Skip to main content

Kotek targets behavioral health system crisis – and plans ahead

As Kotek seeks more funding, the state also is working on a five-year plan
Oregon State Hospital in Salem. | OREGON HEALTH AUTHORITY
March 21, 2023

Gov. Tina Kotek is asking lawmakers to put $74.2 million into behavioral health programs in one bill as she begins crafting a five-year plan to address the state’s crisis.

Kotek and the state’s new behavioral health director, Ebony Clarke, spoke Monday to lawmakers on the Senate Health Care Committee about the need to expand mental health and addiction treatment services and programs in Oregon.

The funding requests in Senate Bill 1044 – and plans for more action – offer Oregonians a glimpse at the new governor’s approach to the state’s behavioral health crisis. Oregon routinely ranks among the worst states for access to care in national studies.

Kotek’s push to improve behavioral health includes more money to treat people and keep them out of jail, off the streets and in programs to avoid a return to Oregon State Hospital after they are discharged from the state-run psychiatric residential facility. 

“When someone is ready to seek a mental health or substance abuse treatment, that should be easy to find, no matter where you are and it should be affordable,” Kotek told the committee. “Unfortunately, we’ve seen a rise in Oregonians needing services and a loss of essential workers who can support Oregonians on their path to recovery.”

The system struggles in all areas. For years, Oregon State Hospital has struggled to admit in a timely manner  people sitting in county jails who need care so they can aid in their defense to face criminal charges. A federal court order mandates the state hospital to treat them, with set deadlines to return to their communities. That order, while it helps the state hospital’s backlog, puts more strain on community mental health programs that serve people in other settings.

Outside the state hospital, other residential facilities lack the beds to meet the demand. In 2021, when Kotek was House speaker, lawmakers put $1.3 billion toward new funding for the state’s behavioral health system, with an eye toward expanding access, incentives for people to enter the workforce and more residential programs.

But even now, hundreds of Oregonians who need services – including residential care – aren’t able to get it.

Kotek stressed, however, that more money alone isn’t the answer.

“I want to say firmly and clearly that money and more money alone won’t provide better results for Oregonians,” Kotek said.

Funding breakdown

The bill would provide $74.2 million for a variety of behavioral health purposes. 

These include:

$20 million for a program aimed at recruiting and retaining providers in underserved areas, such as communities of color and rural areas, through incentives such as student loan repayments and stipends.$15 million for addiction treatment facilities and recovery centers.$10 million for community mental health programs to provide outreach and treatment for people who face civil commitments. The money also would help them after the civil commitment has ended. $8.3 million to expand access to behavioral health rehabilitation services for adults and youth.$7.7 million to expand child and adult suicide prevention programs.$6 million to help people who are discharged from Oregon State Hospital and face the risk of homelessness.$4.9 million for community mental health programs to expand jail diversion services that prevent people entering jail.$2.3 million to expand children’s psychiatric residential treatment capacity.

Separately from that money, the bill would give $1.5 million to Oregon Health & Science University to coordinate the availability of behavioral health residential beds statewide. That would build on OHSU’s work during the pandemic, when the hospital designed a system to track intensive-care beds in hospitals.

The Oregon Department of Human Services would get $4 million for behavioral health specialty care in long-term care facilities.

Oregon’s behavioral health system costs taxpayers billions annually. The governor’s overall proposed two-year budget for behavioral health is nearly $5.6 billion.

Next steps

The bill has a work session and vote scheduled for March 27 to move forward. It also will need approval from the budget-writing Joint Ways and Means Committee.

Clarke, the state’s behavioral health director, said the Oregon Health Authority supports the requests and the proposal’s items. Clarke said they are “critical to expand residential treatment, decrease preventable deaths, divert individuals from hospitals and jails and attract and retain diverse behavioral health care providers.”

Kotek said she directed Clarke to immediately launch a statewide assessment and plan for behavioral health that will be completed by the end of 2023. Kotek said she’ll be back in the 2024 legislative session with a five-year plan for lawmakers, “so every Oregonian can access what they need, when they need it.”

Separately, lawmakers are considering a proposal to expand more residential programs for the behavioral health system. The Oregon Health Authority has estimated the state needs another 282 beds for residential behavioral health facilities, which treat people with acute mental conditions. Separately, programs that treat addiction need 311 beds, according to a state estimate.

House Bill 2544, sponsored by Reps. Rob Nosse, D-Portland,  would put funding toward more residential programs.  

The final price is still in the works as the bill moves forward. But under initial estimates, the 282 beds would cost an estimated $178 million, and $93 million would be needed for the 311 beds.

Oregon Capital Chronicle is part of States Newsroom, a network of news bureaus supported by grants and a coalition of donors as a 501c(3) public charity. Oregon Capital Chronicle maintains editorial independence. Contact Editor Lynne Terry for questions: [email protected]. Follow Oregon Capital Chronicle on Facebook and Twitter.