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Commissioner Sharon Meieran Newsletter - July 2017
Dear Friends and Neighbors,
I hope your summer has been going well! For me, it has been flying by. Although a tremendous amount of work is happening at the County, in this newsletter I want to focus on two specific issues.
First, I am very happy to report that in the closing days of their 2017 session earlier this month, the Oregon Legislature passed a bill raising the minimum sales age for tobacco and vape products from 18 to 21. I strongly advocated for this policy, called Tobacco 21, which will save thousands of lives and millions of dollars. Research shows that youth are especially susceptible to tobacco addiction, and with e-cigarette use on the rise among kids and teens, raising the sales age will keep youth from experimenting with and becoming addicted to tobacco and nicotine products. I look forward to implementing this important policy in Multnomah County.
Second, at the Board of County Commissioners meeting yesterday morning, I sponsored a resolution describing the devastating impact of the opioid epidemic in Multnomah County. We invited several guests to speak on the topic, and their presentations were moving.
Opioids are a class of drugs that includes illegal drugs like heroin, as well as prescription painkillers such as oxycodone. People often think that prescription opioids are safer than illegal drugs because they are prescribed by a healthcare professional, but this is simply not true. As Dr. Alisha Moreland-Capuia from OHSU described in her presentation yesterday, prescription opioids can cause addiction, overdose and death, just like heroin. And in fact, many heroin users started with an addiction to pain medications and transitioned to heroin. This trend is something Haven Wheelock, who manages Outside In’s needle exchange program and who also spoke at our meeting yesterday morning, says she has seen more and more over the past several years among the people she works with.
So what’s driving this epidemic? Prescribers did not cause the opioid epidemic, nor did the people taking these medications. There is a backstory that reads like a John Grisham novel but unfortunately is not fiction. Providers prescribed opioids because large pharmaceutical companies like Purdue Pharma (the manufacturer of Oxycontin) convinced oversight boards that these medications were safe, had minimal abuse potential, and were not addictive. They made these assertions based on essentially no evidence. They gave money to agencies overseeing hospitals and state medical boards to create pain management courses and guidelines for prescribers, essentially recommending that all pain be treated with opioids and minimizing any safety concerns. Oversight agencies then began requiring doctors to follow the guidelines. In fact, physicians were disciplined for NOT prescribing opioids. For decades, physicians were taught that the only way to help their patients in pain was to prescribe opioids. So that’s what we did. Though there are certainly a handful of bad actors, our current devastating epidemic was caused not by careless doctors, but by the irresponsible and aggressive manufacture, marketing and distribution of opioids by large pharmaceutical companies. And we have all had to pay the price.
During the board meeting, we heard two personal stories which brought the issue home in a powerful and profound way:
Mike, a father of three and a former teacher, was prescribed opioids to manage chronic pain. He became addicted, and, when his medications became too expensive, he started using heroin. Mike described the painful losses stemming from his addictions -- his housing, his kids, his job, his stability. Today Mike has a little over 6 months clean, is in a sober living community, and is in recovery.
Tiffany, a mother of three, became addicted to opioid medications when they were prescribed after her c-section. Since then, she’s struggled with addiction to heroin and pain pills, and worked hard to shield her kids from the effects of her habit. Today, she’s celebrating over a year clean and is working for Central City Concern, one of the great community organizations that has supported her recovery.
I’m hugely grateful to Tiffany and Mike for sharing their stories with us. This crisis is real, and the people being hurt are our families, friends, neighbors and co-workers.
On a broader scale, data show that there are huge amounts of opioids flowing into our community -- more than 280 million pills in the state every year. In 2015, retail pharmacies dispensed 1.4 million opioid prescriptions to residents of the Tri-County region alone, which amounts to nearly one opioid prescription per person living in the area. Oregon consistently ranks among the states that have the highest non-medical use of prescription painkillers in the country. And from 2009 to 2015, there were 861 opioid related deaths in Multnomah County, along with over 1,900 non-fatal opioid overdoses between 2013 and 2015. One of the panelists yesterday morning, Dwight Holton from Lines for Life, put these statistics into terrible perspective: with one overdose death occurring every 30 minutes on average, that’s two lives lost just in the span of time it took us to discuss and pass the resolution during the board meeting.
As an emergency physician, I have treated the people brought in to the ER by ambulance after they have overdosed. I’ve seen the impact on individuals firsthand. But the damage is not just to individuals and their families. The harms caused by the influx of these opioid pain medications are felt by our entire community, and the cost has been staggering. In Multnomah County, the demand for substance abuse treatment far exceeds the availability of services, and people are left without anywhere to get help. We have had to devote a larger and larger share of our public resources to deal with the effects of opioid addiction. Dr. Paul Lewis, Multnomah County Health Officer, described these direct impacts on the county -- from our health clinics, to our corrections system, and even to our libraries, there are few county services that this epidemic doesn’t touch in some way. And each dollar spent on the opioid epidemic is a dollar less that we can spend on other desperately needed services.
The resolution I introduced yesterday lays the groundwork for the County to seek reimbursement of some of these costs from Purdue Pharma and others for flooding our community with the drugs that have caused the opioid epidemic and created so much harm. As your County government, we’ve made significant expenditures trying to clean up the damage from this epidemic, and we are now going back to the source of the problem to seek compensation. Our action yesterday sets the stage to do this.
It’s been quite a month, and a lot more has happened. I hope you’ll consider joining me for my constituent coffee coming up tomorrow, Saturday July 29, from 10 to 11:30 a.m. at Home Forward’s Pearl Court Apartments (920 NW Kearney Street). I will discuss these and other issues we are working on at the County and will be available to answer your questions. See below for more details.
I hope you enjoy the rest of summer! There will be no newsletter in August, so I look forward to connecting again in September. As always, please contact me or my office with any questions, comments, ideas or concerns. I love hearing from you, and it really does make a difference.
In good health,
Commissioner Sharon Meieran Newsletter - June 2017
Since my last newsletter, a lot has happened at the County. But before I provide some highlights, I want to tell you how I’m feeling right now about the US Senate Republicans’ effort to abolish the ACA and the life-saving and life-changing services it has provided to millions of Americans. I am angry, disgusted and disheartened (but, sadly, not surprised). As an emergency physician, I know what the impact of such legislation would be, and it would be devastating. If the bill passes, people will die. People will lose their homes and their livelihoods. I want you to know that I will do everything in my power to ensure that, whatever happens, we will be here standing up for those who need services most - our seniors, children, immigrants and refugees, those who are living on our streets, and others who are most vulnerable.
Okay, now that I’ve gotten that off my chest, I do want to share what has been going on at the County, because it’s been a lot! Given how much has occurred, I will only be able to share a few highlights below, but I will also continue to provide updates on my website and through social media.
New County Budget
I am especially proud of the Board’s unanimous vote to approve the County’s budget for the next fiscal year, which begins on July 1. We were working under significant constraints and had to make some very difficult decisions. Given the challenges, I am proud that we worked collaboratively to do what we feel is right for our County. To read more about the budget and the choices we made, please see this article and the resources available on the County Budget Office website.
Housing & Homelessness
Addressing the homelessness and housing crisis in our community is one of my top priorities. No one can maintain their physical or mental health, treat their addiction, or sustain a job when they do not have a safe place to live. As rents continue to rise dramatically in the Portland metro region, it’s becoming increasingly difficult for individuals and families to maintain their housing without help. For minimum wage workers, rent increases since 2005 have made it virtually impossible to afford housing and other basic needs. Prior to my joining the Board, in 2016 Multnomah County and the City of Portland established the Joint Office of Homeless Services to oversee the delivery of services to people experiencing homelessness in Multnomah County. The work of the Joint Office supports strategies adopted by the A Home For Everyone Initiative, a community coalition of cities, county, businesses, faith leaders and community organizations to pursue unified plans to end homelessness. Chief among these strategies are prevention and housing retention; emergency shelter; and placement into permanent supportive housing.
At least every two years, the federal government requires all metropolitan regions that receive funding from the U.S. Department of Housing and Urban Development to do a “point in time” count. This is a count of people sleeping in shelters, transitional housing or in places not fit for human habitation. This measurement uses data from service providers coupled with a “street count” to provide a snapshot of the breadth and depth of homelessness in our region. In February, dozens of outreach workers and volunteers engaged directly with people living on the streets and in shelters to gather the information that helps us gauge our success and pinpoint areas where we need to do better.
The 2017 point in time count data affirm that our comprehensive strategies are working, but also show that we have a long way to go. Fewer people are living on the streets -- including people who have been chronically homeless. But this is in part because more people have accessed temporary shelter, and we know that this is not the answer to the housing crisis. Sadly,the data do show an increase in the overall number of people who are homeless (this number includes people living in shelter), particularly among those who are most vulnerable - people with disabling conditions, unaccompanied youth, and the elderly. This is sobering evidence that we have a lot of hard work ahead of us.
For the budget, I strongly advocated for maintaining our shared County and City budget investments to address and prevent homelessness. The point in time data show that our strategy is making a difference. Last year, under the leadership of Chair Kafoury, the County and City partnered to put $20 million toward this effort. This year, we maintained that shared investment and also partnered to add more than $4.5 million in new resources that will support our existing shelter capacity - including family shelters, domestic violence shelters, women’s shelters, and winter shelters - while also increasing the housing placement and retention services that are so critical for ensuring our most vulnerable people stay in housing. For more information about who we’ve served as well as our budget investments in fiscal year 2018, see the Joint Office of Homeless Services budget presentation.
I continue to carefully follow the Oregon Legislature’s work on a range of important topics. One area that has been a priority for me has been consideration of a statewide Tobacco 21 - or “T21” - policy to raise the minimum legal age to purchase tobacco and vape products from 18 to 21. Raising the legal sales age is a smart, simple change that will save thousands of lives and millions of dollars in our healthcare system, with minimal if any budget impact. I am hopeful that the Legislature will adopt this important public health policy before they adjourn in July. However, if that does not happen, I am prepared to act swiftly in Multnomah County. I have time held on the July 13 Board of County Commissioners meeting (9:30 a.m. at the Multnomah Building, 501 SE Hawthorne Blvd.) for a public hearing to discuss our own policy to raise the legal age to purchase tobacco to 21 years. I encourage anyone interested in this topic to hold this meeting time on their calendar.
There is so much more, but these are some highlights. Thank you so much for taking the time to read this newsletter. I value your input and feedback. And -- as always -- my door is open. Please do not hesitate to call or email with any thoughts, ideas, questions or concerns.
In good health,
Commissioner Sharon Meieran Newsletter - May 2017
- Our health department offers a crisis line and an urgent walk-in clinic if you’re experiencing a mental health crisis.
- The health department also provides services for children and families, including early assessment and intervention services offered in schools and at neighborhood health centers.
- A large percentage of people in our jails are experiencing mental illness, and the County offers assessment and treatment resources within jails (although these resources aren’t adequate and are within a larger public safety system that limits their effectiveness, as I covered in my March newsletter [see below]).
- Our homeless service system is seeking to help people experiencing homelessness who also have histories of cycling through our mental health and corrections systems.
- Our K-12 education system offers mental health resources for students.
- Our hospitals and health clinics are responsible for treating people experiencing mental illness who come to an emergency room or are seeking care.
To be clear, the mental health care services available are not adequate. As a nation, we haven’t invested in adequate community-based mental health care since deinstitutionalization in the 1980s. The lack of investment shows in the fact that the resources we do have are constantly operating at capacity and people often experience prolonged wait times to access treatment. We’ll need to continue to advocate for funding. But in addition, a significant part of the problem is that these systems operate within silos, and some services are duplicated while others are missed completely. I’m interested in ensuring these systems fit together to catch people who are vulnerable to slipping through the cracks. We must advocate for a system that works more holistically and effectively and catches people before they slip through the cracks.
During the County’s budget process over the past month, I have been advocating for targeted investments that will better align our mental health resources. This year, projected revenues are not keeping pace with needs, and the Chair asked Departments to propose two percent reductions. Given these constraints, I’m especially glad to see the Chair has recognized the importance of mental health care - avoiding reductions from the mental health crisis system and investing new resources in mental health treatment in jails. I wholeheartedly support these investments. I also support the investment in the budget in enhanced mental health services in schools. Additionally, I’m seeking funding for a research project dedicated to describing the mental health services available in our community, connections between those resources, and funding and reimbursement mechanisms so we can identify gaps and develop strategies to improve the system as a whole, even within the constraint of our current resources. The Board will vote on the final budget on May 25.
This Sunday, I will be joining in the 15th Annual NAMI Walks with Multnomah County. Please come walk with me and thousands of others to raise awareness!
Finally, as we wrap up the County budget process for the year, I invite you to join me for my first constituent coffee this Saturday, May 20, from 10 - 11:30 a.m. in the Community Center at Stephens Creek Crossing (6719 SW 26th Avenue). I will be available to tell you what’s been happening at the County, to answer your questions, and, most importantly, to listen. Please come for a cup of coffee or tea, I would love to hear from you!
In good health,
Multnomah County District 1 Commissioner
Commissioner Sharon Meieran Newsletter - April 2017
In the last two weeks, we’ve heard news about at least two local Dreamers protected by the Deferred Action for Childhood Arrivals (DACA) program but detained by Immigration and Customs Enforcement (ICE) officers. Francisco Rodriguez Dominguez and Emmanuel Ayala Frutos are members of our community. While both men have been released from ICE custody, these and other ICE actions have caused many of us to become increasingly angry and fearful about what the Trump administration is doing now and what else might happen in coming months. With this in mind, I wanted to share some relevant information about what we’ve been doing at the County, and also provide some resources.
Locally, we’ve moved quickly to take decisive action. In January, the Multnomah County Board of Commissioners issued an official statement condemning ICE activities in the Multnomah County Courthouse. In February, we asked the public to report ICE activity at Multnomah County courthouses, helping us uphold our policy of not assisting ICE or other federal officials in enforcing federal immigration laws. In the past month, the Board of County Commissioners voted to provide emergency funding to nonprofits offering legal aid to immigrant residents, declared Multnomah a “Welcoming County,” and investigated and explained why we do not expect to lose federal funding as we follow state and federal law. We collaborated with Congresswoman Suzanne Bonamici and Congressman Earl Blumenauer on legislation they introduced in late March to block ICE enforcement in “sensitive locations,” including the County’s courthouses and county health clinics.
Although the stance being taken by the federal government is frightening, resources are available to provide some guidance as we navigate these unprecedented actions. The ACLU has provided this document as a guide to ensure that people know their rights if questioned about immigration status. The Immigrant Legal Resource Center (ILRC) engages immigrants to participate in issues critical to their communities and provides expert technical assistance to immigration law practitioners and community organizations. The Welcoming America Coalition, which Multnomah County joined in March, provides resources and technical assistance to a network of cities and counties across the country dedicated to becoming more inclusive toward immigrants and all residents.
Other issues I’ve been actively working on include advocating for raising the age to buy and use tobacco from 18 to 21, continuing to learn all that I can about our system of mental health care, and preparing for the County’s budget process, which kicks off for the Board when Chair Kafoury releases her budget tomorrow. I’m also looking forward to hearing the Chair present her annual State of the County address at the City Club of Portland this Friday at 12:15 p.m..
If you have ideas, questions, or concerns about anything I’ve mentioned (or any other topic!) I invite you to contact me at District1@multco.us or call my office at 503.988.5220. In addition, please check out the upcoming list of budget meetings and other community events below. In particular, I hope you’ll join me on Saturday, May 20 from 10:00am-11:30am, for a Coffee with Constituents at Stephens Creek Crossing-- a Home Forward housing community in District 1 with 122 affordable apartments. I look forward to sharing more about my work as a Commissioner so far, and hearing about what’s important to you.
In good health,
Multnomah County District 1 Commissioner
Commissioner Sharon Meieran Newsletter - March 2017
Dear friends and neighbors,
One of my top priorities as a Multnomah County Commissioner is to improve our system of care for people suffering from mental illness. This priority came into sharp and disturbing focus late last month when Disability Rights Oregon (DRO) released their report about conditions in the Multnomah County Detention Center.
As the report indicates, roughly 40 to 80 percent of inmates in the county’s jails suffer from mental illness. The report calls attention to the serious challenges and human impact of the gaps in our mental health care system, particularly with respect to those who are incarcerated. I’m very concerned about the findings, and I’m committed to working with Sheriff Mike Reese, Chair Deborah Kafoury, leadership in our County Health Department and Department of Community Justice, along with the DRO and other advocacy organizations, providers and individuals with lived experience of mental illness, to ensure that our corrections system treats people with dignity and respect, provides them with appropriate care and keeps them safe. Click below for a full copy of my response to a letter from DRO about the report’s recommendations.
But the problems with our mental health care system stretch far beyond the walls of the jail. We have to keep fewer people with mental illness from ending up in jail, on the streets, and in the ERs. How? Clearly, housing is a huge part of the solution. The Joint Office of Homeless Services and A Home for Everyone Initiative have made significant strides including opening more shelters and improving the supply of affordable housing. But we need more and better supportive housing, shelter options, and services readily accessible to people who are homeless and living with mental illness. We need to meet people where they are at, and provide services in ways that are meaningful to them.
As I prepare for my first Multnomah County budget process as a commissioner this spring, I am learning about existing investments the County makes in mental health care services, and I will be looking for ways to use our limited resources as effectively as possible. Beyond the budget process, I believe we need a thorough inventory of our mental health system as a whole to determine where there are gaps and where we might be able to better align policies to make a difference.
This issue does not lend itself to easy solutions. But taking a deep dive into our system of mental health care is one of my top priorities, and something I will be looking at every single day. I look forward to keeping you updated about this critical work, and, as always, appreciate your input.
I also wanted to share a few other highlights of recent weeks. On Saturday, I attended a town hall held by Congressman Earl Blumenauer at Benson High School. I had the opportunity to meet Zaira Flores and Leo Reyes, who started the amazing Purple DACA Letters campaign sharing stories from students and others who have been able to work and live legally in the United States under the Deferred Action for Childhood Arrivals (DACA) program. Last week, I testified in front of the Oregon Senate Environment & Natural Resources Committee to advocate for cleaning up diesel emissions, which create a heavy burden in health impacts for Multnomah County. As a doctor, I see the downstream impact of this pollution in the emergency room; we can do better by cleaning up diesel at its source. And finally, two exciting developments on Tobacco 21, a priority of mine: just this week, the Lane County Board of Commissioners passed a local Tobacco 21 ordinance, becoming the first county in Oregon to raise the minimum legal age of purchase to 21! I was also happy to see the statewide Tobacco 21 bill pass out of the Senate Health Care Committee. It's now headed to the Senate Floor for a vote. As I work on this issue here in Multnomah County, I'm energized and emboldened by this progress across the state.
In good health,
Multnomah County District 1 Commissioner
Commissioner Sharon Meieran Newsletter - February 2017
Welcome to my newsletter! I am honored to have been sworn in as Multnomah County Commissioner for District 1 on January 3, and I look forward to communicating with you about what’s going on at the County and my priorities, as well as hearing about what’s important to you so I can represent your voice at the County. Please subscribe to this newsletter to stay informed about my work and events.
I’ve hit the ground running (or I should say sliding, on ice and snow…), but, sadly, one of the defining characteristics of my first month in office has been watching what’s unfolding in our federal government. Like many, I’ve been following President Trump’s executive orders closely, and I’ve been shocked and dismayed. It’s been easy to become overwhelmed, disheartened and even despondent as our democracy appears to be undermined with every new Tweet. But what’s happening nationally makes it even more urgent that we work at the local level and uphold our values. I’ve been energized by the power of our collective voice as we’ve marched for women’s rights, rallied for immigrant and refugee rights, and attended town halls with record-breaking participation. I am working with amazing women on the County Board, and I intend to do my part to ensure that our systems continue to support and protect everyone in our community, particularly those who are most vulnerable.
So many of you have contacted me to ask “What can I do??” I know exactly how you are feeling. When I first started advocating for the issues I care about, and I wasn’t sure where to begin, a friend told me “Just show up.” I started showing up at town halls, board meetings, and anywhere I felt I could play a role. Initially I didn’t say much, but soon I began to feel empowered to take the next steps. I spoke up. I engaged. We each need to take action in whatever way we can. If you’re able, donate your time and/or money to support organizations that exemplify your values. Attend rallies and town halls and board meetings. Join advisory panels and community engagement groups. To get involved in County panels and efforts, visit the Office of Community Involvement website at https://multco.us/oci.
Despite the uncertainty at the federal level, I feel a sense of optimism and inspiration being at the county, where I know we can make a difference. I’m working as a County Commissioner to address the priorities I identified during my campaign. Homelessness and affordable housing, mental health care, and public safety are at the heart of the challenges we face as a community. We’ve all noticed how much more visible homelessness has become, something I see as a clear downstream effect of rising rents, unpredictable disruptions to tenancies, and wages that haven’t kept pace with the cost of getting and keeping stable housing. I also know many people have told me they are concerned about people who are homeless and in mental health crisis. During the winter storms, four people who were living on the streets died due to the extremely cold weather, despite the fact that shelter was available. We need to improve the availability and accessibility of mental health treatment, as well as substance abuse treatment. Over the next four months through the County’s budget process, I’ll be focused on protecting critical treatment services despite projected budget cuts, as well as seeking efficiencies and accountability to get better value for the money we have. I’ll also be tracking statewide policy efforts to improve housing stability, and exploring options we have for local action.
See below for articles about our work so far, and please be in touch any time you have an idea, question, or concern. You can call my team at 503-988-5220, email me at firstname.lastname@example.org, and/or follow me on Facebook and Twitter. I look forward to hearing from you!
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