Behavioral health crisis among top priorities for new OHA director

Dr. Sejal Hathi recently took over as director of the Oregon Health Authority. A physician by training, Hathi spent two years as a White House public health adviser and four months as one of New Jersey’s top health officials. She takes over at a challenging time for OHA, as the state continues to struggle with the fentanyl crisis and growing concerns around Oregon’s experiment with drug decriminalization under Measure 110.

“Think Out Loud” host Dave Miller recently spoke with Hathi about her priorities for the agency. The following excerpts from that interview have been edited for length and clarity.

On why she wanted the job:

“Oregon has been, for decades, at the vanguard of bold, progressive, imaginative health policy. It was the first state to articulate and center an ambitious goal of eliminating health inequities by 2030. It has some of the strongest reproductive health laws in the country. It has groundbreaking Medicaid programs… I was excited by that tradition. I wanted to be a part of — and to foster — that legacy.”

“Moreover, it presented an opportunity for me to return home. I grew up on the West Coast. My entire family is still in northern California, and I had been searching for a way to reestablish this region as home. This role gives me the opportunity to do that.”

Her top priorities for the agency:

“I’m going to be launching a regional listening tour at the end of this week where I’m hopeful Oregonians themselves will tell me which challenges they want me to focus on. But if I could name for you three priorities that I’d like to focus on at this stage, it would be health equity, our behavioral health system and access to care.”

“Specifically, around health equity, making sure that we can make our 2030 strategic goal real and set a roadmap with clear benchmarks for what it means to eliminate health inequities for all Oregonians across the state. For our behavioral health crisis — both our country and our state are really engulfed by this unprecedented behavioral health pandemic. We really need to make sure that we are investing in prevention, early intervention, treatment and rehabilitation over the next year. Finally, it’s important to me that we strengthen access to care. What that means is preserving and enhancing our coverage gains over the last few years, but also thinking about how we ensure the coverage folks do receive is comprehensive and affordable.”

On potential changes to Measure 110:

“I think the public has spoken, and where Oregonians are is that the rollout of Measure 110 over the last few years has been fraught. It’s met a lot of challenges, and I think for an unprecedented law — the first of its type in the country — that’s of no surprise.”

“I see my role as implementing the changes to the law that, ultimately, the legislators enact, and doing so with rigor, with transparency and with urgency. Whatever revisions our Legislature chooses to make, my team and I will make sure that we implement them.”

“What was happening before Measure 110 was not working. It’s clear that what is happening right now is not working. But what I do want to highlight is that for all of its challenges, Measure 110 did provide more than $300 million in desperately needed funding for a range of vital services, from treatment to housing to harm reduction… It’s critical, from my view — as a new Oregonian and as a doctor and as a public servant — that this funding and these programs, which expand and fill gaps in our continuum of care, be preserved.”

On how long she plans to stay in Oregon:

“I’m here for the long haul, and I recognize that to do the type of work that we need to address the challenges that lie before us, I’m going to need to be here not for two years, but for two terms, or as long as Oregonians will have me. My husband and I bought a home. We’re here to build a family and to lay down roots.”

“What I will say is that I was in New Jersey for four months because I was attracted by the work that Oregon was doing. I recognize that there’s a lot of work to do; I’m eager to roll up my sleeves, and I hope to do so over many years.”

You can listen to the full conversation with OHA Director Dr. Sejal Hathi here: