Multnomah County Behavioral Health Resource Network Proposal Overview
Proposal outlines initial budget request and allocation for behavioral health resources in Multnomah County. Concerns and feedback from OAC Subcommittee addressed through budget negotiation process, impacting various programs and services provided by organizations such as Bridges to Change, Outside In, SE Works, Inc, WomenFirst Transition & Referral Center, Bright Transitions, Cascadia Behavioral Health, Morrison Child & Family Services, New Avenues for Youth, Lutheran Community Services, and Mental Health & Addiction Association of Oregon.
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Behavioral Health Resource Network Proposal Multnomah County Region August 17, 2022
Multnomah County Initial Budget Request TTL Multnomah County request: Multnomah County Allocation: Under allocation: $48,923,706.69 $58,849,724.17 $9,930,402.48 4
OAC Subcommittee Concerns/Feedback OHA worked with all partially funded programs to revise budgets based on OAC decisions. The following questions were answered through the budget negotiation process: Bridges to Change: What culturally-specific populations will Bridges serve and how is Bridges expanding housing capacity? Bridges to Change will continue to partner with culturally-specific organizations in Multnomah County to serve communities that have been harmed most by the war on drugs. Bridges to Change will add between 125 and 154 units of housing (depending on property costs), including 16 units of culturally-specific housing for African American residents supported by The Miracles Club; 8 units of culturally-specific housing for LGBTQIA+ residents supported by Quest; 9 units of supportive housing prioritizing individual receiving MAT at Recovery Works NW. Outside In: Will Outside In use M110 funds to provide mental health or SUD treatment? Outside In will use M110 funds to serve people using substances. SE Works, Inc: Would like to see more options for supported employment SE Works increased their budget for supported employment and will increase services to clients. 5
OAC Subcommittee Concerns/Feedback WomenFirst Transition & Referral Center: Increase funding for direct client services. Increased rental assistance offerings. Bright Transitions: Fund program, not property purchase Bright Transitions removed the property purchase from their budget. Cascadia Behavioral Health: Not funding doctors, CMA, LNP Cascadia removed these positions from their budget. Morrison Child & Family Services: Make sure there are livable wages. Morrison increased wages per OAC feedback. New Avenues for Youth: Reduce amount of CADCs and peers being hired. New Avenues adjusted the number of FTEs from 6.0 to 4.0 and removed one month from budget (had originally submitted a 19-month budget). Lutheran Community Services: Make sure salaries are tied to the position & exclude psychiatric services and board salaries LCS accepted the directed changes and excluded these items in their final budget. Mental Health & Addiction Association of Oregon: Not funding housing or training. MHA Oregon removed the housing and training items from their budget. 6
OAC Subcommittee Concerns/Feedback Portland Street Medicine: What positions are being filled with contracted staff? The two contracted positions are wound care peer technicians and lived experience contractors. The rest of the positions are employed staff. Providence: Fund detox center but not medical staff. Providence removed the medical staff from budget. Marie Equi Institute: Hire more CRMs, exclude licensed professional counselor (LPC) Marie Equi has added an additional CRM to their budget and 2 peer addiction support specialists. They removed the LPC position. CCC Puentes: Exclude licensed medical provider (LMP) salary CCC Puentes provides culturally and linguistically-specific services to over 315 Latino/a/x individuals per year. Over 60% of these clients are categorically ineligible for Medicaid and who cannot afford coverage. The 0.2 FTE bilingual and bicultural LMP will be the first medical provider at the CCC Puentes site. OHA believes it is appropriate to preserve funding for this position. 7
County Region Under Allocation Guidance Reach out to approved housing providers within the county region to determine whether one or more can expand offerings to meet additional housing needs; or If the county region is still under budget after additional housing options are funded, we will pro-rate the remaining funds. 8
Overview of Housing Additions Bridges to Change: Will add a 15-unit apartment complex, a 9-bed MAT supportive housing house, and two new recovery homes. Will also support Miracles Club and Quest through their expansions. Fresh-Out Community Based Reentry Program: Adding in additional rental assistance for clients. Going Home II: Will acquire gender-affirming housing to serve individuals identifying as African American/Black seeking recovery services without suitable housing. Just Men in Recovery: Added additional emergency rental assistance and utility assistance for up to 300 clients. The Miracles Club: Increased direct rental assistance for supportive housing clients. Added two 8-bed houses for African American clients (stabilization and women s supportive housing). Oregon Change Clinic: Will expand capacity from 25 clients to 60 clients by leasing a new building to build 35 early recovery beds. 9
Overview of Housing Additions WomenFirst Transition & Referral Center: Increased rental assistance for women graduating from their housing program. The Insight Alliance: Added purchase & renovation costs for a 5- bedroom home to offer supportive, recovery, and transitional housing for single adults. Bright Transitions: After removing the real property purchase, Bright Transitions added in rental costs & maintenance for a building that will focus on recovery housing. Project Patchwork: Will increase staff wages to livable salaries; will acquire a 6-bedroom home for family housing. Project Quest: Added an 8-bed supportive housing house for LGBTQIA+ clients and increased supplies costs for the expanded program offerings. 10
Overview of Housing Additions The 4th Dimension: Increased overall budget to accommodate expanded housing offerings in multiple BHRNs: Increased overall housing assistance fund by $250k Increased budget for East County BHRN Community Center to host housing workshops ($45k) Sets aside $497,484 for Latino/a/x-specific housing Proposes to subcontract with Transcending Hope to provide culturally- and linguistically-specific Latino/a/x housing in the Latino/a/x BHRN as there was no approved housing provider that could offer this service in Multnomah. Transcending Hope was an approved housing provider in Washington and Clackamas Counties but did not apply in Multnomah County. Transcending Hope was requested by the Latino/a/x-specific BHRN providers to fill the gap in culturally-specific housing. Transcending Hope will use the funds to build culturally-specific housing in Multnomah County for individuals in recovery. Increased admin fees to 15% to reflect additional work/costs associated with subcontracting. 11
Indigeninity BHRN Budget Reconciliation with Housing Additions and OAC Feedback Grantee Original Request New Request Alano Club of Portland Bridges to Change* Fresh-Out Community Based Re-Entry Program* Going Home II* Just Men In Recovery* MetroPlus Association (Addiction Counselor Certification Board of Oregon) The Miracles Club* Oregon Change Clinic* Outside In Painted Horse Recovery Project Patchwork* Project Quest* SE Works Inc Sovalti LLC The 4th Dimension* The Mental Health & Addiction Association of Oregon WomenFirst Transition & Referral Center* Total Difference $1,021,174.20 $4,588,039.84 $1,021,174.20 $8483,789.61 $0.00 $3,895,749.77 $429,761.00 $494,408.00 $64,647.00 $1,033,618.00 $1,012,016.50 $3,920,496.00 $1,218,008.00 $4,954,114.00 $2,230,024.50 $363,820.00 $2,428,293.00 $1,845,323.00 $1,834,151.00 $767,203.41 $546,088.21 $2,579,502.84 $917,806.84 $132,853.00 $1,230,525.33 $363,820.00 $3,201,077.00 $3,218,373.00 $1,834,151.00 $767,203.41 $1,127,145.29 $2,728,236.84 $917,806.84 $132,853.00 $2,096,752.54 $0.00 $772,784.00 $1,373,050.00 $0.00 $0.00 $581,057.08 $148,734.00 $0.00 $0.00 $866,227.21 $7,497,189.15 $822,979.31 $32,143,214.13 $2,886,217.48 ($4,610,971.67) $952,979.31 $37,410,126.00 $130,000.00 $5,136,911.89 *Housing Provider t$1,408,811.83 is for increased services in all BHRNs. 12
East County BHRN Budget Reconciliation with Housing Additions and OAC Feedback Original Request $984,137.29 $545,025.00 $501,030.50 $391,561.00 $249,878.00 $1,160,091.25 $376,532.00 $1,442,832.00 $146,811.23 $95,473.40 $823,606.00 $930,686.00 $337,494.00 New Request $645,324.95 ($338,812.34) $545,025.00 $1,008,030.50 $395,361.00 $249,878.00 $909,477.50 $376,532.00 $1,442,832.00 $146,811.23 $95,473.40 $823,606.00 $896,018.15 $337,494.00 $45,000 n/a n/a $8,357,956.81 Difference Grantee Cascadia, Inc. CODA, Inc. The Insight Alliance* Iron Tribe Network* Morrison Child and Family Services New Avenues for Youth Northwest Family Services Pathfinder Network Phoenix Rising Raphael House of Portland Volunteers of America Oregon Bright Transitions* Yasiin's Luv LLC The 4th Dimension* Mental Health & Addiction Association of Oregon WomenFirst Transition & Referral Center* Total *Housing Provider tIncreases are accounted for in previous slides and will be used in all BHRNs $0.00 $507,000.00 $3,800 $0.00 ($250,613.75) $0.00 $0.00 $0.00 $0.00 $0.00 ($34,667.85) $0.00 $45,000 n/a n/a n/a n/at n/at $7,985,157.67 $372,799.14 13
No Wrong Door BHRN Budget Reconciliation with Housing Additions and OAC Feedback Grantee Cascade Aids Project Lutheran Community Services OHSU, Addiction and Complex Pain OHSU, Partnership Project Portland Street Medicine Providence Portland Medical Foundation The Everly Project The Marie Equi Institute The 4th Dimension* Cascadia Behavioral Health Pathfinders of Oregon SE Works, Inc. Yasiin s Luv, LLC Total Original Request New Request Difference $359,175.90 $1,257,742.00 $15,028.20 $56,875.00 $489,725.00 $359,175.90 $1,257,742.00 $15,028.20 $56,875.00 $489,725.00 $0.00 $0.00 $0.00 $0.00 $0.00 $3,744,670.00 $89,310.00 $665,754.81 $3,741,918.00 $89,310.00 $665,754.81 ($2,752.00) $0.00 $0.00 n/at n/at n/at n/at n/at n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a $6,678,280.91 $6,675,528.91 ($2,752.00) *Housing Provider tIncreases are accounted for in previous slides and will be used in all BHRNs 14
Latino/a/x BHRN Budget Reconciliation with Housing Additions and OAC Feedback Grantee Central City Concern Puentes Juntos LLC Northwest Instituto Latino De Adicciones The 4th Dimension* SE Works, Inc. Pathfinders of Oregon New Avenues for Youth Northwest Family Services Total Original Request New Request Difference $550,213.00 $490,850.00 $1,071,605.98 $550,213.00 $490,850.00 $1,071,605.98 $497,584.62 $0.00 $0.00 $0.00 n/a n/a n/a n/a n/a $497,584.62 n/a n/a n/a n/a n/at n/at n/at n/at $2,112,668.98 $2,113,166.56 $497,584.62 *Housing Provider tIncreases are accounted for in previous slides and will be used in all BHRNs 15
Pro-Rating Additional Funds Per OAC guidance - if the county region is still under budget after additional housing options are funded, OHA will pro-rate the remaining funds to non-housing providers. Pro-rated funds were calculated as a percentage of the original request, relative to the total of the non-housing providers. Additional pro-rated funds could not be used to fund reductions that the OAC made. Pro-rated funds may be used to expand services, to expand capacity to offer services, or to increase wages to a livable wage. Some providers decided not to use their pro-rated funds or shared them with smaller organizations. 16
Pro-rating remaining funds $4,140,772.69 remained in allocation after housing additions Grantee Original Request Indigeninity BHRN Providers Alano Club of Portland $1,021,174.20 MetroPlus Association (Addiction Counselor Certification Board of Oregon) $363,820.00 Outside In $1,834,151.00 Painted Horse Recovery $767,203.41 SE Works Inc $917,806.84 Sovalti LLC $132,853.00 The Mental Health Association of Oregon $2,886,217.48 East Multnomah BHRN Providers Cascadia, Inc. $645,324.95 CODA, Inc. $545,025.00 Morrison Child and Family Services $249,878.00 New Avenues for Youth $909,477.50 Northwest Family Services $376,532.00 Pathfinder Network $1,442,832.00 Phoenix Rising $146,811.23 Raphael House of Portland $95,473.40 Volunteers of America Oregon $823,606.00 Yasiin's Luv LLC $337,494.00 Percentage Pro-Rate New Totals 3.72% $153,834.39 $1,175,008.59 1.32% 6.67% 2.79% 3.34% 0.48% $54,807.52 $276,304.97 $115,575.06 $138,262.66 $20,013.59 $418,627.52 $2,110,455.97 $882,778.47 $1,056,069.50 $152,866.59 27.28% $1,129,411.17 $4,015,628.65 3.58% 1.98% 0.91% 4.22% 1.37% 5.25% 0.53% 0.35% 3.00% 1.23% $148,254.98 $82,105.08 $37,642.78 $174,761.50 $56,722.52 $217,354.87 $22,116.32 $14,382.55 $124,071.81 $50,841.65 $793,579.93 $627,130.08 $287,520.78 $1,084,239.00 $433,254.52 $1,660,186.87 $168,927.55 $109,855.95 $947,677.81 $388,335.65 17
Pro-rating additional funds Grantee Original Request Percentage Pro-Rate New Allocation No Wrong Door BHRN Cascade Aids Project $359,175.90 1.31% $54,107.92 $413,283.82 OHSU, Addiction and Complex Pain $15,028.20 0.05% $2,263.92 $17,292.12 OHSU, Partnership Project Portland Street Medicine $56,875.00 $489,725.00 0.21% 1.78% $8,567.91 $73,774.43 $65,442.91 $563,499.43 Providence Portland Medical Foundation $3,741,918.00 13.62% $564,114.37 $4,306,032.37 The Everly Project $89,310.00 0.32% $13,454.07 $102,764.07 Lutheran Community Services $1,257,742.00 4.58% $189,472.06 $1,447,214.06 The Marie Equi Institute $665,754.81 2.42% $100,292.38 $766,047.19 Latino/a/x Multnomah County BHRN Central City Concern Puentes $550,213.00 2.00% $82,886.63 $633,099.63 Juntos LLC $490,850.00 1.79% $73,943.91 $564,793.91 Northwest Instituto Latino De Adicciones $1,071,605.98 3.90% $161,431.67 $1,233,037.65 Total $54,708,951.48 100% $4,140,772.69 $58,849,724.17 Allocation Under Allocation $4,140,772.69 $0.00 18
Pro-rating additions Alano Club: Increased renovation costs to expand capacity and added two vans to increase programming and capacity. MetroPlus Association (Addiction Counselor Certification Board): Added an LGBTQIA+ outreach coordinator and training, also added BIPOC and LGBTQIA+ recruitment and training vouchers. Outside In: Revised salaries to provide a livable wage and increased supply budget for approved services. Painted Horse: Will fully cover recovery center lease/utilities; will purchase a van and increase budget for supplies. SE Works, Inc.: Added two new positions to increase supported employment services to clients. These positions will provide active job mentoring at the worksite. Sovalti LLC: Added a counselor staff position. Mental Health & Addiction Assn. of Oregon: Added culturally- specific peer services, BHRN coordinator, increased rent to support larger staff. 19
Pro-Rating Additions Cascadia, Inc.: Removed medical positions and swapped in 4 FTE CRMs and 2 FTE CADCs. Morrison Child & Family Services: Increased pay for parent mentors in alignment with OAC feedback. New Avenues for Youth: Funded additional client assistance and incentive budget; also increased street outreach budget. NW Family Services: The original budget over-estimated the amount of Medicaid reimbursement for a new program. This budget adjusts for that discrepancy as well as increases funding for supplies. Also included is a CADCII and a part-time case manager. Pathfinders of Oregon: Added a 0.15 FTE administration staff to assist with data reporting and added a peer support specialist and increased peer basic needs assistance to expand capacity. Phoenix Rising: Hire a 0.5 peer supervisor Raphael House: Increased direct client supports. Volunteers of America, Oregon: Funding a part-time peer clinical supervisor who will also be responsible for BHRN activities and coordination, and client incentives. 20
Pro-Rating Additions Yasiin s Luv LLC: Increased living wages for staff, increased budget for training, increased budget for rent/furniture/bookkeeping as a result of inflation and rental increases since original budget. Lutheran Community Services: Added rent, which was accidentally left out of the original budget. Also added a SUD Community Outreach & Engagement Coordinator, increased direct client assistance funds. Portland Street Medicine: Increased salaries to provide a livable wage. Increased budget for supplies and infectious disease screening. Providence Portland Medical Foundation: Additional funds will go to increased construction costs for a new Sobering and Recovery Center and for approved services. 21
Pro-Rating Additions The Everly Project: Added salaries to volunteer positions. Marie Equi Institute: Additional staffing costs & increased staff wages. CCC Puentes: Added 0.7 FTE lead/supervisor CADC to provide operational support for the BHRN and direct SUD services to clients. Juntos LLC: Added funds to personnel positions to retain & recruit key positions and fund additional staff training costs. Also added in funds for direct client services (food and housing assistance). NW Instituto Latino: Increased funding for case management and social safety net support for undocumented clients; increased funding for rent to accommodate a larger staff; increased professional development opportunities for staff. 22
Indigeninity BHRN Final Budgets Grantee Alano Club of Portland Bridges to Change Fresh-Out Community Based Re-Entry Program Going Home II Just Men In Recovery MetroPlus Association (Addiction Counselor Certification Board of Oregon) The Miracles Club Oregon Change Clinic Outside In Painted Horse Recovery Project Patchwork Project Quest (Quest Center for Integrative Health) SE Works Inc Sovalti LLC The 4th Dimension Recovery Center The Mental Health & Addiction Association of Oregon WomenFirst Transition & Referral Center Original RequestNew Request $1,021,174.20 $4,588,039.84 $429,761.00 $3,920,496.00 $1,218,008.00 Difference $1,175,008.59 $8483,789.84 $494,408.00 $4,954,114.00 $2,230,024.50 $153,834.39 $3,895,750.00 $64,647.00 $1,033,618.00 $1,012,016.50 $363,820.00 $2,428,293.00 $1,845,323.00 $1,834,151.00 $767,203.41 $546,088.21 $2,579,502.84 $917,806.84 $132,853.00 $1,230,525.33 $7,497,189.15 $822,979.31 $418,627.52 $3,201,077.00 $3,218,373.00 $2,110,456.00 $886,221.67 $1,127,145.29 $2,807,764.31 $917,806.84 $152,866.59 $2,096,752.54 $4,015,518.63 $952,979.31 $54,807.52 $772,784.00 $1,373,050.00 $276,305.00 $119,018.26 $581,057.08 $228,261.47 $1,056,069.50 $20,013.59 $866,227.21 ($3,481,670.52) $130,000.00 23
Indigeninity Final BHRN Screening Interventio SUD Treatment Peer Support x x x HousingHarm Supported Employment n Planning Reduction x The 4th Dimension* Alano Club Bridges to Change Fresh Out Community Based Reentry Program Going Home II Just Men in Recovery MetroPlus Assn (Addiction Counselor Certification Board of Oregon) Mental Health & Addiction Association of Oregon* The Miracles Club Oregon Change Clinic Outside In Painted Horse Recovery Project Patchwork Quest Center SE Works, Inc.* Sovalti WomenFirst Transition & Referral Center* x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x *Participating in more than one BHRN 24
East County BHRN Final Budgets Original Request Grantee Cascadia, Inc. CODA, Inc. The Insight Alliance Iron Tribe Network Morrison Child and Family Services New Avenues for Youth Northwest Family Services Pathfinders of Oregon Phoenix Rising Raphael House of Portland Volunteers of America Oregon Bright Transitions Yasiin's Luv LLC The 4th Dimension Mental Health & Addiction Association of Oregon WomenFirst Transition & Referral Center New Request $797,355.41 $545,025.00 $1,008,030.50 $395,361.00 $287,521.13 $1,059,239.00 $512,761.25 $1,660,187.00 $168,927.55 $109,855.95 $947,613.96 $896,018.15 $388,335.65 Difference ($186,781.88) $984,137.29 $545,025.00 $501,030.50 $391,561.00 $249,878.00 $1,160,091.25 $376,532.00 $1,442,832.00 $146,811.23 $95,473.40 $823,606.00 $930,686.00 $337,494.00 $0.00 $507,000.00 $3,800.00 $37,643.13 ($100,852.25) $136,229.25 $217,355.00 $22,116.32 $14,382.55 $124,007.96 ($34,667.85) $50,841.65 $45,000 n/a $45,000 n/a n/a n/a n/a n/a* n/a* *Increases are accounted for in previous slides and will be used in all BHRNs. 25
East County Final BHRN Intervention Planning SUD Treatment Peer Services Housing x Harm Reduction x Supported Employment Screening The 4th Dimension* Cascadia Behavioral Health* CODA, Inc. The Insight Alliance Iron Tribe Network Mental Health & Addiction Association of Oregon* Morrison Child & Family Servoces New Avenues for Youth Northwest Family Services Pathfinder Network* Phoenix Rising Transitions Raphael House Volunteers of America Oregon x WomenFirst Transition & Referral Center* Yasiin's Luv* Bright Transitions x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x *Participating in more than one BHRN 26
No Wrong Door BHRN Final Budgets Grantee Cascade Aids Project Lutheran Community Services OHSU, Addiction and Complex Pain OHSU, Partnership Project Portland Street Medicine Providence Portland Medical Foundation The Everly Project The Marie Equi Institute The 4th Dimension Cascadia Behavioral Health Pathfinders of Oregon SE Works, Inc. Yasiin s Luv LLC Original Request New Request Difference $0.00 $189,472.06 $359,175.90 $1,257,742.00 $15,028.20 $56,875.00 $489,725.00 $3,744,670.00 $89,310.00 $665,754.81 $359,175.90 $1,447,214.06 $15,028.20 $56,875.00 $563,472.51 $4,306,032.37 $381,255.00 $756,047.19 $0.00 $0.00 $73,747.51 $561,362.37 $291,945.00 $90,292.38 n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a* n/a* n/a* n/a* n/a* *Increases are accounted for in previous slides and will be used in all BHRNs. 27
No Wrong Door Final BHRN Intervention Planning SUD Treatment Peer Services Housing x Harm Reduction x Supported Employment Screening The 4th Dimension* Cascadia Behavioral Health* The Everly Project Lutheran Community Services x The Marie Equi Institute New Avenues for Youth OHSU, Addiction and Complex Pain OHSU, Partnership Project Pathfinders of Oregon* Portland Street Medicine Cascade AIDS Project Providence Portland Medical Foundation SE Works, Inc.* Yasiin's Luv* x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x *Participating in more than one BHRN 28
Latino/a/x BHRN Final Budgets Grantee Central City Concern Puentes Juntos LLC Northwest Instituto Latino De Adicciones The 4th Dimension SE Works, Inc. Pathfinders of Oregon New Avenues for Youth Northwest Family Services Original Request New Request Difference $82,886.63 $73,943.91 $133,374.86 $497,584.62 $550,213.00 $490,850.00 $1,071,605.98 $633,099.63 $564,793.91 $1,204,980.84 $497,584.62 n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a* n/a* n/a* n/a* NW Institute Latino is proposing to subcontract with 4th Dimension for fiscal management, compliance, and administrative support. The 4th Dimension will provide these services as needed as NW Institute Latino builds as an organization. *Increases are accounted for in previous slides and will be used in all BHRNs. 29
Subcontracts The 4th Dimension has proposed subcontracting with Transcending Hope to provide culturally- and linguistically-specific housing in the Latino/a/x BHRN as there was no approved provider in Multnomah County that could provide these services. In addition, Painted Horse Recovery and NW Instituto Latino have requested to subcontract with the 4th Dimension to have 4D provide fiscal management, administrative support, and compliance technical assistance. 30
Latino/a/x Final BHRN Intervention Planning SUD Treatment Peer Support Harm Reduction Supported Employment Screening Housing Juntos LLC x NW Instituto Latino x CCC Puentes The 4th Dimension* x x x x x SE Works, Inc.* x Pathfinders of Oregon* x New Avenues for Youth* x Northwest Family Services* x x x x Note: The 4th Dimension is proposing to subcontract with Transcending Hope to provide culturally- and linguistically-specific housing. *Participating in more than one BHRN 31
Final Multnomah County Reconciliation Original Multnomah County request: Multnomah County Allocation: Under allocation: $48,923,706.69 $58,849,724.17 $9,930,402.48 New Multnomah County Request: Under allocation: $58,849,724.17 $0.00 32
