The Improving People's Access to Community-Based Treatment, Supports, and Services (IMPACTS) Grant
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The Improving People’s
Access to Community-
Based Treatment, Oregon Criminal
Justice Commission
-
Supports, and Services Ken Sanchagrin
Executive Director
(IMPACTS) Grant -
January 1, 2022
Report on the 2019-2021 biennium implementation of the IMPACTS Grant
Program as created by 2019 SB 973
Executive Summary
The Improving People’s Access to Community-based Treatment, Supports and Services
(IMPACTS) grant program was established by the Oregon Legislature through Senate Bill (SB)
973 in recognition of the shortage of comprehensive community supports and services for
individuals with mental health or substance use disorders that lead to their involvement with
the criminal justice system, hospitalizations, and institutional placements.1
The IMPACTS grant program was appropriated $10 million during the 2019-2021 legislative
session to fund programs operated by Oregon’s counties and federally recognized Indian tribes
that provide supports and services to a target population of individuals with frequent criminal
justice and emergency services involvement. The goal of these funded programs is to increase
the availability of community-based supports and services for the target population and reduce
the frequency with which persons served by the program are involved with the criminal justice
system and rely on emergency services, including institutional healthcare placements. In its
inaugural 2020-2022 grant cycle, the IMPACTS Grant Review Committee funded 11 programs,
representing six counties and five federally recognized Indian tribes.
The IMPACTS grant program is administered by a Grant Review Committee, established through
SB 973, and coordinated by the Oregon Criminal Justice Commission (CJC) in partnership with
the Oregon Health Authority (OHA). As the administering body, the Grant Review Committee is
authorized to award funds and to establish and track quality improvement measures of the
funded programs.
Per SB 973, this report includes information available to date on program outcome measures
and evaluation progress, including target population demographic and other program data and
an overview of existing funded programs. It also includes a summary of ongoing data
improvement initiatives, challenges with program implementation, and next steps for the grant
program.
Key Findings
• The program-wide target population totaled 576 individuals
• Grantees have demonstrated an increase in their capacity to identify and contact their
target populations, as local program implementation solidifies
• Grantees have found unique ways to staff their programs and serve individuals in their
target populations
• Data quality improvement initiatives are underway including a revamping of the current
data collection report, implementing grantee data collection technical assistance and
local program evaluation efforts, and a project to identify and access outcome data from
official administrative sources
1
See Oregon Laws 2019, ch 563, § 1-14 (Regular Session), available at https://olis.oregonlegislature.gov.
ORS 192.245(2):
A copy of the report may be obtained by visiting the Oregon Criminal Justice Commission between the hours
2 of 8:30 a.m. and 4:30 p.m., on business days, Monday through Friday at 885 Summer St NE, Salem, OR 97301,
or accessed online at: https://www.oregon.gov/cjc.
Contents
I. Program Contacts and Acknowledgements.......................................................................................... 4
II. IMPACTS Program-Wide Outcome Measures and Evaluation ............................................................. 5
A. Overview of Grant Program Development ....................................................................................... 5
B. Demographics of Program-Wide Target Population......................................................................... 6
1. Target Population Race and Ethnicity Data .................................................................................. 6
2. Target Population Gender Identity ............................................................................................... 7
3. Target Population Members with Mental or Physical Disability .................................................. 7
4. Target Population Members with an Identified Tribal Affiliation ................................................. 7
C. Quantitative Program Outcomes to Date ......................................................................................... 8
D. Current Program & Qualitative Outcomes ..................................................................................... 10
E. Program-Wide Challenges and Identified Gaps .............................................................................. 11
III. Quality Improvement Measures ......................................................................................................... 12
IV. Future of IMPACTS .............................................................................................................................. 13
Appendix A. IMPACTS Grant Review Committee Membership List............................................................ 15
Appendix B. 2020-2022 IMPACTS Grant Program Summaries ................................................................... 15
Appendix C: IMPACTS Background ............................................................................................................. 27
A. Behavioral Health Justice Reinvestment Steering Committee & Senate Bill 973 ........................... 27
B. Senate Bill 973 & The IMPACTS Grant Program ............................................................................. 27
C. Behavioral Health Justice Reinvestment Steering Committee Members ....................................... 28
List of Tables
Table 1. 2020-2022 IMPACTS Funded Programs.…………………………………………………………………………………… 5
Table 2. Target Population Race and Ethnicity Q5....……………………………………………………………………………… 6
Table 3. Target Population Gender Identity Q5……………………………………………………………………………………… 7
Table 4. Target Population Disability Status Q5……………………………………………………………………………………… 7
Table 5. Target Population Tribal Affiliation Q1-Q5……………………..………………………………………………………… 7
Table 6. Target Population Criminal Justice Outcomes Q1-Q5…………………………………..…………………………… 8
Table 7. Target Population Healthcare System Outcomes Q1-Q5……………….…………………………………..…….. 9
Table 8. Target Population Housing Outcomes Q1-Q5……….………………………………………………………………..… 9
Table 9. Target Population IMPACTS Program Contacts Q1-Q5………………………………………………………….... 10
3
I. Program Contacts and Acknowledgements Oregon Criminal Justice Commission: Kaysea Dahlstrom Program Analyst Kaysea.Dahlstrom@cjc.oregon.gov Andrew Powell Research Analyst Andrew.Powell@cjc.oregon.gov Oregon Health Authority: Zachary Thornhill Operations & Policy Analyst zachary.l.thornhill@dhsoha.state.or.us The authors of this report would like to acknowledge the contributions of Kathleen Grover, the original OHA member of the IMPACTS staff team. 4
II. IMPACTS Program-Wide Outcome Measures and Evaluation
A. Overview of Grant Program Development
The goal of IMPACTS programs is to reduce the target population’s involvement with the
criminal justice system and the frequency with which they rely on emergency medical services,
including institutional healthcare placements, by increasing the availability of community-based
supports and services for persons served.
During the 2019-2021 biennium, the IMPACTS grant program was appropriated $10 million to
fund programs operated by Oregon’s counties and federally recognized Indian tribes. The
following is a summary of the programs funded in the 2020-2022 IMPACTS grant cycle:
Table 1. 2020-2022 IMPACTS Funded Programs
Grantee Grant Funding
Clackamas County $499,987.52
Confederated Tribes of Coos, Lower Umpqua, and Siuslaw Indians $322,264.96
Confederated Tribes of Grand Ronde $289,999.96
Confederated Tribes of Warm Springs $282,743.00
Cow Creek Band of Umpqua Indians $490,841.00
Deschutes County $2,403,519.52
Douglas County $1,414,878.72
Klamath Tribes $691,580.00
Lane County $2,527,697.00
Lincoln County $288,490.00
Union County $562,945.27
Though Oregon state-based grant funds are often awarded in alignment with biennia, the
IMPACTS grant cycle spans from July 2020 to June 2022. This is due to three primary
considerations. First, as the IMPACTS funds are designated as Other Funds, the grant monies
are not required to be expended during the 2019-2021 biennium. Second, due to the
complexity of its programmatic goals, initial grant program development took several months
following the 2019 enactment of SB 973, leading to its opening in 2020. Third, the Grant Review
Committee recognized that grantees would need a two-year cycle to launch new grant
programs. What follows is a detailed review of the current program-wide target population and
their outcomes to date.
Additionally, individual program overviews are detailed in Appendix B. These include the service
areas, target populations, goals, challenges, and current statuses for each funded program.
5
B. Demographics of Program-Wide Target Population
Grantees individually establish criteria to determine their local target population. A grantee’s
criteria are framed by use of one of the following definitions: (1) individuals booked into jail
four or more times in a twelve-month period; or (2) individuals that are high utilizers of criminal
justice resources, hospital or urgent healthcare resources, or institutional placements.
The latter definition provides grantees an avenue to serve target populations in communities
where fewer than four bookings in a local jail still constitutes high utilization of criminal justice
system resources. The eight grantees that selected the high system utilizer definition generally
used a combination of data on arrests, law enforcement contacts, jail bookings, hospital usage,
and behavioral health diagnoses to identify their target populations.
1. Target Population Race and Ethnicity Data
When grantees applied for IMPACTS funds, they estimated the number of individuals eligible
for supports and services through the grant program. Once programs began implementation
and reporting, grantees refined their target population from estimates to actual persons
served. As of the most recent reporting period, the total program-wide target population for all
grantees is 576 individuals.
As shown in Table 2 below, of the 576 individuals identified within the IMPACTS target
population, nearly half were white (N=276) and 21% were identified as American Indian
(N=122). The demographics for this population differ from the Oregon Department of
Corrections (DOC) offender population in 2020, which was more likely to be white (79%) and
male (83%), and less likely to be Native American (2%) than the IMPACTS target population
Correction’s.2
Table 2. Target Population Race and Ethnicity Q5
Count % of Target Pop.
IMPACTS Total Target Population 576 --
Race and Ethnicity
White 276 48%
Black/African American 4 1%
American Indian 122 21%
Asian/PI 0 0%
Latinx 14 2%
Unknown/Not Entered 160 28%
2
DOC’s offender population included those individuals on probation, under local control, in prison, or under post-
prison control in 2020. See Oregon Department of Corrections, Issue Brief (November 2020), available at
https://www.oregon.gov/doc/Documents/agency-quick-facts.pdf.
6
2. Target Population Gender Identity
As shown in Table 3 below, of the 576 individuals, 69% identified as male (N=400) and 31%
identified as female (N=176). No individuals identified as non-binary.
Table 3. Target Population Gender Identity Q5
Count % of Target Pop.
IMPACTS Total Target Population 576 --
Gender Identity
Male 400 69%
Female 176 31%
Non-binary 0 0%
3. Target Population Members with Mental or Physical Disability
As shown in Table 4 below, a small proportion of individuals were identified as having a mental
(N=7) or physical disability (N=5). The current data collection framework does not allow for the
identification of individuals with both mental and physical disabilities. The Grant Review
Committee is contemplating a new reporting template that will require grantees to report on
the number of target population individuals they serve who have dual diagnoses.
Table 4. Target Population Disability Status Q5
Count % of Target Pop.
IMPACTS Total Target Population 576 --
Disability Status
Mental Disability 7 1%
Physical Disability 5 1%
4. Target Population Members with an Identified Tribal Affiliation
As shown in Table 5 below, approximately 20% (N=116) of the individuals in the target
population were identified as having a tribal affiliation.
Table 5. Target Population Tribal Affiliation Q1-Q5
Count % of Target Pop.
IMPACTS Total Target Population 576 --
Tribal Affiliation 116 20%
7
C. Quantitative Program Outcomes to Date
Program grantees provide quarterly target population outcome data to the CJC, which
presently includes the following self-reported information on individuals served:
(1) Jail bookings;
(2) Emergency service contacts;
(3) Emergency department visits;
(4) Identified mental health disorder;
(5) Receiving treatment for mental health disorder;
(6) Identified substance use disorder;
(7) Receiving treatment for substance use disorder;
(8) Receiving peer services;
(9) Oregon State Hospital referrals;
(10) Psychiatric hospitalizations;
(11) Permanent or temporary housing status;
(12) Unhoused status; and
(13) Number of IMPACTS program contacts per month.
Tables 6-9 show the self-reported quantitative program outcome data as collected during the
first five quarters of IMPACTS implementation, July 1, 2020 through September 30, 2021. The
data reflected in the tables below show variability, which is likely due to the ongoing efforts of
the grantees to define and increase their data collection capacities during initial program
implementation. Many of the trends in the data are likely indicative of both actual trends in
outcomes for individuals in the program’s target population, as well as increased capacity
within programs to collect and report program data.
Table 6. Target Population Criminal Justice Outcomes Q1-Q5
Quarter Quarterly
Outcome 1 2 3 4 5 Average
Criminal Justice
Jail Bookings 118 236 218 289 232 218.6
Emergency Service Contacts 2 329 401 369 261 272.4
As shown in Table 6 above, jail bookings ranged from 118 in Quarter 1 to 289 in Quarter 4,
while emergency service contacts ranged from 2 in Quarter 1 to a peak of 401 in Quarter 3,
before falling to 261 in Quarter 5.
8
Table 7. Target Population Healthcare System Outcomes Q1-Q5
Quarter Quarterly
Outcome 1 2 3 4 5 Average
Healthcare
Emergency Dept. Visits 202 375 181 132 575 293
Identified Mental Health Disorder 145 151 177 124 187 156.8
Receiving Tx for Mental Health
Disorder 68 114 112 95 99 97.6
Identified Substance Use Disorder 260 272 278 266 318 278.8
Receiving Tx for Substance Use
Disorder 64 79 83 74 70 74
Receiving Peer Services 10 40 41 58 68 43.4
OSH Referrals 0 1 2 11 1 3
Psych. Hospitalizations 0 24 4 6 5 7.8
As shown in Table 7 above, emergency department (ED) visits jumped from 202 to 375 from
Quarter 1 to Quarter 2, before falling over the next three quarters, then jumping to 575 visits in
Quarter 5. In addition, both psychiatric hospitalizations and referrals to the Oregon State
Hospital remained relatively low across all five quarters. Both measures spiked one quarter
before regressing back to their average.
Additionally, the number of individuals in the target population identified as having a mental
health or substance use disorder both increased from Quarter 1 to Quarter 5. This is likely a
result of an increase in screening and identification of individuals with such disorders by
grantees, and not indicative of an actual change among members of the target population.
Similarly, the number of individuals in the target population who received treatment for mental
health or substance use disorders or who received some form of peer services also increased
during that period. As of Quarter 5, 53% (N=99) of individuals in the target population with a
mental health disorder and 22% (N=70) of individuals with a substance use disorder were
receiving treatment for their disorder through the IMPACTS program.
As shown in Table 8 below, by Quarter 5, 69% (N=144) of individuals for whom grantees
reported housing information were either permanently or temporarily housed while 31%
(N=66) were unhoused.
Table 8. Target Population Housing Outcomes Q1-Q5
Quarter Quarterly
Outcome 1 2 3 4 5 Average
Housing
In Permanent or Temporary Housing 0 36 107 107 144 78.8
Unhoused 0 8 38 54 66 33.2
9
Table 9. Target Population IMPACTS Program Contacts Q1-Q5
Quarter Quarterly
Outcome 1 2 3 4 5 Average
IMPACTS Contacts of Target Pop.
1+ per Month 37 61 89 120 145 90.4
As shown in Table 9 above, the total number of individuals in the target population who were
contacted by the IMPACTS program at least one time per month increased dramatically from 37
in Quarter 1 to 145 in Quarter 5, likely reflecting increased program capacity to identify and
serve target population members as local program implementation solidifies.
D. Current Program & Qualitative Outcomes
Throughout the first year of the 2020-2022 grant cycle, IMPACTS grantees found unique ways
to serve their target populations. For example, Deschutes County devised creative staffing
arrangements in order to maintain round-the-clock operations as they expanded service of
their Stabilization Center to 24 hours per day, seven days per week using IMPACTS funds. Due
to the COVID-19 pandemic, they became the only mental health provider in their community
able to provide walk-in, face-to-face services to individuals in need for eight months.
The Klamath Tribes, meanwhile, quickly adapted to the changing needs of their tribal members
by opening a walk-in center in which individuals could receive outpatient services without
pressure to engage. These adaptations enable grantees to better serve their target populations,
especially individuals experiencing mental health crises. In addition to some grantees expanding
their working or open hours, other grantees addressed their physical capability to connect with
their target population. Douglas County, for example, increased the capacity of their Sobering
Center while Lane County expanded their offices to include additional space for meeting with
clients. The Confederated Tribes of Coos, Lower Umpqua, and Siuslaw Indians (CTCLUSI),
adapted to better suit the needs of their tribal members and other American Indian/American
Native residents regardless of where they live. The CTCLUSI modified their program to hire a
Tribal Community Services Liaison to travel throughout their expansive five-county service area
to provide outreach and services to members who may otherwise face barriers to accessing
those services.
Grantees have also been innovative in how to recruit and retain staff during a pandemic by
designing creative staffing plans, developing hiring incentives, and continuing to reevaluate the
needs of their programs. In Lane County, by working closely with employees to regularly
evaluate the program’s development, the county soon recognized that revisions to initially
contemplated credential requirements, as outlined in their original grant application, were
needed to ensure a better hiring match and increase the pool of applicants. By reacting quickly
and adjusting the recruitment posting, those cost savings were shifted to provide additional
client supports.
10In regard to program data, some grantees have benefitted from their existing data sharing
partnerships with community and system partners. Deschutes County, for instance, reported
that its robust partnerships with law enforcement, the hospital system, and other key
community partners allowed them to begin receiving referrals at the outset of their program.
Other grantees worked to establish Memorandums of Understanding (MOUs) or are in the
process of doing so. The multidisciplinary partnership that administers the IMPACTS grant
program in Union County now receives monthly reports from criminal justice partners in their
community, providing them with updates that assist them in identification of and outreach to
members of their target population.
In addition, some grantees are using – or are in the process of implementing – “Collective
Medical,” a software platform that records and notifies staff when a member of an identified
cohort, which could include a grantee’s target population, enters an associated medical facility.
Grantees implementing the Collective Medical platform are optimistic that utilization of that
system will improve contacts with and services to their target population. Improvements are
also anticipated to the grantees’ ability to track and report healthcare data. While the Klamath
Tribes are in the process of implementing Collective Medical, grantees such as Douglas County,
the Cow Creek Band of the Umpqua Tribe of Indians, and Union County currently utilize the
platform and report ease of access to accurate and real-time healthcare data on members of
their IMPACTS target populations.
E. Program-Wide Challenges and Identified Gaps
Grantees faced many challenges in the first year of this grant, including identifying and
contacting their target populations, standing up their programs, implementing their services,
and navigating the many challenges presented by the COVID-19 pandemic.
In March of 2020, Oregon declared a state of emergency due to the pandemic, exacerbating the
criminal justice system and emergency service providers.3 Many jails, hospitals, clinics, and
offices remained closed to the public throughout 2020 and 2021, causing great difficulty for
IMPACTS staff to connect with their target populations. Even after the COVID-19 vaccine was
widely released in Spring of 2021, these entities have continued to endure temporary closures
to the public.4 Several times throughout the pandemic, the Oregon State Hospital (OSH) has
paused acceptance of admissions altogether to slow the spread of COVID-19 and to avoid
overcrowding.5
3
See State of Oregon Executive Order No. 20-03, Declaration of Emergency Due to Coronavirus (COVID-19)
Outbreak in Oregon (March 8, 2020), available at
https://www.oregon.gov/gov/Documents/executive_orders/eo_20-03.pdf.
4
See Lane County COVID-19 Information, Lane County Jail Social Visiting / Attorney Visits (December 28, 2021),
available at https://lanecounty.org/government/county_departments/sheriff_s_office/c_o_v_i_d-19_information.
5
See Oregon Public Broadcast, Oregon State Hospital closes admissions after two patients test positive for COVID-
19 (December 2, 2020), available at https://www.opb.org/article/2020/12/02/oregon-state-hospital-closes-
admissions-after-two-patients-test-positive-for-covid-19/. See also Mental Health Association of Portland, As
COVID-19 unit nears capacity, Oregon State Hospital suspends admissions again (January 8, 2021), available at
https://www.mentalhealthportland.org/as-covid-19-unit-nears-capacity-oregon-state-hospital-suspends-
admissions-again/.
11In addition to the access issues discussed, grantee programs have been impacted by staffing shortages. Several programs were designed to include a team of behavioral health specialists to provide direct services to their target population. Recruiting and hiring for those positions has been challenging due to a nationwide shortage and an unprecedented high demand.6 In addition to the obstacles presented by the COVID-19 pandemic, data collection proved to be a challenge for grantees. At the conception of the application process, the Grant Review Committee significantly abridged the initial data requirements to make the process run quickly and to ease the burden on applicants. This, in turn, meant that several grantees began to provide services to individuals without having built their capacity to collect and report data. Some grantees also struggled with successfully establishing data sharing agreements with jails or hospitals and, therefore, did not have direct access to some of key measures for IMPACTS programs. Of those who attempted the process of establishing MOUs, some were met with bureaucratic barriers that they could not overcome. This issue was exacerbated for grantees whose geographical area spans multiple counties containing multiple jails and hospitals in their jurisdictions, all requiring separate MOUs. Additionally, healthcare data – such as visits to the ED and admissions to OSH – are protected so that sensitive patient health information may not be disclosed without the patient's consent or knowledge.7 It is also especially difficult for jails to share or compare data because Oregon’s jails use various data management systems that do not exchange information and there is no central repository for the data. There are, however, several initiatives in place to improve these data access issues. III. Quality Improvement Measures SB 973 established the Quality Improvement (QI) Subcommittee of the IMPACTS Grant Review Committee to do two things: (1) establish outcome measures or evaluation tools for programs receiving IMPACTS funding, and (2) establish a statewide system for tracking outcome data to inform best practices and improve outcomes for individual participants. Through this subcommittee, two areas of data quality improvement have been identified, including updating the grantee reporting template for more effective, accurate reporting, and using official administrative data sources, rather than self-reported data, for outcome measure data. Because many of the most reliable data sources for outcome measures – such as emergency department visits – are housed within databases that are cumbersome for grantees to access, the QI subcommittee recommended dividing program data collection into two parts: (1) data 6 See Kaiser Family Foundation, Mental Health Care Health Professional Shortage Areas (September 30, 2021), available at https://www.kff.org/other/state-indicator/mental-health-care-health-professional-shortage-areas- hpsas/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D. See also KGW8 News, Oregon Governor Kate Brown extends staffing contract to help healthcare workers (November 22, 2021), available at https://www.kgw.com/article/news/health/oregon-health-officials-working-aid- ailing-healthcare-workforce/283-eb2cda3b-0b53-4ecf-bb6c-cf0da364e0dc. 7 See Centers for Disease Control and Prevention, Health Insurance Portability and Accountability Act of 1996 (September 14, 2018) available at https://www.cdc.gov/phlp/publications/topic/hipaa.html. 12
reported by grantees on a quarterly basis that focuses on the services and supports provided to
grantees, and (2) data gathered by the CJC program staff through official administrative
sources, such as emergency department visits and OSH referrals.
Examples of grantee-reported data currently under consideration for inclusion in the updated
grantee reporting template include:
• Individuals served by IMPACTS;
• Criminal justice services provided to IMPACTS clients;
• Housing needs and housing services provided for IMPACTS clients;
• Behavioral health diagnoses (including substance use, mental health, and dual
diagnoses) and treatment provided for IMPACTS clients;
• Peer mentoring needs and services provided for IMPACTS clients;
• Employment needs and services provided for IMPACTS clients;
• Screening IMPACTS eligibility among IMPACTS clients and assistance in applying for the
Oregon Health Plan; and
• Re-entry assistance needs and services provided for IMPACTS clients.
To support access to administrative data sources, the CJC is engaged with researchers from the
Oregon Health & Science University (OHSU) and Portland State University’s School of Public
Health to assess IMPACTS grantees’ reporting capacities and provide technical assistance on
data access, collection, and reporting.
Additionally, the CJC has launched a project with OHSU’s Center for Health System
Effectiveness (CHSE) for the collection of outcome data from administrative data sources
beginning in 2022. Together, the CJC and the CHSE will identify outcomes to measure, assess
available data sources, and begin the process of acquiring access to those data sources.
Additional data sources may include Oregon Department of Corrections, the Oregon Judicial
Department, and Medicaid claims data from the Oregon Department of Human Services
Integrated Client Services Unit. Moving forward, these data reporting initiatives aim to
significantly improve the quality of IMPACTS data reporting in the coming years.
IV. Future of IMPACTS
During the 2021 Regular Legislative Session, the Oregon Legislature appropriated an additional
$10 million to the IMPACTS grant program for the 2021-2023 biennium. With this funding, two
Requests for Grant Proposals (RFGP) will be released in 2022 – one for counties and regional
consortia and one for Oregon’s federally recognized Indian tribes. The decision to release two
RFGPs was made following Tribal Consultation, during which it was recommended that a tribal-
specific proposal would better meet the unique challenges and needs of Oregon’s nine federally
recognized tribes.
Also, while the additional funding will be available to new applicants and existing grantees,
prioritization of funding existing grantees to maintain their current programs has been
13identified. Further, existing grantees seeking to maintain their program will not be required to respond to the formal RFGP. Existing grantees who wish to substantively change their programs, however, will need to reapply for funding. Additionally, the Grant Review Committee has prioritized equity, inclusion, and cultural responsiveness throughout the IMPACTS grant program moving forward. Among their goals are to impact more diverse populations and to support programs that collaborate with Community- Based Organizations (CBOs), Non-Governmental Organizations (NGOs) and/or Tribal-led Organizations. For the 2022-2024 grant cycle, the Grant Review Committee will require all programs – existing and new applicants – to provide a narrative of how their IMPACTS programs incorporate equity, inclusion, and cultural responsiveness into service delivery and program operation. 14
Appendix A. IMPACTS Grant Review Committee Membership List
Grant Review Committee Seat Member Name and Position
Director of Oregon Health Authority Steve Allen, Co-Chair (Behavioral Health Director,
or Designee Oregon Health Authority)
Director of Department of Corrections Jeremiah Stromberg (Assistant Director of Community
or Designee Corrections)
Chief Justice of the Supreme Court Hon. Suzanne Chanti (Lane County Circuit Court Judge)
or Designee
Executive Director of Oregon Criminal Kenneth Sanchagrin (Executive Director, Oregon
Justice Commission or Designee Criminal Justice Commission)
Director of Housing and Community Connor McDonnell (Housing Integrator, Oregon
Services Department or Designee Housing and Community Services)
District Attorney Vacant (Previously Kevin Barton, Washington County
District Attorney)
Defense Attorney Erik Swallow (Umpqua Valley Public Defender)
Chief of Police Deputy Chief Jeff Williams (Beaverton Police
Department)
County Commissioner Commissioner Claire Hall (Lincoln County)
Director of Hospital That Provides Acute Alicia Beymer (Chief Administrative Officer,
Mental Health Treatment PeaceHealth)
Representative of a Community-Based Stacy Brubaker (Division Manager, Jackson County
Mental Health Treatment Facility Mental Health)
Representative of a Community-Based Dr. Greg Brigham (CEO, Adapt Oregon)
Substance Use Disorder Treatment Facility
Sheriff Sheriff Curtis Landers (Lincoln County)
Representative of a Federally Recognized Dr. Sharon Stanphill (Chief Health Officer, Cow Creek
Tribal Government Health and Wellness Center)
Non-Voting Member of the Senate Senator Sara Gelser (Senate District 8)
Non-Voting Member of the House Vacant (Previously Representative Mitch Greenlick,
House District 33)
Public Member Janie Gullickson (Executive Director, Mental Health &
Addiction Association of Oregon)
Public Member Ramiro “RJ” Navarro (Veterans Program Coordinator,
Project ABLE, Inc.)
Public Member Jaron Riddle (CADC, Transformations Wellness Center)
Appendix B. 2020-2022 IMPACTS Grant Program Summaries
The following pages detail the IMPACTS programs funded during the 2020-2022 grant cycle and
provide specific overviews of each of the 11 funded programs, also known as grantees. These
summaries include information regarding the service areas, target populations, goals,
challenges, and current statuses of each funded program.
15IMPACTS Grantees
Clackamas County
$499,987.52 IMPACTS Grant
Clackamas County’s program is unique in that IMPACTS funds to pay for vouchers for high-
Clackamas County it is the only IMPACTS program housed in a needs members of the target population,
community corrections office. The main goal allowing those individuals to transition from
Population of their program is to provide their target stabilization housing to permanent housing
421,401*
population with wraparound services to help more smoothly. They have also focused their
those individuals find and keep housing, as efforts on identifying and connecting with
well as access mental health resources in a clients at the earliest possible intervention
Size of Target Population
timely manner. point by working with local law enforcement
50 to be notified before a client even leaves jail.
Reported Q1-Q5 Jail Bookings In addition to facing hurdles in providing
for Target Population services to its target population due to the “IMPACTS has served as a catalyst for
expanse of its geographical area, Clackamas Community Corrections to begin to
68
County reports,
Reported Q1-Q5 ED Visits explore resources and services that are
for Target Population “One of our main challenges available throughout the county and
0
demonstrates how needed and [to] start dialogue with organizations to
Reported Q1-Q5 form partnerships that will help
overdue IMPACTS is for our
OSH Referrals bridge gaps for our clients who have
community. By the time a client is
for Target Population
identified for the program, they quickly the highest needs in our community.”
0
escalate to a law enforcement or Clackamas County has also established an
mental health crisis that necessitates internal partnership with OHSU to assist in
building a database and overall program
long term incarceration or evaluation. They report that this database will
hospitalization, or the client absconds assist them in capturing key data about their
before getting connected to services.” IMPACTS clients, such as their contacts with
medical services and law enforcement, as well
In its first year, Clackamas County has used as their housing and employment situations.
16
*Per U.S. Census - April 1, 2020IMPACTS Grantees
Confederated Tribes of Coos, Lower
Umpqua, and Siuslaw Indians
$322,264.96 IMPACTS Grant
The Confederated Tribes of Coos, Lower CTCLUSI quickly adapted these challenges by
Confederated Tribes Umpqua and Siuslaw Indians (CTCLUSI) transitioning IMPACTS program management
of Coos, Lower IMPACTS program is designed to offer to the Tribal Police Department, which has
culturally-sensitive responses to the target maintained operations through the pandemic
Umpqua, and population. The program includes a Tribal and offered greater flexibility in responding
Liaison position who will travel and make those in active crisis. CTCLUSI has begun
Siuslaw Indians home visits to members of the target recruitment for their Tribal Liaison. They look
,Population population. Meeting these individuals where forward to filling the position soon,
they are increases the likelihood of their recognizing this individual will be able to
and
1,297* Siuslaw Indians
engagement in services. The Tribal Liaison more easily make contact with members of
Size of Target Population will also have access to a vehicle to allow their target population and connect them to
11 them to more easily navigate CTCLUSI’s needed services.
large geographic area.
Reported Q1-Q5 Jail Bookings
for Target Population CTCLUSI’s primary service area is one of the
1 largest of all existing IMPACTS programs,
Reported Q1-Q5 ED Visits comprising more than 13,900 square miles
for Target Population on the Oregon coast. This area lacks access
0
to behavioral health services and, due to its
size, presents unique challenges in the
Reported Q1-Q5
Tribe’s ability to make contact with their
OSH Referrals for Target target population. This barrier was further
Population exacerbated by the COVID-19 pandemic, as
0 CTCLUSI explains:
“COVID-19 led to many changes on how
facilities and organizations (including
CTCLUSI) managed operations. [The
pandemic]… prevented some subjects
from having direct access to services and
17
*Per 2021 Oregon Blue Book. While the CTCLUSI it also limited the Tribe's ability to
has an official population of 1,297 members, they
are part of a shared 5-county service area that is
conduct face-to-face meetings and
home to more than 12,200 American Indians/Alaska follow-up with individuals at risk.”
Natives potentially eligible for services.IMPACTS Grantees
Confederated Tribes of Grand Ronde
$289,999.96 IMPACTS Grant
The Confederated Tribes of Grand Ronde
IMPACTS program provides post-treatment
“The tribe's Behavioral Health
Confederated Tribes and post-incarceration transitional services to Program is currently in the
of Grand Ronde Tribal members throughout their service area process of implementing
– including Polk, Yamhill, Multnomah,
Population Washington, and Clackamas counties – from ‘Good Medicine’ initiative
5,567 enrolled members* existing service providers in Portland, Oregon into our program curriculum.
City, and Seaside. The program also funds
Size of Target Population residential treatment for Tribal members who
Good Medicine is
currently do not have access and pays for demonstrated by cultural
53
housing and basic needs to help stabilize teachings, as well as any
Reported Q1-Q5 Jail Bookings members of their target population.
for Target Population positive behavior or action
0 While they have successfully reported on the taken in our everyday lives.
IMPACTS services and treatments received by
Reported Q1-Q5 ED Visits
members of their target population, the
BH staff has completed Moral
for Target Population
Confederated Tribes of Grand Ronde have Recognition Therapy training.
0 described challenges with accessing Use and implementation of
Reported Q1-Q5 healthcare and criminal justice data. A lack of
OSH Referrals existing partnerships and Memorandums of MRT will take place in the
for Target Population Understanding (MOUs) have been the main coming months for our target
barriers in accessing these data. The
0 Confederated Tribes of Grand Ronde are
population receiving services
exploring ways to push past these hurdles and from our Behavioral Health
are in communication with county jails and Program. We now have staff
state prisons regarding the development of
cooperative MOUs. trained in Rental Readiness,
which will assist our target
Great strides have been made by The
Confederated Tribes of Grand Ronde in
population in budgeting,
providing supports and services to members credit repair and application
18
of their target population. for housing.”
*Per 2021 Oregon Blue BookIMPACTS Grantees
Confederated Tribes of Warm Springs
$282,743 IMPACTS Grant
The Confederated Tribes of Warm Springs Warm Springs IMPACTS program were more
Confederated Tribes created its IMPACTS program to fund a full- dedicated than ever to provide supports and
time clinical employee at the Warm Springs services. The program’s Certified Alcohol and
of Warm Springs Correctional Facility. This position is Drug Counselor (CADC) maintains daily
Population responsible for screening arrestees for contact with the jail to stay notified of
5,363 enrolled members* behavioral health needs, following up with members’ releases in an effort to provide
comprehensive assessments, and immediate intervention, assessment, and
Size of Target Population developing individualized treatment and necessary referrals.
21 service plans.
Reported Q1-Q5 Jail Bookings IMPACTS staff continue to adjust their
for Target Population The Warm Springs Correctional Facility practices based on what they learn about how
closed indefinitely due to the COVID-19 to best reach and impact their target
60
pandemic and all its inmates were population. In the next year of this grant cycle
Reported Q1-Q5 ED Visits transferred to Jefferson County Adult they plan to,
for Target Population Correctional Facility.
0 “focus on [their] repeat offenders and
As they adapted to the pandemic’s effects
Reported Q1-Q5 ascertain how we can work with them in
on the way they make contact with members
OSH Referrals of their target population, the staff of the connecting them with available services
for Target Population on the Reservation.”
3
19
*Per 2021 Oregon Blue BookIMPACTS Grantees
Cow Creek Band of the Umpqua Tribe of
Indians
$490,841 IMPACTS Grant
The goal of the Cow Creek Band of the scope of their current target population, they
Cow Creek Band of Umpqua Tribe of Indians IMPACTS program are interested in expanding the supports and
services they provide to increase their target
the Umpqua Tribe of is to intercept members of the target
population from 20 to 60-100 individuals.
population at the jail and emergency
Indians department and help provide them with
wraparound services. The Tribe focuses on The Cow Creek Band of the Umpqua Tribe of
Population
holistic and culturally-relevant care plans Indians shared the following story detailing an
1,760 enrolled members*
designed to meet the identified needs of individual client outcome:
Size of Target Population each individual. The Cow Creek Band of
Umpqua Tribe of Indians have reported “IMPACTS has really been beneficial for
20
several successes of their program, the Cow Creek Band of Umpqua Tribe of
Reported Q1-Q5 Jail Bookings
including: Indians, with the intensive care given to the
for Target Population
“The IMPACTS program has helped tribal target group. There's a young lady
0
Reported Q1-Q5 ED Visits offset the need of our community and who joined the target group in March
for Target Population Tribal Members with a high prevalence who has been institutionalized for
0 of behavioral health disorders, substance significant mental health issues. She is now
Reported Q1-Q5 use disorders, and misconduct. This living at home, maintaining behavioral
OSH Referrals position has also bridged to connect health and medication management.
for Target Population our law enforcement with behavioral One of her goals is to obtain her GED. She
health professionals that can deliver participated in orientation and started
0
appropriate services. Thus, reducing the online classes. She has now progressed to
number of individuals charged with three days a week in person classes. She is
criminal behavior or frequenting the also participating in frequent Equine
emergency department.” Therapy through the Tribe. Pictures of this
young lady during the Equine Therapy
In the first year of this grant cycle, IMPACTS sessions were sent to the Tribe and I have
staff have recognized that they may have never seen her look so happy. The smile
20 more capacity than initially anticipated. They on her face was priceless.”
*Per 2021 Oregon Blue Book report that, now that they understand theIMPACTS Grantees
Deschutes County $2,403,519.52 IMPACTS Grant
Deschutes County’s IMPACTS program weekends. Yet these shifts remain vital to the
Deschutes County expanded the services of the Deschutes 24/7 operation of the DCSC. Focusing heavily
Population County Stabilization Center (DCSC), a Crisis on recruitment efforts and implementing
Stabilization Center with respite and sobering creative staffing models and incentive
198,253*
resources, allowing it to be open 24/7 since measures allowed them to retain high-quality
Size of Target Population October of 2020. COVID impacted Deschutes staff throughout the pandemic, aiding the
23 County’s ability to reach and serve their success of this program.
target population as they would have done
Reported Q1-Q5 Jail Bookings “An elderly individual in the target
pre-pandemic. However, thanks to the DCSC
for Target Population being open 24/7, they became a critical population…accumulated an extraordinary
46 resource in their community. number of jail stays…and [ED] visits after
Reported Q1-Q5 ED Visits his spouse died... [He] was booked into jail
“For approximately 8 months, we were the
for Target Population 30 times and spent a total of 676 days
only mental health agency in our
284 incarcerated. He had 118 visits to the [ED],
community providing face to face walk
Reported Q1-Q5 which included visits both locally and
in services to individuals in need. across the State... [He] felt comfortable
OSH Referrals Because of COVID, the individuals we coming to the [DCSC] and connected
for Target Population served were very high acuity which was a with Peer Supports and a Case
0 challenge for staff at the Stabilization Manager. We were finally able to get
Center and forced us to quickly adapt our [him] hospitalized, confirmed a
staffing and protocols in order to safely neurocognitive disorder diagnosis, and
manage and support this population.” convened a group of hospital Social
Workers, DCSC staff, jail staff, [and] adult
The DCSC is key to their IMPACTS program as
protective services...All of this lead to a
it permits them the ability to assist individuals
successful placement in a memory care
in crisis, including walk-ins and law
enforcement facilitated drop-offs, at any time unit where he remains today and is
of day. Due to the nationwide shortage of doing extremely well.”
behavioral health workers, staffing their
21 programs has also been challenging. They The future focus of the Deschutes County
*Per U.S. Census - April 1, 2020 especially struggled with recruitment for IMPACTS program will be to stabilize their
alternative shifts such as night, swing and staffing and secure sustainable funding.IMPACTS Grantees
Douglas County $1,414,878.72 IMPACTS Grant
Douglas County’s goals for its IMPACTS County reports that Adapt is working to moving
Douglas County program center around a dedicated Intensive the Crisis team to 24/7 coverage.
Care Coordination (ICC) team that specifically
Population focuses on intercepting members of the Adapt, Douglas County’s Community Mental
111,201* target population before they enter the jail or Health Program, underwent a major transition to
Size of Target Population ED, as well as coordinating care for those integrate its treatment, mental health, and
members. primary care services into one Electronic Medical
279 Record (EMR) system. While this change will
Reported Q1-Q5 Jail Bookings The pandemic presented challenges in allow for easier tracking across programs for
for Target Population reaching and connecting with members of individuals who may be receiving multiple
420 Douglas County’s target population cohort. services, a 90-day wait period for new
Reported Q1-Q5 ED Visits reporting metrics to start resulted in a “dark
“Although restrictions are slowly being period” during which no data could be pulled
for Target Population from the system.
lifted across the State, COVID-19 has
744 continued to limit the ability of the ICC
Reported Q1-Q5 team to enter the Jail to see members Despite the many challenges they have faced,
OSH Referrals of the cohort to initiate or continue Douglas County’s IMPACTS program has seen
for Target Population supportive outreach. The ICC team has success stories resulting from the IMPACTS
been thinking outside the box and grant funds and the efforts of their incredibly
0 finding creative alternatives, such as hardworking team. Recently, they have:
connecting through the municipal
court processes instead of the jail when “… [assisted] one client in obtaining
necessary.” employment through the purchase of
interview clothes; [helped] another client
Hiring and retaining behavioral health staff
to maintain employment through the
has also been a challenge for Douglas County
purchase of work-related items (special
throughout the pandemic. They reported
losing both original individuals of the ICC boots for the timber industry); and
team and had to recruit and re-hire quickly. [assisted] two clients in maintaining
Additionally, the ICC team recognized their housing through rental assistance when
22 limited capacity to connect with cohort they faced employment barriers due to
*Per U.S. Census - April 1, 2020 members entering the jail or ED outside of COVID-19.”
normal working hours. In response, DouglasIMPACTS Grantees
The Klamath Tribes$691,580 IMPACTS Grant
The goal of the Klamath Tribes IMPACTS Program staff and providers work diligently
The Klamath Tribes program is to engage Tribal members with and patiently to engage their targeted Tribal
diversion options, substance use treatment, members who are experiencing long-term
Population and behavioral health services. Their homelessness and behavioral health issues.
5,200 enrolled members* IMPACTS program also funds peer support
services, stable housing options, and direct
Size of Target Population “A tribal elder is currently engaged and
client support to provide for the target
making significant progress. When we
18 population’s basic needs that cannot
Reported Q1-Q5 Jail Bookings otherwise be met. When asked what makes first connected, he was living in the alley
their IMPACTS program unique, the Klamath way, braving the cold winter. We sought
for Target Population
Tribes shared: him out and began to engage him,
277
providing sheltering and consistent
Reported Q1-Q5 ED Visits “We provide…access [to] our outpatient physical needs. He was hesitant to enter
for Target Population clinic without the pressure of engaging. behavioral services although in his
2 We allow plenty of time to build trust lifetime he had a plethora of losses and
Reported Q1-Q5 and take a no-low barrier approach in traumas. We connected him to
OSH Referrals meeting them where they are. We supportive family he has been estranged
for Target Population provide outlets for use of traditional from for over a year. We began reducing
medicines, opportunities to go out on the all barriers to access case management
0
land to sacred sites for quiet reflection supports. He was able to move form a
and promote…kinship and close homeless situation to a safe
community-tie values.” encampment to shared housing with
family. He recalled most of his crimes
Although the COVID-19 pandemic were related to homeless life... He had
significantly set back treatment engagement
been using alcohol most days, for the last
and advocacy work, the Klamath Tribes have
20 years. During this reporting period he
made considerable strides in standing up
their program. They are in the process of has consumed two beers. He reports
implementing Collective Medical, a system feeling ‘good’ and remains connected
23 which will allow them to access accurate and to our program, often checking to see if
*Per 2021 Oregon Blue Book real-time data on members of their IMPACTS any of his peers also ‘made it.’”
target population.IMPACTS Grantees
Lane County
$2,527,697 IMPACTS Grant
Lane County’s goal for their IMPACTS hospital systems. Through MOUs, data
Lane County program is to fund a Forensic Intensive collection and sharing are much more
Treatment Team (FITT) to focus on creating efficient and allows for better tracking of
Population
wraparound care for high jail utilizers and IMPACTS clients through the continuum of
382,971*
connecting them with needed services and services. In addition to a growing need for
Size of Target Population supports. supports and services, some of the data Lane
County’s IMPACTS program now has access
4
The COVID-19 pandemic has caused delays in to has provided them with a glimpse into how
Reported Q1-Q5 Jail Bookings their county is responding to the growing
the standing up of Lane County’s IMPACTS
for Target Population program. Specifically, they have experienced number of individuals in need of assistance.
2 challenges in recruiting and hiring behavioral
Reported Q1-Q5 ED Visits health staff. After several attempts to fill the “We have a dynamic daily Tableau
for Target Population positions and having to adapt their program report that is capturing all individuals
8
to changing needs, Lane County better arrested and/or booked in the County
understood the duties their program and Springfield jail and who have a
Reported Q1-Q5
positions would support. They reevaluated
OSH Referrals mental health diagnosis and/or who
their recruitment and were able to broaden
for Target Population the scope of required credentials in an effort have accessed the [ED]. We can sort by
0
to attract more applicants. They are hopeful number of engagements with law
to bring staff on board soon. enforcement… helping us identify our
potential clients. [We have noticed]
“This project is so desperately
how many mentally ill folks [go
needed in our community and
unnoticed by] law enforcement…
we have been working so hard at because [of the existing] civil process
getting it off the ground.” to get folks treated. With the near
halt of civil commitment services
Lane County has successfully established
MOUs with all their community partners through OSH, we are seeing law
including policing agencies, county and local enforcement using arrest and Aid &
24
jails, circuit and municipal courts, and local Assist more, which is driving up our
*Per U.S. Census - April 1, 2020
numbers in Lane County.”IMPACTS Grantees
Lincoln County
Mental $288,490 IMPACTS Grant
Lincoln County’s IMPACTS grant funds the The LEAD team modified their referral
Lincoln County Lincoln County Sheriff’s Office Law practices, thus increasing the amount of time
Population Enforcement Assisted Diversion (LEAD) an individual spends with a licensed
program. LEAD is a pre-booking, harm- professional trained to identify treatment
50,395* reduction diversion program that connects needs and make appropriate service referrals.
Size of Target Population deputies with high utilizers of the criminal
justice system and attempts to divert them Lincoln county reports that prompt referral to
7
to appropriate services as early in the a LEAD navigator facilitates therapeutic
Reported Q1-Q5 Jail Bookings
process as possible. The overall goal of the response, promoting engagement with
for Target Population LEAD model is to reduce the harm these treatment and long-term stability.
9 high utilizers have done to themselves and
Reported Q1-Q5 ED Visits to the surrounding community as a result of “[A local resident] was houseless and
for Target Population mental health issues, substance use, or co- residing in a broken-down motorhome.
occurring disorders. This person was experiencing
1
Reported Q1-Q5 multiple law enforcement contacts a
The LEAD team has experienced challenges
OSH Referrals with referrals from law enforcement and week for domestic violence and
for Target Population have identified that more outreach and substance use related issues. This
education is needed to improve person’s LEAD navigator assisted
3
understanding of the program and its them to engage in substance use
methodology. treatment, secure temporary
housing, obtain identification, and
The LEAD referral protocol has evolved to
meet the needs of the community. It was ultimately engage with a
originally envisioned that officers would comprehensive residential treatment
make eligibility determinations in the field program. Following successful
and refer appropriate clients. However, the completion of residential treatment, this
process proved to be time consuming and person’s navigator assisted them to
burdensome and meant that individuals
transition back into the community
were interacting with a law enforcement
25
officer more than a treatment professional. where they secured employment and
*Per U.S. Census - April 1, 2020
engaged in outpatient services.”You can also read
