Houselessness and Housing Insecurity
Updated: Apr 14, 2020
Fully operationalize the opportunities created under the 2015 Portland City Council State of Emergency Declaration to address the local homeless and affordable housing crisis.
My proposals and ideas focus on three key areas:
Prevent houselessness with new help to COVID-19 impacted renters and homeowners
Be a better partner with the Joint Office of Homeless Services (JOHS); Better address needs of houselessness as well as residents and businesses impacted by campers faster, with more useful and coordinated City government efforts.
1. Save Lives
Last year, 94 people died in Portland while houseless. This number rises every year.
a) Implement the Portland Street Response Pilot Program in Lents.
Proposed by City Commissioner Jo Ann Hardesty, and inspired by the City of Eugene's CAHOOTS (Crisis Assistance Helping Out on The Streets) program, the Portland Street Response program answers calls emergency dispatchers receive related to the houseless population and people dealing with mental health crises. It pairs a paramedic from the Fire Department with a trained crisis worker to respond to 911 calls about a person or people lying in the street, yelling in a park, or suspected of using drugs.
In recent years, more than half of the total arrests in the city have been of people experiencing houselessness. Many of these arrests are mandatory under current police policy--the officer on site is required to run warrants, and if anything comes back, they have to make an arrest. Many of the warrants are for minor infractions, like failure to appear and other issues that are inextricably bound up with the crisis of living outside. This is counterproductive in normal times, but during the coronavirus crisis, it is downright dangerous.
On a HIPPA-compliant basis, I propose that Street Response Pilot record-keeping be integrated with other community health care providers, homeless, mental health and substance treatment providers.
b) Reduce the number of deaths, injuries, and self-harm related to being houseless through earlier identification of individuals most in need of health services.
Multnomah County operates six primary health clinics, along with school-based clinics and other medical and mental health offices for Portland residents. The City of Portland operates 31 fire stations that also house Emergency Medical Services (EMS), grouped into four Battalion Districts. There are up to six hospital emergency rooms that serve Portlanders. A number of nonprofit and low-cost healthcare providers, like Portland Street Medicine, should be further integrated into this coordination group.
To better predict and track the healthcare needs of houseless clients and those at risk of becoming houseless, Portland Fire paramedics and Portland Street Response crisis workers should certify as medical providers with the Oregon Health Plan (OHP) and be HIPPA-compliant and use HIPPA e-healthcare record keeping system.
Obtain from OHP the authorization for Portland Fire paramedics and Portland Street Response crisis workers to sign up new patients and get reimbursed for eligible client services provided.
c) Expand Street Medicine Services, Look for Partnerships with OHSU Medical School
Emergency rooms are often overwhelmed, and due to a variety of barriers, many street houseless individuals are unable to access and navigate existing healthcare services. Since the mainstream healthcare system's traditional care models were not particularly sensitive or adaptable to a houseless person's unique realities of life, illness, and circumstance, houseless Portlanders are being effectively excluded from the care they desperately need.
According to the Street Medicine Institute, there are street medicine programs in over 85 cities across 15 countries on 5 continents. Portland Street Medicine has been in operation since 2016. It is a "coalition of volunteer medical providers, social workers, care managers, and laypeople dedicated to reaching our most forgotten citizens."
Clarify state law so that doctors or clinicians may prescribe and dispense medicines in a street medicine setting.
Due to the risk of lawsuits, street medicine services are limited to using only volunteer clinicians. To allow a mix of volunteers and paid staff, the State and County should provide risk mitigation options, for selected nonprofit medical providers like Portland Street Medicine, to allow them to use volunteer and paid clinicians.
d) Provide for More Treatment: Support the Drug Addiction Treatment and Recovery Act, statewide Initiative Petition 44 (IP44)
The war on drugs has failed.
Oregonians will vote on the Drug Addiction Treatment and Recovery Act in November. It sets Oregon on a public health approach to treating substance abuse.
Instead of arresting and jailing people for drugs, IP44 would begin using some existing marijuana tax money to pay for expanded addiction and recovery services, including supportive housing, to help people get their lives back on track.
The ballot measure doesn’t legalize any drugs. Rather, it removes criminal penalties for small amounts of personal possession of drugs and directs people to drug treatment and recovery services.
2. Prevent houselessness with new help to COVID-19 impacted renters and homeowners
To stop the local impacts of the COVID-19 pandemic, an Oregon statewide stay-at-home order (Update - March 24, 2020: Governor issued order) is needed, and the closure of non-essential businesses is required. Businesses and laid-off workers need quick assistance, including:
March 15, 2020: Buy time until any federal assistance is distributed, unemployment insurance kicks in, enact a moratorium on housing evictions (Update - March 17, 2020: County Chair issued order)
March 16, 2020: With applications and approval criteria, the State of Oregon should follow the state of Washington’s lead and eliminate the requirement to wait a week to file, and streamline red-tape.
March 26, 2020: Initial U.S. Senate proposal needed expanded COVID-19 federal assistance package including: Bigger direct cash payments to Americans; Expand unemployment and paid sick leave benefits; More aid for small businesses; Outlaw internet cutoffs; Keep utilities on. (Update – March 25, 2020: U.S. House and Senate agree on $2 trillion package that expanded benefits to individuals and small businesses).
March 28, 2020: Until any federal or state assistance kicks in for homeowner or any low-income landlords, enact mortgage deferrals for homeowners and small landlords. (Update - March 25, 2020: Included in proposal by The Interim Special Joint Committee on Coronavirus Response for consideration at a yet-to-be called Oregon state legislative special session.)
3. Be a better partner with the Joint Office of Homeless Services (JOHS); Better address needs of houselessness as well as residents and businesses impacted by campers faster, with more useful and coordinated City government efforts.
a. Create City Houseless Rapid Response and Planning Team (CHRRPT) “Chirp”
Hire a City homelessness service coordinator to work with city bureaus and JOHS who works with City Houseless Rapid Response and Planning Team. Staff liaisons assigned from each city council office, each bureau, and key homelessness advocates and service providers, and business district leaders.
Develop intra-bureau coordinated operational outreach and response team that meets at least weekly.
Hire a City houselessness services coordinator to work with the Joint Office of Homeless Services (JOHS).
Establish short-term and long-term action items prioritizing life and safety issues for those experiencing houselessness and those impacted by outdoor camping.
Weekly review and action assignments for responses to questions the city is responsible for addressing under the City/County partnership of the Office of Joint Homelessness Services, including calls to 211 or inquiries to 211info.org.
b. Houselessness prevention and recovery efforts should be culturally-competent and peer-led by people who have recovered from it.
Amplify and expand existing successful peer-to-peer approaches. The best person to empower someone to recover from homelessness is someone who has done it themselves, in Portland:
Develop a workforce training and skills development program for those who seek to recover from houselessness, to get trained and certified to help others do the same.
Develop the training and education career ladder for those practitioners in recovery to have the opportunity to become administrators, board members, and leaders of houseless recovery organizations.
c. Provide more neighborhood day labor opportunities in each area of the city for houseless individuals and those at risk of becoming houseless.
Portland has a long list of unaddressed climate actions. For example, the Environmental Protection Agency (EPA) provides a priority list of human health adaptation needs that often go unaddressed. Create a neighborhood-by-neighborhood list of preapproved climate action tasks that could be addressed with day labor. Provide people at risk of homelessness and those who are houseless a regular opportunity to get hired on a day-labor basis.
Help local nonprofits obtain funding for this program through the Portland Clean Energy Fund (PCEF).
d. Improve local services, identify service gaps or overlaps: Map current public and nonprofit efforts at preventing and addressing houselessness.
Current local homelessness efforts have grown organically over many years. Continue with current efforts but, for future years, map public, private, nonprofit, and philanthropic-funded services.
Compare current collective services against the Theory of Change model. Realign as necessary.
Make sure things work as we want. Learn what it’s like to try recovering from houselessness: Shadow prospective clients through existing processes.