Audit Highlights Improvements Needed In Measure 110 Rollout

Across Oregon, like the rest of the nation, a vast number of people suffer from substance use disorder. In November 2020, the people of Oregon rejected decades of racist, ineffective policies that attempted to solve drug abuse by criminalizing it and passed Ballot Measure 110 (M110). M110 set a new course focused on treatment instead of punishment.

Today, Secretary of State Shemia Fagan and the Oregon Audits Division released a real-time audit report that details how the Oregon Health Authority struggled with implementing the initiative. The report outlines recommendations for the Oregon Health Authority on how to improve M110.

“It is plain as day that Oregon’s drug treatment system is failing,” said Secretary of State Shemia Fagan. “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 Measure 110 work.”

Importantly, auditors note that it is too early to tell whether M110 will be successful. What is clear is that criminalizing drug use has failed to eliminate the harm it causes in our communities. In order to move forward with the goals of M110, OHA must implement the recommendations in this audit and continue working to create a better way of dealing with Oregon’s drug crisis.

Oregon has the second highest rate of substance use disorder in the nation and ranked 50th for access to treatment. Advocates of M110 hope it will succeed where previous recovery and treatment efforts have failed, especially when it comes to supporting Black, Indigenous, and People of Color (BIPOC) communities. To realize that goal, auditors recommend four course adjustments for the Oregon Health Authority:

  • Address fragmentation: Publish a plan by September 2023 for how the M110 program integrates into the overall behavioral health system in Oregon.
  • Ensure that success can be measured: Identify and document gaps that prevent detailed metrics from being implemented that would track the overall effectiveness and impact of M110.
  • Create the foundation for a successful grants program: Develop and document policies and procedures for the M110 program, including clear expectations, roles and responsibilities for Oversight and Accountability Council members and OHA staff and greater support for grant applicants and evaluators.
  • Seek opportunities to expand collaboration with other stakeholders.

In addition, auditors make several recommendations to the Oregon Legislature to address potential risks areas in law.

In keeping with Secretary 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 Measure 110, 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.”

Read the full audit on the Secretary of State website (

Oregon Health Authority response:

Oregon Health Authority (OHA) responded to Secretary of State Shemia Fagan’s audit of the implementation of Measure 110 (“Too Early to Tell: The Challenging Implementation of Measure 110 Has Increased Risks, but the Effectiveness of the Program Has Yet to Be Determined”) with the following statement from director James Schroeder.

“The Secretary of State is right: It is too soon to measure the success of Measure 110. However, OHA recognizes that Measure 110 can only achieve the voters’ intent and reduce the harms from untreated substance use if OHA provides timely, robust support to its implementation and effective, reliable assistance to the Measure 110 Oversight and Accountability Council. OHA will deliver on that commitment.

“Measure 110 represents a new approach to reducing the terrible toll illicit substance use takes on people and families in communities statewide. Measure 110’s first-in-the-nation approach provides more resources for harm reduction, treatment, peer counseling, housing and other services that will give people with substance use disorders the services and support they need to recover, prevent relapse and live heathier lives.

“Under Measure 110, these services are provided through locally coordinated Behavioral Health Resource Networks (BHRNs). Last fall, BHRNs in every Oregon county received funding from OHA to begin delivering more comprehensive and integrated services at the local level.

“The launch of these networks represents the real start of Measure 110 in Oregon.

“OHA agrees with all the Secretary of State’s recommendations directed toward our role in implementing Measure 110. We will pursue each recommendation with urgency and focus.

“Governor Kotek has made it a top priority to make the behavioral health system and Measure 110 work better for communities statewide. I recognize that Measure 110’s success depends on Oregon’s ability to solve many larger challenges in the behavioral health system, such as the need to expand treatment capacity and better support counselors and other workers. I’m committed to getting better outcomes for people with substance use disorders and other behavioral health needs. I look forward to reporting on our progress.”

In the agency’s Management Response to the Secretary of State’s Measure 110 audit, state health officials pledged to take action on four recommendations directed to OHA:

  • Publish the first iteration of a strategic plan that describes how Measure 110 services are being integrated into the overall behavioral health system in Oregon, by Sept. 30, 2023.
  • Identify and address data reporting gaps to better track and evaluate the impact of Measure 110. This work is already underway and will continue through 2023 and 2024, as the state launches new data reporting systems.
  • Improve the technical support OHA provides to the Measure 110 Oversight and Accountability Council (OAC).
  • Help the OAC expand collaboration with the Oregon Department of Corrections, housing programs and other partners who can aid Measure 110’s successful implementation.

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