Jan 29, 2026 | AOC Advocacy, Health & Human Services
Updates on Coordinated Care Organization (CCO) cuts to Community Mental Health Programs funding, impacts of Mink-Bowman lawsuit on local services, Rural Health Transformation grants, state-county partnership on HR 1 implementation, and the Statewide Shelter Program.
In case you missed it: Jan. 23 Local Government Advisory Committee (LGAC) on Health and Human Services (Meeting recording; Chat transcript)
CCO cuts to Community Mental Health Programs funding
Despite CCO’s ORS 414.153 obligation to maintain the mental health safety net system provided through local mental health authorities in order to meet the needs of their Oregon Health Plan (OHP) members, CCOs across the state are making significant cuts to their 2026 contracts with Oregon’s Community Mental Health Programs (CMHP). The mental health safety net, which includes court-ordered services necessary for the Oregon Health Authority (OHA) to effectively manage the Oregon State Hospital census, requires adequate OHP reimbursement for program viability.
The Association of Oregon Community Mental Health Programs described addressing this threat to Oregon’s safety net as a top priority, along with mitigating the expected loss of federal funding from HR1 and a longer term effort to close the funding gap identified in the latest cost study of required CMHP services. Many CMHPs also rely on Behavioral Health Resource Network grants which just received 14% reductions due to falling cannabis tax revenue projections.
CMHPs have been in discussion with OHA on potential solutions, including joint advocacy to the Legislature for sustainable funding for crisis stabilization centers;
prioritizing approval of CMHPs as new Certified Community Behavioral Health Clinics (CCBHCs); ensuring adequacy of CCO contract exhibit M (adequate networks/funding); and establishing a base rate for CCO reimbursement for priority populations and services set by OHA in the County Financial Assistance Agreement, such as Assertive Community Treatment, Early Assessment and Supports (EASA), Supported Employment, and WRAP.
During discussion at the Jan. 23 meeting, committee members noted that the CCO contract cuts have already resulted in loss of service to hundreds of community members, including medication management. Also on the chopping block are intensive youth services, medication assisted treatment for substance abuse, and supported employment, among others.
This issue will be a standing item on the committee agenda each month until it is adequately addressed, including the next meeting on Feb. 27.
Impacts of Mink-Bowman lawsuit on local services
Court Monitor Dr. Debra Pinals provided an update on her work with the state to address the wait times for persons in county jails to be admitted to the Oregon State Hospital (OSH) for competency restoration. Her latest update, Neutral Expert 10th Quarterly Report Regarding the Consolidated Mink and Bowman Cases, published in December, showed an average wait time of 21 days driven by an increase in court-ordered placements; the federal court-mandated maximum is seven days.
The state is accruing fines now in excess of $2 million on a per person per day basis for noncompliance with the court order. The court is making exceptions to the fine for cases where there is a delay in court orders or in transportation by county sheriffs. Those courts and sheriffs are being notified by OSH in those cases. Dr. Pinals is overseeing a workgroup which will decide how to disburse funding from the fines.
A community restoration program manual overseen by Dr. Pinals is now in draft form. She is also focusing on improvements to transitions out of OSH.
Public Consulting Group (PCG) has been contracted to provide an independent evaluation and is currently conducting a ‘deep dive’ into state budgetary allocations and expenditures for behavioral health services in order to identify what resources are needed and where to bring the state into compliance. Report recommendations are expected to come this spring.
Committee discussion noted the need for ongoing collaboration between Dr. Pinals and state and county partners on these efforts.
Rural health
OHA Policy Director Steph Jarem gave an update on Oregon’s Rural Health Transformation plan development. Oregon was awarded $197.3 million for Year 1 with an expected total over the next five years of about $1 billion. The definition of ‘rural’ is the same as used by Oregon’s Office of Rural Health. A contractor will support OHA in conducting regional conversations for the first of five initiatives within the program which focuses on regional partnerships and system transformation. OHA is still in final negotiation with the federal agency and expects to release its RFP in the spring with local award funding probably released in the summer. Director Jarem’s slides provide helpful details on federal eligibility requirements, allowable and not allowable use of funds, and Oregon’s five initiatives. Awards will prioritize ready-to-go projects and projects that are collaborative among local/regional partners.
State-county partnership on HR 1 implementation and the Statewide Shelter Program
County Health and Human Services directors brought forward a request for guidance from OHA on specific codes to use to demonstrate an individual’s exemption from new Medicaid eligibility requirements, e.g., definition of medical fragility, and noted the need for robust provider education ahead of the July 1 implementation of those new requirements. OHP Community Engagement Director Jessica Deas provided an HR1 Impacts and Strategies update. The committee will revisit this topic for new developments in February.
Oregon Housing and Community Services Department Director of Housing Stabilization Liz Weber provided an update on the implementation of the Statewide Shelter Program. Applications for new regional coordinators are now under review and will be announced “soon.” The new rules and program manual will not go into effect until those new regional coordinators are in place. Committee members recommended that new regional coordinators be required to have an active MOU with counties to ensure effective coordination.
Also presented was the state’s process and rationale for allocating the $65 million dollars directed by the 2025 Legislature to increase behavioral health residential treatment capacity and short overviews of OHA and ODHS rebalance proposals currently before the Legislature.
Contributed by: Jessica Pratt | Legislative Affairs Manager
Oct 1, 2025 | AOC Advocacy, Health & Human Services
In case you missed it: Sept. 26 Local Government Advisory Committee (LGAC) on Health and Human Services (Meeting recording and chat transcript)
Rural health
Oregon’s Office of Rural Health (ORH) was established by the Legislature in 1979 and moved from the state public health department to OHSU in 1989. It collects data and provides reports, technical assistance and coordination of rural health activities, as well as recruitment support for rural communities’ health care and Emergency Medical Services (EMS). ORH defines ‘rural’ as any geographic area in Oregon ten or more miles from the centroid of a population center of 40,000 people or more, and ‘frontier’ as any county with six or fewer people per square mile.
Director Robert Duehmig’s slides provide several maps illustrating the locations of these areas, details and links on their available workforce recruitment and retention programs, and examples of the technical assistance and tailored reporting available to rural communities. This technical assistance may be particularly useful to volunteer-staffed EMS to train them on billing practices to maximize service reimbursements.
ORH staff will return to LGAC early next year to provide an update on the implementation of their integrated mobile health program funded by a new Health Resources and Services Administration (HRSA) grant.
Oregon Health Authority (OHA) Policy Director Steph Jarem gave an update on Oregon’s Rural Health Transformation plan development in response to the application released by the Centers for Medicare and Medicaid Services (CMS) on Sept. 15. A public forum will be held the week of Oct. 6 to gather additional input. The application is due Nov. 5 and award decisions are expected by Dec. 31 for a five-year grant. OHA expects to release its RFP in mid-February with local award decisions slated for early May. Director Jarem’s slides provide helpful details on federal eligibility requirements, allowable and not allowable use of funds, and Oregon’s four priority areas. The ‘ruralness’ score estimates for the program are posted on the Sheps Center website.
Wildfire season recap
While there is still some fire activity, the season is quickly winding down. It was a lighter than expected year with only two major events ─ the Rowena Fire in Wasco County and the Flat Fire in Deschutes and Jefferson counties. The state Office of Resilience and Emergency Management (OREM) is providing recovery coordination which includes training and support to local human services partners for safe drinking water and hygiene and providing impact assessment and disaster case management at a per household level.
The county-based disaster registry is an especially valuable tool, with the help of OREM, to populate ahead of an event to allow for very precise evacuation planning for community members at highest risk and efficient emergency response during a disaster.
Recovery coordination is ongoing for the 2025 spring floods in Harney, Douglas, Coos and Malheur counties and for communities impacted by the 2020 wildfires. Director Ed Flick’s slides include a map of resilience hub resources deployed across the state, details of the Genasys Evac tool OREM is piloting and a look ahead at two likely 2026 legislative session bills.
State response to federal policy and funding actions
Interim Deputy Public Health Director Danna Drum reported that the Women Infants and Children program is the only public health program expected to be impacted by the imminent shutdown of the federal government, with current funding likely to run out Oct. 15. Other programs can be maintained through the end of the calendar year and retroactive payment is anticipated once federal funding resumes.
The Oregon Housing and Community Services department is awaiting direction from federal agencies on the implementation of the presidential executive order on homelessness response. Counties and other federally funded Continuum of Care administrators are concerned about the likely fracturing of local homelessness response programs and coordination when federal policy mandates begin to conflict with state policy mandates for state-funded homelessness prevention and response services.
Ashley Thirstrup from the OHA director’s office shared this August Oregon Department of Administrative Services analysis which includes the following excerpt:
“H.R. 1 Medicaid program changes have varying implementation dates. Effective fall 2026, OHA anticipates $22 million in reduced funding, impacting services for certain non-citizens, which includes asylees, refugees, and victims of human trafficking. As noncitizens lose access to services under this category, these populations will likely shift to access coverage under the Healthier Oregon Program (HOP) in order to access benefits. It is not yet clear how these changes will impact Tribal populations’ ability to access Medicaid-funded health services.
“Beginning January 1, 2027, OHA will have to implement changes to meet updated requirements to access Medicaid-funded services. To comply with these changes, OHA will need to make upgrades to existing IT systems to ensure that benefits are being offered in alignment with H.R. 1 provisions. OHA noted a potential need for additional staff to manage call centers to help benefit enrollees navigate pending program and benefit application changes, and staff will be needed to begin verifying eligibility of plan holders beginning in 2027. OHA projects that upon implementing processes to verify benefit eligibility every six months, Oregon will see a reduction in Medicaid funding of $127 million in the 2025-27 biennium, $534 million in the 2027-29 biennium, and $571 million in the 2029-31 biennium. When OHA implements processes to ensure that enrollees comply with work requirements, the projected revenue lost is $344 million in the 2025-27 biennium, $2.2 billion in the 2027-29 biennium, and $2.3 billion in the 2029-31 biennium.
“While OHA manages upgrading existing IT systems to enact this work, the agency will also be working to complete work to stand up a new State Based Marketplace for individuals to secure health insurance coverage. It will be important to ensure that OHA has the capacity and clarity needed to deliver on the work required in H.R. 1, as well as projects included in the agency’s 2025-27 budget. OHA anticipates receiving approximately $175 million to support rural hospitals and health systems during the 2025-27 biennium.
“H.R. 1 will also reduce the resources OHA can draw down from Medicaid based on the Hospital Provider Tax assessed on providers and insurers. The projected reductions to revenue will be $603 million in the 2027-29 biennium, and $1.7 billion in the 2029-31 biennium. Additionally, adults that have Medicaid-funded plans through the Affordable Care Act will have to share a portion of the costs for accessing benefits and services.”
Oregon Department of Human Services Deputy Director of Self Sufficiency Programs Jessica Amaya Hoffman shared the agency’s analysis of the impacts of H.R. 1 on the USDA’s Supplemental Nutrition Assistance Program (SNAP) in Oregon. Immediate impacts include:
“The current levels of support to community providers serving existing SNAP clients will be insufficient to meet needs once SNAP benefits are reduced or eliminated for a portion of the current caseload. The exemption of certain individuals from SNAP benefits will likely place additional pressure on the food bank system as well as other systems of social support throughout Oregon. About 310,000 adults will need to be reviewed for work requirements or exceptions for SNAP eligibility; about 3,000 individuals will lose benefits, including refugees, asylees and other conditionally allowed individuals. SNAP benefits won’t rise with food prices, making it harder for people to afford groceries. About 29,000 households will see an average monthly benefit decrease of $58.
“It should be noted that ODHS expects significant staffing cost increases to comply with the changes in H.R. 1, particularly in the Oregon Eligibility Partnership (OEP) to administer the new Medicaid-eligibility and redetermination requirements. The effective date for many of those changes is December 31, 2026. The changes will require extensive administrative infrastructure, including monthly verification systems, rulemaking, notices, and coordination across ODHS, the Oregon Health Authority (OHA), and the Employment Department. Implementation of the changes will also require significant IT system changes that will carry additional costs. For example, ODHS has estimated a need for approximately 600 positions solely for the more frequent Medicaid eligibility redeterminations.
“Aside from immediate impacts to ODHS customers, the Department is in the process of forming a team to bring down the SNAP error rate. Under H.R. 1, if the SNAP error rate is below 5.99 percent, a state’s share of the cost of benefits remains at zero percent. Only eight states are below 5.99 percent, according to the most recent data reported by Federal Funds Information for States. OEP has indicated that the SNAP error rate will still be above the national average for federal fiscal year 2024, the error rate is expected to be closer to 13 percent, compared to 16 percent in 2023 and 22 percent in 2022. If Oregon can bring down the SNAP error rate, potential savings are significant. If the current error rate continues, the state will be responsible for 15 percent of SNAP benefit costs or approximately $0.5 billion per biennium.”
Contributed by: Jessica Pratt | Legislative Affairs Manager
Apr 30, 2025 | AOC News, Health & Human Services
Which communities do you belong to? Who is your closest friend? What are your dreams? Who do you consider family?
These were the questions asked of members of the 2025 County College class during an exercise led by a peer support specialist at the Oregon State Hospital Museum of Mental Health. Participants began with a paper star symbolizing their support systems. As points are removed, the pieces represent how losing support can impact a life. The activity helped the group reflect on the lives of individuals receiving care at the hospital and better understand the importance of community and support systems in mental health treatment.
In addition to this exercise, the class toured the Oregon State Hospital Museum of Mental Health, which explores the history of the hospital since its founding in 1862. The museum shares stories of the patients who lived there and traces the evolution of mental health care over time.
This experience was part of the third session of County College, a program by the Association of Oregon Counties (AOC) designed to equip new county leaders with training on governance, roles, and responsibilities. The session focused on Health and Human Services — a broad and vital area where counties act as the primary link between state programs and local service delivery. As local mental health and public health authorities, counties are responsible for ensuring that public health, behavioral health, and developmental disability services are responsive to the community’s needs and work in coordination with public safety and other local partners.
“Counties have so many critical responsibilities delegated by the state that it is sometimes hard to track them all,” said Washington County Commissioner Jason Snider. “I really appreciated the thorough sessions on public health, behavioral health, and veteran services. Learning about the long and complicated story of the Oregon State Hospital also helped me connect the current challenges we face with the history of how we got here.”
Throughout the session, participants heard from a variety of agencies that partner with counties to deliver these essential services — including OSU Extension Services, the Oregon Health Authority, the Association of Oregon Community Mental Health Programs, and the Oregon Coalition of Local Health Officials. These discussions offered firsthand insights into the collaborative nature of delivering mental and public health services across the state.
Three county commissioners — AOC President and Umatilla County Commissioner John Shafer, Lane County Commissioner Laurie Trieger, and Wasco County Commissioner Phil Brady — shared their experiences in meeting behavioral health needs in their communities, offering lessons learned and success stories.
Veterans services, like health and human services, are delivered through a long-standing state and county partnership. Lincoln County Veteran Services Officer Keith Barnes provided an overview of services and assistance available to all who have served and their families
At the national level, the National Association of Counties (NACo) supports counties in the intergovernmental system. NACo’s Legislative Director Owen Hart discussed how commissioners can influence federal policy and access opportunities and resources. Gregory Nelson, director of the National Center for Public Lands Counties, provided updates on how the center coordinates with federal agencies on key issues like landscape health, wildfire mitigation, and economic development.
The session wrapped up with iSector sharing best practices on convening leaders from the private, public, and civic sectors to address challenging issues, leaving attendees inspired and better prepared to tackle pressing issues in their own counties.
Executive Director Gina Nikkel emphasized the important role of intergovernmental collaboration in addressing behavioral health. “County commissioners are uniquely positioned to act as convenors and problem-solvers within their communities,” she said. “Behavioral health is a complex issue and I’m grateful for this county college class’s commitment to understanding it and their willingness to work to strengthen how we support individuals with mental health needs.”
Special thanks to OSU Extension Services and CIS Oregon for their financial support that helps make County College possible, and to all our guest speakers for sharing their time and expertise on behavioral and public health, veteran services, and building strong partnerships that support healthy individuals, families, and communities.
For more information on County College visit: https://oregoncounties.org/ed-events/#countycollege
Contributed by: Erin Good | Communications Coordinator
Dec 18, 2024 | AOC News, Health & Human Services, News
In his inaugural address at this year’s annual conference, the Association of Oregon Counties (AOC) President John Shafer (Umatilla County) announced his 2025 presidential initiative, which will “focus on mental and behavioral health to equip us all to exercise our local mental health authority to foster healthy, vibrant, and safe counties across Oregon.”
Shafer’s dedication to mental and behavioral health began during his time with the Umatilla County Sheriff’s Office where he saw firsthand the need for a cohesive and coordinated system of care that provides both behavioral and mental health services. As a newly elected Umatilla County Commissioner, Shafer sought out a service provider that would offer comprehensive behavioral and mental services under one Community Mental Health Program (CMHP), and this model is what Umatilla County still uses today.
“Counties are the local mental health authority,” Shafer explained. “We are responsible for coordinating a continuum of evidence-based services and support for mental health and substance abuse prevention, treatment, and recovery, mobile crisis response, jail diversion, and court mandated treatment that meet the assessed needs of our residents.”
Shafer encouraged fellow county commissioners to familiarize themselves with their CHMP directors, local service providers, and Coordinated Care Organizations (CCOs), and to gain a deeper understanding of their county’s system of care.
Shafer’s presidential initiative kicks off in January with the first in a series of monthly challenges.
January’s challenge:
- Read this short primer on local mental health governance in Oregon, authored by Malheur County CMHP Director Steve Jensen, and to join a brief presentation by Greater Oregon Behavioral Health (GOBHI) CEO Ann Ford at the AOC Legislative Committee meeting on Monday afternoon, Jan. 13.
Stay tuned for additional learning opportunities throughout the year and a celebration at the 2025 AOC Annual Conference.
Contributed by: Erin Good | Communications Coordinator
Sep 30, 2024 | Health & Human Services, Public Safety & Veterans
The Deflection Engagement and Coordination ECHO Program is offering free webinars on deflection. View more information on the OHSU October Bulletin and Deflection Brochure.
Deflection Level Setting
Oct. 8, 2024 from 12-2 p.m.
Learn from national expert, Jac Charlier on deflection. This webinar is ideal for anyone working in deflection, law enforcement or social services. Jac Charlier is the Executive Director of TASC’s Center for Health and Justice (CHJ) and Executive Director and co-founder of the Police, Treatment, and Community Collaborative (PTACC). He is a co-founder of the international deflection movement and works to grow and develop the global field of deflection from research to legislation to policy to practice.
Register Here
Deflection Engagement and Coordination ECHO
Oct. 16, 2024 from 12-1 p.m.
This 14 session ECHO meets every 1st and 3rd Wednesday. Connect with others working in deflection, learn from experts and brainstorm difficult cases with your peers in other counties. The purpose of the Deflection Engagement and Coordination ECHO is to develop the deflection skillset and function as a networking space for the multidisciplinary deflection workforce in Oregon. Participants will learn from the ECHO Team and from their peers operating deflection programs across 28 Oregon counties. County teams in planning and in operational phase of new deflection programs are encouraged to register.
Register Here
Motivational Interviewing
Nov. 1, 2024 from 10-11 a.m.
In this informational and practical training, we will explore how to use motivational interviewing to facilitate positive change. In this series of informational and practical trainings, we will explore how to use motivational interviewing to facilitate positive change. The initial training is applicable to all roles; aspects of the method can be applied in even the briefest of client interactions.
Register Here
Contributed by: Jessica Pratt | Legislative Affairs Manager, Health and Human Services
Jul 25, 2024 | Health & Human Services
NACo commission’s federal-county call to action
The NACo Commission on Mental Health and Wellbeing unveiled its final report at the annual conference in Tampa, Fla. Association of Oregon Counties (AOC) Executive Director Gina Nikkel served as a member of the commission. The report’s four federal policy priorities (plus two) align with AOC’s 2025 state legislative priorities and would increase access to quality local behavioral health services in every Oregon county. The report concludes with a matching call to action for county policy makers, outlining steps to lay the necessary groundwork in anticipation of successful advocacy in Washington, D.C.
Polk County Public Health Director Dr. Naomi Adeline-Biggs named new state public health division director
Oregon Health Authority (OHA) Director Sejal Hathi announced her appointment of Dr. Naomi Adeline-Biggs as OHA’s Public Health Division Director, effective Aug. 19. Along with an impressive history of practice and leadership abroad, Adeline-Biggs is the sitting chair of the Oregon Coalition of Local Health Officials. She was also a dynamic local public health presenter at the most recent AOC County College held in 2023.
The Oregon Criminal Justice Commission (CJC) publishes summary of county deflection program applications
In July, the CJC released a comprehensive summary of county deflection program applications. Twenty-seven Oregon counties will be standing up a new program, either individually or in partnership with a neighboring county. Marion County will use the new funds to bolster its deflection program which began in 2018. The new programs will go live on different schedules, starting in July and going through January 2025. Additional CJC materials on the deflection program, including a FAQ, can be found on the program webpage.
Contributed by: Jessica Pratt | Legislative Affairs Manager
