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May 2021
In this issue ...
The Centers for Medicare & Medicaid Services (CMS) approved Oregon’s application for a Substance Use Disorder (SUD) 1115 Demonstration waiver. The waiver is effective April 8, 2021, through March 31, 2026. The waiver permits Oregon to receive federal funding for Medicaid services provided to qualifying individuals in SUD residential treatment facilities with more than 16 beds. It also expands residential treatment services by including housing and employment support in covered services.
At the guidance of CMS, the proposed Recovery Support Services were separated out from this waiver. This means peer-delivered services outside of a treatment episode will be considered for further conversation and development in the future.
This new federal funding, added to the resources provided in the Governor’s Budget for 2021-23, allows for greater investment in Oregon’s vision to prevent, identify, and treat people with substance use disorder and help them sustain long-term recovery. For more information, read about Oregon’s SUD waiver here.
The Oregon House Committee On Behavioral Health has taken bold and transformative steps this session by passing out-of-committee key bills to improve the state’s behavioral health services. The following bills have been passed and are now before the Joint Committee On Ways and Means for funding determinations:
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HB 2086, which is based upon the recommendations of Governor Brown’s Behavioral Health Advisory Council, aims to improve access to effective behavioral health services and supports for communities of color, Tribal communities, people with lived experience, adults and older youth with serious mental illness or co-occurring mental illness and substance use disorders. The bill directs the Oregon Health Authority (OHA) to adopt rules requiring coordinated care organizations (CCOs) to provide housing navigation services and address social determinants of health through care coordination.
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HB 2949 represents a significant investment in the state’s behavioral health workforce and the Health Care Provider Incentive Program. It focuses on expanding the number of people who provide behavioral health care and strengthening the diversity of our workforce by removing financial and other barriers to training.
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HB 3046 seeks to reinforce the federal parity law that requires insurance companies to provide mental health, behavioral health and substance use disorder treatment coverage on par with medical care coverage. The bill requires each carrier that offers behavioral health benefits to conduct an annual analysis of treatment limitations and report that analysis to the Department of Consumer and Business Services. Additionally, CCOs must provide an annual report on their compliance with mental health parity requirements to OHA each year.
- Planning for 988, the three-digit national number for behavioral health emergencies that goes live July 16, 2022, moves forward with the passage of HB 3069, which addresses innovative and comprehensive 988 crisis response and coordination. The scope of services that could be offered is heavily dependent upon funding levels.
OHA has selected the organizations to receive funding to provide Measure 110-related services. OHA and the Office of Contracts and Procurement received a total of 116 proposals from across the state and chose 48 awardees. The organizations chosen for funding were deemed best suited to deliver services to communities most impacted by substance use disorder and the war on drugs, including communities of color and Tribal communities.
Awardees were able to demonstrate their ability to provide:
- Peer-delivered services (including outreach, recovery mentoring, and housing retention)
- Transitional, recovery, and supportive housing assistance
- Employment programs
- Community service navigation, and
- Increased access to multiple methods of substance use treatment.
In addition, they offer services that:
- Are culturally and linguistically specific,
- Increase low-barrier, trauma-informed, and non-stigmatizing recovery and treatment,
- Support person-directed recovery, and
- Support and expand the peer-based workforce.
An 18-person evaluation committee, which included members of the Oversight and Accountability Council, as well as OHA and Oregon Department of Human Services staff, evaluated the proposals and selected the awardees. Grant agreements will be completed by June 8 and programs will begin shortly thereafter. Current funds will support programming through the end of 2021. See list of awardees here.
In April, OHA convened a Rules Advisory Committee (RAC) to discuss revising sections of the 309 Rule to include additional certification requirements for Qualified Mental Health Associates (QMHAs) and Qualified Mental Health Professionals (QMHPs). After receiving compelling feedback during the RAC, OHA decided to postpone adopting the new requirements until July 2022.
OHA has been discussing such requirements with stakeholders for several years and will continue to analyze questions that were presented during the RAC. OHA will refine some of the new rule language, reopen the amended section of the OAR in the fall of 2021 for further discussion, and make final decisions on any remaining issues by the end of December 2021. OHA will also work with the Mental Health and Addiction Certification Board of Oregon (MHACBO) to ensure people who are currently certified retain certification until the new requirements are in place.
For questions or comments on the QMHA/P certification process, please contact Greta Coe at greta.l.coe@dhsoha.state.or.us or 503-602-4444.
The Health Systems Division (HSD) is putting together a DUII Services Modernization Workgroup and strongly encourages applicants from diverse backgrounds, including individuals with lived experience, to apply. Members will be asked to:
- Review OHA’s current DUII service system,
- Review stakeholder feedback gathered through the listening sessions conducted in February,
- Review stakeholder feedback gathered through the culturally specific focus groups conducted in March and June,
- Review current research on evidence-based practices to prevent DUII recidivism, and
- Recommend system improvements to reduce DUII recidivism and ensure health equity.
Workgroup meetings will be held virtually through Microsoft Teams, with the first meeting to be held in July (date TBD). Monthly meetings are currently expected to last for six to nine months; however, the frequency or duration may be adjusted as needed to meet the goals of the workgroup.
If you are interested in being a member and would like to request a Membership Interest Form, please contact DUII Services Coordinator Marisha L. Elkins at 503-949-5822 or Marisha.L.Elkins@dhsoha.state.or.us.
HSD’s Addictions Treatment, Prevention, and Recovery Unit helps to fund innovative recovery services, like the Reclaiming Lives/Recovery Café in Medford, Oregon, and the NW Instituto Latino in SE Portland.
The Reclaiming Lives/Recovery Café provides a refuge for evidence-based addiction support, where people can find a clean, safe, warm, drug and alcohol-free space that offers free meals and a supportive community to help them achieve and sustain recovery.
Participants receive assistance with housing, social and health services, education, and employment. The program provides care along the entire continuum of a person’s path to recovery, whether they have just begun or are in long-term recovery, or dealing with a relapse, a difficult life change or mental health transition. The Café opened in 2019 and has served more than 625 people.
The NW Instituto Latino was founded in 2001 to address the lack of support for substance abuse disorders in the Latinx population in Oregon. In February of this year, NWIL opened a new Recovery Center, funded by the SAMHSA State Opioid Response Grant 2.
The center is a no-cost, low-barrier program, and provides a safe, linguistically appropriate and culturally sensitive space that is completely Latinx staffed and operated. The center conducts 15 community support meetings in Spanish, has drop-in recovery mentor services, provides harm reduction education and does COVID-19 outreach. To date, the NWIL Recovery Center has had more than 1,800 Latinx Oregonians visit the center.
OHA has published its 2020 Youth Suicide Intervention and Prevention Plan Annual Report, which outlines Oregon’s efforts to decrease the number of suicides among youth. In 2019, the rate of youth suicide in Oregon decreased from the prior year for the first time since 2015. OHA projects the rate of youth suicide reported for 2020 will decrease again, based on preliminary data. This is the first two-year decrease in youth suicide since 2008-2010.
While that information is positive, Oregon still has a long way to go. In 2019, there were 116 reported youth suicide deaths, making suicide the second leading cause of death for people ages 10-24 in Oregon. Steps to address the high number of youth suicides include:
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Funding – The legislature allocated more than six million dollars for youth suicide prevention work for the 2019-2021 biennium. OHA also applied for and received several grants related to suicide prevention across the lifespan. These funds allowed OHA, its contractors, and the Alliance to Prevent Suicide to stand up several statewide programs for suicide prevention, intervention and postvention, and additional funds were necessary for OHA’s Suicide Prevention staff to be responsive to the unique circumstances that occurred in 2020 due to COVID-19.
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Staffing – OHA added 3.0 FTE to its Suicide Prevention team:
- An adult suicide prevention and intervention coordinator,
- A second youth suicide prevention coordinator, and
- A zero suicide in healthcare coordinator.
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Statewide access to best practices – Oregon is one of the only states in the nation to offer low or no-cost suicide prevention programming to communities. The programs are designed to:
- Increase protective factors for Oregon’s children, youth and young adults,
- Train adults to recognize warning signs of suicide, and
- Equip youth-serving providers with critical skills to treat suicide ideation.
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COVID-19 response – In March 2020, OHA convened a team of internal subject matter experts and external stakeholders, including older adults, veterans, school-based health centers and mental health providers, as well as epidemiologists, to address COVID-19-related suicide concerns. This Suicide Prevention, Intervention and Prevention (SPIP) Team has focused on timely data (see ESSENCE report), access to care, equipping providers to transition to a virtual environment and listening to consumer voices.
See 2020 Youth Suicide Intervention and Prevention Plan Annual Report.
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