Skip to main content
Major contract negotiations between the Oregon Health Authority and local health departments continue to drag on, in part over counties’ concerns that the state is pressuring them to take on far more responsibility—and liability—for people charged with crimes who must be “restored” to competency before they can stand trial.
“It really is the state saying to counties, ‘We no longer do behavioral health,’” Multnomah County Commissioner Meghan Moyer tells WW. “Let’s be real. If all we are doing is restoring somebody—which, to be blunt, is forced medication and flash cards on basic court procedures like ‘Who is a judge?’ ‘What does your lawyer do?’—it is not treatment.”
The dispute stems from an effort to revamp a major way the OHA partners with counties to fund and provide behavioral health care services like case management, substance use disorder treatment, and problem-gambling programs—particularly when those services are not eligible for Medicaid dollars.
The state has said its proposal would provide more funding stabillity to counties and set clear expectations to ensure transparency around funding and outcomes.
With the state’s latest target date for implementation, Jan. 1, approaching and various deadlines it once asserted now long past, the parties were in recent days still swapping contract proposals.
Moyer says the OHA is playing a “divide and conquer game” in its contract negotiations, intentionally leaving Multnomah and Marion Counties out of conversations. (“I think that’s because we have had our legal counsel the most dug in to these issues,” she says.)
OHA spokeswoman Kim Lippert says that negotiations are ongoing: “We have nothing more to share at this time, other than to say that Oregon Health Authority and county partners remain committed to the shared goal of ensuring access to behavioral health care to all people in Oregon.”
Counties sent OHA a “redline”—proposed contract edits—Nov. 3, but didn’t receive a response from OHA until Dec. 12, Multnomah County attorney Robert Sinnott said in one email obtained via a public records request. “The counties,” the email said, “immediately evaluated that response and sent another redline back to OHA two days later.”
That day, Dec. 12, OHA Health Director Ebony Clarke sent county officials a link to the scheduling tool Doodle, to set the next meeting time. “Please note,” she wrote, “that both Multnomah County and Marion County will be invited in the next round of discussions and are included on this email. We appreciate your partnership as we work toward getting a finalized agreement, given our shared goal of reaching an agreement soon.”
