Network based systems

Oregon Drug Decrim Measure treatment network back on track after delays, officials say

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“Lack of clarity around roles and responsibilities has contributed to delays, confusion and strained relationships.”

By Lynne Terry, Oregon Capital Chronicle

The state’s implementation of a new drug prevention and treatment network to help tens of thousands of people with substance abuse problems appears to be back on track after months of delays caused in part by mismanagement and error in judgment on the part of the Oregon Health Authority.

It was one of the main messages of a presentation Thursday at a State House committee by Ian Green, performance audit manager for the Secretary of State’s office. Auditors conduct an ongoing or “real-time” audit of the implementation of Measure 110, which was approved by voters in November 2020.

The measure decriminalized the possession of small amounts of drugs while creating a new system of prevention, treatment and recovery based on a network of services in each county.

The delay in setting up these networks comes as Oregon’s drug addiction crisis worsens, with a spike in overdose deaths and widespread availability of crystal meth and life-threatening opioids. Oregon has the third-highest addiction rate in the nation and ranks last for access to treatment, according to national surveys.

Measure 110 dedicated approximately $150 million a year in marijuana tax revenue to addiction prevention, treatment and recovery.

This funding was intended to strengthen community services to treat people in addition to drugs or alcohol, including with more recovery services and special housing. County networks are supposed to communicate with each other to share information, and they are supposed to facilitate patient access to services. The measure also emphasizes equity and cultural competence in services.

The new system was to be approved in January. Instead, a state oversight committee just finished reviewing about 240 applications from organizations seeking a share of the new funding.

Part of the delay, according to the audit, is that the Oregon Health Authority did not provide enough support to the state review board. It is made up of volunteers who have personal experience with drug addiction but no experience designing and implementing a grant program, listeners found.

The committee cannot complete the funding “without sufficient administrative background work done by the OHA,” Green said.

In May, the health authority announced that it would strengthen the committee’s staff.

Green said one problem was that the metric itself was vague on the system.

“The lack of clarity around roles and responsibilities has contributed to delays, confusion and strained relationships,” Green said, noting that “as the first national program, implemented during a pandemic, the challenges we note are not surprising”.

As a result, the review committee had an inadequate process for reviewing grant applications, according to the audit. The state agency has not deployed enough management and oversight to ensure that providers provide equitable access to services. The agency has yet to finalize data collection and tracking, according to the audit.

Steve Allen, Oregon’s director of behavioral health, acknowledged in legislative testimony Thursday that the state had failed.

“Ballot 110 didn’t go through without a few bumps along the way and a few significant bumps along the way,” Allen told lawmakers. “We made a few missteps at the Oregon Health Authority, myself included.”

He said the agency had underestimated the number of grant applications it would receive and the time it would take to review them.

He said to expect missteps.

“Anyone who has worked to implement a $300 million project in a way that has never been done before, we expect challenges along the way,” Allen said.

Once the examinations have been completed, the State negotiates contracts. The money is split among the state’s 36 counties based on population, Medicaid population, homelessness, drug and alcohol arrests, and drug overdose deaths. Suppliers in Multnomah County, with more than 815,000 people, will receive the most – $50 million. Wheeler County, with a population of nearly 1,500, will receive nearly $91,000.

Allen said the state has set a goal to fund vendors three weeks after contracts are signed. He said the agency exceeded that target by releasing funds within 10 days in many cases.

“This part of the process works very quickly,” Allen said.

Green welcomed recent progress.

“These are promising signs that the implementation of Measure 110 is back on track, despite previous setbacks and repeated delays,” he testified. “The adoption of our recommendations should mitigate the risks that could further delay implementation.”

The Secretary of State’s office will continue to monitor program implementation and will provide another update in the fall.

The state calendar shows that the implementation will extend until October.

This story was first published by Oregon Capital Chronicle.

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