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Commissioner Sharon Meieran Newsletter - June 2020

Dear friends,

There has been so much happening over the past month that it is hard to reconcile it in my own mind, let alone in a Newsletter. But all that has happened has been foundational to the work we do at Multnomah County, and so I will do my best to describe what has been going on, along with the County’s response. 

I dedicated my April Newsletter to COVID-19, and in May I discussed budget priorities at the County in light of COVID. These were huge issues.  But since I last wrote, we have collectively witnessed the horrific murder of George Floyd by a police officer; the trauma, outrage, grief and protests resulting from the murder; and the hope that  finally we will have the collective will locally and nationally to enact the broad, bold, meaningful systemic change that is called for after centuries of structural racism, inequity and injustice. The COVID pandemic has highlighted and exacerbated the deep racial gaps and injustices that have always existed. The murder of George Floyd by a police officer, and the outrage and protests spawned by his murder, have turned a moment of tragedy, horror and grief into a collective movement that in particular demands deep reforms of our public safety systems. 

Public safety reform is not a new idea for Multnomah County.  For several years the County has moved toward a more upstream and humane approach to community justice by decreasing the number of people in jail, while investing in preventive approaches such as diversion and substance use disorder treatment. The County’s Fiscal Year 2021 budget accelerates reform through a significant set of cuts and reinvestments, including:

  • Closing a jail dorm (in addition to the two that had been closed in 2016 and 2017).

  • Shrinking the staff for booking functions at the jail.

  • Cutting staff from the District Attorney’s Misdemeanor Unit.

  • Ending the County’s subsidy for school resource officers in Multnomah County.

  • Cutting the exploitative and extractive fees we charge adults who are serving parole and probation in the community, and covering the cost of these fees with savings from public safety cuts.

  • Adding a Schools Unifying Neighborhoods (SUN) site to KairosPDX elementary school, a culturally responsive school of majority Black students and educators in North Portland.

  • Expanding Legal Services Day, which gives people a chance to clear their court records of fines and fees.

  • Investing in providing culturally-specific mobile behavioral health and peer support for people leaving prison or jail, as well as expanding Flip the Script, a culturally-specific program to help people who are leaving incarceration.

  • Restoring funding for the Healthy Birth Initiative, which supports African American pregnant women.

  • Funding the Youth Opportunity and Workforce Development Program, which provides job training and placement, especially for youth who come from underserved and marginalized communities.

  • Expanding Racial and Ethnic Approaches to Community Health (REACH), which seeks to improve health equity for the African American community in Multnomah County.

But these budget changes we adopted in the short-term are only the beginning, and much broader transformational work is needed, with a focus on accountability and outcomes for all of our systems and services to ensure they are effectively serving Black, Indigenous and other People of Color. This work has already begun and will be continuing. I would really like to hear your ideas, awareness of other systems that have done things that have/have not worked, and concerns.

In addition to these changes specific to community safety, our budget included nearly $90 million for our COVID response.  Highlights include:

  • Accounting for federal and state resources, including from the federal CARES Act.  

  • Investments in public health, including investments in contact tracing, community testing, isolation and quarantine monitoring, and culturally-specific outreach.

  • Resources for community-based behavioral health providers to help people experiencing isolation or anxiety due to COVID.

  • Funding to help the most vulnerable in our community, including physically-distanced shelter and motel space, rent assistance, food access, and protective services for elders and people with disabilities.  

Finally, I hope you are aware of the statewide mask requirement that goes into effect tomorrow, July 1. I have called for this common-sense measure that can decrease transmission of COVID for quite some time. I hope everyone follows this guidance in time to stave off a potential devastating surge in COVID cases. 

As we begin the Summer of COVID, I hope you stay healthy and safe. As always, I welcome hearing from you, although for the moment I ask for your patience as I strive to respond. My office has been overwhelmed by email and voice mails over the past several weeks as we have received tremendous outreach about the budget, George Floyd’s death, COVID, and many other issues.  My staff and I seek to identify time-sensitive emails quickly, and we will always get back to you as soon as possible.   

In good health,

Sharon


Commissioner Sharon Meieran Newsletter - May 2020

Dear friends,

First, I am very excited to announce that, on May 19, I was re-elected to a second term as Multnomah County Commissioner for District 1! My fellow Commissioners Jessica Vega Pedersen (District 3) and Lori Stegmann (District 4) were also elected to second terms. As I have often remarked, I am fortunate to serve with an incredible group of women, and I could not be more honored to have earned the support of so many and to have the privilege of continuing to serve with this Board. 

But that was already last week… It is now late May, and it has been more than two months since COVID-19 required us all to make dramatic shifts to keep ourselves, our families, and our community safe.  In some ways, time has sped up for me over the past two months.  Multnomah County has rushed to set up new ways to help people struggling, and I have worked to be an effective advocate for wise policies during this tough time.  And in other ways, I feel like time has slowed way down as I stay at home, my hair grows ever longer, and otherwise things look pretty much the same day after day.  

As we move toward reopening Multnomah County, I wanted to share some of my COVID-related priorities and updates on reopening, as well as information about the County’s budget process. In an effort to streamline my Newsletter, I am trying out a new format, sort of a “Table of Contents” approach. You can read everything by going to the first link below, or skip to areas of interest using the individual links:

Covid 19 Updates and Priorities

Reopening

Wear a face covering!

Protect our older adults

Personal Protective Equipment (PPE)

Multnomah County’s Budget

I am looking forward to co-convening a virtual town hall about COVID-19 especially for small businesses with State Representative Akasha Lawrence Spence on Thursday, June 4, from 4 - 5:30 p.m.  Like all of us, small business owners are struggling right now, and we would love to see you there to hear about your most pressing needs, and to describe some of the resources that are available to you. You must register to join.  Sign up here.   

As you know by now, I love hearing from you. Not surprisingly, I have received more communications over the past couple of months than ever before. Please continue to stay in touch to let me know about your experiences, any questions you may have, or any concerns or ideas. And please share your opinion on the new Newsletter format! 

In good health,

Sharon

COVID-19 Updates & Priorities

I know reopening continues to be the top of mind for many of us.  Multnomah County is making progress toward metrics required to be able to reopen safely.  I also wanted to highlight my current COVID-related priorities, including universal mask-wearing policies, strategies to protect frail seniors, and some progress on personal protective equipment (PPE).  

Reopening

As I discussed in my April newsletter, Governor Brown outlined a phased approach to reopening Oregon’s communities and economy to allow individual counties to begin reopening if they meet specific health and safety criteria.  Multnomah County is uniquely complex in terms of the considerations we need to take into account and the risks we face.  We are all anxious to begin to open our economy, and at the same time we need to ensure we can respond quickly if we see a resurgence in the virus.  Earlier this month, Multnomah County published a dashboard showing our progress toward meeting the prerequisites for the reopening phases.  The County updates the dashboard each Wednesday by 5 p.m. 

As of today, Multnomah County has not applied to the State for reopening. However, we have been actively working on our strategy for reopening, and during a Board briefing yesterday, we discussed our approach and began to discuss the timing of filing our application with the state.  Our tentative plan is to apply during the first week in June and tentatively target June 12 for the County to enter Phase 1 of reopening.  This timeline is subject to additional refinement based on the current situation and on the metrics included in the dashboard. This article discusses the timeline and risks in more detail.   

Wear a Mask! (Or a face covering.)  

Covid-19 spreads through large or small droplets expelled when an infected person coughs, sneezes, or even talks.  As we move toward reopening and begin resuming some normal activities, we are fortunate that there is one simple tool available to effectively slow the spread of COVID19: Face coverings. 

Face coverings are physical barriers that block the large or small virus-containing droplets expelled by the covered person when they talk, sing, sneeze or cough. If any droplets do make it through this barrier, a potential “recipient” further blocks the incoming virus-containing droplets with their own face covering . Almost any face covering will block virus-containing droplets, but the tighter the weave and the more layers of material used, the less chance there will be for droplets to get through the barrier. Two face-covered people have an especially low chance of transmitting the virus to one another, and therefore I believe state or county governments should require face coverings in any setting where people from different households will be interacting indoors.  

I am concerned about the potential for disparate enforcement, or other forms of discrimination, related to the use of face coverings by communities of color. In addition, people with certain disabilities may not be able to wear face coverings, or may be unable to communicate if others around them have their faces covered. And many people may not be able to afford masks or other facial coverings. For these reasons, any approach must take these and other special considerations into account, and include outreach to members from affected communities to develop a plan to mitigate any potential negative impact. 

So far, we have not required people to wear masks indoors in Oregon or in Multnomah County.  We are the only large city or county on the West Coast that does not require masks or other face coverings.  As part of our reopening discussions, I am advocating that we take this important step by issuing a public health directive that all people wear face coverings in indoor public venues, with the special considerations described above.  This will slow the spread of the coronavirus in our community as we reopen. 

Protecting Frail Seniors

Up to 60% of all COVID-19 deaths in Oregon have been in nursing homes. But the State has not yet taken the step of requiring nursing homes to universally test all residents and staff, whether or not someone has symptoms, or otherwise develop a comprehensive strategy to ensure older adults are cared for appropriately.  We know that at least some people who have COVID-19 are asymptomatic spreaders, which is especially dangerous in a nursing home where the population is incredibly vulnerable.  Further, the State continues to release data that obscures the scope of outbreaks within nursing homes.  It is horrifying to me that we are over two months into this crisis and have not yet addressed this situation.  I am advocating for action in this area, including advocating for the Multnomah County Commission as a Board to send a letter requesting that Governor Brown take meaningful action in this area, and I encourage you to contact Governor Brown to do the same. Our individual advocacy can make a difference!

Personal Protective Equipment (PPE)

Finally there is some positive news on the PPE front!  For months I, along with fellow front line providers, particularly my emergency physician colleagues and the Oregon Nurses Association, have called out the need for front line healthcare workers to have adequate PPE so they can be safe. And for months there has remained a discrepancy between what hospitals are saying they have and what healthcare workers actually experience. Our efforts to reopen and resume nonessential healthcare procedures highlights this disconnect, as does the County’s requirement that hospital attest to the fact that they have sufficient PPE.  Many hospitals have attested that they have sufficient supplies of PPE, yet still front line healthcare workers in many hospitals across the state have experienced a glaring lack of protective equipment. 

After months of advocacy, and often feeling like our voices have been dismissed, the Oregon Health Authority has announced that it will adopt the process I have recommended since this crisis began: Convene a group of front line healthcare providers and hospital representatives, and develop a statewide standard for what constitutes appropriate PPE in specific scenarios (i.e., in an emergent crisis, during Phase 1 of recovery as important non-essential procedures begin, etc.). Then coordinate among hospitals so there is consistency in application of the standards. Then develop a meaningful metric that can be measured to ensure hospitals are all meeting this standard. I do not know why this took over two months to do, being a relatively straightforward process and with so much at stake, but I am glad the state is finally implementing these suggestions. 

Multnomah County’s Budget

The County’s fiscal year 2021 budget process is underway, albeit with modifications due to COVID-19.  We have currently delayed our schedule to adopt a budget by about three weeks, and we are holding virtual, rather than in-person, budget work sessions and public hearings.  

In addition to process issues, balancing a budget in the midst of an economic and public health crisis is incredibly challenging because the basics of the budget are so different than during “normal” times.  The economic fallout from COVID-19, along with the County’s public health response, created a massive $58 million hole in the budget.  Further, even though the County is the Local Public Health Authority and has stood up the local response to the public health crisis, and has a larger population than Portland, the City of Portland received the vast majority of federal CARES Act funding (about $114 million, to the County’s estimated $28 million) because of an unfortunate quirk in the federal law.  And finally, last week the State Economist released a grim State budget forecast that will likely mean additional budget reductions here in Multnomah County.

To learn more about the County’s budget, I encourage you to view the May 12 Budget Kickoff and County General Fund Forecast presentation by the County’s Interim Budget Director, Christian Elkin, and Economist, Jeff Renfro.  If you have ideas or thoughts for the Board to consider, please contact us.  We are working toward adopting a final budget on June 11.


Commissioner Sharon Meieran Newsletter - April 2020

Dear friends and neighbors,

It’s hard to believe another month has passed in “Coronavirus Time.” Though much feels the same each day as we are trying to physically distance and stay home, there has actually been a lot going on. I want to take the opportunity here to talk about two things that have been at the forefront of my mind: “reopening” and mental health.

Thoughts on reopening

People are struggling in so many ways as a result of the COVID-19 pandemic, including dealing with the loss and illness of loved ones, the loss of livelihood, and a great deal of stress and uncertainty. A number of counties with smaller populations have already submitted plans to the state for reopening, and Multnomah County is in the process of developing our approach. I appreciate that there is no statewide directive for when and how counties or regions should reopen, because Oregon counties are so diverse and have such different populations and needs. Multnomah County’s plan will necessarily take more time to develop - we have the largest population, largest concentration of vulnerable people, largest number of small businesses, and the highest proportion of hospitals in the state. We have a lot to lose from opening up too much, too soon. Yet it’s also true that we have a lot to lose from unnecessary delay. 

As we move forward, we must be intentional, forward-thinking and proactive. As I learn more about best practices, I am strongly guided by Johns Hopkins Center for Health Security - Public Health Principles for a Phased Reopening During Covid-19: Guidance for Governors. Although directed toward governors, the principles set forth in the article apply to government at all levels. Easing physical distancing measures and reopening to any degree will increase the risk of COVID-19 transmission. There is no way to avoid this. So it is essential that we carefully assess the risks and consequences for each of the decisions we make, along with opportunities for mitigating negative impacts, as we grapple with some of the challenging choices we will face. Most importantly, all of our decisions MUST be based on science, data and a set of clear values that we can apply in an ongoing and consistent way, because our approach to reopening will not be a “one and done” plan. 

There is a quote in the Johns Hopkins guidance that really resonates for me: 

“The desire to get back to normal as soon as possible is a common reaction in a catastrophic context and it is an impulse worth restraining: Governors, mayors, and county executives governing during disasters know the tensions in wanting a swift return to business-as-usual versus aspiring toward greater community safety, equity, and quality of life. The pandemic—which has revealed deficiencies, for instance, in healthcare delivery, the social safety net, and workplace leave policies—represents an opportunity for visionary leadership, goal setting, and transformation.” 

We cannot -- and should not -- ignore the massive inequities and injustices that this pandemic has highlighted and in fact exacerbated in favor of returning to “normal” as quickly as possible. We have an opportunity to reopen in a way that doesn’t worsen risk, perpetuate harm, and in fact has the potential to catalyze opportunities for greater community safety, equity and quality of life. We need to do this right. 

Mental Health and Substance Use Challenges During COVID-19

We’re all facing challenges right now, and these times are especially and uniquely difficult for our friends, neighbors, and community members who live with substance use and/or mental health disorders. May is Mental Health Month. I always look forward to this month as an opportunity to reflect on improving mental health services, building awareness, and eliminating stigma. This May it feels essential to me that our observation highlights and addresses some of the mental health-specific challenges posed by COVID-19.

Many, if not most, of us feel some level of fear, sadness, grief, and/or anxiety right now. For individuals with underlying mental health challenges or a substance use disorder, this pandemic may exacerbate symptoms, impact coping strategies, and interrupt regular sources of support (especially in-person support, such as meetings or groups). And for older adults and young people, this time may be especially trying. Older adults may be feeling particularly isolated and lonely as they are encouraged to stay home and maintain physical distance from others. And many youth are facing brand new challenges without school, sports and other activities that provide independence, an outlet for feelings, and a source of connection. The following are some great resources for elders and for youth:

For older adults:

For youth: 

And for all of us:

I will be hosting a Virtual Town Hall exclusively focusing on Mental Health, Wellness & COVID with Multnomah County’s Behavioral Health Division and other panelists on Tuesday, May 12, from 4 - 5:30 p.m.  Save the date and stay tuned for details!

And don’t forget to tune in to my COVID-19 Virtual Town Hall with U.S. Representative Earl Blumenauer and State Senator Ginny Burdick this Saturday at 11 a.m.  You can watch here and submit a question here.  I hope to “see” you there!

As always, please reach out to me with your ideas and thoughts.  I would especially love to hear about the resources you are relying on for resiliency during this time.  My email address is District1@multco.us

In good health,

Sharon


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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