Analysis of Oregon’s Publicly Funded Substance Abuse Treatment System

Full report is here – Analysis of Oregon’s Publicly Funded Substance Abuse Treatment System: Report and Findings for Senate Bill 1041 (PDF)

Oregon Criminal Justice Commission – September 2019

Summary of Public Expenditure on Substance Abuse Treatment Services

In the 2017-19 biennium, Oregon will spend an estimated $472M ($236M/year) on substance abuse prevention and treatment-related services, including prevention, screening and assessment, brief interventions, detoxification, residential, intensive outpatient, outpatient, medication-assisted treatment, primary care/hospital-based interventions, gambling treatment, and recovery and peer-delivered services.

  • Medicaid (OHP) accounts for 63.3% ($298.3M) of the total public expenditure, followed by non-Medicaid (25%, $117.8M), Department of Corrections (3.6%, $17.2M), Criminal Justice Commission (2.8%, $13.2M), counties (2.2%, $10.5M) and Oregon Youth Authority (.2%, $1M).  Note: DHS does not directly fund substance abuse treatment except in rare circumstances.
  • An analysis of Medicaid expenditures by the Center for Health Systems Effectiveness (CHSE) at Oregon Health & Sciences University (OHSU), found a 59% increase in annual expenditures per capita on substance abuse treatment services from $134 in 2010 to $213 in 2017.
  • Since mid-2014, non-Medicaid expenditures and services are tracked in OHA’s Measures and Outcomes Tracking System (MOTS) which, as detailed in this report, is an unreliable system. Consequently, OHA is in the process of settlements with counties dating back to the 2013-15 biennium, where often county-created spreadsheets are the primary proof of contractual obligations.
  • Spending on substance abuse prevention relative to treatment remains very low, accounting for only 2.9% ($13.6M) of the total public expenditure.
  • In the 2017-19 biennium, OHA will spend $2.3B in behavioral health services: 81% allocated to mental health ($1.9B) and 19% spent on substance abuse treatment services ($430M).