PORTLAND, Ore. — Heidi Stewart, deputy director of the Oregon Department of Corrections and interim health services assistant director, told the Public Safety Subcommittee on March 11 that health services is under strain from staffing shortages, high pharmaceutical costs and scheduling backlogs for off‑site specialty care, and described planned changes including an EHR rollout and MOUD program redesign.

"Pharmaceutical costs continue to have a significant impact on expenses," Stewart told the committee. She said hepatitis C antivirals, long‑acting injectable antipsychotics, biologics and oncology drugs account for a large share of pharmacy spending and that those medications treat about 7.5% of the adults in custody but represent roughly half the pharmaceutical expense.

Staffing pressures have increased reliance on contracted medical personnel. Stewart said the department spent about $17.4 million on medical contracting services last biennium and projects $33.2 million this biennium — a roughly 52% increase — driven by nurse contracting and the use of additional locum contractors.

Stewart described efforts to reduce off‑site care backlogs: reorganizing scheduling under a single clinical supervisor, adding schedulers and ordering additional wheelchair vans to increase transport capacity. She said January off‑site medical trips were 14% higher than the 2024 average after recent adjustments.

Medication for opioid use disorder (MOUD) has presented operational challenges after the department moved away from injectables to tablets. Stewart said tablets have lengthened med‑line times and increased diversion. The department is redesigning the MOUD program and "we're looking at going back to the injectables. Once a month injectable," she said.

On electronic health records, Stewart said DOC is near configuration completion for an EHR with a multi‑phase rollout that will pilot at Coffee Creek in August and OSP in September, with remaining institutions to follow in November. She said dental functionality will not be fully available at initial launch and the department is not requesting added funding for the delay.

Stewart also described quality‑improvement work with the contracted Falcon team and plans to expand clinical pharmacist roles to treat hepatitis C and improve outcomes. She said a lack of permanent clinical staff has driven higher contract staffing costs and that increasing pay for permanent nurses could reduce contracting expenditures.

DOC committed to providing additional data requested by committee members, including wastewater testing trends, staff assault and workplace safety data, and details on off‑site scheduling and aging incarcerated populations.