Behavioral health is a continual focus area for Columbia Pacific CCO, and never was this truer than it was in 2020. This was Columbia Pacific’s first full year directly administering the behavioral health benefit, and we saw the pandemic create unparalleled challenges relative to behavioral health: exacerbated stressors, increasing dynamics of social isolation, difficult recovery journeys, strains on social determinants of health categories like housing, new challenges for children and families, and more. We appreciate all of the feedback from members and stakeholders over the past year regarding the vital nature of behavioral health services. We are also grateful to our provider partners for everything they have done to maintain the delivery of these critical services. As we look forward to 2021, our collective efforts to support the behavioral health system will be buoyed by this feedback and the strengths of our providers.
Regional updates
In 2020, there were several significant developments related to behavioral health at the regional level. The first includes the implementation of telehealth behavioral health services, which are now available to all Columbia Pacific members via providers in all three north coast counties. Another development includes efforts to increase cross-county communication aimed at fostering collaboration among providers and creating space for shared problem solving regarding system barriers. 
Adult behavioral health
We recently established an adult behavioral health system-of-care meeting, which brings together programs serving members who experience severe and persistent mental illness (SPMI) with leaders of behavioral health agencies in Clatsop, Columbia and Tillamook counties. The purpose of the meeting is to increase support and communication around shared local and regional program experiences and best practices. 
Children’s behavioral health
The governance structure for children’s system of care has been fully implemented in the north coast. This includes a practice-level work group in Clatsop, Columbia and Tillamook counties, a cross-regional Youth and Family Advisory Subcommittee, and a cross-regional Executive Committee. This governance structure will work to break barriers to meaningful care and help children and youth live healthy and happy lives with their families and in their communities. 
Substance use disorder
A monthly meeting with the clinical leadership of SUD providers was launched in September 2020. The purpose of the meeting is to develop a shared understanding of the priorities for the three-county region, to share best practices among providers, and to increase collaboration and smooth referral pathways. In addition to the development of ongoing SUD leadership meetings, several SUD clinical trainings have been offered throughout the region, including a six-session medication for opioid use disorder (MOUD) collaborative and a CRAFT training to increase providers’ skills in involving families in SUD treatment. Currently, the format and content for a fall 2021 SUD summit is being discussed given the continued impact of COVID-19.
Clatsop County
Clatsop Behavioral Healthcare (CBH) has two new exciting developments coming soon:
  1. CBH is adding applied behavioral analysis (ABA) services, which will be offered to members through the Developmental Disabilities program in partnership with Footprints Behavioral Interventions.
  2. CBH is developing a community-based rapid-access clinic, which will be based in Astoria. This is essentially a community urgent care clinic for behavioral health, which will offer same-day brief assessments, risk assessments, safety planning, triage, peer recovery ally connections, community referrals, and linkage to the mobile crisis team if needed. 
The CODA Seaside OTP clinic opened in 2020 and they are rapidly getting established as a critical resource in the community. CODA Seaside is also getting the word out that they have same-day access to services and medications available to members who can make it to the clinic from 5:30 a.m. to 11:30 a.m., Monday to Friday. 
Other developments happening countywide, supported by Columbia Pacific:
  • Clatsop County is restarting its Overdose Response Team planning work. The Department of Public Health will support this effort with Columbia Pacific staff moderating the discussion.
  • We have approved a grant to the Astoria Warming Center to support a full-time position to develop a sustainability plan.
  • Our Regional Housing Impact Fund has provided a grant to NOHA to support the development of Trillium House, a 42-unit permanent supported housing project in Warrenton. The project has raised the remaining funds needed and expects to break ground this summer.
Columbia County
Columbia Community Mental Health (CCMH) now offers applied behavioral analysis (ABA) services through its Developmental Disabilities program. CCMH is delivering these services in partnership with Footprints Behavioral Interventions. 
Other county updates include two in-process developments:
  1. The SUD task force has worked to secure a site for the safe syringe exchange and are close to beginning this in 2021. The group is also discussing the possibility of starting MOUD services in the local jail.
  2. Our Regional Housing Impact Fund has awarded Iron Tribe a grant for the purchase of a building in St. Helens. This site — being developed in partnership with DHS — will be used to provide recovery housing for families.
Tillamook County
With the support of a grant from Columbia Pacific, Tillamook County Community Health Center hired a psychiatrist to support and enhance the delivery of behavioral health services. Tillamook Family Counseling Center (TFCC) has also partnered with this psychiatrist to support Columbia Pacific members served by TFCC, which is exciting news. 
Finally, the Regional Community Opioid Response Team (sponsored by Adventist Health in Tillamook) has been meeting regularly and is well on its way to developing a county-wide opioid response plan.

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