Jackson County groups get $17.5 million to help people facing addiction

Dec. 25—With long wait lists to get into residential addiction treatment, the Oasis Center of the Rogue Valley is remodeling three Medford apartments to provide emergency housing for six pregnant women waiting to get into treatment.

Money for the project came from the latest round of funding from Measure 110, the Drug Addiction Treatment and Recovery Act that Oregon voters approved in 2020. The measure also decriminalized possession of user amounts of drugs such as heroin and methamphetamine.

Despite the name of the measure, the state of Oregon isn't using Measure 110 funding from marijuana taxes to fund addiction treatment. Instead, money is going toward housing, peer mentors, clean needles, overdose antidote kits and other support services for people with substance use disorder, the medical term for addiction.

Dr. Kerri Hecox, medical director of the Oasis Center, wants Measure 110 money to fund a full range of services, including addiction treatment. The center received more than $1 million in Measure 110 funding this fall to provide non-treatment services, including emergency housing.

"We're doing emergency housing because we don't have residential treatment to put people in," Hecox said. "It doesn't make a lot of sense. Is this where I think the money should go? No. We need to be able to get people into residential treatment."

After months of Measure 110 funding delays this year, $17.5 million is flowing to 18 organizations in Jackson County. Organizations across Oregon are receiving $268.3 million that Measure 110 diverted from schools, police and other services.

Hecox said Oregon has a severe shortage of detox centers and residential treatment beds. Those services need buttressing with Measure 110 dollars, she believes.

She said medically supervised detox centers help people addicted to alcohol or drugs come off substances more safely.

"People who come off alcohol without medical support can experience seizures and death," Hecox said. "Quitting opioids is not life-threatening, but people can get very ill. They get dehydrated from vomiting and can be in a lot of pain. That makes it very difficult to stop using drugs."

Getting people safely off substances through a detox program allows them to move on to addiction treatment, such as a residential treatment program, Hecox said.

"For people who are acutely unstable and in a social environment with a lot of exposure to drug use, it's extremely hard for them to quit. They have the physical addiction plus the associations with people and settings that trigger cravings. Residential treatment gives people a safe place to separate from that and skills so when they're re-exposed, they don't use," Hecox said.

She said the three apartments that Oasis Center is remodeling for emergency housing will help keep pregnant women and their babies safe while they wait for residential treatment beds to open up. Women who are unhoused or unsafely housed will get priority. The apartments will be supervised, and peer mentors who've experienced past addiction will help the women while they wait.

The apartments are next to Oasis Center, a medical clinic that provides prenatal, pediatric and adult primary care for families impacted by substance use. The clinic connects families with a range of other community services as well, such as job support.

Measure 110 money allowed Oasis Center to remodel the apartments and also buy and remodel a building to create medical exam rooms, mental health therapy rooms and a colorful space where kids can play while their parents get care.

"Almost everyone comes in with their kids," Hecox said.

Oasis Center is subleasing part of its building to Max's Mission, an organization that provides overdose antidote kits and test kits to check for the presence of often-deadly fentanyl in street drugs and counterfeit prescription pills. Max's Mission received Measure 110 funding as well.

Oasis Center also is teaming up with Family Nurturing Center in Medford to begin offering a preschool class soon.

Family Nurturing Center received Measure 110 money to boost services in Jackson and Josephine County. It helps families with babies and small kids who are most at risk of abuse and neglect.

"We're able to expand some of our services that were the most highly requested and sought out by parents with substance use disorder," said Katie Lechuga, senior program director for the Family Nurturing Center.

The center is adding more parent mentors and increasing its respite child care hours so parents can go to court, go to doctors' appointments and attend substance use treatment groups, Lechuga said.

Family Nurturing Center is expanding its long-term housing program that matches families in need of housing with property owners and managers who are willing to give them a shot. The program is a good fit for parents getting out of addiction treatment who may have poor credit history and a criminal record, Lechuga said.

"They're competing against people with no negative history. They're paying all these application fees and getting rejected," she said.

Family Nurturing Center can help cover costs like deposits and a portion of rent. Case managers visit each home weekly, and families learn life skills like budgeting and get employment help if needed, Lechuga said.

By the time families stop getting services from the center, they're self-sufficient and the vast majority stay in their homes, she said.

"Families are not losing housing after we step out," Lechuga said.

She said the distribution of Measure 110 funds took longer than expected, and many organizations are still hiring using money they got this fall.

"People are just now hitting the ground running. A lot of agencies are expanding really cool services," she said.

But like Dr. Hecox from Oasis Center, Lechuga said the state has a shortage of residential treatment beds.

"There are definitely not enough beds for the amount of people who want to access to services," Lechuga said. "People usually have a small window of time where they're ready to go. But then they get put on a wait list for 30, 60 or 90 days. We lose track of them. It would be a dream to get people in right away."

She said some people who go through a medical detox program to safely stop using can't get into residential treatment quickly enough.

"They're getting into detox, and they're there for several days and then they have nowhere to go. They're back on the streets," Lechuga said.

OnTrack Rogue Valley provides a variety of treatment services, including outpatient addiction treatment and residential treatment in Jackson and Josephine counties.

OnTrack received about $3.7 million in funding for programs in the two counties. It's putting much of the money into transitional housing for people who graduate from residential treatment and need a place to stay while they get back on their feet. OnTrack is also investing in emergency housing for people who are waiting to get into residential treatment, according to Sommer Wolcott, executive director of the organization.

"There's a wait list for people to get into detox or residential treatment," she said. "Many are on the streets or in an unsafe housing situation, such as when there's domestic violence. Once a bed becomes available, we often can't track them down anymore. They're on the streets, or they lost hope or they overdosed while they were on the wait list."

Like most organizations, OnTrack doesn't bother asking for Measure 110 money for residential treatment anymore.

The Measure 110 Oversight and Accountability Council — a mixed group of Oregon residents that decides which organizations get money and for what — is very reluctant to grant money for services that can be funded with state and federal Medicaid dollars for low-income people, Wolcott said.

Medicaid does help pay for residential treatment, but the reimbursement rates have been far too low. Many addiction treatment organizations lose money on their residential treatment services, Wolcott said.

"Medicaid reimbursement for residential treatment paid so little that agencies were operating in the red. So saying residential treatment is funded through Medicaid is a misunderstanding of the realities of the system," she said.

Wolcott said addiction treatment organizations haven't been able to adequately pay and retain staff.

"Right now, 32 of our 50 residential treatment beds are operating. The remaining beds are closed due to staffing shortages. At any given time, we have 120 people on our wait list to get into residential treatment," Wolcott said.

Oregon recently won approval from the federal government to raise reimbursement rates by about 30%, but OnTrack had already raised pay by 20% for some positions to try to keep staff, Wolcott said.

"The reimbursement rates are just now getting to the point where they're barely sustainable," she said.

Wolcott said OnTrack is grappling with a state and nationwide worker shortage in addiction treatment. It's particularly hard to fill evening and overnight shifts at residential treatment centers, which have to be staffed 24 hours a day. There isn't enough child care, and people with master's degrees in mental health fields have more opportunities than ever to work from home.

In addition to barely covering the cost of workers, Medicaid doesn't pay enough for addiction treatment providers to save up money to build more residential treatment facilities — despite a huge statewide shortage of beds, Wolcott said.

Among all states, Oregon consistently rates near the top for addiction to alcohol and drugs and near the bottom for access to treatment.

A state-funded research report released this fall found Oregon's addiction treatment services system is half the size it needs to be, with widespread shortages in detox, residential treatment, outpatient treatment, housing for people in recovery, clean syringe programs, overdose antidote kits, classroom prevention programs and more.

Many organizations that help people with addiction are becoming more vocal about what they see as flaws in the implementation of Measure 110, particularly the oversight council's reluctance to fund residential treatment.

It's not clear whether state leaders, including those in the Oregon Legislature, will push for any changes in the coming year.

They could also choose to use other money to buttress detox and residential treatment services.

In the 2021 session, legislators voted to spend $474 million to improve mental health care, including increasing residential treatment capacity and providing incentives to workers in the field. In 2022, they voted to put $130 million toward improving pay and working conditions, among other efforts to improve mental health care, according to the Oregon House Majority Office.

Federal COVID-19 pandemic relief helped the Oregon Legislature make some of those investments.

Oregon is also receiving up to $701.5 million from a settlement with companies that produced and distributed prescription opioids. Opioid settlements will be paid out over several years to help the state, counties and cities with opioid abatement and recovery services, according to the Oregon Department of Justice.

The addictiveness of the medication was underplayed for years. Many people became addicted to prescription opioids and then illicit opioids like heroin, leading to a surge in overdose deaths.

State Rep. Pam Marsh, D-Ashland, said Measure 110 funding alone can't take care of all the investments the state needs to make in addiction services.

She noted residential treatment is relatively expensive, so putting Measure 110 funding into treatment beds would use money up quickly.

With a variety of support services getting funding, Marsh said she's cautiously optimistic the new Measure 110 funding will start to make a difference.

"It's going to organizations that are doing vital work in the community. I'm hopeful we'll start to see the investment pay off," she said.

Marsh said Jackson County organizations won Measure 110 funding to help families affected by substance use, provide opportunities for people in recovery to come together and support each other, increase the number of peer mentors, improve care for people who speak Spanish and much more.

Marsh said addiction treatment alone often isn't enough to help people achieve and maintain recovery. They need the kinds of support services now being funded by Measure 110.

"People in the trenches of addiction work have the opportunity to get funding for things that wouldn't ever get funding otherwise," Marsh said. "The question for the community is are these good investments that will help? I'm impressed with the allocations made in Jackson County. It will provide stability for some really good organizations into the future. The jury's still out on whether these are the right investments. I want to see results on the ground."

Reach Mail Tribune reporter Vickie Aldous at 541-776-4486 or valdous@rosebudmedia.com. Follow her on Twitter @VickieAldous.