The Medical Crisis in Oregon Will Continue Into the Coming Year

Medical Crisis: With the inauguration of Governor-elect Tina Kotek and a new leader at the helm of the Oregon Health Authority, the state of Oregon’s healthcare system will be starting over on January 1, 2023.

Effective January 10, the day both Kotek and Gov. Kate Brown took office, James Schroeder, CEO of the state’s largest Medicaid insurer, Health Share of Oregon, will take on the role of interim director. The incumbent, Patrick Allen, was selected by Brown on an interim basis and will leave him with a full plate.

The Medical Crisis in Oregon Will Continue Into the Coming Year

As the pandemic declines, Oregon continues to struggle with healthcare. Instances of COVID-19, influenza and respiratory viruses like RSV all contribute to a preexisting mental health crisis and a severe lack of hospital beds.

The scarcity of healthcare workers is a persistent problem that has repercussions for hospitals, patient access, and other areas of the industry. Homelessness and a lack of adequate housing are two more problems that have nothing to do with healthcare but nonetheless afflict the state.

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Schroeder’s background is quite varied, spanning from working in low-income Oregonian clinics on the front lines to leadership roles in multinational healthcare businesses. He has served as vice president of safety net transformation and medical director of Medicaid at Kaiser Permanente in addition to leading the 426,000-member Health Share Medicaid insurer. The Neighborhood Health Center in Portland was founded in part due to his expertise as a clinician and executive in a medical clinic that specializes in treating Medicaid patients.

In his new role as temporary director of the Oregon Health Authority, Health Share of Oregon CEO James Schroeder will take over on January 10. Health Share of Oregon is the largest Medicaid insurer in the state. (Photo courtesy of Tina Kotek for Governor)

His new agency has 4,770 workers and an annual budget of almost $17 billion, both of which he will be responsible for overseeing as director. One in three Oregonians, or 1.4 million, are enrolled in the authority’s Medicaid program, which provides access to affordable health care.

The Medical Crisis in Oregon Will Continue Into the Coming Year
The Medical Crisis in Oregon Will Continue Into the Coming Year

What followed is a look back at 2022’s most pressing healthcare challenges for Oregon residents and a preview of what lies ahead.

Institutions of higher learning: The pandemic worsened a preexisting scarcity of nurses and other healthcare workers as professionals retired early or moved for other jobs, leaving institutions of higher learning rushing to fill openings.

While the number of COVID-19 patients requiring hospitalization has decreased, the workforce crisis has not abated. Patients are waiting longer for available hospital beds, and certain surgeries have been delayed as a result.

They told the Capital Chronicle that patient care has suffered due to the shortage of nurses. Oregon Health Authority director Patrick Allen told a legislative committee in September that a lack of staff can have fatal effects on patients.

A triple trifecta of COVID-19, influenza, and RSV (respiratory syncytial virus) this winter has put pressure on hospitals that patients of all ages feel. People of all ages, from the youngest children who are particularly vulnerable to RSV to the oldest adults and those with impaired immune systems, are at increased risk of contracting respiratory viruses like COVID-19 and influenza.

As a stopgap measure, hospitals have adopted crisis standards of care, which provide them leeway in scheduling and duty allocation and enable them to prioritize patients in the event of a shortage. Due to the recent outbreak of these three diseases, the Oregon Health Authority has contracted with a staffing agency to hire dozens of contract nurses to serve pediatric wards at hospitals around the state.

However, these are only temporary fixes. In the upcoming legislative session, lawmakers will consider initiatives to improve the labor force.

The 15,000-strong Oregon Nurses Association, for instance, supports a bill that would impose high daily fines of up to $10,000 on hospitals that fail to comply with minimum staffing levels and a more robust enforcement system. While hospitals are already required by law to create staffing plans, the nurses’ union has called for increased transparency and accountability.

Mental Health

With regard to mental health, Oregon’s system is still unable to keep up with patient demand. A court ruling has placed stricter deadlines on the state-run Oregon State Hospital to admit and care for patients who require treatment to face criminal charges. Misdemeanants have up to 90 days, nonviolent felons have up to six months, and dangerous felons have up to a year to receive treatment at the hospital.

After a lengthy legal battle, the state finally agreed to the new deadlines because it had failed to follow a 2002 court order requiring it to admit patients within seven days of a judge’s determination that they need therapy to aid in their defense.

Oregon State Hospital has asked lawmakers for $4.9 million to provide 59 more posts through the end of the current biennium (June 30, 2022).
However, budget cuts are impacting all parts of the mental health system, not just the state hospital. When individuals are returned to their communities and still require care, county officials and prosecutors say the new timelines put pressure on already-strapped community mental health resources.

Legislators have also promised to address the shortfall of beds in residential mental health programs in the upcoming session, as was acknowledged by state officials.

During the 2021 legislative session, lawmakers allocated $1 billion to various behavioral health initiatives. Most of the money has already been spent or pledged by the state, but the results won’t show up right now.

Addiction Treatment

Addiction treatment in Oregon will enter a new phase in the year 2023. Until June 2023, the state will use almost $300 million in marijuana tax money to finance Measure 110 programs. In 2020, Measure 110 will go into effect, decriminalizing minor drug possession with the goal of improving access to treatment for those who suffer from addiction.

If you’re looking for a state with a high addiction rate, go no further than Oregon. The state of Oregon routinely ranks at the top or near the top of national assessments documenting the prevalence of mental health and addiction issues.

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The health authority, which is responsible for the program, has been criticized for moving slowly in dispersing the funds that were allocated by the law. This summer marks the actual date of distribution, around a year after it was originally planned. The agency also gave the green light to mental health and addiction support systems across all 36 of Oregon’s counties. Health checks, drug rehab, and help finding a place to live and a job are just a few of the services they provide.

However, it will be several months before we see any results. Kotek has expressed a desire for the system to continue but has also promised to keep a careful eye on any new developments.

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