefits, the Governor’s decision to send ventilators to another state in need, and many other actions feel very citizen-oriented, and she feels as though we are headed in the right direction. Emily also mentioned that despite her current cheer to serve those in need, she may be feeling the emotional effects of working through this pandemic for quite some time.

Emily’s point makes us stop and consider: what mental health supports are we providing our health care workers? How can we better support them in this area?

Emily, thank you for your hard work and dedication to Oregonians in need during this critical time. You are genuinely appreciated.

/by