Oregon Democrats, Republicans highlight behavioral health and workforce shortages as healthcare focus areas

Oregon lawmakers on both sides of the aisle highlighted healthcare areas they intend to focus on, including behavioral health and workforce shortages, during the 2022 Oregon State of Reform Health Policy Conference.

 

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Sen. Kate Lieber and Reps. Rachel Prusak and Maxine Dexter represented the Democratic Party at the conference, while Reps. Raquel Moore-Green and Christine Goodwin represented the Republican Party. 

Moore-Green said the most significant piece of legislation she worked on during the past session was Senate Bill 1529, which requires individual and group health insurance plans to reimburse providers for at least 3 annual primary care visits, and 1 annual preventive primary visit. The appointments can be with a primary care provider or behavioral health provider. 

The bill also removes multiple copays for behavioral health services on the same day or in the same facility as primary care services, along with requirements for prior authorization for specialty behavioral health services.

“Part of removing the stigma of mental health is it becomes like going to the dentist [or] the eye doctor,” Moore-Green said. “Our brain is an organ. We don’t treat it the same way we treat our heart. If someone has heart disease we want to get right in there and get it fixed up. People are very resistant to talk about the brain and what goes on in our minds sometimes. And I think removing that is really important because I don’t think there’s a single person in here who hasn’t experienced at least one day of depression in their lives.”

Moore-Green said she is working on a bill that will advocate for the establishment of a Senate behavioral health committee.

Prusak discussed the passage of House Bill 4003 during the last session. The bill supports nurses and aims to shore up the state’s ongoing nursing staff shortage. It expanded programs that support the mental health of nurses.

“We know a lot of people have left the workforce,” Prusak said. “What can we do to support the workforce? One big answer that came out of the bill was we don’t support our nurses with accessible behavioral health. We have the Oregon Wellness Program that is offered to nurse practitioners and physicians, but not nurses. So we were able to tell the Board of Nursing to release money to set up a program so all nurses can access telehealth within 72 hours urgently for behavioral health support. That is getting rolled out to all hospitals.”

Lieber noted that Oregon’s healthcare sector scored a big win with CMS’ recent approval to renew the state’s 1115 Medicaid Demonstration waiver for the next 5 years, an effort that was led by the Oregon Health Authority (OHA). The waiver expanded health coverage for young children and extended eligibility for youths and adults. It will also provide $1.1 billion in federal funds to address inadequate food, housing, and other root-cause issues that lead to poor health.

“People are falling through the cracks in the healthcare system,” Lieber said. “How do you shore up where people are falling through? One of the things we don’t have through the waiver is keeping people on [insurance] when they come out of jail or a state hospital.”

Dexter said care continuity is lacking in the state. 

“When someone goes into a justice-involved situation [or] is moving out of the foster care system, when we have people in the state hospital, these are huge gaps and these are our most vulnerable members of our community,” Dexter said. “So what we have now is this opportunity to bridge that gap. People coming out of those situations will have housing for up to six months paid by the government. I don’t know if any healthcare organization has billed Medicaid for housing before. I certainly don’t think that any housing provider has billed Medicaid for housing.”

Goodwin said she is concerned about putting more responsibilities on OHA’s plate, however. 

“I’m concerned about moving more decisions in the direction of the [OHA],” Goodwin said. “They already, to me, are like this huge freightliner that is just loaded with cargo. And they can hardly move. And we just keep adding to them. And I’m wondering at what point it sinks. This is a system that obviously has to be evaluated, and I want to really help OHA. We want those services to be delivered effectively to our citizens. So I’m looking at that carefully.”

Goodwin said it will be important for Democrats and Republicans to work together to address health sector challenges.

“Our Republican vision, we really see the need for balance in government,” Goodwin said. “The last time there was really balance in the legislature was 10 years ago. Parties have to come together and take the best ideas from both parties. Often, we have a common goal.”