NAMI Oregon Releases Health Transformation Guide
Many Oregonians may still be puzzled by the term "health transformation," but the changes forthcoming in Oregon's Medicaid system could vastly improve health care in our state or just be another shot in the dark that fails to hit its intended target. NAMI Oregon has long advocated for an integrated health care system that focuses on individual and family health. To that end, NAMI Oregon is pleased to issue its "Policy Guide to Health Transformation and Integration in Oregon" that collects all of NAMI's various positions on health care transformation into one document. This will serve as our guiding vision for our advocacy on health care reform.
US DOJ Settlement with Oregon
The State of Oregon and the U.S. Department of Justice have reached an agreement pertaining to the federal government’s investigation over how Oregon treats individuals with mental illness. The crux of the investigation looked at whether Oregon was needlessly institutionalizing individuals in violation of the Americans With Disabilities Act. Read a press release announcing the agreement and a letter outlining the agreement.
Public Policy Update
July 25, 2013
Chris Bouneff, executive director
Thanks to all of our NAMI members and allies for your work this session. Though there wasn’t much for us to rally regularly around, your contacts to lawmakers kept mental health issues at the forefront of the Legislature’s discussions.
Now that the session is over, the real work for NAMI members begins. Your legislators will be holding town halls and listening sessions in their local communities. These are the perfect opportunities to talk directly to your representatives and senators about mental health and NAMI Oregon’s emphasis on new investments in housing (some details below).
You can find information about your legislators at www.leg.state.or.us. Or contact us at the NAMI Oregon office, and we’ll be happy to assist you.
What follows is a summary of the session that ended earlier this month and some issues that we continue to monitor.
Some Good News
The community mental health system got an infusion of new money this legislative session. Much of it is for the expected increase in demand for treatment and support services that accompanies a growing population in Oregon, or what is called “caseload growth.” While that may not seem a monumental development for a chronically underfunded system, it is a positive sign after several sessions of cuts and flat funding. The Legislature also made some targeted new investments in the children’s mental health care system that could help spread effective services, such as early intervention for psychosis, into communities in which such programs aren’t available. Certainly, it was encouraging that mental health was a major topic of conversation with nearly all lawmakers from both political parties.
Some Mixed News
Yes, the conversation about investing in mental health was robust. However, at the start of the session, it appeared that Oregon could be on the verge of a major initiative to fully fund the state’s community system. Senate President Peter Courtney, a Democrat, teamed with Republican Sen. Brian Boquist to introduce Senate Bill 823, which was designed to put the state on the path to a fully funded system. And NAMI Oregon’s housing investment fund legislation, House Bill 3332, earned wide support.
However, the conversation stalled as the parties squabbled over tax increases and cuts to the state’s pension system, or PERS. The parties never could reach the “grand bargain” they sought that would generate additional revenue that could be pumped into education and mental health care. The result was a healthy conversation and general agreement that more needed to be done to fund mental health, but no clear pathway to producing additional revenue for enhanced investments.
The Bad News
Despite strong support from Republicans and Democrats alike, NAMI Oregon’s housing investment fund legislation never saw the light of day in the budgeting process. Even our modest request of around $6 million was lost during the debate over PERS cuts and tax increases. NAMI Oregon plans to promote the legislation again during the 2014 short session next February.
Also, lawmakers approved $80 million in bond debt to build a second state hospital in Junction City. With that, state hospital services will close in Portland in 2015. The state hospital facility in Pendleton, known as Blue Mountain, also will close. Some encouraging news is that funding was approved to create some replacement services in Pendleton to serve Eastern Oregon.
However, Portland will be without state hospital services entirely. Instead, individuals requiring state hospital care will be taken either to Salem or Junction City, far away from their home communities, families, friends, and regular care providers. Already, families struggle to be involved with their loved one’s care for those in the Oregon State Hospital in Salem. In short, this is a devastating development for individuals and families affected by mental illness.
The problem was compounded by lawmakers’ inaction on funding new housing for the community mental health system, outside of some housing to accommodate caseload growth. Instead of spreading housing and treatment services into more communities, the state is concentrating services in two locations that are inaccessible to the majority of the state.
NAMI is determined to continue its pursuit of new investments in housing for individuals living with mental illness, whether supported housing or licensed treatment housing. Individuals needing treatment should be able to access services closer to home, allowing family, friends and others to visit and participate in the treatment planning process. This should be a basic expectation of Oregon’s mental health care system.
Nothing monumental occurred this legislative session, despite some early signs that this could have been a monumental year. However, the session was encouraging. An improving economy allowed legislators to pump new money into Oregon’s mental health system after several sessions of flat funding and cuts to the system. Mental health also held a prominent place in budget and policy discussions. With continued advocacy, we may yet see the day that a momentum builds enough that Oregon will make that monumental investment in our community mental health system.
Looking to 2014
As written above, NAMI Oregon plans to pursue its housing investment fund legislation again. For details on the legislation, please surf to www.goo.gl/l61Ga (link will open a PDF document that summarizes NAMI’s legislation).
Also on the Watch List:
• Oregon is on the hook via its agreement with the U.S. Department of Justice to improve outcomes in the adult mental health system. To date, the state has shown little urgency in making the type of investments that will improve the status of adults living with serious mental illness. We are nearly a full year into the four-year agreement.
• NAMI and many other advocacy groups continue to try to monitor the progress of Oregon’s Coordinated Care Organizations, which are the new managed care plans responsible for caring for those on the Oregon Health Plan. It’s still early in what is called the health transformation process to determine the level of progress, but signs are encouraging in some communities. Of course, signs also are discouraging in other communities.
• NAMI Oregon is looking forward to the Medicaid expansion that will go live on Jan. 1. In combination with Oregon’s new health insurance exchange marketplace, we anticipate more adults who lack insurance to be eligible for the Oregon Health Plan or for subsidized commercial health insurance that includes mental health and addiction benefits. We’ll be watching issues around access and affordability during rollout.
To find contact information for your state legislators, visit the Oregon State Legislature's Find your legislator web page.
Please see previous Public Policy Updates below.
Previous Public Policy Updates
Stay involved with us – sign up for our e-news and legislative alerts, and click the links below to view minutes from Public Policy Committee meetings.
Tell us your story – if you have a personal story that illustrates the need for changes in statewide mental health policy and you would like to become an advocate for policy improvement, complete our Advocate Information Form and return it to us today.
Public Policy Committee meeting minutes - August 2010 (PDF File)
Public Policy Committee meeting minutes - September 2010 (PDF File)
Public Policy Committee meeting minutes - November 2010 (PDF File)
Public Policy Committee meeting minutes - February 2011 (PDF File)
Public Policy Committee meeting minutes - March 2011 (PDF File)
Public Policy Committee meeting minutes - April 2011 (PDF File)
Public Policy Committee meeting minutes - May 2011 (PDF File)
Public Policy Committee meeting minutes - October 2011 (PDF File)
Public Policy Committee meeting minutes - November 2011 (PDF File)
Public Policy Committee meeting minutes - January 2012 (PDF File)
Public Policy Committee meeting minutes - February 2012 (PDF File)
Public Policy Committee meeting minutes - March 2012 (PDF File)
Public Policy Committee meeting minutes - June 2012 (PDF File)
Public Policy Committee meeting minutes - August 2012 (PDF File)
Public Policy Committee meeting minutes - November 2012 (PDF File)
Public Policy Committee meeting minutes - December 2012 (PDF File)
Public Policy Committee meeting minutes - January 2013 (PDF File)
Public Policy Committee meeting minutes - March 2013 (PDF File)
Advocate Information Form (Word Document)
June 2011 Public Policy Update (PDF File)
July 2011 Public Policy Update (PDF File)
October 2011 Public Policy Update (PDF File)
November 2011 Public Policy Update (PDF File)
December 2011 Public Policy Update (PDF File)
January 2012 Public Policy Update (PDF File)
February 2012 Public Policy Update (PDF File)
March 2012 Public Policy Update (PDF File)
May 2012 Public Policy Update (PDF File)
August 2012 Public Policy Update (PDF File)
October 2012 Public Policy Update (PDF File)
February 2013 Public Policy Update (PDF File)
March 2013 Public Policy Update (PDF File)
April 2013 Public Policy Update (PDF File)
CCO Basics Fact Sheet (PDF File)
DOJ Civil Agreement (PDF File)
2013 Legislative Priorities (PDF File)
Housing Bill Summary (PDF File)
Budget Fact Sheet (PDF File)
Medication Access Fact Sheet (PDF File)
Human Services and Housing Committee list (PDF File)