Legislature passed OHA budget as session ends

The Oregon Legislature passed House Bill 5024 which contains the Oregon Health Authority (OHA) budget Saturday as the legislative session drew to a close. No program cuts were made in this budget which runs contrary to Gov. Brown’s recommended budget in December when revenue was forecasted to be low. Key investments include health equity, behavioral health and caseload growth.

 

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The bill passed without change with total funds at $29.8 billion. In the bill, $3.6 billion comes from the general fund, $16.9 billion comes from federal funds and $9 billion comes from other funds. Other funds include money from increasing revenue streams like ballot measure 108, which increased cigarette, vaping and tobacco product taxes and brought in an additional $414.0 million for Medicaid.

In the Governor’s recommended budget in December, OHA’s total fund projections at $27.2 billion were lower than the legislatively approved budget. According to Tom MacDonald, principal legislative analyst with Oregon’s legislative fiscal office, the biggest driver of this increase is caseload growth.

The increase between the Oregon Health Plan (OHP) caseload forecasts in fall 2020 and spring 2021 was 133,000 average monthly members for 2021-2023. MacDonald says that allocating funds to caseload growth is challenging due to OHP pandemic policy changes in which OHP cannot disenroll members during the state of emergency.

“The caseload forecast has more risks in it than under a normal biennium. This one is riskier because of the federal provisions surrounding the pandemic. It is not entirely clear when the federal public health emergency will end and the timing of that will impact the caseload forecast and funding.”

MacDonald highlighted the importance of behavioral health investments in the budget. The bill allocates $130 million to regional development and innovation. These funds invest in increasing the statewide capacity of in-patient residential psych beds to address behavioral health and mental health needs. 

Oregon State Hospital will receive $725.6 million to create two new units to address capacity shortages and community mental health centers will receive funds for more staffing and materials to bring more patients to certified community behavioral health clinics (CCBHCs). CCBHCs will receive $121 million to expand current clinics and to create new clinics across the state.

“[Behavioral health] is a very prominent investment. It is prominent not just the size of the money, but the approach that is taken. I haven’t seen an investment of this nature in behavioral health, given the parameters that are set up.” 

MacDonald also highlighted the legislature’s push for health equity in the budget. Health equity implementation gets $6.8 million as well as 17 new positions for OHA’s Office of Equity and Inclusion to support OHA’s goal of eliminating health inequities in 10 years. Other health equity bills like Cover All People, HB 3352, and the bill on data collection, HB 3159, were also invested in by the legislature.