Audit Recommends Ways to Ensure Oregon's Children Receive Needed Mental Health Treatment

Better documentation, tracking, and continuity of services is needed

An audit by  the Oregon Secretary of State’s Audits Division, identifies several ways the state could better ensure children on the Oregon Health Plan are able to access and continue with needed mental health services. This comes at a time when Oregon’s health care is undergoing a major transformation. The state is beginning to contract with newly formed Community Care Organizations to deliver integrated physical and mental health care, through networks of service providers.

“Oregon is leading the nation with a revolutionary health care transformation that focuses on overall health and prevention,” said Secretary of State Kate Brown. “As an important first step the state has made sure as many eligible Oregon children are on the Oregon Health Plan as possible through Healthy Kids. This audit goes one step further by offering valuable recommendations on how mental health services under the plan can improve so more Oregon kids can remain healthy, in school and at home with friends and family.”

Auditors found unplanned service breaks often occurred during transitions from one type of mental health service or provider to another. For example, some children completing treatment in a residential care facility had lengthy unplanned breaks before outpatient treatment began. Case files sometimes lacked explanations for service breaks and efforts to re-engage the child in mental health services.

In addition, auditors suggested that the state should focus on service timeliness, providing explanations in case files for lengthy service breaks, tracking and analyzing service breaks, and ensuring providers make adequate efforts to re-engage children when unplanned service breaks occur.

Better tracking of demographics could also be useful to ensure maximum access. For example, Hispanic children comprise 30 percent of the children in managed care however, only 3 to 4 percent are receiving mental health services. The rates of young girls and young children accessing services are also low. It is important for the state to provide close monitoring to ensure that low utilization rates among populations are a result of lower mental health needs rather than a weakness in outreach efforts or diagnoses.

National studies estimate that about one in five children nationally has a diagnosable mental health disorder and one in ten children have mental health challenges that negatively impact their ability to function in their environment.

The report, including the agency response, can be found at www.sos.state.or.us/audits.