About the Traditional Health Worker Grant Program

Community-based organizations often don't have the consistent funding to hire, train and grow their THW workforce. The goal of the two-year grant program was to develop a contracting approach to support payment for services that THWs provide to members and the community, reducing disparities and improving accessibility and member health.

"We have been using Traditional Health Workers for years, but grants come, and grants go,” said Holden Leung, CEO of the Asian Health & Service Center. “This grant and this partnership give hope that we can continue to build this workforce so that they really can be supported in the long term and our communities can become healthier because of it.”

CareOregon started by learning more about services these essential workers provide and the populations they serve. Participating organizations and CareOregon used this shared understanding to codesign a payment model that recognizes the unique value of Traditional Health Workers and allows our partners to grow their THW workforce.

Pioneering a new payment service model for THWs

As of December 2022, CareOregon had signed contracts with four of our community-based partners – Asian Health & Service Center, Familias en Accion, IRCO and Our Just Future – to begin to use a new payment service model.

"Developing a sustainable payment model like this is critical because Traditional Health Workers are the social health workforce,” said Amie Diffenauer, Community Programs Manager at Our Just Future. “This program really allowed us to help start to build that workforce and to really recognize it for what it is."

CareOregon will continue to learn alongside these partners how our contracting approach can help support and sustain the Traditional Health Workers workforce and improve member outcomes and experience.

Making the SHIFT

One of CareOregon’s biggest programs during the year was SHIFT (Strategic Healthcare Investment for Transformation), which puts people with behavioral health needs truly at the center of care delivery. SHIFT builds on a successful primary care model that began over a decade ago, moving toward team-based care and redesigning practices. It is designed to foster health care services that improve outcomes for patients while ensuring high provider satisfaction. This means tracking things like how easy it is for patients to get care, how satisfied they are, how involved they are in their own care and how their health improves over time.

In the fall, six diverse behavioral health agencies were selected to participate in the first SHIFT cohort: Cascadia, Clackamas County Health Centers, ColumbiaCare Services, Morrison Child & Family Services, New Narrative and VOA Oregon.

Working to create a roadmap for recovery

CareOregon also joined with Health Share of Oregon, Central City Concern, and Providence Center for Outcomes Research and Education to conduct a groundbreaking study that not only gives a perspective on the true size and scope of behavioral health issues but provides concrete ways to address them. Researchers analyzed claims data for nearly half a million people covered by Medicaid benefits by the Coordinated Care Organization (CCO) Health Share to look at mental health challenges, addiction and risk for homelessness. Health Share serves 82 percent of Oregon Health Plan members in Clackamas, Multnomah and Washington counties.

The study found that disorders grew modestly during the pandemic, including 5 percent more fentanyl use disorder, and recommended a roadmap for recovery in the tri-county region, including care coordination across housing, physical and behavioral health; more outpatient behavioral health and addiction treatment program capacity; and 200-250 inpatient and residential treatment beds for the severely mentally ill.

Innovation in harm reduction and naloxone distribution

CareOregon invested $3.9 million during the year in harm reduction supply distribution in all three Portland metro-area counties, including school-based health centers. The overdose reversal drug naloxone (commonly known as Narcan) is included in every kit distributed, with the intention of reducing fatal overdoses of opioids, including heroin and fentanyl, and providing supplies to underserved communities.

Beyond the Portland area

In the Medford area, Jackson Care Connect CCO used several innovative strategies to address behavioral health needs.

• The CCO provided $4.5 million to Addictions Recovery Center to double its capacity for withdrawal management services, expanding access for life-saving medical intervention.
• It gave $3.5 million to OnTrack Rogue Valley to support its new Cobblestone Family Treatment Campus, which will provide integrated family treatment on a safe, accessible campus, with substance use and mental health treatment, early childhood interventions and supportive services.

In Northwest Oregon, the Columbia Pacific CCO brought back its community Substance Use Disorder (SUD) Summit last fall. More than 200 people attended the free, two-day event in Seaside, where they heard from 40 different speakers.

Spreading awareness of resources

CareOregon also launched a “Recovery is possible” campaign in the fall, featuring real stories of CareOregon members and their journeys through substance use recovery. The campaign included a video series, created to reduce stigma, bring awareness to substance use recovery services and build a community that supports recovery.

Columbia Pacific CCO leads the way

Our Columbia Pacific subsidiary has been at the forefront of our housing work at CareOregon. Since Columbia Pacific launched its Regional Housing Impact Fund in March 2020, it has invested more than $5 million to address housing needs in rural Northwest Oregon, including about $2 million on behalf of some of its largest clinical partners.

The result has been about 300 additional affordable housing units (apartments) in its three-county service region, which has some of the highest per-capita rates of homelessness statewide. Columbia Pacific housing grants have also supported local organizations that serve community members experiencing homelessness.

In June 2023, Columbia Pacific marked a full-circle moment when it joined with community leaders to celebrate the grand opening of Warrenton’s Trillium House. Three years earlier, the project received the first-ever grant ($400,000) from the Columbia Pacific Housing Impact Fund. The opening of Trillium House added 42 units of affordable housing in Clatsop County, which has the state’s highest per-capita rate of homelessness.

To promote housing stability and long-term self-sufficiency, Clatsop Community Action has a staff member onsite to help Trillium House residents access its services. Clatsop Behavioral Healthcare provides referrals and wrap-around services to residents of the five units reserved for households with members experiencing serious mental health challenges.

“Projects like Trillium House support people’s housing stability, so they can stay connected to employment and education opportunities, build community and take other steps to improve their lives,” said Mary Bradshaw of Northwest Housing Alternatives, which developed Trillium House in partnership with the Northwest Oregon Housing Authority.

Clatsop County in focus

Clatsop County is also the site of one of our most ambitious housing efforts so far. In 2023, CareOregon broke ground on Hawk’s Eye Apartments, a project to convert a former hotel into housing for two populations: low-income community members needing behavioral health supports and professionals who work for health care and social safety net organizations. The project is planned to open in late summer 2024.

“Hawk’s Eye Apartments will help address two pressing needs: affordable housing for Oregon Health Plan members and for our health care and social services workforce,” explained Leslie Ford, Columbia Pacific’s Housing Strategy and Development Advisor. “The very limited supply of affordable housing has made it difficult for our community and clinical partners to attract and keep workers.”

Covering more ground

Ford, who has overseen the Columbia Pacific Housing Impact Fund since its launch, recently expanded her geographic focus to include Jackson County, one of several regions included in Gov. Tina Kotek’s first executive order last year declaring homelessness a state of emergency.

Ford is providing guidance and support to the team at Jackson Care Connect, part of the CareOregon family, as the coordinated care organization evaluates potential projects to support.

She has also lent her expertise and problem-solving skills to the Jackson County Multi Agency Coordination (MAC) Group – a collection of government agencies and service providers tasked with working together to meet ambitious, state-defined targets tied to Gov. Kotek’s homelessness emergency order.

The group, which includes Jackson Care Connect, exceeded targets for the addition of low-barrier shelter beds, the rapid rehousing of unsheltered individuals and families, and eviction preventions. For instance, more than 100 individuals and families were rapidly rehoused, which not only entailed finding them a place to live but also providing services to help them make the transition to more-stable housing.

“The incredible work that the MAC Group has done will likely have long-term effects on how the table is set for affordable housing in Jackson County,” Ford said.