Next month, we’ll host the 10th annual State of Reform event. It’s a little crazy to me to think about all of the work in those intervening 10 years. In those early days, Bruce Goldberg was very kind. Amy Fauver showed up for a keynote at the last minute in place of an ailing Rocky King, rather than let us down. And, Jeff Heatherington would say “Push harder. Make this worth the time.”
State of Reform works — it exists — because folks understand the importance of getting together with a diverse group to wrestle big ideas to the ground. It’s not us at State of Reform that is so important. It’s you — and the fact that you know progress only comes by doing the hard work of engaging directly with one another on the big challenges of the day.
So, thanks for letting us be one of the rooms where you put in the work.
With help from Emily Boerger
1. Q&A: Becky Hultberg on hospital workforce
New modeling predicts Oregon hospitals may be filled with COVID patients until mid-November. In this Q&A, OAHHS CEO Becky Hultberg describes how Oregon hospitals are currently coping with the Delta surge, and reflects on the workforce shortage that has gotten worse during the pandemic.
Hultberg says once the state pivots toward recovery, it will have to look back on the recent workforce-related financial impacts of COVID, which she says will be extreme. “We are at the most difficult time of the pandemic from a workforce perspective. It will take us years, or even decades, to normalize…[We need to think about] how we rebuild our workforce, how we reevaluate our training programs, and how we can help our workforce recover.”
2. Legislators on our Detailed Agenda
In less than two weeks, we’ll release the Detailed Agenda for the 2021 Oregon State of Reform Health Policy Conference. The list will include over 50 speakers who will come together on October 26 for one the largest, most diverse convenings of senior health care executives and policy leaders in the state. Be sure to check out the Topical Agenda to get a feel for the day, as well as the Convening Panel to see some of the folks who are helping put the agenda together.
Ahead of the Detailed Agenda release, I wanted to feature some of the legislators that we’ve already lined up to join the conference. Speaking on our “Policy Leadership: Democrats” panel will be Senators Deb Patterson and James Manning Jr, along with Rep. Marty Wilde. On our “Policy Leadership: Republicans” panel you’ll hear from Sen. Dick Anderson and Reps. Raquel Moore-Green and Suzanne Weber. Rep. Tawna D. Sanchez, who Chairs the House Interim Committee on Behavioral Health, will join us on our “Scoping the Challenges, Investments in Behavioral Health” panel.
3. Geographic variation in COVID recovery
After peaking at the start of this month amidst the Delta surge, the latest OHA data shows new COVID cases have declined for the second week in a row. Modeling from OHSU indicates hospitalizations have peaked as well. Despite these positive signs, recovery across the state is not uniform.
An analysis by The Oregonian/OregonLive details the areas of the state with “stubbornly high” COVID spread. It finds that 11 of the 12 ZIP codes with the highest weekly case rates are below the statewide average in vaccinations. According to OHA data, 7% of statewide ICU beds and 8% of non-ICU beds are available. This also varies by location with some regions reporting 41% availability of non-ICU beds and others reporting 4% availability.
4. Behavioral health capacity continues to drop
Oregon’s behavioral health system is struggling with capacity, workforce, and access concerns, according to Heather Jefferis, executive director of the Oregon Council for Behavioral Health. A recent report from OCBH notes that for over 20 years, Oregon has ranked in the bottom 25% of states for SUD and mental health access, but has ranked in the top quarter for systemic need.
The report finds that during the pandemic, capacity of OCBH members dropped between 20% and 75%. According to data provided by Jefferis, the state has a total of 639 single adult residential SUD beds, but currently there are only 399 functional beds due to workforce shortages. Survey results in the report found 92% of behavioral health providers have increased wages to obtain or retain staff, though 92% say they are not able to balance their budgets with the increases.
5. Data collection and climate change response
In a joint statement released earlier this month, the editors of more than 230 medical journals declared climate change the “greatest threat to global public health.” With the summer’s record-setting heatwaves in mind, State of Reform Reporter Patrick Jones caught up with CareOregon CMO Dr. Amit Shah for his take on how health plans can better prepare for these kinds of emergencies.
The key, he says, is better data collection – particularly data related to the social determinants of health. During the June heatwave, Shah says: “We found there were individuals who had air conditioners and cooling systems, but the issue was [that] they didn’t turn it on because they could not afford the utility bill.” He says proactive outreach to understand the issues facing their members will be critical for future emergency responses.