Advocates seek task force to address retention of Medicaid case managers and APS workers

Senate Bill 130, introduced to the Oregon Senate Committee on Human Services on Jan. 30, would establish a task force to study recruitment and retention for case managers and adult protective services (APS) workers who serve consumers of Medicaid-funded long-term care services. The measure, as presented to the committee, sets a membership, directs the task force to recommend ways to address barriers and best practices, requires a report to interim legislative committees by Dec. 15, 2026, appropriates an unspecified general fund amount to the Oregon Department of Human Services for the task force and sunsets the task force on Dec. 31, 2026; the bill also declares an emergency and an effective date of July 1, 2025.

Advocates and frontline workers told the committee that a rising volume of tasks, paperwork and layered policy changes have driven many workers out of or away from these positions. “An ongoing policy dump that has continued to stack up on top of these positions,” said Nicole Palmatier Hazel Baker, who testified on behalf of the Oregon Association of Area Agencies on Aging and Disabilities. She said the task force is intended to distinguish federally required duties from desirable practices and unnecessary tasks so the state can retain staff and remain compliant with Medicaid rules.

Frontline testimony illustrated operational strain. Esperanza Gomez, a bilingual case manager at Northwest Senior and Disability Services, said each assessment or review now requires completion, mailing and tracking of an average of eight to ten forms totaling about 30 pages, and the process of approving provider requests for exceptional hours averages about eight weeks. Michael McNeil, an APS investigator, said policy accumulation and a new review team that returns large shares of reports for amendments had reduced case closures and increased open caseloads: “By August 2024, I had 50 to 55 open cases,” McNeil said, and as of the morning of the hearing he reported 100 open cases at his agency. He said a community report review team returned amendment requests for 72% of cases it reviewed, and that amendment work “takes days to complete and it has little to do with actually protecting a senior or a person with a disability.”

Committee members asked whether the issue could be addressed within the Department of Human Services. Advocates replied that while DHS is undertaking internal reviews of workload models and other processes, those larger agency efforts often move slowly and may not surface frontline recommendations quickly enough. Several senators suggested budget leverage — tying a reporting requirement or corrective action to a budget “pop” in Ways and Means — as an option to ensure timely agency response.

Department of Human Services and Office of Aging and People with Disabilities (APD) officials told the committee the agency is already reviewing workload models and a broader delayed-hospital-discharge review, and said the department would comply with legislative direction whether the task force is staffed by DHS or contracted out. Testimony also noted that Medicaid compliance is mandatory and that loss of case managers or APS staff risks federal audit exposure.

The committee received written testimony from the Oregon Health Care Association in the record. The public hearing on SB 130 closed after the panel’s testimony and questions; no formal committee vote on SB 130 was recorded during this session.