Opioid and meth abuse, veterans services and funding support for vital programs — Rep. Greg Walden heard detailed concerns about these issues from professionals at the Community Counseling Services office in John Day on Aug. 29.
CCS Executive Director Kimberly Lindsay said she was surprised and delighted when Walden’s office contacted them one week earlier and offered to meet CCS staff in person.
Grant County Judge Scott Myers, Commissioner Jim Hamsher and Sheriff Glenn Palmer also attended the meeting.
Opioid abuse has been a major news story in the U.S. for several years, and the recent release of pharmacy distribution data along with high profile court cases has increased the public’s interest.
Walden noted that the recently released data could unfairly focus on some rural areas, but “pill mill” pharmacies that sold unusually high amounts of opioids had been found in West Virginia and shut down.
The opioid abuse problem may be “topping off,” Walden said, but illegal sales of fentanyl, which is 50-100 times more potent than morphine, continues to be a problem. First responders typically carry naloxone with them, which immediately counteracts opioid overdoses but leaves victims immediately craving more, he said. It is a difficult addiction to recover from, he said.
One CCS staff person noted that urinalysis tests at CCS rarely found opioids and typically turned up methamphetamine and marijuana. Another said she was surprised to learn how misinformed or uninformed a police officer in one Eastern Oregon city was about fentanyl and suggested more training for officers.
Palmer said his officers are trained in drug abuse issues. He also noted that Grant County is not exempt from opioid abuse. He said he came across overdose deaths in his 31-year career in law enforcement. In one case, a woman overdosed on oxycodone, and her baby ended up starving to death.
Opioid abusers get pills by “hospital shopping” or breaking into homes of people whose names were in obituaries published in the newspaper, Palmer said. One giveaway is when a pill bottle’s prescription date is only one day old, but the bottle is nearly empty.
Palmer said the legislature’s decision to make methamphetamine possession a misdemeanor had created a “revolving door” for abusers. Walden agreed, noting that a judge told him she had lost the stick in her carrot-and-stick approach to drug cases.
The legislature’s failure to continue funding an integrated mental health program Walden had supported in Congress is posing funding difficulties for CCS.
CCS became a Certified Community Behavioral Health Clinic in 2016 and received about $600,000 during the two-year life of the program in Oregon.
Walden said Oregon was one of eight states that received federal funding for the program. Lindsay, however, noted that federal funding alone will not be sufficient.
Under the CCBHC program, CCS saw a 340% increase in peer services from April 2017 through March 2018, as well as a 220% increase in school-based services, a 130% increase in crisis services, a 90% increase in psychiatric provider time and a 400% increase in veteran services.
Chris Olwine, the program manager, said the comprehensive CCBHC program provides a safety net for the entire community.
Problems with another bill Walden supported in Congress were cited by the CCS professionals. The VA Mission Act, which went into effect June 6, was intended to improve access to care for veterans in frontier or rural counties, and Walden was surprised to find out a provision in the bill might be doing the opposite.
According to CCS clinical supervisor Yao Hui Huang, a requirement that veterans get a recommendation from a primary care provider before receiving financial assistance for mental health counseling could cause a one-month delay.
Veterans are most at risk for suicide and need to connect with mental health professionals right away, Lindsay said. While veterans seeking help eventually can find a bed in Boise or Roseburg, CCS will not turn them away in an emergency, she said.
Lindsay said CCS can place veterans seeking help in the Juniper Ridge Acute Care Facility in John Day, which CCS owns, but the Veterans Administration won’t pay for their care at the 10-bed facility. CCS must absorb those costs, she said.
She also noted that Medicare will pay for behavioral health treatment by licensed professionals, but they must have post-graduate education. Grant County has nobody with those qualifications, and as a result, CCS takes no money from Medicare, she said.
If there was one proposal she could make to Walden, Lindsay said, it would be changing the rules for frontier communities with low populations per square mile so mental health providers like CCS could utilize Medicare funding.