What we found
The vision laid out in M110 — to replace criminalization of substance use disorder with a public health approach — remains unfulfilled due to persistent structural and operational weaknesses across Oregon’s behavioral health system. A coordinated approach would help ensure access to care, and the chance for recovery, does not depend on where a person lives. For a problem that is decades in the making, it will likely take decades of intentional effort to correct. Instead, the pattern of annual revisions has undermined confidence in the program’s direction and hindered the development of long-term strategies. Additionally, without action by OHA to address governance, integration, and accountability, the program has little to no chance to fully deliver on its promise to help Oregonians struggling with addiction. The state’s efforts address only the symptoms of substance use disorder, without effectively treating the underlying disorder itself.
Governance and leadership instability have contributed to inconsistent guidance and poor grant oversight.
The grant process has been inconsistent since the start of M110. A lack of consistent prioritization by OHA leadership, operational turnover, and multiple legislative changes have further complicated efforts to operate the program.
OHA has not yet strategically integrated M110 services into Oregon’s broader behavioral health system.
OHA did not integrate the newly created M110 provider network into the broader continuum of care supported by Medicaid and other state or federal programs. Fragmentation reduces the efficiency and effectiveness of service delivery.
Flawed data and unclear goals prevent OHA from demonstrating M110 effectiveness.
OHA has not collected sufficient information to determine the number of people served or outcomes from the program.
The former M110 telephone hotline was inefficient from the beginning.
As an example of OHA’s dysfunctional implementation, the additional hotline for M110 was redundant and lacked strategic integration, as it duplicated existing efforts and cost the state significant resources.
Counties’ implementation of deflection programs provides inequitable access to services.
Deflection programs, a form of law enforcement intervention created in Oregon in 2024, are implemented inconsistently across counties. In some jurisdictions, deflection does not exist at all, raising concerns about equity of access.