HB 4053
Plain-language analysis
Generated analysis, not an official summary or legal advice. Confirm with linked Oregon documents.
HB 4053 creates a dedicated Emergency Medical Services Program Fund to finance workforce development, training, and innovation, restructures the EMS governance framework by updating advisory board compositions and expanding committee scopes to include long-term care and senior care, mandates demographic data collection within a new EMS data system, removes the regulation of state reimbursement systems from the EMS program's statutory purpose, and extends implementation timelines for certain prior modernization provisions to 2029.
Basis: Bill text · Sources: Enrolled; Staff Measure Summary A; Staff Measure Summary A
Legislative staff identified a need for an EMS Program Fund to accept grants from the Rural Health Transformation Program (RHTP) and to ensure sustainable funding for EMS programs. Issues discussed also included updating advisory committee requirements to allow retired EMS providers to continue service, providing clarity around EMS students and allowing out-of-state students to train in Oregon, and addressing memory care as a topic for the Long Term and Senior Care EMS Advisory Subcommittee.
Basis: Official analysis · Sources: Staff Measure Summary A; Staff Measure Summary A
Inferred from cited text; not a stated purpose.
The measure may aim to reduce administrative burden on EMS centers regarding data registry adoption by removing rigid state timelines and allowing the use of established OHA systems, suggesting a legislative intent to harmonize with national standards without imposing inflexible deadlines that could strain facility resources.
Basis: Inferred · Source: Enrolled
Gains authority to manage a continuously appropriated fund for EMS workforce and innovation; assumes expanded rulemaking duties for minimum education requirements, data system administration, and classification standards; must appoint diverse advisory board members and oversee regional plans.
Basis: Bill text · Source: Enrolled
Subject to updated licensure title protections, minimum education rulemaking, and mandatory demographic data reporting; may voluntarily seek categorization but are prohibited from holding out as designated until OHA recognition; face extended timelines for certain prior registry adoption requirements.
Basis: Bill text · Source: Enrolled
Composition requirements change to include specific representation (e.g., patient equity, rural hospitals, labor unions); scopes expand to cover long-term care and senior care emergencies; the Long Term Care and Senior Care body is redesignated as a subcommittee.
Basis: Bill text · Source: Enrolled
Retain contracting authority; must develop regional EMS system plans including HMO patient transport information; retain exemption processes for volunteer services but with stricter title usage restrictions.
Basis: Bill text · Source: Enrolled
Benefit from potential workforce improvements and equity-focused programming; data collection includes demographic indicators (race, ethnicity, disability status) for quality improvement; may experience changes in care access if facilities lose or gain categorization designations.
Basis: Bill text · Source: Enrolled
OHA can accept federal funds, settlements, and grants for the EMS Program Fund without General Fund appropriation cycles, potentially stabilizing financing for workforce initiatives.
Basis: Bill text · Source: Enrolled
EMS centers must report demographic data to the state data system, which may require updates to internal reporting workflows and privacy safeguards.
Basis: Bill text · Source: Enrolled
Classification of EMS centers remains voluntary, but facilities cannot market themselves as designated until OHA formally recognizes compliance, creating a compliance checkpoint for marketing and patient referral systems.
Basis: Bill text · Source: Enrolled
Implementation timelines for certain provisions of the 2024 EMS Modernization Act are extended to January 1, 2029, delaying full operational requirements for data systems and regional plans in affected areas.
Basis: Bill text · Source: Enrolled
The removal of reimbursement system regulation from the EMS program's purpose shifts that function away from the statewide EMS framework, potentially affecting how state reimbursement mechanisms are administered.
Basis: Bill text · Source: Enrolled
Rural EMS Systems
OHA successfully leverages the new fund to accept substantial RHTP grants, fully financing a rural workforce recruitment and retention program that prevents service collapse in multiple remote counties, maintaining 911 response times and patient access to critical care.
Basis: Inferred · Sources: Enrolled; Staff Measure Summary A
Rural Hospital/Trauma Center
A rural facility fails to adopt a required data registry for a specific categorization within the standard's timeline; it loses the ability to hold out as a designated center, causing patient diversion to distant facilities and significant revenue loss, while OHA's data extraction capabilities expose sensitive patient information due to inadequate security measures.
Basis: Inferred · Source: Enrolled
The text permits broad discretion in fund usage and rulemaking but relies on enforcement mechanisms for title protection and data security. Misclassification or duty creep could occur if oversight is insufficient.
Sources · Enrolled
The measure enhances EMS capacity through dedicated funding and modernized governance but imposes new data reporting obligations and classification compliance burdens on providers while removing the state's statutory role in regulating reimbursement systems.
Dedicated fund enables sustainable financing for workforce development and rural grants without competing with General Fund priorities.
Basis: Inferred · Sources: Enrolled; Staff Measure Summary A
Expanded advisory committee scopes and demographic data collection support targeted improvements in equity and care for underserved populations.
Basis: Inferred · Source: Enrolled
New data reporting and classification requirements may increase administrative costs for providers, particularly rural facilities.
Basis: Inferred · Source: Enrolled
Removal of reimbursement regulation from the EMS program may create gaps or fragmentation in how state reimbursement mechanisms are coordinated with EMS standards.
Basis: Inferred · Source: Enrolled
The enrolled version incorporates House Committee amendments that clarify the EMS Program Fund's purpose, expand advisory board composition requirements, update committee names and scopes (including long-term care/senior care), remove reimbursement regulation from the EMS program, modify data system provisions, and extend operative dates for certain prior modernization provisions. Key changes include adding funding authority to local governments and agencies, renaming pediatric committees, removing specific registry adoption timelines, and updating licensure title protections.
The enrolled bill expands the scope of the Long Term Care and Senior Care EMS Advisory Subcommittee to include management of emergencies in residential care facilities with memory care endorsements, a provision added via House amendments.
Broadens the subcommittee's advisory role to cover specific care settings.
Sources · Enrolled; House Amendments to Introduced
The enrolled bill removes specific timelines for EMS centers to adopt data systems or registries, replacing them with a requirement to comply 'in accordance with the standard,' and allows OHA to use established data systems.
Reduces rigid administrative deadlines for facilities while maintaining compliance with national standards.
Sources · Enrolled
The enrolled bill adds minimum education requirements to OHA's rulemaking duties for EMS licensure and updates student provisions to allow out-of-state students to train in Oregon under specific conditions.
Strengthens licensure standards and expands training opportunities.
Sources · Enrolled
The enrolled bill extends operative dates for certain provisions of the 2024 EMS Modernization Act to January 1, 2029, delaying implementation of data system and regional plan requirements.
Provides additional time for agencies and facilities to prepare for prior modernization mandates.
Sources · Enrolled
The enrolled bill removes the regulation and administration of state reimbursement systems from the EMS program's statutory purpose.
Shifts reimbursement regulation away from the statewide EMS framework.
Sources · Enrolled
Tradeoff: The enrolled version balances expanded governance and funding authority with reduced administrative rigidity for facilities through timeline removals, while extending implementation delays for prior modernization requirements.
high confidence. Analysis is based on the enrolled bill text and official legislative revenue/fiscal/staff analyses. Inferences are clearly labeled and bounded by textual evidence.
Possible effects if adopted; not current bill text.
If adopted, the amendment would explicitly authorize the Oregon Health Authority to direct EMS Program Fund grants toward local governments, healthcare providers, and emergency medical services agencies; expand a senior care advisory subcommittee’s scope to include memory care facilities; and codify strict licensure requirements for EMS practice and title use while creating a narrow statutory defense for unlicensed emergency intervention and clarifying student training exemptions.
Basis: Stakeholder claim · Source: Amendment -2 — proposed amendment
Official sources do not state why this measure was proposed.
Sponsor testimony, staff summaries, committee materials, or statutory findings may explain it.
Inferred from cited text; not a stated purpose.
The amendment likely aims to clarify the Oregon Health Authority’s grant-making authority under the newly created EMS Program Fund and address practical gaps in rural or volunteer EMS coverage by codifying a life-saving defense for unlicensed responders while expanding student training eligibility.
Basis: Inferred · Source: Amendment -2 — proposed amendment
Gains explicit statutory direction to target EMS workforce funding toward local governments, healthcare providers, and agencies; must oversee expanded student training eligibility and advisory subcommittee scope.
Basis: Inferred · Source: Amendment -2 — proposed amendment
Must conduct public hearings to grant volunteer EMS exemptions; may become eligible for OHA-directed EMS funding.
Basis: Inferred · Source: Amendment -2 — proposed amendment
Subject to strict title protection and licensure requirements; students gain clarity on out-of-state program eligibility and permitted title use during clinical training.
Basis: Inferred · Source: Amendment -2 — proposed amendment
Now explicitly included in the Long Term Care and Senior Care EMS Advisory Subcommittee’s advisory scope.
Basis: Inferred · Source: Amendment -2 — proposed amendment
OHA would need to develop grant guidelines targeting specific entity types and establish oversight mechanisms for the expanded advisory subcommittee.
Basis: Inferred · Source: Amendment -2 — proposed amendment
Counties would face administrative costs and scheduling requirements to hold public hearings for volunteer exemptions.
Basis: Inferred · Source: Amendment -2 — proposed amendment
EMS agencies would be required to verify provider licensure levels before ambulance operation, potentially increasing compliance monitoring.
Basis: Inferred · Source: Amendment -2 — proposed amendment
Students from out-of-state programs would gain a clearer pathway to clinical practice in Oregon, provided their programs meet specific accreditation or licensure qualification standards.
Basis: Inferred · Source: Amendment -2 — proposed amendment
Rural communities and emergency responders
A rural county with no licensed EMS coverage successfully uses the statutory defense and volunteer exemption to deploy trained community members during a multi-vehicle collision, preventing fatalities while OHA directs grant funds to establish a sustainable regional response network.
Basis: Inferred · Source: Amendment -2 — proposed amendment
Patients and local EMS agencies
An out-of-state student enrolled in a non-accredited program operates an ambulance without proper supervision, causing patient harm; the strict title protection and licensure requirements trigger enforcement actions that strain local agency resources and delay care during a surge event.
Basis: Inferred · Source: Amendment -2 — proposed amendment
The distinction rests on whether actions fall within the narrowly defined statutory exceptions (volunteer exemption with county order, documented life-saving necessity, or supervised student training) versus routine unlicensed practice disguised as an exception.
Sources · Amendment -2 — proposed amendment
Expanding OHA’s funding authority and clarifying emergency defenses improves workforce development and rural response flexibility but imposes stricter licensure enforcement and administrative burdens that may delay care or strain volunteer systems.
Targeted grant funding could stabilize underserved EMS regions and support workforce retention.
Basis: Inferred · Source: Amendment -2 — proposed amendment
A codified emergency defense reduces legal uncertainty for lay responders acting in good faith to preserve life.
Basis: Inferred · Source: Amendment -2 — proposed amendment
Expanded student training eligibility could accelerate workforce pipeline development.
Basis: Inferred · Source: Amendment -2 — proposed amendment
County-level public hearing requirements for volunteer exemptions could create inconsistent access and administrative delays.
Basis: Inferred · Source: Amendment -2 — proposed amendment
Strict title protection and licensure verification may increase compliance costs for small agencies during staffing shortages.
Basis: Inferred · Source: Amendment -2 — proposed amendment
Ambiguity in out-of-state program qualification standards could lead to uneven enforcement or student placement disputes.
Basis: Inferred · Source: Amendment -2 — proposed amendment
high confidence. Analysis is grounded exclusively in the supplied proposed amendment text and official legislative revenue/fiscal statements. All impacts are framed conditionally as they would apply if adopted.
If adopted, the amendment would direct the Oregon Health Authority to create a discretionary funding program for local governments and EMS entities, explicitly restrict the use of EMS titles to licensed individuals, require at least one licensed provider (above the EMR level) on every ambulance, establish a narrow life-preserving defense for unlicensed emergency care, and clarify legal exemptions for volunteer services and clinical students. The material consequence is a tighter licensure enforcement framework paired with a new discretionary revenue stream intended to support workforce development, while shifting administrative oversight of volunteer exemptions to county boards.
Basis: Stakeholder claim · Source: Amendment -2 — proposed amendment
Official sources do not state why this measure was proposed.
Sponsor testimony, staff summaries, committee materials, or statutory findings may explain it.
Inferred from cited text; not a stated purpose.
The amendment appears designed to standardize workforce qualifications and title usage while accommodating rural volunteer gaps and clinical training needs through explicit statutory exemptions and a dedicated funding mechanism.
Basis: Inferred · Sources: Amendment -2 — proposed amendment; Staff Measure Summary A
Must develop discretionary programming to distribute EMS funding, adopt rules defining student supervision standards, and oversee title enforcement and volunteer exemption oversight.
Basis: Inferred · Source: Amendment -2 — proposed amendment
Must ensure every ambulance carries at least one licensed provider above the EMR level; face strict prohibitions on unlicensed personnel authorization and unauthorized title usage.
Basis: Inferred · Source: Amendment -2 — proposed amendment
May continue operating without higher-licensed providers only if their county board grants a formal exemption after a public hearing; otherwise must comply with licensure staffing mandates.
Basis: Inferred · Source: Amendment -2 — proposed amendment
May legally use training titles and provide prehospital care under supervision if enrolled in qualifying in-state or out-of-state programs, reducing prior ambiguity around student scope.
Basis: Inferred · Source: Amendment -2 — proposed amendment
Bear administrative responsibility for conducting public hearings and issuing formal exemption orders for volunteer EMS entities within their jurisdictions.
Basis: Inferred · Source: Amendment -2 — proposed amendment
Ambulance operators will face immediate staffing compliance requirements, potentially increasing payroll costs or creating temporary service gaps if higher-licensed providers are unavailable.
Basis: Inferred · Source: Amendment -2 — proposed amendment
Counties will incur administrative costs to schedule hearings, draft exemption orders, and maintain records for volunteer EMS entities seeking licensure relief.
Basis: Inferred · Source: Amendment -2 — proposed amendment
The life-preserving defense provides a narrow legal shield for unlicensed emergency care but requires documented diligent efforts to secure licensed services, raising evidentiary burdens during incidents.
Basis: Inferred · Source: Amendment -2 — proposed amendment
OHA funding programming remains discretionary rather than mandatory, meaning workforce development grants depend on future appropriation levels and agency prioritization.
Basis: Inferred · Source: Fiscal Impact Statement A
Rural Volunteer EMS Systems
A geographically isolated county successfully obtains a board exemption and secures OHA discretionary grants, allowing its volunteer ambulance to operate legally with unlicensed volunteers while receiving state-funded training that dramatically improves response times and retention in an underserved region.
Basis: Inferred · Source: Amendment -2 — proposed amendment
Urban/Regional Ambulance Services
A service faces immediate operational disruption or enforcement actions because it cannot rapidly replace EMR-only crews with higher-licensed providers during a surge event, and the narrow life-preserving defense proves legally insufficient to protect routine operational gaps from licensure violations.
Basis: Inferred · Source: Amendment -2 — proposed amendment
The statutory language creates clear legal pathways for exemptions and defenses, but operational reality may strain oversight capacity, creating gaps between permitted conduct and unlawful practice.
Sources · Amendment -2 — proposed amendment
Tightening licensure and title protection ensures standardized care quality but may restrict operational flexibility for rural volunteer services and increase staffing costs, while the new discretionary funding program offers a potential pathway to address workforce gaps if implemented effectively.
Clearer legal boundaries reduce liability ambiguity for students and volunteers operating in emergency contexts.
Basis: Inferred · Source: Amendment -2 — proposed amendment
Dedicated funding programming could stabilize EMS workforce development and training if appropriations materialize.
Basis: Inferred · Source: Staff Measure Summary A
Mandatory higher-licensed staffing on all ambulances may strain budgets and delay deployment in areas with provider shortages.
Basis: Inferred · Source: Amendment -2 — proposed amendment
County-level exemption processes add administrative layers that could delay or complicate volunteer service authorization.
Basis: Inferred · Source: Amendment -2 — proposed amendment
high confidence. Analysis is grounded exclusively in the supplied proposed amendment text, staff summaries, and fiscal statements. No enacted provisions or external data are assumed.
If adopted, this amendment would direct the Oregon Health Authority to establish a discretionary funding program for local governments and EMS providers, expand an advisory subcommittee’s scope to cover time-sensitive emergencies in memory care facilities, strictly regulate the public use of EMS professional titles, and permit supervised clinical training by out-of-state EMS students in Oregon. Material consequences include new OHA administrative programming, expanded regulatory oversight over credential visibility, and increased flexibility for regional EMS workforce development.
Basis: Inferred · Sources: Amendment -1 — proposed amendment; Introduced
Official sources do not state why this measure was proposed.
Sponsor testimony, staff summaries, committee materials, or statutory findings may explain it.
Inferred from cited text; not a stated purpose.
The amendment likely addresses regional EMS staffing constraints and training pipeline limitations by creating a dedicated funding mechanism and removing geographic barriers for clinical education, while standardizing title usage to protect consumers and clarify licensure boundaries. Basis inference: The text shifts OHA’s programming authority toward explicit local funding distribution, explicitly adds out-of-state student clinical eligibility, and codifies title restrictions.
Basis: Inferred · Source: Amendment -1 — proposed amendment
Must design, administer, and enforce a new discretionary funding program and monitor compliance with title restrictions.
Basis: Inferred · Source: Amendment -1 — proposed amendment
Gain eligibility for OHA-administered funds to support emergency medical service delivery.
Basis: Inferred · Source: Amendment -1 — proposed amendment
Subject to stricter rules on public-facing titles; out-of-state students gain access to Oregon clinical placements under supervision.
Basis: Inferred · Source: Amendment -1 — proposed amendment
Face expanded advisory subcommittee focus on time-sensitive emergency management within residential settings. Note: Facility definitions reference Oregon statutes (ORS 443.400, ORS 443.886), but the amendment operates strictly within Oregon EMS jurisdiction.
Basis: Inferred · Source: Amendment -1 — proposed amendment
OHA will incur administrative costs to develop funding criteria and oversight mechanisms, though official analyses indicate minimal overall fiscal impact.
Basis: Inferred · Sources: Fiscal Impact Statement A; IS_Impact HB 4053 2
EMS providers must audit public communications to ensure titles match license levels.
Basis: Inferred · Source: Amendment -1 — proposed amendment
Out-of-state educational institutions must meet Higher Education Coordinating Commission clinical placement standards to participate.
Basis: Inferred · Source: Amendment -1 — proposed amendment
Enforcement will likely rely on consumer complaints or routine audits, creating a compliance burden for smaller agencies. Access to clinical training expands geographically, while funding distribution remains discretionary rather than formula-based.
Basis: Inferred · Source: Amendment -1 — proposed amendment
Rural EMS systems and regional health networks
A rural county with critical EMS shortages secures OHA grants to rapidly recruit and train providers, while out-of-state students fill immediate clinical gaps during a regional surge, stabilizing response times without legislative appropriation delays.
Basis: Inferred · Source: Amendment -1 — proposed amendment
Consumers and vulnerable local agencies
An unlicensed entity exploits enforcement gaps by using “E.M.T.” in marketing materials, causing consumer confusion and liability exposure; simultaneously, OHA’s discretionary funding program faces bureaucratic delays or lacks transparent allocation criteria, leaving vulnerable local agencies without anticipated operational support during a crisis.
Basis: Inferred · Source: Amendment -1 — proposed amendment
The amendment creates new regulatory boundaries and funding discretion but does not mandate specific enforcement protocols or allocation formulas, leaving implementation vulnerable to inconsistent application or misclassification of licensed versus unlicensed actors.
Sources · Amendment -1 — proposed amendment
The measure trades increased administrative oversight and new compliance obligations for OHA against expanded workforce pipeline flexibility and targeted local EMS funding. Upsides include accelerated training capacity, clearer consumer protections regarding professional credentials, and dedicated financial support for regional EMS operations. Downsides involve heightened regulatory burden on state staff, potential enforcement gaps for title misuse, and reliance on discretionary programming that may lack guaranteed continuity or equitable distribution mechanisms.
Accelerated training capacity through out-of-state student clinical placements.
Basis: Inferred · Source: Amendment -1 — proposed amendment
Clearer consumer protections regarding professional credentials.
Basis: Inferred · Source: Amendment -1 — proposed amendment
Dedicated financial support for regional EMS operations via discretionary funding.
Basis: Inferred · Source: Amendment -1 — proposed amendment
Heightened regulatory burden on state staff for program administration and title enforcement.
Basis: Inferred · Source: Amendment -1 — proposed amendment
Potential enforcement gaps for title misuse due to lack of mandated monitoring protocols.
Basis: Inferred · Source: Amendment -1 — proposed amendment
Reliance on discretionary programming that may lack guaranteed continuity or equitable distribution mechanisms.
Basis: Inferred · Source: Amendment -1 — proposed amendment
high confidence. Analysis is grounded exclusively in the supplied proposed amendment text, official fiscal/revenue statements, and committee staff summaries. No enacted provisions or external speculation are included.
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Earliest loaded signal
Introduced bill text posted
Posted Jan 28, 2026, 3:25 PM PST
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Selected document summary
Targeted changes
What the document says to change
On page 1 of the printed bill, line 22, after “3.
Official records (1)
No deeper official pre-number history was found.
Chief sponsors: Representative Dacia Grayber
Regular sponsors: Representative Paul Evans, Representative Lisa Fragala, Representative Mark Gamba, Representative Sarah McDonald, Representative Rob Nosse, Senator Deb Patterson, Senator Lisa Reynolds, Representative Lamar Wise, Representative Tom Andersen, Representative David Gomberg, House Majority Leader Ben Bowman, Representative Travis Nelson, Representative Lesly Muñoz, Representative Daniel Nguyen
House carrier
Representative Dacia Grayber
Third Reading Of House Bills · Version A
Senate carrier
Senator Lisa Reynolds
Third Reading Of House Measures · Version A
A carrier presents the measure or report but is not necessarily its sponsor or author.
Records already listed in Activity are not repeated here.
Official origin records are incomplete; missing facts are not inferred.
36 events
Full timeline
36 entries shown.
Chapter 37, (2026 Laws): Effective date June 5, 2026.
Governor signed.
President signed.
Speaker signed.
Third reading. Carried by Reynolds. Passed.
Ayes, 27; Nays, 1--Robinson; Excused, 2--Drazan, Girod.
Second reading.
Recommendation: Do pass the A-Eng. bill.
Work Session held.
Work Session
Heard and Reported Out · Agenda item 3 · Room HR D · Establishes the Emergency Medical Services Program Fund.
IS_Impact HB 4053 A
Revenue Impact Statement
Public Hearing held.
Public Hearing
Heard · Agenda item 2 · Room HR D · Establishes the Emergency Medical Services Program Fund.
Referred to Health Care.
First reading. Referred to President's desk.
Third reading. Carried by Grayber. Passed.
Ayes, 41; Excused, 12--Boice, Bunch, Diehl, Edwards, Hartman, Levy B, Lewis, Osborne, Reschke, Smith G, Valderrama, Wright; Excused for Business of the House, 7--Boshart Davis, Harbick, McIntire, Owens, Scharf, Skarlatos, Wallan.
Second reading.
House Amendments to Introduced bill text posted
Subsequent referral to Ways and Means rescinded by order of the Speaker.
Recommendation: Do pass with amendments, be printed A-Engrossed, and subsequent referral to Ways and Means be rescinded.
Work Session held.
Work Session
Heard and Reported Out with Amendments · Agenda item 3 · Room HR 60 · Establishes the Emergency Medical Services Program Fund.
IS_Impact HB 4053 2
Revenue Impact Statement
Amendment -2 adopted
Public Hearing held.
Public Hearing
Heard · Agenda item 6 · Room HR 60 · Establishes the Emergency Medical Services Program Fund.
Amendment -2 proposed
Amendment -1 proposed
Referred to Health Care with subsequent referral to Ways and Means.
First reading. Referred to Speaker's desk.
SECTION 23. Section 45, chapter 32, Oregon Laws 2024, as amended by section 4, chapter 485, Oregon Laws 2025, is amended to read: Sec. 45. The Director of the Oregon Health Authority may
ernization activities will be implemented in phases over a several-year period. House Bill 3572 (2025) would have enacted the second phase of EMS modernization, including dire
ernization activities will be implemented in phases over a several-year period. House Bill 3572 (2025) would have enacted the second phase of EMS modernization, including dire
FECT OF AMENDMENT: No amendment. BACKGROUND: The EMS Modernization Act of 2024, House Bill 4081, established the EMS Program within OHA. The EMS Program is responsible for dev
for which they are in training. BACKGROUND: The EMS Modernization Act of 2024, House Bill 4081, established the EMS Program within OHA. The EMS Program is responsible for dev
“Chapter 37, (2026 Laws): Effective date June 5, 2026.”
Confirm with the official record.
Supplemental, source-linked analysis from project researchers and community contributors. It is separate from Oregon's official record.