Dale Jarvis and Associates’ focus was on helping ensure that the needs of at-risk and vulnerable Americans are addressed as the health and human services systems are transformed, with a particular emphasis on persons with mental health and substance use disorders. This included working with states, health plans, regional authorities, and at a national level to develop strategies that align safety net systems with general healthcare system transformation and reform efforts.


Specific areas of project work included:

    • Design and development of safety net accountable care organizations

    • Configuration of new healthcare payment models and performance measurement systems for safety net populations

    • Organization of regional health authorities to coordinate the payors of health, behavioral health, housing and social services

    • Development of person-centered health homes that include bi-directional care: behavioral health services in primary care and primary care in behavioral health

    • Research and deployment of payment strategies to finance integrated primary care/behavioral health services

The following excerpt from the American College of Mental Health Administrators’ November 2010 Newsletter provides some insight into how Dale came to this work.

My first job in healthcare was at the Ann Arbor Free People’s Clinic where I was hired in 1975 as the first financial manager with accounting experience. As I began to learn about healthcare financing, I was struck by how much money was flowing to hospitals and specialists and how little money was available for our clinic or other primary care clinics and prevention projects. I marvel at the notion that 35 years later we still have what can be described as a sick care system (in contrast to a true health care system).

My accounting professors and Deep Throat (in Bob Woodward’s account of Watergate) weren’t alone in their advice to “follow the money.” Large quantities of money flow after we become sick to hospitals, emergency rooms, surgeons, and other specialists that treat the consequences of poor lifestyles, social disparities and unmanaged chronic health conditions. Only three percent of health care dollars are spent on prevention, most primary care practices are “loss leaders” in multi-specialty groups, and mental health and substance use services in most states and private health plans are dramatically underfunded.

Picture this sick care system as an upside down triangle with two sections. The wide, upper portion of the triangle represents the 75% of American healthcare spending related to the treatment of chronic health conditions. The bottom, small, pointy part of the triangle represents all care provided further upstream – primary, secondary and tertiary prevention services; primary care; dental care, recovery-oriented behavioral healthcare, etc. In order to move to a true health care system we need to flip the resource triangle and direct substantially more resources to prevention and early intervention services and supports in order to address the underlying determinants of health, prevent health conditions from becoming chronic health conditions, and dramatically improve the management of chronic health conditions and serious behavioral health disorders when they occur.

My personal goal is to help flip this resource allocation triangle during my work life. Will we succeed? Yes! Maybe. Who knows? But it’s sure going to be an exciting ride.

Mr. Jarvis provided consultations to the following organizations between 2010, when the Affordable Care Act became law, and 2018, when Dale retired:

  • Accountable Behavioral Health Alliance, Corvallis, OR

  • Alaska Behavioral Health Association, Anchorage, AK

  • Arizona Council of Human Service Providers, Phoenix, AZ

  • Arizona State University, Center for Applied Behavioral Health Policy, Phoenix, AZ

  • AspenPointe, Colorado Springs, CO

  • Association of CMHCs of Kansas, Inc., Topeka, KS

  • Association of Oregon Community Mental Health Programs, Salem, OR

  • Behavioral Health Network of Vermont, Burlington, VT

  • Behavioral Health Resources, Olympia, WA

  • Building Changes, Seattle, WA

  • Butte County Behavioral Health, Chico, CA

  • California Alliance of Child and Family Services, Sacramento, CA

  • California Council of Community Mental Health Agencies, Sacramento, CA

  • California Institute for Behavioral Health Solutions, Sacramento, CA

  • California Primary Care Association, CA

  • California Regional Mental Health System Coalition, Willows, CA

  • Capital Area Human Services District, Baton Rouge, LA

  • Cascadia Behavioral Healthcare, Portland, OR

  • Center for the Application of Substance Abuse Technologies

  • Centerstone, Columbus, IN

  • Clackamas County Behavioral Health Services, Oregon City, OR

  • Clark County Department of Community Services, Vancouver, WA

  • Colorado Behavioral Healthcare Council, Denver, CO

  • Colorado Community Health Network, Denver, CO

  • Community Health Plan of Washington, Seattle, WA

  • Community Psychiatric Clinic, Seattle, WA

  • Downtown Emergency Service Center, Seattle, WA

  • Empire Health Foundation, Spokane, WA

  • EMQ-Families First, Campbell, CA

  • Fischer Child Care Association of Illinois, Springfield, IL

  • Georgetown University, Washington, DC

  • Georgia Association of Community Service Boards, Douglasville, GA

  • Greater Lakes Mental Healthcare, Lakewood, WA

  • Greater Oregon Behavioral Health, Inc. The Dalles, OR

  • Health Share of Oregon, Portland, OR

  • Hope Network, Grand Rapids, MI

  • Inland Empire Health Plan, Rancho Cucamonga, CA

  • Integrated Behavioral Health Partnership, CA

  • Jefferson Behavioral Health, Grants Pass, OR

  • Kiely Group, Placerville, CA

  • King County Department of Community and Human Services, Seattle, WA

  • Kitsap Mental Health Services, Bremerton, WA

  • LaneCare, Eugene, OR

  • Larimer Center for Mental Health, Ft. Collins, CO

  • Los Angeles County Department of Mental Health, Los Angeles, CA

  • Marin County, San Rafael, CA

  • Michigan Association of Community Mental Health Boards, Lansing, MI

  • Mid-Valley Behavioral Care Network, Salem, OR

  • Missouri Coalition of Community Mental Health Centers, Jefferson City, MO

  • Multnomah County Mental Health and Addiction Services Division (MHASD), Portland, OR

  • National Association of County Behavioral Health & Developmental Disability Directors, Washington, DC

  • National Council for Behavioral Health, Washington, DC

  • Navos, Seattle, WA

  • New Jersey Department of Human Services, Trenton NJ

  • New Mexico Behavioral Health Services Division, Santa Fe, NM

  • New York Association of Psychiatric Rehabilitation Services

  • North Sound Mental Health Services Administration, Mt. Vernon, WA

  • Northwest Regional Primary Care Association, Seattle, WA

  • Ohio Council of Behavioral Health & Family Services Providers, Columbus, OH

  • Oregon Alliance of Children's Programs, Salem, OR

  • Oregon Prevention Education & Recovery Association (OPERA), Portland, OR 97239

  • Oregon Psychological Association, Portland, OR

  • Peninsula Regional Support Network, WA

  • Penn Foundation, Sellersville, PA

  • Pennsylvania Community Providers Association, Harrisburg, PA

  • PEOPLe, Inc., Poughkeepsie, NY

  • Philadelphia Department of Behavioral Health and Intellectual disAbility Service, Philadelphia, PA

  • Policy Research Associates, Delmar, NY

  • Ryther Child Center, Seattle, WA

  • San Mateo County Behavioral Health and Recovery Services, San Mateo CA

  • Santa Clara County, San Jose, CA

  • Sonoma County DHS Behavioral Health Division, Santa Rosa CA

  • Southwest Washington Behavioral Health, Vancouver WA

  • Southwest Washington Regional Health Alliance, Vancouver WA

  • Spokane Mental Health, Spokane, WA

  • Spokane Regional Support Network, Spokane, WA

  • St. Charles Health System, Bend, OR

  • Stoel Rives LLP, Seattle, WA

  • Telecare Corporation, Alameda, CA

  • The Institute For Behavioral Health Integration, Corvallis, OR

  • Tides Foundation, San Francisco, CA

  • Tri-County Medicaid Cooperative:

  • Trillium Community Health Plan, Eugene, OR

  • Tri-State Memorial Hospital, Clarkston, WA

  • TriWest Group, Boulder, CO

  • UCLA Integrated Substance Abuse Programs, Los Angeles, CA

  • University of Washington. AIMS Center, Seattle, WA

  • Urban Institute for Behavioral Health, New York, NY

  • Washington Community Mental Health Council, Seattle, WA

  • Washington County Community Mental Health Program, Hillsboro, OR

  • Washington State Health Care Authority, Olympia WA

  • Washington State Hospital Association, Seattle, WA

  • Wayne State University Physician Group, Detroit, MI

  • Wellness and Education Board of Central Oregon, Redmond, OR

  • Westat, Inc. Rockville, MD

  • Yamhill County Care Organization, McMinnville, OR

For more information please contact:

John Freeman, Administrator

Dale Jarvis and Associates, LLC

Seattle, WA