Aug 28, 2023 | AOC News
AOC Executive Director Dr. Gina Nikkel, Ph.D. will speak on a White House Office of National Drug Control Policy (ONDCP) webinar on September 27 that will focus on developing and applying for an 1115 waiver from the Centers for Medicare & Medicaid Services (CMS). During this webinar she will share Oregon’s process and discuss how Oregon would utilize the waiver if it were approved by CMS.
“The Association of Oregon Counties is focused on using the lessons and momentum of our joint pandemic response to grow the state-county partnership and begin to clear away some long-standing roadblocks in the system, like the Medicaid inmate exclusion policy,” Gina said.
The webinar will also include remarks from ONDCP Director Dr. Rahul Gupta and Sheriff Koutoujian from Middlesex County, Massachusetts as well as insights from California’s approved 1115 waiver.
“On January 26, the U.S. Department of Health and Human Services (HHS), through the Centers for Medicare and Medicaid Services (CMS), approved a first-of-its-kind Medicaid and Children’s Health Insurance Program (CHIP) section 1115 demonstration amendment in California, which will connect justice-involved people in jails and prisons with community-based Medicaid providers 90 days before their release to ensure continuity of care upon return to the community. For those that meet certain criteria, the demonstration will permit the use of federal Medicaid dollars for certain physical and behavioral health care treatment and community services to address health-related social needs,” NACo reported in February of this year.
Oregon is in the process of implementing a number of new 1115 waiver benefits, including for justice-involved individuals in jails and prisons. Acting Oregon Health Authority Director Dave Baden is engaging with the Local Government Advisory Committee (LGAC) during that process in order to incorporate the expertise of local human services system partners. His July presentation to the LGAC lays out the current thinking and timeline for new benefit implementation.
Contributed by: Jessica Pratt | Legislative Affairs Manager
Aug 28, 2023 | AOC News
The National Association of Counties (NACo), the National League of Cities (NLC), and the Oregon Housing and Community Services Department (OHCS) have joined an effort to promote federal legislation expanding a powerful tool local governments can use to help finance affordable housing developments.
Local governments have been increasingly turning to Private Activity Bonds (PABs) to boost affordable housing construction and alleviate the affordable housing crisis. PABs are a type of municipal “conduit” bond that local governments can leverage to fund construction of buildings, infrastructure, or amenities that provide some public benefit but which are privately owned.
Governments who issue PABs aren’t borrowing any money – the debt is carried by the project developer, who enjoys a favorable interest rate as a result of the federal tax break on investors’ PAB income. Since PABs cost the feds in the form of lost income taxes, states are subject to PAB caps. With the growing popularity of PABs in Oregon, the caps have started to seriously constrain the ambitions of Oregon local governments. As the affordable housing crisis continues, local governments need all the tools they can get to address the problem. The Affordable Housing Credit Improvement Act (AHCIA) of 2023 (AHCIA, S. 1557 & H.R. 3238) would increase the cap on PABs, empowering local governments to get more public benefit projects built.
Call to Action!
Local government leaders are being invited to sign on to a letter supporting the AHCIA.
[Click here to view the letter supporting the AHCIA]
[Click here to sign on to the letter supporting AHCIA]
The deadline for local elected officials to sign on is September 7.
The ACTION Campaign is the main advocacy arm of this effort, and they’ve partner with the National League of Cities, National Association of Counties and the Mayors and CEOs for U.S. Housing Investment to circulate a sign-on letter from local elected officials—specifically, mayors, county executives, and county board chairs—to congressional leadership in support of the AHCIA.
Contributed by: Michael Burdick | Legislative Affairs Manager
Aug 1, 2023 | AOC Business Partner
We would like to acknowledge and congratulate the April NACo Leadership Academy graduates from Oregon. They join over 10,000 graduates and current participants from across the country benefitting from the 12-week online program enabling existing and emerging county leaders to achieve their highest potential.
- Aiyana Bankston, IT Business Analyst, Washington County
- Al O’Quinn, ITS Project Manager, Washington County
- Angela Dolan, Management Analyst II, Washington County
- Brian Hanes, GIS Coordinator, Washington County
- Bryan MacDonald, Configuration Management Supervisor, Washington County
- Charlene Bosell, Senior Database Administrator, Washington County
- Christina Pomrenke, Project Manager, Multnomah County
- Dan Spraker, Network Administration Supervisor, Washington County
- Darren Nichols, Community Development Director, Benton County
- Destiny Fogarty-Olivas, ITS Project Manager, Washington County
- Diane Lee-Kuneer, Administrative Specialist II, Washington County
- John Williams, Facilities Operations Manager, Washington County
- Judy Williams, Strategy and Integration Manager, Lane County
- Justin Ramsdill, Systems Administration Supervisor, Washington County
- Kea Sundberg, Senior Management Analyst, Washington County
- Kevin Babbitt, Advanced Technology Manager, Washington County
- Luke Ross, Technical Services Manager, Washington County
- Mitchell Hernandez, Appraisal Supervisor, Umatilla County
- Nada Mohamoud, IT Business Analyst, Washington County
- Nikki Underwood, Helpdesk Supervisor, Washington County
- Rebekah Bishop, Sr Information System Analyst, Washington County
- Sam Kim, Interim CIO, Washington County
- Savannah Lane, Assistant Director of Budget and Finance, Umatilla County
- Shane Boyle, Systems Administration Supervisor, Washington County
- Suzie Dahl, Director of Land Development Services, Columbia County
- Theme Grenz, Project Management Office Manager, Washington County
- Wayne Flynn, Advanced Technology Manager, Washington County
Invest in Your Team with Leadership Training!
Our September cohort is just around the corner. Prioritize leadership development today and deliver results for your team and county. Scholarships are available.
CLICK HERE TO LEARN MORE AND ENROLL
Developed by General Colin Powell, the Professional Development Academy and NACo, the High Performance Leadership Academy is an online 12-week program that helps your workforce develop fundamental, practical leadership skills to deliver results for counties and residents.
Contributed by: Kristen Paul | Public Affairs Associate
*Sponsored content provided by AOC Business Partner.
Jun 27, 2023 | AOC News
National Association of Counties Commission on Mental Health and Wellbeing Amplifies Message at White House, on Capitol Hill
As a member of the National Association of Counties (NACo) Commission on Mental Health and Wellbeing, Gina Firman Nikkel, Ph.D, advocated last month in Washington, D.C. for policy priorities around mental and behavioral health. The commission also released new research highlighting county perspectives on this national crisis.
Part of Mental Health Awareness Month efforts, on May 10, the group joined the White House State and Local Partners Forum on Mental Health and Wellbeing, and on May 11, the commission met on Capitol Hill with the Bipartisan Mental Health Caucus and the Bipartisan Addiction Task Force. The commission shared crucial county perspectives geared towards strengthening the intergovernmental partnership and urging action to achieve shared goals.
“Counties in Oregon are the boots on the ground – and by law – the local mental health authority. We must continue to present the whole story of what is needed to coordinate and deliver an effective local continuum of care. This care should be driven by science not profit. It should be driven by people experiencing mental health challenges and addiction not commercialization. And, it should be driven by compassion not apathy,” stated Nikkel.
The commission released new data based on a survey of over 200 U.S. counties, with findings focused on the mental health landscape in counties and the areas of greatest need. Key takeaways from the research include:
- The nation is facing an acute escalation of the mental and behavioral health crisis.
- Seventy-five percent of counties reported an increase in incidence of behavioral health conditions in the last year, and 89 percent reported an increase compared to five years ago.
- Youth behavioral health needs are at the forefront of the crisis.
- Two-thirds (67 percent) of counties reported that youth behavioral health conditions are “definitely a problem” or “very prevalent and/or severe.”
- Limited access to services inhibits county residents from receiving the help they need.
- Seventy-four percent of counties cited financial costs as a barrier to expanding access to behavioral health services, and 71 percent cited lack of direct service providers.
- The crisis is exacerbated by a lack of behavioral health workers.
- Nearly three-quarters (72 percent) of counties consider the shortage of behavioral health workers in their county to be “definitely a problem” or “a severe problem.”
- The financial and human costs of behavioral health are compounding across all county systems.
- Eighty percent of counties indicated that they incurred associated costs in the legal system (courts and jails), 77 percent indicated associated costs in law enforcement, and 54 percent indicated associated costs in the health system and hospitals.
“This data released on behavioral health conditions by the NACo Mental Health Commission is significant and supports what our counties are experiencing on the ground in their communities. We must tackle the workforce shortages, unfair policies, and the risks of profit over personalized care,” stated Nikkel.
The new research pairs key findings with associated policy objectives, including:
- Amending detrimental policies under Medicaid, like the Medicaid Inmate Exclusion Policy (MIEP) and the Institutions for Mental Diseases (IMD) exclusion
- Obtaining direct and flexible resources to support the recruitment, training and retention of a sufficient behavioral health workforce
- Enhancing the intergovernmental partnership for the development and modernization of local crisis response systems and infrastructure, and
- Enforcing policies that ensure equitable coverage for treatment of mental illness and addiction.
The events last month marked the first in-person meeting of NACo’s Commission on Mental Health and Wellbeing since it was announced in February. The group is focused on building urgency, awareness, and crucial partnerships around the mental health crisis in America, with plans to release in-depth policy and programmatic recommendations in early 2024.
For more information about NACo’s Commission on Mental Health and Wellbeing, click here.
Feb 14, 2023 | AOC News
The National Association of Counties (NACo) announced the appointment of AOC Executive Director Gina Firman Nikkel, Ph.D. to the newly created NACo Mental Health and Wellbeing Commission, during its annual legislative conference held in Washington D.C.
The 14-member commission, created to drive change in the nation’s mental health system and policies, is composed of county leaders with mental health-centered expertise.
Nikkel, who has served as AOC’s Executive Director since 2020, brings to the commission many years experience as a therapist and program manager in rural county mental health and crisis work; 11 years as the Association of Oregon County Mental Health Program Director, eight years as a county commissioner, and nine years as the President and CEO of the international Foundation for Excellence in Mental Care (FEMHC) which she helped create. Dr. Nikkel holds a master’s degree in counseling and a Ph.D. in Social Public Policy and Leadership.
“I’m honored to have been appointed to this commission,” commented Dr. Nikkel. “The work of this body is critical in meeting the urgent needs of Americans in the mental health crisis we are currently facing.”
The commission’s charter is:
- Stimulate national sense of urgency, through an intergovernmental partnership framework, for addressing our nation’s crisis with mental health and wellbeing of residents, especially our most vulnerable.
- Elevate the national awareness of the roles, innovations, and pain-points facing county governments in addressing this escalating crisis.
- Achieve NACo’s public policy agenda, such as the full implementation of Mental Health Parity standards, modernize the unequal coverage of mental health care through the “institutions for mental disease” (IMD) prohibition, repeal the Medicaid Inmate Exclusion Policy for people held in jail pre-trial, and build the mental health workforce and continuum of care for the future.
- Align a cohesive national and intergovernmental strategy to improve and enhance the mental health and wellbeing of all Americans, with a special focus on our most vulnerable populations.
Issues that the committee will tackle are broad ranging, including the need for mental health professionals and increased need for service. Currently, one-third of the U.S. population lives in a county designated as a mental health professional shortage area.
“In 2021, nearly one in four U.S. adults and one in five adolescents experienced a mental illness,” said NACo President Denise Winfrey. “This commission understands the urgency of the moment. It’s made up of people who, in their own communities, are seeing the effects of the mental health crisis, and have an idea of where we need to start in order to address it.”
“The gap in service and continued increase in demand exacerbated by the pandemic has elevated the need for us to roll up our sleeves with coalition partners across a continuum of care, and drive real change through investments and policy,” said Nikkel. NACo is working with the White House, the U.S. Department of Health and Human Services, the Council of State Chief Justices, and many more coalition partners on this initiative.
Counties are well-positioned to lead action on the mental health crisis because counties play an integral role in local health, justice and human services systems. Direct mental health service delivery responsibilities are falling increasingly to America’s counties, which serve as the nation’s safety net for residents in need, act as first responders, operate crisis lines, and manage public hospitals and detention centers.
Between April 2023 and February of 2024 the commission will meet and convene sub-groups to develop a final report and recommendations at the 2024 NACo Legislative Conference.
For more information about NACo’s Commission on Mental Health and Wellbeing, click here.
Contributed by: Megan Chuinard | Public Affairs Associate
