After statewide tour, health authority director plans to improve Oregon’s health care system 

by Ben Botkin, Oregon Capital Chronicle
December 13, 2024

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Oregon Health Authority Director Sejal Hathi wants to improve Oregon’s health care system, including keeping rural hospitals open and supporting homeless people and testing children for lead poisoning.

This week she released a report outlining 16 wide-ranging goals that stem from her meetings with health care leaders in more than a dozen cities across the state during a tour of Oregon during her first six months on the job. Among her goals, Hathi wants to cut back bureaucracy for mental health and addiction treatment providers and ensure local public health agencies have adequate staff to test and treat Oregonians for sexually transmitted infections.

Community leaders pressed those issues and others in their meetings with Hathi in Astoria, Bend, the Dalles, Eugene, Hood River, Grants Pass, Klamath Falls, Lebanon, Medford, Pendleton, Portland, Redmond and Salem. Hathi’s report cites more than 60 issues community leaders would like addressed and 16 areas where state officials have started to tackle the needs. They include ways to make health more accessible and help providers as they serve Oregon’s most vulnerable people, including residents who face homelessness or mental health challenges.

“Many of these challenges are longstanding and complex, but that doesn’t mean we can’t make meaningful, if incremental, progress,” Dr. Hathi said in a statement. “The feedback we received from these communities is driving tangible steps forward at OHA to remove barriers and improve outcomes — and I’m grateful to both staff and our partners for helping us better serve all Oregonians.”

Hathi started her role as the authority’s director in January and is near the end of her first year on the job.

Here’s a look at some the goals:

In rural eastern Oregon, officials raised concerns about the closures of hospital and clinic services. In Baker City, Saint Alphonsus Medical Center closed its maternity ward, forcing parents to drive some 44 miles away for a delivery. The agency is researching state and federal policies and searching for ways to support health care facilities in rural areas more and reduce the risk of closures.

In southern Oregon, communities told Hathi they need more action so children are tested for lead exposure. In response, the Oregon Health Authority has started to work on a new rule to ensure that providers are reimbursed when they conduct lead testing for people on Medicaid, which provides health care to about 1.4 million low-income Oregonians.

The agency also wants to increase the rates of childhood blood lead screenings among youngsters enrolled in Medicaid and set that goal in its strategic plan. 

In the Willamette Valley, local public health agencies said they need more funding to test for sexually transmitted infections and HIV. The health authority is working on strategies to make more funding available, including from federal dollars.

The health authority also wants to make it easier for doulas to be paid through Medicaid. Doulas provide non-medical support to pregnant women during and after a pregnancy. The health authority plans to seek funding to expand doula hubs in communities. Individual doulas would be able to join the hubs so they receive more administrative support as they navigate the Medicaid billing system. 

The health authority has two more plans for Medicaid. The agency will provide health care providers with more guidance on how to bill Medicaid when they provide care for people who are homeless and living on the street. In 2023, federal Centers for Medicare and Medicaid Services made a new billing code available so providers could bill for outpatient services to houseless people. 

The Oregon Health Authority has plans to support organizations and community health workers so they can be reimbursed by Medicaid. Community health care workers are on the front lines of health care, working to help patients access programs and services they need. They often use their backgrounds and experiences to relate to the people they serve and build trust.

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