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Despite Budget Crunch, Oregon Health Authority Plans 3 New High-Level Behavioral Health Positions

Some state employees question the decision which is part of an overhaul by Steve Allen, who was hired as the agency's behavioral health director last year.
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The Oregon Health Authority in Salem. | OREGON HEALTH AUTHORITY
July 7, 2020

The Oregon Health Authority plans to add new management positions to its behavioral health division, even as the agency faces potential budget cuts that could slice hundreds of millions from programs and services.

The positions are part of an overhaul of the authority’s behavioral health unit that was in the works before the pandemic forced the authority to focus on responding to the virus. Oregon’s behavioral health system is widely considered to be sorely inadequate, and bolstering the state’s response to mental health issues has been a priority for Gov. Kate Brown.

Yet the agency appears poised to forge ahead at a time when the state is grappling with a $2.7 billion revenue shortfall for the upcoming year and the possibility that agencies might have to make double-digit budget cuts.

The three positions are: a director of children’s behavioral health, an adult mental health and addictions director and a tribal behavioral health liaison. 

Behind the scenes, authority staff question the agency’s move to add managers while the state is keeping other positions vacant to save money.  For example, Brown’s proposal for an initial round of nearly $150 million in cuts to agencies calls for positions at Oregon State Hospital to stay vacant if they are not involved in direct patient care. 

One authority employee, who spoke on condition of anonymity, told The Lund Report that the plan is likely to anger the public, including many advocates who are worried about program cuts. A mental health advocate, Kevin Fitts, weighed in on the adult mental health and addictions director position description during a June 26 meeting with agency staff and other advocates. But several others were unaware of the reorganization plan. The authority defended the move which is part of an overhaul planned after Steve Allen was hired as behavioral health director  in 2019. 

“As we manage the current and continuing effects COVID-19 has on Oregonians’ behavioral health, this unit’s work has never been more important,” authority spokeswoman Sarah Kelber said in a statement.

Public records show the children and family behavioral health director position is a management position with a salary range of $6,554 to $9,666 a month, or $78,648 to $115,992 annually. The other two positions are not yet classified, a process that determines the salary ranges. But based on agency records, the adult mental health and addictions director likely would be paid $7,586 to $11,171 a month, or $91,032 to $134,052 annually, and the tribal liaison position would be paid $5,397 to $7,586 a month, or the equivalent of $64,764 to $91,032 annually.

The tribal liaison will interact with Oregon tribes on behavioral health issues and work on state programs and services, according to a draft of the position description. 

The adult mental health and addictions director will have a lead role in strategic planning for the $2 billion publicly funded system of adult mental health and substance abuse treatment, according to a draft of the job description. The director will communicate with a variety of stakeholders and officials, including lawmakers, coordinated care organizations and the Oregon State Hospital. 

The children and family behavioral health director will oversee strategic planning and direction for the  $500 million publicly funded system that provides mental health and substance use disorder services to children, adolescents, young adults and families. 

Both director positions are high profile and require “interaction with the media on controversial policies and decisions,” the job descriptions state. 

At the same time, the authority has submitted plans to the governor’s office that outline scenarios for a potential 17% budget cut for the remainder of the two-year budget cycle, which ends June 30, 2021. Brown ordered similar proposals from all agencies amid plunging state revenues. 

The cuts are not final, and lawmakers could offset some of the shortfall with reserves or federal relief funds if Congress sends more aid to states. Brown will call for another special session this summer to address the budget.

The authority potentially could face drastic cuts. It would lose more than $370 million under its scenario, when factoring in lost federal money from Medicaid cuts. The Oregon State Hospital, which serves people with behavioral health needs, would lose nearly one-quarter of its beds, from 704 to 531. The authority also seeks trims to individual positions. For example, the authority proposes $133,570 in savings by keeping a dental director position open and delaying efforts to integrate dental care with behavioral and physical health care. 

Ben Morris, a spokesman for the Services Employees International Union Local 503, which represents many state employees, said the labor organization is most concerned about  having enough frontline workers - not managers. 

“In general, our members want the agency to prioritize  frontline workers who provide direct services to Oregonians,” Morris said. “Public health workers are feeling overwhelmed and understaffed due to the enormous needs during COVID-19. We should be taking every effort to ensure that those needs are being met.”

Kelber, the authority spokeswoman, said the agency is not spending new money on the positions. Instead, she said the authority plans to pay the new hires with money from vacant positions in the authority’s Health Systems Division after staff retirements and departures.

Kelber said the child and family behavioral health services director was posted and interviews are expected soon. The agency is still finalizing the description for the other positions and seeking input from advocates. 

You can reach Ben Botkin at [email protected] or via Twitter @BenBotkin1.

Comments

Submitted by Maureen Nash on Sun, 09/13/2020 - 15:30 Permalink

it is easy to criticize new proposals but please don't lose historical context. Oregon's very troubled Mental health and addictions division was crippled beyond belief when Saxton cut many middle managers. The institutional knowledge that was lost is irreplaceable and took a teetering MH system to totally dysfunctional.  

i suggest we find out what the people who worked in the 1990s when Oregon had a nationally admired MH system did differently. this long predates my 2005 arrival in Oregon. By 2005 it was well established that the legal system would rather allow the mentally ill to die on the streets "with their rights" rather than recognize that those with serious mental illness often have anosognosia which is why involuntary commitments exist in every state and around the world. A decade or 2 later, Saxton cuts the knees of a struggling department under the guise of efficiency. And OHA and OSH have mostly abandoned geriatric citizens in Oregon. There is one middle manager who valiently tries  to link DHS and OHA to serve this large and needy population but not nearly enough. just as children are not small adults, geriatric patients are not just old adults.

Until OR has a vision for how to serve those with serious mental illness and substance use disorders, with structural changes to the commitment system, there is little hope for Oregonians who suffer.

If this requires the addition of  administrative leadership, that should not be a surprise.

It is so easy to criticize but Pat Allen appears to have sone some research and appears to have a vision for the future. there is nothing in Oregon that needs more intelligent vision and planning than the Behavioral Healthccare. 

I believe we need to support a 5 year vision and plan and then reassess based on progress or lack thereof.