Oregon mental health professionals for youth are frustrated.
At a roundtable Thursday, health care providers and representatives from tribal health agencies and Portland Public Schools voiced their frustration that public and private health insurance plans are leaving many young people untreated. did.
They called for expanding the mental health care workforce in schools and overhauling outdated regulations that limit care settings and providers. He said the insurance companies should be held accountable for the denial.
The roundtable was convened by Oregon Senator Ron Wyden at the Southwest Portland Campus of Oregon Health & Science University. He sat down with Chiquita Brooks-Rashua, director of the federal Centers for Medicare and Medicaid Services, to discuss youth mental health care for the new school year with parents and students.
Wyden said children in Oregon were “clearly and loudly ringing alarm bells” and needed more mental health support.
Other participants agreed.
A 2020 survey of nearly one-third of Oregon students by the Oregon Department of Health and the Oregon Department of Education found that nearly half have felt sad or hopeless for more than two weeks . And according to a report released this week by the Annie E. Casey Foundation, the number of children in Oregon suffering from mental health issues has risen from 11% for her in 2016 to 16% for her in 2020. increased, increased by 40%.
Wyden said the pandemic has exacerbated the mental health crisis for children in Oregon.
Wyden, Brooks-LaSure, and health care providers agreed the school needed more counselors and therapists. They said Medicaid should provide greater access to mental health care.
Two out of five children in Oregon have insurance through Medicaid, a federal program for low-income families. Nationwide, nearly half of all children have free coverage from Medicaid and the Children’s Health Insurance Program (CHIP).
expansion of the workforce
In 2019, the state allocated more than $1 billion in the 2019 Student Success Act to help pay for mental health care in schools. In addition, Oregon received millions of dollars from the American Rescue Plan during the pandemic, and was directed to spend some of it on mental health staff and programs.
But money isn’t solving the problem, according to Colt Gill, director of the Oregon Department of Education.
“The Student Success Act has provided us with the funding to hire more counselors,” Gill said at the Oregon Senate Education Committee’s November meeting. “We can’t find them.”
During a discussion, one mother said her son had been on a waiting list for six months to see a school counselor.
Brooks-LaSure spoke publicly about her agency’s policy to increase the number of mental health care providers in schools by allowing more flexibility in who counselors treat and what they value. He said he was open to comments. As an example, they could treat school children or veterans, or provide family counseling while working in schools. The public can submit comments until the end of August.
Portland Democrat and pediatrician Rep. Lisa Reynolds said about 30% of her patients are on Medicaid. Due to the shortage of mental health professionals, some people wait weeks or months to see a therapist.
Reynolds said more doctors should be trained in mental health care and pay more for social workers, counselors and therapists. Oregon regulations require equal pay for physical and mental health care, but therapists typically get paid less than those who provide physical care. More payments would increase the number of experts, she said. “We need to compensate mental health care providers just like we do physical health care providers,” she said.
Randy Kamphouse, director of the new Ballmer Institute for Child Behavioral Health at the University of Oregon in Portland, offers a curriculum to students interested in the field. In the fall of 2023, the Institute’s first class of 200 undergraduates will be doing internships at Portland Public Schools. They start by screening students to identify those at risk or susceptible to mental health issues.
Outdated regulations hinder progress
Many of the panel’s health care providers expressed dissatisfaction with policies under Medicaid that limit care.
Laura Platero, executive director of the Portland Northwest India Health Commission, said the restriction that health care providers could only claim reimbursement if care was provided at the facility was particularly restrictive. She told Brooks-LaSure that Medicaid should extend to tribal practices, such as canoe healing programs for Native American youth. It can strengthen children’s cultural connections and combat suicide and substance abuse.
She said her agency struggles to help children with their mental health.
“We have struggled to find inpatient care for young people, and even when we do, we have to wait and it is too expensive,” she said.
Robin Henderson, chief executive of Providence’s behavioral health, said she oversees the state’s only child psychiatrist, which often has a waiting list. I mentioned that I am facing the biggest problem with refunds. All Oregon insurers are supposed to include clinics in their networks, but many do not, she said.
“We need regulators to hold insurance companies accountable,” she said.
She criticized some insurance companies for requiring pre-approval before allowing treatment. They often deny reports, she said.
“I can’t tell you how many times I’ve heard ‘It’s a behavioral health issue,'” Henderson said.
Money approved by the school counselor
Wyden said “loud calls for help” from students pushed the recent Safe Communities Act to the finish line. The law, which includes his $1 billion to school counselors over five years, was incorporated into his gun safety bill Congress passed in June.
Oregon student Trace Terrell, a senior at Lapine High School, testified in favor of the bill before the U.S. Senate Finance Committee chaired by Wyden. Terrell said about 80% of his colleagues who were referred for counseling were never heard from.
Wyden said Thursday that Terrell’s testimony had a big impact on the committee that played a big role in crafting the gun safety bill.
Wyden said more help is coming. He indicated that Congress would likely pass a “major bipartisan package” to help states add youth mental health professionals.
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