New report identifies 3,000-bed, $500 million gap to meet Oregon’s needs for behavioral health treatment

SALEM, Ore. (KTVZ) — Oregon needs nearly 3,000 adult residential mental health and substance use treatment beds to close gaps in the state's system of care and meet its future demand for treatment -- and the price tag is a big one, according to a new report released Thursday.

Closing this gap would represent more than a 70% increase above Oregon’s current treatment capacity. According to the report, it would take more than $500 million over five years or more to close this gap.

The findings will inform an ongoing funding and implementation effort that state leaders are committed to pursue, which could take several biennia to complete.

The finding is based on results from a new preliminary study that Governor Tina Kotek directed the Oregon Health Authority to commission last year. It was produced by the Public Consulting Group, a leading public sector solutions implementation and operations improvement firm that has produced similar studies in Washington and other states.

“Too many Oregonians are struggling to get the help they need for a mental health or addiction challenge, and the state needs to lead with a strategic approach to addressing these gaps in health care,” said Governor Kotek.

“We need more resources, to be sure, but we also need better data so we can better serve Oregonians. This preliminary assessment tells us more about the gaps we need to fill to ensure Oregonians in every corner of the state can access the care they need, when they need it.”

The draft study provides a preliminary analysis of the current residential treatment capacity for people with behavioral health disorders, the number of beds needed to address unmet needs (through the fall of 2025), and cost estimates to close existing gaps among different levels of care. (The study does not estimate the need for outpatient treatment.)

Highlights of the report include:

• Oregon currently has 4,819 residential beds to treat people with behavioral health disorders. This figure represents beds in the adult mental health and substance use residential facilities examined in this report, which includes medically monitored withdrawal management to adult treatment, foster homes, state hospitals and psychiatric hospital care and other programs. Currently planned expansions in these facilities would increase the total to 5,175.
• Current capacity needs to grow by approximately 3,000 additional residential treatment beds over the next several years. In the preliminary report, analysts estimate that the amount of additional funding the state will need to fill the gap in treatment beds is at least $500 million over 5 years. The preliminary estimate does not include operational costs.
• The types of treatment with the largest current gaps are:
  • Residential substance use treatment beds: Preliminary assessments demonstrating a range of 1,156- 2,169 additional beds needed (beyond its current capacity of 1,606, with 44 more beds in the process of being opened).
  • Withdrawal management beds- preliminary assessments demonstrate Oregon needs 523 additional beds (beyond its current capacity of 349 and 16 more in the pipeline.)
  • Secure residential treatment facility (SRTF) beds: Preliminary assessments demonstrating Oregon needs 171 additional beds beyond its current capacity of 546 (and 77 coming on-line.)

Over the past four years, the Oregon Legislature has invested more than $1.5 billion to expand behavioral health treatment capacity to meet the need of mental health residential beds, raise provider payment rates and to stabilize the treatment workforce. Oregon’s current shortfall in capacity would be even greater without these investments.

State officials will release a final version of the report that will provide a complete analysis and a proposed funding strategy in June 2024. The final report will refine and further analyze capacity needs and cost projections to expand adult residential behavioral health capacity.

“We now have clear and reliable preliminary benchmarks to pursue a sustainable multi-year funding and program effort to ensure every person in Oregon with a serious substance use disorder or mental illness can get the care they need,” said OHA’s Behavioral Health Director Ebony Clarke.

But state officials are not waiting for completion of the studies before acting and pursuing next steps.

State officials have already identified potential funding sources for several short horizon – “shovel-ready” projects, which local providers are poised to pursue across the state. Those are defined as projects likely to come online within the next year or two that aim to address what are considered critical service gaps.

State behavioral health director Clarke said, “Our goal is to ensure that no one who needs and wants care for a mental health or substance use disorder should be turned away from lifesaving treatment.”