00:48:02 Jacek: Hello from Salem! 00:51:15 Gregory: You know what 'they' say.... 00:52:12 Gregory: Is there a list of attendees? by Org or position? 00:53:59 Jerome: There needs to be funding and staffing for tracking outcomes if we want to sustain funding for services. 00:55:23 Troy: THANK YOU for finally mentioning P2P meth 01:00:42 Gregory: 👏🏼 01:02:35 Caren: Can you save the chat or make it saveable to keep good ideas? 01:02:55 Rosie Bueford: Absolutely! :) 01:03:12 Gregory: agree sharing deliverables is wonderful. 01:03:30 Gregory: Mind, body, spirit, context (including Oral etc) 01:05:05 Jacek: Thank you so much, Rep Sanchez!! We need to stop causing citizens to contort their lives and needs to help the system operate without difficulty. 01:05:41 Gregory: Context has to include Justice System. I think our 'silos' unintentionally have created 'competing goods' of public health, justice, 'health= mind, body, mouth,) and Context (SDOH, political/policy determinants of health) 01:06:03 Jacek: Agreed, Gregory! 01:07:08 Dana: ❤️ 01:07:32 Gregory: Justice, DHS/Foster care, "health" and context at times have policies that contradict each other and force individuals, families AND providers to be 'caught in the middle' Integrated HHS to include consistent policy, regulations, programs that CAN set up systems to provide care for people in crisis. 01:09:40 Caren: How do we keep babies from falling in river AND how do we keep river from being polluted by toxic systems? 01:09:52 Jerome: Who evaluates the evaluators and evaluation system to ensure it reflects the values of consumers and other stakeholders? 01:10:54 Richard: We need to get rid of regulations that will send more children and adolescents down the correctional path on unable to stay on the mental health path. Recent regulations have made it almost impossible to safely treat kids and limit their exposure to trauma and put many mental healthcare workers at risk for allegations of child abuse. 01:12:08 Jacek: Jerome, there are a number of us in the OHA Behavioral Health Committee meeting on every other Monday where we are pushing for qualitative outcome measure to be employed, with Community-Based Participatory Research methods be recommended as one option. 01:14:09 Jerome: Jacek, those are the kinds of conversations we need to identify and highlight what is most important in the work. 01:14:24 Jacek: Agreed. 01:19:01 Troy: new directions is awesome! 01:19:38 Gregory: Public Health should be a core part of all primary care. I would hope that vaccinations (and success at vaccinating) is a core component for all. When I have done humanitarian medicine, we trained eye and dental providers to assist in vaccines. Many of my NUNM friends are pro vaccine; but the pandemic has taught us that it so important.. The more we can keep politics out of exam room, 01:19:49 Gregory: the better off we will all be. 01:20:43 Carrie: Proud to say I’ve gotten all my covid boosters at NUNM :-) 01:20:58 Jerome: Workforce training and development, yes! Loan forgiveness programs, too! 01:20:59 Gregory: SO glad to hear that Carrie! 01:21:29 Amy: If want to hear more about youth mental health We Can Do Better is hosting a virtual conference November 9 focused on Relational Health: Supporting our Youth at home, school and in community https://www.wecandobetter.org/events/we-can-do-better-2022-conference/ 01:22:35 Gregory: 👏🏼 01:26:06 Jacek: We currently/finally have an OHA director and mental health system director who are actually including consumers in decision-making processes. 01:28:11 Julie: We use best-practice models in the integration of behavioral health in primary care and primary care in behavioral health. We have many integrated care leaders in Oregon. Both nationally known and internationally known as well. We have a lot of experts in this and very well developed integrated programs, particularly behavioral health integrated into patient-centered primary care homes. Let's not forget all the work we already have done her in Oregon. To double click on what Ebony said...we do not need to re-invent the integrated efforts we do in our state. 01:28:21 Jacek: But as they for the first time in Oregon ensure consumer participation in decision-making, it processes take longer at the beginning, but many who seem uncomfortable with this shift are complaining about the time needed among other things. We need to support Pat Allen and Steve Allen with forging a more effective path for public health system operations. 01:29:21 Julie: the implementation is hard and that is why it is not commonly done in primary care 01:29:49 Jacek: (Sorry for my typos when I type fast to get a chat in.) 01:30:23 Dana: ^^what makes the implementation hard? are there actions we can take to make it easier? 01:30:27 Dana: @Julie 01:30:53 Julie: This is a long conversation. Maybe next forum could call together the many integration efforts that are present in our state. 01:32:39 Gregory: Bingo, the combination has synergistic effects. while we have done it, we have limited space to do it (better with virtual); complex issue for complicated problem including BH parity; Medicaid/Medicare parity etc. 01:32:40 Jerome: We are still learning how best to integrate consumer input and peer support specialists. We need to be able to show the skeptics how it helps and that takes time and effort. 01:32:49 Julie: We also have implemented this model in our state. It is not new here. We started implementing it in our state before 2011. 01:33:02 Julie: In primary care 01:33:14 Mike: I don't that is correct, Carolyn. I know one CCO has paid for it as I was the BH Medical Director there. 01:33:33 Julie: I don't think payment is a barrier either 01:33:34 Gregory: we have implemented but could greatly expand 01:34:43 Karen: Our CCO has nine contracts with primary care clinics to implement CCM OR Behavioral Health Primary Care Integration. They choose which model to implement based on their needs and strengths 01:34:44 Dr. Caroline Fisher: mike, most but not all of the CCO’s, but not OHP open card 01:34:53 Gregory: I think if payment was completely covered and high enough it would be fully implemented. something is in the way....not entirely sure what it is. 01:35:31 Julie: Double click that Ebony! Together we are so very much better! We strengthen each other! 01:36:44 Mike: Strongly support the great work Caroline is doing -- we need to work toward layering/hybridizing CoCM on top of the PCBH model (embedded BHCs in primary care) based on the IBHA standards. Together we are stronger! 01:37:30 Julie: Double click that my friend...lots of progress to come in the future for integration in Oregon ...we are stronger together! 01:38:24 Jacek: I believe that true inclusion of consumers in decision-making bodies having authority and equity central to decision-making is new and very uncommon. It has not been around for years. Our history has been relegating service-users to "advisory" groups who are not central to the decision-making processes, but instead are peripheral and incidental to the decision-making done by the power players who want to determine what is best for service-users. 01:41:08 Jerome: Right, Jacek. What does meaningful consumer input look like and how do you get it and use it? 01:42:09 Robert: Housing is a problem across the board in our state, not only for our patients/clients. We can train more workforce and increase their compensation, but they still can't find affordable housing in our county. Yet another barrier to effectively addressing behavioral health needs. 01:43:18 Samuel: A modest correction that the SB 770 single payer proposal increases costs. It doesn't. The proposed plan provides more benefits to more people for $1 billion less per year. Samuel Metz, MD s@samuelmetz.com. Former member of SB 770 task force. 01:43:26 Tabitha: We also need to get creative and find ways to braid our available housing resources, particularly with newly approved Medicaid 1115 waiver flexibility and the Metro Bond Measure for Supportive Housing Services resources in the Tri-County area. 01:43:31 Jacek: It doesn't happen without support from leadership since power sharing doesn't come easy for those who have had the most in the past and feel sidelined when expected to share. It is unfamiliar to them, and they often oppose real service-user inclusion without actually intending to. 01:43:51 Gregory: 👏🏼 01:44:22 Tabitha: Also, sorry - my Zoom account ID is ambiguous. Tabitha Jensen, Deputy Director, New Avenues for Youth (she/they) 01:45:00 Troy: Are any of the panelists primarily from the Addiction Medicine field? 01:45:19 Jacek: The people who understand the system best, in terms of actual effectiveness of services provided, are those who receive those services, and not those evaluating only whether the system worked as planned. 01:46:30 Rosie Bueford: Since our time is short - please go in the Q/A and vote for the question you'd want answered most 01:46:57 Jerome: Too often the outcomes followed are cost savings such as reducing hospitalization. This neglects important positive indices of quality of life. 01:48:01 Jacek: (This chat is valuable. I used to have to stand in line for the microphone at the Multnomah Athletic Club to ask a question at the Health Forum!!) :-) 01:49:02 Jerome: Residential programs represent an alternative to hospitalization. 01:49:40 Jacek: I can't see any Q&A questions other than my own. 01:50:05 Jerome: Click "all questions" at the top left. 01:50:53 Dana: Great point, Dr. Henriksen! We're only reaching 50% of WIC eligible families right now. 01:50:53 Jacek: Aha!!! Thank you Jerome! 01:51:01 Gregory: Nice answers by all 3! 01:51:10 Dana: ❤️ Thank you, panelists! 01:51:25 Gregory: 👏🏼 01:51:40 Gregory: Basic income, less poverty helps us all 01:52:18 Jacek: Social determinants of health and all the research showing its "therapeutic" effects physically and mentally. 01:52:29 Gregory: a non-means based child tax credit at state level would assist; especially if we could also sustain federal benefit 01:53:14 Nancy: Basic income 01:53:31 Robert: Emphasize previous points by several panelists that investing in upstream funding (child programs) will give multiplied cost savings for our state downstream 01:54:20 Tabitha: CCO 2.0 (and soon 3.0) mandate the consideration of SDoH in access to care and payment flexibility. This is not optional. 01:54:47 Jacek: Definitely, Tabitha! 01:54:52 Gregory: The ROI on first 1000 days is immense but it is over a lifetime. Biennial budgeting at state and then annual budgets of almost everyone else compounds the context of building toward solutions 01:55:32 Gregory: Well Said Amy! 01:56:13 Jacek: Peers and service-users have been shown to improve services design and evaluation effectiveness. 01:57:47 Gregory: this also happens internal to professional systems; and sometimes unintentional impact of good meaning legislation/implementation 01:58:26 Jacek: I believe the effectiveness of Peers is because of their "Recovery" perspective, and that if they were to take on a medical model/expert perspective, they would not be able to use that same reference point. 02:01:07 Jacek: I have research colleagues where lived experience researchers are constantly stigmatized and not offered the same opportunities as their traditional researcher colleagues. 02:02:14 Joe: Thank you all! 02:02:20 Marybeth: Amy, thank you for naming and deferring to the leadership of the peer movement itself in shaping their roles in this work. 02:02:23 Jacek: Thank you for everything! Great discussion and hopefully a base for action. 02:02:41 Gregory: Very great discussion and panelists; 02:02:47 Gregory: Miss working with Amy Baker! 02:04:49 Rep. Rob Nosse: $ 3 billion in kicker dollars would allow a governor to make a lot of progress on all the things! 02:04:56 Jacek: Thank you for giving these folks acknowledgement and credit. 02:05:02 Amy Baker: Yes!!!