Case Studies

Behavioral Health Service Hub & Pod Village for Houseless Adults

Rural communities in Oregon often struggle to meet their behavioral health and affordable housing needs, especially for low-income and houseless adults. Rather than compete for resources, a social services nonprofit based in Forest Grove, Oregon envisioned a centralized hub where behavioral health providers in neighboring communities could connect with houseless adults. Acknowledging that behavioral health services alone could not address basic needs, a supportive housing pod village in a nearby location is in development as a means of provide these community members a place to live while they navigate options for more permanent, affordable housing.

Without in-house expertise in behavioral health or supportive housing, the social services nonprofit partnered with Lones Management Consulting to assess the community's needs, design an operating model for the service hub and pod village, and provide project management for construction.

The service hub design is rooted in the principles of low-barrier access for both clients and provider-partners, lived-experience, and sustainability. The pod village design includes onsite facilities to host programs aimed towards helping residents pursue recovery and develop the job skills they need to find employment.

Elder Community Resiliency Campus

According to the Oregon Legislature, the Portland Metro needs an additional 49,000 affordable housing units to meet current demand, and forecasts point to difficult market conditions for decades to come. Low-income seniors are particularly vulnerable to these market conditions, as many live on fixed incomes and face a higher likelihood of experiencing adverse life event such as the loss of a spouse or developing a chronic illness. To address the unmet needs of Portland's seniors, a faith-based social service nonprofit located in Northeast Portland is developing a two-acre campus that integrates transitional housing with onsite programs to provide nutritional assistance, mental health support, health system navigation, oral health care, and workforce development.

Lones Consulting was engaged to conduct research and produce an initial set of recommendations regarding feasibility. Moving into Phase II of the project, LMC is providing strategic advisory, grant development, and project management support for the eight-figure capital campaign; conducting a sustainability study, and project managing the pre-construction due diligence necessary to make the site 'shovel ready'. The project is on track to break ground in early 2025 with an estimated completion date of mid-2026.

Medicaid Reimbursement for a Housing & Shelter Nonprofit

Becoming a Medicaid-billable provider can be a significant challenge for growing nonprofits with limited resources, but achieving this status is often critical for their long-term sustainability. Housing organizations in Washington are eligible for Medicaid reimbursement through the Foundational Community Supports (FCS) program, which is run by Washington Health Care Authority, the agency responsible for administering Medicaid throughout Washington. A nonprofit based in Vancouver, Washington that provides shelter, rapid rehousing, and permanent supportive housing engaged Lones Consulting to assist them in achieving Medicaid-billable provider status with the goal of supporting their programs through FCS.

Lones Consulting researched the requirements, conducted an organization-wide risk assessment, complied data, developed policies and procedures, and produced a report which included prioritized recommendation and an implementation plan. After careful consideration, Lones Consulting was asked to complete the application process on the behalf of the organization.

SWOT Assessment for a Growing Housing & Health Provider

A common challenge for nonprofits providing outpatient healthcare and housing services is diversifying programs while maintaining the balance necessary to ensure all their programs thrive. A Federal Qualified Health Center in Portland, Oregon providing mental health services, addiction recovery support, primary care, wellness programs, and permanent affordable housing engaged Lones Consulting to conduct a SWOT assessment to gain a global view of the organizations strengths, weaknesses, opportunities, and threats.

Lones Consulting interviewed internal and external stakeholders and produced a report outlining recommendations to assist with future program development, quality improvement, and risk management.

Portland 24/7 First Responder Drop-off Center

The Portland area lacks a low-barrier 24/7 facility to take people experiencing acute intoxication
and co-occurring conditions. As a result, first responders and law enforcement have few options
for helping individuals in crises other than jail or the emergency department. This leads to poor
outcomes and increased concerns around community safety, including limiting people’s ability to
stay housed.

In response, Lones consulting was engaged by Multnomah County to align stakeholders on a shared vision and develop a 24-7 Drop-off Center that will provide:

A “no wrong door” approach for Multnomah County’s first responders to deflect individuals in a crisis from emergency departments and jails, providing another option other than being left on the streets in crisis
A multidisciplinary care team that will provide trauma-informed, culturally responsive services, including:
- Rapid intake, triage, and assessment
- Appropriate treatment such as sobering and early withdrawal management
- Peer provider support, care coordination and transfers to other providers in the care continuum such as residential detox and withdrawal management providers, psychiatric emergency services, day centers, and transitional housing
Distinct milieus, quiet rooms, and security staff with de-escalation training and management support to create the safest environment possible for staff and clients
A commitment to 24/7 Drop-off clients and members of the surrounding community to proactively discharge and transport clients to a treatment facility that can support their next step to recovery or a designated location within a specified geographic range
The capacity to verify and document client transfers to providers in the behavioral health crisis continuum.
Evaluation, continuous quality improvement and data sharing to help drive performance, transparency, and accountability across the crisis continuum.

The model will also include a new transportation program to assist first responders in the field,
providers, and 24/7 Drop-off clients. The transportation capability will:

Transport intoxicated individuals from the street to the 24/7 Drop-off
Coordinate transportation to the 24/7 Drop-off with local dispatchers, first responders, and community providers
After clients receive sobering services, support care coordination by transporting individuals to their next step or a designated location
As needed, support rapid transfer of clients who are triaged with a high acuity medical or behavioral health need that the 24/7 Drop-off is not scoped to provide

Critical dependencies that are out of scope for this project, but critical for the broader behavioral health continuum in addressing the drug crisis include:

Residential withdrawal management and treatment
Psychiatric services for individuals with severe and persistent mental illness
Building the operational model based on currently existing Medicaid payment mechanisms

Summary 24/7 Drop-off Center Flow

Community Health Worker Billing and Quality Standards Hub

Community-based community health worker (CHW) programs can be a critical and proven resource for addressing health equity. Current payment models for CHWs are usually inefficient and difficult to navigate due to heavy administrative burden, insufficient understanding of scope, and inability to measure patient wellness outcomes. These factors can impact provider quality and revenue cycle, and lead to incomplete or inaccurate reporting by payers.

A state-wide community health worker’s association has partnered with Lones Management Consulting to develop a third-party “hub” solution for payers and providers. The new model will create a shared vision for a regional network of community-based organizations with CHW programs. As a hub, the association will provide third-party billing services and clinical supervision to the network. Goals of the project include:

Formation of a regional network of CHW providers with a shared focus on tools and standards.
Enhanced performance reporting and regulatory compliance from standardized data collection and tracking practices.
Improved revenue cycle leading to reduction of billing errors and better payment.
Increased support of CHWs and groundwork for effective value-based payment models focused on health equity and the reduction of disparities.

Safety Net Clinic and Workforce Pathway Program

Health systems are experiencing a severe workforce shortage that is compounded by a gap in cultural and language competency. At the same time, many safety-net providers are unable to keep up with the need for services.

With the support of Lones Consulting, a safety-net clinic and community college partnered to develop a campus clinic that has expanded access and addressed workforce shortages in the community. The clinic opened on the college campus in July 2023 and now offers primary care for the uninsured as well as students. The new space houses an innovative workforce pathway program, that offers students enrolled in MA and RN tracks a fresh approach to training in community-based healthcare, so they can pursue job opportunities within local health systems confidently.

The Lones Consulting team worked with the project partners from its inception through to project completion, providing strategic advisory support and grant development for its capital campaign, and functioning as the owner representative, project managing all phases of clinic development.

Peer Recovery Campus

One-on-one peer-delivered service programs are a proven way to improve outcomes for individuals with mental health and substance use issues. Yet there is often a common barrier of no centralized physical location for individuals to access these peer services. At a regional level, the need for such a center has been exacerbated dramatically due to the increased isolation, job loss and stress caused by the COVID19 pandemic.

In response, LMC is helping a statewide mental health and addictions association that specializes in peer-provider workforce programs develop a peer recovery campus. Scheduled for a 2024 opening, the new campus will be a headquarters for the organization and a multi-service hub with community partners, while providing housing, peer services and training programs. The new campus will serve as a welcoming place with resources for “peers,” i.e., people with mental health and/or co-curing mental health and addiction experiences, to be in community with each other, where they are free to be themselves and define their own recovery.

Lones Management Consulting has been engaged since the project’s inception to provide strategic advisory support and grant development for its capital campaign, an function as the owner representative, project managing all phases of campus development.

Safety Net Clinic Community of Practice

Community supported clinics play a critical role in the safety-net, providing essential medical services to individuals unable to access care. Often providing free care, and staffed with volunteer providers, these clinics rely heavily on community grants and donations and commonly struggle to maintain workforce continuity due to funding constraints.

Lones consulting was engaged by a partnership of five regional health systems and payers to provide individualized strategic advisory support for capacity building efforts to their grantee cohort of 13 community supported clinics. Goals of the ongoing engagement have included technical assistance to help the clinic grantees meet the unmet needs of the communities they serve, enhance population health, and support the long-term sustainability of each organization.

Over time, the health system partners have recognized not only the incredible value and vibrancy that each grantee brings to the community, but also the opportunity to build linkages, shared goals and a funding platform for the entire cohort. From this, the consortium has expanded the role of the Lones consulting team to include the development of a community of practice for the clinic grantees. Goals of the community of practice include:

Help clinic grantees wishing to partner to identify shared goals, and grant opportunities
Align these grantees on a plan to collectively pursue grant funding for identified goals, market the partnership, and effectively manage shared grant funds
Develop a proposal on behalf of the grantee partners to fund identified goal(s), pending grantee participation, alignment, and the availability of grant opportunities