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					                                                     WASHINGTON COUNTY
                                                                                      OREGON




February 29,2008                                                                RECEIVED
                                                                                 MAR 03 200B
Robert Nickel                                                                ADDICTIONS & MENTAL
                                                                               HEALTH DIVISION
DHS-AMH Division
500 Summer S1. E-86
Salem, OR 97301-1118


Dear Mr. Nikkel

Enclosed is a copy of the 2009-2011 Biennial Implementation Plan for Washington
County behavioral health prevention and treatment service. There are several Review
and Comment forms that still need signatures; these are the LADPC, Mental Health
Advisory, and PSCC. Those forms will be forwarded at a later date after the councils
have met and had an opportunity to adequately review the plan. Any changes to the plan
after those reviews will be submitted at that time.

In the mean time if you have any questions fell free to contact me or our department staff
identified as the point of contact responsible for the various service sections.




Sincerely,




Rod Branyan
Interim Executive Director




                       Department of Health & Human Services
                      Mental Health and Developmental Disabilities
                   155 N. First Ave., MS 70, Hillsboro, OR 97124-3072
                                      (503) 846-4528
                                   (503) 846-4560 Fax
                                 RECEIVED
                                  MAR 03 2008
                               ADDICTIONS & MENTAL
                                 HEALTH   DPJ!S!O~·J




    Washington County
          2009-20011
Biennial Implementation Plan

             for

Mental Health and Addiction
 Prevention and Treatment


          March, 2008




                                           o
                                  Table of Contents
Executive Summary                                                                   2
Standard Plan:
2. Description of the County Planning Process                                       4
3. 2009-2011 Identified Priorities                                                  8
4. State Hospital and Acute Care Inpatient Linkages                                10
5. ResidentiaIlDetoxiOutpatient Addiction Services Coordination                    11
6. Addiction/Criminal Justice Service Coordination                                 11
7. Description of Plans for the 2009-2011 Allocation of State Resources
       MRS 20 - Non-Residential Adult Mental Health Services                       12
       MRS 22 - Child and Adolescent Mental Health Services                        13
       MRS 24 - Regional Acute Psychiatric Inpatient Services                      16
       MRS 25 - Community Crisis Services for Adults and Children                  16
       Pre-Commitment Program, Residential Coordination, Jail Services, Hospital   18
       and PSRB Coordination
       MHS 28 - Residential Treatment Services                                     20
       MHS 30 - Psychiatric Security Review Board                                  20
       MHS 31 - Enhanced Care Services                                             21
       MHS 34 - Adult Foster Care Services                                         21
       MHS 36 - Pre-Admission Screening and Resident Review Services               22
       MHS 37 - Start-up Special Projects                                          22
       MRS 38 - Supported Employment Services                                      22
       MRS 39 - Community Support Services for the Homeless Mentally III           23
       MHS 201 - Non-Residential Adult Mental Health Services (Designated)         23
       SE 60 - Alcohol and Drug Treatment Enhancements and Housing                 23
       SE 61, 61A, 62 AND SE 67 - Residential                                      24
       SE 66 - Detoxification                                                      25
       SE 66 AND 66A - Outpatient, Intensive Outpatient and Case Management        26
8. Prevention Services Plan                                                        28
9. Gambling Services Plan                                                          35
10. Children's Mental Health Services Plan                                         35
11. Older Adult Services                                                           38

County Contact Information                                                         40
Attachment 1 List of Subcontract Services                                          42
Attachment 2 Washington County Board of Commissioners Approval                     47
Attachment 3 Local Alcohol and Drug Planning Committee Review and Comments         48
Attachment 4 Local Mental Health Advisory Board Review and Comments                49
Attachment 5 Commission on Children and Families Review & Comments                 50
Attachment 6 County Funds Maintenance of Effort Assurance                          51
Attachment 7 Planned Expenditures of Matching Funds and Carryover Funds            52
Attachment 8 Review and Comment by Local DHS Service Delivery Area Manager         53
Attachment 9 Review and Comments by the Local Public Safety Coordinating Council   54
Attachment 10 Prevention Strategy Sheet                                            55



                                                                                   1
              Washington County 2009-2011 Biennial
                      Implementation Plan

                               Executive Summary
In November 2007, the Washington County Behavioral Health Council (BHC), the advisory
body responsible for addressing service issues for youth and adults with mental health, alcohol
and other drugs, gambling or other program areas related to behavioral health, met for its
biennial retreat to review priorities, identifY progress made, and to develop new goals and
priorities for the coming biennium.         The process acknowledged that much has been
accomplished over the past biennium including:

•   Increased State funding for supported employment
•   Increased State funding for youth addiction programs
•   Supported evidence-based practices workforce development initiatives in the County
•   Increased State funding for Intensive Community Services for Youth
•   Initiated a Mental Health Court
•   Secured State funding for a Forensic Assertive Community Treatment program to divert
    mentally ill from jail
•   Secured State funding for an Early Psychosis Identification and Treatment Program
•   Increased adult mental health treatment utilization, expanded criteria to access Rehabilitative
    services for Severely Mentally III adults
•   Expanded services provided by the Washington County Crisis Team to include Transitional
    Intensive Case Management services
•   Secured funding for supported housing slots for Early Psychosis Project and Forensic
    Assertive Community Treatment Program participants.
•   Reduced referrals to residential treatment by 50% through successful implementation of the
    Children's System Change Initiative
•   Increased youth and families served in outpatient mental health services
•   Provided participation and support for school mental healt.lJ. initiatives
•   Secured State funding for intensive treatment recovery services for parents with children
    involved in the child welfare system
•   Received continued grant funding to support the drug court
•   Developed additional housing for women with children involved in the drug court and child
    welfare
•   Received additional funding for gambling intervention, outreach and prevention
•   Initiated contract with Pacific University to evaluate access to culturally competent services

After reviewing the 2007 -2009 priorities, accomplishments, and emerging behavioral health
issues, the Behavioral Health Council identified the following needs for service system
improvements, advocacy, resource development, and planning for the 2009 - 2011 biennium:



                                                                                                  2
•   Supported Employment: Continue to enhance, improve and expand services to make
    Supported Employment services available on demand to severely mentally ill adults enrolled
    in Rehabilitative services
•   Improve housing options for the mentally ill by increasing supported housing, independent
    living with rent assistance, and housing options for families
•   Improve training, recruitment, and retention of the behavioral health workforce
•   Increase and enhance detoxification resources for adults and adolescents in Washington
    County
•   Achieve equitable funding in State General Funds for Acute Care
•   Participate in health care reform advocacy that emphasizes the needs of seriously mentally ill
•   Adult Outpatient Services: Address resource shortfalls in the provision of services to
    individuals with less severe mental health conditions

These considerations are included in the development of this Plan. The Council will continue to
prioritize these goals, develop specific strategies for advocacy and implementation, and evaluate
outcomes over the next two years. Also included in the Biennial Plan are a description of state
hospital and acute care linkages, residential/outpatient addiction service coordination,
addiction/criminal justice service coordination, the Prevention Services Plan and the Gambling
Services Plan.




                                                                                                3
1. County Contact Form
See Attachments

2. Description ofthe County Planning Process
The Washington County Behavioral Health Council (BHC) is an advisory committee to the
Department of Health and Human Services and the Washington County Board of
Commissioners. It is responsible for addressing service issues for youth and adults with mental
health, alcohol and other drugs, gambling or other program areas related to behavioral health.
Local Alcohol and Drug Planning Committee (LADPC) and Mental Health Advisory Board
responsibilities are integrated under the responsibility of the Behavioral Health Council.
Members live or work in Washington County and include behavioral healthcare providers,
consumers and other individuals in recovery, family members, representatives of child-serving
agencies, school representatives, a member of the Commission on Children and Families,
advocates, professionals in the field, and lay citizens.

In 2006, The Washington County Behavioral Health Council concluded a year long planning
process to identifY the highest priority needs for advocacy efforts and the development of new
resources and services. The goals ofthis process were:

•   To develop a vision ofthe ideal system of care
•   To conduct a current system assessment of what exists and whether current services meet
    "system of care" criteria
•   To conduct an assessment of what is needed by identifYing gaps in services and in funding
•   To develop a list of what is needed to fill those gaps
•   To develop a strategic plan for how to advocate for resources necessary to build a high
    quality, comprehensive system of care accessible to all, not just those eligible for public
    funding
•   To merge advocacy for the adult and children's systems of care
•   To expand and encourage partnerships and collaboration
•   To insure consideration of the needs of adults, children, and families; of special needs
    populations (e.g. older adults); and of culturally specific populations (e.g. the Hispanic
    population)

After examining the existing service array comprehensively, the Behavioral Health Council
identified a number of gaps and issues in the continuum of care. The Council then set about
prioritizing these gaps and needs narrowing the list to the five highest priority areas. It is the
Council's intent to focus legislative advocacy efforts towards these priorities:

1. Restore and Stabilize OHP
2. Increased and stable funding for Supported Employment Services




                                                                                                4
3. Increased resources for alcohol and drug treatment including improved access to residential
   treatment services, improved detoxification services, increased resources for youth addiction
   programs, and specialized treatment for older adults
4. Funding for Evidence-Based Practice workforce development, implementation, training and
   support
5. Improved resources for Intensive Community-Based Services for uninsured or underinsured
   children

In November 2007, the Council met again for its biennial retreat to review these priorities,
identifY progress made, and to develop new goals and priorities for the coming biennium.
Addressing the top priorities set by the Behavioral Health Council last biennium, it was
identified that Washington County Behavioral Health has achieved the following:

    •   Increased Supported Employment Funding: Received $178,220 in additional funds
        through a competitive process and successfully expanding supported employment
        services from one provider to three enabling services for an additional 100 clients

    •   Increased funding for youth addiction programs: Through the state's adoption of
        population-based formula Washington County received an increase of$I,045,376 for the
        2007-09 biennium to expand and enhance outpatient and intensive outpatient treatment
        services for youth as well as adults.

   •    Evidence-Based Practices Workforce Development: Provided $247,310 for workforce
        development activities within mental health service provider agencies including Solution
        Focused Brief Therapy, Trauma Focused Cognitive Behavioral Therapy, Dialectical
        Behavior Therapy, Wellness Management and Recovery, Dialectical Behavior Therapy,
        Seeking Safety, and Supported Employment

   •    Increased resources for Intensive Community Services: Received $407,664 additional
        for biennium for indigent, uninsured children and families


Additionally accomp!is!unents made over t..he past two years not specifically tied to the Council's
top five priorities include:

   •    Mental Health Court: A specialty treatment court specifically targeting mentally ill
        individuals involved in the community corrections system.

   •    Forensic Assertive Community Treatment (FACT): Secured funding for the addition
        of an assertive community treatment team to provide intensive mental health services to
        mentally ill involved in the criminal justice system.

   •    Early Psychosis Identification and Treatment Program: Secured funding for a
        program designed to mitigate the devastating impact of psychosis on young individuals
        by intervening early in the development of a severe mental disorder


                                                                                                 5
•   Increased adult mental health treatment utilization: Provided mental health services
    to an additional 138 seriously and persistently mentally ill individuals for a total of 1225
    clients in treatment. Reduced restrictions to Rehabilitative Services for severely mentally
    ill adults by expanding access criteria

•   Transitional Intensive Case Management for individuals not successfully connected to
    services who are referred by emergency departments, hospitals, the Washington County
    Involuntary Commitment Team, and the Washington County Crisis Team.

•   Supported Housing: Secured funding for 26 supported housing slots for individuals
    involved in the Early Psychosis Project and the Forensic Assertive Community Treatment
    Program. This funding will provide rental subsidies and skills training to allow high risk,
    chronically mentally ill individuals to obtain and maintain housing in the community

•   Children's System Change Initiative: Successful implementation of a community-
    based intensive wraparound and care coordination service for seriously mentally ill
    children affecting a 50% drop in admissions to Psychiatric Residential Treatment
    Services.

•   Increased youth and families served in outpatient mental health services, serving an
    additional 163 youth and families in 2007.

•   School Mental Health Initiatives, including support for school-based mental health
    services in Forest Grove High School and the Hillsboro School District and participation
    in the Partnership for Student Success, a grant funded multi-system initiative to increase
    integration between mental health and schools across seven school districts

•   Intensive Treatment Recovery Services, providing addiction treatment to parents with
    children involved in the child welfare system

•   Continued funding for Drug Court, enabled by a successful grant application

•   Additional Housing for Women with Children involved in the drug court and child
    welfare through a cooperative partnership with DHS-Child Welfare, DHS-Self
    Sufficiency and an addiction treatment provider

•   Additional Funding for Gambling Intervention, Outreach and Prevention, to
    identify and special populations and increase service penetration and engagement

•   Insuring Access to Culturally Competent Services: As a part of our planning process,
    in 2007, Washington County began a project through a contract with Pacific University to
    conduct an evaluation of the of the publicly funded mental health system in Washington
    County regarding service access and competency for cultural minorities. Pacific
    University faculty will interview key system participants, review relevant professional
    literature on best practices guidelines for culturally competent service delivery in a


                                                                                              6
        publicly funded mental health service system, identify practices that support and do not
        support the provision of culturally competent services, and prepare a report of key
        findings including recommendations for actions to improve access and increase cultural
        competency of the Washington County mental health system.

Finally, the Behavioral Health Council reviewed and explored national, statewide and local
emerging issues in behavioral health including primary care integration, general health care
reform efforts, the Statewide Children's Wraparound Project, Medicaid payment error audits,
and the under-resourced Detox service system in the metropolitan region.

Additional Addiction Planning Efforts: A comprehensive addiction services Request for
Proposals was released for Outpatient, Intensive Outpatient, Case Management and Drug-Free
Housing Services in the fall of 2007. Contracts and services resulting from this RFP began
January 1, 2008. Funding for these services consisted of combining the existing funding for SE
66 and SE 60 along with the newly approved funding for Intensive Treatment and Recovery
Services (ITRS) and the Equity Distribution adjustment. A planning process for addiction
services was initiated prior to the release of the RFP to assist our department in identifying
priorities and gaps in services that directed or expanded funding toward those service and system
areas priorities.
The planning process consisted of a survey to treatment providers, agency/community partners,
the Behavioral Health Council and a similar survey to consumers of service, to solicit input in
several areas. The survey for providers, partners and the BHC consisted of 5 sections. They
were: 1) Outreach and interventions, 2) Outpatient, 3) Residential and Detoxification, 4) Service
Supports and 5) System Supports. For obvious reasons the consumer survey focused strictly on
sections 2, 3 and 4. In the survey all were asked to rank their top three priorities for each section.
The top three ranking priorities for each section are as follows:
Providers. Partners and BHC
   1.      Outreach and Interventions
           • Intervention Services for families
           • Linkages to emergency care
           • 24/7 peer crisis response program
   2.      Outpatient Services
           =   Integrated treatment services for individuals with co-existing mental healL~, f\.&D
               and criminal justice involvement.
           • Develop and provide family treatment services
           • Increase treatment capacity for adolescent treatment
   3.      Residential/Detox
           • Increase residential capacity in general
           • Residential for co-occurring disorders
           • Increase Detox capacity
   4.      Supportive services
           • Increase Drug-free Housing
           • Increase service supports to facilitate transition from residential to the community
           • Enhance outpatient services to include "wraparound"
   5.      System Supports


                                                                                                    7
           •   Funding for Evidence-Based Practices, workforce development, training and
               support
           •   Improve linkages with community partners
           •   Increase provider reimbursement rates to treat clients

Consumers/Clients
   I.      Outpatient
            • Increase funding for indigent DUn treatment
            • Methamphetamine specific treatment programming
            • Develop and provide family treatment service
   2.      Residential/Detoxification
            • Increase residential capacity specific for women with children
            • Increase residential capacity in general
            • Expand residential like alternatives
   3.      Barriers/Gaps
            • No drug-free housing for Hispanics
            • Develop 24/7 peer crisis response program
            • Lack of drug-free housing for women with children

Included in the Addictions planning process were means to ensure Cultural Competent services:
   •    Solicited input from Hispanic clients and service providers
   •    Funding identified specifically for Hispanic treatment
   •    Funded a new youth bi-cultural/bi-lingual treatment program for Hispanics.


3. 2009-2011 Identified Priorities
After reviewing the 2007 -2009 priorities, accomplishments, and emerging behavioral health
issues, the Behavioral Health Council identified the following needs for service systern
improvements, advocacy, resource development, and planning for the 2009 - 2011 biennium:

   •    Supported Employment. Continue to enhance, improve and expand services to make
        Supported Employment services available on demand to severely mentally ill adults
        enrolled in Rehabilitative services. Currently there are 1225 consumers enrolled in
        Rehabilitative services and only 130 are receiving supported employment services. We
        expect our efforts will increase this number significantly over the next biennium.
   •    Improved housing options for the mentally ill by increasing supported housing,
        independent living with rent assistance, and housing options for families. In 2005
        Washington County completed a survey of mental health providers and consumers
        regarding housing needs in the County and in 2007 the Washington County Mental
        Health Department's Five-Year Housing Plan was completed establishing housing
        priorities for the County Mental Health Department for the 2006-201 0 period. In
        preparing this Plan, input was solicited from stakeholders including providers, the
        criminal justice system, and hospitals.


                                                                                                8
    •   Improved training, recruitment, and retention of the behavioral health workforce.
        A highly trained, stable workforce is key to providing high quality, effective services. In
        our current, largely private non-profit, provider system, there is a high level of staff
        turnover due to low compensation packages and stressful work conditions. Additionally,
        recruitment is challenging due to an apparently shrinking candidate pool. Within the
        candidate pool that does exist, traditional graduate level training often does not
        adequately prepare workers in the skills needed for Community Mental Health work. All
        of these factors contribute to reduced quality and effectiveness of mental health services.
    •   Increase and enhance detoxification resources for adults and adolescents in
        Washington County. Currently there are only 3 detox beds located within Washington
        County. In addition to the number of beds being woefully inadequate for our population,
        the antiquated rate does not support a high quality, safe, detox service. There is a need
        for an increase in beds in the County in addition to a rate increase.
    •   Achieve equitable funding in State General Funds for Acute Care. Currently there is
        profoundly unacceptable inequity in the direct allocations to of these funds to
        Washington County. As compared to a statewide per capita of$7.99, Washington
        County's per capita is currently $0.95. This severely compromises our ability to pay for
        indigent inpatient care for residents who need it and resnlts in a large amount of
        uncompensated care for hospitals. We are also unable to invest any acute care funds in
        sub-acute, respite, or other community services designed to avoid hospitalization.
    •   Participate in health care reform advocacy that emphasizes the needs of seriously
        mentally ill. As the Oregon Health Fund Board proceeds in their efforts to improve
        health care access statewide, it is important to assure that a mental health benefit is
        included in the benefit package and that the integrated biopsychosocial service delivery
        system within the Community Mental Health system is preserved for the most vulnerable
        citizens with severe mental illness.
   •    Adult Outpatient Services: An additional anticipated problem for the next biennium is
        the provision of adult outpatient mental health services. This service, which provides
        outpatient therapy and medication management to individuals with less severe mental
        health conditions such as depression, anxiety, and trauma, was begun in 2005 after
        Washington County received an equitable, population-based distribution of MHS 20
        funds. Initially, $395,000 was budgeted annually for the service. Each year of operation,
        the demand for the service has meant an increase in budget, by 71 % the second year to
        $674,000 and by 33% the third year to $900,000. This, coupled with increases in
        numbers of un/underinsured individuals with severe and persistent mental illness in
        Rehabilitative services (an additional 13 8 seriously individuals for a total of 1225 clients
        in treatment), means MHS 20 resources are not adequate to support the adult outpatient
        program any longer. Pending any hoped-for increase in funding, we intend to offer a
        program designed to link these individuals (over 1200 per year) to safety net clinics and
        low- and no-cost counseling services.

These considerations, along with others the Council identified including immigrant, aging, and
veterans issues; PSRB, the fight against stigma, and funding medications for the uninsured are
included in the development of this Plan. The Council will continue to prioritize these goals,
develop specific strategies for advocacy and implementation, and evaluate outcomes over the
next two years.



                                                                                                   9
4. State Hospital and Acute Care Inpatient Linkages
The Washington County service system is linked to the state hospital, acute care units and
ECMU in several ways and with several staff. Washington County staff are active participants in
the monthly Metropolitan Acute Care Advisory Council, local Ecas meetings and local and
regional ECMU staffing and planning efforts.
The adult Hospital Liaison (IFTE) provides most of the linkage capacity by working directly
with Adult and GeroPsychiatric consumers who are either committed or placed at aSH Portland,
aSH Salem or BMRC under a guardian's authority. The Hospital Liaison participates in
treatment teams, staffings and discharge planning meetings. The Hospital Liaison is also
connects families and community programs with the hospital.
The Adult Mental Health Supervisor participates in the Metropolitan Acute Care Advisory
Council which serves as a problem raising and problem solving entity for acute, intennediate and
long term care facilities.
A new position, the PSRB Coordinator, works with providers serving consumers who are placed
in the community on Conditional Release. She also works with the Board and aSH to evaluate
potential candidates and ensure transitions are as smooth as possible.
The Residential Coordinator provides primary linkage with the Ecas and ECMU system to help
facilitate transitions into the community. This includes regular meetings and staffings as well as
participation in ad hoc planning and problem solving efforts. The Residential Coordinator is also
frequently critical in creating individualized transition options through linkages with the hospital
treatment teams and both the local mental health and AMHD.
Although the function is secondary to primary duties, civil commitment investigators are in the
acute care hospitals daily and either identify areas of concern or, due to their availability, hear
about hospital concerns. These issues are brought to the Adult Mental Health Supervisor for
direct resolution or referral to the appropriate Program Coordinator.
The Washington County Child Care Coordination team is responsible for assisting community
providers, stakeholders, and families acting on behalf of children in accessing and/or returning
from acute inpatient care and long-tenn residential stays in the Secure Children's Inpatient
program (SCIP) Stabilization and Transition Services (STS), and the Secure Adolescent Inpatient
Program (SAIP). Child and adolescent referrals for extended care are conducted through the
Extended Care Coordinating Committee. This committee is responsible for the review of
requests from acute hospitals and psychiatric residential programs for extended placement of
children. This committee is composed of representatives from Washington County Mental
Health, representatives from the SCIP/SAIP/STS programs, AMH, Juvenile Department, DHS
Child Welfare, and Northwest Regional Education Services District. The committee facilitates
the referral in collaboration with parentslguardians, AMH, and care providers. When a child is
deemed not to be appropriate for extended care, the committee assists parents and guardians with
appropriate community-based services and resources.




                                                                                                 10
5. Residential/Detox/Outpatient Addiction Services Coordination
For Washington County clients, detoxification services are coordinated with outpatient by
assigning a case manager/recovery coach to facilitate the transition into an outpatient treatment
program. The case manager/recovery coach works with the client to identifY and eliminate
barriers, coordinate services by getting signed releases of information, setting up a follow-up
appointment with a counselor at an agency of their choice, sending chart information, and
transporting the client to the appointment, if appropriate. Many clients who enter Detox are not
enrolled in any treatment program, so CODA either works with the client to enter their outpatient
program or facilitates a transition to another county program based on the clients' individual
circumstances. The case manager/recovery coach once again coordinates the transition between
programs whether internal or external.

This process of coordination for the three contracted residential treatment programs to outpatient
services is virtually the same for the three programs; Tigard Recovery Center (TRC),
Mountaindale Recovery Center (MRC) and DePaul. All three programs coordinate referrals
back to the county of origin following the same process describe in the coordination of Detox
services above except for transportation. Also each program can coordinate the transition to their
own specific outpatient programs if the client decides to remain in Washington County. Either
the primary counselor or case manager facilitates the transition from residential to outpatient
through a formal or informal process dependent on the county of origin or program. At a
minimum, the residential program contacts the outpatient provider or county and develops a
transitional plan as part of the discharge planning process.

6. Addiction/Criminal Justice Service Coordination
The Washington County criminal justice system represents a very large proportion of referrals
into the addiction treatment provider system and as such the provider system works very closely
with Community Correction Probation and Parole. Addiction treatment service are coordinated
in several ways: I) through the development and signing of releases of information in order to
share relevant A&D information regarding treatment progress, compliance and results of
urinalysis, 2) providers routinely incorporate evidence-based practice regarding criminality and
criminal thinking patterns into treatment programming, 3) hold client treatment staffing when
necessary to hold clients accountable, 4) development of specific treatment programming for
adolescent, women and minorities. As stated previously, our department in partnership with
community corrections awarded funds to provide an intensive outpatient treatment program for
criminal justice clients on-site at the Community Corrections Center. This program previously
was funded jointly with our department and community corrections. In the recent RFP, our
department allocated 100% of the funding for the program. This allowed Community Correction
to utilize their funding to open an additional treatment dorm for a 60-day residential A&D
treatment program that focuses on clients who have relapsed.




                                                                                               11
In the 2007-09 biennium the department was awarded funding to expand the pilot drug court
program from 20 to 55 clients. This is a highly coordinated program that includes the following
partnerships with: the District Attorney Office, Community Corrections, Circuit Court Judge, the
Public Defenders Office, DHS-Child Welfare, and the treatment provider. Entry into the drug
court program is prioritized by eligible criminal offenses and severity of chemical dependence.
There is no SE 66 funding currently utilized for the operation of the program. The department
contracts with Cascadia BHC to provide specific treatment prograrmning and to prioritize
eligible clients for the drug court.


7. Description of Plans for the 2009-2011 Allocation of State
Resources
MHS 20 - Non-Residential Adult Mental Health Services

Washington County will continue to assure the provision of rehabilitation services for
individuals with a severe and persistent mental illness. Services are tiered into several levels of
care in order to assure that the individuals with the greatest level of need receive the most
service. There will be continued emphasis on the development of evidence based treatment
programs with a focus on fidelity measurements to ensure these programs are true to the model.
These programs include Wellness Management and Recovery, Strengths-Based Case
Management, Integrated Dual Diagnosis Treatment, Family Psychoeducation, Supported
Education, Supported Employment, Supported Housing, Dialectical Behavior Therapy,
Cognitive Behavioral Treatment of Depression and Anxiety Disorders and Seeking Safety for
treatment of PTSD. During the next biennium specific emphasis will be placed on developing
truly integrated substance abuse treatment with mental health treatment. Washington County is
also proud to be implementing a Forensic Assertive Community Treatment (FACT) team to
divert serious and persistently mentally ill individuals involved with the community corrections
system from jail and Transition-Aged Youth Services including early psychosis treatment
services and services for youth transitioning out of child and adolescent services and into adult
mental health treatment.

Washington County is one of the fastest growing counties in the state. Since the year 2000, it
has added more individuals to the overall population than any other county, approximately
65,700 new residents. Not surprisingly, there has been a corresponding increase in the n1l.tllber
of individuals served through general funds. Over the course of the last three years, Washington
County has seen a significant increase in the number of rehabilitation clients served with MHS
20 funds. Between 2005 and 2007 the number of severely and persistently mentally ill adults
served in Rehabilitation services using general funds to pay for treatment increased 150% from
329 clients to 494. Due to this rapid growth, a significantly higher amount of MHS 20 funds
were used to pay for this treatment. During the same time, the number of clients with episodic
conditions such as depression or anxiety who were served in Adult Outpatient increased 214%
from 503 clients to 1076. Even if the number of General Fund clients served remained level
from this point forward, MHS 20 funding is inadequate to cover expenses associated with these
programs. Additionally, Washington County had previously funded several other programs with
MHS 20 funds including our Washington County affiliate NAMI, the Older Adult PCP
Integration Project and the Washington County Consumer Council. It was felt that each of these


                                                                                                12
services provided critical support to the community and therefore needed to continue despite the
inability to fund them using MHS 20. Washington County made the decision to continue these
programs using OHP funds. Unfortunately, funding Adult Outpatient with MHS 20 was no
longer feasible and this program could not be funded through other avenues. The significant
increase in the number of clients served in this program in conjunction with the increased costs
in serving rehabilitation clients has made this program unsustainable. We have developed a
significantly scaled back program to provide brief assistance and referral using MHS 25 funds as
a replacement for the Adult Outpatient program so that this population is not without any service
options.

Programs receiving MHS 20 funds:

Homestreet-Banyan Tree, Inc. - Provides housing, residential care, and rehabilitative services
to Washington County adults with mental illness. Homestreet provides intensive services
coordination and housing for up to five adults in the Extended Care Management Bridges
Project.

Luke-Dorf, Inc. - Provides housing, respite, residential care, and rehabilitative services to
Washington County adults with mental illness. Luke Dorf has also recently opened the first
shelter in Washington County for homeless mentally ill individuals.

LifeWorks Northwest Open Gate - Provides rehabilitative services, supported employment and
vocational services to Washington County adults with mental illness.

LifeWorks Northwest Older Adult Services - Provides outpatient assessment, therapy,
medication evaluation and management and day treatment services to older adults with severe
mental illness and dementia. Many services are provided in the consumer's place of residence
although the Older Adult Program has its own specially designed centrally located building.

LifeWorks Northwest Transition Aged Youth Programs - Provides early psychosis
intervention and intensive case management services for clients transitioning from youth services
into adult mental health treatment.

Cascadia Behavioral Healthcare - Provides rehabilitation services including case management
and medication management to individuals with a severe and persistent mental illness. Cascadia
is also the provider for the Forensic Assertive Community Treatment program.

Asian Health and Human Services Center - Provides culturally specific rehabilitative services
to Washington County adults with severe mental illness.

Oregon Health Sciences University Intercultural Psychiatric Program: Provides culturally
specific rehabilitative services to Washington County adults with severe mental illness.




                                                                                              13
MHS 22 - Child and Adolescent Mental Health Services


Outpatient mental health services for children and families continue to be provided by the five
agencies that were awarded contracts through a competitive process in 2005. These agencies are:
       LifeWorks Northwest
       Youth Contact
       Cascadia Behavioral HealthCare
       Western Psychological and Counseling Services
       Morrison Center

Three levels of care are offered by the outpatient providers, and youth are assigned to a level
based on a CASH score and the service intensity needs. The levels are Brief Recovery/
Maintenance, Outpatient, and Intensive Outpatient and descriptions of expectations and program
description for each level can be found in our Policy and Procedure Manual. At all levels,
services are flexible and vary in intensity, frequency and location, depending on the
individualized needs of that child and family, and may include outreach, assessment,
consultation, case management, interpreter services, medication management, parent or child
skills training, individual, family and group therapy.

In accordance with state guidelines, all of the child outpatient service providers incorporate
Evidence Based Practices into their treatment, which include but are not limited to: Solution
Focused Therapy, Cognitive Behavioral Therapy, Brief Strategic Family Therapy and Trauma
Focused CBT.


Early Childhood Mental Health: There are two early childhood initiatives that will continue
and Washington County hopes will strengthen the early childhood mental health expertise and
resources in our County. Washington County funds an Early Childhood Mental Health
Consultation model utilizing MHS 22 and Oregon Children's Plan Grant funds. Subcontracted
through The Morrison Center, the program offers mental health consultation to Head Start and
other childcare providers coupled with site and home based support for early childhood
practitioners &'1d families.

Additionally, Washington County collaborated in the development of the Promotora program,
developed through a State Incentive Grant award. When the grant funding expired in December
of2006, Washington County took over 100% of the funding and expanded the program by 50%
to cover the entire county. Washington County contracts with LifeWorks NW for three
bilingual/bicultural Promotoras to do outreach and engagement to Latino families with young
children. Families are provided with education and parenting skills, and the youth are screened
for potential mental health issues or developmental delays. The Promotoras assist in linking the
family to community services as needed, and this initiative continues to develop pathways to
culturally appropriate prevention, early intervention and treatment services in settings where
children and families spend time, such as Head Start centers or health clinics. Effective July 1,



                                                                                              14
2008, due to lack of State General Fund resources, funding for this program will be shifted to
OHP Prevention, Education and Outreach funds and will continue uninterrupted.

Intensive Service Array:
       Care Coordination: Washington County has launched an integrated OHP/CMHC
       Child and Family Care Coordination Team to fulfill obligations under both the
       MHO Agreement and the Intergovernmental Agreement to provide
       comprehensive care coordination for children and families eligible for the
       Intensive Services Array under the Children's System Change Initiative. 5.0 FTE
       Child and Family Care Coordinators staff this team. Approximately 2.0 FTE are
       funded through MHS 22 funds. Care Coordinators facilitate the Child and Family
       Teams in planning and coordinating a family-driven, culturally competent,
       individualized plan of care for ISA eligible children. The Care Coordinator
       develops an ongoing, supportive relationship with the family, facilitates
       communication and coordination between team members, completes a
       strengths/needs assessment with the team, organizes and coordinates multiple
       services/supports, creates linkages to and monitors transitions between levels of
       care, and monitors and when necessary identifies additional services/supports as
       needed.

       Home-Based Stabilization Services: To enhance our local system of care and
       have alternatives to facility based treatment, Washington County went through a
       competitive Request for Proposals process in fall of 2005 for Intensive
       Community Treatment Services, and awarded the contract to LifeWorks NW. The
       review committee included family representation, as well as system partners from
       Child Welfare and Education. The LifeWorks NW Home Based Stabilization
       program is part of the Intensive Service Array and provides ICTS level services in
       the home and community that incorporate a Multi-Systemic Therapy approach.
       The program is staffed with 5 QMHP clinicians and 2 QMHA skills trainers.
       Services are individually tailored in type, frequency and intensity, but often
       consist of four or more contacts per week, and 24/7 crisis response by a clinician
       that is familiar with the family. This program generates revenue through fee-for-
       service billing paid by MHS 22 funds, and service capacity was expanded in July
       of 2007 with additional state funds for non-Medicaid ISA youth.

       Psychiatric Day Treatment: With the additional MHS 22 funds allocated to non-
       Medicaid ISA youth, Washington County will be able to serve six youth for up to
       90 days for a transition period from PRTS to the community. Currently
       Washington County holds a contract with LifeWorks NW, the only Psychiatric
       Day Treatment provider in Washington County; serving youth ages 3-18.

School-Based Mental Health Services: The Hillsboro School District was awarded a Safe
Schools/ Healthy Students grant from SAMHSA, DOE and DOJ in 2005, and as part of the
Mental Health component they contracted with Washington County to hire a team leader to
develop and supervise a Care Coordination Team housed within the district. The grant is
currently finishing the third year, and will be in the no-cost extension year during the 08-09


                                                                                            15
school year. Washington County will be absorbing the cost of the team leader position out of
MHS 22 and OHP funds beginning in March 2009. The team of 7 QMHP School Based Care
Coordinators works with youth referred by school staff due to social, emotional or behavioral
issues. The Care Coordinator then meets with the referrant, student and family as appropriate to
assess what the current needs are. This may include observation of the student, home visits with
the family, advocacy for the student or family, and case management to link the student and
family to any necessary community services. The Care Coordinator will then communicate the
outcomes to the referrant and assist in facilitating communication between the school and
community agencies. In addition this program has provided critical feedback to the local system
of care in terms of barriers to access.

MHS 24 - Regional Acute Psychiatric Inpatient Services

As stated earlier, currently there is profoundly unacceptable inequity in the direct allocations to
of these funds to Washington County. As compared to a statewide per capita of $7.99,
Washington County's per capita is currently $0.95. This severely compromises our ability to pay
for indigent inpatient care for residents who need it and results in a large amount of
uncompensated care for hospitals. Weare also unable to invest any acute care funds in sub-
acute, respite, or other community services designed to avoid hospitalization.

Washington County will continue to insure the provision of inpatient services delivered to
individuals on holds. These costs far exceed our allocation of MHS 24 funds necessitating a
sizeable investment of county general funds. Washington County benefits little from state MHS
24 fund in local hospital contracts since Providence Health system, our most frequently used
hospital system, does not participate in those contracts.

As discussed elsewhere, Washington County employs a full-time Hospital Liaison who works
with consumers, families, hospitals and community programs to develop transition plans and
coordinate services for Civilly Committed Washington County residents in the State Hospital
and acute psychiatric hospitals. The Liaison function serves over 100 individuals per year at
eleven primary hospitals. Again, due to the inadequacy of MHS 24 funds, we fund this position
with other resources.
We will be participating with other Metro area counties to propose that the State bring the
effected counties as a group up to the statewide benchmark per capita of $7.99. If this is
done, we will agree to be responsible for the payment of acute care costs to hospitals consistent
with AMH's Cost of Care policy. We believe that the direct allocation of these funds to counties
will allow us to do appropriate utilization management and will mean stronger linkage to
community-based care for hospitalized clients and incentives to invest savings in more cost-
effective front end community-based services.

MHS 25 - Community Crisis Services for Adults and Children

Programs receiving MHS 25 funding:

Providence Health Systems - The County contracts with Providence's phone service to provide
the Washington County Crisis Line 24 hours/day, seven days per week.



                                                                                                16
Cascadia Behavioral HealthCare - Cascadia operates the Washington County Crisis Team
providing both mobile and facility-based, face-to-face crisis evaluation, intervention, and
stabilization services. These services are available 24 hours per day, seven days per week,
serving adults, older adults, children, adolescents and families experiencing the sudden onset of
psychiatric symptoms or the serious deterioration of mental or emotional stability or functioning.
Access to the team is triaged by telephone through the Washington County Crisis Line. Services
include face-to-face crisis assessment and evaluation by qualified mental health professionals;
consultation with families, other professionals, or community partners such as law enforcement
and community members; medication evaluation, if needed; psychiatric consultation; emergency
medications; hospital diversion; stabilization services/follow-up care, as needed; referral to
appropriate services; flexible funding to assist with emergency housing, transportation or other
unmet needs contributing to the crisis episode; and language/culturally specific services.

A new component to the team is the addition of two FTE who will provide intensive transitional
services for individuals not connected with a treatment provider who require a high level of
support as they transition out of an acute care setting, such as an emergency department or
inpatient psychiatric unit, and back into the community. The goal of this team is to provide
"bridging" services to assure there is no gap in treatment during this period between
hospitalization and connection with a community mental health provider. The team is focused
on assuring a firm connection with a treatment provider to minimize the number of individuals
who fail to engage in community based services following an acute care episode.

Boys and Girls Aid Society - provides crisis respite/shelter services for youth accompanied by
crisis intervention, counseling, transportation and case management available 24 hours per day.
Respite services are provided in the homes of certified and trained foster homes and in a shelter
setting for up to 7 days.

LifeWorks NW Home-Based Stabilization - A competitive Request for Proposals process was
held in the fall of 2005, and LifeWorks NW was awarded the contract to provide the ICTS
Home-Based Stabilization Program for Washington County. The LifeWorks NW program is part
of the Intensive Service Array and provides ICTS level services in the home and community that
incorporate a Multi-Systemic Therapy approach and utilize Collaborative Problem Solving. The
program is staffed with 5 QMHP clinicians and 2 QMHA skills trainers. Services are
individually tailored in type, frequency and intensity, but often consist of four or more contacts
per week, and 24/7 crisis response by a clinician that is familiar with the family. MHS 25 funds
support the costs of the program that are not covered by revenue from fee-for-service billing

Non-Facility-Based Flexible Respite and Housing Flex Funds - Washington County contracts
for non-facility-based respite services provided in a variety natural, transitional, or emergency
housing environments including consumer's apartments, family homes, residential care settings,
hotels/motels, etc. by "wrapping around" services of coaches, skills trainers, consumer mentors,
Qualified Mental Health Associates, Qualified Mental Health Professionals, nursing or other
medical staff to provide services. The services are provided up to 24 hours, 7 days per week,
based on the individual needs of the client and may include medication monitoring, support and
counseling, assistance with activities of daily living, skills training, or daily structure and



                                                                                               17
support. Housing flex funds are used in circumstances where access to housing has the outcome
of avoiding hospitalization or shortening lengths of stay. These funds are used for emergency,
temporary, or transitional housing costs, rent assistance, paying rent deposits, etc. The following
programs contract for these funds:

       Homestreet-Banyan Tree
       Luke Dorf, Inc.
       LifeWorks Northwest
       Cascadia Behavioral Healthcare
       Asian Health and Service Center
       OHSU Intercultural Psychiatric Program

Pre-Commitment Program, Residential Coordination, Jail Services, Hospital and PSRB
Coordination:

The Washington County Health and Human Services Adult Mental Health Team (AMHT)
includes 10 FTE, consisting of 1 FTE Supervisor/Program Coordinator, 5 FTE Mental Health
Specialists II, 1 FTE Senior Mental Health Service Coordinator, 1 FTE Program Coordinator, 1
FTE Services Coordinator I, and 1.0 FTE Administrative Specialist 2. Also attached to the team
is a Deputy Sheriff who functions as a liaison with the law enforcement community.

The broad duties of the AMHT are Civil Commitment, Hospital Liaison, Residential
Coordination and contract management, Jail Liaison, PSRB coordination and contract
management, special needs residential development and disaster planning.

The Civil Commitment Team of the AMHT consists of 3 FTE investigators, 1 FTE information
and court coordinator and portions of every team member. Seven staff are certified investigators
and backfill during peak workload periods. Specific ICP activities include conducting
approximately 1000 investigations and coordinating over 65 hearings each year. One
investigator also acts as the Trial Visit Monitor and works with subcontract providers to monitor
20 individuals on commitment status living in the community. Each investigator is assigned to a
community agency to provide individual consultation.

Both the number of investigations and hearings have dropped over the past several years. This is
in part due to a very strict view of the law by our Judges, County Counsel and the Public
Defenders Office. It may also be due to an increase in funding to out patient and crisis
providers. It certainly runs contrary to the significant population growth in the County over the
same period of time.

Washington County's Hospital Liaison position is 1 FTE for approximately 20-25 committed
residents in acute care or the State Hospital system. This also includes regular contact with the
Geropsychiatric units. The Hospital Liaison has historically worked closely with all committed
consumers in acute care settings and the adult psychiatric units of OSH and BMRC. That effort
included early staffing with stakeholders, routine contact to monitor progress and in ideal
situations, coordination of transition planning.




                                                                                                18
The Liaison position often serves to remind and encourage treatment teams to get referrals
submitted early and to insure that benefits are in place before the release date. Coordination with
BMRC has been difficult. With the projected change of BMRC to a SRTF we will hold off
further communication to resolve the larger problems until the new organizational structure has
been determined. If we are unsuccessful with direct communication with BMRC we will engage
AMHD for support and consultation.
The PSRB Program Coordinator is a new 1 FTE position that has evolved out of the
development of a 12 bed SRTF. In the Washington County subcontract system the program
coordinator is responsible for monitoring the PSRB provider system. As a result, she will work
with clinicians responsible for the monitoring and supervision of individual consumers and will
be the contract manager for PSRB treatment facilities and all special fuoding directed to PSRB
consumers. The new position is an important and critical addition to the monitoring and
oversight capabilities of the County.

Residential Coordination (l FTE) is provided through the screening, eligibility determination
and agency monitoring of two Residential Treatment Facilities, six Residential Treatment
Homes, and 29 Adult Foster Homes, serving over 200 individuals each year.

A five-year plan for residential services was completed in May of2006. Housing needs were
prioritized in the following order:
         1. Access to independent housing and supportive services. The major barrier was seen
            as the need for housing subsidies and other financial supports.
        2. Reduction in size of Residential Treatment Facilities and a corresponding increase in
            service intensity.
        3. Increase in intensity and quality of services in Residential Treatment Homes.
        4. Rapid access to appropriate housing for chronically homeless experiencing
            mental illness.
         5. Develop a Secure Residential Treatment Facility.
        6. Develop mental health foster capacity to service clinically complex and medically
            fragile consumers.
        7. Develop residential treatment horne for transitional youth.

A proposal has been submitted (2/08) to AMHD to reduce the size of the two Residential
Treatment Facilities. If approved, residents will have private rooms, be less crowded in common
areas, and will receive a more intensive level of residential service. The homes will also be
better prepared to serve consumers being discharged from hospitals and those with more
complex needs.

A Jail Liaison (1 FTE) is located in the jail and works with inmates to develop community
mental health treatment options. Over 350 evaluations are completed each year on 275 inmates.
Inmates are tracked until they make their initial outpatient appointment. This position will work
closely with the newly develop Forensic Assertive Case Management Team which should be
operating by the Summer of 2008.

MRS 28 - Residential Treatment Services



                                                                                                19
Residential care delivered on a 24-hour basis to individuals 18 years or older with mental or
emotional disorders that have been hospitalized, who are a hazard to themselves or others, or
who need training in living and/or symptom management skills to successfully maintain in a
community setting. Eligibility determined by the County residential coordinator, the Extended
Care Management Unit or the Psychiatric Security Review Board. Screening and approval for
placement is a collaborative process involving the appropriate combination of interested
stakeholders. Three types of residential facilities are supported with MHS 28 funding:
Residential Treatment Facilities, Residential Treatment Homes and a Secure Residential
Treatment Facility.
There are 29 RTF beds in Washington County_         Programs receiving MHS 28 funding for
Residential Treatment Facilities are:

       Luke-Dorf, Inc.
       Homestreet-Banyan Tree, Inc.
There are 18 RTH beds targeting consumers who are ECMU eligible. Programs receiving MHS
28 funding for ECMU Residential Treatment Homes are:

       Luke-Dorf, Inc.
       Homestreet-Banyan Tree, Inc.

There are 7 RTH beds targeting consumers who are on Conditional Release under PSRB.
The only program offering this level and type of service with MHS 28 funding is:

       Luke-Dorf, Inc.

There is one, single bed, highly intensive RTH that provides services to one ECMU consumer.
The program receiving funding for this individual is:

       Haven House, Inc

There are 12 Secure Residential Treatment beds with a mixed use of 8 beds for Psychiatric
Security Review Board consumers and 4 beds for Washington County residents needing a secure
environment to prevent a hospitalization or needing a step-down from the State Hospital. The
program receiving MHS 28 funding for SRTF services is:

       LUke-Dorf, Inc.

MHS 30 - Psychiatric Security Review Board

Funding provides community treatment and supervlSlOn services for persons under the
jurisdiction of the Psychiatric Security Review Board. Eligible persons are those individuals
determined "not guilty except for insanity" during criminal court proceedings. Services are
provided in 8 dedicated Secure Residential Treatment Horne beds, 5 dedicated Residential
Treatment Horne beds, and 2 Residential Treatment Horne beds that swing from PSRB to ECMU
depending on need and a variety of RTF and supported living services. We are currently serving


                                                                                           20
21 consumers with about one third being Washington County residents. There are 15 individuals
identified with Washington County responsibility at Oregon State Hospital under PSRB.
Local Administration funds are being used to support a I FTE Program Coordinator who has the
sole responsibility of managing and monitoring PSRB providers.
Programs receiving MHS 30 funding are:

       LifeWorks Northwest
       Luke-Dorf, Inc.

MRS 31- Enhanced Care Services

Enhanced Care provided to individuals residing in nursing homes, adult foster homes or other
facilities licensed by the Seniors and People with Disabilities Division (SPD) who require mental
health and psychiatric rehabilitation services. Services are intended to enable an individual remain
in the most independent living situation possible and to specifically avoid placement in the geriatric
service wards at Oregon State Hospital. Programs receiving MHS 31 funding are:

       LifeWorks Northwest - Older Adult Program

MRS 34 ~ Adult Foster Care Services

Adult Foster Care services are delivered on a 24-hour basis to individuals 18 years or older with
mental or emotional disorders who have been hospitalized or who are a hazard to themselves or
others or who otherwise require long-term care to remain in the community. Services are
provided in a family home or facility with five or fewer individuals.
Services delivered in Adult Foster Homes include money and household management,
supervision of daily living activities, management of physical health problems, provision and
management of routine and crisis transportation and the administration and supervision of
medications.
Adult Foster Homes have become an important part of our treatment continuum. They have
been critical component in reducing our census at the State Hospital and have become a warm
and homelL~e enviror..ment for consumers v/ho have had little success in more structured
facilities or independent living.
The number and quality of Adult Foster Homes have increased through the expansion several
quality providers. Those providers have opened additional homes while providing supervision
and oversight to new homes and staff. Over the next year it is projected that at least five homes
licensed by Seniors and People with Disabilities Division (SPD) will convert to AMHD licensed
homes. Depending on the availability of funding, this will lead to an increase in 2 beds. At this
point there are:

       Twenty-four SPD Licensed Homes serving 47 consumers.
       Five AMHD licensed homes serving 18 consumers.




                                                                                                21
MHS 36 - Pre-Admission Screening and Resident Review Services

Funds are used to detennine the need for psychiatric hospital or other mental health services for
individuals residing in licensed nursing facilities. All services are provided by a QMHP or a
Licensed Medical Practitioner. Programs receiving MRS 36 funding:

       LifeWorks Northwest - Older Adult Program

MHS 37 - Start-up Special Projects

Special projects funding are awarded to implement new or revised mental health services. No
plans are currently in place for FY 09-11; however no biennium has gone by without the
initiation of some project utilizing this service element for Start-Up. Funds awarded for this
special project may not be used for real property improvement in excess of $5,000. Programs
receiving funding in this category in 07-09 are:

       Luke-Dorf, Inc.

MHS 37 - Start-up Housing Renovation

This special project is intended to finance improvement or repairs to real property used by a
Provider as living arrangements for people with mental health disorders. Funds awarded for this
special project may not be used for real property improvement in excess of $5,000. Programs
that have received funding this biennium in this service element are:

       Luke-Dorf, Inc.
       Homestreet-Banyan Tree, Inc.

MHS - 38 Supported Employment Services

Washington County will continue to receive funding for supported employment services
resulting from a successful application in a competitive process for State General Fund dollars.
Specific emphasis has been placed on expanding this service in order to make it more available
to more Washington County residents. Services are delivered to individuals with chronic mental
illness enabling them to obtain and maintain employment. These services may include
supervision, coaching and job training in integrated competitive employment or transitional
employment services provided at or away from the job site. Programs receiving MHS 38
funding:

LifeWorks Northwest: The supported employment program offered at LifeWorks' Open Gate
program was recently rated at the highest level of fidelity possible scoring 75 out of 75. This
established program continues to serve approximately 105 combined non-OHP and MHO-
referred consumers. It has also been an integral training component for the new programs being
developed at Luke Dorf and Homestreet offering its expertise and knowledge base to help the
new programs become established.



                                                                                              22
Luke Dorf, Inc.: Recently began providing this service and has seen a rapid movement toward a
fidelity based program. Currently, the Luke Dorf program is working with approximately 25
consumers, both OHP and non-OHP.

Homestreet Banyan Tree: Recently began providing this service and despite several staffing
setbacks remains committed to implementing a fidelity based supported employment model

MHS 39 - Community Support Services for the Homeless Mentally III

Community Support Services for the Homeless Mentally III are outreach services, screening and
diagnostic treatment services, habilitation and rehabilitation services, community mental health
services, alcohol and drug treatment services, case management services, supportive and
supervisory services in residential settings, referral services and housing services delivered to
individuals with severe and persistent mental illnesses, including those with co-occurring
substance use disorders, who are homeless or at substantial risk of homelessness. Services may
also include training and educations services for persons who work with homeless individuals
with severe and persistent mental illness. Funds are matched by MHS 20 dollars. Programs
receiving MHS 36 funding:

       Luke-Dorf, Inc.

MHS 201- Non-Residential Adult Mental Health Services (Designated)

MHS 201 funded services are mental health services delivered to individuals specified in the
Financial Assistance Award who have a chronic mental illness, or other mental or emotional
disturbance posing a hazard to the health and safety of themselves or others. Services are
provider to ameliorate the disabling effects of mental illness. Programs receiving MHS 201
funding:

       Luke-Dorf, Inc.
       Homestreet-Banyan Tree, Inc.
       Cascadia Behavioral Health, Inc.

SE 60 - Alcohol and Drug Treatment Enhancements and Housing

Adult Treatment Services: Through an approved agreement with the State AMH Division,
previous funding for the Women with Children's Intensive Outpatient Program through
LifeWorks NW was internally transferred to support and expand funding to increase capacity for
youth outpatient treatment and rental subsidies for ITRS parents with children who need housing.

Adult Housing Services: The County received funding to provide drug-free housing through
rental subsidies for adult individuals and their families. These funds are directed toward all
clients who either need a drug-free environment to participate in outpatient treatment, clients
returning to the community after completing residential treatment, clients involved in Drug Court




                                                                                              23
or parents who have children being returned by DHS. Funding is directed to serve 21 individuals
at any point in time.

In addition, the housing rental subsidies were expanded to serve exclusively parents with
children involved in the Intensive Treatment Recovery Services (ITRS). Expanding of housing
services specifically for women with children was a priority that was identified in the department
planning process. Both housing funded services for rental subsidies went through a recent RFP
#27107P process that was completed with contracts beginning January I, 2008. The RFP
resulted in contracting with LifeWorks NW and CODA, Inc. for both housing for parents with
children and for other clients who need housing to participate in treatment. In addition, Cascadia
BHC was awarded funding to provide housing to any client enrolled in A&D treatment.

Youth Treatment Services: As stated above, funding for youth treatment was expanded to
increase capacity and the intensity of treatment services and was supported through the
department planning process. The award through the RFP was granted to LifeWorks NW and
Youth Contact. Both treatment providers have bilingual, bicultural treatment capacity; strong
partnerships with the Juvenile Department, OYA and Juvenile Crime Prevention services; and as
mental health treatment providers can address the specialized needs of youth with dual-
diagnoses. Each of the treatment providers offer both Level I and Level II treatment, dependent
on the needs of youth; incorporate individual, family, in-home services, group work and case
management to support treatment goals; and utilize random urinalysis to support sobriety.


SE 61, 61A, 62 AND SE 67 - Residential

Residential treatment services continue to be a significant need within the continuum of care for
Washington County residents. One of the issues identified by the County, providers,
stakeholders and consumers through the survey planning process is how there is a lack of
residential capacity for both youth and adults, as well as, how residential beds are distributed
among Counties. Washington County receives funding for 30 beds plus 2 new ITRS beds for
which we contract with Mountaindale Recovery Center, CODA Tigard Recovery Center and
DePaul for adults. In the current system, population is not a factor on how residential beds are
distributed. Washington County is the second largest county in the State with a population over
500,000 and yet receives the same number of beds as counties with a fraction of the population.
Residential treatment capacity continues to be the largest treatment need identified and is
exacerbated by the growth in population and stagnant residential capacity. Washington County
currently has about 90-100 clients on waitlists for these two programs; this translates into about
10-11 beds available for Washington County residents at anyone time.

Adult Residential Services SE 61: There are no changes planned regarding residential treatment
services. These contracts are for the time period of July I, 2004 to June 30 2008. There will be
a competitive bidding process in 2008-2009 for residential treatment services. The number of
residential beds contracted continues to be 32 with 20 contracted to serve the western county
region and 12 that serve both Washington and Clackamas County exclusively. The County
continued contracts with DePaul, CODA and LifeWorks for SE 61 and LifeWorks for SE 62.




                                                                                               24
Below are the following programs bed capacity allotment.

       Program                                       Current Capacity

       LifeWorks NW-Mountaindale                      9 (women and 10 children)
       LifeWorks NW-Mountaindale (IRTS)               2 (women and 2 children)
       CODA-Tigard Recovery                          12 (men only)
       DePaul Treatment Center                        9 (women & men)
       Totals                                        32

Adult Residential Services SE 61A and SE 62A (IRTS): There were new residential beds that
were appropriated in the last legislative session to serve parents with children involved
specifically with DHS-CAF. The state granted Washington County two additional residential
beds and two children's beds. Those beds have been contracted with LifeWorks NW
Mountaindale Recovery Center.

Youth Residential Services: DePaul Treatment Center continues to provide residential
treatment services through a state contract, for Washington County youth. DePaul's capacity is
very limited, with up to two/three beds available for youth from Washington County at anyone
time. The beds are typically full, and a wait of more than four to eight weeks for entry is not
unusual. With continued rapid population growth in the County and no increase in residential
resources, there is a real need to explore strategies to increase residential capacity or develop
additional residential or residential-like programs for youth in order to impact this crisis in our
continuum of care.

SE 66 - Detoxification

The County currently contracts with CODA for 6 beds for detoxification services, which are
divided equally between Washington and Clackamas Counties. The funding provided for
detoxification services continues to be woefully inadequate and continues to present challenges
to provide high quality, safe detoxification services when the funding historically is based on a
"social" detoxification model. This model is outdated along with an antiquated reimbursement
rate. The detoxification needs identified in our planning process for Washington County is to
increase capacity and adequately fund a sub-acute detoxification model that provides a much
higher level of medical care to stabilize clients. This higher level of medical care is needed due
to the increased acuity of the client's medical condition upon admission. Despite lower levels of
reimbursement, the current provider, CODA, is providing such services. Washington County
along with Multnomah and Clackamas counties are involved in a Tri-county Task Force to
identify capacity issues, service model, staffing needs and reimbursement rate for detoxification
services. It was recommended by a consultant hired to develop a Corrections Master Plan for the
Jail that a county as large as Washington should provide it's own detoxification service. Our
department along with the Sheriffs Office and Community Corrections supports this
recommendation and is working with the State AMH Division work group to develop a budget
package recommendation to include in the governor's budget for the next legislative session
beginning in 2009.




                                                                                                25
SE 66 AND 66A - Outpatient, Intensive Outpatient and Case Management

Since we received additional funding through the legislature for the Equity Redistribution
process and Intensive Treatment Recovery Support services for DHS-CAF parents with children,
an RFP was developed to combine the existing base revenue with the new legislative approved
funding and then place the entire outpatient system out for a competitive bidding process. This
process was finalized December 2007 with new contract for the full continuum of treatment
services, including adult outpatient services, minority outpatient, youth outpatient, ITRS
outpatient and drug-free housing. The RFP is for a four-year period of time from January I, 2008
to June 30, 2012. The most significant outcome from this RFP was increasing outpatient
capacity and intensity of services for the entire system, but especially youth treatment.

In addition, Washington County was the recipient of two competitive grants (Criminal Justice
Commission and Criminal Justice Services) to fund the Drug Court treatment services. The
funding brought some stability and sustainability to the continued operation of this program. We
now have the capacity to serve 55 clients at anyone time in the program. Of the 55 total clients,
15 clients are women with children who are involved in both the criminal justice system and
DHS child welfare.

The following is a list of the programs receiving SE 66 funding along with a brief description of
servIces:

Adult Outpatient Services SE 66:

Change Point, Inc. provides Level I & n outpatient treatment services for both the dominant
culture and specific bilingual bicultural service to the Hispanic/Latino population. The current
office is located in Beaverton. They provide a full compliment of outpatient treatment services
including community corrections and Dun clients.

CODA Inc. provides outpatient treatment services for clients coming out of residential and
detoxification programs as well as level I & n clients. The program is in the process of
relocating to new office space in Tigard due to the growth of the program. They provide the full
compliment of outpatient treatment services to DHS-child welfare, community corrections, and
Dun clients. 1.11 addition, CODA provides an Opioid Replacement treatment program that offers
Buprenorphine in conjunction with outpatient treatment. The program has limited capacity of 10
fully funded slots for those clients who are below 200% of poverty and are non-OHP eligible.
The program does provide these services for clients who can pay either due to OHP coverage or
insurance.

DePaul Treatment Center provides Level I & n outpatient treatment services with case
management to clients who are on residential wait lists. This service is located in Hillsboro and
provides services not only to clients on the wait list for residential treatment but also to men and
women clients involved in Community Corrections, DUn and Child Welfare.

LifeWorks NW continues to be the largest provider in the county for outpatient, intensive
outpatient and case management services. LifeWorks NW continue to provide the full


                                                                                                 26
compliment of outpatient treatment services to men and women, women-specific services, Dun
and Community Corrections clients. In the most recent RFP, LifeWarks was awarded funding to
provide bilingual, bicultural treatment services to the Hispanic population. An innovative
component of the program is the use of "Promotoras", who are literally promoters of health.
These individuals are out stationed at various sites in the county such as the Virginia Garcia
Health Clinic to facilitate connection to services, including A&D treatment. These Promotoras
will allow access to a group of Hispanic clients previously untapped. LifeWarks provide
services in multiple locations throughout the county including Tigard, Beaverton, and Hillsboro.

Cascadia BHC is a new provider as a result of the recent RFP. They were awarded funding to
provide outpatient treatment to the general addictions population. In addition, they were funded
to provide intensive outpatient services to Community Corrections probation client's onsite at the
Washington County Community Corrections Center. Cascadia also became our treatment
provider for the Washington County Drug Treatment Court Program. Cascadia has two site
locations in the county; Beaverton and Hillsboro.

Adult Outpatient Services SE 66A (ITRS):

Through the RFP process LifeWorks NW and CODA were .awarded funding to provide ITRS
intensive outpatient treatment services to non-OHP and low-income parents with children
involved with DHS-Children, Adults and Families. These services are slated to begin January 1,
2008 once the contract with the State AMHD is finalized. As part of the treatment services,
parent will have access to childcare, and recovery mentors who will assist clients tei remove
barriers and enroll in services in order to engage in treatment. The program is very early in the
developmental stages and we will be continuing to meet with DHS-CAF to coordinate and
implement this valuable service

Youth Outpatient Services:

Through the State Equity Redistribution process and an approved request by AMH to use some
of the previous SE 60 funds differently, Washington County was able to double the allocation
identified for youth outpatient treatment services. The lack of youth treatment funding was
identified through our planning process as one of the top five issues needing to be addressed by
our county through our recent RFP process. As a result, our department was able to increase the
number of providers from two to three to address capacity issues, to expand the intensity of
services by requiring agencies to provide and expand level 2 intensive outpatient services and to
reduce the wait time for youth and families to access treatment.

Youth Contact, Inc. provides Level I & n treatment services incorporating individual and family
counseling to support treatment goals; and utilizing random urinalysis to support sobriety. Youth
Contact has bilingual, bicultural treatment capacity; strong partnerships with the Juvenile
Department and School Districts; and as a mental health treatment provider can address the
specialized needs of youth with dual-diagnoses.
LifeWorks NW provides Level I & n treatment services incorporating individual, family and
group work to support treatment goals; and utilizing random urinalysis to support sobriety.
LifeWorks have bilingual, bicultural treatment capacity; strong partnerships with the Juvenile


                                                                                               27
Department, OYA and School Districts; and as a mental health treatment provider, can address
the specialized needs of youth with dual-diagnoses.

Cascadia was selected as a new youth provider and will be operating a specific Youth Hispanic
Outpatient Treatment Program. The program will provide level I and 2 treatment services along
with family counseling services. Currently the program will be operating some of their services
on-site at several Hillsboro Middle and High Schools. Cascadia operates at two site locations;
Beaverton and Hillsboro.

Adult Prevention Services:
Washington County continues to provide a half-time employee for universal prevention activities
for adults. The goal is to increase awareness of alcohol, drug and gambling issues in the
community, reduce stigmas and to promote and identifY treatment resources. Recently those
activities have expanded to include other populations such as youth, military and the Hispanic
community.

Adult Minority Treatment Services:
Currently, there were two programs contracted to serve adult Latino clients in a bilingual
bicultural treatment program. The two programs are ChangePoint and LifeWorks NW.
Additionally, there are other providers that operate in the county; Visions in Recovery, Seasons
and Treatment Services Northwest. The increase in the number of providers increases treatment
capacity and expands geographical access by providing services in Hillsboro, Beaverton and
Tigard. In addition Change Point also has counselor(s) that are bilingual in Russian, but they do
not have a specific program designated for the Russian population. There are several other
providers that do have individual counselors that offer bilingual services to Hispanic/Latino
population.

Youth Minority Treatment Services:

Both LifeWorks and Youth Contact are the current youth providers with bilingual, bicultural
treatment capacity, but there is no designated specific program to serve Hispanic/Latino youth.
In the recent RFP process, Cascadia BHC was awarded a contract for a specific bicultural,
bilingual youth and family program located and providing services in Hillsboro and Beaverton.

8. Prevention Services Plan
The Commission on Children and Families serves as the advisory body for Alcohol and Drug
Prevention services in Washington County. The County assigns a Program Coordinator in the
Child and Family Services Unit (CFSU) of the Department of Health and Human Services to
serve as the County Prevention Coordinator and serve as staff liaison for prevention services to
the Commission on Children and Families. This Program Coordinator is responsible for
development, monitoring and oversight of the substance abuse prevention services funded with
A&D 70 funds and coordination of prevention efforts of A & D, mental health, JCP and relevant
CCF programs.




                                                                                              28
Funding strategies for substance abuse prevention for children and adolescents in Washington
County were developed through the Partners for Children and Families (SB-555) planning
process and aimed at building a community comprehensive prevention system with involvement
and partnership of all its groups and sectors. Substance abuse prevention emerged consistently as
a priority for the county in meetings with community groups, including community alcohol and
drug prevention coalitions, to discuss needs and issues facing children and families and potential
strategies to address them.

Detailed information about substance abuse issues can be found in the Washington County
Community Comprehensive Plan for Children and Families. In completing planning activities
related to substance abuse, Washington County opted to speak to reducing substance use among
youth, including both the 8th and 11 th - grade group.

The planning process for the 2009-11 Implementation Plan involved a review and discussion of
the priorities identified through the SB 555 planning process, and the County's prevention efforts
will continue to be focused on the school, family, and community domains' risk and protective
factors that create a web of influence around the substance abuse issue. The allocation plan for
2009-11 will be based on needs identified in the community planning process with flexibility for
modification should new issues emerge. In the spring of 2008, the RFP process for the 2008 -
11 funding cycle will be completed.

The County will continue to fund only those programs that are based on needs' assessment, have
measurable outcomes (with a focus on school/peer/family bonding, parent communication skills,
and community coalition development), utilize evidence-based strategies, include parent
involvement and use evaluation as a tool for quality improvement. In addition, the CCF requires
one or more of the priority substance abuse strategies identified in the Washington County
Community Comprehensive Plan for Children and Families to be incorporated into the program
design. Those strategies include: 1) peer-based approaches, including the youth summit and
action teams, mentoring and support; 2) parent education and support; 3) positive youth
development activities; 4) enhancing school based services and supports; and 5) strengthening
community alcohol and drug prevention coalitions.

The County will continue to dedicate a minimum of $20,000 annually to support a minimum of
two community substance abuse prevention coalitions. Beaverton Together! and Tualatin
Together! have received these funds in the past. The Helping Empower Youm Together (HEY!)
Coalition was established using the Communities That Care model, in 2007 through a Safe
Schools Healthy Students grant which is currently in its final year. Coalitions which seek
funding from the County will be encouraged to seek alternative sources of funding for after-
school and substance abuse prevention programs through targeting individuals, corporations and
foundations in their fundraising activities.


CSAP Strategy Integration

It is anticipated that the programs selected for funding through the RFP process will address key
CSAP prevention strategies as described below.



                                                                                               29
STRATEGY: INFORMATION DISSEMINATION: Infonnation dissemination provides
awareness and knowledge of the nature and extent of substance abuse and addiction and its
effects on individuals, families, and communities. The strategy is also intended to increase
knowledge and awareness of available prevention programs and services. Programs supported in
the current funding cycle, through June 2008 include:

I. Youth Contact - Student Assistance Program which includes classroom presentations and
   peer leader training in four Washington County school districts.
2. LifeWorks NW - FAST - Families and Schools Together which provides parent education
   and parent-child interaction activities to improve family communication and school bonding.


STRATEGY: PREVENTION EDUCATION: In 2009-11 biennium, Washington County will
continue to fund programs that provide skill building and parent education utilizing both Alcohol
and Drug prevention and CCF funding streams. Additionally, new funding from AMH for the
Strengthening Families for families with 10-14 year olds has helped to significantly expand
parenting options, providing an evidence-based model for the parents of adolescents, and are
being integrated into the Alcohol and Drug prevention services in the County. The CCF plans to
continue support and funding for parent education programs and is working to expand capacity
to serve all minority populations.

Program supported in the current funding cycle, through June 2008 include:

I. Families and Schools Together (FAST), an evidence-based model being implemented by
   LifeWorks NW (A & D funds).
2. The Incredible Years Parenting evidence-based curriculum implemented county-wide
     through the Parenting Consortium which is coordinated by LifeWorks NW (CCF funds) and
     through the SIG Early Childhood Behavioral Health project;
3.   Family Coaching program, a home-based skill building model operated by LifeWorks NW
     (CCF funds).
4.   Student Assistance Program, operated by Youth Contact and serving students in four
     school districts provides skill building groups on a selective basis to at-risk youth, to enhance
     resiliency skills and reduce risks of substance abuse.
5.   All Stars, an evidence-based cumculurl1 is offered in selected schools througl1 the Student
     Assistance Program operated by Youth Contact.
6.   Guiding Good Choices, is being offered to parents in the Hillsboro School District through
     the Safe Schools Healthy Students grant.
7.   Strengthening Families, parenting classes targeting families with youth between 10 and 14
     years old. Funds will support classes to be offered by a number of community agencies,
     including behavioral health providers. Agencies to be contracted with include: CODA,
     Cascadia, ChangePoint, LifeWorks NW, Youth Contact. Initial contracts will be through
     June 2008, with contracts for 2008-09 to be detennined in the spring based on the first six
     months' experience.




                                                                                                   30
STRATEGY: ATOD ALTERNATIVES Alternatives provide for the partIcIpation of target
populations in activities that exclude substance abuse. The assumption is that constructive and
healthy activities offset the attraction to or otherwise meet the needs usually filled by alcohol,
tobacco, and other drugs and would therefore minimize or remove the need to use these
substances. Programs currently funded, through June 2008, include:

1. Tualatin Together! - WEB Program - Welcome Everybody is designed to assist students as
   they transition from middle school into high school by providing student mentors and
   ATOD-free activities.
2. Youth Contact - Student Assistance Program offering peer based models such as peer
   mediation and peer helpers.
3. CCF funds support after-school activity programs in school and community settings that
   target middle school age youth and offer a range of social, recreational and academic
   enrichment activities in Beaverton, Forest Grove, Hillsboro, and Tigard-Tualatin School
   Districts.

 STRATEGY: PROBLEM IDENTIFICATION AND REFERRAL: Problem identification and
referral aims to classify those who have indulged in illegal or age-inappropriate use of tobacco or
alcohol and those who have indulged in the first use of illicit drugs and to assess where their
behavior can be reversed through education. Current programs, through June 2008, include:

1. Youth Contact: Through the Student Assistance Program serving Banks, Beaverton, Forest
   Grove and Hillsboro School Districts, screening and referrals for alcohol and drug and other
   Issues.

STRATEGY: COMMUNITY-BASED PROCESSES: The Washington County Commission on
Children and Families continues to support the on-going development and maintenance of
community coalitions through funding and staff participation in coalition meetings as
appropriate. Two coalitions are currently supported through Washington County Alcohol and
Drug funds: Beaverton Together! and Tualatin Together!. The Commission has also worked
with the Hillsboro School District through the Safe Schools/Healthy Students grant on the
development of the Helping Empower Youth Together (HEY!) community coalition in
Hillsboro.

The \Vashington County COlThl1ission on CI-tildren wid Fful1ilies   Youu~   Advisory Council held
the first Washington County Youth Summit in November 2005. Over 250 middle and high
school students from all seven school districts participated. In November 2006 more than 300
middle and high school students from the seven districts participated, and the Summit in October
2007 saw the number of students participating grow to some 350 youth. Summit attendees
identify areas of concern on their campus centered on drug, alcohol, and tobacco prevention,
student/school success, violence prevention and honoring diversity. Each team that attends the
summit is eligible for a small grant to implement student-led projects in the participating schools
with funding through the Enforcing Under-Age Drinking Laws grant from AMH and funding
from the CCF. Each year has seen in excess of20 student led projects implemented through out
the county.




                                                                                                31
STRATEGY: SOCIAL POLICY AND ENVIRONMENTAL APPROACHES: This strategy
establishes or changes written and unwritten community standards, codes, and attitudes, there by
influencing the incidence and prevalence of the abuse of alcohol, tobacco, and other drugs by the
general population. Current programs, through June 2008, include:

I. Beaverton Together! through Alcohol and Drug prevention funding and the federal Drug
     Free Communities grant worked to expand and strengthen the coalition and is working in
     partnership with the Beaverton Police Department, OLCC, and local vendors to stop the sale
     of alcohol to minors.
2.   The development of the Helping Empower Youth Together (HEY!) Coalition through the
     federal Safe/Schools Healthy/Students grant in Hillsboro, and implementation of several
     evidence based programs following the needs assessment process: Guiding Good Choices,
     Brief Strategic Family Therapy, Students Move, and social norms marketing.
3.   The CCF is partnering with ORI in Forest Grove and Oregon City to train and support
     partnerships with local law enforcement to engage in Shoulder Tap campaigns, and to assess
     impact of the campaigns in comparison to similar communities where such campaigns are
     not conducted.
4.   The CCF in partnership with the Hillsboro Youth Advisory Council has hosted a townhall
     meeting to specifically address the use of alcohol by minors.
5.   CCF and Beaverton Together! and the recently established HEY! Coalition have worked in
     several middle and high schools in the Beaverton and Hillsboro School Districts on a variety
     of social norming campaigns to promote substance-free youth. The work in Beaverton was
     supported by SAMHSA funds through the grant to reduce use of Ecstasy and other club
     drugs, and in Hillsboro it has been supported through the Safe Schools Healthy Students
     grant.

Cultural and Gender Specific Issues

Due to the rapid growth ofthe Hispanic and diverse SE Asian population, Washington County is
experiencing a consistent rise in the demand for culturally specific prevention and treatment
services. Increasing our capacity to provide culturally competent services to meet the needs of
our diverse populations was a major theme that emerged in the SB 555 (Partners for Children
and Families) planning process.

Through the contracts with community agencies, CCF staff promotes services for minority
populations including youth from diverse racial and ethnic groups, and gay, lesbian, and bisexual
youth. All requests for proposals must reflect the ability to reach the diverse populations and
capacity to build on cultural strengths empowering minority youth and families. Through the
contract monitoring process, the CCF assures that all providers adhere to the standards of
cultural sensitivity and appropriateness of services for diverse populations.

Currently, two A & D prevention and treatment providers have bilingual and bicultural capacity
(LifeWorks NW and Youth Contact). In addition, County CCF funds support the Cascadia
Behavioral HealthCare Pride Project), a youth development program which has a goal of helping
sexual minority youth to make healthy choices for themselves.



                                                                                              32
The Commission on Children and Families utilizes the County's demographic data as a basis for
planning and evaluation. As indicated in 2007-08 Prevention Annual Report of Washington
County, the percentage of the African American, Hispanic, Native American and SE Asian
adolescents among the participants of the prevention programs corresponds with the
community's ethnic composition.

In spite of the accomplishments mentioned, there continues to be a lack of substance abuse
services for Latino communities in the rural eastern and southern parts of the County. Extremely
diverse and fast growing SE Asian populations also experience a shortage of culturally
appropriate and langnage specific services. A growing demand for bicultural/bilingnal staff
limits agencies' ability to retain staff and leads to a "bidding war" among the providers. In
addition, there is a need for more staff training on incorporating cultural/ethnic values and health
beliefs into the prevention and treatment curricula. One of the key features of the SIG Early
Childhood Behavioral Health project was to build capacity among behavioral health providers
through providing targeted and specialized training, to provide culturally appropriate behavioral
health services, and to increase the number ofbilingnal/bicultural staff entering the field.

There is also an identified need for culturally sensitive and appropriate parenting education and
skill training for minority families on issues related to substance abuse and dealing with the
common concerns for recent innnigrants, including inter-generational conflict. Fear of seeking
assistance outside the family, lack of awareness of community resources and understanding of
how the system works lead to limited self-advocacy and serves to perpetuate problems within the
minority communities. In the new Strengthening Families initiative, classes will be routinely
offered in English and Spanish. A culturally specific team of Somali-Bantu immigrants has been
trained in the curriculum and will be working with University of Iowa personnel to adapt the
curriculum for this new and growing immigrant population in the county.

Within the context of 2009-11 implementation plan for the minority prevention and treatment
services and in accordance with the strategies developed through the SB-555 plauning process,
the CCF will be focused on the following directions:

•   In the community domain, aiming at building community laws and norms, through support
    for minority parents in developing and adoption ofthe community set ofbehavioral rules and
    expectations for youth. In addition, a key strategy will be to empower minority populations
    and broaden their participation in the community decision-making process.

Beaverton Together!, one of the community coalitions which the County continues to support
with A&D funding, continues work to increase involvement of the underrepresented ethnic
groups' leaders with its Planning Board.

The Hillsboro HEY! Coalition, through the Safe Schools Healthy Students grant has worked to
assure a broad and diverse community board, including members of minority populations and
youth.

Through a grant received from SAMHSA, the County worked in partnership with Beaverton
Together! to implement the Communities that Care model and to implement community based



                                                                                                 33
strategies to change norms and behavioral expectations, particularly with regard to use of ecstasy
and other club drugs. A diverse community board, including representatives from the Latino
community and SE Asian communities worked to implement community strategies selected and
to develop strategies to sustain efforts.

• In the family domain, provide culturally specific and appropriate parenting education and
    skill training in order to promote parent empowerment and alter their perceived parental
    attitudes.

In 2007-2009 biennium, Washington County will continue to fund programs that provide parent
education while specifically targeting minority populations or have the adequate proportion of
minority families among their clientele. In 2007-09 the following programs will address the
family domain:

    I. The Incredible Years Parenting curriculum implemented county-wide through the
       Parenting Consortium coordinated by LifeWorks NW (CCF funds)
   2. Family Coaching program of LifeWorks NW (CCF funds); and
   3. Families and Schools Together (FAST) of LifeWorks NW (A & D funds).
   4. Strengthening Families parenting curriculum implemented county-wide through
       network of behavioral health providers (AMH funds)
The CCF anticipates it will to continue support and funding of the existing parent education
programs and will work to expand their capacity to serve all minority populations.

• In the individual domain, continue to work on improvement of services' cultural sensitivity
    and appropriateness

Both substance abuse treatment providers succeed in retaining bilinguallbicultural staff as well as
some agencies that provide preventive services. Nevertheless, there is need for additional
resources to recruit and train competent staff to ensure access and quality services for minorities
throughout the continuum of care.

Professional Development Training

The County routinely provides notices of local and state training opportunities to staff and
community providers. Each county staff person has a training aHo\vance available to support
participation in training identified in individual training plans. Through the RFP process
providers are expected to include training funds in their budget to assure staff have access to
needed training. The County has previously sponsored a team of participants (including provider
representatives, school representatives and community representatives) to state sponsored
prevention conferences. It is anticipated that the County Prevention Coordinator will provide
some training and consultation to representatives of schools and community agencies. Finally,
through the Safe Schools / Healthy Students project in partnership with Hillsboro School
District, the CCF has made training available to prevention and treatment providers as well as
other key stakeholders in the Communities that Care model which includes detailed information
about risk and protective factors and related evidence-based strategies that target youth, families,
schools and the community. Training for partners delivering new evidence-based curricula and



                                                                                                 34
programs in the past year has included: Guiding Good Choices, Brief Strategic Family Therapy,
and Strengthening Families. Additionally, through a federal grant to support integration of
mental health services in the schools, a variety of trainings have been offered to school and
community partners in identification and assessment of students with behavioral health concerns
and supporting school success.

9. Gambling Services Plan
A revised 2007-08 Gambling Implementation Plan for prevention/outreach was approved and
there will be no anticipated changes that will occur in the 2009-2011 biennium .unless there is an
increase in funding (See Previous 2007-08 Prevention Implementation Plan). The universal
prevention activities are provided by the Department of Health and Human Services and the
Indicated Prevention activities are provided by LifeWorks NW.

LifeWorks NW are the sole treatment provider with three primary locations for the delivery of
gambling treatment services. The locations are at their East Beaverton (Millikan Way), North
Beaverton (Cornell) and Tigard sites. The primary use of the prevention activities is to increase
the referral rate for certain sub-populations and geographic locations. A competitive bidding
process will occur in the spring of 2009 and a brief needs assessment process will take place to
assist the department in identifying needs, gaps and barriers to treatment that could be impacted
by this RFP process.

10.    Children's Mental Health Services Plan
Washington County continues to make good progress in implementing the Children's System
Change Initiative (CSCI). We are fortunate to be able to provide an integrated system
incorporating both MHO (Mental Health Organization) responsibilities and CMHP (Community
Mental Health Program) responsibilities into a single access point and a comprehensive System
of Care.
We currently employ 5 Care Coordinators who work with our ISA youth and families to
facilitate Child and Family Teams and develop Service Coordination Plans. These Care
Coordinators are able to stay connected to the youth and families through all levels of service
while in the ISA and as they transition to a lower level of care They are able to authorize
treatment services and can do so in the child and family teams, which gives the team great
flexibility to develop meaningful service plans that can be implemented immediately. Through
the advocacy of our Care Coordinators and family voices we continually receive feedback about
our service system. This allows us to then work with our contracted and non-participating
providers to tailor services and intake procedures to meet the unique needs of these youth and
families.

Stakeholder Involvement: The following groups were formed to insure stakeholders'
participation in the development and refinement of policy, procedure and operations of the
System of Care:




                                                                                               35
Children's Intensive Services Advisory Council: This group began meeting in the
summer of 2004, more than a year before implementation of the System Change
Initiative. We were fortunate to have strong interest and involvement at the outset from
critical partners such as education, child welfare, juvenile justice, providers and families.
This group was responsible for approving the system design, eligibility determination
process and making recommendations for needed services. Their continuing role is to
identify needs; establish priorities; provide system oversight, planning and evaluation;
advocacy and make recommendations for system improvements. Participants include
51 % Family Members/Advocates, provider representatives, DRS Service Delivery Area
Manager, DRS Branch Managers, Washington County Juvenile Justice Manager, OVA
Manager, School District Representative, and Washington County MHO Leadership.

Children's Intensive Services Coordinating Committee: This group is intended to
provide operations oversight, or serve as the "management team" for the Washington
County System of Care. The group manages coordination issues between systems,
participates in joint planning and policy making; does system monitoring and problem
solving, identifies and commits existing and/or new resources, and develops/revises
working agreements. This committee has also become a venue to staff particularly
challenging cases, as a replacement for the Complex Case Consultation Committee which
is no longer meeting due to lack of referrals. We view this as a positive indication that
most case specific challenges are being addressed at the child and family team level.

Participants include DRS Central staff, DRS Branch Managers, OYA District Manager,
Juvenile Justice Manager, ESD Representative, FCHP Representative, Family/Advocate
Representatives, Washington County MRO Staff, Washington County Developmental
Disabilities Supervisor, ISA Providers, Early Childhood Provider System Representative,
Washington County A & D Staff, and Acute Care Attending Psychiatrist.

Alternate Care Committee: This is a long standing committee jointly established by
DRS, OVA, Juvenile Justice and Washington County to provide a venue for placement
questions and referrals. The committee meets bi-weekly to review children in the custody
of these agencies referred for out-of-home placement for the treatment of behavioral
issues. Representatives from DRS and OVA staff this meeting. A Washington County
Child and Adolescent Care Coordinator is also present at this meeting. Recently, as an
outcome of discussions in the Coordinating Committee, the time slots for this committee
have increased and the role has expanded to include clinical consultation in addition to
placement questions.




                                                                                          36
Expansion of Intensive Commnnity Based Services: As stated above, Washington County
continues to contract for lCTS services with LifeWorks NW and for crisis and planned respite
services with Boys and Girls Aid. Both services are an integral part of the system of care,
particularly essential for keeping youth in their own community. As the system of care evolves
locally, more youth are successfully remaining in the community rather than being placed in
facility based care. Correspondingly, the capacity for the Home Based Stabilization program has
increased to meet the demand. In addition, for youth and families that are not for some reason
able to get their needs met through the LifeWorks NW program we have expanded our outreach
to non-panel providers to provide home based intensive treatment services to those youth.

Early Childhood Mental Health: As mentioned earlier, Washington County hopes to
strengthen the Early Childhood Mental Health expertise and resources in our County through
two early childhood initiatives: The Early Childhood Mental Health Consultation model
subcontracted through The Morrison Center, offing mental health consultation to Head Start and
other childcare providers coupled with site and home based support for early childhood
practitioners and families. Additionally, through funding the continuation of the Promotora
Program, Washington County seeks to build sustainable capacity in the behavioral health as well
as the early childhood system, to identifY Latino children and families with behavioral health
concerns and to develop pathways to culturally appropriate prevention, early intervention and
treatment services in settings where children and families spend time, such as Head Start centers
or health clinics.
However Washington County continues to identify a need for more focused training of our
provider system on the assessment and diagnosis of early childhood mental health. In addition,
we recognize that it must be a partnership with graduate programs to enhance the education in
early childhood mental health diagnosis and treatment for our incoming workforce.

School-Based Mental Health Services: As stated earlier, Washington County will be
continuing funding to support the team leader for a school based care coordination program in
our Hillsboro School District. This initiative is being viewed as a pilot for other districts to
model services after. In the previous biennium (07-09) we co-funded a position with MRS 22
funds for a care coordinator position at the Forest Grove High School in the Forest Grove School
District. This year two other districts are applying for Safe Schools/ Healthy Students grants and
may also be developing a similar program.

Data from the Hillsboro program has highlighted the need for school based services, with ahnost
3% of the district's 20,000 plus students using the service. In addition, over 40% of the students
served to date are Hispanic, which is a much higher percentage than our countywide penetration
rate for mental health services by this population. Four of the seven program staff are bilingual
(Spanish) and bicultural. This is a model we intend to replicate in some form throughout the
county.

This program has also prompted some systemic changes related to access and treatment barriers
for youth and families. The school based clinicians work closely with the family as they are
linked to mental health services and have first hand exposure to the strengths and barriers related
to accessing services. This feedback is then used to work collaboratively with the system
providers to make necessary changes.



                                                                                                37
11. Older Adult Mental Health Services
Mental Health Services: In Washington County, older adults are provided mental health
services in several ways. First services are provided through the general mental health service
system of crisis and rehabilitation services. Second, services may be provided through the
specialized services at the LifeWorks Northwest Older Adult Program. And third, services are
provided through ECOS funding that provides intensive services to older adults exiting the
Oregon State Hospital (aSH). Finally, mental health services may be provided within the
primary care setting.
The Older Adult program at LifeWorks has been in existence for over 20 years. It receives
ECOS funding that supports mental health clinical services to consumers in a Skilled Nursing
Home (ECF) and several Adult Foster Homes, one owned and operated by LifeWorks. The
program has contracts with the Department of Aging and Veterans Services to provide both
mental health services and day program services for individuals with both dementia and mental
illness. Individual services are provided both at the Older Adult Program site and through
outreach to consumers in their homes or place of residence. Referrals come through PASARR
screenings, DAVS case managers and protective service workers.
Washington County also continues to support the Primary Care Integration Project which began
in 2005. In collaboration with Disability, Aging and Veterans Services (DAVS), LifeWorks and
The Portland Clinic, a .6 FTE psychologist was out-stationed in one of the Portland Clinic's
large multi-service clinics.. The goal of the project was to engage older adults in the less
stigmatizing physical health care environment, complete an assessment and make referrals to
appropriate care at either LifeWorks or other community mental health programs. Since its
inception, the program has expanded its clinic location to include the Legacy King City Primary
C<tre clinic. This was done to expand the outreach to additional individuals who may benefit
from the service. Unfortunately, due to competing demands on MRS 20 funds, this program can
no longer be funded by General Funds. The funding stream has been shifted to OHP at this time.
In addition to the above direct services, the Residential Coordinator has established close
relationships with the local aging services and SPD branches as well participating in ECOS
planning meetings. Also, the Hospital Liaison has met with all of the treatment teams at aSH
working with consumers identified as Washington County residents and is available to work with
social workers on transition planning for any patient deemed ready for discharge. Between work
with the general adult population, PSRB patients and our older consumers the Hospital Liaison
travels to the Salem campus twice each month. Finally, members of the mental health, chemical
dependency and DAVS planning staff participate in monthly planning and coordinating councils.
Over the course of the last year, Washington County assisted in a community education effort to
prevent older adult suicides. Using existing expertise within our provider network, a
presentation was offered to several primary care clinics. In addition, older adult suicide
education was incorporated in the services and support offered in the Primary Care Integration
Project. Education was provided to physicians and staff at the Portland Clinic to help them
identify and refer older adults with depression. A short training module on depression and
suicide was included in most of the topics presented by LifeWorks in their education programs
presented to families and providers. Finally, the information described above was offered to



                                                                                            38
DAVS staff in the hope that they might identify, engage and refer some of their depressed and
possibly suicidal clients currently going unnoticed. At this point, Washington County plans to
continue the effort to educate the community about Older Adult suicide by incorporating the
information into the existing service array.

In summary, the County has good resources for older adult services in several areas. There is an
appropriate level and quantity of services available to address the needs of residents returning to
the community from Oregon State Hospital. LifeWorks also has training systems in place to
maintain and expand the workforce skill levels. LifeWorks' longstanding relationship with
Aging Services is also an asset. Finally, the incorporation of Aging Services into the Department
of Health and Human Services should also facilitate improved coordination.

Gaps are primarily in the area of funding to serve uninsured or under-insured residents. With
most of available funding be targeted towards achieving hospital census targets and responding
to Geropsychiatric, Forensic and PSRB needs, there is little additional resource available to
direct towards "routine" services to all residents and older adults in particular.

Alcohol and Drug Services: As discussed earlier, Washington County recognizes the need for
specialized alcohol and drug prevention and treatment services to the older adult population.
Currently our system is serving adults age 65 and older utilizing existing SE 66 funding and
resources. The 2002 Washington County Data Book indicates that there were only 28
individuals enrolled in treatment for substance abuse in Washington County that were age 65 or
older. In addition, there were only 308 individuals enrolled between the ages of 50-64. The
population of Washington County residents that are 65 and older and between 50-64 years old is
39,956 and 61,217 respectively. This represents less than .5% penetration rate for our older adult
population.

County staff from the mental health and addiction service system over the last several years have
been members of a sub-committee of the Department of Aging and Veteran Services (DAVS)
advisory council. The sub-committee's focus is to identify service gaps and umnet needs for
mental health and addiction services for the older adult population. In addition, a member from
that advisory council also attends the Behavioral Health Council meetings and in effect is a
liaison between the two advisory groups. Through this process, an issue that continues to surface
is not only the lack of treatment options that are specific to the older population, but also
identifying opportunities to intervene. This population does not present for mental health and
addiction services in the usual way.

The focus of our advisory group discussion has been on identifying prevention, education,
intervention and outreach strategies to increase the penetration rate.            One of the
recommendations and priorities from both the DAVS advisory group and the Behavioral Health
Council strategic planning process was the development of a specific older adult outpatient
treatment program. As funding resources become available, the County will prioritize this
service along with the other needs and gaps in services to determine were best to place scarce
resources. The ability to address the system priorities is strictly dependent on increasing the
existing funding base for addiction treatment services.



                                                                                                39
                        Office of Mental Health and Addiction Services

                            County Contact Information Form
11. County Contact Information
County:                Washington
Address:           155 NE First Ave, MS 70
City, State, Zip: Hillsboro, OR, 97124
Name and title of person(s) authorized to represent the County in any negotiations and sign any
Agreement:

Name      Bob Davis                               Title County Administrator
Name      Tom Brian                                    Title Chair, Board of Commissioners

12. Addiction Treatment Services Contact Information
Name      Jeff Peters
Agency Washington CountyDHS
Address       155 NE First Ave, MS 4
City, State, Zip     Hillsboro, OR 97124
Phone Number         503 .846.4976    Fax._--"5-"'O""3.""84""6"'-.4"'5"'6""0               _
E-mail        jeff-Peters@co.washington.or.us.                                         _

19,.pr~vention Services Contact Infotrnation

Name MarvNunnenkamp
Agency Washington County Commission on Children and Families
Address 155 NE First Ave, MS 5
City, State, Zip Hillsboro, OR 97124
Phone Number 503.846.4918                Fax      503.846.4954
E-mail_MarvNunnenkamp@co.washington.or.us

14.   Mental Health Services Contact Information

Name      Kim Burgess
Agency Washington County DHS                                                       _
Address      155 NE First Ave, MS 70
City, State, Zip Hillsboro, OR 97124
Phone Number 503.846.4552 Fax        503.846.4560
E-mai1__kim_burgess@co.washington.or.us                                        _




                                                                                               40
       Gambling Treatment Prevention Services Contact
       Information
Name      Jeff Peters
Agency Washington County DHS
Address       155 NE First Ave, MS 4
City, State, Zip     Hillsboro, OR 97124
Phone Number         503.846.4976     Fax._--,,-50",3"".8""4""6""".4"'56"'0"------       _
E-mail        jef(peters@co.washington.or.us.                                        _

 6. State Hospital/Community Co-Management Plan nCOJotal:::tt
    Information
Name      John Fryer
Agency Washington County DRS
Address       155 NE First Ave, MS 70
City, State, Zip   Hillsboro, OR 97124
Phone Number          503.846.4920           Fax      503.846.8287




                                                                                             41
                          Addictions and Mental Health Division - Attaclnnent 1

       LIST OF SUBCONTRACTED SERVICES FOR                         Washington County

          For each service element, please list all of your treatment provider
       subcontracts on this form. In the far right column indicate if the provider
               delivers services specific to minorities, women, or youth.

                                       Adult Mental Health

Provider            iC'   ~Jll)roX~~icens~   Service   AMHFundsin                 Specialty     .,~



Name                      IDNnmber           Element   Subcoutract
                                                       (Annual)                                 <\;;
Homestreet-Banyan         93-0793127         MHS 20,   $820,508 (20, 24)
Tree, Inc.                                   24,28,30, $25,180.00 (38)
                                             34,38,    $43,892 (28)
                                             201       $1,325 (30)
                                                       $7,750 (34)
                                                       $20,104 (201)
Luke-Dorf, Inc.           93-0685734         MHS20,    $365,534 (20, 24)
                                             24,28,30, $25,180.00 (38)
                                             38,201    $83,292 (20)               Connell Rent Subsidies
                                                       $18,060 (28)
                                                       $98,515 (30)
                                                       $143,993 (201)
LifeWorks Northwest       93-0502822         MHS20,    $497,749 (20, 24)          Older Adult
                                             24,38,30 $61,536 (38)
                                                       $7,395 (30)
Cascadia Behavioral       93-0770054         MHS20,    $198,322 (20, 24)          Minority- Hispanic
Healthcare                                   24,201    $7,200 (201)
Asian Health and          93-0770054         MHS20,    $19,443 (20,24)            Minority - Asian
Service Center                               24
OHSU Intercultural        93-1176109         MHS20,    $19,443 (20,24)            Minorities, refugees
                                             24
Haven House, Inc.         514557             MHS       $21,834 (20)
                                             201A




                                                                                                      42
                         Addictions and Mental Health Division - Attachment 1

  LIST OF SUBCONTRACTED SERVICES FOR                              Washington County

                                          Crisis Services
Provider                        A.pprovaI!Li¢ens   Service  • ~ Funds i1i/n}              Specialty
Name                            eIDNumber          Element . SlI.bcontract (Aumial)       Service
Providence Health               93-0386929         MHS25 $180,000
Systems
Cascadia Behavioral             93-0770054         MHS25      $750,000
Healthcare
Boys and Girls Aid              93-8386791         MHS25      $80,000                     Youth
Society
Homestreet-Banyan Tree,         93-0793127         MHS25      $98,640
Inc.
Luke-Dorf, Inc.                 93-0685734         MHS25      $48,240
LifeWorks Northwest             93-0502822         MHS25      $283,966
Cascadia                        93-0770054         MHS25      $137,883
Asian Health and Service        93-0770054         MHS25      $4,329
OHSU Intercultural              93-1176109         MHS25      $14,744
Western Psychological           93-0921282         MHS25      $77,399

                         Child and Family Outpatient Mental Health
                            ApprovatnLicense       Service   AMHFundsin           Specialty
   Name                     IDNumber               Element   Subcontract          Service
   Cascadia Behaviorai      93-0770054             MHS22     $139,000             Youth
   HealthCare

   LifeWorks Northwest      93-0502822             MHS22     $574,000             Youth


   Morrison Center          93-0354176             MHS22     $40,000              Youth


   Western Psychological    93-0921282             MHS22     $60,000              Youth
   and Counseling

   Youth Contact            93-0780364             MHS22     $178,000             Youth




                                                                                                  43
                     Addictions and Mental Health Division - Attaclnnent I


LIST OF SUBCONTRACTED SERVICES FOR                            Washington County


                           Early Childhood Mental Health

Provider                Approval/License     Service     AMHFundsin           Specialty
Name                    IDNumber             Element     Subcontract          Service
Morrison Child and      93-0354176           MHS22       $80,000              Early Childhood
Family Services

LifeWorks NW            93-0502822           MHS22       $250,000 per year    Early Childhood
                                                         (changing to OHP
                                                         funding July 2008)



                                Intensive Service Array

Provider                Approval/License     Service     AMHFundsin           Specialty
Name                    IDNumber             Element     Subcontract          Service '
Washington County                            MHS22       $453,000             ISA Care
                                                                              Coordination

LifeWorks NW            93-0502822           MHS22       $126,000             ISA Psychiatric
                                                                              Day Treatment

LifeWorks NW            93-0502822           MHS22       $140,000             ISAHome
                                                                              Based
                                                                              Stabilization
                                                                              (ICTS)



                              School Based Mental Health

                        ApprovaI/License     Service     AMH Funds in         Specialty
Name                    IDNumber             Element     Subcontract          Service
Washington County                            MHS22       $54,346              School Based
                                                                              Mental Health




                                                                                                44
                      Addictions and Mental Health Division - Attachment I

  LIST OF SUBCONTRACTED SERVICES FOR                           Washington County

      Alcohol & Drug Treatment & Gambling Treatment and Prevention



Adult & Youth Services                                         Annual Funds
Cascadia BHC                93-0770054         SE 60---        $22,530        Housing
                                               SE 66---        $247,343       Corrections
                                                                              Youth-Minority
                                                                              Drug Court
CODA, INC                   93-0716860         SE 61------     $367,830       Residential
                                               SE66-Detox      $72,990        Housing
                                               SE 66------     $168,000       Detox
                                               SE 66A----      $238,561       ITRS
                                               SE 60------     $76,310        Women
                                               SE 67------     $87,600
Change                      93-1229222         SE66            $265,400       Minority
Point
DePaul                      93-0706892         SE 61-------    $275,872       Residential
Treatment                                      SE 66-------    $153,000
                                               SE 67-------    $65,700
LifeWorks NW                93-0502822         SE 60-Youth     $82,260        Youth
                                               SE 60-House     $106,678       Housing
                                               SE 61-------    $275,872       Residential
                                               SE 6IA-----     $61,137        ITRS-Res.
                                               SE 62-------    $110,898       Minority
                                               SE 62A------    $22,119        Youth
                                               SE 66-Adult--   $220,000       ITRS-OP
                                               SE 66-Youth-    $131,740
                                               SE 66A------    $233,520
                                               SE 67--------   $80,160

LifeWorks NW                93-0502822         SE 81           $380,303       Gambling
                                               SE80            $28,000
                                               SE83            $22,208
Youth Contact, Inc.         93-0780364         SE60            $82,260        Youth
                                               SE66            $65,740




                                                                                            45
                          Addictions   and Mental Health Division - Attachment I

       LIST OF SUBCONTRACTED SERVICES FOR                              Washington County

                     Beer and Wine Tax Revenne and Drug Court Funding
                               for Alcohol and Drug Treatment



                                 93-0770054          SE66-BIW--                        Youth
                                                     Drug Court--                     Minority
                                                                                     Corrections
           LifeWorks NW          93-0502822          SE 66-BIW--         $43,018      Minority




                              Youth Alcohol and Drug Prevention

rlUVlU~'                  ApprovaJJLicense       Service      AMH Fnlulsiii        Specialty Service
Name .• <.                IDNnmber               Element      Snbcontract

Beaverton Together        93-1132097             A&D70        $12,025              Youth Prevention

LifeWorks NW              93-0502822             A&D70        $10,841              Youth Prevention

Tualatin Together         93-0572833             A&D70        $12,025              Youth Prevention

Youth Contact             93-0780364             A&D70        $14,511              Youth Prevention
Washington County                                                                  Prevention
HHS/CCF                   93-6002316             A&D70        $115,819             Coordinator

WCHHS/CCF - Youth                                                                  Under-Age Drinking
Summit Projects           93-6002316             EUDL         $7,500               Prevention


LifeWorks NW              93-0502822             BIWTax       $22,509              Youth Prevention

Youth Contact             93-0780364             BIWTax       $80,000              Youth Prevention




                                                                                                   46
                   Addictions and Mental Health Division - Attachment 2

           BOARD OF COUNTY COMMISSIONERS REVIEW AND APPROVAL

County:      Washington County




In accordance with ORS 430.258 and 430.630, the Board of County
Commissioners has reviewed and approved the mental health and addiction
services County Biennial Implementation Plan for 2009-20 II. Any comments are
attached.

Name of Chair:     .2cT-"'o""m"-'B""n"-'·""an"'                           _
Address:     155 N First Ave.
             Hillsboro, OR 97124
Telephone Num~:                                   ~ _

Signature:
Date:
                 Mri::;fCk: ~
           e2fC;2(ff
                                503-846-8681


                                   tJr            r     7~
             T           J
                Addictions and Mental Health Division - Attachment 3

          LOCAL ALCOHOL AND DRUG PLANNING COMMITTEE
                    REVIEW AND COMMENTS

County:                W-'-'--"a"'s""h""in,.g""to"'n"'---                       _

Type in or attach list of committee members including addresses and
telephone numbers. Use an asterisk (*) next to the name to designate
members who are minorities (ethnics of color according to the U.S. Bureau
of Census).


The Commission on Children and Families serves as the LADPC for Alcohol and Drug
Prevention Service for Children and Youth.

Membership roster is attached.

The Plan was reviewed and discussed at the regularly scheduled CCF meeting on
February 14,2008.



In accordance with ORS 430.342, the        Washington
County LADPC recommends the state funding of alcohol and drug treatment
services as described in the 2009-2011 County Implementation Plan.
Further LADPC comments and recommendations are attached.


Name of Chair: _ _---...:C"'hri=·"'st"'in""e'-'M=u""IT"-'a"-'y'----                 _
Address:                               ----"'2~06~5o....NW~~O~v-"ert"-""'on"-       _
                                         Beaverton, OR 97006
Telephone Number:                            503-690-6073
                                           Commission on Children & Families
                            COMMISSION BOARD             Doug Riggs                           STAFF
                            Dawn Bonder                  13123 SW Wellington Place            William Thomas
                            14667 NW Heathman Lane       Tigard, OR 97223                     Director
                            Portland, OR 97229           C 503-702-5120                       C 503-380-1665
                            C503-645-2757                doug@ngrc.com                        W 503-846-4491
                            dawnbonder@gmail.com
                                                                                              Diana Stotz
                            Martha Brooks                Katie Riley                          Sr. Program Coordinator
                            17355 SW Sugar Plum Ln.      250 NE Hillwood Dr.                  503-846-4732
                            Beaverton, OR 97007          Hillsboro, OR 97124
                            W 503-649-2068               W 503-494-2556                       Betty Merritt
                            H 503-649-9438               H 503-640-8689                       Program Coordinator
                            mbrooks@fightcrime.org       C 503-349-2965                       503-846-4547
                                                         F 503-494-4981
                            Kristine Harris              katieriley@comcast.net               Mary Nunnenkamp
                            3754 SE Meier Ct.            riley@ohsu.edu                       Program Cordinator
                            Hillsboro, OR 97123                                               503-846-4918
                            H 503-648-1325               Enedelia Schofield
                            kris@xprt.net                1436 Brookwood                       Tracy Northfield
                                                         Hillsboro, OR 97124                  Program Coordinator
                            Marilyn Harrison             W 503-844-1690                       503-846-4496
                            14073 NW Killin Rd.          H 503-693-0810
                            Banks, OR 97106              F 503-844-9702                       Sunny Ross
                            W 503-532-7326               schofiee@hsd.k12.or.tls              Program Specialist
                            C 503-382-7395                                                    503-846-8031
                            H 503-324-4651               Dick Stenson
                            F 503-648-4175               44872 NW Plum Hill Lane              Pam Bainbridge-Cowan
                            Marilyn.harrison@nike.com    Forest Grove, OR 97116               Administrative Specialist II
                                                         W 503-681-1893                       503-846-4539
                            John Leeper                  H 503-359-5179
                            1160 SW Muirwood Driver      F 503-681-1608
                            Portland, OR 97225           dick.stenson@tuality.org             E-MAIL STANDARD:
                            H 503-643-2811               nancy.hopkins@tuality.org            flfStname_lastnarrie@
                            kangaroo@4-1as-brisas.com                                         co.washington.or.us
                                                         EX-OFFICIO MEMBERS
                            Donna Maddux
                                                         Jill Archer
                            21737 SW Fuller Drive                                             FAX: 503-846-4954
                                                         W 503-846-4571
                            Tualatin, OR 97062
                            H 503-312-6251
                                                         jill_archer@co.washington.or.us
                            madduxl@comcast.net                                               ADDRESS:
                                                         Erin Calvert
                                                         W 503-846-3484                       Washington County HHS
                            Christine Murray, Co-Chair                                        Commission on Children & Families
                            2065 NW Overton Ct.          erin_calvert@co.washington.or.us
                                                                                              155 N First Ave., MS 6
                            Beaverton, OR 97006                                               Hillsboro, OR 97124
                                                         Sia Lindstrom
                            H 503-690-6073
                            c.chrisnsteve@verizon.net    W 503-846-5792
                                                         siaJindstrom@co.washington.or.us
                                                                                              Revised: 9/2007
                            Marv Ott
                                                         Heather Kitto
                            3216 Oakcrest Dr.
                                                         W 503-681-6970
                            Forest Grove, 97116
                            W 503-324-8591               heather.kitto@state.or.us
                            H 503-357-8782
                                                         Tom Vlahos
                            marvo@banks.k12.or.us
                                                         W 503-277-6603
                                                         tom.p.vlahos@State.or.us
                            Jill Raichel
                            5302 SE Baseline Rd. # II

   e .•                     Hillsboro, OR 97123
                            W 971-673-1768
                                                         BOCC LIAISON
                                                         Desari Strader

   iii
  \1<.UUrnGI'ON COUNTY
      COMMISS!(}.'i ON
                            H 503-648-1975
                            lill.raichel@state.or.us
                                                         W 503-846-8681
                                                         desari_strader@co.washington.or.us

  ClllLnRENA.'lpFAM1Ut:S
'l'og:ttFierfar cfii[t!nm
              Addictions and Mental Health Division - Attachment 4


               LOCAL MENTAL HEALTH ADVISORY COMMITTEE
                      REVIEW AND COMMENTS


County:                                       _


Type in or attach a list of committee members, including addresses and telephone
numbers.




The                                 County Local Mental Health Advisory
Committee, established in accordance with ORS 430.630(7), recommends
acceptance of the 2009-2011 Biennial County Implementation Plan. Further
comments and recommendations of the Committee are attached.

Name of Chair: - - - - - - - - - - - - - - - - - - - -
Address:                                                           _


Telephone Number:                                                     _
Signature:                                                        _
Date:   -----~-----------------




                                                                                   49
                                             BHe MEMBERS
                                                   2/28/2008 13:30


ATTENDED        NAME                  POSITION                   MAILING ADDRESS                 PHONE/FAX
           I                                                                                       .

       1 Bill Kroger            Consumer/Advocate           12030 SW Setter Way            Hm: (971) 645-6889
                                                            Beaverton, OR 97008        I
                                                                                       I

       2 Bruce Bartlett         Citizen Advocate            PO Box 91582                   Hm: (503) 645-4863
                                                            Portland, OR 97291-0582        C: (503) 706-6389

       3 Christine Murray       Family Member               2065 NW Overton Ct.            Hm: (503) 690-6073
                                CCF Representative          Beaverton, OR 97006            C:  (503) 351-8570
                                                                         .



       4 Earl Egan          IFamily Member                  9015 SW Jamieson Rd.           Hm: (503) 292-4610
                                                            Portland, OR 97223             Fax: (503) 292-4610

       5 Howard Spanbock        Adult MH Provider        Greenburg Road                Wk: (503) 726-3700
                                Luke-Dort                Tigard, OR 97223              Fax: (503) 726-3701

       6 Jason Leinenbach   ISheriff's Office                                          Wk: (503) 846-8322
                                                        I                              Fax: (503) 846-8287

       7 Judy Harris        Behavioral Health Provo 447 Baseline                       Wk: (503) 640-4222
                            Youth Contact           Hillsboro, OR 97123
           ,
       9 Marland Henderson Consu mer/Advocate            11795 SW Katherine St.            (503) 590-2399
                                                                                       I Hm:
                                                         Tigard, OR 97223              Wk: (503) 639-5537

      10 Mary Monnat            Behavioral Health Prov 14600 NW Cornell Rd.            Wk: (503) 617-3822
           I                    LifeWorks NW           Portland, OR 97229              Hm: (503) 805-7318

      11 Olga Parker            Member at large          PO Box 66344                  Wk: (503) 781-9065
                                                         Portland, OR 97290
                                                        I
      12 Paul Hagemann      Consumer/Advocate           119800 SW Tile Flat Rd.        Hm: (503) 628-3047
                                                         Porltand, OR 97007            Wk: (503) 293-0105
                                                                                       Fax: (503) 293-9040

      13 Ralph Sipprell     ' Consumer/Advocate          8000 SW Linden Rd.            Hm: (503) 292- 2427
                                                         Portland, OR 97225

      14 RamsayWeit         Citizen Advocate             5350 NW Pondosa Dr.           Hm: (503) 936-3306
                                                         Portland, OR 97229            Wk: (503) 643-5437

      15 And rea Travers    CODA                         Tigard Recovery Center        ,Wk: 503-624-0312
                                                         10362 SW McDonald              CI: 503-318-5438
                                                         Tigard, OR 97224

      16 Nona Clarke        WCCC                         6695 S 1st Avenue Suite 200   503-681-7900
                                                         Hillsboro, OR 97123

      17 Ian May            Wash Co Juvenile Just. 155 N First Ave, MS 59              503-846-3557
                            I                      Hillsboro, OR 97124
                  Addictions and Mental Health Division - Attachment S

 COMMISSION ON CHILDREN & FAMILIES REVIEW & COMMENTS

County:                    W-'-'--"a"'sh"i"n"'g"'to"'n"'-                               _


The Washington County Connnission on Children and Families reviewed and discussed
the Plan at its regularly scheduled meeting on February 14, 2008.




The       Washington                              County Commission on
Children & Families has reviewed the alcohol and drug abuse prevention
and treatment portions of the county's Biennial Implementation Plan for
2009-2011. Any comments are attached.

Name of Chair:                          C=hr"-'i"'-st""in"'e"--=-'M""u"'IT"'a"-y'----           _
Address:                            -'2:;0"-'6=S'--'N'-'--'-W'----"O~v-=e""'rt=o=n          _
                                        Beaverton, OR 97006
Telephone Number: ----'S"-'0'-"3--'-6e.;;9'-"O--'-6""0'-'-7=..3                                 _

Sign~
                    ~')yJ
Date:
          I
              a -ato                  -ortJ=
                            Addictions and Mental Health Division - Attachment 6



           COUNTY FUNDS MAINTENANCE OF EFFORT ASSURANCE




As required by ORS 430.359(4), I certifY that the amouut of county funds allocated to alcohol and drug treatment

and rehabilitation programs for 2009-2011 is not lower than the amouut of couuty funds expended during 2007-

2009.




Name of County Men al Health Program Director


Signature



Date




                                                                                                                   51
                 Addictions and Mental Health Division - Attachment 7

  PLANNED EXPENDITURES OF MATCHING FUNDS (ORS 430.380) AND
                    CARRYOVER FUNDS


County:     Washington

Contact Person:      Kristin Cassidy


Matching Funds

    Source of Funds                Amounts                Program Area




Carryover Funds

AMH Mental Health Funds
 Carryover Amount from        Planned Expenditure       Service Element
       2007-2009
       3,489,539                   3,489,539          All Service Elements




  AMH Alcohol & Drug
 Funds Carryover Amount       Planned Expenditure       Service Element
     from 2007-2009
          63,059                       63,059         All Service Elements




                                                                             52
Feb.26 2008 10: 19AM   DHS DISTRICT 16 ADMIN 598 7948               No. 3270   P 2




                  Addictions and Mental Health Division - Attachment 8

        REVIEW AND COMMENTS BY THE LOCAL CHILDREN, ADULTS
        AND FAMlLIES DISTRICT MANAGER FOR THE DEPARTMENT OF
                           HUMAN SERVICES


    Couuty,   JkgNf/ON -IYmjc1 II,
    As Children, Adults and Families District Manager for the Department of Human
    Services, I have reviewed the 2009-2011 Biennial County Implementation Plan
    and have recorded my recommendations and comments below or on at attached
    document.




    Signature: +~~4~~~--------~---'---
    Date:   O? - :<S--;l.oo8
                                                                                    49
                    Addictions and Mental Health Division ~ Attaclnnent 9


        REVIEW AND COMMENTS BY THE LOCAL PUBLIC SAFETY
                    COORDINATING COUNCIL


County:                                                    _

The Local Public Safety Coordinating Council has reviewed the 2009-2011
Biennial County Implementation Plan. Comments and recommendations are
recorded below or are provided on an attached document.




Name of Chair:                                                                  _
Address: - - - - - - - - - - - - - - - - - - - - - -


Telephone Number:                                                               _
Signature:                                                                  _
Date:                                                                       _




                                                                                    54
                                  Addictions and Mental Health Division - Attachment 10


                                      2009-2011 County Biennial Implementation Plan


                                             PREVENTION STRATEGY SHEET


County         Washington                                              Prevention Coordinator     Mary Nuunenkamp


Using the grid below, list all the proposed programs for which the County is requestingfunding. Include all the
Program Outcomes (process objectives) and Intermediate-Level Outcomes (educational, attitudinal & behavioral
objectives) for each ofthe proposed programs. All outputs and outcomes must be measurable.

NOTE: Final programs, outputs and outcomes for 2009-11 will be determined through RFP process to be
conducted in spring 2008 for 2008-11 funding cycle. Programs, outputs and outcomes listed here are for current
programs. Strategy sheets will be updatedfollowing RFPprocess

  Proposed                      Proposed                                           Proposed
  Programs                      Outputs                                            Outcomes
                    I) Outreach to a mininoum of 6          1) 80% of participants attending cultural competency
Beaverton           cultural/ethnic commnnity               training will report increased knowledge and skills as
Together!           leaders/organizations.                  measured by an evaluation survey.
                    2) 50% oftargeted cultural/ethnic       2) The number of culturally/ethnically diverse
                    organizations will provide ATOD         individuals/orgatrizations that participate in Beaverton
                    prevention activities to their youth.   Together! activities will increase by a mininoum of 10%.
                    3) Provide cultural competency          3) 80% of youth participatiog in small grant activities will
                    training to Beaverton Together          report increased connection to and involvement in their
                    Board.                                  schools and communities as measured by survey at the
                    4) Provide small grants to yonth        end of their grant.
                    gronps, particularly through
                    cultural/ethnic commnnity
                    orgatrizations to develop and
                    implement youth desigoed ATOD
                    prevention activities.

LifeWorks NW-       1) 16 families complete an eight        1) 80% offamilies report greater confidence in their
Families and        week class                              interactions with school staff
Schools Together    2) 20 families participate in home      2) Families who complete the prograru will demonstrate
(FAST)              visits                                  iruprovements in communication and bonding with
                    3) 15 families participate in           children.
                    monthly family meetings




                                                                                                                     55
                             Addictions and Mental Health Division - Attachment 10


                                2009-2011 County Biennial Implementation Plan


                                      PREVENTION STRATEGY SHEET


County         Washington                                       Prevention Coordinator Mary Nunnenkamp




Using the grid below, /lst all the proposedprograms for which the County is requesting funding. Include all the
Program Outcomes (process objectives) and Intermediate-Level Outcomes (educational, attitudinal & behavioral
objectives) for each ofthe proposedprograms. All outputs and outcomes must be measurable.

          Proposed                               Proposed                                  Proposed
          Programs                               Outputs                                   Outcomes


Tualatin Together! - WEB          I) 72 eighth graders trained as peer      I) 80% of sixth graders report
Program                           mentors                                   increased knowledge of how to be
                                  2) 900 sixth graders participate in one   successful in middle school
                                  day orientation with WEB                  2) 75% of sixth graders' report feeling
                                  leaders/mentors                           more connected to school
                                   I) 500 hours offacilitation of peer      I) 90% of youth involved in peer
Youth Contact - Student           based activities aimed at increasing      activities will report increases in
Assistance Program                protective factors for 300 youth          positive peer relations
                                  2) 95 students will receive screening,    2) 75% of students receiving screening
                                  referral and crisis intervention          and referral services will follow
                                  3) 500 hours of group skill building      through on recommendations for
                                  activities for at risk students           service
                                                                            3) 75% of youth involved in skill
                                                                            building groups will report feeling
                                                                            more connected to school.




                                                                                                                  56
           Addictions and Mental Health Division - Attachment 9

   REVIEW AND COMMENTS BY THE LOCAL PUBLIC SAFETY
               COORDINATING COUNCIL

County:     0Otsl~""~4'" t."J,\__
The Local Public Safety Coordinating Council has reviewed the 2009-2011
Biennial County Implementation Plan. Comments and recommendations are
recorded below or are provided on an attached document.

                                      -t L. t'l",- Q.,j.   o..v-tLO":Uc;   flc




Name of Chair:   ~ eyr-<e«e
                       ..
Address:      (6   <;;. S (J 5W (11;£IZL2J         f:ZO~1d
            ctiik e/4 ()    E R:.7a   Ai    ZJ IS 97 ~()<

				
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