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Drawing millions of dollars in taxpayer funds, a program at Oregon Health & Science University has since 2023 sought to track real-time occupancy at residential mental health and addiction treatment centers statewide.
The idea is to help hospital emergency departments and other providers discharge patients more efficiently into a behavioral health care network where beds are scarce. The Oregon Behavioral Health Coordination Center, one OHSU leader said when it launched, “will ensure clinicians have a full picture of available resources as they work to help someone in mental health crisis.”
More than two years later though, the OBCC’s results have left an Oregon workgroup unimpressed. A recent report to state lawmakers says the coordination center has been hampered by basic flaws, generating new administrative burdens but “little utility” for the state’s behavioral health care system.
“It’s a lot of money for very little return,” says Chris Bouneff, executive director of Oregon’s chapter of the National Alliance on Mental Illness.
Bouneff was one of several members of the House Bill 4092 Workgroup, a collection of Oregon stakeholders—the voting hospital representative came from Providence Health & Services—convened by the Oregon Council for Behavioral Health at the direction of a 2024 state law. The group’s final report, issued in recent days and reviewed by WW, recommended ways to relieve administrative burdens in the Oregon behavioral health system and help it run more efficiently—making it all the more notable that it singled out the OBCC, which was itself created in efficiency’s name.
The report arrives as the Oregon health care system faces significant financial strain, and policymakers are scrambling to cut costs while preserving key services.
Reached for comment, OHSU said its behavioral health coordination center was created with input of providers, hospitals and the Oregon Health Authority. “This report and its recommendations,” spokesperson Eric Robinson said in a statement, ”appear to have been compiled without any contact with OHSU, or an opportunity for OHSU to respond to questions or offer information.”
Asked about the report, OHA spokesperson Amber Shoebridge said the health authority has “been working directly with OHSU’s OBCC to establish a comprehensive, real-time, centralized database of behavioral health bed capacity which can be used to support faster referrals and admissions to medically-appropriate facilities.”
As of early this year, OBCC’s listed staff included, among others, an administrative coordinator, a consultant, an engineer, and a team of patient transfer coordinators. The center launched on the basis of $1.5 million state lawmakers allocated in 2022, and it received another $5.4 million the next year, largely to support ongoing operations, according to a 2024 OHSU article. OHSU also received $800,000 in federal funds to build out the OBCC space as part of a broader remodel of Mission Control, a futuristic-looking screen-lined room where OHSU tracks and coordinates the flow of patients in its own facilities and around the state.
It is not entirely clear how much practical use Oregon’s behavioral health care providers have made of the OBCC’s services. The House Bill 4092 Workgroup said it sees value in a statewide behavioral health care bed registry system—indeed, Bouneff says, such ideas have been tried before—but that its members “have expressed frustration over the high cost” of the OBCC system “given its limited utility and lengthy development timeline.”
The report listed a couple specific issues. For one, it said, the registry is a standalone, detached system that relies on “duplicative reporting” by the state’s residential, substance use disorder and inpatient psychiatric providers.
OHSU notes that participation is voluntary. Of the treatment facilities that do participate, an OBCC slideshow presented earlier this year indicated some submit real-time bed census data automatically. But data from most participants was inputted manually—”not a recipe for efficient data collection,” Bouneff, adding that many providers already face “data reporting fatigue.”
The workgroup also cited “serious structural flaws” in the OBCC system. As an example, the report said, the center’s current data do not include a gender marker, making it harder for providers to determine if a given bed is actually available and appropriate for a given patient.
In its statement, OHSU said the OBCC project is ongoing, that it hosts monthly meetings to update stakeholders, and that it has worked with providers on the center’s technical aspects and operations.
OHSU adds that the real-time bed tracking tool “does not currently include private health information, including gender identity, based on concerns raised by behavioral health providers to minimize the risk of revealing patient identities. We are currently working through how to display relevant information such as gender identity while still protecting patient privacy.”
In its report, the workgroup said the OHA should recognize the “severe limitations” of the OBCC and establish a “continuous improvement process” that better reflects provider feedback.
The report had recommendations on other fronts as well. Among other things, the workgroup advised the OHA to address the issue of patients boarding in hospitals due to placement shortages, and to clarify who—Medicaid plans, county health departments, hospitals—plays what role in the care coordination process. The work group also says it would have welcomed more transparency from the OHA about its ongoing contract negotiations with county health agencies.
Still, the report says, Oregon’s behavioral health care challenges run far deeper than administrative inefficiency: Fundamentally, it says, the state lacks treatment capacity for all the Oregonians struggling with mental illness and addiction.
“It is important to recognize a major issue underlying this recommendation is the lack of services and placements for people who need them,” the report says. “No amount of care coordination nor increased clarity of roles and responsibilities will counteract the deep system-wide gap in needed services and placements across the state.”
