For Oregon families seeking overnight behavioral health respite, a Medicaid benefit does not necessarily translate into available care. Megan Miller, who lives in Eugene, told InvestigateWest that her 8-year-old son has neurodevelopmental needs and that his Medicaid plan technically covers two weeks of “relief” overnights a year. She has never used the benefit because there is nowhere nearby to take him. Instead, she found a Lane County daytime program that offers just a few hours of care one Saturday a month.
Miller's situation is not unusual in Oregon, where state officials and advocates say there is no statewide funding available for youth behavioral health respite, according to InvestigateWest. The gap became more acute in 2025, when Kairos NW closed Interval House, its youth respite home in Medford, after operating for a decade. The closure left southwestern Oregon with just one respite provider within a three-hour drive between the California border and Eugene — a program located in Grants Pass, 140 miles south of Eugene, the outlet reported.
In its account of the closure, InvestigateWest described Interval House as one of Oregon's few overnight behavioral health respite providers. Staffed around the clock by trained providers, the home could accommodate up to three children for stays of a few days. The program combined routine activities and structured choices with opportunities to address behaviors, and served about 30 children a year on average, the outlet reported. Some Kairos programs serve more than 700 children.
Funding Cut Before the Closure
InvestigateWest reported that Jackson Care Connect ended operational funding for Interval House, leaving reimbursement tied to occupied beds rather than the cost of keeping the home staffed and ready. Jackson Care Connect said low utilization meant limited funds needed to go elsewhere.
Sarah Hollingworth, Kairos NW's outpatient services director, told InvestigateWest that families' need for respite is often taken for granted. She said weekend appointments had waitlists even as weekday slots went unused; when a child with aggressive behavior was accepted, other children could not be placed at the home at the same time. That constraint further limited how many families could use the scarce beds.
Respite Remains an Unmet Need
Local systems of care in Lane, Linn, Benton and Lincoln counties have identified regularly accessible respite as one of their communities' biggest unmet needs.
Anna Williams, director of Oregon's System of Care Advisory Council, said respite is a proven approach that saves the state money long term by preventing emergency-room or inpatient stays through giving families a break. She said expanding respite access will require state-government collaboration and substantial state investment, the InvestigateWest report notes.
Oregon's Medicaid Outlier Status
Oregon is one of only two U.S. states that does not mandate Medicaid coverage for youth respite care, while 48 other states treat it as a standard Medicaid service, according to InvestigateWest's reporting. Federal Medicaid funding cuts are also expected to add pressure on the regional Medicaid networks already deciding whether to cover these services.
The gaps come as emergency departments absorb more of the crisis load. Oregon has ranked among the worst states nationally for access to youth mental health care, and in 2024 nearly 13,600 Oregon youths under 18 visited emergency departments for mental health crises or substance use disorder — with one in four age 11 or younger, according to The Lund Report. From 2020 to 2024, emergency-department visits for these reasons rose 15% among children ages 7 to 11 and 72% among children ages 0 to 6, the outlet reported, and a 2025 OHSU report found about 12% of Medicaid-enrolled youths seeking mental health care were held in emergency departments for three to seven days because no acute-care bed was available.
A separate 2024 watchdog review from the Oregon Health Authority's Ombuds Program, reported by The Oregonian, found that families have spotty access to respite care for children. That review also found that only nine of Oregon's 16 coordinated care organizations had provided the state's Medicaid-funded intensive in-home treatment program for youth 20 and younger since 2022, with just 321 youth receiving that in-home care between 2021 and 2023. From mid-2021 to mid-2023, 4,725 Oregon Health Plan members age 25 or younger visited hospital emergency rooms and received a mental health diagnosis.
Repeat crises
A finding from the Oregon Health Authority Ombuds report points to recurring emergency care: more than 11% of youth who receive mental health care in emergency rooms seek the same care again within three months, KOIN reported.
How Other States Handle Respite
Most states fund respite services through Medicaid waivers, though many cap the amount of care covered — annual limits for children range from seven days in Florida to 180 days in Minnesota, according to the National Academy for State Health Policy. Illinois took a different route in July 2022, implementing a state plan amendment that covers respite specifically for children and youth with serious emotional disturbance. Caregivers of children with chronic and complex needs nationally still report that respite is not sufficiently available, the organization notes, even in states with established coverage.
Oregon officials are exploring requiring Medicaid coverage for respite care, but as of now no statewide funding exists, leaving families like Miller's to navigate a patchwork of scarce, unevenly distributed options.
