OHA Ombuds Releases 2023 Six-Month Report

Posted on January 4, 2024

Ombuds to formally present its recommendations to the Oregon Health Policy Board January 9

Oregon Health Authority’s (OHA) Ombuds Program, which serves as the advocate for Oregon Health Plan (OHP – Medicaid and Children’s Health Insurance Program) members, released a report detailing top concerns from OHP members specific to child and youth mental health.

Established by legislation, the Ombuds Program provides recommendations and additional oversight internally to OHA Medicaid programs, and externally to Medicaid contractors. The program is independent of Medicaid implementation, operations or compliance.

The Ombuds Program also advocates for access to care and quality of care, as well as channeling member experience into recommendations for systems improvement. OHP members come to the Ombuds Program when they cannot get the support they need elsewhere after other avenues have not led to resolution. These issues often represent systemic concerns impacting other members.

The Ombuds 2023 Six-Month Report focuses on Child and Youth Community-Based Mental Health. The report highlights a central member story that illustrates the need experienced by many children and youth in Oregon for better access to local care, as well as data from the Ombuds Program and Oregon Health Authority. Based on these data and case stories, the report makes recommendations to improve mental health services and supports for children, youth and families across Oregon as follows:

  • Require statewide networks. OHA should implement a statewide OHP network for both inpatient and outpatient mental health services by requiring coordinated care organizations (CCOs) and OHA fee-for-service (FFS) programs to contract with all willing outpatient and residential behavioral health providers for children and adults in the state;
  • Prioritize funding of community-based children’s mental health services at amounts equal to or greater than investments in adult mental health funding and at least proportional to the number of young people in Oregon;
  • Prioritize development and implementation of culturally specific services to eliminate the racial and linguistic disparities in accessing mental health services, follow-ups from emergency departments (EDs), and overrepresentation of youth of color in ED boarding;
  • Strengthen peer workforce within children’s mental health;
  • Speed up access to outpatient mental health services for youth accessing Mobile Response and Stabilization Services (MRSS);
  • Fully implement Intensive In-Home Behavioral Treatment Services (IIBHT) within all CCOs and OHA’s FFS program;
  • Fund and implement mental health respite care for each member’s entire lifespan;
  • Create an independent Office of the Ombuds for Children and Youth in Oregon under the Governor’s Office to advocate for children, youth, young adults and families in need of services across multiple systems.

Each person who seeks Ombuds Program assistance deserves nurturing and support. The stories they share often illustrate challenges experienced by others. Each story teaches us how we can improve Oregon’s Medicaid delivery system and understand the impact of health inequities on Oregonians who receive or are eligible for the Oregon Health Plan.

The Ombuds Program will formally present its findings and recommendations from the Six-Month Report to the Oregon Health Policy Board Jan. 9, 2024.

Read the full report here. To refer a concern to the Ombuds Program, contact udsOffice@dhsoha.state.or.us“>OHA.OmbudsOffice@dhsoha.state.or.us, leave a message at 877-642-0450 or visit here.

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