[Sora] OHA Ombuds 6 Month Report and Ombuds Charter

[PINNEY Ellen]

Hello SORA colleagues,

I have been remiss in ensuring you receive a copy of the OHA Ombuds Six Month 2024 Report<https://www.oregon.gov/oha/ERD/OmbudsProgram/OHA%20Ombuds%202024%206%20Month%20Report.pdf>.  It is also attached.  You can find all Ombuds reports on the OHA Ombuds website here<https://www.oregon.gov/oha/erd/pages/ombuds-reports.aspx>.

I have also attached the recently approved Ombuds Team Charter<https://www.oregon.gov/oha/erd/OmbudsProgram/Ombuds-Program-Charter.pdf>,  finalized with the help of Director Hathi and the Medicaid Advisory Committee, which codifies the intent and authority of the Ombuds program.  You can find the Charter and its signatories on the Ombuds website here.<https://www.oregon.gov/oha/erd/pages/ombuds-reports.aspx>

Ombuds logged 1396 concerns for the first six months of 2024.  1058 of those concerns related to Medicaid / Oregon Health Plan challenges.  Concerning trends continue to include:

  *   Access to appropriate behavioral health support and services.
  *   Non emergency medical transportation included wrong ride, no shows, late shows and long standing provider appointments missed.
  *   Unmet housing needs drove the number and equity related concerns Ombuds received related to health related services (HRS) or/and health related social needs (HRSN).  Clients, hopeful if not confident that they might qualify, shared they felt abandoned or ignored by their CCO or provider.  Providers expressed exhaustion about the amount of paperwork required for what was more often than not, a non-response.
  *   Eligibility, specifically continued Medicaid eligibility for those who are Medicare eligible as Oregon comes to the end of the public health emergency unwinding.  When clients with Medicare lose Medicaid, they lose most access to NEMT, dental care and mental health services which Medicare does not do a good job of supporting.
  *   Dental care, access to timely dental services and challenges with dentures.

The next Ombuds report will summarize case volume and case themes for all of 2024.  In addition, the year end report will highlight ways the OHA Ombuds team has engaged community in identifying not only issues but solutions for the concerns we hear about.   You should expect to see the Ombuds 2024 Year End report early next year.

I would welcome observations and questions about anything you read here.

Ombuds work would not be possible without your own.  We are stronger together.

Yours on behalf of the Ombuds team and those we collectively serve,


To health,

Ellen Pinney
Ombuds
(She/Her)
Oregon Health Authority
Ellen.Pinney at oha.oregon.gov<mailto:Ellen.Pinney at dhsoha.state.or.us>
Cell: 503-884-2862 /Toll Free: 877-642-0450
OHA.OmbudsOffice at odhsoha.oregon.gov<mailto:OHA.OmbudsOffice at odhsoha.oregon.gov>

-------------- next part --------------
An HTML attachment was scrubbed...
URL: <https://omls.oregon.gov/pipermail/sora/attachments/20241216/6caed1e3/attachment.html>
-------------- next part --------------
A non-text attachment was scrubbed...
Name: OHA Ombuds Team Charter with Signatures.pdf
Type: application/pdf
Size: 1970846 bytes
Desc: OHA Ombuds Team Charter with Signatures.pdf
URL: <https://omls.oregon.gov/pipermail/sora/attachments/20241216/6caed1e3/attachment.pdf>
-------------- next part --------------
A non-text attachment was scrubbed...
Name: OHA Ombuds 2024 6 Month Report Desktop FINAL (7).pdf
Type: application/pdf
Size: 1765035 bytes
Desc: OHA Ombuds 2024 6 Month Report Desktop FINAL (7).pdf
URL: <https://omls.oregon.gov/pipermail/sora/attachments/20241216/6caed1e3/attachment-0001.pdf>