The Clackamas County Board of Commissioners decided they could not sign onto a letter with State Rep. Janelle Bynum, D-Clackamas, calling for new measures to improve access to mental health care for all Oregonians.
During a policy session Tuesday, commissioners were generally supportive of the message Bynum is pushing that Oregonians, particularly those of color, are in dire need of more access to mental health services as this outbreak of COVID-19 continues to cause stress and anxiety for hundreds of thousands who are now without jobs, dealing with health issues or simply fearful over these uncertain times.
But there were certain provisions in Bynum's letter that the board couldn't support.
Bynum's letter, addressed to Gov. Kate Brown and Oregon Insurance Commissioner Andrew Stolfi, requested three things.
The first is to allow mental health interns — of which there were 1,446 in Oregon as of March 27 ready to practice — on insurance panels so they can begin serving Oregonians seeking treatment and bill their insurance properly.
"These newer counselors have often developed more cultural competency through education, and many are counselors of color or from underrepresented communities," Bynum wrote. "As a result of not being able to bill insurance, clients do not get the care they need, and some end up having to forgo mental health treatment entirely."
Secondly, the letter asks the state to reduce its current requirement of 2,400 hours to receive licensure to practice as a mental health professional in half to 1,200 so that Oregon can attract new professionals and bolster its mental health workforce. The letter notes that Oregon is potentially losing valuable workforce due to its restrictive requirements with Idaho only requiring 400 hours, Washington 1,200 and California 1,750.
Last, Bynum is requesting that a COVID-19 mental health relief fund be set up to help recruit and retain counselors of color to meet the growing demand for mental health professionals in Oregon's communities of color and in rural areas.
According to Trent Wilson, county government and public affairs specialist, the county's departments were generally in favor of the provisions laid out in Bynum's letter, but the Housing, Health and Human Services Division expressed concern over the lowering of the hour requirement for licensure.
The issue of hour requirements is one that's been discussed ad nauseam within the Oregon Legislature, but with little movement in any direction. Commissioners agreed they didn't feel comfortable supporting something they have no professional expertise in making a decision on.
"My concern is, who are we to judge what qualifications people have to do their work," County Chair Jim Bernard said. "I'm just a county commissioner; I'm not a doctor, so I don't support signing this."
Commissioner Ken Humberston agreed, adding that he'd like to hear more as to whether the hour requirement change would be temporary in order to put more boots on the ground during the continued coronavirus outbreak or permanently.
According to Rep. Bynum, the change would be permanent, and she stands by the implementation of that measure.
"Through having higher direct hourly requirements than the states around us, we have made it harder for our recruiters to obtain the workforce that we need," Bynum told Pamplin Media Group. "Through lowering the direct hourly requirement to match Washington's, we would gain a competitive advantage in hiring over some other states."
She also points out that even before the coronavirus pandemic, Oregon has long struggled to connect those seeking mental health care with the services they need.
According to a workforce analysis compiled by the Oregon Health Authority in March 2019, Oregon's population reports higher rates of mental health conditions including serious mental illness and serious thought of suicide when compared with national rates and the rates of its neighboring western states. Oregon youth report concerning levels of serious mental health conditions with rates of serious thought of suicide that double (sixth grade) and triple (11th grade) the rates of adults in Oregon.
The OHA's analysis also found that mental health prescribers as a whole identify as approximately 80% white and 89% non-Hispanic, with significant underrepresentation of Hispanic prescribers at only 5% in comparison with 13% of Oregon's general population.
"Communities of color were not alone in flagging the challenges of Oregon's mental health care system as this has been identified as a problem by OHA, the (Oregon) Advocacy Commissions and county mental health departments," Bynum said. "We do not have the workforce that we need right now. Now more than ever, we need mental health practitioners to help us heal so that we can not only survive, but thrive after this pandemic."
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