Representatively Speaking August 2021

By State Representative Rob Nosse

This is the first one of these columns that I have written since the 2021 Legislative Session ended. Now that I have had a little break, I have been reflecting on what we accomplished, as well as observing where we need to invest further or just frankly fix something. (I will say more about “unfinished business” in a future column.)

We passed a lot of good bills this session addressing racism in policing, making investments in Oregon’s economic recovery and affordable housing, mandating safe storage for guns, expanding access to healthcare and setting ambitious goals in our effort to confront climate change when it comes to our power grid and utilities.

As you may have read about in my recent opinion piece for The Portland Tribune, one other major area of accomplishment this session was passing a historic behavioral health “package” of bills and budget allocations to finally start meaningfully addressing behavioral and mental health in our state.

Our state is experiencing a behavioral health crisis that touches the lives of nearly every resident. Many of us have directly experienced the difficulty of finding treatment for ourselves or a loved one. 

Parents, teachers and students have seen the rising levels of behavioral challenges in our schools and almost everyone in our corner of Portland has witnessed the growing frequency and severity of individuals experiencing mental illness on our streets.

Our state struggles with high rates of substance use disorder, overdose deaths and suicide. Mental Health America ranks OR 48th in the country due to our higher prevalence of mental illness and lower rates of access to care. 

Oregon has the 11th highest youth suicide rate in the US and during January-June 2020, at least 339 people died of a drug overdose here. 

Meanwhile, people with behavioral health needs are “stuck” throughout the system – waiting for beds at the State Hospital or stuck in the State Hospital because they cannot be discharged due to a lack of community placements, stuck in jail or houseless, and thus with no way to recover.

Clearly none of this is good. Oregonians need and deserve better.

An improved budget forecast and President Biden’s stimulus package opened the door to finally think transformationally about behavioral health. 

With the help of local advocates from SE Portland and across the state, we were able to pass a $474 million behavioral health package for Oregonians. 

The investment package broadly targets four main priority areas.

First, it will fill some of the gaps and support the community needs we already know exist, like expanding access to crisis services. 

Second, it will fund a surge in our workforce, helping improve conditions for those already doing the work and attracting new workers from more diverse backgrounds. 

Third, it establishes a fund for community innovation, where local stakeholders can determine the most pressing needs in their community.

Too often we have approached behavioral health with a “one size fits all” approach, but what works in Medford may not work in SE Portland. This fund will allow our community to find what works for us while reducing strain on the overall system. 

Finally, the package creates a transformation fund to align and transform the behavioral health system to ensure greater system accountability, outcomes and funding alignment, clear roles and responsibilities, and ultimately sustainable funding for appropriate and quality services.

Lest you forget, we approved Ballot Measure 110 last November, which moved $302 million in funding to substance use disorder treatment, transforming the way we deal with addiction in this state.

The goal of these investments is to create a system in behavioral health, seamlessly integrated with physical healthcare, with multiple entry points, “no wrong doors’’ and as few gaps as possible. 

We will know we have succeeded when patients have timely access to services at all levels and when we see reductions in houselessness, ER visits, hospitalizations and overdoses. 

With this approach, I hope to look back on 2021 as the year we began true transformation of our behavioral health system. Over the next several years as these investments take shape, I hope everyone in our community will begin to see the difference.

Representatively Speaking August 2021

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