Marion County will receive millions from the state under a broad contract for behavioral health services designed to help people get housing.
The County Board of Commissioners voted Wednesday to accept $6.31 million from the Oregon Health Authority for housing assistance and behavioral health treatment through June 2023.
That decision came six weeks after commissioners delayed a vote to accept the funding because of continued frustration with the state over Oregon’s public hospital capacity crisis.
Commissioner Colm Willis told the Salem Reporter that they want to first make clear that state funding will not provide the necessary level of care for patients who are prematurely discharged from Salem Hospital. The hospital cares for Oregonians with severe mental health problems who are usually court-ordered to receive treatment.
The Oregon Health Authority said in a statement Friday that the funding is intended to provide a variety of supportive housing and treatment options for people in Marion County with serious and persistent mental illness. The agency did not mention in its statement that the funding was intended to help with problems at the state hospital.
The state money is part of $100 million in one-time funding that has been allocated to community mental health programs in Oregon through HB 5202, which became law in April, according to OHA spokesman Tim Hyder.
“We are saying yes to accepting state dollars to improve the services the county can provide here locally,” Willis said.
How the county spends the funding, if at all, will depend on what ideas are brought up by nonprofits or private providers, Ryan Matthews, administrator of Marion County Health and Human Services, said at Wednesday’s board meeting.
The county will issue a request for proposals to consider contracting with a local vendor. Government funding can help with one-off costs, such as providing hospital beds for people with intellectual and developmental disabilities.
“Marion County is not going to buy these homes, renovate them, staff them and manage them, so we have to work with our partners to see what they’re willing to do,” Matthews said at the meeting. “We really wanted to have a wide spectrum because we wanted everything to be open to us.”
Matthews said county officials are also concerned about whether the state will continue to provide funding in the future for the efforts it is investing in now. He said their conversations with OHA gave them enough confidence to accept the government money and look for ideas for services to spend it on.
But Willis said if county officials don’t believe the proposals they receive will improve behavioral health in the community, they will send it back to the state.
“If in a few months the state of Oregon says, ‘Hey, if you give us that $6.3 million back, we can fix the state hospital, I’d be happy to do that.’ Because I really see that as the highest and most important thing that needs to happen right now in behavioral health in the state of Oregon,” he said. “We will do the best we can with the money they give us and until the hospital is down we will continue to have people not getting the treatment they need on our streets.”
The state hospital continues to face contempt of court proceedings as attorneys for the counties and patients say hospital officials failed to admit people with mental illnesses to receive treatment ordered by judges. Hospital administrators say they don’t have the resources to admit everyone the judges order admitted.
A federal judge in late August set limits on how long patients found unable to aid and abet their own defense because of mental illness or disability can be ordered to receive treatment at the Salem hospital. This decision meant that about 100 patients were eligible to be discharged back to the county from which they were referred.
Matthews said county officials are hoping to receive proposals for nursing homes to treat seniors with persistent mental illness.
“It’s a population that’s often really hard for us to place because of the dual need,” he said.
State funding would include money for a rental assistance program, hotel vouchers for short-term shelter and hiring new staff, such as a full-time behavioral health nurse to help elderly residents.
Willis said the county can use the funding to cover utility payments or first and last month’s rent for those who need it.
He said it could also be used to hire a housing navigator for the Department of Health and Human Services, who helps “our highest-needs clients” overcome barriers to housing.
“If you have someone struggling with a mental illness or a developmental disability or an addiction … it can be hard enough just to make sure you get to your appointments and get through your day and deal with the struggles that you have , and then layering on top of this type of housing market that we’re in,” Willis said. “Even government-subsidized housing requires a lot of paperwork. It’s a process-heavy system for someone to try to navigate.”
Willis said he knows of people in the community who are considering opening a secure residential treatment facility that would have 16 beds or less, and county officials are willing to consider their proposal.
But Willis said the full $6.31 million may not be enough to build such a facility, as it could cost about $10 million to build. He said multiple counties could channel their resources to open one with additional state aid.
“It’s really not a service that local community mental health programs have ever done and we don’t really have the expertise to do it,” he said. “This is really an area where the Oregon Health Authority needs to do its job. It is legally their job and they are simply not doing a job right now and our communities are less safe as a result.
Contact reporter Ardeshir Tabrizyan: [email protected] or 503-929-3053.
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