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Despite widespread public support for the county’s proposed $25 million “sobering center,” powerful health care interests are raising concerns behind closed doors.
WW has obtained a letter drafted by six major Portland-area health care organizations, including all three major hospital systems, and CareOregon, the state’s largest Medicaid insurer. The April 2 letter says hospitals are the “optimal” place for police to drop off intoxicated Portlanders—in other words, not the new facility outlined by county officials in a plan that Multnomah County Chair Jessica Vega Pederson promised to “move swiftly” to implement earlier this week.
That plan, which was presented to the board last month by County Commissioner Julia Brim-Edwards, is to create a “24/7 First Responder Drop-Off Sobering Center,” a place that police can drop people off that’s not the jail and not the city’s overburdened emergency rooms. “Involuntary sobering services will be phased in,” Pederson said in a press release announcing the county already had a design firm working out the details of how to stand up the center.
The April 2 letter offers a similar vision to the county’s—but a completely different plan to achieve it. The county instead needs a “receiving center,” it says. “A hospital-based drop-off and receiving center is optimal given the need for assessment and triage” for people with serious medical needs, like psychosis, while the county’s new downtown homeless day center, the Behavioral Health Resource Center, could be refurbished to handle people who just need to sober up.
The “draft” unsigned letter lists seven organizations at the bottom: Health Share of Oregon, Oregon Health & Science University, CareOregon, Providence Health & Services, Central City Concern, Legacy Health and CODA.
WW first reported the letter’s existence Wednesday in a story on who’s meeting with first lady Aimee Kotek Wilson. As that story noted, the CEO of behavioral health at Providence has met with Kotek Wilson six times, though both parties deny that the sobering center was a topic of conversation.
WW reached out to all seven organizations for comment. Providence and CareOregon deferred to Health Share, which took credit for drafting the letter.
“Our goal in creating this document was to support ongoing capacity-building efforts by providing evidence-based analysis and recommendations based on considerations of both long-term efficacy and clinical safety. We have deep regard for the hard work being done by Multnomah County as well as Washington and Clackamas counties to address the overlapping crises of homelessness, mental illness and substance use and will continue to partner in support of these efforts,” said a spokesperson.
CCC’s CEO, Andy Mendenhall, issued a statement to WW attempting to have it both ways. “We absolutely support the recommendations contained in the letter. We also have deep regard for the work being led by Multnomah County and support their plan.”
OHSU disowned it. “The draft letter was not approved by OHSU, and therefore OHSU’s name should not have appeared on it,” a spokesperson said.
Why the letter was drafted in the first place remains unclear, but it indicated that hospital systems are using their clout to influence the county’s plan behind closed doors.
They have significant financial incentive to direct as many potential clients through the doors of their ERs. And this wouldn’t be the first time they’ve thwarted county efforts to stand up a sobering center.
A multiyear effort to build a sobering center ended last year with Legacy and Providence committing to build 17 new psychiatric beds—and the promised drop-off center was left by the wayside.
In a statement, Vega Pederson said her staff had met with Legacy Health, presumably to discuss the letter’s concerns. “Some of the concerns addressed in the letter make recommendations that we’ve already moved forward,” she said. “We will continue to engage with system partners and providers on this effort.”
Commissioner Brim-Edwards emphasized the letter wasn’t finalized. “It isn’t changing our focus and drive toward a solution,” she explained. “We all know that we need another option besides jail, emergency rooms or leaving people on the streets.”