Develop infrastructure related to budget policy priorities
Oregon State law 430.223 (2)(d) states that the ADPC “shall develop a comprehensive addiction, prevention, treatment and recovery plan for this state. The plan must include, but is not limited to, recommendations regarding… budget policy priorities for participating state agencies."
The logical place to start to accomplish this mandate is to assess the entirety of state spending across the SUD continuum of care. The Oregon Health Authority (OHA) commissioned a one-time SUD financial analysis for 2021-23 biennium spending, which can serve as a baseline. From there, the ADPC intends to develop a process for collecting SUD spending information from each of its 14 partner agencies.
Meanwhile, the ADPC intends to work with OHA and community mental health programs (CMHPs) to analyze allocations from the OHA Mental Health, Alcoholism, and Drug Services Account. This account is a legally-required part of the state's general fund. State law requires that 40% of this fund go toward counties for alcohol and drug abuse prevention, early intervention and treatment services; 40% to OHA to be used for state matching funds to counties for the same purpose; and 20% to OHA for prevention, intervention and treatment for adults in custody and individuals on parole/probation. The funds are braided with other funding with no current mechanism to assess how much of the MHA&DS funds go to individual communities and contractors.
Lastly, the ADPC intends to conduct a financial accounting of current primary prevention expenses in the state. Currently, the system is siloed, with funding appropriated in ways that do not necessarily align with primary prevention.
Find the ADPC's detailed strategy below:
Support stable and sustainable
funding for an SUD Continuum of
Care
Oregon funds SUD services in part with substance-specific revenues established by statute. For instance, Measure 110 and Measure 91 allocate funding from cannabis tax revenues to these services. Additionally, the state funds SUD services directly from opioid settlement funds.
These funds offer the state revenue for services that aren't covered through state general or federal funds. With that in mind, the ADPC wants to prioritize these funds for services that are not funded via Medicaid. Ultimately, the ADPC wants to ensure that spending from these sources aligns with the ADPC's Comprehensive Plan.
Find the ADPC's detailed strategy below:
Maintain an independent Commission staffed by subject matter experts
Oregon is unique in having a state-level commission on substance use that is staffed with subject matter experts. The ADPC's staff helps the state conduct oversight of SUD programs and services, plan the management of such programs and services, and it helps coordinate agency partnerships.
The ADPC aims to strengthen the role it plays in the state's SUD system in part by clarifying its purpose. By clarifying that the ADPC is an independent commission, it can reduce confusion among state and local partners and more effectively implement the Comprehensive Plan.
Find the ADPC's detailed strategy below:
Support culturally specific responsiveness
The ADPC strives to support equitable access to culturally responsive care for all Oregonians.
To this end, the ADPC has determined that it needs to improve the consistency of certain definitions across state law. For instance, what counts as a “culturally responsive" service versus a “culturally specific" or “linguistically specific" service?
Additionally, the ADPC aims to develop best practices for funding and contracting with culturally specific providers. These best practices must meet the linguistic needs of the provider and recognize the realities for those accessing services. Procurement processes can be challenging to navigate for smaller organizations, and cultural differences should not make it any more challenging.
Find the ADPC's detailed strategy below:
Build and maintain data infrastructure to support decision-making
Oregon needs better systems to track the outcomes and performance of its programs, across and within agencies. This is especially true as the state faces changes in the reliability of federal data sources related to public health and substance use.
To build up this infrastructure, the ADPC intends to analyze and report on SUD-related All Payor All Claims (APAC) data annually. APAC data refers to information collected from public and private health insurers related to medical, pharmacy and dental claims. This information can help us understand how healthcare services are used, the costs and quality of such services.
Additionally, the ADPC aims to help improve data sharing within and between state agencies. This will entail taking steps such as completing an audit to identify reliable sources of non-claims related substance use data across state agencies and systems.
Find the ADPC's detailed strategy below: