By Maxine Bernstein
oregonlive.com
MULTNOMAH COUNTY, Ore. — Multnomah County’s chair on Thursday made a slight concession to criticism she faced for not previously proposing any money to support an around-the-clock, drop-off sobering center in Portland from the county’s millions of dollars in unanticipated tax revenue.
Chair Jessica Vega Pederson offered $150,000 from a $62 million pot to help study and design a future sobering center.
The small amount comes four years after the city’s only sobering center closed abruptly in 2019, and follows years of deep, similar study by a broad coalition of community leaders, medical care providers, public safety officials and peer support specialists that was largely discarded.
The chair also added eight sobering beds at a planned subacute stabilization center that would also provide walk-in services, eight shelter beds, intensive outpatient treatment and drug withdrawal management services, according to her policy advisor April Rohman. Where that center will be or when it would openhas not been determined.
Vega Pederson asked Commissioner Julia Brim-Edwards to lead a committee to come up with a design and plan for a sobering center and return to the county board by March 1, with the anticipation of setting aside additional money for such a center in the 2024-2025 fiscal year budget.
“Four years is a long time, too long as many of our community members know,” for the city and county to have gone without a drop-off sobering center since the closure of Central City Concern’s Sobering Center, Brim-Edwards said.
Central City Concern’s sobering center suddenly shut down in December 2019 following dozens of accounts of people harming themselves in isolation cells. The closure came amid a growing need to help those struggling from a mix of alcohol, drug and mental health issues.
The county chair’s package of spending, which was approved in a 4-1 vote, sets aside about $7 million for the subacute stabilization center that would also include eight sobering beds; the $150,000 to plan for an around-the-clock sobering center and $6.5 million in recovery housing for people suffering from mental illness and substance abuse.
Before the vote, commissioners heard from local residents and social service providers who urged the board to fund and launch an around-the-clock emergency sobering center as quickly as possible for people suffering from drug and alcohol intoxication or mental psychosis.
David Dixon, co-chair of Portland’s Downtown Neighborhood Association’s homeless-houseless team, said the association supported a much more “significant investment in the county’s grossly inadequate sobering and detox facilities.”
Jon Isaacs, vice president of public affairs for Portland Metro Chamber, said “We are perplexed as to why the stabilization center will not roll out 24/7 first responder drop-off services.” He said such a center is critical for the city’s recovery.
Erica Gustavson, a Portland mom and owner of a hair salon in Northeast Portland, urged the county board to help those in crisis who are “literally dying on the streets,” and provide a location for first responders to take people who are suffering from serious drug, alcohol or mental health problems.
“We need to get back to drop-off detox to truly make a difference on the streets to immediately help someone in crisis,” she said.
Old Town resident Aaliyah Mays put it bluntly: “How are we in this three years later and there are no emergency detox centers?”
Commissioner Sharon Meieran finally pressed the county chair: “Are we investing in a sobering center where people might be dropped off to sleep it off, where they can be safe, a facility that’s not an ER ?”
The immediate answer: No.
Vega Pederson told The Oregonian/OregonLive that she believes hospital investments in sobering beds will provide a “higher level” of medical care to help meet the more acute needs of people suffering from significant use of multiple drugs, alcohol and mental illness.
The eight sobering beds inside a future stabilization center would be in addition to the 17 sobering beds that Unity Center for Behavioral Health and Providence Portland Medical Center have agreed to provide by either this fall or next spring, Rohman said.
“Acknowledging some of the challenges with operating a large-scale sobering center,” an executive committee of hospital, mental health care, coordinate health care and addiction providers “decided to focus on smaller programs across multiple sites with a stabilization center as their hub,” Rohman said.
Meieran voted against the spending package, saying it reflected a patchwork of steps that weren’t coordinated and appeared to be politically expedient.
An emergency department physician, Meieran said the intent of the initial city-led coalition of at least 80 organizations who brainstormed a replacement for Central City Concern’s Sobering Center was to deter people from ending up in overcrowded emergency departments.
The coalition called itself the Behavioral Health Emergency Coordination Network — or BHECN — and met regularly since 2020 until it disbanded late last year. It had proposed a one-stop, drop-off, triage, stabilization and referral center where first-responders can take people who are suffering from drug abuse, alcohol intoxication and mental illness on the city streets.
An executive committee of the network continued to meet until earlier this week, when it announced it was ending its work.
People who are in need of immediate medical care or are in danger of dying should be taken to an emergency department, Meieran said.
“But there are ways to approach sobering from methamphetamine, sobering from fentanyl use, sobering from the combination of all these drugs that can be achieved in centers that are not emergency departments,” Meireran said. “That was the intention of BHECN.”
Saying she was “flabbergasted” by the chair’s approach, Meieran attempted to offer a counter proposal, but as she pulled up a flow-chart with her ideas on how people can be moved from the streets to shelter and ultimately housing, the county chair told her that Thursday’s meeting wasn’t the time for that.
Meieran, though, said she would have supported a substantial investment for a true around-the-clock, drop-off sobering center where first responders could take people suffering from drug psychosis or alcohol intoxication, plus money for recovery-oriented, long-term transitional housing. She has pushed for turning the Crowne Plaza Hotel in Northeast Portland, located close to Unity Center, into a recovery-based transitional housing hub where people leaving an emergency department, sobering center or jail could then go for continued care and treatment.
Brim-Edwards said she plans to work with each commissioner, including Meireran and her “deep expertise,” as well as city and public safety officials to come up with a plan for funding a true around-the-clock drop-off sobering center in the next year’s budget.
“I think it’s really important that we bring in first responders so that we hear exactly what they need,” she said, adding that she doesn’t want people waiting for hours in a hospital emergency department or in jail if they can be taken elsewhere to come down from their drug-induced high or alcohol intoxication.
Commissioner Susheela Jayapal approved the proposed spending but said she wasn’t comfortable with how it was assembled, describing it as a “package that feels cobbled together..without a through-line that links the individual investments.” She also made it clear she recognizes that more sobering beds are essential from a public safety response.
“I would hope and expect to see the city partnering with us to make its own much more substantial investment in that category,” she said.
The city has set aside $1.9 million in the Police Bureau’s budget for behavioral health emergency stabilization, according to Cody Bowman, a city spokesperson.
Kevin Dahlgren, who has done homeless outreach in the county for three decades, said police, firefighters and paramedics have more contact with people suffering on the city’s streets than anyone else.
“A drop off center would help our most vulnerable receive the care they need. They will get stabilized and with the right support and guidance can connect to other services on the road to full recovery,” he said.
He called it “something that is needed if we want to end this humanitarian crisis.”
Steve Herring, the chief executive officer of Living Room Theaters in downtown Portland, said the spending investments chosen by the county deny Oregonians “basic health services in the form of substance use detox and addiction treatment services.’’
He told the board he wore a shirt that read, “Mission Impossible,” to the meeting for a reason.
“It’s not just the title of a Tom Cruise movie, ‘Mission Impossible, Dead Reckoning,’ ‘’ he said. “That’s where we are today as a result of dysfunction across all levels of government.”
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