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Commissioner Sharon Meieran Newsletter - March 2021 
 

Greetings friends,

As the weather warms and we continue our incremental progress to recover from the pandemic, I’m increasingly finding sources of inspiration, resilience and hope.

But, there have also been acts of violence and hate that continue to shake us to our core, and I want to acknowledge Soon Chung Park, Hyun Chong Grant, Soon cha Kim, Yong Eh Yoo, Xiaojie Tan, Daoyou Feng, Delaina Ashley Yaun and Paul Andre Michels, who were murdered earlier this month in Atlanta in shootings fueled by anti-Asian hate. In the wake of the shootings, my fellow Commissioners Susheela Jayapal and Lori Stegmann spoke to their own experiences as Asian American women who have felt the impacts of racism personally, and are facing today’s climate of heightened fear. Our Board issued a statement condemning anti-Asian hate and mourning the tragic killings in Atlanta.

On a different note, I want to recognize today as International Transgender Day of Visibility (TDOV). Held annually on March 31, this is a time to celebrate transgender and non-binary people around the world, and bring awareness to the work that is needed to eliminate the discrimination and violence that trans people face. TDOV is personally meaningful to me this year, as I support a close family member in exploring their gender identity and their own process of transitioning. The Multnomah County Board of Commissioners will consider a proclamation tomorrow (Thursday, 4/1) honoring TDOV, and I invite you to tune in to join us.

March has been chock full of advocacy, at all levels. I will focus this newsletter on several ways advocacy has manifested for me this month through my work at Multnomah County.

Frequent Users Systems Engagement (FUSE)
FUSE is a national initiative, started by the Corporation for Supportive Housing (CSH). The goal of FUSE is to identify the people who most frequently come into contact with homelessness, healthcare, and criminal justice systems, often at great cost, both financially and in terms of individual trauma and suffering. Ultimately, this data can be used to support coordinated systems solutions to more effectively serve the people who our systems are failing, and also to most effectively use our limited resources.

My office has championed FUSE since its launch, as part of a larger vision of better serving people who fall through multiple cracks across many systems. Our local FUSE initiative has been underway since 2018, and involves a partnership between CSH, the Joint Office of Homeless Services (JOHS), Health Share of Oregon and Multnomah County’s Local Public Safety Coordinating Council (LPSCC). The FUSE analysis was completed and presented to our Board this month, which was a very exciting milestone.

As an emergency physician, it did not surprise me that people who are the most frequent users of ERs are also most frequently cycling through homelessness and through our jails. But FUSE demonstrated this starkly and in a data-driven way. Being in supportive housing keeps people from cycling through multiple systems. Supportive housing is the pivot point - avoidable emergency department visits, jail bookings, and hospitalizations all dropped significantly once people were housed.

FUSE makes the case - objectively - for all of our systems to coordinate more effectively, and to invest in supportive housing. I believe this is the approach we must take with regard to prioritizing investments through the Metro Supportive Housing Services Program, and an approach I will continue to use my voice to support.

Legislative issues

Since my last legislative update in February, I have testified on a number of additional important topics before the Oregon State Legislature:

  • OHA Budget - Behavioral Health: I testified on behalf of Multnomah County and as the co-chair of the Association of Oregon Counties’ Health and Human Services Steering Committee on the Oregon Health Authority budget bill (HB 5024) regarding Behavioral Health and the Oregon State Hospital. My testimony focused on advocating for community-based behavioral health resources. Oregon has long recognized the value of preventative physical healthcare -- we know that investing in upstream preventative services leads to better outcomes and cost savings. The same is true with regard to behavioral healthcare, yet our funding priorities are often backwards -- we look first to cut the services that are least expensive and most effective, while safeguarding exorbitantly costful institutional care.
  • Safe firearm storage: I provided written testimony in support of HB 2510 which would require safe storage of firearms, reporting of the loss or theft of a firearm, and supervision of minors using firearms. As an ER doctor, I have seen the devastating impact of gun violence firsthand when treating people who have suffered from gunshot wounds and bearing witness to their families’ grief. We know that suicide is a leading cause of death among Oregon youth, that a suicide attempt is often an impulsive act when someone is in crisis, and risk increases with access to a highly lethal agent. It is indisputable that reducing an individual’s ready access to a firearm greatly reduces the likelihood of that person dying by suicide.
  • Alcohol and cancer risks: I testified in support of HB 3297 which would require the Oregon Liquor Control Commission and Oregon Health Authority to study alcohol labeling requirements that would include printed advisories regarding the dangers of alcohol. There is ample evidence for the myriad health risks associated with alcohol use, and we have known that alcohol causes cancer for several decades. Yet, there is a major disconnect between the very real risks of alcohol use and the public’s perception of those risks. A comprehensive, public health approach to reducing the harms associated with alcohol must include improved education and communication to promote awareness of cancer risks.
  • COVID-19 recovery - county perspective: I testified before the House Subcommittee on COVID-19 about local government and reopening. I was joined by Commissioner Mark Bennett from Baker County, OR, and it was remarkable how many challenges, needs, and lessons learned are shared across rural and urban environments. My testimony focused on our continued public health infrastructure needs, financial and policy support for housing and small business, and how we must leverage this pandemic as a learning opportunity to improve coordination, communication, and reduce silos.
  • Peer Respite: I testified in support of a concept that is very important to me -- peer respite services. Last month I testified for HB 2980, and this month I had the opportunity to support a companion Senate Bill (SB 680). These bills are the result of years of committed advocacy by people with lived experience, and I am always proud to lend my voice to this work. Peer-staffed crisis respite is proven to reduce rates of Medicaid-funded hospitalizations and health expenditures for people who access the respite. We should consider these kinds of services an essential part of our system of care that make other services more effective, and I hope to see this legislation advance to fund more peer delivered services.
  • Improving access to HIV preventive medications: I testified in support of HB 2958 which would improve access to HIV preventive medications including PrEP (pre-exposure prophylaxis) and PEP (post-exposure prophylaxis). As we fight to end the HIV epidemic, removing barriers to life saving medications is crucial. This is especially important for people who experience marginalization, discrimination, and other challenges to receiving basic healthcare. We need to ensure that medications like PrEP and PEP are truly accessible -- meaning available, affordable and convenient -- in as many places as possible, and without barriers for those who need them.

Using Our Voices

As County Commissioners, we sometimes do not have the authority to directly influence some of the issues that are important to our community, but we can exercise our individual and collective voices to raise awareness and advocate for those issues. I was involved in two particularly meaningful advocacy efforts this past month.

  • The Portland Area Workers Rights Board panel supporting Providence nurses: The Portland Area Workers Rights Board (WRB), convened by Portland Jobs With Justice, is designed to “bring to light and respond to injustices in the workplace.” Earlier this year, nurses working for Providence Health & Services throughout the state of Oregon contacted the WRB about serious concerns with Providence's treatment of nurses and patients on the frontline of the COVID-19 pandemic. In January, we heard directly from nurses about their experiences. In February, I stood in solidarity with nurses at a rally to support their demands for adequate workplace protections and support. And this month, I participated in a virtual hearing -- Protect Nurses, Protect The Community: A Workers' Rights Board hearing on Providence and their response to nurses and COVID-19 -- during which we approved a resolution affirming the experiences of nurses and calling on Providence to agree in writing to implement a nurses’ bill of rights for COVID-19 protections.
  • Letter to Homeland Security regarding federal agents’ use of tear gas: Last month, I was contacted by constituents in my district who shared concerns about the use of chemical munitions by federal law enforcement around the U.S. Immigration and Customs Enforcement (ICE) facility in my district, directly adjacent to the K-8 Cottonwood School of Civics and Science and in close proximity to an affordable housing complex that is home to many Veterans. This ICE facility has been the site of numerous protests, during which federal law enforcement officers have deployed tear gas as a method of crowd control. Physical debris and residual toxic chemicals have been found on the Cottonwood schoolyard -- including teargas residue and canisters -- which could pose a health risk to young children, teachers, and the surrounding neighborhood. We do not have any legal authority at the local level to influence the actions of federal law enforcement officers and the tactics they use. However, we can speak with a strong, unified voice to demand change. I spearheaded a letter from the Multnomah County Board of Commissioners outlining our concerns about the use of tear gas in residential neighborhoods, parks, and other places across Multnomah County where people live, work, and play. The letter calls on new Secretary of Homeland Security, Alejandro Mayorkas, to prohibit the use of chemical weapons in proximity to schools, residential neighborhoods, and other locations near vulnerable populations. The letter also requests that DHS address the environmental and other health impacts of CS gas that’s been deployed - including transparent information sharing and direct environmental remediation.


As I write this Newsletter, spring has sprung, more people are getting vaccinated, and the sun is shining. I am experiencing some cautious optimism. But this is where it’s imperative that we don’t lose sight of the end game, and that we remain vigilant - Covid continues, and in fact cases have begun to creep up as people experience a false sense of security that we’re “out of the woods.” We are so close, but we are by no means at the finish line. I urge you to take advantage of being outdoors, gardening, exercising, walking with friends in a socially distanced and appropriate way. AND continue to wear masks, wash your hands, sanitize surfaces, and engage in the behaviors that, sadly, have become second nature to us over the past year.

There’s a lot going on, and as always I welcome your questions, ideas, thoughts and concerns. Happy spring!

In Good Health,

Sharon


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