JASON E. KAPLAN We talked about fentanyl. Another thing I hear is that the meth people are using now is different than the meth people were using 10, 20 years ago. It’s a lot more potent, and it’s a lot cheaper. That is driving a lot of the behavioral health acuity that we see that is distressing for members of the community. And a more potent, more reinforcing drug is also harder for folks to quit. I need to emphasize that we have a behavioral health workforce crisis of unprecedented proportion. Folks have simply left the industry. Folks got tired. Folks, in particular, got tired of referring people to nowhere and trying to coordinate people to nowhere. That leads to a certain level of moral injury, emotional fatigue and burnout. It is absolutely critical that we have a statewide strategy for recruiting individuals into the behavioral health treatment continuum of all stripes: drug and alcohol counselors, peers, bachelor’s-level behavioral health folks, master’s-level behavioral health folks. It’s going to take time to build up that workforce, to meet the needs of the state. It is probably the most important part of how we actually get to having enough capacity to meet the community need. CCC is working in partnership with a variety of different parties to establish a learning academy. We’re supporting an apprenticeship program with our partners at AFSCME. And we are in a holding pattern right now regarding being able to have enough folks to do the supervision, to actually do the training of the next generation. It’s important for leaders to be courageously patient as we navigate this. I have good reason to be optimistic that the right leaders at the state, metro, city and county level levels and CCO levels are engaged, they’re communicating, they’re starting to row in the same direction. They’re really starting to see this as the public health issue and challenging crisis that it is, and also understand that this is complex and multilayered. The reason to be optimistic is that people are communicating and people are agreeing that we need to be grounded in good public health data in order to align strategies to solve these challenges for the state and for the region. Policy-wise, what do you feel Central City needs from local governments? What are the things that you’re watching? I think, most importantly, we’re really watching how we are working together. And I’m really encouraged that Central City Concern and other community-bene t organizations are able to participate in new and different ways with the Joint Of ce of Homelessness Services, with County Behavioral Health and with the city. I see a level of collaboration and partnership and commitment that is refreshing, is new and unique, and it gives me a great sense of optimism in terms of coordination of strategy. We are very hopeful that the Oregon Health Authority will engage in intentional design and strategy work to ensure that folks who need an inpatient level of psychiatric care and stabilization will have access to that resource. In addition, the Medicaid 1115 demonstration waiver is really exciting. It is the functionality that gives states discretionary spending opportunity for the Medicaid bene t. Oregon is one of ve states in the country that has a housing bene t as part of the Medicaid waiver. We’re really hopeful that the Oregon Health Authority will see the 1115 Waiver as the opportunity that it is for this region and ensure that there is coordinated deployment of that bene t. It’s an opportunity for the very rst time in Oregon for housing to be paid for as a bene t out of the Medicaid system. We know through some pilot work that that saves money and saves a lot of unnecessary spending and health care dollars related to the complications of being houseless. 15
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