Multnomah County Commissioner Meghan Moyer is requesting $1.75 million from the state to establish a task force aimed at connecting individuals with severe mental illness to Medicaid-funded treatment.
Moyer presented her plan to the county board on Tuesday, emphasizing that it would address a significant gap in support services for those with debilitating mental health conditions.
The initiative aims to keep individuals with chronic conditions off the streets, out of hospitals, and away from jails.
“How do we stop this?” Moyer asked. “We stop this by using Medicaid long-term care for this population.
So instead of allowing every interaction point to inevitably result again in homelessness, we go to those interaction points and we intervene.”
Moyer criticized Oregon’s current approach to aiding those with long-term conditions, noting that while Medicaid programs like the Oregon Health Plan are available for emergency treatments, there is a lack of funding for longer-term healthcare solutions.
She aims for Multnomah County to set a precedent for other governments.
“There is no front door to long-term services,” Moyer told the board.
She added, “I cannot tell you the number of families who have called the organization I used to work for, Disability Rights Oregon, begging to know how to get their loved one the help they need.”
Moyer traveled to Salem on Wednesday to advocate for her project to lawmakers, who are currently navigating an uncertain budget amidst competing priorities in this year’s legislative session.
If her plan receives funding, the county intends to hire three case managers and six Medicaid eligibility workers.
These professionals would screen individuals at various interaction points, such as the county jail, Unity Health Center, and homeless shelters, to determine their eligibility for Medicaid plans.
Additionally, Moyer’s proposal calls for state workers to assist county healthcare providers in obtaining licenses to accept Medicaid.
As part of this plan, Moyer suggests the Oregon Health Authority and the county conduct research to evaluate the program’s financial effectiveness.
Once the one-time state funds are exhausted, she believes the program could transition to sustainability through billing revenue from Medicaid.
This pilot project aims to alleviate the financial burden of homeless services taxes on the county, particularly important given the current $70 million shortfall in its homeless services budget for the next fiscal year.
Moyer intends for the county to connect with 150 individuals in the program’s first year and 250 in the second year.
She acknowledged that these figures might seem low but asserted that they are strategic to ensure realistic goals and deliverables.
“You may look at that and think ‘that is a really small number,’” Moyer said.
“This is intentional.
I do not want to over promise and under deliver.”
Moyer is also advocating for the county to utilize the Community First Choice Option.
This option is designed for seniors and individuals with disabilities who require home and community-based care as an alternative to nursing homes.
Once eligibility workers screen a participant, they could develop a care plan to connect them with needed services and help guide them through the process, Moyer explained.
County case managers would track participants’ progress and offer support along the way.
Currently, the county helps older adults and people with physical disabilities enroll in the Oregon Health Plan; however, Moyer highlighted that this plan does not provide the same comprehensive long-term care coverage offered by the Community First Choice Option.
Board members voiced their support for Moyer’s initiative during Tuesday’s meeting.
Chair Jessica Vega Pederson remarked, “This is a way, I think, of really tying the needs of that population to the right financial resource that would be able to provide (services) in a way that we’re just not currently doing anywhere.”
The discussion occurs amid a challenging landscape for federally funded healthcare, as Congress is contemplating cuts to Medicaid spending.
Commissioner Julia Brim Edwards expressed concern over the reliability of these resources moving forward, given the potential for federal rollbacks.
“With the (federal) administration’s continuing assault on health care, including Medicare and Medicaid, I’m curious about the shift from going from one-time state money into being covered by Medicaid,” she said.
Moyer acknowledged that the pilot project would be vulnerable due to federal uncertainties but emphasized that the support model and target population it addresses make it somewhat more resilient.
“Therefore under any scenario of income eligibility changes, they won’t be impacted,” she added.
— Austin De Dios covers Multnomah County politics, programs, and more.
Reach him at 503-319-9744, [email protected] or @AustinDeDios.
image source from：https://www.oregonlive.com/politics/2025/04/county-commissioner-pitches-new-plan-to-ease-portlands-mental-health-crisis.html
