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The Oregon Legislature approved legislation to expand housing care, help individuals in need, and combat the epidemic of opioid overdoses.

Metro Creative Connection

On some fronts Oregon Legislature initiated immediate steps to address the state's mental health and addiction issues. On another issue, legislators did not take direct action by forming an task force to consider ways to address the issue.

In one instance, lawmakers approved an extensive proposal to make the opioid reversal drug more readily available in various locations, including public schools and other buildings. Also, they passed a 40 cent monthly phone tax that will fund a brand new crisis hotline 988. However, other options will require longer to come through they created a task force to examine alcohol taxation and addiction programs instead of increase the wine and beer tax to fund rehabilitation programs.

While the 2023 legislative session is over, Oregon remains in the struggle with a complicated set of addiction and behavioral health crisis. The options for residential treatment for people who are struggling with issues related to their mental health are a bit limited, with more beds needed than available. The opioid addiction epidemic as well as deaths due to overdoses are increasing in Oregon with lethal fentanyl readily available.

Both lawmakers and advocates acknowledge that a long period of work are ahead for Oregon's behavioral health system.

Treatment for residential needs

Through various legislation State lawmakers have allocated money to improve the number of residential treatment centers for those who require addiction or mental health treatment services.

They comprise:

The lottery bonds will be worth $50 million money to improve the quality of residential treatment for those suffering from severely mental disorders. This was made possible by Senate Bill 5506 which is an end-of-session budget plan.

$15 million to build centers that help kids and adults who suffer from addiction to alcohol or drugs is part of Senate Bill 5525, which governor. Tina Kotek has not yet signed.

It's not clear how many people these budget funds could help. It's unclear how many people the budget items could help. Oregon Health Authority officials didn't give an article in the Capital Chronicle with an estimate of the number of beds they're planning to increase.

However, lawmakers would like to know where the money is going – and what the requirements will be. Senate Bill 5525 requires the agency to produce an account of the number of beds in the behavioral health facilities that the system currently has as well as how much money was spent on the system. This report is due February. 1st, 2025. It will be presented to the Legislature's joint budget committee once the long session begins in the coming months.

“We will know how much more residential treatment capacity we need to have,” said Rep. Rob Nosse, D-Portland and chairman of the House Committee on Behavioral Health and Health Care. “And we'll either fund it or make a lot of progress towards getting it.”

In 2021 the Legislature set a record $1.3 billion into the field of behavioral health, which covers a wide range of requirements, including increasing the number of residential facilities as well as incentives to retain and recruit individuals in the field of behavioral health. Nosse explained that the new spending is a continuation of that.

“None of that went away,” Nosse stated. “This is a new investment on top of that.”

Oregon State Hospital

Oregon State Hospital, the state-run residential psychiatric facility that is located that is located in Salem in Oregon, as well as Junction City, will benefit from the legislative actions both indirectly and directly as stated by Amber Shoebridge, a spokesperson for the hospital.

The legislature has allocated $6 million to case management to assist patients to leave the hospital to return to their community, Shoebridge said in an email.

It's unclear how much that will help in meeting the demands. The hospital hasn't made any staff available to answer questions.

A state-run hospital which is run by the Oregon Health Authority, accepts patients that are “aid-and-assist” patients with pending criminal charges, and in need of medical treatment to assist the defense. The hospital also accommodates patients who are convicted, with the exception of for insanity and are referred to the hospital instead of being sent to prison.

The hospital has been subject to criticism and lawsuits in recent years due to its inability to get patients through the treatment process and return patients to their communities quickly. It has resulted in hundreds patients sat in jail waiting for treatment, which has led to lawsuits filed by disability advocates as well as other groups. In September the federal court ordered an institution of the state government to receive and send “aid-and-assist” patients back to their homes within 90 days of misdemeanors as well as six months for charges of felony as well as one year for felonies that are violent.

Mental health in the community

After leaving at the hospital for state, they receive treatment through community mental health programs that operate in all of the 36 counties in Oregon.

These programs are able to help people to stay healthy and avoid ending in prison or the state hospital. They provide a variety of treatment, services and programs.

The new funding available to support community-based mental health services includes:

$7 million to increase the availability of community services for those suffering from severe mental illness in the civil obligation orders.

A little over $5 million is allocated to community mental health programs which offer treatment to patients who are in prison. They are referred to as jail diversion.

In the meantime the providers claim that the resources available to provide community-based mental health centers and the state hospital discharged patients earlier than it did in the past said Cherryl Ramirez as Executive Director of the Association of Oregon Community Mental Health Programs.

“The problem is with the faster discharges, we just don't have the capacity in the community to place people in appropriate settings,” Ramirez told me during an interview. “Especially with aid-and-assist clients, they're much more likely to be houseless.”

Ramirez said that the state's investment in residential services and community mental health services, as well as the funding of 988 are progress in the right direction. However, she added that the state is in need of more community-based staff and across the entire healthcare system for behavioral health.

988 hotline

Oregonians will pay an annual tax of 40 cents per month on their mobile phones, including cell phones from January 1 to help pay for the state's suicide prevention number 988 and crisis line for behavioral health.

The service, which is run by the non-profit Lines for Life in Oregon was made available in 2022, as part of an overall mandate from Congress.

According to House Senate Bill 2757 tax revenues will go towards the hotline's call centre. The rest of the money will be used to be used to fund Mobile crisis response groups. These teams, which are established throughout the state, provide specially trained experts to those who have problems at the side of the road, for instance and guide them to assistance. They are a viable alternative to the traditional law enforcement system and when combined with the 988 phone number as the alternative for 911 call.

Ramirez said the proposal was offering a reliable source of funds that could assist in increasing the number of behavioral health professionals needed for emergency response groups.

“We need to invest a lot of funding into hiring a workforce because we need many more teams to be able to have the staffing required 24/7,” Ramirez declared.

In its initial year, the tax on phone calls is anticipated to bring in about $26 million.

Opioid-related overdoses

The increase in the number of deaths due to opioids has alarmed public health officials and state advocates, in particular when fentanyl is aplenty on the streets.

Deaths has more than doubled over the past few years. As of 2019, there were 280 people in Oregon suffered from opioid overdoses as well in 2020 the number reached 472 according to Oregon Health Authority statistics. The death rate increased again in 2021 which saw 737 deaths. The death toll for 2022 is not yet fully counted. The total number of deaths is 631.

The bills that were passed included:

Fentanyl possession will be a class A misdemeanor which could result in up to 364 days in prison and a fine of $6250, or both. The legislation, House Bill 2645 which Kotek hasn't yet signed was supported by Republicans and is designed to equip law enforcement officers with the tools to tackle the issue and drug dealers. It will close a loophole that was caused by the passage of Measure 110, which voters approved in 2020 to make it illegal low-level drug use and allocate more money into addiction services.

Naloxone is the life-saving medication that prevents opioid overdoses will be made accessible in public schools and in public buildings as part of House Bill 2395, which has not yet been officially signed. In the legislation, first responders such as paramedics and firefighters would be able to distribute Naloxone kits to those who may be at danger of an accidental overdose.

The Oregon Health Authority, Board of Education and Alcohol and Drug Policy Commission will create educational materials that will educate schoolchildren regarding the risks of using opioids as part of Senate Bill 238, which Kotek has made law. Tony Morse, policy director of the Portland-based advocacy group Oregon Recovers and Oregon Recovers, has applauded the passage of the bill as it is needed in light of the alarming rise in overdoses of opioids among Oregon teens.

Lawmakers also enacted additional measures to combat addiction:

For children, House Bill 2767, which is currently on the Kotek's desk, will establish a path to “recovery” schools, which assist students with addiction problems to alcohol or drugs to gain accreditation and approval from the state. In the present, Oregon only has one recovery school, Harmony Academy Recovery High School located in Lake Oswego.

House Bill 2513, currently waiting for Kotek's signature, will introduce administrative changes that will help the state meet the requirements of Measure 110. It will give more staff support for the oversight council, and establish dates for audits and other adjustments.

Alcohol addiction

Lawmakers made smaller steps towards dealing with the state's growing problem of alcohol dependence, and set up an task force to study the problem.

Six people per day die from alcohol-related causes in Oregon as per an Oregon state report. The year 2021 saw 2,153 individuals passed away from alcohol-related causes, such as liver disease and excessive consumption according to state statistics.

According to House Senate Bill 3610 Oregon will establish a twenty-member taskforce to analyze the costs of alcohol and addiction services, incorporating input from the industry and public health officials as well as health care providers and people who advocate for rehabilitation. The task force will be mandated to examine how alcohol tax is imposed as well as the funding available for addiction treatment, and decide if lawmakers should increase the tax on alcohol in order to fund better addiction services. The bill, yet to be approved by Kotek is a requirement for this task force make lawmakers their recommendations by September 2024.

Advocates are happy with the decision as an important move toward the direction they want to go.

A state report found that the costs of drinking too much in Oregon was around $4.8 billion, which includes the loss of earnings due to work as well as the costs of vehicle accidents as well as court cases and health care, education, and human services programs.

“If you can make drinking a little bit more costly, then you have less consequences that come out of excessive alcohol use,” said Tony Morse, policy and advocacy director of Oregon Recovers, which advocates for solutions to Oregon's addiction crisis. “Number two is that it's a source of revenue in times of need for more detox, treatment and prevention programs in Oregon. It's a bucket of money that can be used to pay for these urgently needed services.”

The bill's approval comes following unsuccessful attempts to increase taxes on alcohol, such as this session, in which Governor. Tina Kotek requested – then removed a request from the Oregon Liquor and Cannabis Commission to add a 50 cent surcharge to alcohol bottles to pay for addiction and mental health services.

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