When It's Not Working: Letting a Clinician Go Without Betraying Your Values
Letting a clinician go can fit your values if three things are true: they knew the expectations and had a real chance to meet them, their clients are protected through the transition, and they leave with their dignity intact. Most of what makes a separation ethical happens months before the conversation. What usually goes wrong isn't the decision. It's the delay.
The COA Requirement and the July 2027 Associate Deadline: What Oregon Group Practices Need to Decide Now
Starting July 1, 2027, board-registered associates in Oregon can serve Medicaid (OHP) members only if they are licensed or work for an agency that holds an OHA Certificate of Approval (COA). If your group practice has associates seeing OHP clients and you don't hold a COA, you have about nine months to choose a path. COA applications are backlogged, so this is not a decision to leave for spring.
Practicing Across the Oregon–Washington Line: What Portland Metro Practices Need to Know
Every Portland-metro practice hits this eventually — a client moves across the river, a strong candidate is Washington-licensed only, a college student comes home for the summer. What follows is what I have confirmed with the boards' own materials as of September 2026, including one answer that surprised me.
How to Start a Group Therapy Practice in Oregon: Licensing, LLC & Payer Basics
Starting a group therapy practice in Oregon comes down to four things: making sure your (and your clinicians') licenses are in order, choosing and registering a business entity, getting credentialed with the payers you want to accept, and understanding Oregon's specific rules for Medicaid and behavioral health. Oregon does a few things differently than other states — especially its coordinated-care Medicaid system and a Certificate of Approval requirement — so here's what to know before you build. I've walked this path myself building Sprout Therapy PDX from solo to 40+ clinicians, and I'll flag the Oregon-specific traps along the way.