Oregon Health Authority Substance Use Disorder Financial Analysis (PDF – full report)

Oregon Health Authority Substance Use Disorder Financial Analysis (PDF – Presentation)

SUMMARY – In a budget note in HB 5006 (2021 regular session), the Oregon State Legislature directed the Oregon Health Authority (OHA) to analyze the adequacy of behavioral health structures in the state, including conducting an analysis of behavioral health costs and financing. Following that direction, OHA contracted with Public Consulting Group LLC (PCG) for a financial study of Substance Use Disorder (SUD) services in Oregon, specifically comprised of three components: a financial inventory of public spending on SUD services and supports, cost estimates to address unmet need across the care continuum, and a review of revenue options to address unmet SUD needs.

Approximately $1B of publicly-funded SUD services and supports funded in Oregon during the 2021 – 2023 biennium were inventoried. The inventory includes a summary of SUD spending by agency, service category, county, and fund category and type. Dollars spent on services and supports across the care continuum are delineated across the setting categories, as determined by OHA and external agency stakeholders, who were engaged via monthly Steering Committee meetings: primary prevention, harm reduction, treatment, recovery supports, peer-delivered services, drug courts, and other. Several setting categories are further delineated into unique service types in the financial inventory. The “other” setting category includes administration, drug screen/collection, DUII, intoxicated driver program fund, and technical assistance/program evaluation services. A portion of funds could not be allocated into a setting category and are categorized as undetermined in the inventory.

PCG generated cost estimates to address unmet needs based on workforce and program gaps identified in external reports and through state agency analysis. The total annual cost for meeting identified gaps in SUD services and supports in Oregon is estimated at $6.85 billion. This total estimate contains system-wide costs that may not be directly funded by the state, and it does not indicate what portion of those costs would—or should—be borne by the federal, state, or local governments, other sectors, or individuals seeking to join the workforce. The level of burden to the state for this total cost will need to be assessed in future studies.