Oregon Democrats, Republicans highlight behavioral health, workforce shortages as health care focus areas – State of Reform

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

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

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

The bill also eliminates multiple copayments for same-day or same-facility behavioral health services as primary care services, along with prior authorization requirements for specialty behavioral health services.

“Part of de-stigmatizing mental health is that 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 a heart condition, we want to go in right away and fix it. People are very resistant to talking about the brain and what sometimes happens in our minds. And I think removing that is really important, because I don’t think there’s a single person here who hasn’t experienced at least one day of depression in their life.

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

Prusak discussed the passage of House Bill 4003 during the last session. The bill supports nurses and aims to support the ongoing nursing shortage in the state. It has 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 response that came out of the bill was that we don’t support our nurses with affordable behavioral health. We have Oregon Wellness Program which is offered to nurse practitioners and physicians, but not to nurses. So we were able to get the Board of Nursing to release money to create a program so that all nurses have access to telehealth within 72 hours of an emergency to support behavioral health. This is spreading across all hospitals.

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

“People fall through the cracks in the health care system,” Lieber said. “How do you support yourself where people fall? One of the things we don’t have through the exemption is keeping people [insurance] when they leave prison or a public hospital.

Dexter said the state lacks continuity of care.

“When one enters a situation involving justice [or] comes out of the foster care system, when we have people in the state hospital, those are huge gaps, and those 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 these situations will have housing for up to six months, paid for by the government. I don’t know if any health care organization has billed Medicaid for housing before. I certainly don’t think any housing provider has charged Medicaid for housing.

However, Goodwin said she is concerned about placing more responsibilities on OHA.

“I’m concerned about moving more decisions in the direction of [OHA]” said Goodwin. “To me, they’re already like this huge cargo liner that’s just been loaded with cargo. And they can hardly move. And we just keep adding them. And I wonder at what point it sinks. It’s a system that obviously needs to be evaluated and I want to really help OHA. We want these services to be delivered efficiently 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 care 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. The parties should come together and take the best ideas from both sides. We often have a common goal.”

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