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Commissioner Sharon Meieran Newsletter - November 2022
Last week, Portland Mayor Ted Wheeler and Commissioner Dan Ryan introduced a set of resolutions containing proposals intended to holistically address homelessness in Portland. It demands clarity in the roles and responsibilities of government so that we can optimize the coordination of our work. Given that this proposal is on many of our minds, I will focus on what the resolutions include, why I support them, and how they tie into my longstanding priorities to address the intersection of homelessness, behavioral health and the criminal justice system.
Summary of City of Portland Resolutions to Address Homelessness
Portland City Council is considering five resolutions proposed by Mayor Wheeler and Commissioner Ryan as part of a comprehensive plan to address homelessness.
At their meeting last week, City Council heard from over 200 community members about the proposal, including myself. You can watch the meeting here (my testimony appears at minute 48:11). The written version of my testimony is posted on my website. I appreciate the community members who testified, many of whom waited for hours to have their voices heard.
Council may vote on the resolutions this Thursday, November 3rd at 2:00 pm. Links to all the relevant information can be found here. In addition, Commissioner Hardesty has proposed several amendments, which can be viewed at this link. The resolutions are summarized below:
- Increase affordable housing capacity (Resolution 899)
This resolution will catalyze production of 20,000 units of affordable housing by 2033 through policy and regulatory adjustments, public/private partnerships, and investments. For example, the resolution calls for the creation of a landbank of up to 400 publicly owned sites and directs City bureaus to pursue immediate actions (i.e. centralized permitting) to streamline and reduce the cost of building affordable housing.
- Provide employment opportunities (Resolution 900)
The City of Portland will join a regional multi-jurisdictional government partnership with labor, minority chambers of commerce and community organizations that have established workforce programs in order to expand work options for people who are homeless or at risk of becoming homeless.
- Increase access to shelter and behavioral health services (Resolution 901)
This will expand the number of shelter slots within 18 months of securing funding, including the establishment of at least three designated camping sites that could serve up to 500 people each. The City will partner with Multnomah County to support the opening of a polysubstance/meth stabilization center (the Behavioral Health Emergency Coordination Network program I have been involved in). This resolution also incorporates a citywide ban on unsanctioned encampments, which is one of its most controversial features.
- Fund the homelessness response package (Resolution 902)
No information for Resolution 902 has been provided, but the intent is to address the funding strategy for the homelessness response package being considered through these resolutions.
- Diversion to treatment rather than jail (Resolution 903)
The City of Portland commits to partnering with the Multnomah County District Attorney and others to implement a diversion system that refers homeless individuals away from the criminal justice system and into treatment or other services when they have engaged in low level criminal behaviors related to addiction or mental illness.
Why I support the comprehensive proposal
I originally ran for the Multnomah County Board because the core work of the County has been my life’s work and passion. Too often in the emergency department we see people ending up in crisis because the safety nets meant to support them have failed. I knew that if we intervened earlier, we could change people’s trajectories and put them on a better path. This is particularly true at the intersection of homelessness, mental illness and addictions.
Since arriving at the County, I have seen how our systems function (or, more accurately, do not function), and recognized the degree to which basic accountability, planning, data and coordination across systems is lacking. I have pushed for systems change to improve accountability, clarification of roles and responsibilities, data collection, and coordination within and between systems.
I have also worked to address the crises in homelessness, mental health and addictions, and public safety that have worsened due to lack of effective underlying systems and oversight.
I have been frustrated by the lack of urgency that I’ve felt has been a hallmark of the County’s work around homelessness, and have called this out many times, along with proposals for solutions. Though I have not always agreed with the City’s approach to homelessness, I believe they have been doing the best they can to try to act with urgency, and in some instances have stood up programs to fill gaps that exist because the County has not lived up to its responsibility as the Local Mental Health Authority, Local Public Health Authority, and director of the Joint Office of Homeless Services.
To me, the Mayor and Commissioner Ryan’s proposal seeks to address the issue of partnership and collaboration in a way that clarifies roles and responsibilities moving forward. I wish this had been done years earlier, but I am glad that it is finally happening. I am excited to be a partner in this work because much of what is included in the proposals echoes and/or aligns with my work at the County:
- Mental health systems transformation - I convened state and local mental health leaders, advocates and peers to create a Blueprint for Better Behavioral Health to transform our dysfunctional and often destructive “system” of mental health care to a holistic, preventive and proactive model that ensures people access to the right services in the right place at the right time.
- Addictions crisis triage and stabilization center - I brought the County on board with a collaborative project championed by Mental Health Court Judge Nan Waller and the City of Portland, involving health systems, public safety leaders, Coordinated Care Organizations (CCOs), advocates, consumers with lived experience, and community based organizations, to create a meth/addictions triage and stabilization center.
- Reducing unsheltered homelessness using data, goals, accountability, planning and transparency - I partnered with Portland City Commissioner Dan Ryan to get Built For Zero (BFZ) adopted at the Joint Office of Homeless Services. This national proven model has been successfully used to end unsheltered homelessness in jurisdictions across the United States. BFZ focuses on identifying a shared community goal of having essentially zero people living unhoused, and building what’s needed to meet that goal. This requires both a quantitative and qualitative approach, so that we are able to truly understand what investments are needed to ensure the safety and livability of our community.
- Investing in interventions that cycle through multiple crisis systems - I sponsored a comprehensive analysis identifying the most frequent users of multiple crisis systems - jails, homeless shelters and ERs - in order to develop effective interventions that improve care and coordination, and also save millions of dollars in ineffective use of resources. This Frequent User Systems Engagement (FUSE) project built on my work as President of the Oregon College of Emergency Physicians, where I successfully led efforts to get an information sharing system (Emergency Department Information Exchange, “EDIE”) adopted in all hospitals and most social service agencies across the state. The County recently embarked on a pilot project to put the findings of the FUSE analysis into action.
- Spearheading innovative proposal to create new forms of alternative shelter that can be rapidly established and replicated across the County - I led the joint Portland-Multnomah County effort to fund community-driven alternative shelter projects, including micro-village projects I’ve supported for years- WeShine and Beacon Village. In the County’s last Budget I secured funding to advance the growing network of community members and organizations striving to create an ecosystem of shelters that will improve the health and safety of people living outside in ways that meet their needs.
- Coordinating Behavioral Health Crisis Response - I led a process to map the large number of uncoordinated behavioral health outreach and crisis response services across Multnomah County (final report here). I am working closely with Portland City Commissioner Mapps to coordinate the City of Portland’s emergency response and dispatch system with Multnomah County’s crisis response so that we have a more responsive, functional, efficient system of crisis response.
- Ensuring accountability and oversight in county contracting with community based organizations - I sponsored the hiring of a third party analyst to review and make recommendations for the County’s contracting processes for the billions of dollars paid to community based organizations providing direct services, particularly homeless services.
Concerns have been raised about the content of some of the City’s resolutions, and I will briefly address two of the issues I hear most about - the sidewalk camping ban and the size of potential sanctioned campsites. However, it’s important to recognize that none of the resolutions contain specifics. This is why it will be so important to deeply understand and be directly involved in the process of fleshing out the strategies.
- Sidewalk camping ban and enforcement
The reality is that the City of Portland already acts to move people from sidewalks and other areas based on health and safety concerns. However, the current mechanism is arbitrary and ineffective. I believe that when we are telling people where they can’t be, we need to provide options of places they can go, where they want to go, and then help them get there.
I have worked with hundreds of people doing direct outreach on the streets. I have yet to meet one who has said they want to be living on a sidewalk in garbage and pooping on a doorstep. Many do tell me that they won’t go to the only shelter option offered to them because they would have to give up their pet, or they’ve been assaulted in the past and fear for their safety, or they’ve had their belongings stolen. I understand how they must feel, and I wouldn’t go to the proffered shelter if I were in their shoes. So we need options that make sense for people.
The number of people living outside is not effectively counted and I believe the total number is probably closer to ten thousand than the five thousand often reported. As we provide shelter and housing that gets thousands of people off the streets, we will also have a clearer picture of what else we need to do, particularly in relation to criminal behaviors. Homelessness itself is not a crime and should not be criminalized. However, some of the behaviors engaged in by some people living outside - drug dealing, sex trafficking, chop shops, violence - are serious crimes, often victimizing vulnerable individuals whoa re also homeless and have nowhere to turn for help. These criminal behaviors need to be addressed with the appropriate enforcement and serious consequences.
- The prospect of large encampments
I share the concerns I’ve heard from many people about developing very large campsites with up to 500 people in a single location. I do not believe this approach will be effective in getting people safer, healthier or housed. However, I am encouraged by some promising models that have shown success even in some of the most difficult environments. Last week my Chief of Staff, Cynthia Castro, had the opportunity to join City Council representatives on a trip to Los Angeles to meet with Urban Alchemy leadership and frontline staff to learn about their work in supporting people experiencing homelessness. During the trip, they toured two outdoor sites, which provide necessary support and resources for houseless members in the community.
The reality is that none of the resolutions are the end of the conversation.
I am committed to continuing my work to design and implement real solutions to the homelessness crisis that will have a real impact on the lives of all County residents, housed and unhoused. I am grateful to my City colleagues for demanding urgent action and greater collaboration to do this work. It is past time for us to end the human suffering on our streets.
And finally, speaking of government - we have less than a week to go until the general election on November 8th! There is so much at stake and it’s crucial that all of our voices count. If you haven’t already turned in your ballot, please do so. If you need information or assistance with any aspect of voting, please let us know! We will help get you whatever you need.
I wish you and your loved ones all the best as the leaves turn, the rain comes down, the election happens, and we transition into the holiday season.
In good health,
Dear Friends and Neighbors, It’s hard to believe that fall is upon us. Though spring is often considered the time for rebirth, fall holds special meaning for me as a time of reflection and renewal. As kids head back to the first full school year since the COVID pandemic began, and we all attend to work, family, and whatever life brings our way, I would like to share some information, updates and resources around mental health services in our community.
As many of you know, mental health has been my passion and my priority for years. In fact, one of the main reasons I first ran for Multnomah County Commissioner was to improve our mental health systems. As an emergency physician, every day I would see people in mental health crises fall through the cracks in our “systems” of care and end up in the ER, one of the most expensive and least effective places to deal with their underlying issues. The County serves as the region’s Local Mental Health Authority, coordinating a network of community behavioral health services and providing crisis services, and I felt this was the ideal place to work on policy that could intervene upstream, prevent crises, and put people on a better path.
What I found was not a functional “system” of care, but a series of programs that are often difficult to access, not coordinated in an effective way, and leave people with nowhere to turn. Despite the heroic efforts of providers on the front line, people too often fall through the cracks in our systems of care and end up in the ER, jails, or the streets. And with the COVID pandemic, things have gotten worse.
The last few years have been stressful, challenging and isolating. They have been particularly difficult for youth and young adults, who were already experiencing an epidemic of depression, anxiety, suicidality, self harm and other serious mental health issues before the pandemic began. Seeing this play out in the emergency department, working with colleagues throughout the behavioral health system, and influenced by my own personal experience as a mother of two teenagers, I partnered with youth to host a second Youth Mental Health forum, building on the learnings and experience of our first forum that took place on the brink of the pandemic.
The event was profound, and youth representing a broad and diverse spectrum of our County courageously shared their own personal stories, shared their experiences in “the system,” and recommended solutions to better support youth mental health in our schools, in our health systems, in our families, and in our communities. The main takeaway, which I have shared in a prior newsletter but can’t be emphasized enough, is that we need to engage our kids and, more than anything, listen.
Additional feedback we received was the need to raise awareness about existing mental health resources. With kids back in school, the following can be helpful:
- YouthLine: a free teen-to-teen crisis support and help line from 4-10pm daily (adults are available by phone at all other times). Call 1-877-968-8941. Text ‘teen2teen’ to 839863. Chat www.oregonyouthline.org
- National Suicide Prevention Hotline: English: 1-800-273-8255 and Spanish: 1-300-628-9454. The Lifeline provides 24/7, free and confidential support for people in distress, prevention and crisis resources for you or your loved ones. https://suicidepreventionlifeline.org/
- Trevor Project: Text START to 678678 or TrevorLifeLine: 1-866-488-7386. Provides support to LGBTQ students in crisis. https://www.thetrevorproject.org/
- Multnomah County Mental Health Crisis Line: 503-988-4888. A 24-hour hotline where a mental health counselor will always answer to respond to mental health needs. Available in all languages. https://multco.us/mhas/mental-health-crisis-intervention
- Urgent Walk-In Clinic for Mental Health: 4212 SE Division, Portland. Must call 503-963-2575 before heading to the clinic. The clinic provides immediate care during a mental health crisis, options to speak to a psychiatrist or a mental health nurse practitioner and help with medication and treatment. https://cascadiabhc.org/
- National Domestic Violence Hotline: 1-800-799-7233 and TTY 1-800-787-3224. Confidential hotline for anyone experiencing domestic violence or abuse. https://www.thehotline.org/
- Dougy Center: 503-775-5683. Phone lines open 9-5 Monday–Friday. Provides support for Grieving Children and Families. https://www.dougy.org
- Some great additional resources are provided by National Alliance on Mental Illness (NAMI) on their Back to School Resources page. You can also contact their HelpLine at 503-228-5692 or by email at email@example.com.
- Portland Opportunities Industrialization Center-Rosemary Anderson High School under the leadership of Joe McFerrin, which provides on-staff therapists for students;
- Reynolds School District, under the leadership of Superintendent Dr. Ortiz, which provides ongoing support and case management services to meet youth and families where they’re at; and
- Peace In Schools, a nonprofit organization and a national leader in mindfulness education led by Janice Martellucci. Peace in Schools partners with Portland Public Schools offer semester-long, for-credit Mindfulness classes for high-school aged students in partnering schools. They also offer intensive, experiential, research-based professional development trainings specifically designed for educators, counselors, principals, parents and anyone who works with youth.
And if you are a youth, or know one who would be interested in ongoing planning and advocacy around mental health in schools, please contact my office at District1@Multco.us! We are engaged in planning the next steps of our work to empower and engage youth in getting them the services and supports they want and need to improve their mental health and wellbeing. Thank you to the County’s Behavioral Health Division, School Health Centers, NAMI, and others on the frontline who are supporting youth and their mental health. And, best wishes to youth, families, and educators this school year!
Charter Reform - Emphasis on Accountability and Transparency Many living in the region are aware of the City of Portland’s proposed charter reform measure. Fewer people are aware that Multnomah County has undergone its own charter review process and has referred seven proposed measures to the ballot. Charter Reform at Multnomah County only happens every six years, and it is a big deal. I appreciate the Multnomah County Charter Review Committee (MCCRC) and the many hours they spent poring over our Charter and engaging with community. Their work is complex and deals with issues that are crucial to good governance. For me, good governance must be rooted in accountability and transparency, and in that vein I want to call out two key amendments that are intended to build greater transparency and accountability into the work of the Board of County Commissioners:
- Establishing an Ombudsperson housed in the Auditor’s office. Other jurisdictions, including Portland, have an Ombudsperson dedicated to serving the public through complaint investigation and resolution. This position and approach, which functions outside of government, promotes fairness, competency, and accountability. I particularly appreciate that the MCCRC, and the County Auditor, recommended that this role be enshrined in Charter. Some of my colleagues testified to express their belief that the position should be established through County Code, which is set by the Board of County Commissioners. However, I believe that this approach belies the entire purpose of the position, which is meant to build trust with the public and ensure impartiality. Having the position be in Code rather than Charter is not accountability, it is conflict of interest.
- Providing the County Auditor with timely, unrestricted access to county employees, information, and records, including for nonprofit organizations that contract with the County. I have been very concerned about contract oversight and accountability since reviewing the 2008 Large Contracts Audit. The Audit described failure of accountability in administering and overseeing the massive contracts the County enters into with nonprofits delivering services. The Board of County Commissioners at the time enacted a review process, a report was issued with a number of recommendations, and a “Contracts System Redesign Team” was formed to implement the recommendations. However, in former Auditor Steve March’s 2015 follow-up report, he called out the failure of the County to have made any changes, and called on the Chair and Chief Operating Officer to make system improvements. While our County contracting has been recognized for excellence in compliance (the technical aspect of contracting), there is no centralized system of oversight, accountability or standardization in how contracts for hundreds of millions of taxpayer dollars are administered at the County. This is shocking, and I am very concerned that there is no clear line of sight into the County’s massive contracts to determine whether we are getting what we pay for. This is especially worrisome as we allocate resources for two huge new tax measures - the Metro Supportive Housing Services Measure and the County’s Preschool For All. In our recent budget, I secured funding for an outside consultant who will assess our contracting, procurement and contract management policies and procedures and make actionable recommendations to improve both system performance and transparency. Complementary to this work, the MCCRC has advanced the Auditor’s proposed Charter amendment requiring timely, unrestricted access to information, records, and employees required to perform their duties, and including “right-to-audit” clauses in contracts and subcontracts. I have personally experienced how challenging it can be to try to access information and records at the County in my own work trying to understand our systems and data. It is absolutely essential that the Auditor be able to audit the contracts and subcontracts by which virtually all of the County’s services are provided. I would have assumed this basic foundation of good governance existed, but unfortunately it has not been the case, which is why it was recommended for adoption in the Charter.
To hear the MCCRC’s final report and recommendations that were presented to the Board in their entirety, along with all Board members’ comments, you can watch this Board Meeting video.As the seasons change and we begin to gear up for wet and cold weather, I hope you and your family are enjoying these fall days and are in good health. Remember that my office is always here if you need anything!
In Good Health,
Greetings Friends, Family and Neighbors! I hope this newsletter finds you and your loved ones in good health, and that you are staying safe and cool as hotter temperatures impact our region. I had the opportunity to take a vacation during the first half of July, and so it was a short (but full!) month. This newsletter will highlight a couple of key areas I’ve focused on that relate to issues near and dear to my heart: Behavioral health crisis response, coordination and integration of systems, and meaningful access to healthcare.
County and City Coordination: Behavioral Health Response System
For the past few months, my office has worked with Portland City Commissioner Mingus Mapps and his team to bring together representatives of the City of Portland, Multnomah County, and other organizations who operate within the universe of behavioral health crisis response. Our goals were (1) to identify the intersections between our systems and have a shared understanding of our respective roles and responsibilities, (2) describe the universe of co-existing outreach and crisis response services for behavioral health, and (3) begin the process of identifying how we can better coordinate our work to optimize our responsiveness to the people we serve. The meeting built off of the Sequential Intercept Mapping (SIM) Project I sponsored in 2019, that identified all the organizations and agencies in our region that responded in some way to people experiencing varying levels of behavioral health crises while homeless. The analysis confirmed that a vast array of organizations and agencies in our region were engaged in providing a variety of outreach and crisis response services, but there was an overarching lack of coordination, and there were both duplication of efforts between government entities and even within the government entities, yet also large gaps in services. For example, if someone is having a mental health crisis, they can call the County crisis response hotline (503-988-4888), in which case they could be connected to Cascadia Behavioral Healthcare’s Project Respond team; 911, in which case they could be connected to ambulance services, law enforcement, the fire department, or Portland Street response, depending on the situation or time of day; or 988, the new national mental health crisis line operated by Lines for Life, which offers live telephone and text connections for people in crisis, along with referral as needed. As we expand programs, access new sources of funding, develop a Behavioral Health Emergency Coordination Network, and expand the number of hotlines available, it is more important than ever that we establish a coordinated and effective crisis response and dispatch system. Commissioner Mapps, who oversees the Bureau of Emergency Communications (BOEC), and I saw our meeting as an opportunity to begin to break down some of the silos that exist, and begin to work towards the goal of having our systems function together to best serve our community.
I have been a supporter of universal access to meaningful healthcare for as long as I can remember. I recall writing in my medical school essay about how I intended to use my experience as a lawyer to advocate for access to healthcare for all people, especially those most marginalized and vulnerable. My feelings about universal access grew even stronger during my practice of emergency medicine, where I’ve witnessed firsthand the systems failures that have resulted in people falling through the cracks in the systems meant to support them. As a Commissioner, I have supported Healthcare for All Oregon and their work to bring meaningful, affordable, equitable healthcare to all Oregonians. I sponsored a resolution in 2018 calling on the Governor and State Legislature to develop a comprehensive plan for universal healthcare. The Legislature subsequently enacted SB 770, which established the State’s Task Force on Universal Health Care, tasked with “recommending a universal health care system that offers equitable, affordable, comprehensive, high quality, publicly funded health care to all Oregon residents.” And this spring, I was honored to be invited to join the Task Force. We are in the final stages of assembling and refining all of the information gleaned through consultants, actuaries, community listening sessions, and more, to present to the State Legislature in September. I am deeply grateful for the opportunity to serve, and I will continue to fight to ensure that our healthcare system provides quality, affordable, accessible and equitable healthcare - including behavioral healthcare! - for all.
I started last week by volunteering with Portland Street Medicine to provide medical care and other services and supports to those living unsheltered outside. I ended the week working a shift in the ER. And throughout the week I saw so many people suffering from the extreme and prolonged heat. I want to express profound gratitude to those who supported our community during that record stretch of high temperatures, including the many County and City employees who volunteered in our cooling shelters (including the tireless Tabitha from my team!) and those who coordinated the County’s emergency response. This weekend promises to be another hot one. I encourage people to volunteer, donate water and supplies to organizations that provide resources to our community members most vulnerable to the heat, and educate themselves on the signs of heat exhaustion and heat stroke. Please stay hydrated, stay cool, stay safe, and stay in touch!
In Good Health,
Greetings Friends and Neighbors,Although there is much to share from this past month, which celebrated Pride and honored Juneteenth, I have to start with the calamitous US Supreme Court ruling overturning Roe v. Wade. I am heartbroken and outraged by this shameful decision to strip away people’s most fundamental right to autonomy over their own bodies. The repercussions for access to reproductive healthcare and justice, and the implications for expansion of this unconscionable infringement on human rights to other marginalized groups, particularly the LGBTQIA+ community, are profound. What has kept me going over the past week (has it only been a week??) has been coming together, standing in solidarity, and knowing that none of us are alone as we fight back against the staggering injustices wrought by the so-called “Justices” of the Supreme Court. I still haven’t been able to process my emotions over the Supreme Court’s decision, and honestly, I may never be able to do so. But as I have reflected over the past days, I’ve thought a lot about positionally and perspective, and I would like to share some of those thoughts with you.
- Positionally: Even with abortion being a constitutionally protected right, it was only meaningfully a “right” for those who had access. I was fortunate - as a white, upper middle class woman, I never worried I would not have access to any reproductive health services, including abortion care should I need it. But a tremendous number of women and gender non-binary individuals, particularly those who were Black, Indigenous, Latina/x and other people of color, did not have access. And without access, the impact was that the right to abortion stemming from Roe v. Wade essentially did not exist. As many of us face this reality for the first time, we must never forget, nor fail to elevate and stand in solidarity with, those who have been historically marginalized, oppressed and discriminated against as we fight for reproductive healthcare, justice and equity for all.
- Perspective: As a physician, I have cared for thousands of patients who have suffered the devastating consequences of lack of access to the full spectrum of reproductive healthcare, including abortion. I have counseled patients who have been sexually assaulted and prescribed emergency contraception for them. For patients with unwanted pregnancies, I have prescribed abortion-inducing medications. I have referred to abortion providers (which, thankfully, are available in our region). And I have directly assisted in abortion procedures. I have been grateful that I could be there for my patients and provide them with what they needed. But the Supreme Court’s ruling overturning Roe v. Wade has changed the equation. There is now the potential that I can be prosecuted for actions I take as a doctor. It is inconceivable to me that health care providers - healers - those sworn to do no harm - could now potentially be subject to criminal prosecution because of their support of and unwavering commitment to their patients. I am scared about what may happen, and the legal implications for providers even in states where abortion is still legal. And my heart goes out to my fellow providers who live in states where laws seemingly coming straight out of the stone age are in effect and may directly impact their work on the front line.
- Perspective: I am not a religious person. However, I do identify as Jewish, and this cultural, spiritual and historical heritage deeply impacts my life. Over the past few weeks, I’ve been thinking about the Jewish perspective on where life begins, and abortion, and this has both given me solace, and enraged me even further. In Judaism, life does not begin at conception. A fetus does not become a person until birth. And abortions are required when the mother’s health is at stake. Similar tenets are true in other religions. However, this reality, and the Freedom of Religion guaranteed by the First Amendment of the US Constitution, has been completely ignored by the Supreme Court’s ruling.
I had the opportunity to discuss some of these concepts with Jane Arcana, a writer and former member of the original pre-Roe underground abortion service the Janes, along with Rabbi Rachel Joseph, on a panel hosted online and in person at the Oregon Jewish Museum and Center for Holocaust Education. Please stay tuned for release of the recording.
Budget Reflections Although it’s hard to segue from the overturn of Roe v. Wade to the budget, these things are actually connected. Our budget is how we put into practice our values and policies to support community health, safety and justice. Multnomah County’s Budget Office will post final documents for our Adopted Fiscal Year 2023 Budget in mid-July. Our base budget is a very strong indication of our shared values across an incredible array of work. It also reflects innovative new programs, along with expansions of existing programs and services that have proven successful. The FY23 Budget makes major investments in supportive housing, violence prevention and response, addressing racial inequities internally at Multnomah County and externally in the community, behavioral health, support for the County’s workforce, and more. Throughout the budget process, I continued to push for and support funding of services and systems improvements that address some of the most urgent crises facing our community: behavioral health, homelessness, public safety and public health. Some specific items that I focused on include:
- Alternative shelter as a way to urgently respond to the public health crisis of people living unhoused. I have long advocated for a network of micro-villages distributed across the County that can reduce harm and improve the health, safety and dignity of people living outside and the community, even as outreach workers strive to connect them to housing. I appreciate the community of alternative shelter providers who have come together to establish a learning collaborative to facilitate the establishment of micro-villages and other innovative alternative shelter models. In this budget, I secured funding that will leverage this community effort to create a system that can more rapidly and effectively provide places people can be, and want to be, even as they are facing being removed and told where they can’t be. I look forward to continuing to work with a diverse array of community members, including faith institutions, mutual aid providers and other outreach workers, small business owners, neighborhood associations, behavioral health providers, and most importantly people experiencing houselessness themselves, to forge a path forward toward a system that truly reduces the harm and suffering of people living unhoused, and supports the community as a whole.
- Increased accountability and transparency in County contracting. Most County services are provided through contracts with community based organizations. Previous audits have identified gaps in the County’s approach to contracting for services, and identified ways that the County can improve. While County contracting has been recognized for excellence in technical compliance, there is significant work to be done to improve our processes and work towards greater accountability, consistency, and responsible management of taxpayer dollars. I was able to secure funding for an outside consultant who will help assess our current contracting approach and provide recommendations for how we take our contracting to the next level.
- Improved culturally responsive healthcare for people who are LGBTQIA+. Too often, individuals who are LGBTQIA+ do not have access to care in a space that is safe, affirming, and holistically meets their needs. This has significant negative impacts on their overall physical and mental health and wellbeing. I was grateful to work with Commissioner Jayapal to secure funding for the Health Department budget to contract services focused on creating an affirming and safe environment for LGBTQIA+ community members to receive healthcare.
- Public safety and community engagement. I was proud to support District Attorney Mike Schmidt and work with the community in advocating for funding MCDA Access Attorney Program (MAAP), a program that connects the justice system to community by centering equity, safety, and accountability through local partnerships and on-the-ground community engagement. A huge thank you to Commissioner Jayapal for championing the MAAP budget amendment and partnering with Commissioner Stegmann to fund legal services and expungement efforts for all County residents.
- Behavioral Health. Behavioral health has been a priority for me throughout my career, and the need right now is unprecedented. I was glad to support further investment in the County’s Behavioral Health Resource Center, resources to advance the Behavioral Health Emergency Coordination Network (BHECN) project, which I have been deeply engaged in since its inception, more mental health support for youth, and funding to pilot supportive housing using the Frequent Users Systems Engagement (FUSE) model, which I advanced at the County.
- Workforce. This budget makes significant investments in our workforce at the County, including our own employees and managers, and also organizations that contract with the County. We are facing workforce shortages and retention challenges for critical services. This expands on efforts to move toward a living wage for those working for the community based organizations that do so much of the front line work in community. There is more work to be done as we develop a fair, equitable and sustainable approach to contracting with service providers, but this investment will make a significant difference in the immediate term.
- Access to abortion services. We are fortunate to live in a state that offers the most protections around access to reproductive health services in the country, including abortions. However, with the overturn of Roe v. Wade, there is work we can do at a local level to provide access to people who are forced to leave their communities to seek services here. This is why I am proud to have co-sponsored a budget amendment with Commissioner Vega Pederson to secure additional funding to support reproductive healthcare access.
The budget process can be complex and difficult. We have to make tough choices and weigh the importance of each and every service that the County provides. Although there were areas of disagreement and aspects of this budget that I feel need more clarification, I support the budget overall and am confident that we will improve our processes even further as we invest in the services that are so crucial to our community. Here is a link to my full comments.
Built for Zero: An Additional Resource to end homelessness As we struggle to address the public health, public safety and humanitarian crisis of thousands of human beings living unsheltered on our streets, there has been controversy about an approach called Built For Zero (BFZ). Specific concern has been directed at a core element of BFZ - the “By Name List” - which is a comprehensive list of people in the community experiencing homelessness, maintained in real time. BFZ is not a solution to homelessness. It is not a silver bullet, or a salvation in failed attempts to address homelessness. It is a methodology. A proven strategy that focuses on identifying a shared community goal of having essentially zero people living unhoused, and building what’s needed to meet that goal, based on the needs of people actually experiencing homelessness. I had an opinion piece posted which helps clarify what BFZ and By Name Lists are, and what they are not. In addition, one of the developers of BFZ, Roseanne Haggerty, did a brilliant presentation on BFZ at an event co-sponsored by HereTogether, the Interfaith Alliance on Poverty, and ShelterNowPDX. I strongly encourage you to watch this presentation.
I hope that you enjoy the upcoming holiday weekend, and that you stay safe. I have provided some information below about preventing illness and injury due to excessive heat, which you can share with your families and networks. And, as always, I appreciate hearing your questions, concerns, thoughts and ideas, so please don’t hesitate to reach out.
In good health,
Greetings Friends and Neighbors,
I look forward to writing a newsletter that does not begin with a reflection on something unprecedented, extreme or tragic. But sadly, this will not be the day. Over the past three weeks, we witnessed three mass shootings in short order, including the racially motivated rampage in Buffalo, NY, the mass murder of elementary school children and teachers in Uvalde, TX, and the killing of hospital staff in Tulsa, OK. The events were horrific and devastating.
Many people have spoken eloquently about these events and I wish I could say something meaningful. But honestly, I have few words left, and none that can do justice to the depth of sadness and outrage I feel. So instead, I will share some of what has inspired me and kept me going these past few weeks: The voices of youth taking to the street and demanding action on the climate crisis. The social media post of a Hillsboro dad and former Marine, Ben Beers, who surrendered his guns to the Hillsboro Police Department to be destroyed, noting that it is past time for the United States to wake up about our gun violence problem and question the application of the Second Amendment that was created when Black people and women were not considered human, and the guns we have today could not have even been imagined. And the voices of teens at our Youth Mental Health Forum, courageously speaking their truth to policymakers in hopes of changing the mental health systems that are failing them.
Speaking of mental health…
I am always grateful for efforts that seek to raise awareness about mental health, fight stigma, and promote healing, and there were many opportunities to engage over the past month. I supported a Board proclamation that established May 2022 as Mental Health Month, spoke and walked at the first in-person NAMI Walks Northwest in three years, met with regional behavioral health leaders to discuss the issues and tour the beautiful, trauma-informed Fora Health Recovery Center, and hosted Multnomah County’s second ever Youth Mental Health Forum.
My commitment to mental health advocacy has been longstanding, informed by my experience as an emergency physician. All too often, we care for people in the ER because they have not received adequate mental health support in the community, and end up in crisis, in the place that too often is the most expensive and least effective place to deal with their underlying issues (save jails). And then they languish in ERs for days, and even weeks, because there is nowhere for them to go. The conditions are particularly devastating for youth. In 2014, I called out the crisis of youth languishing in emergency rooms in an Oregonian Op-Ed: 'Boarding' psychiatric patients in emergency departments is barbaric, and I desperately advocated for changes in our system of behavioral healthcare. Sadly, the crisis has only worsened, as described in two recent New York Times articles: “‘It’s Life or Death’: The Mental Health Crisis Among US Teens,” and “Hundreds of Suicidal Teens Sleep in Emergency Rooms. Every Night.”
To address the challenges facing youth, in 2020, my office hosted Multnomah County’s first Youth Mental Health Forum, planned in partnership with an incredible core team of youth, along with mental health providers, community organizations, and school-related groups. Teens were invited to share some of the mental health challenges they were facing, identify barriers to getting the support they needed, and suggest solutions to fix our dysfunctional system. Elected and community leaders were invited solely to listen and learn. The event was powerful and illuminating. One pandemic, two years and countless COVID variants later, I hosted a follow up Youth Mental Health Forum, and the experience was mind blowing as teens avidly participated in small group discussions, and courageously shared their experiences with the entire audience.
My office is compiling the information, and we will share a detailed report with policymakers and the public. In the meantime, some common themes did clearly emerge:
- A sense that parents, teachers, school counselors, administrators and other adults didn’t actually understand what youth were experiencing or have the tools or language to support them;
- that parents and other adults often did not just listen to kids; that the approaches implemented by most schools were not informed by students and were largely ineffective;
- and that there were no services available, particularly services that were culturally specific.
Our work is cut out for us, and I already have meetings scheduled with Portland Public Schools and other stakeholders to talk about next steps.
A huge thank you to Congresswoman Bonamici and City Commissioner Hardesty - two champions for youth mental health and education - who provided opening remarks, and all the elected officials, including my fellow County Commissioner Lori Stegmann, and policymakers who attended and engaged.
Moving on to Universal Healthcare…
In partnership with Commissioner Jayapal, I was proud to introduce a resolution to support single-payer universal healthcare. As a doctor, I have seen firsthand how unequal access to affordable health care can devastate families and individuals facing some of the most challenging moments of their lives. Income should not dictate whether someone lives or dies, or the quality of healthcare they receive. The Multnomah County Board of Commissioners unanimously passed the resolution, which strongly urges the Governor to request the federal waivers that would allow Oregon to receive the federal dollars for its own state-based single payer universal healthcare system that is comprehensive, equitable, affordable, accessible, and of high quality.
As the Co-Chair of the Association of Oregon Counties Health and Human Services Committee, I am also honored to have been appointed to the State Task Force on Universal Healthcare and look forward to diving into this work. If you want more information on how to engage with the Universal Healthcare Task Force including, listening sessions, agendas, and how to utilize language services to participate, click here.
And now - Highlighting a proposal I will be making for the FY 2023 budget regarding homelessness!
As mentioned in previous newsletters, the Chair released her proposed budget May 5, and the Board has been hearing from department directors about their goals for using investments to adequately fund County services, and from community members about their priorities.
Although I have a range of budget priorities, I will highlight a single one here: A way to urgently address the public health, public safety and humanitarian crisis of people living, and dying, unsheltered, outside.
Last year, I proposed a Framework to Reduce Harm for People Living Outside. This was not adopted by fellow commissioners, which I believe was a missed opportunity. This year, having seen a worsening of unsheltered homelessness, and some successful examples of how we can do things differently, I am submitting a refined version of my original proposal, and I hope that my fellow commissioners will join me in supporting it. The detailed version is posted on my website (it is still a work in progress!) and I hope you will take a look and provide feedback. But here is a brief summary:
The most pressing issue facing Multnomah County is the public health, safety and humanitarian crisis of people living and dying, unsheltered, on our streets. We do not have an accurate count of how many people are living outside or have a breakdown of what their needs are, but we do know that:
- There are thousands of people living outside;
- They are living in squalor, in unhealthy, unsafe and inhumane conditions;
- They are dying in ever-increasing numbers;
- There is a prevalence of serious behavioral health issues, particularly serious mental illness and/or methamphetamine and/or opioid use; and
- Many people living outside desperately want to live in better conditions, but for a variety of reasons are unable to live in traditional indoor shelter, and in the best case scenario, the thousands of housing units it would take to house them will not be available for years.
What we need to do:
- Urgently reduce harm to unhoused individuals and the community at large;
- Save lives; and
- Establish a system where relationships can be established and services provided in a way that optimizes people’s pathways to health and housing.
How we can get there:
We can meaningfully move toward the goals described above by adding three components to our existing shelter options to form an ecosystem:
- A new and broadly distributed type of low impact living space with a very small footprint (“microsite”). Each site will have about 10 living units with basic amenities (toilet, handwashing, laundry, showers, trash collection), easily built and replicable, distributed equitably throughout the City/County.
- Safe parking sites. Various sizes, with basic amenities, distributed throughout the City/County.
- Coordination and centralization. Outreach workers need to know where to consistently find people to establish relationships and get them the housing, behavioral health and case management services they need.
Why is this proposal worth investing in?:
- This is what many people living outside would prefer;
- It allows outreach workers to consistently find people and establish relationships, which is the key to getting people the services they need;
- Outreach work can be coordinated and therefore optimized;
- People can live safer, healthier, and with more dignity, setting them up for success in permanent housing once it becomes available;
- This model can be rapidly scaled to meet the real scope of need at less cost than any alternative; and
- The negative impact on the environment - garbage, biowaste, toxic waste, vermin - can be dramatically improved.
The reality is that many people living outside, business owners, direct service providers, faith leaders, and other community members, are asking for the same thing. Rather than pitting people against each other and perpetuating divisive rhetoric, my proposal can bring people together.
To be clear - this proposal will not solve homelessness, and it is not a “housing” solution. It is a small part of a massive puzzle. But it can make a tremendous difference in the lives of real people who are suffering every day, and it can improve our community.
If you support the proposal, please consider letting my fellow commissioners know that you would like to see it funded in this year’s budget. And if you have a small property, parking lot, facility, or funding you would be interested in dedicating to this project, please let me know!
As mentioned in prior newsletters, you can advocate for programs/services to be included in the budget, or raise any other issue you believe needs attention, in a number of ways:
- Email the County Commissioners at:
Chair Kafoury: firstname.lastname@example.org
Commissioner Susheela Jayapal: email@example.com
Commissioner Jessica Vega Pederson: firstname.lastname@example.org
Commissioner Lori Stegmann: email@example.com
- Testify at a Multnomah County Board meeting. Community members can offer testimony, either written or oral, in person or virtually, any Thursday morning starting at 9:30am. If testifying in person, please sign up using the sign in sheets as the check in table on the day of the meeting. If testifying virtually, you must sign up by 4:00 pm the Wednesday before the meeting. Virtual attendance sign up can be completed on the Board Clerk’s website.
I always appreciate hearing your questions, concerns, thoughts and ideas, so please don’t hesitate to reach out! I hope June is a good month for you and your families.
In good health,
Greetings Friends and Neighbors,
As always, I hope this newsletter finds you and your loved ones well. As I was preparing to send out my regular newsletter, I was shocked to learn of the leaked US Supreme Court opinion overturning Roe v. Wade. I will address this first and foremost.
As I expressed during our Multnomah County board meeting today:
“I was outraged and horrified, but sadly not surprised, to read the draft SCOTUS opinion. It has felt like a ticking time bomb which has now exploded, and the shrapnel is landing in every community throughout our country.
As the Medical Director for the Oregon Foundation for Reproductive Health I fought for abortion as part of our public health continuum. As an ER doctor, I’ve cared for individual women who have been devastated by unwanted pregnancy or complications, and counseled them about their full range of healthcare choices, including abortion. I have performed abortion services. As a County Commissioner I’ve championed policies that support reproductive health and justice for all women, particularly those who are most vulnerable and marginalized. And as a mother, I’ve fought for my children’s healthcare rights.
The SCOTUS opinion pierces the heart of freedom and justice in our country. It is not acceptable. I will stand up and fight for the rights of all people to make decisions about their own bodies, and healthcare providers to help them make the decisions that are right for them.
Healthcare is a human right, and abortion is healthcare!"
Now to resume with my regular newsletter.
April was quite a month - snow fell, Ramadan, Easter and Passover all coincided (for the first time in 30 years!), the Lao New Year was celebrated, our community Marched Against Murder, we read names of those murdered in the Holocaust, Black April honored and commemorated the lives, land and freedom lost with the fall of Saigon. In my office, we continued to work on some of our key policy issues and prepared for the upcoming budget process.
As I mentioned in my last newsletter, the Fiscal Year 2023 County Budget development process continues to ramp up, and the Chair will release her proposed budget on May 5th. For now, I will share my general areas of focus for this budget season:
- Urgently addressing the humanitarian crisis of people living and dying in increasing numbers on our streets.
- Ensuring access to baseline and crisis response services for mental health care and substance use disorder.
- Unsiloing and integrating our systems through innovative programs and strategies such as Frequent User Systems Engagement (FUSE),the Behavioral Health Emergency Coordination Network (BHECN) and emergency management.
- Enhancing the County’s contracting process to provide improved accountability, transparency, quality, and cost-effectiveness, and optimize alignment of spending with the County’s policy priorities.
- Improving public safety through investment in services that focus on real time and local solutions, such as the Multnomah County District Attorney’s community-based teams, and interrupt violence at the community level.
- Pursuing interventions that go beyond identifying people who have died while living outside, but actually focus on solutions to decrease deaths.
- Continuing to champion meaningful access to reliable high speed internet, particularly for marginalized community members.
- Preventing and mitigating the impacts of climate change and natural disasters.
Throughout the budget process, I encourage you to voice your priorities to the Chair and all of the Commissioners by testifying during Public Testimony on Thursday mornings at the beginning of each Board meeting, by testifying at dedicated virtual listening sessions which are scheduled for May 18, May 25, and June 1, and/or by contacting the Chair and Commissioners directly by phone or email.
Earth Day: I was happy to join fellow volunteers picking up trash in Multnomah Village with SOLVE, a fantastic organization that connects community members to opportunities to improve our environment and build a legacy of stewardship.
Lao New Year: I joined hundreds of Lao community members in celebration of the new year at the Lao Buddhist Center in Gresham. The Lao New Year is traditionally a time for cleansing and renewal, and the day was filled with celebration, joy, dancing, food, and connection.
We Choose Love Ramadan Iftar - Muslim Educational Trust (MET): MET has served as a bridge between Muslims and non-Muslims by bringing people together, forming partnerships, and encouraging open and honest communication. This month, I was happy to join MET and community members for the We Choose Love Ramadan Iftar (fast breaking) Dinner to celebrate 29 years of MET’s incredible work. I am so grateful to Wajdi Said and so many other partners for continuing the process of building a Beloved Community. I look forward to many more years of partnership and bridge-building.
March Against Murder: In response to an unprecedented level of gun violence and homicides across the Portland metro area, peace activists, family members of gun violence victims, community based organizations and neighbors gathered and marched to call for and end to the violence. I deeply appreciated hearing from leaders like Lakayana Drury of Word Is Bond and Pastor Mark Jackson of REAP Inc., who are elevating the voices of young Black men and creating a new generation of Black leaders, and speaking with so many of the youth. The event was supported by the Multnomah County Health Department, and I appreciated the employees who showed up for the community.
47th Black April Remembrance: April 30 commemorates the fall of Saigon and the end of the Vietnam War. I was honored to join members of the Oregon Vietnamese Community in their ceremony remembering the loss of their loved ones and their beloved land, and their harrowing journeys to new lives in the United States. The day was also a celebration of freedom and resilience, and the songs, stories and music were beautiful expressions of the power of community to heal and to thrive.
Yom Ha’Shoah (Holocaust Day of Remembrance): This day falls on the anniversary of the Warsaw Ghetto uprising in the Jewish calendar. Every year on Yom Ha’Shoah, communities around the world uphold the memory of victims of the Holocaust through the Reading of the Names, a public recitation of Holocaust victims’ names, ages, and birthplaces. The Oregon Jewish Museum and Center for Holocaust Education (OJMCHE) sponsored the Reading of the Names at Pioneer Courthouse Square on April 28. A selection of community members and elected officials continuously read names from 10-5, and I joined in the reading, including the names of 19 of my own family members. This experience is hard to bear, but is always profound and powerful. I appreciate OJMCHE sponsoring the event, and fellow community members who joined me in reading names.
Central Eastside Together Contract Renewal: Central Eastside Together is one of three “enhanced service districts” in Portland that are funded by the collection of fees from local businesses and in turn provide trash cleanup, outreach, safety, graffiti abatement, and other services in the districts. I testified before Portland City Council in support of Central Eastside together, and am thrilled that City Council voted to renew the service contract. Central Eastside Together is a truly innovative approach to a service district, with meaningful inclusion of people experiencing houselessness on their board, incorporation of trauma-informed approaches, and support of safety and dignity for all who live, work, or visit the Central Eastside. I want to thank Portland City Commissioner Jo Ann Hardesty for her work in making Central Eastside Together a reality, and Kate Merrill for her years leading the Central Eastside Industrial Council. She has been a phenomenal partner, and has been instrumental in putting the “together” in Central Eastside Together.
Cynthia Castro Appointed My Interim Designee!
County Commissioners each designate a district resident to serve in their stead should they be unable to serve the remainder of their term. The Board recently approved my Chief of my Staff, Cynthia Castro, as my Interim Designee. Cynthia is brilliant, thoughtful, kind, equanimous (word of the day!) and collaborative. She worked for Commissioners Carmen Rubio and Amanda Fritz at the City of Portland, where she spearheaded programs related to language access, equity, and health, and served as liaison to Portland Parks & Recreation, the Office of Equity and Human Rights, and the Regional Arts and Culture Council. Cynthia earned her Masters of Public Health from Oregon State University, and her broad range of public health work spanned women’s health, nutrition, and health disparities. Cynthia has been invaluable in helping bridge the gaps in procedure and culture between the City and County, and I know she would serve District 1 effectively, with community voice always at the center, should my seat be vacated and she be appointed as the District 1 Commissioner.
Finally, we are preparing for our 2022 Youth Mental Health Forum. My office is working with youth leaders, community partners, school districts, and service providers in planning a 2022 Youth Mental Health Forum, building on the event I hosted in 2020. We were at a crisis point in terms of youth mental health even before the COVID pandemic, and the challenges our youth are experiencing now are extreme. This forum will provide a space for youth to come together to share their experiences, and empower youth voices in informing policy decisions that will impact them. The forum is for youth ages 13-21 and will take place on May 21st in-person and virtually. Email my office at firstname.lastname@example.org for more information. Details will soon be posted on my website and shared via a number of avenues, including on social media.
Thank you for continuing to engage with my office and share your thoughts, wisdom and perspective on the crucial work of the County. I look forward to engaging with you as we officially enter into our budget season!
In good health,
Dear Friends and Neighbors,
Spring has sprung, and I am ready for the longer and warmer days ahead. I hope that you and your families have been well, and have had a chance to spend time outdoors (and maybe even travel for Spring Break!) At the County, spring also means budget season. Much of my focus for the Fiscal Year 2023 Budget will continue to include addressing homelessness, along with investing in mental health, substance use, public safety, and, of course, public health. I will discuss all of these in more detail over the coming months.
My goal is to make sure that you, as a member of the community, are able to understand the budget process and effectively advocate for your priorities.
Multnomah County Fiscal Year 2023 Budget Development Process
The County’s Fiscal Year 2023 budget development process is well underway and will ramp up in the coming months. I want to keep you as informed as possible throughout this process and make sure you know how you can engage.
Unlike at the City of Portland, County Commissioners do not oversee bureaus. Departments are overseen by directors, and directors report directly to the County Chair. Prior to fall, directors work with their teams and other partners to develop their departmental budgets. During the fall they meet with the Chair to discuss their proposals. After discussion with the Chair, departments’ proposed budgets are posted in the form of “program offers.” You can find this year’s submitted department budgets on the County’s Budget Website.
Based on all of the information she receives, the Chair makes executive decisions on what to include in the budget, and shares her decisions with department directors. The directors adjust and finalize their budgets in line with the Chair’s direction, and submit their final versions to the County Budget Office. The County Budget Office puts all of this together into the Chair’s “Proposed Budget,” which this year will be released on May 5th.
During the month of May, County departments will present their proposed budgets to the Board in a series of work sessions. The County will also host public forums, which provide opportunities to advocate for funding to be allocated to specific programs. Check out our Budget Calendar for information about work sessions, public hearings, and other budget process milestones.
As in prior years, I will be hosting virtual Budget Open Houses, which provide opportunities for people to learn more about the County’s Fiscal Year 2023 Budget Development Process, hear about my budget priorities, and share their thoughts about how the County should be spending public dollars. Given the relatively short turnaround time for budget decisions once the Chair’s Proposed Budget is released, and to provide ample opportunity for people to learn about the process itself, my first open houses will be held in April, on Wednesday April 27 from 4-5 pm, and on Saturday April 30 from 9:30-10:30 am. Click Here to RSVP
Addressing the homeless crisis continues to be one of my top priorities and will be one of my main focuses this budget season. For Fiscal Year 2023, the County’s budget for homelessness exceeds $250 million, primarily through the Joint Office of Homeless Services (JOHS). Our budget is supposed to allocate funds in a way that puts our policies into action. However, over the years I have been doing this work, I have observed many issues with our budget processes, which I believe contribute to systems not working as they should.
One of the challenges involves lack of a shared and articulated vision about how to effectively address homelessness. Since the new year, it has felt like every week or two there is a new statement or proposal about how we should address homelessness, without any formal plan or proposal that supports the plan or puts the idea into the context of our larger system. This is exacerbated by underlying structural fissures and siloes not only between the city and county, but within the county itself. I could write a treatise about the structural issues, but a picture speaks a thousand words: click here to see image.
I have previously provided a written summary of the landscape of homeless services governance in the region, but decided to depict it in diagram form because I felt it would better convey the complexity of the system. It turns out that was an understatement, and this issue of underlying structure demands attention.
Further complicating matters is the ongoing debate that seems to pit “Housing First” (providing permanent housing to people without precondition, along with services that support them if they are amenable to the services) against other approaches to homelessness (transitional housing, bridge housing, alternative shelter, etc.). The reality is that we need places where people can be as safe and healthy as possible, along all aspects of the shelter to housing continuum. In my view, if housing is available and people want it, then we should do everything possible to make and support this connection. At the same time, people living outside, for whom housing may not be available or desirable, deserve something better than the squalor in which they are currently living.
I know we can do better, and in fact other regions have done better. I was encouraged by my recent tour of the “Safe Stay Communities” alternative shelter in Vancouver, Washington, along with its partner Safe Parking Zone. In particular, providers and individuals living in the site validated what I have heard from providers and those living unhoused for years - not everyone is ready to transition from living on the streets directly into permanent housing, and being in a small site with basic services can facilitate the establishment of relationships and transitions into housing.
This month, I co-hosted a virtual Alternative Shelter Network Event with non-profit organization WeShine PDX. The event drew over 40 participants who were eager to come together and share their experiences, challenges, opportunities, and ideas for supporting people experiencing homelessness through alternative shelter projects in a more coordinated and effective way. Moving forward, the hope is to establish a new community-driven learning collaborative for alternative shelter operators and mutual aid providers in the Portland Metro Area, which I wholeheartedly support.
The event also reinforced my belief that we need a network of alternative shelters as part of a broader ecosystem of options. Alternative shelters can be done cheaply, quickly, they have smaller footprints, can improve safety and livability for all, and help people prepare for transition into permanent housing.
In the Fiscal Year 2023 County Budget Development Process, I will again bring forward a proposal that supports a coordinated network of alternative shelters, at scale, dispersed across the County. Below is an outline of what I am proposing.
Proposal for a network of small alternative shelters and safe parking sites
My proposal envisions a holistic ecosystem of shelter sites that meet a variety of people’s needs, at a scale that will make a difference, with an urgency that speaks to the crisis we are facing. As I further refine my plan and seek funding to support it through this year’s budget process, I very much welcome your engagement and support.
My proposal adds the following elements to our current mix of shelters:
- A new and effective shelter type: Micro-sites of 10-ish structures, distributed equitably throughout the County, that all provide basic amenities (toilet, hygiene, shower and laundry access, trash and sharps pickup).
- Safe parking lots: Many people are living in their vehicles. I envision safe parking lots where people can park their vehicles, other than the street, where they have access to basic amenities.
- Coordination so that case management, behavioral health and housing services effectively reach the people who need them and have the best chance of being successful.
- Scale. I envision micro-sites or safe parking lots dispersed equitably across the county. If there was one in every neighborhood, that is 100 sites serving at least 1000 people. Because of their smaller footprint, they would put less stress on neighborhoods. People are already living unsheltered in neighborhoods across the county, the micro-sites and safe parking lots would be vast improvements than current conditions.
We need to address the crisis of unsheltered homelessness and death on the streets effectively and urgently, at a scale that makes an impact, in a way that makes sense, and, most importantly, improves the safety and health of people living outside, along with the community as a whole.
Update on Homeless Advisory Structure
As I shared in my January 2022 newsletter, it has taken almost three years for the County to recommend an updated structure for its housing advisory body, A Home For Everyone. During this time I requested changes that could have been implemented in real time, such as inclusion of behavioral health, public health, urban camping impact reduction, people representing alternative views on shelter, and more individuals with lived experience of houselessness. I was told there was a consultant hired to do an evaluation and make recommendations regarding restructuring, but they left and there was no final work product.
The Joint Office of Homeless Services (JOHS) took over the work themselves, and proposed some structural changes. I proposed a model incorporating required functions and also a broader oversight and advisory structure. I solicited feedback from you and others, and my most current proposal incorporating the feedback I received can be found on my website. I deeply appreciate all of your thoughtful emails and input.
At our Board briefing on 3/15, we were informed that JOHS would be taking a different approach. Rather than making the structure more inclusive, streamlined, unified and accountable, to me it feels like we are going backward. Many people have invested untold time, money and energy into this process, but it seems we are ending up with only required elements that should have been present from the beginning. We do need these, but this isn’t progress; it’s what we should have been doing all along. I’m concerned that after two and a half years, we are back to square one, and have not achieved the improved advisory and oversight functions many of us were hoping for and that we urgently need.
Please stay tuned for more updates.
County welcomes new Interim Joint Office of Homeless Services Director
Marc Jolin led the Joint Office of Homeless Service (JOHS) since its inception in 2016. He recently announced that he would be stepping down, but staying on with the JOHS until June 2022 to help with leadership transition. I have appreciated Marc’s deep knowledge, thoughtfulness, compassion, ability to explain complex concepts, and dedication to changing the broader conversation around homelessness. We may have disagreed about certain aspects of how the crisis of unsheltered homelessness should be addressed, but Marc always took the time to talk about any aspect of the work, listen, and thoughtfully respond to my questions. And he was relentless in showing up, 24/7, whether driving someone to a warming shelter himself in the middle of the night, responding to a COVID pandemic, or responding to multiple government entities, each with a totally different structure and role, and each with its own set of unique personalities and political minefields.
This week, Shannon Singleton took over the helm of JOHS as the Interim Director. She will serve in this role while the County undergoes a national search for the permanent director position. Shannon was the Director of Equity and Racial Justice for Governor Kate Brown and is the former executive director of the homeless services non-profit JOIN. She also previously worked for the Portland Housing Bureau and Cascadia Behavioral Healthcare. I look forward to working with Shannon in her new role as Interim Director.
So much has been going on at the County, in our community, and in the world at large. I hope that in the mix of all things you are in good health and doing well!
In Good Health,
Dear Friends and Neighbors,
Before going straight into my February newsletter, I want to take a moment to express my profound anger and grief at what has unfolded in Ukraine over the past few days, and share my support for those in our community who have family or friends in Ukraine. My heart goes out to them, along with the thousands of Russians who oppose the actions of their dangerous and malevolent president.
I also want to express my horror and sadness at the incidents of violence over the past weeks that occurred in neighborhoods dispersed across Multnomah County that resulted in lives cut short, and families and loved ones with holes left in their hearts.
While the specter of the devastating situation in Ukraine overshadows so much right now, along with the tragedies that unfolded in our County, it is important to continue to focus on what we can do to make things better in our community. I will use this newsletter to share some of the inspiring moments that shone through this past month.
The Environment, Emergency Preparedness, and Clean Air.
CEI Hub Final Report Published
In 2019, I was proud to sponsor a Multnomah County resolution focused on the potential impact of fossil fuel infrastructure in our region. A key part of that work involved assessing the potential risks to human life, health and the environment that would flow from a major earthquake or other disaster causing the disruption of the fuel tanks located in the Critical Energy Infrastructure Hub in NW Portland. With an understanding of the potential impact, the County and other governments could consider what approaches could prevent or mitigate the catastrophic risks, and at the very least ensure that the companies storing their products in these tanks bore the full responsibility for paying the costs of any damages due to an infrastructure failure.
Toward that end, Commissioner Jayapal and I, with the partnership of Commissioner Hardesty at the City of Portland, secured funding for an assessment of the potential damage. We also held multiple Town Halls, engaging with neighbors and other community members about the risks. Our work culminated in the Critical Energy Infrastructure (CEI) Hub Seismic Assessment final report, released earlier this month, which found that a Cascadia Subduction Zone earthquake could potentially result in the biggest fuel spill in U.S. history and cost $2.6 billion in damage.
The release of the final report dovetailed with the introduction of Senate Bill 1567 sponsored by Senator Dembrow. SB 1567 would hold industry to account to improve the seismic resilience of their tanks at the CEI Hub and direct the Department of Energy to develop a Seismic Security Plan so we are better prepared. You can read my testimony in support of SB 1567 here.
We are awaiting a final legislative decision on SB 1567, but regardless of the outcome, our work around the CEI Hub paves the way for all levels of government to work together to address the risk stemming from the fossil fuel infrastructure located in our backyard.
Clean Air All The Time For Everyone!
As many of us have learned over the course of the past few years, woodsmoke, though evocative of coziness and fond memories for some, also results in poor air quality, exacerbation of lung and heart disease, and is a significant contributor to human-caused cancers.
In 2017, after hearing from community members impacted by woodsmoke and poor air quality, I worked with Multnomah County’s Director of Sustainability, John Wasiutynski, joined by Commissioner Vega Pederson, to bring forward an ordinance to reduce wood burning on bad air quality days during parts of the year.
I was pleased that Commissioners Vega Pederson and Jayapal continued to build on the original wood smoke by bringing forward amendments to further reduce the harmful effects of wood burning and with recognition that there are no good days for wood burning. The updated wood smoke ordinance extends the wood smoke curtailment season from the months of Oct. 1 through Feb. 31 to all year round. The ordinance also removes the green-yellow-red burn advisory structure - “green days” are removed to indicate people are asked to avoid burning at all times, but the County will still post voluntary “yellow days” to alert people to worsening air quality, and on a “red day” people must not burn with very limited exemptions. The ordinance also removes an exemption for EPA-certified wood stoves. The new wood-burning rules are in effect now.
Climate models have confirmed that global emissions must be halved by 2030 to keep warming below 1.5 deg C. We know that exceeding this level will have catastrophic impacts on global health, safety, and the economy, and we have already gone beyond the tipping point. We, as a global community, need to take aggressive action to prevent further harm, reduce carbon emissions and reverse the impacts of the climate crisis, and improve resiliency in our communities so that we can respond/adapt to the ongoing impacts of the climate crisis. And all of this needs to happen as we shift our paradigms to center environmental justice and the voices of those most impacted.
Although we need to be doing all of this work urgently, there are things we can do literally right now to make a significant difference. One major contributor to poor air quality, climate change, and major negative health impacts, is diesel fuel. “Renewable” diesel is a form of diesel that is highly refined, which improves combustion efficiency and reduces harmful emissions. Renewable diesel works in any truck engine without the need for modification, can flow through the same fuel pumps, and costs the same or even less per gallon. It can be used immediately as a replacement for petroleum diesel.
House Bill 4141 - Better Fuels Oregon - was introduced at the Legislature, and I testified before the Joint Transportation Committee in favor of this bill from the perspective of a physician explaining the health impacts of petroleum diesel. You can read my testimony here. Although unfortunately the bill did not pass, it raised awareness and garnered tremendous bipartisan support. A Task Force will investigate how HB 4141 could be successfully implemented by 2025. A tremendous “Thank you!” to Keith Wilson, who has been a pioneer in using renewable diesel, and who spearheaded so much of this work.
Helping Hands - Teamwork and Collaboration.
HOPE Team Ridealong
I have heard a lot of positive feedback about the Multnomah County Sheriff’s Homeless Outreach and Programs Engagement (HOPE) Team and their engagement with houseless individuals in East County. Earlier this month I did a ride along with members of the Team, visiting members of the community living unsheltered, and I saw firsthand how they are leading with compassion, building trust, establishing meaningful relationships, and getting people the services they need. This was a perfect example of how we can help reduce harm and suffering to individuals and the community, even as we pursue the supports and services that will enable people to ultimately sustain permanent housing. It was also a window into the kind of program that can build trust and relationship between law enforcement and community.
A Time to Listen, A Time to Act: Faith Community Forum on Houselessness
Having heard the challenges being faced by faith leaders wanting to provide services to help people living unhoused, and having heard the barriers faced by organizations and individuals wanting to get people the housing they need and work with organizational partners, I spoke with Pastor Rick McKinley of Imago Dei Church and we brainstormed ways to bring community together to learn about houselessness, hear about some innovative approaches to serve those living unsheltered, and find ways to form partnerships in furtherance of a common goal.
On February 18th, we co-convened a forum on houselessness with the faith community, Multnomah County, City of Portland and City of Gresham leaders, service providers, and people with lived experience of being houseless. The forum was hosted by Pastor Mark Strong at Life Change Church in North Portland. The turnout was incredible, and the level of engagement and shared mission of service to help those most vulnerable was inspiring. I have already heard about connections made because of the forum and I am excited to keep the momentum going.
I want to thank all who attended the forum, including our panelists: City of Gresham Councilor Vince Jones-Dixon, City of Portland Commissioner Dan Ryan, Kevin Farmer, Mark Rowlett, Matt Lembo from Beacon Village, Tess Fields from Home Share Oregon, Janet McManus of WeShine PDX, and Caleb Coder from Cultivate Initiatives. You can view a recording of the event here.
One aspect of the forum that really resonated with people was our office’s pictorial graphic representing how the homeless system functions in Multnomah County. When I started as a Commissioner, I was regularly frustrated in my efforts to understand how the pieces of the homeless governance structure fit together. I prepared a summary that describes the landscape as I understood it, which I have shared on my website. For this forum, I asked Tabitha from my office to create a basic graphic that put the information together in picture form. She did an amazing job, and, as they say, a picture speaks a thousand words:
Seeing the system laid out, it becomes very clear very quickly why the system doesn’t function as effectively as it could and requires greater coordination across organizations, agencies, and all levels of government. This is a topic that needs a lot more discussion, and I will share further information in March.
Black History and Future Month
Multnomah County Proclamation
Last week Multnomah County proclaimed February Black History and Future Month, with the theme”Health and Healing”. During the presentation, we heard inspiring testimony from Lisa Saunders, Executive Director of Faithbridge LLC, and Tia Jones, community member and Faithbridge client. Faithbridge is an organization that reconnects women in trauma and life transition to their roots in faith through hosted workshops and retreats. Lisa and Tia talked about what it would look like if an entire community was truly allowed to embrace healing, and how individuals who have been traumatized can face that trauma, and, through community, understand that the traumas they have faced don’t define them.
“Word Is Bond - In My Shoes”
I joined two separate Word Is Bond “In My Shoes” walking tours through different areas of Portland. Word Is Bond is a fabulous organization with a mission to “rewrite the narrative between young Black men and law enforcement through leadership development, critical dialogue, and engagement.” The “In My Shoes” tours take community members through different neighborhoods, led by Black youth who grew up in the neighborhoods and share their own stories. I am grateful to the youth who led these tours; they shared their time and talents with us. I want to also thank the mentorship and vision that Word Is Bond has provided through the leadership of Executive Director Lakayana Drury.
Walk, Hike, March Through History - Selma Bridge Reenactment
Finally, I joined a tribute to honor the spirit, work and words of Rev. Dr. Martin Luther King, Jr., with the Walk, Hike, March Through History Selma Bridge Reenactment. Pastor Edward Williams of the Mt. Olivet Baptist Church offered a beautiful and inspiring sermon in the spirit of peace, love, equity and liberation - “We need to wake up and stand up and speak up - so that the bright and beautiful victories of the past don’t become the faded memories of today.” We were met on the bridge with a stellar performance by hip hop artist Mic Crenshaw. The event was co-sponsored by Love Is King and Forest Park Conservancy.
As an elected leader, and as a human being, I am committed to doing everything in my power to address the systemic racism that permeates all aspects of life for our Black community members.
We continue to face challenges in our world, both far away and closer to home. We also see incredible, and sometimes unexpected, beauty. As we all do the best we can and move through our days, I hope that you will continue to stay in touch and reach out to share your experiences and insights with me.
In good health,
Dear Friends and Neighbors,
It’s hard to believe that tomorrow is already the first day of February! January has flown by, but it’s included some important milestones and events which have been powerful and grounding as we move forward into 2022.
Events of note:
- On Martin Luther King Jr. Day, the Skanner Foundation held their renowned annual breakfast, celebrating the life, spirit and vision of Dr. King. This was an inspiring event, where scholarships were announced for students who plan to pursue educational goals to serve their communities, and who you can already tell will be leaders. There were moving speakers, and I was particularly affected by the music and profound lyrics of singer/songwriter/poet Lo Steele, reflecting on self and power and belonging.
- The prior Friday evening, Congregation Beth Israel held their annual Shabbat service in honor of the Reverend Dr. Martin Luther King Jr. This is one of the events I look forward to each year, and even though we were not physically together for the second year in a row, the power and spirit of the speakers and the community and the music flowed through my computer screen and into my home and filled my heart and soul.
- The Lunar New Year is celebrated in a number of Asian communities, and I was fortunate to be invited to two incredible celebrations welcoming the Year of the Tiger. I attended the Vietnamese Community of Oregon’s Vietnamese Lunar “Tet” Festival, and the Chinese Friendship Association of Portland’s Lunar New Year Celebration. I learned a lot about the importance and meaning of the Lunar New Year, which welcomes a new start, and is celebrated by gatherings of friends, family and community. I met an array of wonderful people, and was blown away by the art, music, calligraphy, costumes, colors, and traditions uplifted at both of the events. Each Lunar New year is celebrated by a cycle of 12 Zodiac animals, with this year’s animal being the tiger. I’ve been informed that the tiger symbolizes courage and strength, and is associated with hope. This feels particularly auspicious as we experience the ongoing impacts of the pandemic, need to stay strong, and look forward with messages of hope and healing.
- On International Holocaust Remembrance Day, on the 77th anniversary of the liberation of Auschwitz-Birkenau concentration camp where over one million people were killed, I spoke to the rising antisemitism across the country and globally. It has been seen in direct acts of violence, like the recent hostage taking at Beth Israel Synagogue in Colleyville, Texas, and in less direct but still vile forms of hate such as harrassment, offensive slurs, bullying, threats of violence, and Holocaust denial. The Holocaust was the systematic, state-sponsored, persecution and murder of six million Jews by the Nazi regime and its collaborators between 1933 and 1945 across Europe and North Africa. While Jews were the primary victims, the Nazis also targeted other groups for persecution and murder including but not limited to Romas, people with disabilities, some Slavic peoples, Black people, and people who now would identify as LGBTQIA+. I asked that we take the time to reflect on the millions of lives stolen by the hands of hate, and then read the names of 19 of my own family members, including my father’s four year old cousin Elinor, who were murdered. You can read my statement or watch me deliver it by clicking here.
In the spirit of volunteerism, I trained with other members of the community to engage in this year’s Point In Time Count (PITC) which is required to obtain certain federal funding for homeless services. The goal of the PITC is to provide a snapshot of how many people are living outside during a certain period of time each couple of years. I am looking forward to the County pursuing a more meaningful count - a “By Name List” - over the coming year, which I have advocated for so that we can understand not only how many people are living outside, but who they are so that we can actually meet their needs.
Finally, at the beginning of the year I shared that a process is underway to restructure A Home for Everyone (AHFE), the advisory body that makes budget and policy recommendations for Multnomah County and the City of Portland around homelessness and housing. Though reading about an advisory committee might not seem overly exciting to some, its makeup, structure and governance is extremely important in determining how hundreds of millions of dollars are spent on homeless and housing services. I am deeply grateful to those of you who took the time to review my AHFE restructuring proposal and provide feedback! I read and listened to all of your messages, and I incorporated this feedback and what I heard from others at neighborhood meetings and on my Virtual Office Hour into a second draft, which is currently posted on my website. The next steps and timeline for the process of adopting the new AHFE structure have not been made clear, but I will share them with you once I get further information. In the meantime, there’s still time to provide feedback on my revised draft, and I’d still love to hear from you!
Critical Energy Infrastructure (CEI) Hub Update!
Many of you have continued to check in with my office about the status of the Critical Energy Infrastructure (CEI) Hub seismic risk analysis final report and any follow up action. I am excited to announce that the final report will be published by EcoNW very soon! Look out for updates on my twitter and facebook pages next week!
In addition to our work at the local level, I’m very excited that State Senator Michael Dembrow will be introducing Senate Bill 1567, “requiring energy terminal owners to submit comprehensive seismic vulnerability assessments and risk mitigation plans to the Oregon Department of Environmental Quality no later than June 1, 2024. The legislation also requires the Oregon Department of Energy to develop a statewide Energy Security Plan to better prepare for a seismic event, protect local communities, and align with Oregon’s greenhouse gas reduction goals.” I plan to testify in support of SB 1567 during the short legislative session.
Welcome new Policy Director Cristina Nieves!
Thank you for your patience and understanding during the month of December while my team was short staffed. I am pleased to share that we are at full capacity again with the recent hiring of our new Policy Director, Cristina Nieves. Cristina’s experience as the daughter of a single mother who immigrated to the United States drew her to public service, and she has been serving the public her entire working life. She was most recently with Common Cause Oregon, a non-profit organization focused on ensuring democracy and empowering all people to engage in our political system. Before that, she worked as a Senior Policy Advisor for Commissioner Amanda Fritz at the City of Portland. I am so excited to have Cristina as my Policy Director, she is a wonderful addition to our team.
In Good Health,
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