Auditors say it’s too early to tell if Oregon’s Measure 110 will be successful

Published: Jan. 26, 2023 at 10:27 PM PST
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PORTLAND Ore. (KPTV) - Last week, the Oregon Secretary of State’s Office released its audit of Measure 110, stating the challenging implementation has increased risks, but the effectiveness of the program has yet to be determined. While auditors noted it is too early to tell whether Measure 110 will be successful, the report states it is clear that criminalizing drug use has failed to eliminate the harm it causes in communities.

Click here to read the full audit report.

What the report found:

  • ”There is a significant risk that policymakers and the public will be unable to gauge the impacts and effectiveness of M110 due to existing grant management and data collection efforts.”
  • Program governance, including the organizational structure of the Oversight and Accountability Council and M110 grant process, can be improved: Roles and responsibilities under M110 were not clear and the existing system faces multiple silos and fragmentation, the Oregon Health Authority failed to provide enough support to ensure implementation of M110 was successful, and M100′s grant application process can be made more efficient and consistent.
  • Existing silos and fragmentation in the delivery of mental health and substance use disorder treatment provide opportunities for greater collaboration and coordinated efforts. Stakeholder collaboration could be improved, especially coordination with the Department of Corrections and other public safety agencies and opportunities could be improved, especially coordination with the Department of Corrections and other public safety agencies and opportunities to collaborate with the Oregon Housing and Community Services and other housing authorities.

“It is plain as day that Oregon’s drug treatment system is failing,” said Secretary of State Shemia Fagan. “This is incredibly frustrating for me, and many Oregonians, because treatment is a matter of life and death for people we know. I have a brother in recovery right now. I want to see Measure 110 work.”

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According to reports, Oregon has the second highest rate of substance use disorder in the nation and ranked 50th for access to treatment. Advocates of M110 hope it will succeed where previous recovery and treatment efforts have failed, especially when it comes to supporting Black, Indigenous, and People of Color (BIPOC) communities. To realize that goal, auditors recommend four-course adjustments for the Oregon Health Authority:

  • Address fragmentation: Publish a plan by September 2023 for how the M110 program integrates into the overall behavioral health system in Oregon.
  • Ensure that success can be measured: Identify and document gaps that prevent detailed metrics from being implemented that would track the overall effectiveness and impact of M110.
  • Create the foundation for a successful grants program: Develop and document policies and procedures for the M110 program, including clear expectations, roles and responsibilities for Oversight and Accountability Council members and OHA staff and greater support for grant applicants and evaluators.
  • Seek opportunities to expand collaboration with other stakeholders.

“Predominately I agree with what the Secretary of State’s Office said,” said Tera Hurst, the Executive Director for Oregon Health Justice Recovery Alliance. “There were some bureaucratic issues that need addressing. We’ve been calling that out for almost a year now, really asking the state to step in and make sure these providers are getting what they need and the support they need.”

Hurst adds she believes a lot of good has come from the ballot measure passing as well.

“The thing that I think was problematic is that there was a mention that the first $30 million wasn’t accounted for and we weren’t sure what the outcomes were. That’s just not the case. The Measure 110 providers that we work with, they know where every single dollar is going. They know what the outcomes are for each of their clients because they are on the front lines talking and working with those folks and they take this role very seriously. They count every penny anyways because that’s what you do when you run an organization or a business. I think that ultimately they submitted that information. The auditor’s office wasn’t able to get it from the agency, but that’s very different than saying we don’t know where the money went and we don’t know what the outcomes were. That’s just not true. So the first six months of Measure 110 funds being out, and it was only 10% of the funds, we know that 16,000 Oregonians got services. That’s huge. So we do know what the outcomes are. The outcomes are people’s lives have been saved, they are housed, and they are getting the support and the help that they need. We’re not saying that this process was great, there were a lot of issues with it, but it’s also a new program and everybody should get a little bit of grace and give them time.”

Oregon Health Justice Recovery Alliance is an advocacy organization focused on successfully implementing Measure 110.

“I’m a person in long-term recovery, so seeing a law that not only was working to destigmatize people who use drugs and addiction, but also really moving it to a healthcare response was inspiring and exciting, especially for me and my family and my community,” said Hurst. “We get to work with some of the most incredible providers across the state who are doing work that is saving lives. They do everything from engaging folks tent to tent to working with someone who is looking for safe housing, connecting them to services that are really critical especially when you’re trying to get on a path to long-term recovery.”

Hurst says they are adopting the recommendations from the audit and on Thursday, met with legislators at the State Capitol to discuss Measure 110 going forward.

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“We want to ensure people we are going to continue these services and give people the stability they need; the providers and the people who rely on the providers,” said Hurst. “I really hope we can continue to destigmatize addiction and make sure that we are building out a system of service where when you need help, you don’t have to wait and you can get help both in your own language. I would also like to see a fully funded, well-running behavioral healthcare system that really treats the whole person and we don’t keep trying to silo issues from a person.”

Oregon Health Authority (OHA) responded to the audit, with director James Schroeder releasing the following statement:

“The Secretary of State is right: It is too soon to measure the success of Measure 110. However, OHA recognizes that Measure 110 can only achieve the voters’ intent and reduce the harms from untreated substance use if OHA provides timely, robust support to its implementation and effective, reliable assistance to the Measure 110 Oversight and Accountability Council. OHA will deliver on that commitment.

Measure 110 represents a new approach to reducing the terrible toll illicit substance use takes on people and families in communities statewide. Measure 110′s first-in-the-nation approach provides more resources for harm reduction, treatment, peer counseling, housing and other services that will give people with substance use disorders the services and support they need to recover, prevent relapse and live heathier lives.

Under Measure 110, these services are provided through locally coordinated Behavioral Health Resource Networks (BHRNs). Last fall, BHRNs in every Oregon county received funding from OHA to begin delivering more comprehensive and integrated services at the local level.

The launch of these networks represents the real start of Measure 110 in Oregon.

OHA agrees with all the Secretary of State’s recommendations directed toward our role in implementing Measure 110. We will pursue each recommendation with urgency and focus.

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Governor Kotek has made it a top priority to make the behavioral health system and Measure 110 work better for communities statewide. I recognize that Measure 110′s success depends on Oregon’s ability to solve many larger challenges in the behavioral health system, such as the need to expand treatment capacity and better support counselors and other workers. I’m committed to getting better outcomes for people with substance use disorders and other behavioral health needs. I look forward to reporting on our progress.”

In the agency’s Management Response to the Secretary of State’s Measure 110 audit, state health officials pledged to take action on four recommendations directed to OHA:

  • Publish the first iteration of a strategic plan that describes how Measure 110 services are being integrated into the overall behavioral health system in Oregon, by Sept. 30, 2023.
  • Identify and address data reporting gaps to better track and evaluate the impact of Measure 110. This work is already underway and will continue through 2023 and 2024, as the state launches new data reporting systems.
  • Improve the technical support OHA provides to the Measure 110 Oversight and Accountability Council (OAC).
  • Help the OAC expand collaboration with the Oregon Department of Corrections, housing programs and other partners who can aid Measure 110′s successful implementation.