Kairos NW closes Eugene-area respite home as Medicaid funding shrinks

Megan Miller, a single mother in Eugene, waited months to secure a monthly Saturday morning slot for her eight-year-old son. Her son, who has neurodivergent needs, required a break from the stress of a recent move and school change. The available care offered only a few hours of supervision once a month. Miller described the arrangement as a game changer for her son’s ability to engage with peers and for her own well being.

Miller’s search illustrates a gap in Oregon’s youth behavioral health system. The state lacks a dedicated funding stream for youth respite care. Oregon is one of two states that does not mandate Medicaid coverage for these services. Regional Medicaid networks, known as coordinated care organizations, decide independently whether to pay providers. Only half of these networks currently list providers offering overnight respite care in their benefits documents.

Kairos NW, a nonprofit that provides youth mental health and foster care services, closed its Interval House facility in Medford last year. The home had operated for a decade. It was one of the few providers in the state offering overnight supervision for children with complex behavioral health needs. The closure followed a decision by Jackson Care Connect, the regional Medicaid administrator for Jackson County, to scale back funding. The network cited low utilization rates and the need to allocate limited funds to other services.

Interval House was staffed around the clock and could accommodate up to three children at a time. The facility aimed to replicate a familiar home environment rather than a clinical setting. Children participated in arts, crafts, and local outings while maintaining their usual routines. Susan Tremper, a former live-in provider, said the structure allowed staff to address specific behaviors like anger or shyness in a low-pressure setting. The home served an average of 30 children per year.

Jeremiah Rigsby, chief legal and public affairs officer for CareOregon, which operates Jackson Care Connect, said the funding model evolved because initial projections for care usage differed from actual member needs. The network now reimburses providers only for occupied beds rather than covering fixed operational costs. Interval House had approximately $58,000 in annual operational costs before the funding cut. Rigsby noted that members in Jackson County still have access to one other respite provider.

The closure has widened the geographic gap in the region. There is now only one respite provider available within a three-hour drive between the California border and Eugene. That facility is located in Grants Pass, 140 miles south of Eugene. Sarah Hollingworth, outpatient services director at Kairos NW, said the loss is difficult because the service was established for a long period before it disappeared without a clear transition plan. She noted that the home had limited capacity because it avoided placing children with aggressive behaviors alongside other kids for safety reasons.

State health agencies have invested in outpatient services to stabilize children after crises, but providers say gaps remain. A report from the Oregon Health Authority’s Ombuds Office released earlier this year links a rise in children boarding in emergency departments to inadequate outpatient services. The report found that emergency room visits for mental health crises or substance use increased by 15% between 2020 and 2024. The increase for children under age 6 was 74%.

Cate Drinan, a pediatric patient advocate with the Ombuds team, said families often exhaust available options before seeking emergency care. She has observed families choosing to relinquish custody of their children to child welfare agencies after repeated failed attempts to access community-based support. Anna Williams, director of Oregon’s System of Care Advisory Council, described respite care as a proven approach that can prevent more expensive crises. She said the service helps relieve family stress and can avoid the need for inpatient settings.

Respite care in Oregon dates back to the 1980s, when the state shifted away from institutionalizing children. The state funded local respite networks for nearly a decade before cutting the program from the budget in 2010. State officials are currently exploring how to require Medicaid coverage to improve availability. However, regional networks say costs have risen and they are already overstretched by existing mandated services. Federal cuts to Medicaid funding are expected to add further pressure to these budgets.