The Oregon Health Authority came asking the Legislature’s Emergency Board for an additional $14.6 million in general fund money to fill as many as 40 new positions, but will likely go back to work with just $9 million in new state money after pushback from Sen. Alan Bates, D-Medford.
Health Authority Interim Director Suzanne Hoffman told the emergency board’s subcommittee that the new positions and new money was needed to deal with rising costs at the Oregon State Hospital and costs associated with the unexpectedly large expansion of the Oregon Health Plan, including an increase of inspectors at the Office of Equity & Inclusion from one to six to handle potential complaints to coordinated care organizations about healthcare access and treatment related to civil rights.
The health authority has no evidence that civil rights complaints of CCOs are rising with the expansion, so, in a compromise with Bates, Hoffman agreed to hire just one new inspector and then come back for additional funding if two employees cannot handle the caseload.
“This is the biggest rebalance and most complex rebalance we’ve had in my 15 years,” said Bates, who has been mentioned as a candidate for the currently unfilled official director’s position at the Oregon Health Authority, but hasn’t admitted publicly that he’s a candidate. “There needs to be some real changes as far as repurposing and streamlining that has not been done.”
Bates chairs the subcommittee, which made a recommendation Monday to the full budget board, which meets Wednesday. The money will come from a special reserve fund that the Legislature created in 2013 to handle unpredictability in the budget.
“If you can’t trust the message, you can’t trust the messenger,” said Rep. Mike McLane of Prineville, the leader of the House Republicans. “I have more trust in Senator Bates than I have in OHA. In the last year, you have a credibility problem.”
Despite an injection of money into community mental health programs, the state hospital continues to be overwhelmed by a growing number of people in a mental health crisis who have been charged with a crime but committed because legal authorities have deemed them unfit for trial. The hospital has also had a lower attrition rate in its workforce than expected.
Hoffman also explained new costs by citing changes to the Oregon Health Plan to cover the autism treatment known as applied behavior analysis, and the problems with associated with Cover Oregon that required health authority involvement to get people signed up without a working website -- but the money to hire consultants and temporary workers to assist with sign-ups was covered by the federal government, Bates told The Lund Report.
In a flip from a previous meeting of the Emergency Board, the Department of Human Services Director Erinn Kelley-Siel told legislators that her agency could live within the budget it had been allocated through some minor trims and by shifting money within the agency.
Fewer than expected people have needed a leg-up through the state’s self-sufficiency and child welfare programs, and Kelley-Siel said the state also received bonus money from the federal government for the food stamp program. These savings are offset by increased caseloads among seniors and people with disabilities.
“This is the result of policy changes you’ve made in child welfare and changes in the economy,” Bates told Kelley-Siel.
Just 10 months ago, it was DHS that came calling to the Legislature with a $101 million budget gap, and the Oregon Health Authority crowing about budget savings and rewards from the federal government for signing up more children for healthcare than expected. The Legislature ended up granting DHS most of its request with a transfer in funds from the health authority’s surplus.
The human services budget subcommittee also recommended that the last $3.4 million be released from a special fund set up to help senior citizens after the Legislature in October 2013 made changes to the healthcare tax deduction that resulted in higher taxes for affluent seniors.
“It keeps us solidly fulfilling our commitment when we indicated these funds would be going in this budget cycle,” said Sen. Richard Devlin, D-Tualatin, the legislative budget chairman.
About half that money -- $1.7 million, will go to Oregon Project Independence, which should provide funding to help about 860 seniors for the last six months of the current budget cycle, and completely cover the current list of 330 people waiting for the program.
Oregon Project Independence is a popular program with both major political parties, providing assistance to middle-class seniors that allows them to stay in their homes, but is frequently on the budget chopping block since it receives no federal Medicaid dollars and must rely entirely on state resources. Money left over should be able to carry over the program into the next biennium that starts in July.
Most of the other $1.7 million will go to the Oregon Department of Transportation to aid local transit districts with their paratransit programs, which carry seniors and people with disabilities who are unable to easily navigate public transit service. The state assistance could also help keep transit districts from siphoning off money from their regular operating budgets to prop up these more expensive services.
Chris can be reached at [email protected].
