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Drug addiction, mental health will dominate session, lawmakers say

Lawmakers clashed in an Oregon Health Forum panel over how much ‘stick’ is needed to promote treatment and fix Measure 110
screen showing Zoom chat with one woman, two men
At a Jan. 31, 2024 virtual discussion of the Oregon Health Forum, Rep. Rob Nosse (right) joined Rep. Ed Diehl (bottom) and several other lawmakers to talk about the upcoming legislative session with moderator and journalist Emily Harris (left) .
February 1, 2024

Sending people to jail for possession of small amounts of drugs while also boosting treatment for addiction will be at the top of lawmakers’ minds as they gather in Salem next week.

At a preview of the upcoming legislative session, lawmakers on Wednesday made clear that the 35-day session will be dominated by conflicting visions for modifying Measure 110, the controversial voter-approved 2020 ballot measure that decriminalized possession of drugs such as meth and opioids. The discussion was organized by the Oregon Health Forum, a sister organization of The Lund Report.

Asked about their health care priorities, several lawmakers cited the push to make changes to Measure 110, including some level of recriminalization to push drug users to seek treatment. Proponent’s of the measure had promised it would address Oregon’s lack of treatment services, but critics have complained that with fewer arrests, people weren’t being sent to drug court where they could be connected with treatment programs.

Oregon state Rep. Ed. Diehl, R-Scio, said that Measure 110 didn’t create Oregon’s addiction crisis, but has “made it a lot worse.”

“People need an incentive to go into treatment,” he said. “I think everybody realizes that. The majority of Oregonians realize that and they’re frankly demanding it.” 

Majority Democrats last week unveiled House Bill 4002, which would make it a low-level misdemeanor to possess drugs like heroin, fentanyl or meth. The bill would allow people to escape charges if they enter a “deflection program,”which involves at least a behavioral health screening and meeting with a case manager. The bill also seeks to streamline access for people dealing with addiction.

Diehl noted that the League of Oregon Cities and groups representing law enforcement have criticized the Democrats’ proposal and instead support ideas captured in a bill pushed by Republicans, House Bill 4036. The bill would make possession a higher-level misdemeanor than the Democrats’ bill would, in theory exposing people to as long as a year in jail as the statute is written. 

Both the Republican and Democrat bill proponents see their approach as fueling diversion programs leading to treatment. The Republican-backed plan calls for being on diversion for one year to avoid charges, while the Democrats envision a 30-day period.

State Rep. Rob Nosse, a Portland Democrat who chairs the Oregon Behavioral Health and Health Care Committee, portrayed the Republican plan as unrealistic and unreasonable. 

“The crux of this is going to be how much, to use the phrase ‘stick,’ are you going to require?” he said. 

Nosse said the most important thing lawmakers can do during the session is to allocate as much spending as possible for substance use disorder and residential treatment facilities, including money to hire trained workers to staff them. 

Doing so, he said, will ease logjams elsewhere in Oregon’s behavioral health system. He said that the Oregon State Hospital has patients ready for less restrictive settings but can’t discharge them because of the lack of beds in residential treatment facilities. 

“If we can get more of that stood up … we will go a long way to turning this sort of poor mental health outcome, poor ranking that this state has,” Nosse said. 

Asked about the numerous surveys that have come out over the years finding Oregon’s behavioral health spending was middle-of the pack despite bottom-of the-pack results, Nosse attributed the difference to Oregon’s county-based mental health system. He noted he has another bill surveying counties’ mental health programs and their needs, to determine whether they are spending adequately.

Diehl disagreed with Nosse’s diagnosis, however. “I just don't feel like we're making the best use of our dollar,” he said, singling out the oversight committee to award funding set up by Measure 110. “Many of us do not believe that they are prioritizing the right types of addiction treatment and recovery services.” He said the Republican bill would abolish the group and give the governor more control over spending.

“The point is that we do have … many bureaucratic layers and we need to take a real look at that here,” Diehl said.

Lawmakers also addressed other aspects of addiction.

State Rep. Lisa Reynolds, a Beaverton Democrat and pediatrician, said that the state needs to prevent addiction from happening in the first place and that schools need to have “robust evidence-based curriculum” on drug use in schools. 

“We’re not going to treat our way out of this addiction problem,” she said. 

Reynolds said she would sponsor a bill expanding funding for the Nurse-Family Partnership, which assigns pregnant patients who have a substance use disorder to nurses who will stay with the affected families until they are two years old. 

The event also highlighted other health care-related bills lawmakers will pursue during the session. 

State Sen. Deb Patterson, a Salem Democrat who chairs the Senate Health Care Committee, said she would focus on a bill to help hospitals struggling with patients who can’t be discharged because there aren’t enough beds in nursing homes or other specialized care settings. 

She said the bill will expand the number of public guardians, a court-appointed position to protect someone who has been deemed incapacitated. There are about 500 people waiting to be assigned a public guardian and increasing staffing will help people with advanced dementia or severe mental illness to find a placement, she said. 

State Sen. Cedric Hayden, a Fall Creek Republican and Health Care Committee vice chair, said he would prioritize Senate Bill 1565, a related bill that would allow family members of people with disabilities to serve as their state-paid caretaker. During the pandemic Oregon relaxed its policy of refusing to pay people to be paid caretakers for family members, as other states do. His bill would allow family members to be paid caregivers if workers aren’t available. 

State Rep. Travis Nelson, D-Portland, said he would focus on addressing the rise in violence against health care workers. Nelson, a registered nurse, is introducing a bill that would increase the penalty for assaulting a health care worker from a misdemeanor to a felony. 

He said that health care workers across the state have been calling for the increased penalty. Currently, he is working on a forthcoming amendment to the bill that would account for people who commit assaults while suffering from dementia, delirium or some other kind of acute mental health disorder.