August 13, 2020

Portland Business Journal: A behavioral health CEO on why community health solutions are critical to combating COVID

By Derald Walker, President and CEO of Cascadia Behavioral Healthcare. This article originally appeared in the Portland Business Journal


Many Oregonians have been dealt a lousy hand of cards by no fault of their own. There are members of our community with serious mental health challenges, and on top of this, they suffer from various chronic physical health conditions that statistically shorten their lives by 25 to 35 years. And now, amid a global pandemic, we face an unprecedented increase in demand for health care services. It is heart-wrenching to think that without the necessary funding, we will be putting already vulnerable people at further risk of potentially fatal health complications.

In order to keep Oregon engaged in Certified Community Behavioral Health Clinics (CCBHC) services, which includes 12 organizations across the state, the Legislature must approve the required state match, which will secure $77 million in federal funds for mental health and addiction services for Oregon. Early indications show that the state Legislature will not be considering this funding match in the upcoming special session. We know that state money is in increasingly short supply, but there are devastating implications to this decision on our state’s health care system. Without this continued funding, we are putting the lives our state’s most vulnerable citizens at risk.

In addition to providing crucial services to Oregonians who traditionally lack access to care, community health solutions are critical to combatting the Covid-19 pandemic. As the pandemic rapidly grew and evolved, CCBHCs kept the community safe and healthy by being able to respond quickly with prevention and preparedness measures to some of the most vulnerable Oregonians.

As part of our CCBHC efforts, Cascadia has learned that the three of the top four reasons that our behavioral health clients visit Emergency Departments include physical health complications related to high blood pressure, asthma, and diabetes. These are also three conditions that are directly correlated with a greater risk of acquiring Covid-19 and having worse outcomes from the disease. Given that ED utilization is a significant driver in health care costs, any investment in state matching funds for CCBHC will yield a greater savings to our overall health care system.

Additionally, over 95 percent of those served at Cascadia are Medicaid recipients, many of whom are individuals facing complex medical concerns as well as a mental health and/or substance use disorders, along with housing and employment instability. The CCBHC model has allowed for continued and consistent outreach, enabling us to maintain a healthy and trusting relationship with our clients by providing education, resources, testing, and treatment.

The CCBHC model has been tremendously helpful for our clients and the broader health care system in a number of ways, such as reducing emergency department utilization and medical admissions, as well as significantly reducing Hemoglobin A1C values for individuals with co-occurring mental health diagnoses and diabetes.

It must be noted that Covid-19 is disproportionately affecting communities of color, accounting for 43 percent of all confirmed cases in the Portland metro region. The opportunity that the CCBHC program presents to reduce inequities cannot be emphasized enough, as there remains widespread lack of access to meaningful, culturally relevant, trauma-informed resources and care for Black and brown communities.

We can’t protect the health of our communities without the state’s support — continued funding for CCBHCs is crucial, especially during this pandemic. Inadequate funding for CCBHCs in our communities’ greatest time of need will have a profound impact on the individuals who rely on these services, who will soon be left without options and may face potentially life-threatening health concerns.

As we face these proposed budget cuts, we encourage members of our community to reach out to the governor’s office to push for continued support and funding of CCHBCs, to protect the health of our whole community.