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OHA proposes flexible, longer CFAA to give counties budgeting control and tighten outcomes reporting
Summary
Oregon Health Authority presented a reworked County Financial Assistance Agreement that replaces rigid service elements with core service areas, extends terms to 5.5 years, embeds financial reporting and relies on a new ROADS data system to track outcomes and reduce administrative burden.
The Oregon Health Authority on July 7 detailed major changes to the County Financial Assistance Agreement (CFAA), telling the Joint Task Force on Regional Behavioral Health Accountability that the agreement will move from multiple, prescriptive service elements to broader core service areas, give counties greater budgeting flexibility and tie funding to locally approved plans.
Krista Jones, deputy director for behavioral health service delivery, said the CFAA is the non-Medicaid mechanism that provides financial assistance to local mental-health authorities to operate community mental health programs (CMHPs). John Collins, deputy director in charge of operations and strategy, said the revision aims to make the agreement more outcome-driven while reducing administrative burden.
Key changes include lengthening the contract term from two years to 5.5 years to allow time for system transformation, replacing service elements with core service areas so counties receive a lump sum and budget based on a local plan, and embedding financial reporting tied to those plans. "We're giving them the freedom to look at the services that are described under the core service areas, figure out what's most needed for the community and would produce the best outcomes," Collins said.
OHA officials emphasized statutory priority populations that must be covered in local plans: priority 1 (forensic and civilly committed individuals, including aid-and-assist and PSRB cases), priority 2 (individuals at risk of moving into those high-need populations), priority 3 (those at risk of hospitalization or removal from home) and priority 4 (prevention investments).
On the question of why many counties have not yet signed the new agreements, Commissioner John Schafer said around 24—26 counties were holding off because the contract omitted a previous clause stating services were "subject to availability of funding." Collins said OHA removed the phrasing to reflect the new structure and extended the signing timeline to allow counties to develop local plans in the context of known budgets; OHA said it will retroactively reimburse counties if agreements are signed after the effective date.
To reduce the paperwork burden, OHA plans to rely on a new ROADS (Resilience and Outcomes Analysis and Data Submission) system for much of its monitoring and to limit additional reporting to cases where ROADS cannot provide necessary information. Krista Jones said the agency expects quarterly review meetings with counties and will provide technical assistance when outcomes fall short because of resource or workforce limitations.
Staff warned of an uncertain fiscal future: senators noted the legislature used one-time reserves in 2025 to fund several behavioral-health initiatives and cautioned the task force and OHA to build flexibility into planning should federal and state dollars decline.
OHA staff said CMHP local plans are due Oct. 1, 2025, with final plans intended to be completed by December to coincide with CFAA signatures and that the CFAA draft previously circulated will be revised through summer and fall workgroups before final execution.
