Community, Cottage Grove, Public Safety

Despite M110, mental health services stressed in Rural Lane

Jon Roberts’ road to recovery didn’t start until his fourth time in prison. It was only then he was offered the chance to enroll in the Substance Use Disorder (SUD) program. 

“What came before that was seven felony possessions for controlled substances,” he said. “It was right there, clearly on paper. You didn’t have to be a rocket scientist to figure out I had a problem.”

Now, Roberts works as the Qualified Mental Health Associate (QMHA) program manager for South Lane Mental Health (SLMH), dedicating his life to removing barriers to treatment. He advocated for Measure 110 when it passed back in 2020, even traveling to Salem to meet with state leaders. 

“If we can stop punishing people for having a problem and do the actual healing work with them, they can create a life that doesn’t infer the need to feel different. They can love to wake up in the morning and enjoy what they’re doing,” he said. 

South Lane Mental Health is one of 18 organizations in Lane County that has received funding through Oregon’s voter-approved M110 — and one of the only to operate outside the Eugene/Springfield area. So far, it’s covered roughly $300 million in grants for organizations offering services from housing to needle exchanges; OHA released a report this week saying it served over 60,000 people in recovery through the end of September.

M110 reclassified possession of small amounts of drugs as a civil violation and funds addiction treatment and harm-reduction efforts by reallocating tens of millions of dollars from the state’s cannabis tax. The landmark legislation made Oregon the first state in the country to decriminalize possession of small amounts of hard drugs and instead allows police to write low-level tickets for possession. The tickets can be waived if the recipient calls a hotline and gets a health assessment.

“It’s hard for people to come in and ask for help,” he said. “It’s the hardest thing in the world to admit you have an issue. So rather than locking people up for having a problem, we’re going to try and help solve it. It’s a beautiful approach, but it takes a fair amount of work to build the infrastructure to push that vision through.” 

Under M110, SLMH is grouped with a cohort of other organizations or a Behavioral Health Resource Network (BHRN) to refer clients to additional services. 

An estimated 61,000 people in Lane County with a substance use disorder need but haven’t received treatment in a specialty facility in the past year, experts say. 

For Alison Canino, Interim Executive Director of SLMH, the lack of wrap-around support in rural Lane makes her job that much more difficult. Wait times for simple therapy appointments can take anywhere from three weeks to two months. 

“Particularly in rural communities, there can be a shameful kind of rhetoric around substance use,” she said. “We’re the only game in town right now, unless you want to go up to Eugene, which for our folks might as well be going to Portland. When we don’t have access to other resources that can help, like housing and grievance support, there become more and more barriers to care.” 

Law enforcement weighs in 

In Springfield, Police Chief Andrew Shearer says that “based on just the data that’s been presented to us statewide, in combination with just the anecdotal things that we are seeing on the streets today, it’s not working.” 

Through December 2022, law enforcement statewide wrote 3,768 tickets under M110. 

Relative to the number of people arrested for simple drug possession before the law took effect, this is much less than before, according to state officials. 

The plunge was expected as the new law set up a system for police to instead issue tickets for small amounts of drugs like heroin, methamphetamine and LSD. But so far, police agencies generally haven’t embraced the plan — handing out only an estimated 1,280 tickets statewide, most often for methamphetamine and heroin, according to the latest available data from the Oregon Judicial Department.

“I don’t want this to be law enforcement’s job to solve people’s addiction issues,” Chief Shearer said. “But I do want a mechanism in place that’s effective. I think we were pretty mature in just decriminalizing this without the infrastructure in place to effectively deliver service to the people that need it.” 

SPD collaborates with CAHOOTS and White Bird Clinic to provide mobile crisis care to individuals in Springfield, something Shearer emphasized is crucial to policing across the state. 

“We are still the first people that encounter individuals who are struggling when they’re out on the street at night,” he said. “But I think the problem is the lack of services to deal with people that are in addiction. I mean, there isn’t a law enforcement solution to it, nor do we want it to be, or think it should be.” 

Sherer also spoke to changes within department policy to emphasize de-escalation training and crisis intervention in everyday interactions. 

“Unfortunately, drug use drives property crime,” he said. “It affects those quality of life crimes, and we’re not really able to move the needle forward.” 

State debate

M110 has recently come under scrutiny after an audit report from Secretary of State Shemia Fagan’s office and the Oregon Health Authority also detailed that it’s “too early” to determine the effectiveness of M110 and its programs. 

“It is plain as day that Oregon’s drug treatment system is failing,” Fagan said in a statement. “This is incredibly frustrating for me, and many Oregonians, because treatment is a matter of life and death for people we know. I have a brother in recovery right now. I want to see M110 work.”

In keeping with Fagan’s mission to build trust by telling Oregon’s whole story, auditors also looked at the racist history of drug laws in Oregon and noted the disproportionate harm caused by the War on Drugs in communities of color.

“With M110, voters, myself included, sent a clear message to state leaders that we need a new, more effective plan for drug treatment in Oregon,” Secretary Fagan said. “OHA and the State Legislature must continue working to make the new program work for our families and our communities.”

The audit details the steps taken since M110 was approved by voters and implemented in February 2021.

Since then, at least one BHRN has been created in each Oregon county for providers to collaborate and deliver free substance use services for their communities.

But the forming of these coalitions took much longer than expected, even though possession of small amounts of hard drugs had already been decriminalized by M110 long before the treatment networks were in place.

“Last fall, BHRNs in every Oregon county received funding from OHA to begin delivering more comprehensive and integrated services at the local level,” new OHA Director James Schroeder said in response to the audit’s release. “The launch of these networks represents the real start of M110 in Oregon.”

According to the health authority, 42,000 people were helped over the last year, with $32 million handed out to programs that help those with substance abuse. When it came to services, however, OHA’s said that only about 4,000 of those 42,000 people got substance abuse treatment. 

Still, Lane County Public Health says it’s still too early to determine the effectiveness of M110. 

“The initial audit around M110 is a little bit unfair,” said Jason Davis, Public Information Officer for Lane County Public Health. “It’s not a full picture, and we know that there’s an entire system that has to be overhauled in order for some of these tactics to be effective — we want to fund the entire continuum of care when it comes to behavioral health.” 

The “continuum of care,” includes wrap-around services for individuals suffering from SUDs, things like the Lane County Behavioral Health Center, expanding the efforts of mobile crisis units and building more affordable housing. 

“There are some logistical pieces that still need to be worked out,” he said. “But I can’t stress enough that there is a lot of hope. Rather than calling back to the war on drugs, which clearly didn’t work, we’re trying to take individuals who have diagnosable behavioral problems and get them into treatment, rather than putting them behind bars.” 

Expanding services in Rural Lane

To date, SLMH has been paid over $300,000 in M110 funding — all of which is going to support a new peer mentor and expand its existing harm-reduction model. 

Camino says that M110 funds have been prioritized for services that aren’t typically funded by Medicaid, such as low-barrier resources, harm-reduction resources and peer support.

“This will take a while,” she said. “We’re building a foundation of networks so we’ll be able to get clients access to resources at a faster pace, but housing continues to be a barrier we are struggling with in Cottage Grove.” 

More recovery resources of every kind are needed throughout the state, according to a recent Oregon Health and Science University Analysis. The research found the state has only about half the disorder prevention, harm reduction, treatment and recovery resources it needs to serve those populations fully.

Lane County needed to include 47% of the recommended services, and of those, there was a 71% service gap specifically for peer support specialists.

South Lane County continues to lack a mobile crisis unit, something Camino says would help support the efforts of SLMH. 

“It’s not uncommon for our first responders in South Lane County to be called out to help somebody in crisis,” she said. “But, that person is also struggling with living with addiction. And we want to be able to meet them at that moment. The continuum of care includes a place to sleep at night. It’s all connected.” 

Officials with SLMH are in conversation with local law enforcement and LCPH to bring mobile crisis units to Cottage Grove, Creswell and surrounding areas but say challenges with police leadership are halting progress. 

“Where we’re at right now creates an inability to call the right folks to the table, and just sit down and hammer something out,” Robert said. “It will take community buy-in too, and all of those things take time.” 

Future funding is connected to services provided; however, the budget is at risk during this upcoming legislative session. A dozen proposed bills want to change how the measure operates or repeal it entirely.

“The challenge moving forward will be maintaining the level of finding available for prevention services,” Davis said. “However the governor’s new budget and priorities are certainly a lot around behavioral health. What we see in that realm will have a positive impact and expand what is possible.” 

For Alexis, an unhoused mother at the Brian Miller encampment behind the Dari Mart in Cottage Grove, South Lane Mental Health was critical to her sobriety. 

“People want services in their hometown,” she said. “My family is here, I’m comfortable here. I don’t want to go to Eugene.” 

The team at SLMH supported her through her addiction struggles and continues to connect her to their support network. “There are a lot of people in this camp who need mental health or drug help and there should be room for them,” she said. “It’s not their fault. The best thing to do is try, instead of shutting them away.”