SALEM, Ore. (KTVZ) — Measure 110 is still far from achieving its promise to help Oregonians struggling with addiction due to frequent policy changes and a lack of stability, coordination and data at the Oregon Health Authority, according to an audit released Wednesday by the Secretary of State Audits Division.  

“Oregon has struggled to respond to substance use for decades, and fentanyl is only making the problem worse. Enough is enough. We can and should do better,” said Secretary of State Tobias Read.

“With a consistent, long-term strategy, stronger coordination, and better data, Oregon can help more people get the care they need, and we’ll all have safer, healthier communities. These recommendations don’t require new resources, just a commitment to providing basic oversight, common-sense governance, and accountability.”

Here’s the rest of the news release highlighting key findings in the audit:

Measure 110 faced serious headwinds from the start. Oregon reports some of the highest rates of substance use disorder in the nation. The pandemic, the rapid spread of fentanyl, and Oregon’s historically poor access to treatment only made the crisis worse. When voters passed Measure 110 in 2020, Oregon ranked 50th in the nation for access to treatment.

However, auditors found issues with frequently shifting legislative policies and uneven program implementation at OHA that contributed to the lack of results.

For example, legislators changed parts of Measure 110 nearly every year since it passed, making it hard for OHA to build or evaluate long-term strategies. Inside OHA, leadership changes, reorganizations, and unclear accountability weakened the program from the start. Measure 110 services are still not well integrated into Oregon’s broader behavioral health system, leaving them fragmented and harder to manage.

Auditors also found OHA lacks reliable information to track basic metrics — demographic data such as race, ethnicity, age, and gender is often missing or inconsistent, making it hard to know whether funding is reaching communities most harmed by the “war on drugs.”

Even determining whether the number of treatment providers has increased since 2020 is difficult, based on available OHA data. Without better data, neither OHA nor lawmakers can tell if policies, services, or millions of dollars in grant funding are improving access to treatment.

Auditors issued six recommendations to OHA to strengthen Measure 110, including:

• Develop an implementation roadmap with timelines, accountability, and clear deliverables.
• Require all Measure 110-funded providers to participate in standardized data reporting.
• Complete an analysis to create a baseline that can be compared to new data to measure progress.

“If OHA follows these recommendations, and the Legislature avoids the temptation to make further significant changes for some time, Measure 110 will be stronger and more likely to help Oregonians struggling with addiction,” said Secretary of State Read. “Clearer laws, better coordination, and better data will help ensure tax dollars actually get people into treatment.”

Read the full report on the Secretary of State website.

Oregon Health Authority responds to Measure 110 audit from the Oregon Secretary of State

PORTLAND, Ore. — Historically, Oregon’s behavioral health system has gone underfunded and overburdened. Today, with renewed focus and broad alignment, the Oregon Health Authority (OHA), is working to change that, reimagining what treatment can look like across the state when accountability meets action. An audit released by the Secretary of State shows that the agency has taken significant steps to strengthen program oversight and ensure responsible, effective use of Measure 110 dollars.

This important work is underway and producing meaningful results. As of today, there are 234 Behavioral Health Resource Network (BHRN) grantees across the state, with one in each county. These services include culturally and regionally specific care that connects or re-connects patients with the communities they call home. With each step taken to improve Oregon’s behavioral health system, lives are saved, bonds are rebuilt, and barriers to care are lowered for those who need it most.

“OHA appreciates the results of this audit and is acting with urgency on the findings,” said OHA’s Behavioral Health Division Director Ebony Clarke. “We are committed to ongoing work to strengthen oversight, responsible stewardship of Measure 110 dollars, and ensuring that every person in Oregon has access to the behavioral health services they need.”

OHA acknowledges initial implementation of Measure 110 was challenged by tight timelines and insufficient staffing. However, in the last year OHA has significantly grown and stabilized the Measure 110 program through improved leadership, management, and staffing.

As noted by the SOS Audits Division, regular legislative changes since 2020 have impacted OHA’s ability to establish and stabilize BHRN programming and oversight.

OHA acknowledges past Measure 110 data limitations and has invested in Measure 110 data improvements. The data collected by the 234 grantees and submitted to OHA has increased dramatically. Through implementation of the Strategic Data Plan, OHA is already charting a forward-looking evaluative approach that emphasizes ongoing performance measures and BHRN provider-reported indicators. This method better captures program outcomes through programmatic and client-level metrics collected quarterly. These metrics will be publicly available via the BHRN program quarterly dashboard, which will provide aggregate data on program activities and service level metrics.

History of What Was Audited

Measure 110 was a ballot measure passed by Oregonians in 2020 to expand addiction services and social supports through redirected marijuana tax revenue and law enforcement savings.

As noted by the Secretary of State’s Audits Division, several legislative changes since 2020 have impacted OHA’s ability to establish and stabilize the Behavioral Health Resource Network’s (BHRN) programming and oversight. During its first years, these changes altered timelines, expectations and funding formulas. Most notably, HB 4002 (2024) shifted one of the foundational tenants of the original legal framework by recriminalizing drug possession and changed how people access BHRN services. Declining cannabis tax revenue and criminal justice cost savings have also reduced available funds.

Despite these shifts, OHA remains focused on maintaining statewide access to treatment, harm reduction and recovery services. Even with funding instability for Measure 110’s BHRNs, OHA has ensured available funds are used efficiently and effectively to support essential behavioral health services statewide.

OHA Implementation and Program Improvements

Following two previous audits, OHA continues to take clear action – responding to past findings and addressing key issues raised in the most recent review. From 2022-2025, programs receiving Measure 110 funding reported 3 million encounters with people in need of addiction and social support services. , More than 80% of the funded BHRN providers performed outreach at least once per week and approximately 40% of these providers performed outreach five or more times weekly, resulting in thousands of new clients accessing critical BHRN services.

This work is made possible in part by OHA’s substantial process improvements, including:

Leadership and Structure

• Hiring a dedicated Measure 110 Executive Director (October 2024), program manager (February 2025) and additional leadership staff (2025).
• Expanding the M110 program team from three to 18 full-time positions, providing stability and expertise.
• Embedding project management, grant administration and cross-division coordination into daily operations.

Governance and Oversight

• Reorganizing the program to ensure alignment with the OHA Director, Behavioral Health Division Director and Governor’s Office priorities and strategies.
• Successfully completing the 2025 grant process and incorporating lessons learned for the upcoming funding cycle.
• Preparing for the shift of grant-making authority from the Oversight and Accountability Council (OAC) to OHA in 2026 under Senate Bill 610 (2025).

Data and Accountability

• Launching enhanced Behavioral Health Resource Network (BHRN) grant reporting in 2025, including client-level reporting.
• Implementing standardized expenditure and staffing reporting to ensure the responsible use of every Measure 110 dollar.
• Utilizing a public facing dashboard to ensure robust data is collected and shared, including plans for additional data reporting for the current grant cycle.

Additionally, while the Audits Division recommends OHA conduct a baseline study to determine the impact of Measure 110 funded services, data limitations and the availability of appropriate data comparisons significantly hinder OHA’s ability to conduct such a study, possibly to the point of rendering it impossible. However, OHA has invested in many data improvements that will allow the agency to report out on BHRN program impact and client outcomes by 2027.

Work to Improve Access to Behavioral Health Services Continues

“We have built a responsive high performing team overseeing M110 implementation to help build a system that is coordinated, evidence-based and responsive,” Clarke said. “OHA is committed to collaborating with partners to ensure we are leading with stability, collaboration and compassion.”

OHA continues to advance the equity goals at the heart of Measure 110 by improving culturally specific services, strengthening funding processes and ensuring that communities disproportionately harmed by past drug policies have access to care.

Substance use disorder is a long-term public health challenge. OHA will continue strengthening Measure 110 implementation and ensuring that public funds are used effectively to support treatment and recovery to reduce harm and save lives across Oregon.

House Republican Leader Lucetta Elmer Responds to State Audit on Measure 110

SALEM, Ore. — Today, House Republican Leader Lucetta Elmer (R-McMinnville) released the following statement in response to the audit released by the Secretary of State showing Ballot Measure 110 (2020) — which aimed to replace criminalization of substance use disorder with a public health approach — failed due to poor strategies, inadequate data, and wasted resources:

The Secretary of State’s audit confirms what too many Oregon families have already lived through: Measure 110 failed to deliver on its promise to help people struggling with addiction, and the state failed to provide the leadership and oversight needed to prevent that failure.

Measure 110 was sold as a compassionate, public health approach. Instead, it became a system with no clear direction, no meaningful accountability, and no urgency — even as overdose deaths continued to rise. In 2023 alone, more than 1,700 Oregonians died from drug overdoses. While overdose deaths declined in nearly every other state, Oregon fell further behind.

The audit makes clear that the Oregon Health Authority lacked stability, coordination, and measurable goals. Funds were distributed without consistent oversight, data was insufficient to show whether programs were working, and services were not integrated into Oregon’s broader behavioral health system. The result was wasted time, wasted resources, and lives lost that did not need to be.

This was not a failure of compassion — it was a failure of leadership.

Oregonians expect their government to act when policies aren’t working, especially when lives are on the line. Instead, warning signs were ignored, repeated requests for improvement went unanswered, and accountability was absent.

We owe it to families, first responders, and people battling addiction to do better. A public-health approach must be focused on saving lives, getting people into treatment, and delivering results — not protecting a broken system. Oregonians deserve urgency, transparency, and leadership that is willing to admit when something isn’t working and course-correct immediately.