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<p class="MsoNormal"><span style="font-size:12.0pt;font-family:"Verdana",sans-serif;color:black">Hello SORA colleagues,
</span><span style="font-size:12.0pt;font-family:"Verdana",sans-serif;color:black"><o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:12.0pt;font-family:"Verdana",sans-serif;color:black"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:12.0pt;font-family:"Verdana",sans-serif;color:black">I have been remiss in ensuring you receive a copy of the
<a href="https://www.oregon.gov/oha/ERD/OmbudsProgram/OHA%20Ombuds%202024%206%20Month%20Report.pdf">
OHA Ombuds Six Month 2024 Report</a>. It is also attached. You can find all Ombuds reports on the OHA Ombuds website
<a href="https://www.oregon.gov/oha/erd/pages/ombuds-reports.aspx">here</a>.<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:12.0pt;font-family:"Verdana",sans-serif;color:black"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:12.0pt;font-family:"Verdana",sans-serif;color:black">I have also attached the recently approved
<a href="https://www.oregon.gov/oha/erd/OmbudsProgram/Ombuds-Program-Charter.pdf">
Ombuds Team Charter</a>, 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
<a href="https://www.oregon.gov/oha/erd/pages/ombuds-reports.aspx">here.</a> <o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:12.0pt;font-family:"Verdana",sans-serif;color:black"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:12.0pt;font-family:"Verdana",sans-serif;color:black">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:<o:p></o:p></span></p>
<ul style="margin-top:0in" type="disc">
<li class="MsoListParagraphCxSpFirst" style="color:black;margin-left:0in;mso-add-space:auto;mso-list:l0 level1 lfo3">
<span style="font-size:12.0pt;line-height:105%;font-family:"Verdana",sans-serif">Access to appropriate behavioral health support and services.
<o:p></o:p></span></li><li class="MsoListParagraphCxSpMiddle" style="color:black;margin-left:0in;mso-add-space:auto;mso-list:l0 level1 lfo3">
<span style="font-size:12.0pt;line-height:105%;font-family:"Verdana",sans-serif">Non emergency medical transportation included wrong ride, no shows, late shows and long standing provider appointments missed.<o:p></o:p></span></li><li class="MsoListParagraphCxSpMiddle" style="color:black;margin-left:0in;mso-add-space:auto;mso-list:l0 level1 lfo3">
<span style="font-size:12.0pt;line-height:105%;font-family:"Verdana",sans-serif">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.<o:p></o:p></span></li><li class="MsoListParagraphCxSpMiddle" style="color:black;margin-left:0in;mso-add-space:auto;mso-list:l0 level1 lfo3">
<span style="font-size:12.0pt;line-height:105%;font-family:"Verdana",sans-serif">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.
<o:p></o:p></span></li><li class="MsoListParagraphCxSpLast" style="color:black;margin-left:0in;mso-add-space:auto;mso-list:l0 level1 lfo3">
<span style="font-size:12.0pt;line-height:105%;font-family:"Verdana",sans-serif">Dental care, access to timely dental services and challenges with dentures.<o:p></o:p></span></li></ul>
<p class="MsoNormal"><span style="font-size:12.0pt;font-family:"Verdana",sans-serif;color:black"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:12.0pt;font-family:"Verdana",sans-serif;color:black">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.<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:12.0pt;font-family:"Verdana",sans-serif;color:black"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:12.0pt;font-family:"Verdana",sans-serif;color:black">I would welcome observations and questions about anything you read here.<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:12.0pt;font-family:"Verdana",sans-serif;color:black"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:12.0pt;font-family:"Verdana",sans-serif;color:black">Ombuds work would not be possible without your own. We are stronger together.<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:12.0pt;font-family:"Verdana",sans-serif;color:black"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:12.0pt;font-family:"Verdana",sans-serif;color:black">Yours on behalf of the Ombuds team and those we collectively serve,
<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:12.0pt;font-family:"Verdana",sans-serif;color:black"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:12.0pt;font-family:"Verdana",sans-serif;color:black"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:12.0pt;font-family:"Arial",sans-serif;color:black;mso-ligatures:standardcontextual">To health,</span><span style="font-size:12.0pt;font-family:"Arial",sans-serif;color:black"><o:p></o:p></span></p>
<p class="MsoNormal"><i><span style="color:#1F3864;mso-ligatures:standardcontextual"><o:p> </o:p></span></i></p>
<p class="MsoNormal"><b><span style="font-size:12.0pt;font-family:"Arial",sans-serif;color:black;mso-ligatures:standardcontextual">Ellen Pinney<o:p></o:p></span></b></p>
<p class="MsoNormal"><span style="font-size:12.0pt;font-family:"Arial",sans-serif;color:black;mso-ligatures:standardcontextual">Ombuds<o:p></o:p></span></p>
<p class="MsoNormal"><i><span style="font-size:12.0pt;font-family:"Arial",sans-serif;color:black;mso-ligatures:standardcontextual">(She/Her)<o:p></o:p></span></i></p>
<p class="MsoNormal"><span style="font-size:12.0pt;font-family:"Arial",sans-serif;color:black;mso-ligatures:standardcontextual">Oregon Health Authority<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:12.0pt;font-family:"Arial",sans-serif;color:#1F497D;mso-ligatures:standardcontextual"><a href="mailto:Ellen.Pinney@dhsoha.state.or.us">Ellen.Pinney@oha.oregon.gov</a><o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:12.0pt;font-family:"Arial",sans-serif;color:black;mso-ligatures:standardcontextual">Cell: 503-884-2862 /Toll Free: 877-642-0450<o:p></o:p></span></p>
<p class="MsoNormal"><span style="color:black;mso-ligatures:standardcontextual"><a href="mailto:OHA.OmbudsOffice@odhsoha.oregon.gov"><span style="font-size:12.0pt;font-family:"Arial",sans-serif">OHA.OmbudsOffice@odhsoha.oregon.gov</span></a></span><u><span style="font-size:12.0pt;font-family:"Arial",sans-serif;color:#0563C1;mso-ligatures:standardcontextual"><o:p></o:p></span></u></p>
<p class="MsoNormal"><b><o:p> </o:p></b></p>
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