Mental Health Leader Outlines Looming Funding Cuts, Access Gaps in Rural Oregon
The Dalles, Ore., Aug. 27, 2025 — In a wide-ranging conversation on the CCCNews Podcast, Mid-Columbia Center for Living Executive Director Al Barton warned that looming changes to Medicaid could leave rural Oregonians with fewer behavioral health services — even as demand continues to grow.
Barton, who leads the tri-county mental health provider for Wasco, Hood River, and Sherman counties, said recent federal policy shifts could reduce Medicaid enrollment by up to 15% starting in 2026, especially in areas like eastern Oregon, where up to 40% of residents rely on the program.
“We recognize that when there are fewer people with Medicaid, the behavioral health needs don’t go away,” Barton said. “People still need help — they just may not have insurance.”
New federal work requirements and income verification rules may leave more residents uninsured, Barton said, pushing them into already strained public systems. While MCCFL offers sliding-scale fees for those without insurance, Barton noted the agency is preparing for a scenario with “more demand and fewer resources.”
Oregon currently ranks 47th in the nation for access to behavioral health care, despite some of the highest rates of mental health and substance use issues. Barton said state investment in prevention services has lagged behind the need.
“Access is really about how quickly someone can get help when they need it,” he said. “That might mean a walk-in during the day, or a mobile crisis team showing up within two hours.”
MCCFL has 160 employees and offices in The Dalles, Hood River, and Wasco. The agency operates crisis services, outpatient counseling, peer support, addiction recovery, and intensive youth and family programs. Its new children’s services facility on East 19th Street expanded access to trauma-informed care for families and school-age children.
One major recent setback involved the collapse of plans to build a full-scale behavioral health crisis campus in partnership with Wasco County. Federal rules around treatment facility funding made the original plan financially unworkable. Instead, MCCFL is now pursuing a more limited crisis receiving center and a local residential addiction recovery facility — a move Barton calls a “pivot” in the face of fiscal uncertainty.
Barton also discussed the agency’s response to the Rowena Fire, which destroyed more than a dozen homes in June. MCCFL deployed support staff to local listening sessions and continues to provide emotional support for those processing trauma in the fire’s aftermath.
“We can’t get people’s houses back,” Barton said, “but we can offer support and try to help them find a way forward.”
As financial clouds gather, Barton said community collaboration, public education, and legislative partnerships will be key to keeping services viable.
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