County raises telehealth and crisis-stabilization concerns as behavioral health bill clears House

Holly and county legislative staff reviewed House Bill 4 070 (HB 4070) during the Feb. 19 legislative update, describing the bill as a technical streamlining measure that addresses roles and administrative requirements within Oregon’s behavioral health system.

Holly said county priorities included removing language that could require community mental health programs to pay for psychiatric care without funding; she said that particular fix did not survive the amendment process because hospitals opposed it and the Oregon Health Authority flagged large fiscal exposure. "Apparently, there's some language that got put in over time that then required behavioral community mental health programs to pay for psychiatric care even if there was not money to be, in in their funding in their budgets," Holly said.

Holly and staff said language to allow medical screenings rather than full medical assessments at crisis stabilization centers was included in the bill’s dash amendments, which could reduce staffing and compliance costs for local facilities that do not have doctors on-site. "The language we wanted in there was medical screenings, which can be done by a variety of credentials, and we would currently be in compliance with that language," Holly said.

A significant unresolved issue is telehealth billing by unlicensed clinicians. Holly raised concerns about Charlie Health, a national telehealth provider she said has billed roughly $80,000,000 in Medicaid in recent years using shell offices and unlicensed clinicians. That provision—aimed at rein in unlicensed telehealth billing—did not make it into the final amendment but may be pursued in another vehicle or the long session.

Why it matters: counties and local behavioral health providers say unfunded mandates and staffing requirements can make local crisis and stabilization centers financially unsustainable; changes to assessment language and telehealth rules affect how services are delivered and funded.

Next steps: staff said HB 4070 has passed the House and will move to the Senate, where further amendments could occur; county partners plan continued advocacy on telehealth billing and funding clarity.