November 20, 2019

The Multnomah County Auditor released a review Wednesday of County services for adults with serious and persistent mental illness. The audit focuses on two programs — Assertive Community Treatment (ACT) and Choice care coordination — created to support people with serious and persistent mental illness. 

Among the findings: 

  • More than half of people who are involved with the civil commitment system are not receiving the most intensive services the county offers. 

  •  Instead of funding the programs in each fiscal year for which state funds were disbursed, the Division reserved some of that money for future programs, such as housing developments.

Auditor Jennifer McGuirk will present her findings to the Board of Commissioners Dec. 3. 

Ebony Clarke, who was appointed Director on the Mental Health and Addiction Services Division last year, said she welcomed the review. [Read County leadership’s full response].

“I absolutely agree with the Auditor that for those who receive them, the County’s intensive services are working,” she said. “We also agree that there are too many people in our state and locally with serious and persistent mental illness who are not getting these services.”

Clarke was appointed interim director in August 2018, and named Director the following March, guiding the Division through a period of turnover and transition. She said McGuirk pointed to issues of transparency and access that Clarke has begun to address as part of a division-wide policy review process.

The audit found that the Division deferred some money intended to serve clients with immediate and severe mental health needs in order to increase long-term supportive housing for those same individuals.

“We have to balance two critical missions — serve people who need help right now and create a system that can help more people in the future. Because we know the need is only growing,” she said. “There is a lot we can’t control: the cost of housing, the influx of people, the competing demands in Salem. I’m focused on what we can control and what we can fix.”