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Commissioner Sharon Meieran Newsletter - March 2020

Dear friends and neighbors,

I hope you are staying well during these uncertain times. I will be honest - this has been a challenging newsletter to write for a number of reasons: (1) I imagine many people (myself included) are tired of hearing about COVID-19 and have information overload; (2) despite #1, I do feel compelled to address COVID-19 but don’t know what to say; and (3) I very much want to write something uplifting, but this is hard when I’m feeling frustrated, anxious, and unsettled much of the time.  

Despite these challenges I very much want to connect with you! So I have decided to just share how I am feeling, provide links to some sources of information that I feel are particularly useful, tell you about some highlights of positive things happening at the County, and continue to provide an “open door” (virtually, of course) to ask me questions and share your thoughts.

What I am thinking about

First, it has been challenging to wear two hats (or given the times should I say two masks?) as both a County Commissioner and as an emergency physician. I feel a tension between having the background, knowledge and deep connection to the healthcare community, while at the same time being a local elected official who, in reality, has limited control over information or decision-making in this crisis. In “normal times” these two perspectives are quite complementary, and I ran for and love holding this position because I can bring my perspective as a frontline healthcare provider to my role as a policymaker.  However, in this situation these dual roles have sometimes felt at odds. I have had the opportunity to observe the interplay of politics and public health, and at times I have passionately disagreed with approaches to preparing for and responding to this crisis. Ultimately, though, dwelling in hindsight does not move us forward, and each day I am committed to doing everything in my power to proactively address COVID-19 in our community. 

Our reality today remains stark. COVID-19 is very easily transmitted, and it can be deadly. There is no vaccine and there is no cure. It is especially dangerous for older adults, people with underlying breathing problems, and people with challenged immune systems. Anyone can get sick, and, most importantly, anyone can be a carrier. Even if you are not at high risk - if you are young, healthy and fit - you can still get and transmit this virus  to someone else who is more vulnerable, and that person could become very sick and even die. So PLEASE do everything you can to keep yourself and others safe: stay home as much as possible; stay six feet apart from anyone that is not your immediate family, wherever you are; and stay connected in healthy ways. 

Despite the stark reality of COVID-19, I am also thinking a lot about the opportunities and learning that can be born from this crisis, and I see so many things happening in our community that are positive. For example, systems approaches have become more streamlined and efficient; barriers and bureaucracy have been broken down; I’ve witnessed incredible innovation, creativity, kindness, generosity, and tireless dedication. While there are certainly challenges and mistakes to be made along the way, I think much of this quick, nimble, creative problem-solving is inspiring, and I hope that as we emerge from this pandemic, we can thoughtfully consider how to hold onto some of what we’ve learned and implemented, even when we’re no longer pressed by crisis to do so.  

What I have been doing

Every day my staff and I participate in briefings, talk to colleagues and experts, reach out to individuals and leaders of our local partner organizations and businesses, talk to community members, ask a lot of questions to inform my perspective, offer ideas to help inform others’ perspectives, and help get information to my constituents. 

More tangibly, I have engaged in local efforts to address the COVID-19 crisis: 

  • My staff and I have been helping to get the word out and staff shifts to receive, sort, and organize donated Personal Protective Equipment (PPE). I was approached with the idea of a fellow physician, Dr. Vesna Jovanovic, who had been brainstorming with colleagues about how to address the shortage of PPE we have all been hearing about. Dr. Jovanovic connected with Multnomah County, which partnered with Portland Fire and Rescue to organize an effort. The response from our community has been beyond what I could have imagined: we’ve received donations ranging from individuals who happen to have a couple of extra N95 masks at home to organizations that have gathered together palette-loads of supplies. And it’s been wonderful to get to know some of the County employees who have been staffing the donation center. I have to say, it feels satisfyingly real and concrete to take boxes of supplies and organize and record them, knowing they will be put to use in a meaningful way.   

  • I went out with Portland Street Medicine to help get the word out to people living in encampments about COVID-19, what they can do to prepare and be safe, and provide supplies they might need. I can’t express how much admiration and appreciation I have for the volunteer physicians, social workers, nurses and others who do this work every day, serving some of the most vulnerable, and most at risk, in our community.

  • I joined a number of Multnomah County employees in setting up a new shelter at the Oregon Convention Center, ensuring that appropriate physical distancing measures can be met for those in shelters. 

  • Working in the ER has given me a different perspective. From home it has been hard to absorb the reality of what the COVID-19 pandemic means. Streets have been emptier, stores closed or providing limited services based on physical distancing, but the concept of COVID-19 has been mainly theoretical and gleaned from what I read in media accounts. In contrast, in the Emergency Department I have “donned” and “doffed” PPE that is in very short supply, wiping down my equipment for reuse. I have seen people in respiratory distress. I have seen the incredible dedication, cohesiveness and determination of the doctors, nurses, registration, CNA, other hospital staff and first responders who come to work every day to care for those who are sick. It is clear to me based on this experience that the pandemic is very real here in Oregon.  

I have also been strongly advocating for policy measures that will help save lives:

  • I have been advocating at the local and state levels for strong physical distancing measures, some of which are included in the Governor’s “Stay Home, Stay Healthy” executive order. The key to slowing the transmission of COVID-19, and hopefully preventing our healthcare systems from becoming overwhelmed, is early, sustained, widespread physical distancing with as few exceptions as practicable. 

  • I have been connecting with the healthcare community both at the individual provider level and at the hospital systems leadership level to listen to and address the concerns and needs of the community. 

  • I have been outspoken about the dire need for PPE for frontline healthcare providers and other appropriate equipment for those working in our shelters and other service areas.  The PPE donation effort is a tremendous help that will supplement the PPE we need to acquire as a state and county. I am interested in efforts to support sustainable local PPE manufacturing as well as other aggressive purchasing efforts at the state and local levels.  

  • I helped convene a group of emergency physicians from throughout the state to meet with US Senator Ron Wyden to discuss issues front line healthcare providers are experiencing right now.

What Multnomah County is doing

There is a lot happening at the County level, and you can learn more about all of it on Multnomah County’s dedicated Novel Coronavirus COVID-19 page which includes Frequently Asked Questions, guidance for individuals, organizations, and sectors, and important information and resources for our community. A couple of highlights to share here:  

  • Just yesterday the County released the region’s first dashboard of COVID-19 case data which will help public health track this pandemic locally.

  • County departments have gotten creative to continue to meet our community’s needs -- did you know that you can still get a marriage license by mail? Or that the Library has tons of online materials available? This is all in addition to the countless health, public safety, and vital human services functions that are still happening across the County. Learn more about what’s open and what’s closed here.  

  • Earlier this month Multnomah County announced a temporary moratorium on residential evictions for nonpayment of rent due to wage loss resulting from COVID-19. This action aims to prevent homelessness and housing instability during this economic and public health emergency. 

What YOU can do

There are a number of things you can do right now to support our community:

  • Donate or volunteer! From donations of Personal Protective Equipment and other supplies to volunteering your time, the County can connect you to opportunities. Volunteering and donating to support essential activities is specifically allowed under Governor Brown’s Stay Home, Save Lives executive order, but please still practice safe physical distancing guidelines whenever you leave your home.   

  • Stay safe and stay engaged! Many organizations are struggling tremendously to keep their doors open and continue doing vital work. Think about causes and organizations you care about, and learn more about ways to materially or financially support them. 

  • Show your appreciation! Thousands of people continue to show up each and every day to perform essential work in healthcare settings, grocery stores, delivery services, childcare centers, and countless others. Send a letter, put a sign in your window (our neighbors did this and every day I am reminded of how much people care), call a friend or loved one.

  • Stay healthy and take care of one another! Physical distancing can lead to isolation and anxiety. The County has suggestions and resources for coping and supporting one another.  And as the weather improves, know that it is fine (and healthy!) to go outside, provided you keep a healthy distance from others. I had an amazing walking meeting with my friend Congressman Earl Blumenauer last week, and he had a brilliant idea to use a six-foot ribbon to ensure that we kept safe distance. He brought a tape measure, a spool of ribbon and scissors, and we walked exactly six feet apart the entire time.

  • Looking for work? The County is hiring new staff for emergency shelters. If you or someone you know would like to learn more about positions supporting these essential services, you can find information here

I know times are difficult right now. There is so much uncertainty, and even with the seemingly endless supply of news, real information is hard to come by. I’d never realized how much positive energy I got from simple physical proximity to people, and I deeply miss this connection. But we can still engage and connect with each other, and especially during these strange, surreal times, it’s more important than ever that we do so. 

And remember, we’re all in this together and whatever each of us can do has meaning -  whether it’s delivering meals to a neighbor, staying home to protect others from getting sick, volunteering in a shelter, donating money to an important cause, sewing a mask, or whatever you feel comfortable doing. As Helen Keller said in one of my favorite quotes:

“I am only one, but still I am one. I cannot do everything, but still I can do something; And because I cannot do everything I will not refuse to do the something that I can do.” 

My office is happy to help connect you with information and resources. We will be hosting a virtual town hall next Wednesday, April 8, from noon - 1 p.m. (details below). You can still tune in to board meetings and board briefings remotely. And please continue to email and call me! I have already heard from so many constituents and community members with questions, ideas, concerns, and thoughts, and this really makes a difference. 

Please be well, stay safe and stay connected!

Warmest regards,

Sharon

Virtual town hall details

Wednesday, April 8

Noon - 1 p.m.

To join Zoom Meeting on April 8:

https://us04web.zoom.us/j/227412716

Meeting ID: 227 412 716

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Meeting ID: 227 412 716

Find your local number: https://us04web.zoom.us/u/f7irFJlgZ


Commissioner Sharon Meieran Newsletter - February 2020

Dear friends,

Last Saturday, I convened a Youth Mental Health Forum with special guest Ron Wyden. It was truly an incredible event, and I am dedicating this newsletter to sharing some of my key reflections from that experience with you.

The purpose of the forum was to hear directly from youth about their experiences with mental health issues, and to listen to their ideas for solutions. The event was strongly youth-driven and youth-led, with high school students forming the core of our planning group, and serving as moderators and discussion facilitators. Policymakers -- including state legislators, school board members, school administrators and others -- were invited to listen. About 230 people attended, and over 150 were youth from across the County. 

I was truly blown away by the courage, honesty, brilliance, creativity, and strength of each of the young people who showed up. They shared important reflections and ideas that we captured during the event, and we are currently working on compiling thoughtfully and holistically to share back with the community. While there is way too much to be distilled into a single newsletter, I want to share some highlights.

Experience. Kids are experiencing tremendous pressure that can lead to anxiety, depression, self-harm, substance use and other negative outcomes. This pressure comes from a number of sources, but three key themes were: 

  • There is a lot of negative stuff going on in the world creating a sort of existential despair. The urgent threat of climate change, practicing “active shooter” drills in school, divisiveness and hatred being disseminated at the highest level of government-- youth are angry at this world adults have created for them. 

  • Almost universally, kids feel uncertain about their futures in terms of whether they can afford a place to live, get into college, afford college, get a job, etc. 

  • Challenges faced by teens are made worse by social media. Adolescence is already a time of change, and can be traumatic and isolating. Social media can make it feel like others’ lives are perfect, magnifying the loneliness and negative self-talk many youth already experience.

Barriers. Youth talked about several things that keep them from getting the support they need:

  • Stigma. There is a perception that issues of mental health can’t be talked about.

  • Lack of adult support, including connection to a “caring adult” who can meet them where they’re at, or to a certified mental health counselor who can provide actual therapy. 

  • Parent/guardian challenges can be extremely disruptive to kids’ own emotional wellbeing. 

  • Kids expressed that, even if counselors were available (which was extremely rare), often their families could not afford copays or the cost of services. 

Solutions: Youth offered many ideas for how to address and prevent mental health issues:

    • Challenge stigma. Normalize mental health as part of school curriculum, as part of everyday language, conversation and life. Connected with this, mental health events and services must be more than “one and done,” like an all-day event or a single class. 

    • Access matters. Youth want trained counselors whose primary job is to provide mental health support at school, for free. 

    • Who provides services is important. Stigma is especially hard in communities of color, and we need many more counselors who are people of color to help combat this stigma. Peer-to-peer support can also be very effective. Youth are often more trusted and helpful than adults. 

    • Be flexible with attendance. Attendance and timeliness in school are important, but students often need accommodations to support their well-being.  

    • Start early. Start conversations, curriculum, and interventions in elementary and middle school to help instill a sense of self-confidence, wellbeing and resilience. By the time kids have gotten to high school they feel it’s too late. 

In addition to the exceptional insights shared by young people, the process itself was truly remarkable. The youth participants were engaged, courageous, passionate, kind and thoughtful. The power and depth of the conversation was profound. And an overarching message was that youth are the experts in what they are experiencing, along with what solutions would help them. When suicide is the second leading cause of death among youth ages 13 to 25, and the 2018 State of Our Schools report by Oregon Student Voice found that access to mental health resources is the most important policy concern of students today, we need to listen you youth now more than ever and engage them in all levels of conversation about policy. 

It can be easy to get mired down in despair, or fear, or hopelessness when faced with the heavy mental health challenges our youth experience. But last week helped remind me that our only path forward is one that follows the lead of resilient, smart young people who give us the mandate and ideas to make things better. With discussions happening statewide about how to use a historical amount of funding to bolster student mental health, these kinds of conversations with youth could not be more timely. I am excited about carrying the ideas and spirit of the Forum forward to help manifest real change for our youth.  For now, please enjoy the images of the day included below.

In good health,

Sharon Meieran


Commissioner Sharon Meieran Newsletter - January 2020

Dear friends,

Happy new year! A lot has happened over the past month, and 2020 is definitely well underway. In this Newsletter I want to focus on looking ahead to this year’s State legislative session which begins next week. 

2020 Legislative Session

As we enter the 2020 short legislative session, I want to share some of the County’s top priorities, bills that I will be following closely and issues I hope to see in the longer term as we look toward 2021. 

Many of Multnomah County’s top priorities this year focus on addressing reductions, shortfalls, and “unfinished business” from 2019. For example, last year as the 2019 legislative session came to a close, I wrote in my June newsletter about some funding cuts that would have a major impact in Multnomah County, especially cuts to community mental health. For the 2020 session, our top legislative priorities include:

  • $12.5 million in capital funding through a partnership with the state to support the behavioral health resource center. This Center would provide peer-delivered support, shelter and transitional housing specifically for those who are homeless and living with serious behavioral health challenges. This is a pressing need in our continuum of care and can serve as a model for addressing the needs of people who are the most vulnerable in our community. 

  • Release $9 million in community mental health funding that the state held aside in 2019 while examining the funding formula used to determine need. Community mental health funding from the state is based, in part, on a caseload forecasting process that guides the allocation of resources. Since the 2019 Legislative session, Multnomah County has participated in a workgroup to update these behavioral health caseload forecast methodologies, processes and related funding formulas. Two of the key aims of this workgroup are to ensure that the cost of providing services is accurately reflected in how funding is determined, and that there are no disincentives or penalties for communities with successful outcomes. 

  • Approval of $50 million across the state to right-size the community corrections budget by paying counties for the actual cost of providing services. Every six years the Department of Corrections is required to extensively study the actual cost of providing community corrections services, such as parole and probation supervision and associated treatment and re-entry programs. In 2019, the Legislature’s allocation for the 2019-21 budget years did not take into account the most recent study which concluded that the state was underpaying Counties nearly $51 million every biennium for what it actually costs to provide those services statewide. 

  • Full support for intellectual and developmental disability case management services, totaling $5 million for 2019-21 biennium. 

  • Restore $850,000 for domestic violence co-located advocate services in Multnomah County, which were cut significantly in 2018. 

In addition to these key funding priorities, there are hundreds of policy bills that the County will be monitoring, and a few that I think are particularly important and worth noting: 

  • Restricting the sale of flavored nicotine products: Multnomah County has been carefully considering possible local action to curb youth vaping by restricting the sale of flavored products, including menthol cigarettes and e-cigarettes. This legislative session, there are at least two measures aimed at restricting the sales of flavored nicotine products, which we will be tracking closely; 

  • Affordable housing continues to be a top priority for Multnomah County, and we will be advocating for a bill to reduce houselessness through a statewide long-term housing voucher program. Many individuals and families, especially those who rely on a fixed income, struggle to keep up with rising housing costs. With thousands of people in Multnomah County sitting on federal housing voucher waitlists, we need to explore local solutions to get -- and keep -- people stable in their housing; and

  • Meaningful action on climate change was a critical issue last legislative session that did not advance. We must take action on our climate crisis now.  I hope that the Legislature is able to make progress this session to cap greenhouse gas emissions.

Also worth noting, there are several issues that didn’t “make the cut” for consideration during this short legislative session that remain important to me: 

  • Increasing Oregon’s beer and wine tax which is among the lowest in the nation and hasn’t been raised significantly in decades;   

  • Amending our civil commitment laws to better meet the needs of people in mental health crisis who often end up incarcerated, in the Oregon State Hospital, or even die on our streets because they do not receive the services they need to prevent these tragic outcomes; and

  • Fully investing in a robust system of community-based mental health by shifting away from expensive institutional care. 

I will be working on these issues in the interim between now and the long legislative session in 2021, and hope they will be taken up for consideration during that session.

As always, I love to hear from you!  Contact me with ideas, questions, or concerns at District1@multco.us or (503) 988-5220.


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