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Commissioner Sharon Meieran Newsletter - February 2018

Dear friends,

Last week, we were reminded that winter isn’t done with Multnomah County yet... Although the snow was beautiful, it was also a stark reminder for me of what people without homes endure, especially when the weather is severe. A little over a year ago, we had a snow storm that truly pushed our resources, planning, and preparedness to the limit. This time around and with a year as county commissioner under my belt, I’ve been really proud to see how Multnomah County has learned from and improved our response to severe weather to help ensure that people are safe, warm, and sheltered.

During the recent snow storm and cold spell, Multnomah County declared severe weather over five days, almost doubling the number of severe weather days active this season. We started the week providing more than 300 beds working with our partner Transition Projects, and added 125 beds at a Multnomah County Department of Community Justice building that we'd readied in advance, as those initial beds filled. Overall, we provided a safe, warm place for 300 to 350 people, on average, to sleep each night, and community-led sites served a few hundred more people every night. Nearly 50 county employees stepped up and volunteered to work shifts at our warming shelters, and countless partners joined them around the clock to keep doors open for those who needed shelter. More than a dozen trained medical resource volunteers, including my husband, offered their time helping guests at the shelters. Dozens of community members also stepped up to volunteer their time. Meanwhile, providers said community members responded to our calls for essential winter gear with a surge in donations. We coordinated with 211 to connect people with transportation, and worked hard to hold to our values by ensuring that nobody would be turned away from shelter during severe weather.

As always, there is a lot happening at the county. This month, I want to share some things that really stuck with me as this month has flown by.

  • On the first day of February, I cosponsored a resolution passed by the Board encouraging the Legislature to continue to work towards universal access to health care for Oregon.  We heard from people about their personal experiences with the health care system - as patients, as business owners, and as health care providers. As I discussed in my last newsletter, we need to ensure that everyone has real, meaningful access to health care.         
  • I traveled to Salem during the opening days of the 2018 legislative session to testify in support of House Bill 4143, legislation brought forward by the Governor’s Opioid Epidemic Task Force. In Multnomah County, there are very few services and programs that have not been touched by the opioid epidemic. Our health clinics, public safety services, housing resources, and even our libraries are affected, as we’ve had to devote a larger and larger share of public resources to deal with the effects of opioid addiction, and as the demand for substance abuse treatment across the board -- from detox to residential -- far exceeds the availability of these services.
  • I hosted a community listening session that included showing a documentary focused on youth mental health. After the screening, members of our community engaged in discussions about their experiences and perceptions of our mental health system, and reported back on their vision for a better system.  I’m grateful for everyone who attended and told their personal stories, especially the youth who participated.  The feedback from this listening session will inform the mental health system analysis Human Services Research Institute (HSRI) is conducting for Multnomah County.  
  • The county made a tough decision to indefinitely suspend services at our largest shelter serving families while we work to assess the condition of the facility. Last year, the number of people served by the shelter more than tripled, and despite the County’s efforts to mitigate challenging conditions and capacity needs -- by increasing motel vouchers,  limiting the number of people who could stay at the facility each night, and by opening the Mitzvah House family shelter at Congregation Beth Israel -- we could no longer ensure that the facility was safe for the families staying there. Closing the family center was a heartbreaking decision because we know the need is so great. Fortunately, we were able to move families into motel rooms, so kids can stay connected to their schools and parents connected to services until they are able to move into homes of their own.
  • We proclaimed February as Black History and Black Future Month in Multnomah County, and the Multnomah County Employees of Color Employee Resource Group hosted speakers, performers, and community members with a celebration: Black History Month and 365 Days a Year: A Celebration of African American Achievement Everyday. We also proclaimed February 7th as National Black HIV/AIDS Awareness Day, and heard from an amazing panel about the progress we’ve made, and the health disparities African Americans still face.
  • I toured the Mid County Health Center, which does much of the county’s immigrant and refugee health work. It was incredible.  The clinic serves about 11,000 people, who can receive medical, dental, pharmacy, and behavioral health care all in one place.  Patients speak 81 distinct languages, and the clinic seeks to coordinate appointments with translators so everyone receives high quality health care.  The number of immigrants and refugees seeking care at the clinic has fallen significantly in the current political climate, reinforcing my commitment to continuing to fight to ensure that immigrants and refugees have safe access to medical care and support.  
  • The Board was briefed on the Native American Rehabilitation Association of the Northwest's (NARA) latest efforts, as well as how County funding has made an impact in the Native community and Multnomah County. Afterwards, we were honored with NARA blankets -- it was a special and moving experience.
  • The ordinance Commissioner Vega Pederson and I introduced to address pollution from wood fires took effect this month.  The winter burning season ends March 1, but starting October 1 and beyond look here for information about air quality and burning restrictions.  Under our ordinance, wood fires that aren’t for cooking are prohibited on the worst air quality days in the wintertime.  There are exceptions if a wood fire is your only source of heat, if you are low income, or if there is an emergency, such as a power outage.   

There is even more I could say, but this is a potpourri of the types of things I’ve been working on at the County.  As always, please don’t hesitate to contact my office with questions or ideas.  You can reach me by email at district1@multco.us or by phone at (503)988-5220. I always look forward to hearing from you!

In good health,

Sharon Meieran
Multnomah County District 1 Commissioner

Commissioner Sharon Meieran Newsletter - January 2018

Dear friends,

Last week, Oregon voters protected access to healthcare for thousands of Oregonians by adopting Measure 101. I strongly supported the measure, canvassed, rallied and am so glad voters passed it.   

Since the election, I’ve been reflecting on how important it is to ensure that everyone has health insurance and real, meaningful access to healthcare. If Measure 101 had failed last week, hundreds of thousands of Oregonians, including thousands of kids, would have faced uncertainty about whether they would have coverage if they became sick. They would be grappling with the reality that they might not be able to access potentially life-saving preventive care. They would have had to face impossible decisions about whether to pay for food, rent, or medications.

As an emergency physician, I cared for many newly insured patients after the Affordable Care Act took effect. The fact that newly insured patients were still coming to the ER first for routine care seemed to surprise many people, but as an ER doctor, I and many of my emergency medicine colleagues expected to see this from a systems standpoint - despite having insurance, this influx of patients coming to the ER still did not actually have connections with primary care providers or know how to use other resources available in a health care system. For example, I vividly recall seeing a woman with severe emphysema the day she received insurance. She did not need to be hospitalized, but she was chronically ill, her breathing troubles had been worsening for years, and she was finally was covered.  As a result, she knew she could go somewhere to seek the kind of care she had needed for a long time. I was able to connect her with primary care and a pulmonologist, and just wish our system could have allowed this to happen sooner, and without her having had to suffer for years and ultimately come to the ER.

Expansions in Medicaid eligibility have moved us closer to universal coverage, but there are still people in our community who are not connected to the coverage and care they need. In Multnomah County, about 16% of people seeking care at the county’s health clinics are uninsured. These individuals are still able to get care and help enrolling in coverage, and this percentage is much lower than it was before the Affordable Care Act (when about 31% of clients at County clinics were uninsured).  But clearly, 16% of people uninsured walking through the door is unacceptable from a humanitarian standpoint, and unsustainable from a financial standpoint.

That is why I’m championing a resolution for Board consideration this week supporting universal health care. Our Oregon Legislature has a history of working to improve healthcare access, including their work in 2014 to expand Medicaid eligibility, their work over several years to investigate financing options to improve coverage and access, and passage of two strong measures in 2017 to ensure comprehensive coverage for kids and reproductive health coverage regardless of immigration status.  Currently, the Legislature’s Universal Access to Health Care Work Group is meeting with a directive to develop a set of recommendations to the Legislature to guide consideration of approaches that would achieve “universal access to an adequate level of high quality health care at an affordable cost.”  

The resolution before the Board this week supports this progress by thanking the Oregon Legislature for its work toward universal health care and urging the Governor and Legislature to continue working to develop a comprehensive, equitable, and high quality system of health care that is accessible to all.  If you’re interested in hearing more about this topic, you can join the Board meeting tomorrow, Thursday, February 1, at 9:30 a.m.at the Multnomah County Building at 501 SE Hawthorne Blvd., or watch live or recorded here

Finally, please remember to RSVP if you’re interested in attending the second community mental health listening session coming up on Tuesday, February 6, at 6 p.m.!  At this event, we will screen the documentary film Not Broken, which is a powerful film focusing on the stories of youth with lived experience of mental illness, as well as listen to community members’ experiences of the current mental health system and their vision for a better system.  Seating is limited, so please RSVP by tomorrow, Thursday, February 1, to reserve your seat.

Whether it’s at the community listening session, at our board meeting supporting universal access to health care, or in the community, I hope to see or hear from you soon!  

In good health,

Sharon Meieran
Multnomah County District 1 Commissioner

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