Oregon's Largest Treatment Center for Mothers Closes as Perinatal Beds Shrink

The Letty Owings Center, a 29-bed residential addiction treatment program in northeast Portland that allowed pregnant and parenting women to keep their children with them, will close permanently at the end of October after 37 years. Central City Concern, the nonprofit that has operated it since 1997, told the investigative newsroom InvestigateWest that a growing deficit, the cost of repairing the building, and the failure to find another provider willing to take the program over left no path forward.

The closure caps a year in which Oregon lost roughly 20 percent of its residential treatment beds for pregnant and parenting people, according to InvestigateWest's estimate. About 120 of those beds remain statewide, most of them along the I-5 corridor. The Associated Press distributed the story nationally on Oct. 30.

For families, the practical loss is specific: a place where a mother could enter residential treatment without surrendering her child to foster care, where staff held babies so a newly sober parent could sleep, and where child welfare workers could allow overnight visits. Programs that accept children up to age 5 are rare, and the state does not separately count how many of them exist.

What Oregon's Own Mortality Review Says

The case for these beds is not anecdotal. Oregon's Maternal Mortality and Morbidity Review Committee, a governor-appointed panel that reviews every death of a pregnant or postpartum Oregonian, published its biennial report in February 2025 covering deaths from 2018 through 2021.

Of 69 deaths reviewed, the committee determined that 32 — 46 percent — were pregnancy-related, a ratio of 19.4 deaths per 100,000 live births. The single most frequent underlying cause was mental health conditions including substance use disorder, which accounted for 13 of those 32 deaths, or 41 percent. Substance use disorder alone accounted for four more. The committee judged 23 of the 32 deaths (72 percent) to have been potentially preventable.

It also found that discrimination was a contributing factor in 15 of the 32 pregnancy-related deaths — 47 percent — writing that "discrimination against people with mental health and/or substance use disorders was a leading contributing factor." The committee's first recommendation is blunt: "All payers, including Medicaid, should prioritize coordinated mental health/substance use disorder care for pregnant people."

Timing matters for families planning care. Thirty-one percent of Oregon's pregnancy-related deaths occurred between 43 days and one year after the end of pregnancy, meaning the year after birth carries risk that a short treatment stay does not address.

Demand Has Risen, Not Fallen

The need these programs serve has grown. A study published Dec. 23, 2025 in the Journal of Addiction Medicine by Oregon Health & Science University researchers examined more than 5.5 million hospital records and found that the prevalence of an opioid-related diagnosis in pregnancy more than doubled, from 0.14 percent in 2008 to 0.33 percent in 2020. Those pregnancies carried significantly higher risk of neonatal intensive care admission, respiratory distress, preterm birth and infant death, along with maternal hypertension, hemorrhage and the need for blood transfusions.

"Here in Oregon, only one in four residential treatment programs offer care for pregnant persons, and some counties have no obstetric care or addiction care resources available at all," said Kristin Prewitt, M.D., M.P.H., a co-author of the study and a fellow in OHSU's addiction medicine section and department of maternal-fetal medicine.

The pressure on the remaining programs is measurable in Portland. Andy Mendenhall, Central City Concern's chief executive, cited an analysis by HealthShare of Oregon — the coordinated care organization serving most Portland-area Medicaid enrollees — estimating that roughly 550 pregnant people needed treatment for psychosis, stimulant or opioid use disorders in 2024. Even if only a quarter of them required residential care, that would exceed the state's entire perinatal bed capacity.

Why These Beds Cost More Than They Are Paid For

Oregon has been adding residential capacity overall: the state's public dashboard tracking behavioral health housing and licensed residential investments reports steady growth, and the governor's office announced in June that state-funded expansion had passed 1,000 open beds. But that accounting is organized by funding stream and facility type, not by whether a program accepts children. Beds for pregnant and parenting people are not a category the state publishes, and neither is the prevalence of substance use disorder among pregnant Oregonians.

The economics of the programs that do accept children are unforgiving. Mendenhall said restructuring Letty's operations to meet clients' growing needs would have added $2 million a year in costs, on top of a projected $1 million deficit for 2027. Central City Concern's revenue exceeded $200 million in 2025, but the nonprofit is bracing for Medicaid cuts that are beginning to take effect.

Program directors describe a reimbursement system that does not pay for what a mother and child actually require. Diapers, clothing, food, transportation to prenatal appointments and NICU visits, and the parenting and financial literacy classes that help parents satisfy child welfare requirements are largely unrecoverable. Room-and-board reimbursements passed through counties cover a fraction of real costs. And as clients arrive with more prescriptions to manage, more staff hours go to supervising self-administered doses.

The clinical picture has also shifted. Purer methamphetamine has brought more psychosis and mental health crisis into residential settings, while fentanyl's persistence in the body means longer stays and higher doses of methadone or buprenorphine, said Amanda Risser, Central City Concern's chief medical officer.

The closure was not the first this year. A Volunteers of America Oregon residential program for women paused operations in April, requiring staff to place 47 clients; five who were pregnant or postpartum went to Letty Owings. That program's closure was later made permanent. Letty Owings stopped admitting new patients in July, two months before announcing it would close; its waiting list had typically run longer than 20 women.

What This Means If You Are Pregnant and Using

The most important clinical point is that treatment during pregnancy is safer than untreated addiction. Medication for opioid use disorder — methadone or buprenorphine — is the standard of care in pregnancy, and stopping abruptly is riskier for both parent and fetus than continuing under medical supervision. Our guide to addiction treatment during pregnancy walks through what to ask, and our medication-assisted treatment guide explains how the medications work.

When you call a program, ask directly: do you accept pregnant patients, and up to what age can my child stay with me? Is there on-site child care? Does the program coordinate with prenatal care and with the Department of Human Services? How long is the waitlist? Fear of child welfare involvement is a documented barrier to care — the mortality review committee named discrimination as a factor in nearly half of Oregon's pregnancy-related deaths — so ask whether the program helps parents meet custody requirements rather than treating those requirements as a disqualification. Our guide on CPS investigations and substance use covers that process.

What's Next

Governor Tina Kotek has directed the Oregon Health Authority and the Oregon Department of Human Services to create a cross-agency team to address the loss of perinatal treatment capacity. OHA communications officer Kim Lippert said the work "will kick off this month" and that the team will partner with providers "to identify practical recommendations that address immediate risks, underlying systemic funding, and operational concerns."

State Rep. Rob Nosse, whose district includes the center, said he planned to meet with Central City Concern. State Sen. Lisa Reynolds, a pediatrician, said she is working with providers on where red tape can be cut, and that the closure has "changed the timeline" for that work.

Meanwhile Oregon's overdose picture is improving at the margin without being resolved. The Oregon Health Authority reported in May that 1,544 people died of drug overdose in 2024, down from 1,833 in 2023 — the first year-over-year decline since 2016 — with roughly 1,100 deaths in preliminary 2025 data. More than 90 percent of reported overdose deaths involved fentanyl, methamphetamine or both, and 62.2 percent involved multiple substances.

For a family deciding where to turn this week, the state's capacity dashboard and the June expansion announcement are less useful than a phone call. Start with your coordinated care organization if you are on the Oregon Health Plan, or with a hospital-based program that combines prenatal care and addiction treatment, such as Project Nurture, which operates in Portland.

Where to Get Help

• SAMHSA National Helpline — 1-800-662-4357, free, confidential, 24/7, English and Spanish.
• 988 Suicide & Crisis Lifeline — call or text 988.
• FindTreatment.gov — searchable directory of licensed treatment, filterable by payment type and services.
• Oregon Health Plan members — call the member services number on your CCO card and ask specifically for residential programs that accept pregnant patients and their children.