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Safe Schools Central Oregon

Potential strategies Care Network

Build the roster against a map, and do not run it on pro bono alone

Proposed, for board reviewMonths 4 to 12; the tribal partnership on the tribe's timeline

Build the roster against a map, and do not run it on pro bono alone

Named roster slots for Madras, Prineville, La Pine, Sisters and Redmond with telehealth and an in-person first visit at a school-based health center or county clinic; partnership rather than importation with BestCare (the community behavioral health provider in Madras and Prineville) and Warm Springs; a Spanish-speaking navigator share; billing insurance where a clinician accepts the family's plan, volunteer slots reserved for uninsured youth, a small rapid-access fund contracted through a clinic, and a quarterly dashboard of days to first appointment by town and insurance type.

The need runs east and north of Bend. In 2025, Jefferson County 8th graders reported a past-year suicide attempt rate about double the state’s, about 16 percent of the county’s 8th and 11th graders said they could get and use a gun without an adult’s permission, and 42 percent were not sure. Jefferson County 509J has about 314 students per counselor and no school psychologist. In a 2024 survey, only 4 of the 23 Medicaid providers offering appointments for youth had openings outside Bend. A roster that looks regional on paper will fill its Bend slots first and call it done unless the gaps are published by town every quarter.

The infrastructure for a first visit exists: certified school-based health centers in Bend, La Pine, Redmond, Sisters, Prineville and Madras, and the county-run sites reportedly turn no child away for inability to pay. BestCare, the community behavioral health provider for Jefferson and Crook counties, is reported to place clinicians in schools and to run an open access (walk-in) clinic in Madras. Warm Springs Community Counseling already provides no-fee counseling for children and youth and 24/7 crisis response for tribal members and reservation residents; the right posture is to ask the tribe and BestCare what they want amplified, not to place Bend clinicians in Madras.

Pure pro bono (clinicians donating all of their time) does not scale, and the local payment picture is tightening: the regional Medicaid plan, PacificSource Community Solutions, is cutting behavioral health rates, which providers warn means fewer local options. That makes volunteer slots precious and argues for spending them on young people the system misses, billing insurance where it exists, and buying a block of sessions from a clinic for the rest. The one number families and funders will understand is days from flag to first appointment, by town.

Why we think it works

What we would do

  1. Survey the founders' roughly 35 therapists and 100 practitioners for town, languages, Native or Latino community experience, telehealth capacity, travel willingness, which insurance plans they accept, and whether they would see Care Network youth as paying clients at a fast appointment, on a sliding fee, or in volunteer slots; publish the gaps by town every quarter.
  2. Ask BestCare (Madras and Prineville), Warm Springs Community Counseling, the school-based health centers run by Mosaic Community Health (the region's nonprofit community clinics) and the Crook Kids Clinic whether they would host first visits under their own credentialing and whether their clinicians would join the roster on their own terms; ask the Oregon Hunters Association chapters and the ranges which local therapists they know and recruit those first.
  3. Request an introductory meeting through the Warm Springs main line and Community Counseling before any outreach on the reservation; invite a Tribal Council designee and a Youth Council member to the board; put any data work under a tribal resolution; keep the partnership off year-one measures.
  4. Fund a Spanish-speaking youth navigator share at the Latino Community Association or BestCare and interpreter-supported telehealth now, rather than waiting for bilingual therapists; promote the 988 crisis line's Spanish chat and the Spanish site of SafeOregon (the state's school safety tip line) in Madras, Redmond and Prineville.
  5. Reimburse only documented mileage and telehealth costs for Jefferson and Crook referrals under a written policy, so volunteer immunity (the legal protection volunteers keep only while they are unpaid) holds; the intake coordinator, never the school, collects insurance information, if any, after the family consents.
  6. Create a rapid-access fund (target $15,000 in year one) contracted with one clinic, Mosaic's school-based health center sponsor or BestCare's Madras open access clinic, for a block of sessions for uninsured youth, so no roster volunteer is ever paid; publish sessions purchased and remaining each quarter.
  7. Track which insurance plans roster clinicians accept, quarterly, as the rate cuts take effect; raise youth time to first appointment through the Central Oregon Health Council's Regional Health Improvement Plan process, where the Medicaid plan already reports; train the coordinator and the three county district attorney victim advocates on eligibility for Crime Victims' Compensation (the state program that can help pay counseling costs for victims of crime).
  8. Follow through when a referred young person does not show: a second call to the family, telehealth from a school office or health center, and transportation help from unrestricted funds; count the share re-engaged, not only the no-show rate.

How we would know it is working

  • Roster slots filled per town, published quarterly with Bend separated from outlying towns
  • Share of Jefferson and Crook referrals seen within the ten business day target, reported quarterly
  • Number of bilingual and Native clinicians on the roster, and first visits hosted at school-based health centers or county clinics
  • Share of referrals seen at no cost to the family; rapid-access sessions purchased and used
  • No-show rate and share of no-shows re-engaged within two weeks

What could get in the way

A Bend-centered roster that looks regional on paper; Madras and Prineville slots filled by Bend clinicians driving in once a week.
Publish open slots by town every quarter, recruit by town, and let BestCare and Warm Springs clinicians join on their own terms with the group paying mileage, telehealth and the navigator share.
Bilingual and Native clinicians are the scarcest category in a workforce already short, so named slots may stay empty for a year.
Fund the navigator share and interpreter-supported telehealth now, and say so rather than list an empty slot.
Mixing paid and volunteer work for the same clinician can void volunteer immunity, and a nonprofit paying clinicians directly becomes a payer, with the obligations that brings.
Contract with one clinic for a block of sessions; keep paid sessions with separate clinicians or outside the volunteer agreement.
Arriving in Warm Springs with a program designed elsewhere, and data work on tribal students without consent, would harm the district's own relationship with the tribe.
Follow the tribe's lead, go through Community Counseling first, put any data work under a tribal resolution, and keep the tribal timeline off the group's measures.

Who we would work with: BestCare Treatment Services (the community behavioral health provider in Madras and Prineville), Confederated Tribes of Warm Springs (Tribal Council, Community Counseling), Papalaxsimisha (a Warm Springs youth and family organization), Mosaic Community Health (the region's nonprofit community clinics) and Deschutes County School Based Services, Latino Community Association and OSU Juntos (a program for Latino families and students), Lines for Life (the Oregon crisis line nonprofit; YouthLine Native and 988 Spanish), PacificSource Community Solutions (the regional Medicaid plan) and Central Oregon Health Council, District attorney victim assistance programs in Deschutes, Crook and Jefferson counties, Jefferson County 509J and Crook County school districts

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