Addiction recovery services receive funding from M110

In 2020, Oregonians passed Measure 110, which decriminalized small amounts of illegal drugs and directed more money to addiction recovery services. Two years later, the bulk of the money for the first budget cycle has finally been distributed. We get an update from Tera Hurst, the executive director of the Oregon Health Justice Recovery Alliance. That’s the advocacy group focused on successfully implementing Measure 110.

The following transcript was created by a computer and edited by a volunteer:

Dave Miller: It’s now been almost two years since Oregonians passed Measure 110. That ballot measure decriminalized small amounts of illegal drugs and directed more money to addiction recovery services. After a long set up process, the bulk of the money for the first budget cycle has finally been distributed to a wide variety of service providers. Tera Hurst joins us now to talk about what this funding will actually mean. She is the Executive director of the Oregon Health Justice Recovery Alliance. That’s an advocacy organization focused on successfully implementing Measure 110. Tera Hurst, thanks for joining us. I want to start with the big picture before we drill down. Why did you support Measure 110?

Tera Hurst:  That’s a great question. As a person in long term recovery and with a lot of friends and family in my community, I recognize that substance use is not something that should be treated as a criminal justice issue. It really needs to be treated as a healthcare issue. And I think that a lot of us who supported [Measure 110] and continue to support it, recognize that the war on drugs that has been going on for 50 years has been a failure and has been not only ineffective for getting people into recovery, but really saddles them with lifelong barriers to housing, employment  and education. That just exacerbates the problem. So 110 is shifting to a health based and science backed approach to substance use and that’s why I think it’s such an important law and such a transformational law. It will also have a huge impact on those communities that have been most impacted by the war on drugs. And in Oregon we know that’s our Black Latino, Native, Indigenous and Tribal communities.

Miller:  I think that what a lot of Oregon voters thought or assumed they were voting for or getting was a measure that was going to trade investments in jail for investments in residential treatment. But it seems like what we’re actually getting is different from that. Is that a fair short version of what this measure is actually going to mean - that this is not necessarily about big investments in residential treatment per se?

Hurst:  Yes, I think that there’s kind of a societal misconception that residential treatment is treatment and anything else is aside. And I would say that that’s a narrow definition of the types of services that people struggling with substance use actually need. And so what Measure 110 does is to fund low barrier treatment services. For one person [that] may mean intensive outpatient services combined with supportive safe housing or a mentor. [For] another person, it could be that they need medication assisted treatment combined with peer support. So what Measure 110 does that, I think, absolutely honors the will of the voters is it meets people where they’re at. It connects them with the resources they need. Those services are only sometimes residential and and it really is about ensuring that people have access. There’s no wrong door to treatment. There’s no wrong door to services. And the cost will no longer be a barrier because Measure 110 makes sure that cost isn’t a thing that keeps somebody from getting the services they need.

Miller:  Have you already seen an increase in people who are accessing services or treatment?

Hurst:  Yeah. So I think some of the pieces that get missed in this story sometimes is that we were able to get an early infusion of funds called an Access To Care grant in the second part of 2021. What OHS’ report found was that 16,000 Oregonians were able to access services due to these new funds. This was about $30 million, which is only 10% of the funds that are getting infused now. And so you can see what an incredible impact that has on people, whether they were trying to access harm reduction services or getting connected with housing or even working with a peer. I mean peers can be that seed that gets planted that really makes it so that you are able to find the next services and you can learn more about how you can treat your substance use. So it’s an incredible amount of people served in such a short time. We should get new numbers, about what the latest Access to Care grants were able to do, by the end of this year.

Miller:  What about the broader projections once more of this money, the biggest slice of it has actually been distributed? What are the estimates for the increase in all kinds of services and what it will actually mean for Oregonians? I’m thinking about the broad array, the kind of treatment options that maybe people in the past may have associated more with drug treatment - detox beds or residential treatment beds - and also the kinds of harm reduction services that you say we don’t think enough about? How many more of these options should be available or will be available say a year from now?

Hurst:  So it’s hard to say exactly a year from now. But what I can tell you is that we had about $260 million going out into the community in June and it’s about finished. That means that we only have two counties left, out of 36, that have not finalized their agreements and have had the money go out to their accounts. That being said, what they’re setting up are these things called Behavioral Health Resource Networks. There will be at least one network in every county. And that just basically means that these are a network of providers who are predominantly community based providers who are able to offer the services that people need. And that can look really different as you were just saying. So to kind of go a little bit down the weeds, if you look at an organization like CORE [Community Outreach for Radical Empowerment] which was one that you had on your program not too long ago. They serve in Lane County. Their grant is a little over $1 million and they’re one of the only harm reduction distribution programs for youth in the state of Oregon. So they’re gonna be able to expand their harm reduction program.

And I think it’s important for folks to understand that research shows clients engaged with harm reduction are five times more likely to enter treatment and about three times more likely to stop using drugs than those who don’t use these programs. They [CORE] are also going to be able to get a permanent space which may not seem like a lot for many. But this is a program that operated out of tents and in parks. And so now they’re creating an advocacy center for youth in Eugene. And they will be providing programming anywhere from art therapy classes to resumè and other life skills workshops. Then they’re also going to be helping their clients with assistance dollars that basically help with move in costs, some documentation of their recovery and also homelessness prevention. So that’s one kind of on-the-ground.

Another is just going with some of the folks that you’ve talked to on the program, the Miracles Club, which is operating in Washington and Multnomah Counties. The 110 fund will create 18 new transitional housing beds. And this includes the first and only transitional housing for LGBTQ+ African american women in recovery. They’re also going to be able to expand their street outreach efforts in Multnomah County and they’re having a new presence in Washington County. So that’s another really important and critical piece of infrastructure for these folks who are looking for safe housing, especially for African american women in recovery [who are] looking for housing.

Bridges to Change is a large operation. They got over $13 million for services in four counties, Clackamas, Multnomah, Washington and Wasco County. That grant’s gonna fund 202 new supportive low barrier housing beds. Having safe housing, we hear this from a lot of folks who are saying, sure I can go to treatment, but then when I get out I have nowhere safe to live. And so I go right back out. So having that foundation to have safe housing and access to safe housing is really critical. And Bridges is also going to be able to hire 67 new staff to expand their outreach. And that’s going to be anyone from a service navigator and a case manager to also somebody who’s on the phone who can help with peer support when somebody is in crisis. The early 110 funds, the Access To Care grant, actually helped Bridges keep their recovery house in the Dalles open and also expand services there. So that’s a small example of what this work and these funds can do.

Miller:  If I may just interject because two weeks ago we talked again about the enormous problems that meth in particular is causing in Oregon both for people who are addicted but also rippling through to hospitals and mental health care facilities and housing issues and the criminal justice system. And we also heard that there doesn’t seem to be a concerted statewide effort to respond specifically to methamphetamine addiction. What is Measure 110 going to mean for meth addiction?

Hurst:  It’s important for us to focus. And what Measure 110 and what Health Justice Recovery Alliance is really focused on is making sure that we have the suite of services. What we do know is the contingency management, an intervention that has been shown to be really effective for folks with a methamphetamine addiction, is one of the services that is now being able to be funded through Measure 110.

Miller:  Can you remind listeners what this is?

Hurst:  Contingency management, at the core, basically encourages and incentivizes folks to stay off of meth by offering sometimes financial incentives to have a clean drug test at the kind of simplest form. And there’s a lot of documentary research that shows that this really is one of the only effective ways to get people at least started on that path to recovery.

Miller:  And you’re saying that there’s going to be more access to services like this,which actually does seem to be helpful in terms of meth addiction more from Measure 110 directly as a result?

Hurst:  The piece that’s really important is that Measure 110 creates flexibility for these types of programs that we know are evidence based and trauma informed and we’re able to have the flexibility to get those up and running. It also is stable funding. Right? So this is not just for this biennium, this is gonna be going on for the next however many bienniums that we’re able to keep this program going. That means that people and providers can actually put the resources needed to get these programs up and running and also know that they’re going to have the stability of funding to be able to keep them going. Because these are really expensive programs to get going and to staff up on and we can’t keep asking our providers to do these things without stable funding. And that’s really how we’ve been operating as a state, which is why we’re 50th in the nation in access to services. So I just want to make sure that we’re really looking at the full picture and not just isolating one drug at a time because ultimately we’re not going to be able to solve this crisis unless we look at all of the different factors that go into it and there’s not one simple fix for any one of them.

Miller:  What do you say to people who regularly see people shooting up in broad daylight in the middle of Portland and who then come to the conclusion that Measure 110 is not working. What do you say to them?

Hurst:  I think that it’s important to recognize that there’s a lot going on on our streets right now. There’s a simple scapegoat of Measure 110 when the reality is that these are pretty complicated and intractable issues. And so I would say that Measure 110 as you said, the money is just getting out the door right now. The service still needs to get set up and we’ll begin moving. Recognize that this is five times more money than we have put into these types of services before as a state. There will be transformational changes from it but we do have to give it time. This isn’t something that’s going to happen overnight. It’s not a quick fix. It took us 50 years to get to this place with the War on Drugs. We’re gonna need time to really make sure that we can move from a failed approach to addiction to one that’s really based in health and science and best practices.

Miller:  One of the big arguments that I remember against Measure 110, including by some people who are themselves in recovery, was that the threat of prosecution in the old model was the only way for some people to actually get into treatment - that the carrot wasn’t enough. So the stick, for some people, was actually helpful. Without the stick, does the carrot actually look better? I guess what I’m wondering is how you get people to actually take advantage of these new services or options that are increasingly going to be available if they don’t have to use them?

Hurst:  I would say that if that was true, we wouldn’t be in this situation, right? So we’ve tried to incarcerate our way out of this crisis for more than 50 years as I said. And more people are addicted than ever before and more people are incarcerated than ever before. And so what we were doing simply wasn’t working. We were also adding barriers to people by giving them criminal records, right? They can’t get housing, they can’t get jobs, they can’t have access to a bank account - all the things that are so critical for being able to live a successful life. So, these are important pieces that were not taken into consideration when we say that people need to have that type of a stick.

The other piece that’s really important is that a lot of evidence shows forcing people into treatment usually doesn’t work. And it also shows that the risk of dying immediately after being discharged from compulsory care prediction is really high, especially for younger clients. So we really need to move to a model where services are evidence based, they’re voluntary and they’re accessible. And most people will access services if they’re available, if they trust the community and trust the providers. And that’s why Measure 110 is really investing in our community-based providers. There’s a lot more relationships there. There’s a lot more more understanding of what the needs are when it’s somebody who’s actually been there and has been in a similar situation and maybe come from a similar culture or are able to provide linguistically specific care. That’s what Measure 110 is investing in and recognizing that this is going to take time. This is a really important step and it’s something that will take time.

Miller:  Finally and briefly, the people that voters empowered to make the decisions about which service providers should get grants have lived experience with addiction many of them. But most of them don’t have experience in budgeting and awarding grants and this version of a big state bureaucracy that’s giving out millions and millions of dollars. Is this the right system, in your mind, for deciding who should get this money?

Hurst:  Yes, I think that the folks that serve on the council are people with lived experience and their role in this is really to ensure that the most effective services on the ground are being funded. It’s also the intent of the Measure to make sure that they were housed in an agency that does have all the contracting, procurement,  budgetary and financial experience for multiple reasons. They were not able to get the support that they needed in order to be able to really go through this process. I do feel like we need to remember that, you know, prior to 110, thousands of Oregonians wanted help and couldn’t get it. And now thousands of people who want help can get help. And that’s a direct result of this law. And that’s because of the council being able to identify these core services. So there are some tweaks that need to be made along the way. That’s why we’re an advocacy organization, committed to ensuring that it will be implemented as the voters intended. But that can’t be done if we cut it short.

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