Oregon mental health leader says state finally has money to increase treatment beds; Their employment is another matter

The head of Oregon’s health department says the state is making strides toward providing enough beds to house Oregonians with mental illnesses who can’t live alone.

The biggest challenge, said department director Ebony Clark, is finding employees who can care for them.

What we found is that we have the funding, Clarke told The Oregonian/OregonLive, but we don’t have the human capacity to staff the new programs.

As the state distributes more than $230 million earmarked in the last legislative session for behavioral housing, it promises to add more than 1,100 much-needed units in licensed housing statewide by June 2025.

But as The Oregonian/OregonLive reported last month, nearly a quarter of mental health clinic jobs in Oregon are vacant, and six Oregon counties had no psychologists last year. People of color, children and rural Oregonians are most affected by the shortage of mental health workers.

Clark, a licensed clinical social worker, took over the reins of the Oregon Department of Behavioral Health eight months ago. Before that, she spent more than a decade at the Multnomah County Health Department, including serving as director.

The state agency, she said, is trying to find ways to attract health workers to rural communities and encourage more students to pursue careers in behavioral health.

She said the state raised reimbursement rates by 30 percent last year for rural and culturally specific behavioral health providers as a way to boost wages for those workers.

The agency also said it will prioritize student loan repayment grants to rural providers and provide funding for clinical supervision, a costly requirement for student training. The state also offers sign-on bonuses and grants to help house and retain rural suppliers.

OHA will continue to advocate for funding creative solutions to address workforce issues, Clark said in a follow-up email.

Clark said the agency also approved a rate increase for coordinated care organizations, health networks that manage care for people on Medicaid. The goal, she said, is to offer more behavioral health services and hire more providers. Medicaid covers low-income Oregonians and people with disabilities.

She said OHA is distributing $80 million to recruit and retain more health workers, with rural and historically underserved communities being prioritized.

Clark acknowledged that states’ efforts face a major stumbling block. Recruiting qualified mental health providers, particularly in rural areas, remains difficult. They have to travel long distances and accommodation is often scarce in remote communities.

But as the state grapples with how to recruit and retain staff, it’s still trying to come up with a long-term plan to address the behavioral health crisis.

Governor Tina Kotek commissioned an analysis of the state’s mental health housing capacity. By the end of the year, the state will have a complete record of how many treatment beds it has, including safe residential treatment facilities and housing for drug addicts.

That report will help launch a five-year plan, Clark said, which would help allocate funds and identify what the state needs to build.

Clarke said that as she works to stabilize Oregon’s behavioral health system, she hopes to draw on the lived experiences of individuals and communities across the state.

She noted that the staff of the Office of Health Authority Recovery and Resiliency, established in 2021, includes nine individuals who have experienced behavioral health issues. These staff members are tasked with going into local communities and engaging people with behavioral health challenges in discussions that inform state policy.

I believe individuals and communities really do have the answers, Clark said. We have the ability to be brave and say that we are not experts on all things behavioral health. And if we identify as experts, how willing are we to try something different to get a better outcome?

Nicole Haiden contributed to this report.

Jayati Ramakrishnan; jramakrishnan@oregonian.com

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