October 11, 2021

Rapid Engagement

Reducing Barriers to Behavioral Health

Purpose

Our goal is to make accessing outpatient behavioral health services easier, faster and more user-friendly for people across Oregon. 

Why are we advocating for Rapid Engagement?

  • Oregon Administrative Rules (OARs) require a comprehensive assessment and service plan prior to the initiation of services for provider organizations certified by the Oregon Health Authority.
  • Agencies covered under these Rules are not able to focus their early client interactions on building relationship and trust, understanding client priorities, and meeting immediate client needs.  Instead, agencies are required to conduct a lengthy assessment before offering therapeutic services.
  • These requirements are not trauma-informed or client-centered.  They create additional barriers to care for the people who need them the most.

 What changes are important for Rapid Engagement to work?

  • Rapid Engagement intends to create more flexibility for the intake process.  In the Rapid Engagement approach, agencies can start with a brief assessment and the use of an initial diagnosis (that may be more general or unspecified) for billing up to 6 visits.  Having the flexibility to use an initial diagnosis, with appropriate documentation of medical necessity and justification for that diagnosis, allows agency staff to focus on the relationship with the client, while developing the clinical case formulation, assessment, and comprehensive service plan over time.   
  • Rapid Engagement emphasizes a team-based approach to engagement, including elevating the role of workforce members with lived experience, such as Peer Support Specialists and Recovery Mentors, to create a trusting and collaborative relationship between agencies and individuals seeking services.

What will be required to implement Rapid Engagement?

  • Revise the relevant OARs that impact mental health and substance use disorder treatment settings.
  • Create alignment with Coordinated Care Organizations (CCOs) contracts, including the contracts between OHA and the CCOs, and the CCOs and the behavioral health provider network.
  • Create an evaluation plan to inform the implementation and effectiveness of Rapid Engagement.
  • Establish a pilot process to test and improve the Rapid Engagement approach.

What are the design principles guiding the development of Rapid Engagement?

  • Elevate consumer experience as #1 priority.
  • Meet people where they are at, build relationships and respond to needs from the very first interactions.
  • Value the guidance of people with lived experience.
  • Elevate the role of the peer workforce in service engagement.
  • Prioritize health equity. Improve access and quality for the people who face most barriers.
  • Emphasize trauma-informed practice and cultural humility.
  • Reduce administrative burden for intake and reporting.
  • Integrate the perspectives of all members of the clinical team.
  • Provide culturally and linguistically responsive services.

What is out-of-scope for Rapid Engagement?

  • Although our goal is for Rapid Engagement to be the standard access model for all people, as a partnership with the Oregon Health Authority, this initial effort is limited to people who are covered by the Oregon Health Plan.
  • Although our goal is to reduce administrative burdens overall and re-focus our efforts on the individuals being served, the changes proposed by Rapid Engagement are limited to revisions to the Oregon Administrative Rules and Oregon Medicaid program, including the CCO contracts.  Administrative requirements required by other grants, programs or accreditation bodies would not be impacted by Rapid Engagement at this time. 

How is Rapid Engagement being developed and implemented?

  • In partnership with the Oregon Health Authority, the Association of Oregon Community Mental Health Programs is facilitating a multi-stakeholder planning process.  This process includes a Rapid Engagement Steering Committee and workgroups focused on key topics.  The Oregon Council for Behavioral Health and the Oregon Primary Care Association are key partners in this effort, along with representatives from Community Mental Health Programs, culturally specific behavioral health programs, and CCOs.
  • Prior to being finalized, Rapid Engagement will be piloted by a small, diverse group of agencies.  This group will use process improvement methods to improve the Rapid Engagement client journey.

How will consumers be impacted by Rapid Engagement?

  • Our vision is for Rapid Engagement to become the standard of care for all outpatient specialty behavioral providers.  Our goal is that consumers in any part of the state can expect to receive support, therapeutic services, and easy access to behavioral health care when they need and want it from their local agency, without having to answer a long list of questions just to start getting help.
  • Our hope is that Rapid Engagement will also improve behavioral health workforce satisfaction and experience, improve retention, and boost morale.  These changes would not only improve access to and quality of services, they would also support the people working in behavioral health by putting people before paperwork.

How can I learn more or get involved?

If you are interested in learning more or getting involved, please contact Cherryl Ramirez or Ariel Singer.