Marion County Commissioners accept $6 million in state money for behavioral health housing

Marion County will get millions from the state under a broad contract for behavioral health services intended to help people get into housing.

The county Board of Commissioners voted Wednesday to accept $6.31 million from the Oregon Health Authority for housing assistance and behavioral health treatment through June 2023.

That decision came six weeks after commissioners postponed the vote to accept the funding due to ongoing frustrations with the state over the Oregon State Hospital’s capacity crisis. 

Commissioner Colm Willis told Salem Reporter they wanted to first make clear that the state funding won’t provide the level of care needed for patients who are discharged early from the Salem hospital. The hospital cares for Oregonians with severe mental health issues who are typically court-ordered to receive treatment.

The Oregon Health Authority clarified in a statement Friday that the funding aims to provide a variety of supported housing and residential treatment options for people in Marion County with serious and persistent mental illness. The agency made no mention in its statement that the funding is intended to help with issues at the state hospital.

The state money is part of $100 million in one-time funding that has been distributed to community mental health programs across Oregon through HB 5202, which became law in April, according to OHA spokesman Tim Heider.

“We are saying yes to accepting state dollars to enhance the services the county can provide here locally,” Willis said. 

How the county will spend the funding, if at all, will depend on what ideas are raised by nonprofits or private providers, said Ryan Matthews, Marion County health and human services administrator, at the Wednesday board meeting.

The county will issue a request for proposals to consider contracting with a local provider. The state funding can help with one-time costs, such as providing beds in residential treatment facilities for people with intellectual and developmental disabilities.

“It’s not going to be Marion County that’s going to purchase these homes, renovate them, staff them and operate them, so we have to work with our partners to see what they’re willing to do,” Mattthews said at the meeting. “We really wanted to have a broad spectrum, because we wanted everything to be open to us.”

Matthews said county officials were also concerned about whether the state would continue to provide funding in the future for the efforts it is investing in now. He said their conversations with OHA gave them enough assurance to accept the state money and seek ideas for services to spend it on.

But Willis said if county officials don’t believe the proposals they receive will improve behavioral health care in the community, they will send it back to the state.

“If a couple of months from now, the state of Oregon says, ‘Hey, if you give us that $6.3 million back, we can fix the state hospital, I’d be happy to do that. Because I really see that as the highest and most important thing that needs to happen right now in behavioral health in the state of Oregon,” he said. “We’re going to do the best that we can with the money that they’re giving us, and as long as the hospital isn’t working, we will continue to have folks not getting the treatment they need on our streets.”

The state hospital continues to face contempt of court proceedings as attorneys for counties and patients have argued hospital officials didn’t admit people with mental illnesses to get treatment ordered by judges. Hospital administrators heve argued they don’t have the resources to take in everyone that judges order be admitted.

A federal judge in late August set limits on how long patients found unable to aid and assist in their own defense due to a mental illness or disability could be ordered to receive treatment at the Salem hospital. That ruling meant around 100 patients became eligible for discharge back to the county from which they were referred.

Matthews said county officials are hoping to receive proposals for residential treatment homes with skilled nurses to treat older adults with persistent mental illness.

“Those are a population that are often really hard for us to place because of the dual need,” he said.

The state funding would include money for a rental assistance program, hotel vouchers for short-term shelter and hiring new employees, such as a full-time behavioral health nurse to help serve older residents.

Willis said the county could use the funding to cover utility payments or first and last months’ rent for those who need it.

He said it could also be used to hire a housing navigator for the Health and Human Services Department that helps “our highest-needs clients” work through barriers to being placed into housing.

“If you have somebody who’s struggling with mental illness or a developmental disability or addiction … it can be hard enough just making sure that you’re getting to your appointments and getting through your day and managing whatever struggles you have, and then to layer on top of that kind of housing market that we’re in,” Willis said. “Even the government subsidized housing, there’s a lot of paperwork involved. It’s a process-heavy system for somebody to try to navigate.”

Willis said he knows of people in the community who are exploring opening a secure residential treatment facility, which would have 16 beds or fewer, and county officials are open to looking at their proposal.

But Willis said the full $6.31 million may not be enough to build such a facility, as they can cost around $10 million to build. He said multiple counties could pulley their resources to open one with additional state help.

“This really is not a service that local community mental health programs have ever run before, and we don’t really have the expertise to do that,” he said. “This really is an area that the Oregon Health Authority needs to do its job. This is statutorily their job, and they’re just not doing a job right now and our communities are less safe as a result.”

Contact reporter Ardeshir Tabrizian: [email protected] or 503-929-3053.

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Ardeshir Tabrizian has covered criminal justice and housing for Salem Reporter since September 2021. As an Oregon native, his award-winning watchdog journalism has traversed the state. He has done reporting for The Oregonian, Eugene Weekly and Malheur Enterprise.