State audit calls on health authority to fix problems with Oregon’s Measure 110 addiction program

The Oregon Secretary of State audit, released Thursday, said more time is needed to determine whether Measure 110, which was approved by voters in 2020, is addressing the state’s addiction crisis. Millions of Oregonians struggle with addiction, and they have a hard time getting help. The law decriminalized low-level drug possession and directed people toward treatment programs funded with more than $100 million annually in cannabis tax revenue.

The audit noted that the Oregon Health Authority needs to address barriers that have delayed efforts to establish addiction treatment and support programs in Oregon. The agency is overseeing the rollout of the measure.

The auditors said the authority needed to provide more support to the grant-making council to set up treatment and service centers in each county. The auditors said the authority needed to establish clear targets to determine whether the program was working as intended.

The measure was sold to voters as a way to cure Oregon’s addiction crisis and help people with addiction problems get better instead of locking them up, but critics say it has failed. Police say the state is inundated with illegal drugs, and people with addiction problems have few options for treatment and support.

The audit said Oregon had the second-highest addiction rate in 2020 — more than 18% of Oregonians age 12 and older were affected — and it ranked last nationwide. The ballot measure raised hopes that Oregon would make headway in addressing its addiction crisis, but the epidemic only worsened due to limited treatment programs and the spreading opioid epidemic.

For the past two years, advocates have criticized the Oregon Health Authority for being slow to roll out the program. Mike Marshall, director of Oregon Recover, a nonprofit that advocates for people with addiction problems, has been a frequent critic of the rollout of Measure 110 programs. He told the Capital Chronicle on Thursday that the failure has been with the states’ leaders.

“When voters gave him this whole new program to be a tool to help end the addiction crisis, because he didn’t have a vision, he couldn’t integrate it,” Marshall said.

Gov. Tina Kotek named a new interim head of the health authority, and she responded to the audit. Interim Director James Schroeder said in a statement that his agency needs to pursue the audit recommendations with “urgency and focus” if the program is to be successful.

“I recognize that the success of Measure 110 will depend on Oregon’s ability to address several major challenges in the behavioral health system, such as the need to expand treatment capacity and better support counselors and other workers,” he said. . “I am committed to achieving better outcomes for people with substance use disorders and other behavioral health needs.”

‘A matter of life and death’

Secretary of State Shemia Fagan said during a news conference on Thursday that she voted in favor of the measure. He has a personal connection to the crisis. In 2009, Fagan, a third-year law school student, learned that her mother had overdosed on opioids and methadone and was in the intensive care unit in Portland. Fagan and his brothers helped their mother move to Pendleton, where she recovered, found a job and a home, and remained clean for about six years before she died.

“Like most Oregonians, I am dissatisfied with our failed drug treatment system,” Fagan said. “Those of us who are personally affected by family members are more than disgruntled. Angered. And make no mistake, this is a matter of life and death. Measure 110 must work because real people’s lives are at stake.” is hanging.

The 42-page audit points to the state’s missteps in implementing the program, which is based on treatment and service networks in each county and tribal territory. Among the problems: the state provided grant applicants with confusing and contradictory information; The Authority allocated too few staff to support the programme’s new Oversight Council; and tensions arose between council members and authority staff members.

auditor’s conclusion

State auditors found:

  • The program needs more data to determine whether the measure is working and the money has been spent appropriately. For example, the health authority provided an initial $33 million grant to providers when the program began. But the agency lacked data on how the money was spent or how the grants improved access to treatment and services, the auditors said. The measure required the authority to establish an oversight and accountability council appointed by approximately 20 citizens to award more than $100 million annually to providers. The auditors found that the authority did not provide the council with sufficient support and resources to do its job. Council members, many of whom are out of full-time jobs, told the auditors they were unable to work effectively because of a “lack of experience or leadership,” the auditors wrote.
  • The auditors found that the state’s review and handling of grant applications was chaotic, with incomplete documentation, confusion among applicants, and inconsistent standards. The problem escalated because the council received over 300 applications – more than anticipated.
  • Council members became frustrated with the staffing of the Health Authority’s staff. A council member told auditors the group spent more than 100 hours evaluating grant applications and returned work marked “incomplete” by authority staff.
  • The measure required the state to create a hotline for people with substance abuse issues. But auditors found it may not be the best use of taxpayer resources because the state already has other hotlines that help people with drug and alcohol issues. During its first 15 months, the hotline had 119 calls, costing more than $7,000 per call.

Kip Memmott, director of the secretary of state’s audit division, said auditors were surprised to find that the health authority took a hands-off approach during the rollout and defied the council.

The new council, Memmott said, “didn’t really have the ability to know where they were going. And so we’ve lost a lot of time there. … While it’s not surprising, it’s a little disappointing.”

the road ahead

The auditors recommended to the health authority:

  • Publish a plan by September that details how the program fits into the state’s overall behavioral health system. The system is complex and includes Oregon State Hospitals, community mental health programs, residential programs, and private providers.
  • Develop goals so that progress can be measured to show the public and policy makers how the program is doing.

For the Oversight Council, the auditors recommended that it collaborate with agencies that work in addiction or related areas, including the Oregon Department of Corrections, Oregon Housing and Community Services and the Oregon Interagency Council on Homelessness.

Schroeder, the authority’s director, said in its audit response that the authority plans to issue a strategic plan by the end of September.

The authority is also working on collecting data that shows how people in the program are doing, he wrote.

Marshall of Oregon Recover hopes that lawmakers and Oregon’s new governor will work to improve the state’s addiction program.

“I think it would help legislators and Governor Kotek to recognize that Measure 110 needs to be better managed from the top down so that it is effective in creating a system of care and giving people better access,” Marshall said. Told.

Sen. Floyd Prozansky, D-Eugene, and chairman of the Senate Committee on the Judiciary, said state lawmakers also plan to work on bills that address the measure. He said lawmakers will look into whether the amount of the drug is considered personal use — and below the threshold for prosecution. The MLA also wants to know how the money was withdrawn and where it went.

The Oregon Capital Chronicle is a professional, non-profit news organization. We are affiliated with States Newsroom, a national 501(c)(3) nonprofit supported by grants and a coalition of donors and readers. The Capital Chronicle retains complete editorial independence, meaning that decisions about news and coverage are made by The Oregonian, for The Oregonian.

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