Legislature convenes for “short” session

January 27, 2020

The Oregon Legislature will convene for a 35-day “short” session the first week in February. Ostensibly, such short sessions are supposed to be focused on rebalancing the state’s biennial budget. However, these sessions have evolved into hectic legislative sprints in which new budget asks and major policy bills are debated. Hearings and agendas are scheduled and changed on a moment’s notice, and it’s nearly impossible to follow and participate meaningfully in all that goes on.

We will have more specifics on policy bills as they are released this week. There is one important bill around workforce compensation (our community workforce is vastly underpaid) that we will support. And there may be others of interest on which we’ll report later. Until we have more on policy bills, below is an update on the Oregon Health Authority budget request and the Governor’s Behavioral Health Advisory Council, which was appointed in the fall.

* The Oregon Health Authority (OHA) is asking for about $81.6 million in new state general funds for the Oregon State Hospital, which is already approved for $496.8 million in general funds for the 2019-21 biennium. Much of the cost is tied to staffing and to shortfalls in revenue that the hospital anticipated from third-parties, such as insurance. The ask is huge — a 16 percent increase in the hospital’s state general fund budget.

(In all, the state hospital consumes around 25 percent of state general funds spent on health care via the OHA division that manages the Oregon Health Plan and community mental health. And very little to none of that spending is eligible for a federal match, unlike community-based services, which are eligible for Medicaid and Medicare matches.)

Separately, OHA will be asking for another $20 million to open more state hospital beds to accommodate the growing demand for “aid and assist” patients. These are individuals who are arrested and deemed unable to participate in the legal process due to symptoms of their mental illness.

Aid and assist isn’t truly treatment. It’s a minimal intervention so that someone is restored to “competency” so they can participate in the legal proceedings against them. Recovery, continued recuperation, continued engagement with community treatment, housing and other social determinants of health — none of these are goals of aid and assist services.

Between both budget requests, that’s $100 million in state general funds to serve a small number of people without any concurrent investment to prevent people from ever reaching this high level of acuity. In short, our system will still be overwhelmed with aid and assist patients unless we do more.

We are still working with our partners on how we will respond to these requests.

* The governor has appointed a 35-member Behavioral Health Advisory Council that is charged with helping the governor’s office to devise budget and policy proposals for the 2021 Legislature. I and several other NAMI partners were appointed to the group.

The group convened in late October and has spent most of its time examining past advisory group reports and discussing priority areas for further examination. At our last meeting, we divided into smaller “affinity” groups to examine three pressing areas — housing and housing supports, programs and services, and workforce. Council members had to choose one group on which to serve.

I am co-chairing the group on housing. Some years ago in a survey, NAMI members named housing as their No. 1 policy priority, so it seemed logical that my energy would be best spent seeing that investments and policy changes in housing reflected the varied needs that individuals and families living with mental illness present.

I don’t believe anything revolutionary or transformative will come of the Council’s work. But it’s a worthwhile endeavor that will influence the governor’s proposed budget for the 2021-23 biennium. We may even see some important policy reform. But by and large, what comes out of this group will likely be tinkering around the edges of our current system rather than major or wholesale reform.

You can follow the group’s progress at:
https://www.oregon.gov/oha/HSD/BHP/Pages/BHAC.aspx