Oregon Health Authority needs more language and behavioral health services, report says • Oregon Capital Chronicle

The Oregon Health Authority needs to step up efforts to provide health care to Oregonians who speak different languages ​​and expand access to behavioral health treatment, a new state report finds.

ReportsThe report, released this week by the agency’s ombudsman program, scrutinizes flaws in the state’s Medicaid program, which provides medical, dental and behavioral health care to low-income Oregonians. People who speak languages ​​other than English can have a hard time getting services, especially when providers don’t have staff or interpreters who speak their language, the report said.

Other Oregon residents face a shortage of residential behavioral health facilities and outpatient clinics that result in long wait times, inadequate care, or both.

Oregon’s Medicaid program, the Oregon Health Plan, covers 1.4 million Oregonians who earn more than 138 percent of the federal poverty level, or about $21,000 per year per person, or $43,000 per year for a family of four.

The Ombudsman program operates within the Oregon Health Authority, independent of Medicaid, to help people get better health care. In 2023, the program responded to nearly 3,000 concerns, most of which were about the Medicaid program. Concerns include a variety of issues, including access to care, quality of care and billing issues.

Sarah Dobra, a program manager for the ombudsman, said in a statement that health officials need to work on “solutions to the statewide behavioral health crisis.” They also need to work with local Medicaid insurers that contract with the state to provide services to patients, Dobra said.

The report, based on state data and stories from Oregon Health Plan enrollees, also offers a window into the experiences of ordinary Oregonians struggling to access health care.

Struggles within the system

In one report, an immigrant mother used a medical transportation company to take her disabled son to a doctor’s appointment. The driver dropped the mother, who didn’t speak English, and her son off in pouring rain several blocks from the appointment. The transportation company didn’t accept her complaint, the report said.

“This invalidated members’ experience, failed to elevate their voice and did not take into account language or disability considerations,” the report said.

In another case, a family with a child with complex mental and physical illnesses was unable to find a residential facility. The Ombudsman Program worked with a Medicaid insurer to find an intensive care unit so the child could return home from the hospital. Home care was eventually arranged, but it was not the best outcome.

“The young people never received the initially recommended level of care – admission to a rehabilitation facility,” the report said.

In another example, a woman needed a therapist for her mental health care. Her Medicaid insurer gave her a 90-page list of 772 therapists, but only eight worked in her area and were certified to provide services to her. Some of the therapists worked in other specialties, such as addiction treatment or child behavioral health. One had passed away, and the others had moved out of Oregon.

“This caused members to feel distressed, anxious and suffered from insomnia,” the report said.

The report recommends increasing Medicaid payments to medical and dental providers who provide interpretation services. Behavioral health providers already receive higher payments for interpretation services.

The report’s findings reflect ongoing and persistent concerns about the behavioral health system, Chairman Kevin Fitts said. Oregon Mental Health Consumers Association. This small Portland-based nonprofit works to give residents a greater say in the state’s behavioral health system.

Fitts said in an interview that people get frustrated trying to navigate a system that gives them inadequate access and services, and policymakers need to keep the voices of consumers who need care top of mind in their efforts to make improvements, he said.

“People are apathetic and numb to the lack of response to this issue, and I think there are a number of reports and audits that suggest this is a big challenge,” he said.