Drug Addiction Treatment and Recovery Act (Measure 110) / 2020 Oregon Ballot Measure 110
The purpose of Measure 110 is to make screening health assessment, treatment and recovery services for drug addiction available to all those who need and want access to those services; and to adopt a health approach to drug addiction by removing criminal penalties for low-level drug possession.
Multiple criminal sentencing laws regulating the possession of controlled substances changed from felonies to Class E violations on February 1, 2021.
The initial measure required OHA to establish:
- A Treatment and Recovery Services fund, financed with marijuana revenues. This would fund the new Addiction Recovery Centers and Community Access to Care grants.
- Fifteen 24/7/365 Addiction Recovery Centers throughout the state by Oct. 1, 2021.
- A grant program to support the Addiction Recovery Centers.
- A second grant program to increase access to community-based services.
- An Oversight and Accountability Council to oversee the distribution of the grants. OHA would provide technical, logistical and other necessary supports to the council.
- A 24/7 Telephone Addiction Recovery Center by Feb. 1, 2021.
In November 2020, Oregon voters passed by referendum Measure 110, or the Drug Addiction Treatment and Recovery Act. When they passed the ballot measure, the people of Oregon recognized:
- Drug addiction and overdoses are a serious problem in Oregon.
- Oregon needs to expand access to drug treatment.
- A health-based approach to addiction and overdose is more effective, humane and cost-effective than criminal punishments.
- Making people criminals because they suffer from addiction is expensive, ruins lives and can make access to treatment and recovery more difficult.
It is the policy of the State of Oregon that screening, health assessment, treatment and recovery services for drug addiction are available to all those who need and want access to those services.
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The Oregon Health Authority (OHA) appreciates the role of the Secretary of State Audits Division in providing oversight of Oregon’s State funded programs on behalf of taxpayers and the people we serve. The scope of this audit was focused on efforts made by OHA and the Oversight and Accountability Council (OAC) to implement the state’s new Behavioral Health Resource Network (BHRN) program to serve families and individuals affected by substance use disorder. The objective was to examine specific elements of Measure 110 (M110) as required by Senate Bill 755 (SB755) ensured including the effectiveness of governance provided by OHA and the OAC to meet the intent of the ballot measure and associated legislation. In response to the drug addiction and overdose rates in the state, Oregon voters passed Measure 110, which decriminalized the possession of substances for personal use and instituted a health-based approach to addiction and overdose. SB755 an equitable approach to implementation by mandating creation of an Oversight and Accountability Council (OAC), comprised of community members with lived experience, substance use disorder treatment providers, policy, and subject matter expertise. The OAC has the sole authority to award BHRN funding or amend grant agreements. The OAC, in consultation with OHA, also supervises program implementation. This legislation created a paradigm shift in decision-making (external partners are decision-makers and OHA is in a supporting role) that required building new relationships and developing trust with community partners and the Council. This paradigm shift, coupled with ambitious implementation timelines and stretched OHA staffing resources due to the pandemic, led to an initial delay in implementation. To date the Measure 110 program through the direction of the Oversight and Accountability has created 42 BHRN’s across all 36 counties in the state through over 230 separate grant agreements. Creating at least one network of low-barrier services in each county at no cost to the individual accessing services. The choice of the council to use
https://www.oregon.gov/oha/HSD/AMH/Documents/M110-Audit-Response-Letter-Kip-Memmott.pdf
January 17, 2023 Page 2 of 5 grant agreements as funding vehicles and the flexibility of the cannabis tax dollars allows for these BHRN’s to build infrastructure in a way other funding generally restricts. The council's direction to decentralize power by creating grant agreements with each individual entity, while a heavy lift, was done strategically to ensure that smaller, innovative, harm reduction focused, and culturally and linguistically specific serving organizations were not left out of a process that historically marginalized their voices. The work of systems change is rarely as public as M110 has been, but that is true to the spirit of this paradigm shifting work. Below is our detailed response to each recommendation in the audit. RECOMMENDATION 1 Publish a plan by September 2023 for how the M110 program integrates into the overall behavioral health system in Oregon. Agree or Disagree with Recommendation Target date to complete implementation activities Name and phone number of specific point of contact for implementation Agree September 2023 Bessie Scott Narrative for Recommendation 1 OHA agrees that the behavioral health system in Oregon needs a comprehensive strategic plan that incorporates Measure 110. As new leaders join the agency, OHA will develop a strategic behavioral health action plan, which the agency will evolve and regularly adjust over time based on community engagement, ongoing data collection and funding available to address program priorities. OHA will issue the first iteration of this strategic priority framework (which will include M110) by September 30, 2023. RECOMMENDATION 2 Identify and document gaps that prevent detailed metrics from being implemented that would track the overall effectiveness and impact of M110. • Develop and communicate a plan for addressing the gaps to appropriate stakeholders. Emphasis should be placed on developing metrics that allow policy makers and the public to effectively assess the impact and effectiveness of the M110 program. Agree or Disagree with Recommendation Target date to complete implementation activities Name and phone number of specific point of contact for implementation Agree December 31, 2024 Bessie Scott Narrative for Recommendation 2 OHA acknowledges that continued data collection is necessary to accurately measure the effectiveness of M110. Since the inception of M110, there have been barriers to adequate data collection due to changes to the behavioral health reporting system (MOTS) and challenges at the Partner level (e.g. experience level, capacity) that have hindered ideal January 17, 2023 Page 3 of 5 data collection efforts. In 2023, a state-level health records system, coined Resilience Outcomes Analysis and Data Submission (or ROADS), is expected to replace MOTS and allow all Providers to report client-level data on M110-related services. ROADS will have the capacity to store requirements specific to those outlined in SB755; BHRN Partners will be able to submit the client-level data necessary to evaluate the outcomes of M110. In addition to the creation of ROADS, OHA is nearing completion of a Behavioral Health Data Warehouse (BHDW) that will allow analysts to connect client-level information across reporting systems. This will ultimately create a system that connects information on Class E Violations and dismissals, access to treatment services, demographics, and outcomes at the client-level. Client level data on M110 services will allow OHA analysts to better determine metrics such as rates of screening waivers and subsequent treatment plan initiation and completion across different geographic and demographic categories. OHA acknowledges that many BHRN Partners are new to health care and reporting systems. To avoid over-burdening the Partners, and in accordance with the suggested removal of unnecessary burdens on behavioral health providers as described in HB5202, OHA and the OAC approved a Phased Data Work Plan for 2022-2023. The Work Plan requires aggregated data submission from all BHRN Partners, regardless of some organizations’ capability to submit additional data. This will allow OHA to view trends and outcomes on an aggregate level and allows the BHRNs to submit data requirements at the same frequency. In addition to the Work Plan, OHA is currently monitoring M110-related data in other statewide reporting systems. This includes drug-related death and hospitalization data from the Center of Health Statistics, Medicaid claims data on SUD diagnoses and treatment services, and poison control data. Because these systems have historical data prior to M110 implementation, they can provide baseline information for evaluating the effect of M110 statewide.
View the Measure 110 Behavioral Health Resource Network (BHRN) Dashboard for approval progress, service entity coverage and funding progress by county.
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