Children's System Advisory Council - April 23rd, 2021 9:30am-12:30pm Zoomgov Edition - Draft - Oregon.gov
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CSAC 4/23/21 9:30-12:30
Children’s System Advisory Council
April 23rd, 2021 9:30am-12:30pm Zoomgov Edition - Draft
Virtual Attendees:
Name (Original Name)
Jula Krewson
Annette Marcus
Joseph Stepanenko
Wendy Hill
Beth Edens
Laura Rose Misaras
Shane
Chelsea Holcomb she/her OHA
Michelle Owens
Kathy Zurfluh
Jessica Stout - OHA
Teri Pettersen
Ariana Brooks (she/her)
Sena Benson-Arb
Kristie Nelson she/her
Alexis Alberti
Michelle Brandsma
Lev Schneidman (they/them)CSAC 4/23/21 9:30-12:30 Teri Pettersen (Teri Pettersen) Dana Hafter-Manza (d) Roxane Wilson Royce Bowlin - Oregon Alliance (Royce) Dr. Wolfe Cindy Smith Elliott Hinkle B Grace Bullock (she her hers) ODE Frances Purdy Nikobi Petronelli Sherri Alderman Lisa Butler She/hers Oregon Family Support Network Jammie Gardner Laurie T. Child & Family Behavioral Health(she#her) Laura Rose (she/her) Alex Palm Megan Auclair Steph Jarem Adam Rodakowski (He/Him) Hilary Harrison - she/her Ice Breaker- Nikobi Petronelli/YYEA
CSAC 4/23/21 9:30-12:30
March 2021 Minutes Review: corrections: add Kathy Zurfluh to attendance. Motion: Grace Bullock.
Second: Teri Pettersen. Minutes passed with majority of quorum aye votes.
Family Report Out:
o Video presentation by Roxanne Wilson. Format is not compatible with the state, but it is okay to reach out
to Roxanne for more information on legislative process around suicide prevention work and for a copy of
the presentation.
o “A time for families” started 9 weeks ago and has been a time for families to connect with Chelsea
Holcomb and reps from the Ombud’s program and parent/warm line. Feedback as been difficultly around
navigating services and breakdowns of system gaps (difficulty for admittance to residential treatment and
transition from). Typical time for follow up with individuals that need help is about 3-5 hours. CSAC Family
Rep Policy Workgroup continues to work with feedback from families and integrating recommendations to
Chelsea and the work of the Child and Family unit.
o Applicants are being considered for the Oregon Consumer Advisory Committee (Carol Dickey and several
others). Seats opening this summer.
o Seat open on CSAC for foster parents/resource parent.
o Vigil happening in Albany for recent hate crime in the area.CSAC 4/23/21 9:30-12:30
Feedback Policy/Vision Themes
Collective common themes:
• Transition age youth (focus on this population)
• Community needs, what do they need? What does that look like?
• More involvement with the School System as partners
• SUD- access issues and barriers (dual diagnosis, police involvement, geographic barriers)
• Focus on best practices as well as evidenced based practices.
• Not all family dynamics are included (ex. Youth involved with Juvenile Justice System or children of
incarcerated parents, refugees, religious, etc.)
• Barriers for youth seeking services (culturally responsive, police involvement, not having the trauma
treated correctly).
Today’s discussion points:
• some clarifying questions around the feedback themes; are these recommendations that have not been
included or do they need to be expanded on?
• Culturally adaptive addressed in policy, what does this mean? Translate in different languages or how is
this defined?
• More involvement with school system as partners, do we look at the CFBH unit for strategies on how to
implement this?
• Additional themes include, trauma informed care and lived experience.
• Have folks from CSAC been able to share this their respected groups?CSAC 4/23/21 9:30-12:30
• Has been shared with DHS Director’s office and within Child Welfare. Some opportunity with overlatp with
Child Welfare Vision for Transformation paper. Self Sufficiency would also be another interested group to
pull in. 2 Gen provides a framework for incorporating different agencies which would be another positive
to involving Self Sufficiency.
• Young Adult Leadership Council- has been another group that Michelle Owens has been in connection with
for the this work as well.
• Royce Bowlin- shared with The Oregon Alliance, some hesitancy around new policies and papers but can
share the document from crosswalk for the Child Welfare Transformation paper.
• Uprise Collective (Diversity and Inclusion training organization) will come to CSAC and do some work to
implement a new lens to address this work.
• Purpose for this paper; to have a continuous workplan for the CFBH unit, will also drive Policy Option
Packages during legislation.
• Jamboards (Google product) have been a successful tool for similar work for collaboration and theme
building.
• https://oregonearlylearning.com/wp-content/uploads/2021/01/Raise-Up-Oregon-Progress-
Report_January-2021_1.6.21.pdf
• American Rescue Act funds being distributed to State Agencies and other organizations could be another
place to connect on where/how there is an alliance with values in paper as part of community feedback.
Medicaid Waiver: Megan Auclair and Stephanie Jaram
Link to PowerPoint and other supporting document: https://www.oregon.gov/oha/HSD/BH-Child-
Family/CSAC/CSAC_1115Waiver_overview_04232021.pdf
https://www.oregon.gov/oha/HSD/BH-Child-Family/CSAC/Waiver%20Vision%20and%20Goals_APRIL_Final.pdf
What is the waiver?
Medicaid is a federal program administered by states.CSAC 4/23/21 9:30-12:30
Federal law sets Medicaid minimum standards related to eligibility and required benefits.
But states can waive certain federal regulations to achieve greater flexibility around eligibility, benefits, delivery
systems, etc. than is otherwise allowed under Medicaid rules.
Who is covered
What benefits are provided
How much individuals may be charged for cost sharing
How providers will be paid
Must include a formal evaluation of impact.
An 1115 Demonstration waiver is the broadest type of waiver available under Medicaid.
• Opportunity to pilot changes not otherwise allowed
• Must be budget neutral and improve system for patients
• More than one type of waiver – today we’re focused on Medicaid but there are other waivers available
Waiver Timeline
Oregon is applying to the Centers for Medicare & Medicaid Services (CMS) for a new five-year Medicaid 1115
Demonstration waiver.
• Future Work Sessions
Starting in late May, OHA will convene focused work groups to help OHA integrate experiences with the
delivery system and identify what changes are neededCSAC 4/23/21 9:30-12:30
• Sessions will be divided into a three-part series with objectives that align with content development and
audience
• Part 1: Define problem, • Equity Centered System of Health
Drivers, Barriers
• Access to Coverage
• Part 2: Potential Strategies and
• Smart, Flexible Spending through Global Budget
Theories
• Reinvest Savings in Across Systems
• Part 3: Program detail, quality,
and evaluation
Overarching Waiver Goal:
Advance Health Equity
If we are successful in our waiver application,
Oregon will continue to lead the way on Medicaid reform –
pioneering new ways to center equity in health system transformation.
To achieve this, our policy framework breaks down the drivers of health inequities into four actionable sub-goals.
Questions/comments/action steps
• Reinvesting the savings bucket, what are the implementation for for profit CCOs? How would this impact
them? Megan and Stephanie will bring back to Medicaid team.
• Why are we staying with the CCO model as a means of getting us to the four goals? Has been successful
to cultural shifts at the local levels although there are gaps to still be addressed. Seen lower costs
throughout our systems at a state level.CSAC 4/23/21 9:30-12:30
• What is specific planning around children, families, and young adults? The plan is still not definitive and
continuous work with the Chelsea Holcomb and her team to look for opportunities. One example is housing
supports, narrowing focus to families with children or children of incarcerated parents. Looking for
flexibility at the federal level for expanding coverage.
• Medicaid dollars are often left over at ODE, could this funding be reutilized to BH for children and
families somewhere in the waiver? Taking back to Medicaid team.
• Barrier to Peer Delivered Services not being able to bill directly for, can this be addressed in the waiver?
• Advocating for children in Juvenile Justice System and Incarcerated Youth and need for transition
services (Medicare, Foster care, etc.)
• CMS covering children up to age 25 to help with transitions (18,21)? Looking into a 5-year extension but
will also bring this back to Medicaid team.
• Can we have someone from Washington state to present on their waiver ideas?
• Question for the group: what would it look like/would it be beneficial to have a CCO specifically for
children? The group commented on positives around giving voice to children and resolving some barriers
to SOC services. Others commented on access barriers to physical location(s) and that children and families
are sometimes under one bucket.
Public Comment:
• Nikobi Petronelli - Emily Morrissey will no longer be at YYEA and Nikobi will continue to fill her role beyond
June.
• Adam Rodakowski (SOCAC Co-Chair) – thank you all for taking the lead on drafting the document to build
connection.
• Shane Roberts – need for discussion on awareness of impact of social media on mental health.CSAC 4/23/21 9:30-12:30
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