By LYNNE TERRY/Oregon Capital Chronicle
SALEM — Oregon lawmakers are proposing nearly $200 million to help treat more Oregonians struggling with mental health issues and addiction problems.
Hundreds of thousands of people rely on outpatient and residential programs for treatment for addiction, severe depression and other disabling mental disorders but during the pandemic they’ve often had to wait months for help.
House Bill 4004 would provide higher state payments to nonprofits that provide therapy, life skills training and addiction treatment to expand and retain staff. The proposal was developed in talks with industry leaders who said they’ve had to limit or reduce the number of patients they treat because they don’t have the money to attract enough employees to serve them.
“Across the board, behavioral health providers are struggling to attract and maintain a workforce,” said Rep. Rob Nosse, D-Portland and chair of the House Behavioral Health Committee. “This crisis is forcing the closure of programs and threatens the whole system.”
Nosse said more money is needed to keep the system afloat while that state works on long-term solutions.
Royce Bowlin, executive director of the Oregon Alliance, which advocates for children and families, agreed.
“The funding represents an essential short-term bridge for many community-based service providers serving kids, families and houseless youth,” Bowlin wrote in an email. “We still need to push forward with a long-term plan that leads to excellent, relevant and accessible services.”
During the pandemic, the demand for the mental health services have grown while the industry has continued to lose workers from burnout and low pay, according to a recent report prepared for the Oregon Health Authority.
The state ranks fourth nationwide for inadequate mental health treatment services, it said. The report said the lack of services hurts people of color and those who need culturally tailored treatment the most.
“We cannot afford to reduce access to behavioral and mental health care when many people are struggling with their mental health,” Nosse said during a hearing. “We must pay this workforce better.”
Loss of beds
Before the pandemic, Oregon had nearly 3,300 beds to treat children with addiction issues and adults and children needing mental health care, according to the Oregon Health Authority. By November 2021, the state had about 150 fewer beds. The cuts weren’t across the board. Adult mental health facilities increased capacity by adding 63 beds, while children’s mental health facilities lost about 90 beds. Residential treatment for children and adults also shrank by 145 beds.
Outpatient services also shrank, according to Chris Bouneff, executive director of the National Alliance on Mental Illness Oregon, a Portlandadvocacy group.
“The losses really are staggering,” David Baden, chief financial officer for the Oregon Health Authority testified at a recent legislative hearing. “It is a true crisis. This bill as written provides some additional resources to hopefully stem that crisis.”
The House Committee on Behavioral Health was nearly unanimous in approving the plan last week. Rep. Christine Goodwin, R-Roseburg, was the lone dissenter, explaining she doesn’t think the legislation would expand staffing.
The proposal was referred to the budget-writing Joint Ways and Means Committee for consideration. Nosse, who co-chairs the committee’s Subcommittee on Human Services, said he expects the budget committee to allocate $132 million from the general fund for hiring and retention grants and $61 million from the fund for increasing the reimbursement rates that insurers pay to providers serving Oregon Health Plan patients. Medicaid tends to pay mental health providers less than commercial insurers but it also covers more services, the health authority’s report said.
Sizeable investments in 2021
Last year’s session ended with an historic $1 billion in investments in behavioral health.
They included about $130 million for housing for people with mental health struggles and about $120 million to open behavioral health clinics statewide as part of Measure 110, which was approved by voters in November 2020. The measure decriminalized drugs with the intention to get people treated.
But so far, that’s largely not happened. The Legislature also approved about $70 million to expand capacity at the Oregon State Hospital’s Junction City campus, add staff and help with aid-and-assist patients, who’ve been languishing in jails waiting for treatment so they can aid in their criminal cases. The state hospital remains under court orders to admit such patients within seven days.
But the bottleneck continues. According to a legislative presentation earlier this month by Steve Allen, the health authority’s behavioral health director, 103 aid-and-assist patients were awaiting admission to the hospital on Feb. 4, with an average wait time of three weeks. A third of them had been waiting more than two months, he said.
Allen acknowledged that the government was moving slowly in implementing the investments. For example, it’s yet to establish peer respite centers, which were approved by the Legislature to give patients a place to go for help from others with similar experiences.
“Folks would argue that this was one of the most historic sessions in terms of behavioral health,” Nosse said, referring to the investments approved in 2021 “Unfortunately, there are no short-term fixes.”
Allen said implementing the approved programs had been slowed by the pandemic, with agency staff focused on that.
- Oregon Capital Chronicle is a nonprofit Salem-based news service that focuses its reporting on Oregon state government, politics and policy.