Oregon’s DHS Discriminates Against Mental Health Services: Budget Request Highlights Failure to Comply

2025–27 Agency Budget Request

Title: 560 – Ensuring Access to Services for Individuals with Mental Health Conditions
Submitted: Aug. 30, 2024
Attachment: Policy Option Package Form

The Oregon Department of Human Services (DHS) has revealed that it has not followed federal rules for years. This oversight has led to significant problems for Oregonians with mental illness. In multiple cases, the state denied necessary help, despite having a federal requirement to provide it.

Chris Bouneff, executive director of NAMI Oregon, expressed frustration: “They know they’re discriminating against people with mental illness, and yet they are making the conscious effort to continue to do it.” This situation has affected some of the most vulnerable individuals.

Historically, DHS began offering community care to the elderly and those with disabilities but did not include people with mental illness. Initially, this practice was legal. However, when the Affordable Care Act was enacted, Oregon failed to extend similar services to individuals with mental health conditions, violating federal obligations.

DHS provides Medicaid funding to support caregivers who assist with daily living tasks. This support is vital for those who may otherwise need institutional care. Instead of offering similar aid to people with mental illness, DHS redirected them to other state programs, which often provide inadequate assistance.

A recent report showed that only 3% of individuals referred by DHS to community mental health programs received the services they needed. Many individuals facing severe mental health challenges entered emergency rooms repeatedly due to the lack of proper support. This phenomenon is referred to as the “revolving door,” where individuals cycle through emergency care without receiving ongoing help.

Advocates, such as Meghan Moyer from Disability Rights Oregon, have urged the state to address this issue. The ongoing crisis results in high costs and inadequate care for a population that requires consistent support.

This year, the state has acknowledged this failure. DHS requested $10 million from the general fund to hire experts to run the necessary programs. Governor Tina Kotek and the Legislature will decide whether to approve this funding. Advocates believe that implementing this program could significantly reduce costs and improve care outcomes.

Moyer stated, “I think this can be a game changer” if executed properly.