Mad Dash Towards 2025 Session

The Legislature is barreling towards the 2025 Session (a "long" session) and this week held more than forty hearings and work groups in the barely functional Capitol. Hundreds of advocates, citizens, lobbyists and government officials packed the hallways and hearing rooms as the sound of jackhammers and power tools often overwhelmed witness testimony. This was also the "filing deadline," meaning that for any bill to be ready for consideration on day one of the session, it had to be turned into Legislative Counsel by Friday.

Health and Behavioral Health Workforce

House Behavioral Health and Health Care heard from licensing boards about their processes and timelines, and whether they support joining licensing compacts. The Mental Health Regulatory Agency and Board of Licensed Social Workers have new executive directors who will hopefully turn around long license processing times and arduous processes.

Several interstate compact bills, including for Physician Associates, Dentists and Dental Hygienists, and Professional Counselors and Psychologists, will be introduced in the 2025 session. Chair Nosse noted that the committee will need to negotiate this compact-by-compact as they all differ considerably.

The President of Oregon’s Chapter of the American College of Emergency Physicians asked for incremental fixes to address emergency department boarding challenges. He told heartbreaking stories of patients being treated in hallways, waiting for care and transfers – treatment that none of us would want for our family members. He said we need more hospital beds, more funding for hospitals, and more staff.

NWPA is working with our clients on this issue, and helping to draft two bills impacting the behavioral health workforce. One provides funding and direction for the establishment of BH apprenticeships aimed at entry level workers for school and youth settings. Another is renewal of the remarkably successful "Prosperity 10K" which was included as "Section 3" of SB1545/Future Ready Oregon, the state's massive investment in workforce. P10K was fast tracked to Local Workforce Boards, which got money on the ground almost immediately. Much of that funding went into this arena. Check out some of the progress: Oregon Workforce Partnership Behavioral Health Connections

Behavioral Health Funding

Meanwhile, Senate Health heard updates on how key behavioral health funding is being spent:

$16.9M from HB 5024 (2023) on 74 adult SUB residential beds, 12 withdrawal management beds, and 1 peer-run recovery campus
$18M from SB 1530 (2024) on recovery housing. A dozen organizations have received 27 awards for capital development for 241 beds and ongoing operational support
$86.5M from HB 5204 (2024) on behavioral health capacity, including 10 crisis stabilization centers, 28 withdrawal management beds, 2 primary care clinics, and 94 housing units.

The Health Authority also presented the June 2024 Behavioral Health Residential Facility Study, which found that nearly 4,900 beds are projected by fall 2025; 8103 are needed. To complete these projects, $175 million per year in additional funding would be needed.

Sen. Daniel Bonham (R-The Dalles) asked about appropriate staffing for the beds we currently have, and if we shouldn’t focus on that first. OHA answered that the solution is a “yes, and”.

Legal System Challenges and Deflection Program Rollout

The Oregon Public Defense Commission spoke to the House and Senate Judiciary Committees about the unrepresented persons crisis. The number of people in custody without legal representation is the highest ever. The issue is decades in the making. The Commission plans to eliminate the unrepresented population in custody by March 2025 and out of custody by March 2026. To achieve this, it is asking for additional funding from the Emergency Board and in the upcoming biennium.

The Criminal Justice Commission updated the Joint Addiction and Safety Committee on the rollout of the deflection grant program created by HB 4002. So far, 27 programs across 28 counties have been funded, though implementation varies. Initial data shows a steady number of arrests, mostly for possession charges and status offenses.

OHP 115 Waiver and Bridge Program

The Health Authority received federal approval and launched the OHP Bridge Program on July 1. As of September, it has 26,243 members (22,000 of whom moved from OHP’s temporary expansion program.)

CMS also approved Oregon's 115 waiver in July. The state can now provide a limited expansion of Medicaid to incarcerated people 90 days prior to release.

The state is launching its OHP health-related social needs housing supports in November.

Drug Pricing

FQHCs and others that benefit from 340B drug pricing told the Senate Health Committee that drug makers are directly attacking the program by restricting or eliminating their ability to use contract pharmacies, instituting a rebate model, and requiring very burdensome data. Chair Patterson said legislation will come from both chambers about 340B in 2025.

Housing and Homelessness

Oregon Housing and Community Services Executive Director Andrea Bell presented a high-level overview of its 2025-2027 budget request to the Senate Housing Committee. Its pillar on housing stabilization includes:

Maintaining existing state-funded shelter beds
Improves shelter data management and collection
Sustaining the Rehousing and Long-Term Rent Assistance programs
Funding for upstream strategies, including the Oregon Eviction Diversion and Prevention Program, to increase housing stability and prevent homelessness.

Legislators are also working on round two of HB4134, which allocated funding (and fast tracked it!) for specific city infrastructure projects that met key criteria and were focused on workforce housing.

And .... we are working with the The Alliance4Kids on a bill to expand and revise the "Youth Experiencing Homelessness" program, which we've grown from barely $600,000 to more than $21 million over the past 4 years. Unfortunately, more than 15 Oregon Counties still have no significant resources for these young people. Our bill would expand these funds, and also require that the Administration consider allocating up to 30% of housing resources to youth and families with youth. The bill would also allocate specific funding to Local Workforce Boards to create entry level workforce programs for homeless youth providers. We're excited about the chances for this innovative, bi-partisan approach.