Supporting Oregon's Behavioral Health Workforce

Introduction

The Oregon Health Authority (OHA) acknowledges the current status of our state’s health care system. We are in extraordinary times. Our medical and behavioral health care systems, as well as the workforce that provides care within them, need our support more than ever.

Provider Updates

In response to the Omicron surge, OHA scheduled eight weekly meetings with behavioral health residential providers to:

• Share information, supports and resources on managing the Omicron surge, and
• Hear from providers about additional support and resources they need and answer any questions providers may have.

Meeting dates and material

Workforce Supports

OHA is currently taking the following steps and making the following changes to ease the burden on providers. These steps will ensure providers can continue providing critical services for the people of Oregon for the remainder of the COVID-19 Public Health Emergency.

Childcare for workers

OHA provided $8M to hundreds of licensed behavioral health providers for childcare stipends. The stipends went directly to staff, improved supervision, and working environment improvements.

Retention and hiring bonuses

OHA provided $15M to provide retention and hiring bonuses of up to $2000. The bonuses went to more than 7,000 workers serving clients directly in residential settings.

Residential emergency staffing needs

OHA has been able to provide staff support to both children’s and adults’ licensed behavioral health facilities to offset the impact of COVID-19 on the workforce.

Vacancy payments and rate increases

• On Dec. 21, 2021, the Centers for Medicare & Medicaid Services (CMS) approved our request to extend the rate increase and vacancy payments. We are requesting a $3M rebalance to cover the state’s general fund contribution to support that increase.
  
• OHA will continue to provide vacancy payments to residential providers impacted by the COVID-19 pandemic. Vacancy payments are Medicaid-reimbursed. Emergency CMS authorities allow these payments for empty beds when the reason for the bed vacancy is due to the pandemic. This has helped provide stable income for providers during COVID-19. More than $30M has been paid to date.
  
• OHA implemented a temporary 10% rate increase for residential behavioral health providers from July 2020 to June 2021. A federally approved Medicaid Disaster Relief State Plan Amendment (SPA) and COVID-related funding provided by the legislature supported this increase. Almost $13M has been paid to date – directly to providers and to CCOs for providers. The rate increase will cover July 2021 through the end of the COVID-19 Public Health Emergency.

Reducing administrative burdens

OHA, in collaboration with key partners, has:

• Paused certain reporting requirements. This will make it easier for providers to take care of patients. They will also have less paperwork to do during workforce shortages. See the list here.
  
• Reduced some Measures and Outcomes Tracking System (MOTS) data reporting requirements. The list is here.
• Suspended in-person non-emergent or statutorily required site visits where possible for Psychiatric Residential Treatment Services (PRTS) and Substance Use Disorder (SUD) providers.
• Promulgated a temporary amendment to Oregon Administrative Rule 309-019-0140 Service Plan and Service. The change was filed on Sept.14, 2021, effective Sept. 14, 2021, through March 12, 2022. It allows a qualified mental health professional who meets the qualifications of a Clinical Supervisor to sign off on new and annual service plans.
  
• Consulted with the Governor’s Office about flexibility in nursing scope of practice with the Oregon State Board of Nursing (OSBN). OSBN has advised OHA that nurses already have considerable flexibility to assign tasks traditionally performed by nurses to non-nursing staff. OSBN has helped to connect agencies with nursing education programs to facilitate clinical practicums for nursing students in behavioral health settings.

These changes are also addressed in Oregon's emergency planning to stabilize systems of care for children and families.

Accessibility

For individuals with disabilities or individuals who speak a language other than English, OHA can provide information in alternate formats such as translations, large print, or braille. Contact the Health Information Center at 1-971-673-2411, 711 TTY or COVID19.LanguageAccess@dhsoha.state.or.us.