[{"_1":2,"_100":-5,"_101":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,76,88],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},"mediaId",6242385,"mediaKeyId","3247797-4abc68404b8f1a96910b90ad1e1f1f09","parentId",3247797,"title","Oregon Health Authority begins rulemaking on where associate behavioral health providers may bill Medicaid; advocates warn patients could lose care","audioSeconds",561,"startMs",1109000,"endMs",1670000,"viewUrl","/Search/View?dp=1&key=3247797-4abc68404b8f1a96910b90ad1e1f1f09&start=1109&end=1670","thumbnailUrl","https://assets.pipeline.soar.com/3247797-4abc68404b8f1a96910b90ad1e1f1f09/thumbnail_1109000.jpg","articleUrl","/articles/6242385/Oregon/Oregon-Health-Authority-begins-rulemaking-on-where-associate-behavioral-health-providers-may-bill-Medicaid-advocates-warn-patients-could-lose-care","mediaUrl","https://secure.pipeline.soar.com/6242385-131d80127e774d3808283ce54dc0edf3/orig.mp4?Expires=1770975036&Signature=m5n1BBxIXEze5QNoQrescoo9KpzmVJsnEF-3nrhfM3609iwHizBnE3ieNLmFhmbpKXLq5tEXyOTdeWCCU85I8uRENXKcNgOv-pTYxsk8bgZLsyvlUHEVa54Jt~DkwwLz2cqWICgS6yQrBP1JrESA~lQWDN6J3x-~YGHK6~KR8-Eu~P8DhjpDO4BsB1WREM2thRNuXF0IRxhuprSOqqrKp4hPAg9rBGemvhjq06wFiX9-4JNZ5uVo3AFH0LOWf86jCwG5IaZMj4zZrU8Vxn4QLMOs672Q4TJIfvmSw10ZjVhd9chitC1XZkiMa5qJ0ZX3d-iIp4pzbaxAmDEl0Gl4dw__&Key-Pair-Id=KUT5TJCACFTXG","author","Oregon Legislature","date","2025-05-08T00:00:00Z","article","Oregon Health Authority officials told the Senate Committee on Early Childhood and Behavioral Health they will launch a formal rulemaking process this fall to consider changes to administrative rules that govern how associate behavioral health providers may bill the Oregon Health Plan. OHA said any implementation would not begin until mid‑2026 to allow time for outreach and adjustments.

The rulemaking follows complaints to OHA about workforce capacity and supervision in high‑acuity community settings. OHA officials said they have received concerns from coordinated care organizations (CCOs), community mental health programs, providers and people with lived experience and intend to collect more input, surveys and listening sessions before drafting new rules.

OHA’s process, Director Emma Sando, Medicaid director, said, “We intend to launch that process in the fall, and, after taking in all of that input over the next several months … we have already provided details that these implementation efforts wouldn't begin until 2026.” Ebony Clark, behavioral health director at OHA, described longstanding concerns about ensuring supervision and safety for people receiving care: “We wanted to really make sure that we were being thoughtful and intentional … assuring quality, safety, and standard.”

Why it matters: advocates and provider groups told the committee that an insurer decision announced in December, and actions already taken by CareOregon, have begun removing access to Medicaid‑paid care for many patients before OHA’s rulemaking begins. Andy Walsh, senior health policy advisor at the Children’s Institute, said data OHA provided to the Oregon Health Policy Board show CareOregon oversees three CCOs that account for about 80.6 percent of associate provider claims and that CareOregon told associates it would stop reimbursing them for Medicaid clients unless they worked for a community mental health program or had a certificate of approval (COA). Walsh said the change will likely “impact 80% of these associate providers and their clients” in the state regions covered by those CCOs.

Provider and associate groups told the committee the immediate effect of insurer policy and the prospect of a rule restricting practice settings could sever established relationships between OHP members and their therapists. Natasha Yoganachandra, a professional counselor associate representing the Coalition of Oregon Professional Associations for Counseling and Therapy and Oregon Therapists for Equity, told the committee her group’s survey work and conversations indicate a large number of members may lose access to their chosen provider. “In conversation with CareOregon, they said that the change will impact 5,700 members this July,” she said, and the coalition’s estimate for a statewide impact if a similar rule applied everywhere is about 10,000 OHP members.

Advocates urged OHA to pause any rulemaking or to delay changes until a full health‑equity impact assessment and more public data are published. Andy Walsh said the House Bill 2235 work group convened by the legislature studied workforce problems and did not recommend this change; he said the work group “was also not consulted by OHA in making this decision.” Walsh said the work group’s nearly 100‑page report cites systemic reasons for workforce shortages and documents trust issues with some community mental health systems.

OHA officials said they are collecting more evidence. “We are right now hearing from the community, doing research, and holding a variety of different opportunities for listening sessions,” Sando said. Sando and Clark told the committee OHA will publish surveys for providers and continue public meetings and that final policy choices will depend on that public input and on the formal administrative rule process in Oregon.

What was not decided: The committee received no formal rule or regulation change at the hearing. OHA emphasized the agency has only announced an intent to pursue rulemaking and that specifics — including whether settings will be restricted, the exact supervision standards, or whether billing changes would increase or reduce Medicaid spending — will be determined through the rulemaking and community engagement process.

Concerns raised to the committee:
- Advocates and provider groups warned restricting Medicaid billing for associates to community mental health programs could reduce access for priority populations (BIPOC, LGBTQ+, immigrant communities, rural residents and young children) and worsen waitlists. Walsh said the health equity committee he co‑chairs voted unanimously to oppose the proposed change in a preliminary health equity impact assessment submitted to the board.
- Providers and associates said community mental health programs often lack adequate supervision capacity and that funneling associates into larger agencies will not solve root causes. Andy Walsh: “We have seen that community mental health programs are actually unable to provide proper supervision, and that is a major reason for the workforce shortage.”
- Advocates said district‑by‑district insurer actions are producing immediate harm. Walsh and Yoganachandra said CareOregon’s December communications prompted the first concrete client disruptions before the state rulemaking process began.

Numbers and timing reported to the committee:
- OHA told the committee it plans to open rulemaking in the fall and that any implementation would not begin until mid‑2026.
- CareOregon told advocates it expects to cut off reimbursement for associates serving Medicaid clients at certain settings effective 07/31/2025 for the three CCOs it oversees, a move advocates say will impact thousands immediately.
- Training and supervision requirements discussed: Dr. Emma Sando and Ebony Clark described licensure pathways; Andy Walsh said social workers pursuing the licensed clinical social worker credential often need about 3,500 supervised hours while LMFTs and LCPC/LCPC‑equivalents typically require about 1,900 supervised hours.

Next steps cited by OHA: OHA said it will publish a provider survey, continue listening sessions and community engagement, collect additional data requested by the Oregon Health Policy Board, and proceed with the formal rulemaking process if warranted. Advocates requested a public health‑equity assessment and broader data release before any insurer or state policies take effect.

Stakeholders told the committee they want publicly available data about where associates currently practice, how supervision is provided, and the expected impact on priority populations before changes are finalized. OHA and the provider groups agreed to continue engagement.","mediaType","Video","parentTitle","Senate Committee On Early Childhood and Behavioral Health 05/08/2025 1:00 PM","oneSentenceSummary","Oregon Health Authority officials told the Senate Committee on Early Childhood and Behavioral Health they will start rulemaking this fall to consider changes limiting the settings where associate behavioral health providers may bill the Oregon Health Plan; advocates said insurer actions already risk cutting off thousands of patients.","taxTitle","Early Childhood and Behavioral Health, Senate, Committees, Legislative, Oregon","taxId",78276,"location","Oregon","headline","","shortSummary",{"_33":77,"_35":36,"_37":38,"_39":78,"_41":79,"_43":80,"_45":81,"_47":82,"_49":83,"_51":84,"_53":85,"_55":56,"_57":58,"_59":86,"_61":62,"_63":64,"_65":87,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6242375,"Senate committee forwards House Bill 2013A to the floor to add licensed outpatient SUD programs as commercial mental health providers",55,4056000,4111000,"/Search/View?dp=1&key=3247797-4abc68404b8f1a96910b90ad1e1f1f09&start=4056&end=4111","https://assets.pipeline.soar.com/3247797-4abc68404b8f1a96910b90ad1e1f1f09/thumbnail_4056000.jpg","/articles/6242375/Oregon/Senate-committee-forwards-House-Bill-2013A-to-the-floor-to-add-licensed-outpatient-SUD-programs-as-commercial-mental-health-providers","https://secure.pipeline.soar.com/6242375-f4e8cd4e977356f0da90bd91f6f77c1e/orig.mp4?Expires=1770975036&Signature=c5OZR2U8667FCcCPmsBUEuuR8k8Tmc0VBFZKBK8NKolVTEkg1ORunjvAEMElTh3SpNZDGEcZSAeHogYbF6sueosXkWFzUyTCQybOdcVr34EuaKJ25pnKCPJwaV~zWjH7JGoBvbHaxst5-bzMsiZeN0g~zmHNKPLp6zQG1HZOBbA61aPGH1aB5y9nRzHBCUul5XUbg0iEIhiKoyvyDn3ECdXc7Xxkd1sLQSbCQrRClt5vmIVRc~b~dZa2xzjzEqPCqqXCBn--TC4Zen~LutVXx6MufGpQJm0uXfxsLTa5z9WhVwH52cgcWd~3pH1GkDVQUK8HNMdktp1ErinMzJi26Q__&Key-Pair-Id=KUT5TJCACFTXG","The Senate Committee on Early Childhood and Behavioral Health advanced House Bill 2013A to the Senate floor with a due‑pass recommendation after a brief work session. The bill would add licensed outpatient facilities that operate certified substance use disorder (SUD) programs employing certified alcohol and drug counselors (CADCs) to the list of providers covered under commercial insurance reimbursement for mental health services.

Vice Chair Anderson moved the bill to the floor “with a due pass recommendation.” After roll call, the committee recorded the following vote: Senator Gorsegg — yes; Senator Litticombe — excused; Senator Patterson — aye; Vice Chair Anderson — aye; Chair Reynolds — aye. Chair Reynolds announced he would carry the bill to the floor. Committee staff said the fiscal impact is minimal and there is no revenue impact; fiscal and revenue impact statements are posted on OLIS.

What the bill does: Committee staff summarized that House Bill 2013A adds licensed outpatient facilities that have certified SUD programs and employ certified alcohol and drug counselors as eligible providers for commercial insurance coverage of mental health services and reimbursement. The committee noted the measure had been amended in the House and is presented as the engrossed A version.

Outcome: The motion passed and the committee sent House Bill 2013A to the Senate floor with a due‑pass recommendation.

Next steps: The bill will proceed to the Senate floor for further consideration. Chair Reynolds said he would carry the measure unless other senators objected.","The Senate Committee on Early Childhood and Behavioral Health voted to forward House Bill 2013A to the Senate floor with a do‑pass recommendation; the bill adds licensed outpatient facilities with certified SUD programs that employ certified alcohol and drug counselors to the list of providers eligible for commercial insurance mental health reimbursement.",{"_33":89,"_35":36,"_37":38,"_39":90,"_41":91,"_43":92,"_45":93,"_47":94,"_49":95,"_51":96,"_53":97,"_55":56,"_57":58,"_59":98,"_61":62,"_63":64,"_65":99,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6242380,"State and county officials outline preschool slots, funding and goals; Multnomah County’s Preschool for All aims for universal seats by 2030",855,2545000,3400000,"/Search/View?dp=1&key=3247797-4abc68404b8f1a96910b90ad1e1f1f09&start=2545&end=3400","https://assets.pipeline.soar.com/3247797-4abc68404b8f1a96910b90ad1e1f1f09/thumbnail_2545000.jpg","/articles/6242380/Oregon/State-and-county-officials-outline-preschool-slots-funding-and-goals-Multnomah-Countys-Preschool-for-All-aims-for-universal-seats-by-2030","https://secure.pipeline.soar.com/6242380-93f418e3421b66cd22c8e6d57f1046ad/orig.mp4?Expires=1770975036&Signature=Mw18NtZHLO9GdjRd6X611ggDV7c0ZDwwAKfJojJGYp7KVsJNi4OBzGsuorhzT9xGx3WN5mB6oXUkhQbqN~sVsO55XalJfONd9WNkvaoA~YPUGEifj-WytKL~lQgaNoUY5i0gZA~CIlH-CK~-FIfOjEZh-zKoeKYfhtbslwWONCwptnE~vryUWlOigN70A6~JHW8-yqA1qTkKJQy-UdZx9CnoZ4BPOONzz4BGM2K-1UEEFLJYVxnS2P-FQDB5U9QhWxPIXDYOAgjEX1WPTiQkHVxppr-6ybcwRYszGwmfrHPrdkg9zn3HVOkJ-pOVzLC5JZEBab5nPEdwe~-v66XRHA__&Key-Pair-Id=KUT5TJCACFTXG","State and county officials told the Senate Committee on Early Childhood and Behavioral Health how state and federally funded preschool programs combine with Multnomah County’s local Preschool for All initiative to expand preschool seats and raise staff pay.

Alyssa Chatterjee, director of the Department of Early Learning and Care, described three state programs — Preschool Promise (state program for families at or below 200% of the federal poverty level), Oregon Prenatal to Kindergarten (OPK; Oregon’s Head Start model) and Employment Related Day Care (a voucher program up to 250% FPL) — and said those programs and federal Head Start funding form the foundation for local expansions. “Our preschool promise program provides high quality preschool to families living at or below 200% of the federal poverty level,” Chatterjee told the committee.

Multnomah County official Brooke Chilton Timmons said voters approved Preschool for All in November 2020 with 64 percent support and the initiative is designed to grow to provide universal, publicly funded preschool to 3‑ and 4‑year‑olds in the county by 2030. “Preschool for All connects 3 and 4 year olds in Multnomah County to free, culturally responsive, inclusive preschool,” Chilton Timmons said.

Key figures presented to the committee:
- State and federal slots cited: 1,241 state‑funded OPK slots and 616 federally funded Head Start slots across 47 sites in Multnomah County; 587 Preschool Promise slots across 24 providers and 34 sites; and Preschool for All’s additional 2,225 slots across 80 providers and 133 sites, yielding a combined total of about 4,669 publicly funded preschool slots in the county from the listed investments.
- Teacher wages and program quality: Preschool Promise requires participating programs to provide lead teacher wages comparable to kindergarten teachers. Chatterjee described progress in raising pay: the lead teacher average salary in Preschool Promise programs is about $53,000 and assistant teacher average about $35,000; OPK lead teacher averages were cited near $48,000 and assistant teacher averages near $33,000, with infant‑toddler averages lower.
- Multnomah County goals and finance: Preschool for All estimates it will need about 11,200 seats to reach universal preschool in the county. The program expects to expand gradually and saved funds in early years to address a projected funding gap of more than $500 million that will occur as seat counts increase and revenues catch up; the county uses a dedicated savings strategy and planned tax rate adjustments written into the ballot measure. The county plans to add nearly 3,800 seats in the coming year and is on a path the county projects will reach universal by 2030.

Officials described eligibility and access rules: Preschool for All is universal for resident families of 3‑ and 4‑year‑olds (no income eligibility), but the program uses income to prioritize seats so that families with lower incomes are more likely to be offered seats. Chatterjee said 71 percent of Preschool for All families enrolled this year have incomes at or below 350 percent of the federal poverty level; 5 percent of enrolled families were experiencing homelessness; and 30 percent of enrolled children speak a language other than English at home (61 languages represented).

Chilton Timmons told the committee the program uses multiple fiscal stability tools — a contingency fund, a reserve fund and dedicated savings — and that a technical advisory group will recommend whether a scheduled tax rate increase should proceed; the advisory group will make a recommendation to the Multnomah County Board of Commissioners in mid‑2026.

Providers, county staff and state officials described coordination on workforce and facilities, and Chatterjee said DELC coordinates with Business Oregon and Oregon Housing Community Services on childcare infrastructure while DELC provides coaching, substitute pool management and program standards. Chatterjee said the state and county programs share many quality standards: “There are standard best practices that you would expect to see when you're thinking about high quality preschool,” she said.

Questions from the committee included how Preschool for All interacts with state programs and why some providers choose Preschool for All over Preschool Promise. Chatterjee said program choices are sometimes driven by hours covered and per‑slot funding levels; she added that some providers select Preschool for All for longer‑hour options and higher per‑slot payments.

What was not decided: The hearing was informational; no legislative action or changes to state rules were adopted at the session. Officials said they will continue coordination and report to legislative committees as requested.

Next steps cited: Multnomah County will convene a technical advisory group this summer to analyze the program’s tax rate and make a recommendation by August 2026; DELC and county staff said they will continue to coordinate workforce, facilities and program improvement efforts and share evaluation data collected by internal and external evaluators.","Department of Early Learning and Care and Multnomah County officials described state, federal and local preschool slot counts, workforce pay goals and a county plan to reach universal preschool by 2030; officials said the county program saves early revenue to cover a projected multi‑year funding gap.","actionData","errors"]

Article not found

Oregon Health Authority begins rulemaking on where associate behavioral health providers may bill Medicaid; advocates warn patients could lose care

Senate committee forwards House Bill 2013A to the floor to add licensed outpatient SUD programs as commercial mental health providers

State and county officials outline preschool slots, funding and goals; Multnomah County’s Preschool for All aims for universal seats by 2030