State leaders are now considering dozens of options to close that gap, caused in large part by major federal funding cuts.<\/p>\n
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But mental health and addiction service providers in Oregon warn that some of the proposed solutions could have serious consequences for behavioral health workers on the front lines who say the impact could be felt far beyond the health care system.<\/p>\n
At the corner of Southeast 122nd and Burnside, the basics come first. The nonprofit 4D Recovery set up something of a resource fair Thursday, complete with a hot meal for people living out on the streets.<\/p>\n
“They feed us; we get to eat,” said Sunrise, who is homeless in this area.<\/p>\n
“It’s always nice to get a warm meal,” added Byron, also homeless.<\/p>\n
4D Recovery is an addiction treatment and mental health service provider. Many of their employees are people who made it out of street life want to help others do the same.<\/p>\n
“I came from the streets myself about 11 years ago,” said Joshua Hernandez, a peer mentor with 4D Recovery. “(It means) being able to empathize with people, try to help people overcome.”<\/p>\n
But services like these are now under threat. Federal cuts are expected to leave Oregon with a $421 million Medicaid funding gap impacting the Oregon Health Plan, which provides health insurance to 1.4 million lower-income Oregonians.<\/p>\n
“When someone does have OHP, it allows them to be able to enter some of these detoxes and that’s huge,” said Hernandez, referring to facilities that provide withdrawal management services.<\/p>\n
But OHP isn’t just vital for Oregonians on the margins, it’s also vital for providers like 4D Recovery, which rely heavily on Medicaid reimbursements.<\/p>\n
“These cuts will potentially take away some jobs,” said Bo Brinson, manager at 4D Recovery. “Reimbursements are how 4D is able to do some of the outreach.”<\/p>\n
As the extent of the funding crisis became clear, Gov. Tina Kotek created an advisory group to find ways to close the looming gap. Between them, group members came up with more than 40 ideas, among them limiting benefits, delaying planned rate increases and reducing provider payments \u2014 meaning fewer people insured and less money for healthcare service providers.<\/p>\n
“When cuts like these happen and decisions like these are made, those people do fall through the cracks and then there are overdoses, and it’s just devastating,” said Brinson, referring to 4D’s clients.<\/p>\n
Meanwhile, Portland addiction treatment provider Fora Health said that once federal changes take effect in January, many people will be losing healthcare coverage \u2014 an impact expected to grow significantly over the next five years.<\/p>\n
“This includes people who are houseless, returning from jail or prison, leaving psychiatric hospitals, and pregnant women and their partners,” said Fora Health CEO Devarshi Bajpai in a statement. “We regularly see individuals recover from severe substance use disorders and go on to live healthy, productive lives.”<\/p>\n
There’s also the threat of cuts to peer mentors like Hernandez \u2014 people who have been through addiction and are employed to help others still in the thick of it.<\/p>\n
“Peers are really doing the boots-on-the-groundwork helping to save lives,” said Brinson.<\/p>\n
Because just about everyone who’s been through it agrees: addiction doesn’t have a timeline.<\/p>\n
“It doesn’t happen overnight; it takes time, and it takes support,” said Selina, who now stays in the Menlo Park Safe Rest Village, but was previously on the street.<\/p>\n
“It took me eight times, you know,” said Brinson. “If it was on this last time, and if my coverage didn’t cover, then who knows where I would be?”<\/p>\n