Sustaining Community Mental Health Programs
- The non-Medicaid budget fully funds the current service level for community mental health without program reductions.
- In addition, there is an increase of $20.1 million in tobacco tax revenues available to fund mental health programs. Oregon Health Authority plans to use most of the increase for programs that will help the state to meet the goals outlined in the U.S. Department of Justice Performance Plan.
- Priorities include:
- $10-$15 million in additional funding for mobile crisis services and rental assistance with peer support.
- Other investment priorities include:
- School-based access to behavioral health
- Implementation of the Suicide Prevention and Intervention Plan.
- $2.5 million for veterans’ behavioral health services.
State/Local Plan for Behavioral Health
The legislature included two sets of instructions to Oregon Health Authority on mental health services. These Budget Notes state:
- The Oregon Health Authority shall conduct a rate analysis, including but not limited to provider costs as well as expected revenues from billing for rehabilitative services. The agency shall report to the Interim Joint Committee on Ways and Means by November 30, 2017 with a proposed plan for a standard rate or set of rates, a proposed schedule to move all providers to these rates, an analysis of the cost, and plans for funding both the Medicaid and non- Medicaid components.
- The plan should prioritize increasing rates for providers with the greatest disparity in rates, that is, providers who receive the lowest rates compared to more recent providers who typically receive higher rates. Contingent on available funding, the agency will implement at least the first phase of the plan beginning January 1, 2018. If the agency is unable to fully fund the plan within their existing budget, they should request additional funding during the 2018 legislative session.
- The Oregon Health Authority shall work with coordinated care organizations, County Mental Health Programs, local Public Health, local mental health authorities, and others, within each geographic area, to create a single plan of shared accountability for behavioral health system coordination that builds on existing structures and partnerships and fosters further innovation and collaboration with other organizations, by July of 2018. The agency shall provide a progress report to the Joint Committee on Ways and Means during the 2018 legislative session, and a final report to the Legislature by December of 2018 on each region’s governance model and plan for shared accountability.
Slight Increase in Oregon State Hospital Funding
The Oregon State Hospital (OSH) received a 5.9 % budget increase over 2015-17 Legislatively Approved Budget. Most of the increase comes from increased Medicare billing. The budget maintains the closure of three currently unoccupied cottages and two unoccupied wards at the Junction City campus. The closure of two unoccupied cottages at the Salem campus is also maintained.
Intellectual and Developmental Disabilities
- Eliminated funding for the five regional crisis support programs.
- Reduced the family support program by half ($1.3 million General Fund). This action could affect approximately 500 children and their families.
- Capped bed hold payments to Group Home and Supported Living providers at 21 days, instead of 45.
- Decreased the budget by $2.2 million ($4.7 million total funds) based on an effort to review inactive client records and remove clients from the caseload if they no longer need or want services.
- Reduced $12.0 million General Fund ($24.0 million total funds) through implementing a new assessment tool and other management actions to help curb cost growth. ODDS was instructed that if it cannot meet the target with those actions, then it should consider and bring forward eligibility changes for legislative review and approval during the 2017–19 biennium.
- Retained funding in the Fairview Trust.
- Continued funding for the Centralized Abuse Management project
- Added $21.3 million General Fund ($50.5 million total funds) over the 2015–2017 level for CDDPs and Brokerages.
- Approved $13.5 million General Fund ($45.5 million total funds) to increase provider rates by five percent effective October 1, 2017.
Seniors and People with Disabilities
- Continued funding for Oregon Project Independence, including the program for people with disabilities.
- Continued funding for the General Assistance program.
- Continued funding for Oregon Care Partners, a statewide training program that provides training free of charge to direct caregivers and staff.
- Continued funding for Aging and Disability Resource Connection (ADRC) development activities.
- Approved funding for the Centralized Abuse Management (CAM) system.
- Approved funding for the ONE/Integrated Eligibility/Medical Eligibility system.
- Approved new staff to support eligibility, case management, adult protective services, licensing and administrative work.
- Approved a plan to strengthen the CA/PS assessment. This is expected to tighten eligibility, resulting in loss of services for approximately 4% of current caseload, or 1,200 individuals.
- Approved a plan to update the hours that are authorized for in-home consumers. Overall hours will likely decrease by 15%.
- Approved a plan to eliminate the live-in service option for in-home consumers.
- Approved cost of living increases for assisted living, residential care, memory care and in-home agencies. The increase is 5% on 7/1/17 and 2.5% on 7/1/18.