Talking Points for Leslie Ford – first meeting with staff of Cascadia

distributed to Cascadia admin staff, Winter of 2001

Introductory Points

  • Planned events are moving along at a predictable rate
  • The merger is on track. We expect to close by April or May
  • We’re still negotiating with Multnomah County for the Primary Provider Contract
  • Walk – In Clinic numbers are increasing, slowly at Gresham
  • Mobile Team numbers are increasing
  • Critical incidents have been minimal since merger
  • Bridgeway II opens February 7
  • Specific concerns can be addressed by supervisors

Q: What is the foreseeable future of Cascadia?

A: Most public health systems and certainly Portland’s public mental health systems are put together piecemeal. There is no “design,” or “reform,” or overarching planning effort. Typically a problem has presented itself in the form of an event or an advocate, and the bureaucracy has responded to the problem with an adjustment to its behavior. This stacking of adjustments is effective in the short run, responsive to community needs and immediate goals. But as a management tool, left unchecked for many years, these adjustments accumulate to

Our current “reform” is not a lot different. There has been substantial influence from previously unheard – not listened to – stakeholders, including some consumers of our mental health services, politicians from various parts of state and local government, advocates from allied social services, families and friends of people with mental illness. This has caused a more through investigation of the problem, and perhaps a more insightful adjustment.

The advantage of the adjustment is Cascadia, with its depth of knowledgably, its diversity, its ability to refer clients toward strengths, will better serve consumers of its mental health services.

Q: What does “client for life” mean?

The key principle to hold onto is we’re shifting clinical perspective from “episode of treatment” to “duration of engagement.” Engagement could mean a single contact – or it could mean many years of contact, depending on the individual.

Our goal is to see consumers not just as billing codes, but as people. Our challenge is to move from traditional mental health where consumers are patients, where contact comes after crisis and is minimized, where interventions are often temporary or offloading, to Public Mental Health which is system smart and system dynamic, which does long-term planning and presents a relationship of interventions and natural systems of support within the individuals own community.

The County is creating a Primary Provider Policy Manual, which will be available as a draft very soon.

Q: What does the new Verity model mean to me as a staff member of Cascadia?


Q: Will our health benefits be changing with the merger?

A: We have put our health benefits out to bid and we will be hearing from our broker in the near future concerning which companies bid on us and what the rates will be. Our hope is that as a larger company we can attract more competitive rates, however, because our utilization of health services is so high we may not make any progress on this issue.

Q: How does the merger effect seniority?

A: Original dates of hire have been transferred to Cascadia and as Unity merges, we plan to take the same steps with Unity staff.

Q: Will any facilities at Cascadia close?

A: They already have. We have consolidated the administrative offices for Cascadia downtown at the Unity offices on Fifth Avenue. This has allowed us to close our administrative offices for Network on Milwaukie Avenue.

There are no plans to close any residences or any clinics.

Q: When will Unity be fully merged with Cascadia?

A: The legal paperwork will be finished April or May. But to be fully merged is more than a legal proceeding. It means becoming one entity, one corporation, having one mission and one set of goals. We’re merging the cultures of three – or five – organizations. This is going to take time and trust.

Q: The County recently audited Cascadia programs. What was the result of the audit?

A: Cascadia’s children’s intakes were shut down at the request of Multnomah County from December 3 until we strategized a way of resolving several problems. Intakes were reopened on December 17. The problems that the audit revealed were real and substantive. We’ve made remedies and will be watching the programs carefully.

Q: Each agency has similar programming. How will these programs be merged?

A: Yes. There will be consolidation of similar programs. It’s through this reorganization that funding can be freed up to provide additional services for consumers.

Q: Will there be staff cuts in the future, capitalizing on the savings with the new administrative structure?

A: Staffing patterns will change as needed.

Q: Will any programs at Cascadia close?

A: Programming at Cascadia is an evolving process. There are no programs planned to close, but we do intend to be active and assertive in finding out what works best and moving toward that best practice.

Q: Are other mergers being planned?

A: Administrative staff is rolling out the merger of Cascadia and Unity now. Nothing will be planned until that merger is finalized and settled.

Q: What’s the impact of the Walk-In Clinics on hospitalization?

A: We’re collecting data and the County is collecting data to answer this question. What we know is the number of people coming to the Clinics is increasing slowly, and those people generally reflect the population of the area.

Q: What is the status of the Secure Evaluation Facility?

A: Currently the County is looking at two possible configurations. One is to locate the SEF at the Donald Long Center, in an unoccupied set of pods. This location has transport and possibly neighborhood problems. The second option is to physically enlarge Hooper Center and provide services there. With CCC there is the positive potential of service integration with Detox, but the construction would take several months.

Q: How will salary equity be resolved?

A: The HR department has been, and will continue to be, involved in an exhaustive effort to review equity between positions as well as individuals. This is a project that takes some time but we have already made some adjustments and will continue to do so as finances allow. We are very committed to this effort.

Q: Will vacation and sick leave hours carry over? Will there be a change in vacation and sick leave hours?

A: For Unity staff represented by the union, we will adhere to the contract language. For other employees we are putting together a proposal that combines both Mt. Hood and Network leave policies. We are hoping to have combined leave (folding sick and vacation leave together) but having holidays be separate from the leave bank. We will be explaining all this in much more detail in the next two months.

Q: Will my agency retirement plan be recognized and continued by Cascadia?

For Cascadia employees, retirement plans have been recognized and are continuing under a new plan titled Columbia Funds. It is anticipated that the same will be true for Unity employees at the time of the merger.

Q: Will there eventually be one phone system for Cascadia? Will there be a single staff directory?

A: We’re in the process of joining Mt Hood and Network’s data systems. When Unity merges, we’ll begin integrating with their data system. There should be one staff telephone and email directory very soon.

Q: Will there be a Cascadia web site?

A: There is a start-up page at Admin staff are working on building a larger, more robust site now.