County behavioral health and public health to shift ATOD prevention work amid Medicaid changes; staff warn of potential service impacts

During department reports, county and community behavioral health leaders discussed two linked topics: a proposed administrative transfer of alcohol, tobacco and other drug (ATOD) prevention services from the community mental-health contractor (CCS) back to Morrow County Public Health, and potential impacts of anticipated Medicaid rule changes on local behavioral-health service delivery.

Public-health and CCS representatives described a mostly administrative transfer: the County Financial Assistance Agreement (CFAA) with the state does not currently include prevention, and staff said prevention work was historically under community mental health but has shifted in many Oregon counties into public health. CCS staff and the county's public-health director said public health already conducts tobacco-prevention and community outreach and could absorb ATOD prevention work without creating a new position. Commissioners indicated informal consensus and asked staff to amend the relevant contracts and identify an effective transition date (staff suggested a November 1 transition if operationally feasible).

Separately, a CCS representative outlined concerns about prospective federal- and state-level Medicaid changes that may begin to affect local services in 2026'28. The staff member said potential program changes under discussion include a $35 co-pay, work requirements and provider tax rules that could reduce CCO (Coordinated Care Organization) revenues and lead to fewer billable visits. Staff emphasized that frequent, high-need clients ' including children who require multiple visits per week and residents in residential programs ' could be disproportionately affected if families must pay out-of-pocket per visit. The CCS representative said provider taxes and increased administrative burdens could also reduce provider revenues, potentially affecting service availability.

Commissioners and staff discussed contract language changes to remove prevention from CCS's contract and route associated funds and duties to public health; commissioners asked staff to prepare contract amendments and consult the Board of Commissioners or the County's finance office if a formal amendment or resolution is required. No formal board vote was recorded on the prevention transfer; staff said they would prepare the necessary contract language and timeline for board consideration.

Ending: Staff will draft contract amendments, identify a transition date for prevention services and coordinate with the county's finance office and the community mental-health provider; commissioners asked that impacts to service continuity and vulnerable populations be monitored as Medicaid policy proposals evolve.