Health Care Agency Leadership Lays Out Plan to Go Back to Basics

OKLAHOMA CITY — Today, Secretary of Health and Mental Health and Oklahoma Health Care Authority (OHCA) CEO Clay Bullard, Interim Commissioner of the Department of Mental Health Greg Slavonic and Commissioner of the Department of Health Keith Reed laid out a plan to go back to basics at the Department of Mental Health and Substance Abuse Services (ODMHSAS).  

Leaders highlighted the significant progress made within the department to address budget challenges and emphasized the importance of delivering essential services to Oklahoma’s most vulnerable residents.

Interim Commissioner Slavonic and Secretary Bullard outlined changes already implemented as well as proposed rulemaking to ensure that state services are focused on the Oklahomans who are most at risk.

Secretary Bullard also cast a vision for structural changes at the Department of Mental Health to ensure the long-term ability for the state to meet its legal obligations to Oklahomans suffering from behavioral health conditions.

Following extensive discussions among the three state agencies, Secretary Bullard determined that structural reforms are necessary to ensure responsible stewardship of state and federal Medicaid dollars and improve outcomes for Oklahomans relying on behavioral health services. He laid out a plan to move Medicaid management back to OHCA, move grant and contract management to the Department of Health and equip ODMHSAS to continue its mission of facility management while exploring future opportunities.

“We’re asking that all Medicaid dollars are managed by the Health Care Authority," said Secretary Bullard. "When a partner agency is unable to repay OHCA for the second consecutive year, it creates a real cash flow risk for an agency that serves one in four Oklahomans. This restructuring is about protecting the stability of the state’s Medicaid program and ensuring those dollars are used effectively for the Oklahomans who depend on them.”

“Access to care is not changing. Services will continue in all 77 counties, our facilities remain open, and Oklahomans can reach free, 24/7 support through 988,” said ODMHSAS Commissioner Greg Slavonic. “Now is the time to build on the momentum we’ve created and put the system on stable footing for the long term.”

“We are ready to stand alongside our sister agency and provide support where it’s most needed.” OSDH Commissioner Keith Reed, said. “Our shared goal is clear: ensuring Oklahomans receive the care and services they need. At the Department of Health, we manage complex systems and funding every day. We have built a strong, stable foundation and are prepared to help strengthen the broader system. Mental health is a vital part of public health, and by working together, we can better address the needs of every community. This is about partnership, not replacement, and staying focused on what matters most — serving Oklahomans.”

Proposed legislative action

• Redirect Medicaid dollars currently allocated to ODMHSAS to remain under OHCA, consolidating oversight of those funds within the authority.
• Grant a temporary exception allowing the Commissioner of Health to hold concurrent roles overseeing both the Health Department and ODMHSAS beginning at the end of the legislative session through the end of December 2026. Under this arrangement, the Commissioner of Health would evaluate ODMHSAS programs and work to streamline federal grant funding with broader health efforts across the state.

Medicaid eligibility and rulemaking

Under current federal Medicaid guidelines, most states cover adults up to 138% of the Federal Poverty Level (FPL).

ODMHSAS rules currently allow Oklahoma to deem individuals earning up to 200% of the FPL eligible for services — 62% above the standard Medicaid threshold. This expanded eligibility has cost the state approximately $10 million per year.

ODMHSAS will propose a rule change to align Oklahoma's eligibility threshold with the federal standard of 138% FPL, which officials anticipate will reduce the state's annual obligation for those claims.

Proposed future action

• Redirect Medicaid dollars currently allocated to ODMHSAS to remain under OHCA, consolidating oversight of those funds within the Health Care Authority.
• Allow a period of transition to move grants and contracts departments to the Department of Health.
• Empower the Commissioner of Health to evaluate ODMHSAS programs and streamline federal grant funding with broader health efforts across the state.

###