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Have more questions? Contact the SHIFT team at SHIFT@careoregon.org
Columbia Pacific CCO’s Strategic Healthcare Investment for Transformation (SHIFT) initiative is a new investment in transforming specialty behavioral health organizations across Oregon so that people with behavioral health needs are truly at the center of care delivery, and care teams can thrive. Through a collaborative process, SHIFT will build client-driven, outcomes-focused, team-based care models that eliminate health inequities, assure timely access to care, and prepare providers for advanced value-based payment models. FIT is the back bone of SHIFT as it ensures client-centered transformation through a culture of feedback.
Columbia Pacific is committed to a vision where members in each of its regions have access to a high-performing behavioral health home. Decades of systemic underinvestment in behavioral health at the local, state and federal levels has resulted in significant access challenges and health inequities. Today, we are entering a new phase of opportunity for transforming behavioral health. New and significant financial investments are being made to shore up specialty behavioral health services, and we must capitalize on this opportunity to reimagine and transform the practice of care delivery.
The SHIFT initiative will support clinical, financial and operational transformation of outpatient behavioral health by:
Eligible mental health and substance use treatment agencies across CareOregon’s networks, including Columbia Pacific CCO, Jackson Care Connect and Health Share of Oregon, were invited to apply for SHIFT to receive the initiative’s intensive technical and financial resources.
Six diverse behavioral health agencies have been selected to participate in this first SHIFT cohort, and we're excited to welcome the following agencies to the SHIFT community!
| Phase | Timeline | Description |
|---|---|---|
| Cohort Selection | August – December 2023 | CareOregon invited eligible agencies to indicate their interest and intent to apply for SHIFT by submitting a letter of intent. Agencies submitted written applications. CareOregon reviewed all written applications and invited select agencies to interview. CareOregon notified agencies selected to participate in the first SHIFT cohort. |
| Preparation and Planning | January - February 2024 | CareOregon held a SHIFT Welcome Webinar for first cohort agencies. Agencies began working with Advisors from the National Council for Mental Wellbeing as well as their CareOregon FIT Advisor. Metro providers updated FIT FRIFM, SOI Checklist, and existing FIT implementation plans as needed. |
| Assessment and Design | March – August 2024 | SHIFT Cohort Launch Retreat was held on March 5-6. Agencies worked on current state assessments and developed their SHIFT business and implementation plans , including a plan to ensure platform element requirements are met. Each agency is unique and designed their own path forward ensuring the path leads to achievement of the SHIFT first cohort goals. CareOregon approved all six SHIFT agency business plans. Agencies received the second round of grant funding to support Phase 3- Platform Elements Implementation activities. |
| Platform Element Implementation | Starts September 2024 | To be successful with SHIFT, agencies need to ensure a base level of readiness across areas like leadership capacity, data management infrastructure, and subject matter expertise. These are considered platform elements. Before launching into full implementation, agencies implement needed platform elements, based on assessment. Agencies continue FIT implementation efforts. |
| Begin Full SHIFT Implementation | After Platform Implementation through 2026 | OnOnce platform element implementation is complete, agencies will work towards the end of 2026 goals defined in the business plan. FIT implementation continues. The remaining funding will be distributed in 3 payouts based on achievement of milestones defined in the business plan. |
| Sustainability and Continued Improvement | 2026 and beyond | The full SHIFT and FIT transformation will not be complete in three years! Agencies will continue to build upon the initial work and focus on achieving long term SHIFT and FIT goals.
Each agency will develop and implement a plan to ensure sustainability. |
The Building Blocks Framework document is available to all behavioral health providers serving CareOregon members through the Connect provider portal platforms. To access the document, follow these steps outlined below or email SHIFT@careoregon.org:
To participate in SHIFT, agencies must:
The SHIFT Learning and Advisory Council provides strategic advice and guidance to CareOregon for the SHIFT initiative during at least the program's first launch year. Specific responsibilities of the Council include:
View the SHIFT Learning and Advisory Council member slate for the April 2023 - March 2024 year.
NOTE: we’ve asked Learning and Advisory Council members to extend their membership through June 2024.
The SHIFT cohort refers to the six behavioral health agencies who applied and were selected to participate in SHIFT. They will receive the intensive technical and financial support and resources to implement the Building Blocks, learn what works, and accomplish the initiative’s aims.
Participation in the Learning and Advisory Council does not suggest later participation in SHIFT’s first cohort of providers.
Unlike certified behavioral health clinics which have a formal designation/certification and are required to serve clients across the lifespan and both mental health and substance use disorder (SUD) services, SHIFT is not a certification program and will intentionally support providers who serve specific populations or offer specific service arrays (e.g., mental health only, or SUD only). We envision certified community behavioral health clinics (CCBHCs) will benefit from the operational structure and processes to be outlined through SHIFT. Additionally, the SHIFT initiative provides participating agencies a unique menu of tools, training, and technical assistance, including executive coaching.
"Building Blocks” are the core components of specialty behavioral health care necessary to deliver the SHIFT vision and include the specific operational processes and structural elements required for behavioral health agencies to operate efficient and effective services according to the guiding values. The full set of Building Blocks to be used in SHIFT were endorsed by the Learning and Advisory Council. The concept of building blocks is modeled from a similar framework established for person-centered primary care homes. The Building Blocks Framework document is available for review by all behavioral health providers serving CareOregon members and is accessible through the CIM/Connect provider portal platforms. Click here for instructions to access the document.
Agencies to participate in SHIFT have been selected; there was a comprehensive application and interview process to reach that decision. Click here to see which agencies were selected to participate in the first SHIFT cohort.
Only outpatient behavioral health agencies that hold a certificate of approval and are in-network with Columbia Pacific CCO, Jackson Care Connect, and/or Health Share of Oregon/CareOregon behavioral health network are eligible to participate. See detailed eligibility criteria below.
To participate in SHIFT, agencies must:
To participate in the first SHIFT cohort, active enrollment or plans to initiate/resume enrollment in the FIT incentive program is a requirement for agencies who have been offered the opportunity to be in the incentive program. Enrollment in the FIT incentive program is not a requirement for agencies who have not had the opportunity to be in the incentive program. For example, substance use disorder (SUD) agencies and agencies in CPCCO have not yet had the opportunity to enroll in FIT and are therefore eligible to participate in SHIFT despite FIT enrollment.
Agency does “not deliver only clinic-based services" refers to (a) the regular provision of services to clients in settings other than the clinic, including in the client's home, or in another community setting and (b) outreach and engagement work with, for example, people experiencing houselessness. It is not referring to telehealth only services.
Assuming that the school-based mental health programs provide full outpatient mental healthcare (with assumed pediatric focus) and meet all other eligibility criteria, these services would qualify as eligible for SHIFT. Agencies with school-based mental health programs will not be excluded from applying just because of their unique site of service. Noting that more information about the program’s current business model, services offered, and population served will be requested and reviewed throughout the application and interview process to evaluate against SHIFT supports and expected outcomes.
The SHIFT team hosted an informational webinar to kick-off the SHIFT application process in July 2023. The meeting was recorded and is available via an on-demand link. If you’d like to review the presentation, email SHIFT@careoregon.org and we will send the link to the recording.
Board endorsement does not mean that the agency’s board is required to review and approve the application before submission, rather that they are supportive of the agency applying for SHIFT. An applying agency’s board should be fully informed about the SHIFT initiative opportunity, in agreement that SHIFT is aligned with the organization’s mission, and confident that the agency, if selected, will be able to participate in the level of effort described in the SHIFT application. The intention is to ensure that selected agency boards are aware and prepared for discussion and approval of the eventual CareOregon/agency business plan and financial terms.
Success of the first cohort of agencies in SHIFT from 2024-2026 will entail:
The full support plan includes:
It’s difficult to estimate the level of effort for SHIFT because the answer is highly dependent on the specific agency’s size, capacity and needs. However, we do know that SHIFT will be a really intensive effort. SHIFT is intentionally well-resourced by CareOregon to comprehensively support participating agencies throughout the duration of the three-year cohort engagement. To launch SHIFT, participating agencies should expect to have committed and engaged executive teams, dedicated program leadership and program team (if not full-time program staff), and resourced administrative/ operations design and implementation experts. SHIFT funds can be used to resource some of these roles, but it will not be successful if existing leadership does not have the time/capacity to engage. Again, the structure and staff designations are agency-dependent, but the intention is to have, at a minimum, dedicated support to design, implement and manage the efforts.
An executive leadership team is typically made up of the following roles, and in smaller organizations, one person may hold more than one role:
The executive team provides strategic and operational oversight of the agency, including developing and executing the strategic goals to achieve the agency’s values, mission, and vision. The executive team works together to:
Executive coaching support to the executive team and individual executive team members will be designed to allow the team and its individual members to reflect on their approach to working with each other as leaders of the agency. Topic areas include aligning the values of the organization with the culture and day to day operations, adoption of team-based care principles, adaptive versus technical approaches to change management, aligning resources with strategic priorities, and managing versus leading staff. Fundamental to executive coaching is the creation of a dynamic, catalytic space for executive staff to grow together in their knowledge and skills as leaders.
SHIFT agencies are required to hire external executive consulting supports for executive coaching scope at a minimum, change management and implementation consulting scopes are recommended as needed.
Agencies will need to carefully assess whether and how implementing SHIFT with its funding, training, tools, and technical assistance can align with and strengthen existing large-scale programs. SHIFT consultants and advisors will work closely with participating agencies to help integrate SHIFT plans with other ongoing agency programs.
Membership on the Learning and Advisory Council was extended through June 2024. The Learning and Advisory Council was initially established for the initiative’s first launch year, and its membership and objectives will be re-evaluated later in 2024. The SHIFT initiative is currently resourced to support six behavioral health agencies in this first cohort, but we are hopeful that, with successful outcomes, we will be able to expand its reach in the future.
Have more questions? Contact the SHIFT team at SHIFT@careoregon.org.
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