By Ben Botkin/Oregon Capital Chronicle
The Oregon Health Authority wants to expand access to health care, grow the state’s behavioral health system and connect more families to preventative health care.
The goals are foundational for the agency’s aim of eliminating inequities in health care by 2030. The health authority on Tuesday released its strategic plan that will guide that work. The plan covers the next three years and encompasses broad areas like access to health care, behavioral health care and tribal health.
The goal is to end systemic unfairness in the health care system that leads to different health outcomes for different communities, such as people of color, minority residents and immigrants. Inequities can lead to major life-changing consequences, with Black people and Native Americans having shorter average lifespans than white residents. Oregonians in rural regions struggle to access care and have more diabetes, heart disease and depression.
The inequities can manifest in different ways and contribute to a person’s overall health, including a lack of access to providers, unaffordable housing or a lack of translation services in health clinics.
“These inequities go beyond health statistics,” Dr. Sejal Hathi, the health authority’s director, said in a press conference. “They rob people of dignity, of opportunity and quality of life, and when it comes to health, we’re all connected.”
The plan covers five broad areas:
- Expanding the behavioral health care system with more workers, preventative services for children and youth and adding more beds in treatment facilities.
- Expanding access to affordable health care. This includes outreach to enroll Oregonians in coverage, whether through the Oregon Health Plan, the state’s version of Medicaid, or a newly launched program for those who make a little too much to qualify for Medicaid. The state also wants to increase the number of providers through loan forgiveness programs and grow the number of certified traditional health workers, who have cultural ties to the communities they serve.
- Increasing services to keep families healthy. This includes preventative health services, especially for new parents before and after birth and putting in place the housing and nutrition benefits that the state’s Medicaid plan will provide in a new program.
- Working with Oregon’s nine federally recognized tribes. The agency has met with tribal members and hired a consultant to help officials finalize goals in this area.
- Making the health authority more responsive to communities with a more diverse workforce.
Measuring success
Officials will track various areas to monitor their progress, for example, by logging the number of people who get sick with diseases that can be prevented. They’ll also track access to health care and workforce numbers and will create public dashboards to show developments.
But the 42-page plan doesn’t spell out specific numeric goals for each area. For example, officials aim to decrease the number of people accessing the emergency department for behavioral health visits, but it doesn’t set a targeted goal.
Asked about the lack of metrics, Hathi said the state will track the performance internally.
“In addition to those high-level outcome measures for each strategy, every action in turn has outcome and process measures associated with it that we will ourselves track internally through our internal performance management system,” Hathi said. “Those get far more granular than perhaps is of interest to the public eye, but we are making sure that we incorporate those monitoring plans into our implementation planning work.”
The plan calls for increasing the number of behavioral health treatment beds statewide, but doesn’t identify a target for the end of 2027. The state needs 3,700 more beds, according to a report published in June.
It’s unclear how many more beds the state can add in three years.
Hathi said the state will publish a dashboard in the coming weeks that outlines the goals for different types of beds and how many beds have been funded from 2021 to now.
Currently, the state can treat about 4,000 people in its residential facilities and plans to add nearly 400 more beds by the fall of 2025.
Need for community support
It’s unclear how it will cost to achieve the goals in the plan, but much of the work will depend on providers who will need state help. Since 2021, the Legislature has allocated more than $230 million for behavioral health housing and residential treatment programs after years of underfunding.
But providers have complained to the Oregon Capital Chronicle that the health authority has been slow to disburse funds, especially to “shovel-ready” projects, even while acknowledging the need is urgent.
Critics say it will need to speed up the bureaucracy.
The health authority also will need community buy-in, something Hathi said state officials plan to address. “In weeks to come, OHA will launch a statewide call to action, mobilizing our collective will and calling on our partners across state and local government, on health care payers and providers in academia, philanthropy and business to step up and take bold action to advance the strategic plan,” Hathi said.
Health care providers who joined Hathi in a news conference said they were encouraged by the state’s focus. Brenda Johnson, CEO of La Clinica, a migrant and community health provider in the Medford region, said the work is meaningful for those most impacted.
“In my community, here in southern Oregon, I see tragedies in the lives of people who have limited or no access to care, people who delay care or travel far and at great expense to receive it,” said Johnson, also chair of the Oregon Health Policy Board.
The plan marks the culmination of work that started in 2019 with widespread community engagement. That work informed the state’s response to the pandemic, when Oregon published metrics that showed vaccination rates in hard-to-reach communities.
This story first appeared in the Oregon Capital Chronicle.
