Mental Health Association of Portland

On January 22, 2012, Will Hall, founder of Portland Hearing Voices, trained 7 new facilitators to lead Portland Hearing Voices groups. Portland Hearing Voices support group has had more than 250 people involved since its founding, with visitors and regular participants learning about new ways to understand and support each other around extreme states such as voices, mania, paranoia, and usual beliefs. It is the only group of its kind in the area and one of just a few on the west coast. Groups have been held every twice a month for over a year and will now move to every week, at the same time and place:

Every Tuesday, 6:00-7:30pm, at Empowerment Initiatives, 3941 SE Hawthorne

The new format for the group has 2 facilitators, with Will Hall sometimes present for backup. All of the new facilitators have attended the support group and identify with having experienced voices, visions, and/or extreme states of consciousness. Some have facilitated groups before. Hall’s next step is to expand the regional Hearing Voices network to other locations in and around Portland. Eventually he hopes to expand this network regionally to the rest of Oregon, Washington and California.

Hall trained the new facilitators in basics such as the goals of the groups and essential structures. The training also covered how to handle challenging and triggering situations. After teaching the basics, Hall encouraged new facilitators to find what works for them as group leaders and to experiment with new forms while keeping the essentials. Each new facilitator has a unique story and background, so there is a diversity of style, knowledge and experience that is now coloring the Portland Hearing Voices community. The new skills and energies are sure to keep PHV inspiring, strong and ever evolving.

“Participating in the facilitator training reinforced for me the importance of witnessing experience in building community. I value the effects of being seen and heard. I left the training feeling like a completely different person,” said one participant in the training.

Check their website portlandhearingvoices.net for news and updates on future groups. Portland Hearing Voices is open to all experiencers. Family members and friends are invited to the Mental Diversity Meetup (see the PHV website for details).

Emily E. Smith, The Oregonian, Wednesday, January 25, 2012

Washington County District Attorney Bob Hermann and defense attorney Robert Axford have responded to the state bar regarding ethics complaints, which say they sent a man to the state hospital on a legally invalid order.

Responding to the complaints filed last month by retired Lane County Judge Jim Hargreaves, the attorneys defended their work in the aggravated murder case of Donn Thomas Spinosa.

Judge Thomas Kohl signed an order for a “mental illness magistrate hold” in October last year, supposedly sending Spinosa, 58, to the state hospital indefinitely.

Twice accused in his ex-wife’s 1997 killing, Spinosa has never been found mentally fit to stand trial. Doctors have found Spinosa, diagnosed with schizophrenia, unable to care for himself and dangerous to others.

Hargreaves said in his complaint the law does not allow for the magistrate hold.

“Such an order is entirely without legal foundation in Oregon and stripped Mr. Spinosa of all his rights and protections,” Hargreaves wrote in the complaint.

Hargreaves also filed a complaint last month with the Commission on Judicial Fitness and Disability against Kohl.

Read – Previous coverage from the Oregonian
Read – Jim Hargreaves’ complaint
Read – Bob Hermann’s response
Read – Robert Axford’s response

Hermann and Axford both told the state bar they believed the order was valid and did not intentionally violate the law.

In a letter to the state bar Friday, Hermann said, “Quite simply I vigorously deny I was involved in taking a position that was frivolous; that I deceived the tribunal (judge) by not disclosing contrary legal authority; that my actions were prejudicial to the administration of justice; or that I assisted a judge in violating the law.”

Before the order was signed, Hermann told Kohl a permanent magistrate hold was necessary because of the civil commitment process was not enough to keep Spinosa in custody.

In his response to the state bar, Hermann says he received a letter from the state hospital on Aug. 26, 2010, saying Spinosa’s civil commitment would not be renewed and he had “reached maximum benefit of treatment in the hospital and is ready to be discharged.”

In anticipation of Spinosa’s discharge, he said, Hermann refiled charges of aggravated murder, for which there is no statute of limitations. Detectives arrested Spinosa on Oct. 1, 2010, the day his civil commitment expired, Hermann wrote.

Hermann explained to the state bar that he first heard of a magistrate mental illness hold “as a viable legal option” at a Pacific University forum on mental health issues in October last year. Days later, Axford pitched the idea of such an order to resolve Spinosa’s case, Hermann wrote.

“Mr. Axford further advised the parties, I believe on the record, that the mental health staff ‘expert’ in his office had been exploring the concept of the magistrate hold and had even run it by some judges who thought it was a legitimate option,” Hermann wrote.

In Axford’s Jan. 6 response to the state bar, he says fought to protect Spinosa from future reindictment.

“The gravamen of the dispute, I believe, is that I somehow restricted Mr. Spinosa’s liberty interests when my intent was to protect him from future harm that would come if the process were to be repeated.”

Dismissing the aggravated murder charge was the main goal for the defense “to protect Mr. Spinosa from a potential death sentence,” Axford wrote.

He hoped to return Spinosa to the state hospital, he said, where the symptoms of his mental illness seemed to improve.

“To see Mr. Spinosa decompensate in the jail like I did was heartbreaking,” Axford wrote. “He wasn’t eating regularly, lost a lot of weight, rarely showered or brushed his teeth; he wasn’t taking any medications and was essentially being stored in a one-man cell for virtually the whole time.”

The Client Assistance Office of the State Bar conducts an initial review of all complaints. On Wednesday, the State Bar notified Hermann and Axford that the CAO found “sufficient evidence to support a reasonable belief that misconduct may have occurred” and referred the matter to Disciplinary Counsel’s Office for further investigation.

Police kill man, shoppers delayed, from KGW.com, 1/25/2012

Man killed in officer-involved shooting had fake gun, from KPTV.com, 1/25/2012

Man killed in Portland police shooting pointed replica handgun at officers, KOIN.com, 1/25/2012

Man shot by officers on downtown garage had fake gun, KATU.com, 1/25/2012

Police Shoot At Man Atop Downtown Parking Garage, Portland Mercury, 1/25/2012

Police: Man Shot by Officers Had Replica Handgun, Mentioned “Suicide By Cop”, Portland Mercury, 1/25/2012

At least four arrested as Occupy Portland demonstration takes to streets, Oregonian, 1/25/2012

Man killed in confrontation with Portland police, AP.com, 1/25/2012

Police Confrontation Ends In Death Of Portland Man, OPB.org, 1/25/2012

Oregon gunman killed in standoff, UPI.com, 1/25/2012

Portland Police Shoot At Suicidal Man, KXL.com, 1/25/2012

Man shot by police had a fake handgun, Portland Tribune, 1/25/2012

Portland police fatally shoot Brad Lee Morgan after he points what looks like a handgun at officers, Oregonian, 1/25/2015

A Portland police sergeant and an officer early Wednesday fatally shot a 21-year-old man who had called 9-1-1 saying he had committed a robbery at knifepoint and threatened to jump off the top of a downtown parking garage.

Police checked two downtown parking garages as an emergency dispatcher stayed on the phone, talking to the man. When the dispatcher asked if he had a gun, he said “possibly.” The dispatcher notified officers trying to locate the man that the caller was making “suicide by cop” statements, police said.

An officer and sergeant drove to the rooftop level of a nine-story SmartPark garage at Southwest Fourth Avenue and Morrison Street. About 3:35 a.m., they spotted the man, who had climbed onto the top of an elevator shaft on the southwest corner of the garage. He reportedly told a dispatcher that police had found him but he wasn’t going to go with them, police said.

Time line of recent police-caused death incidents

• June 30, 2011: Central Precinct Officer Dane Reister mistakenly fired four live rounds at William Monroe from a less-lethal shotgun, striking him in the hip with five buckshot pellets.
• June 8, 2011: U.S. Justice Department launches an investigation to see if Portland police have used excessive force, particularly against people with mental illness, following a spike in police shootings the past 18 months.
• Jan. 2, 2011: Officers Larry Wingfield and Jason Lile fired 12 gunshots at Thomas Higginbotham when they say the homeless man inside an abandoned Southeast Portland car wash walked toward them holding a knife with an 8-inch blade. Higginbotham, 67, was struck 10 times and died from wounds to the chest and abdomen.
• May 12, 2010: Officers James Defrain, Cody Berne and Andrew Polas fired at Keaton Dupree Otis, 25, who died in his car after he shot and wounded Officer Christopher Burley during a traffic stop near Lloyd Center.
• March 22, 2010: Officer Jason Walters shot Jack Dale Collins four times as he emerged from a restroom at Washington Park’s Hoyt Arboretum with blood on his face and advanced toward the officer with a razor-type blade.
• Jan. 29, 2010: Officer Ron Frashour shoots Aaron M. Campbell, 25, in the back and kills him in the parking lot of the Sandy Terrace Apartments in Northeast Portland.

At 3:47 a.m, the officers called for Project Respond crisis workers and, four minutes later, police asked for members of the bureau’s Crisis Negotiation Team to respond and help talk the man down.

As police waited for them and additional officers to arrive, an officer started talking with the man.

About 4:01 a.m., an officer and sergeant fired multiple shots at the 21-year-old when he reached into his pocket and pointed what looked like a gun at them, police said. The man dropped out of sight below a ledge of the elevator shaft.

Officers from the Special Emergency Reaction Team, a tactical unit of officers, were called to approach the man because police on the roof did not know if he was wounded or simply hiding behind the wall “lying in wait,” Sgt. Pete Simpson said.

The tactical unit moved in, using a fire ladder to reach the top of the elevated elevator shaft, and found the man slumped in the northwest corner of the raised elevator shaft. He was dead. A black handgun that police later determined was a replica firearm was found beside him.

The man shot has been identified as Brad Lee Morgan, of Portland. He had a prior burglary conviction and had threatened suicide in the past during a domestic and child custody dispute, according to court records.

Earlier this month, Morgan had pleaded guilty to first-degree burglary and sentenced to 36 months of probation. On Jan. 17, he was booked into the Justice Center jail and released, accused of tampering with a witness. He was accused of preventing the mother of his child from calling 9-1-1 on Dec. 16, court records show. She had obtained a restraining order against him.

During today’s investigation, police recovered a bullet from an office on the 14th floor of a nearby building at 888 Southwest Fifth Avenue, and another that a pedestrian found in a crosswalk at Southwest Fifth Avenue and Yamhill.

Police did not say how many shots the officer and sergeant fired.

Mayor Sam Adams, who serves as police commissioner, Chief Mike Reese and his two lieutenants, Assistant Chiefs Larry O’Dea and Eric Hendricks all responded to the early morning scene – the first fatal officer-involved shooting since Jan. 2, 2011. It comes as the bureau is under federal investigation for its use of force, particularly involving people with mental illness.

“As the Police Bureau does with any investigation” Adams said, in a statement, “we will look for opportunities to learn from this incident.”

As office workers and shoppers went about their business in downtown later Wednesday morning, Portland firefighters assisted police in removing the deceased’s body about 10:15 a.m. The man was seen wearing a black sweatshirt, jeans and work shoes.

Portland firefighters carried the man down a ladder from the top of the elevator shaft onto the garage rooftop, where deputy medical examiners were waiting. An autopsy is scheduled for Thursday.

The sergeant involved is a 15-year bureau veteran, and the officer joined the Portland Police Bureau nine years ago. Both were working Central Precinct night shift. They’re on paid administrative leave, standard policy as the investigation progresses.

Portland homicide detectives are continuing to investigate and the case will be presented to a grand jury for review.

A man who called 9-1-1 and threatened to jump from the roof of a downtown parking garage Wednesday morning, pointed a replica handgun at officers. He was shot and killed. It was the first officer involved shooting for the Portland Police Bureau since January 2011.

The shooting marked the first officer-involved shooting since Portland Office Dane Reister mistakenly loaded his bean-bag shotgun with lethal rounds and seriously wounded William Kyle Monroe in Southwest Portland on June 30. Reister – the first officer to be indicted for his on-duty use of force – has pleaded not guilty to third-degree and fourth-degree assault and negligent wounding in that shooting.

The last fatal officer-involved shooting occurred Jan. 2, 2011 in Southeast Portland. Thomas Higginbotham, 67, was shot by Portland police when he advanced on two officers while holding a knife. Officers Jason Lile and Larry Wingfield responded to the former Lucky Car Wash near Southeast 82nd Avenue and Powell Boulevard on reports that a security guard had been threatened. Higginbotham walked out of an inner room at the vacant carwash holding a knife. One of the officers fired a Taser, then both officers fired their weapons after Higginbotham continued to approach. A grand jury found no criminal wrongdoing.

The U.S. Department of Justice is currently investigating whether Portland police use of force is excessive, particularly involving people suffering from mental illness.

Portland police kill armed man in early morning rooftop confrontation in downtown Portland, Oregonian, 1/25/2015

Portland police respond to early morning downtown officer-involved shooting, Oregonian, 1/25/2015

Portland firefighters remove body from roof of parking garage after officer-involved shooting, Oregonian, 1/25/2015

Portland police fatally shot troubled man, Oregonian, 1/26/2015

Facebook posts show man shot by police officers was distraught, KPTV.com, 1/26/2012

Man killed in Portland police shooting pointed replica handgun at officers, KOIN.com, 1/26/2012

Man killed in Portland police shooting pointed replica handgun at officers, KOIN.com 1/25/2012

Portland police shoot and kill a man at a downtown parking garage, Oregonian, 1/25/2012

Statement from Brad Lee Morgan’s family:

This morning a young man was shot by the police. His name was Brad Morgan. He was twenty-one years old and was born on 09/07/1990. His family and friends loved him very much and are having a very difficult time in this situation.

Brad was a very loving father of an eight month old boy and nothing in the world meant more to him than his family. He was honest, loving, and caring. He knew what he wanted to achieve in life but didn’t know how. This time in his life grew very difficult to handle. No matter what people may think of him at anytime in life, it will never change the fact how much he cared about his family and people.

Everybody makes mistakes and Brad was out to correct them. It seemed to him that after he got one leg up that both legs got kicked out underneath. If this is true for you or anybody true to you please ask for help.

In this moment of sadness, lets all have a moment of silence for those who have passed away last year and the beginning of this year to help us remember life doesn’t last forever and to enjoy every second of it while we have the chance.

This morning a young man was shot by the police. His name was Brad Morgan. He was twenty-one years old and was born on 09/07/1990. His family and friends loved him very much and are having a very difficult time in this situation.

Early this morning, January 25, 2012, Portland Police officers shot and killed a man in downtown Portland.

UPDATE – What happened to Brad Morgan

Prior to today’s shooting, it had been over a year since a Portland police officer killed a civilian. That this is notable at all highlights a serious problem in the way Portland police interact with citizens, especially those citizens with active mental illness and/or untreated addiction.

The Mental Health Association of Portland has collected the names and known history of over 220 persons shot and/or killed by Portland area police officers since 1970. The list is not comprehensive, but it clearly shows a correlation between active mental illness or addiction and the chances of being killed or wounded by police officers.

The year-plus from Thomas Higginbotham’s death on Jan. 2, 2011 until today may be the longest duration without a police-caused death in Portland’s history.

Higginbotham, age 67, was described by friends as a late stage alcoholic. His shooting death was described by police through the media as having occurred as he advanced toward two officers holding a “large knife.” It is unknown if the Multnomah County District Attorney convened a grand jury to inquire about the death of Higginbotham, or what parts of the county’s use-of-force plan were followed.

UPDATE – Examining the Grand Jury Transcripts in the Police Shooting of Tom Higginbotham, Portland Mercury, January 28, 2011

This past year saw an encouraging milestone: the grand jury indictment of Officer Dane Reister, who shot and permanently injured William Kyle Monroe, a person with a history of mental illness, on June 1. Reister’s trial is scheduled to begin Feb. 1. We believe Reister’s case will mark the first time in over 40 years that a Portland officer will be tried for a use-of-force crime in Multnomah County. This has not occurred since 1969, when Officer Steven Sims was convicted of murder after he killed girlfriend’s husband while in uniform.

We do not have any reason to believe routinely brutal interaction between police and persons with active mental illness and/or addiction is exclusive to Portland, or to Oregon, or to current practice. We believe scrutiny of almost any police bureau will show the same strong correlation. Aside from being male and between the ages of 18 and 50, active mental illness and addiction is the most common factor in police-caused deaths.

What we have learned from our research is the following.

1. Many facts disseminated in the first hours after a police-caused deaths with impartial review are found to be inaccurate.

2. An inquest by a coroner or a transcript of a grand jury is rarely released. Multnomah County has changed this slightly over the past four years.

3. City governments are insured for criminal and civil trials by private insurance companies, which influence policies about speaking forthrightly and quickly about the event. This lack of communication undermines trust and confidence between persons with mental illness and addiction, their friends and family members and the police. This, in turn, seeds future tragedies.

4. For the most part media ignores the ‘long tail’ of police-caused deaths, and is over-influenced by officers trained to persuade journalists.

5. It is unclear whether police officers or police bureaus learn from mistakes.

6. The current community mental and addictions health does not have the capacity to intervene prior or during a crisis.

7. Incarcerating persons with active mental illness or addiction in a state hospital or treatment center is brutal, often ineffective, legally and financially impossible.

8. As long as there are not welcoming and engaging community services available to persons with mental illness and addiction which are instantly perceived by impaired persons as worthwhile and valuable to them, we will have sick people interacting with police, and, probably, we will have more police-caused deaths.

9. Persons who are killed by police officers receive no justice. They are irretrievably dead. The legal system will only represent their interests if a profit is to be made. Local civil rights organizations rarely come to their defense. Community mental and addiction health agencies stay mum, hidden behind their confidentiality ethos and their unstable government funding issues. Families and friends rarely have the capacity to wage a protracted advocacy or legal campaign to cause justice. Many in the community are more comfortable mourning people who behave erratically or oddly than engaging with them. The media moves on.

Police-caused shootings are complex. We hope there is a thorough investigation by police homicide detectives, that the district attorney and other parts of the criminal justice system in Multnomah County follow the tenets of their use-of-force procedures, that the district attorney convenes a grand jury and presents all evidence to that jury, and that the grand jury transcripts are made public as soon as possible.

As yet we know little about this morning’s shooting, not even the names of those involved. But the Mental Health Association of Portland will continue to support the right of persons with mental illness and/or addiction not to be brutalized or killed by police.

Finally, the Mental Health Association of Portland extends our sympathy to the family and friends of the person who died today. We hope they will remember their loved one in their best hours and not at their worst.

By Kate Mather, The Oregonian, Tuesday, January 24, 2012

A 29-year-old Oregon State Police trooper was held for a mental assessment today after he allegedly told police he left an explosive package at a Mt. Angel park.

Mt. Angel officers took Joseph Conklin into custody on a police officer hold about 3:45 a.m. after he was reportedly screaming and yelling in the street near City Hall at 5 Garfield St., said Police Chief Michael Healy.

As an officer was approaching Conklin, he spotted a backpack sitting at a gazebo in Berchtold Memorial Park, located just east of City Hall, Healy said. Conklin told officers he left an explosive device in a package and investigators put the two together.

The area around the park was evacuated, along with two nearby houses. The Mt. Angel School District also delayed the start of all schools for two hours as crews responded to the scene.

An Oregon State Police bomb squad arrived about 5:45 a.m. and determined there were no explosives inside the backpack, Healy said.

Investigators later learned a second package might have been left near St. Mary’s Church, located just a few blocks away at 575 E. College St., Healy said. Officials searched the area but didn’t find anything in the area.

The church, park and City Hall reopened about 7 a.m. No injuries were reported.

Conklin was taken to Salem Hospital for a mental health assessment, Healy said. He has not been arrested or charged.

The 29-year-old was placed on paid administrative leave on Dec. 15, 2011 pending an investigation into an internal matter related to police reports, said Lt. Gregg Hastings, an OSP spokesman. He was hired in August 2008 and worked in the patrol services division in Florence.

By Damian Mann, Mail Tribune, January 23, 2012

A west Medford neighborhood is reeling after a police officer shot to death an 18-year-old Sunday after he brandished a butcher knife on his front porch — the second time law enforcement has used deadly force in a little more than two weeks.

Elias Angel Ruiz, who police said couldn’t be subdued with a stun gun, was pronounced dead at the scene at 812 Pennsylvania St., after officers responded to a domestic disturbance call at 2:21 p.m., according to Medford Police Chief Tim George.

An officer was treated and released after falling to the ground, injuring his hip.

Neighbors say multiple shots were fired, though the exact number hasn’t been confirmed by Medford police yet.

“I don’t know how many shots — maybe more than six,” said Clinton McDonald, a 31-year-old father who lives on nearby Summit Avenue.

He said Ruiz’s mother, who was standing outside his house, cried out, “Why did you shoot my son?”

According to Jackson County records, the house was purchased in 1994 by Ramiro and Alejandra Ruiz.

McDonald said he pulled his daughter out of a baby swing next to a window when the gunshots started, fearing one of them would strike her.

“I think it is very unfortunate that they were shooting down a street in a neighborhood,” he said.

This is the second law enforcement shooting in recent weeks. On Jan. 5, 20-year-old fugitive James “Jimmy” Georgeson was shot by U.S. Marshals outside a west Medford grocery store. Georgeson was a career criminal with drug and mental health problems and had a history of assaulting police officers, according to criminal records.

The investigation into the shooting of Ruiz will follow procedures laid out in the Jackson County Deadly Force Plan.

Under the plan, all responding officers at the shooting surrender weapons to an evidence officer. An autopsy must be performed on the victim. Police officers have video cameras that also are reviewed as part of the investigation.

George said an investigation is under way to determine how many shots were fired and in what direction. The investigation will be conducted to determine if only one officer fired his weapon, he said. George said he wouldn’t disclose the names of the two officers directly involved, but said they would be placed on mandatory administrative leave until the case is presented to a Jackson County grand jury.

Separate 9-1-1 calls came in from both the mother and son, George said, so police still are trying to determine the events surrounding the dispute.

George said Ruiz was making suicidal threats to police dispatch. Ruiz was screaming for help, and the mother was heard crying, George said.

As many as four officers responded to the scene after dispatchers said Ruiz had armed himself with a knife, locked himself inside the house and struck himself with an unknown object, George said.

The mother and her 13-year-old son had left the house before officers arrived, George said. Officers attempted to call Ruiz at the scene. They found the front door locked, George said.

When Ruiz appeared on the front porch, he brandished a butcher knife and an officer attempted to use a stun gun, George said. He said he couldn’t confirm how far the officer was standing from Ruiz. Stun guns used by police can either be used up close or from a distance of about 15 feet away.

When the stun proved unsuccessful, George said a second officer used deadly force. George didn’t reveal the names of the officers.

“This is traumatic for the family members, and for everybody else involved in this,” George said.

The entire confrontation took place between the sidewalk and front porch, he said. Officers are authorized to use deadly force if the circumstances for that type of force are reasonable, George said.

He said he wouldn’t speculate on the distance an officer could be standing from someone who is brandishing a knife in order to justify using deadly force.

“These are complex, lengthy and detailed investigations,” he said.

An unsuccessful attempt to resuscitate Ruiz was made after the shooting, George said.

The Oregon State Police is the lead agency involved, but other local jurisdictions have been called in as well. The Jackson County Major Assault and Death Investigation Unit is investigating the shooting.

Investigators worked into Sunday night, erecting a canopy over the death scene, while a police van was stationed at the street. They will continue the investigation today.

Police cars buzzed through the neighborhood during the day and crime scene tape blocked off a portion of Pennsylvania St.

Joyce Snell, a 65-year-old neighbor, said the shooting has set her and her husband on edge because they are already concerned about people coming to their house at night.

“We keep our doors locked, and we don’t answer after dark,” she said.

She said she heard noises sometime after 2 p.m, but thought the wind had picked up a trash can, making it rattle across the street.

“We heard four loud noises right in a row,” she said.

Snell, like other neighbors, didn’t know the Ruiz family, but she said she’d never heard any other disturbances from the house.

Lee Teague, a 59-year-old neighbor, said he was a little concerned because he didn’t see or hear anything until he saw police cars roaming through the neighborhood.

“I’m really shaken by the fact that I didn’t hear it,” he said.

Teague said he doesn’t understand why anyone would threaten an officer.

“You don’t assault police officers — they’ve got guns,” he said. “I’m just sad people are making decisions to put their own lives in danger.”

Kathy Cupp, a 54-year-old neighbor, said the neighborhood is usually very quiet, and she never heard any other disturbances at the Ruiz household.

“It’s sad,” she said. “You hate to hear it’s a kid.”

Cupp said she thinks several gunshots were fired.

“I heard a pop, pop, pop, and then I saw the police running everywhere,” she said.

Cupp said she thinks the police are trying to do the best they can in a dangerous situation.

“I feel bad for the policeman,” she said. “I feel bad for everybody.”

Eyes and Ears Newsletter is actively seeking submissions from mental health consumers/survivors/ex-patients. Your story and perspective is needed to make this truly the voice from the inside. Previously published works are welcome and accepted. Personal stories, articles, editorials, poetry, and black and white art are all welcome. Anonymous work will be considered. Please send writing/art that is relevant to Portland and mental health issues to eyes.ears_newsletter@yahoo.com

From The Eugene Register Guard, January 22, 2012

Supporters of a planned psychiatric hospital in Junction City hope that isn’t the case, but it faces an uphill battle in the Oregon Legislature next month

As soon as the rains slow this spring, preliminary construction work could begin on the long-­promised state psychiatric hospital next to Highway 99 south of town.

READ – all about the Oregon State Hospital

For a community that has dealt with uncertainty over the past five years as the project repeatedly morphed and got hit with delays, that’s tantalizingly close.

“There’s been a lot of highs and lows throughout the process, and I think the community members who have been following it are taking a ‘we’ll believe it when we see it’ approach,” City Administrator Kevin Watson said.

“Once construction crews are out there and dirt is getting moved around though, there will be more excitement. … I definitely think everyone’s hopeful that it could help out the community in terms of jobs.”

For work to commence this year, however, the Legislature will need to approve during its four-week session in February a $29 million allocation of general fund-backed bonds for the hospital (a small portion of which would go to the nearly completed Salem psychiatric hospital). That allocation would keep the Junction City project moving through next summer and take a big bite out of its total remaining construction costs of $84 million.

But the timing is difficult given state government’s dire financial problems. Projected biennial state revenues have decreased by $300 million since the 2011 legislative session was adjourned. The state debt policy advisory commission recently recommended that the governor and the Legislature not authorize any “net increase in general fund-backed debt” until the end of the 2011-13 biennium.

While the hospital was endorsed publicly by Gov. John Kitzhaber in September, the state’s overstretched debt capacity could swell the Legislature’s ranks of long-standing bipartisan opponents of the Junction City hospital, possibly resulting in yet another construction delay — or even a more permanent derailing.

The importance, for the hospital’s future, of what unfolds next month isn’t lost on Junction City residents, Watson said.

“People will be watching what happens,” he said.

The community care issue

Many people elsewhere in the Lane County also will be watching, given that the hospital is projected ultimately to bring hundreds of permanent jobs to a county hammered by the Great Recession.

In late December, Rep. Dennis Richardson, a Central Point Republican who is the GOP’s point man on budget issues, slammed the Junction City hospital project in his monthly newsletter.

Richardson stressed that moving away from institutional mental health care and focusing on community-based care immediately is cheaper for the state and more humane for patients, arguments long made by mental health advocacy groups and other project opponents.

Richardson claimed that the state could build multiple 16-bed facilities in communities throughout the state for less than the cost of completing the Junction City project. He also wrote that, once opened, those facilities would be eligible for federal matching funds to cover operational costs, unlike the Junction City hospital, where operations would be completely state-funded.

Rep. Val Hoyle, a Eugene Democrat whose district includes Junction City, said Richardson’s newsletter ignored the fact that the Junction City project is intended to serve a population that needs 24-hour supervision and that contains many forensic patients — patients who have plead guilty except for insanity to crimes.

“Some people require hospital-level care,” she said. “And when we close the psychiatric hospitals in Portland and Pendleton, Oregon won’t have enough of those beds.”

OSH Portland and Blue Mountain in Pendleton, which would both require significant renovations to meet federal standards, are currently scheduled to be closed by 2015.

Residential security

Hoyle also criticized a proposal in Richardson’s newsletter that smaller mental health care facilities be placed on industrial land. Richardson argued that doing so could appease “neighborhood placement concerns” by keeping patients with mental illness “far from residential neighborhoods, yet close enough for families to visit and provide needed social support.”

Hoyle responded that “when (mental health advocates) say, ‘We want patients to get their treatment in their community,’ they’re not talking about warehousing them next to warehouses.”

Asked about the industrial land idea, Richardson said he had simply been “vetting” the concept in his newsletter, and that he had since changed his position, based partly on some criticism he received.

However, he disagreed with Hoyle that all forensic patients must be treated in institutional settings.

“The security of community facilities is an issue of design,” he said. “Facilities could be built in a way to harden their security and make them safe for nearby residential areas.”

Richardson also stressed that the possibility of federal matching funds for community facilities is “the financial point that is very powerful.”

Asked if Richardson’s newsletter was indicative of a possible GOP caucus position against the project in the Oregon House — an evenly split chamber where every bill requires bipartisan support to pass — House Republican Leader Kevin Cameron of Salem said that there hadn’t yet been “an in-depth leadership discussion about it.”

But he added, “My personal position is close to” Richardson’s.

“Our bonding capacity is maxed out at the moment,” he said. “2013 is a different year. But to be able to fund the bonds for projects like Junction City, we have to get people working again in private sector.”

In light of the fresh wave of opposition to the Junction City hospital, Hoyle said that she believes the project “has become a political bargaining chip (in Salem) for people to get what they want.”

“It’s unfortunate, because delaying or stopping the project would be very damaging,” she added.

Richardson responded that there was nothing “political” about his opposition to the hospital.

“This is not a new position for me to take,” he said. “This project did not make sense four years ago, and it doesn’t make sense now.”

Getting ready to build

Until the Legislature tells her otherwise, Linda Hammond, director of Oregon’s addictions and mental health treatment programs, is implementing a construction plan that would allow the hospital to open in early 2015, to coincide with the expected closures of satellite state hospitals in Portland and Pendleton.

Under that plan, the 257-acre Junction City site would be “prepped” for construction this spring and summer, Hammond said. That work would include building roadways and utility infrastructure on the property and laying down the foundations of some future buildings.

Most of the actual building construction is set to occur during the summers of 2013 and 2014, Hammond said, with most of the building shells going up in 2013.

Should the Legislature decide to postpone the approval of the hospital bonds for a year, Hammond said, “It would make it extremely difficult to meet the target date of 2015.”

“The biggest driver for construction around this state is that you get short (outdoor) construction windows,” she added.

Fitting the remaining work into two summers rather than three would be challenge, Hammond said, because the Junction City site is generally a “pretty wet” parcel.

While no blueprints or sketches of the facility have been made public yet, hospital design work is scheduled to be finished this year, Hammond said.

Making corrections

Jodie Jones, the project administrator, said that despite state plans to transform the facility into a prison eventually, designers are “first and foremost building a hospital.”

Still, Jones said, care is being taken to avoid plan elements that obviously would be at odds with a prison facility.

For example, designers are leaving space between buildings and the property line, so as to potentially accommodate the outside perimeter fence that a prison might require, but that the state hospital does not.

The hospital also will feature several large group treatment rooms that a prison might not have a use for, Hammond said. Therefore, they will be designed so they can easily be transformed into dormitories.

The transition pre-planning can only go so far, however, Jones said.

“We have to be careful about building something completely to Department of Corrections standards now, because we don’t know how much those standards will change in the years it takes to transition the facility,” she added.

A mental hospital long in the making

• February 2007: State officials select Salem and Junction City as the preferred sites for two new psychiatric hospitals to replace the aging Oregon State Hospital in Salem. The new 620-bed Salem facility is to open in 2011, while the 360-bed Junction City facility is scheduled for a 2013 opening.
• September 2008: Work begins on Salem hospital.
• Spring 2009 to summer 2011: State spends about $25 million on water and sewer infrastructure upgrades in Junction City to accommodate the hospital, as well as a proposed prison, both located on the same 257-acre site on Highway 99.
• 2010: State hospital planners reduce the size of the Junction City facility to 270 beds.
• February 2011: Gov. John Kitzhaber reduces the size of Junction City hospital to 174 beds, based on state’s projected needs, and includes all remaining construction costs for the facility — $84 million — in his initial 2011-13 budget. Kitzhaber scraps the proposed prison on the site.
• June 2011: The Oregon Legislature delays the proposed opening of Junction City hospital until 2015 and approves a $5 million allocation for the project to continue infrastructure and design work. Legislators also unveil long-term plans to transition the hospital into a Department of Corrections facility that would treat prisoners with mental health and addiction issues.
• September 2011: Kitzhaber publicly endorses the Junction City hospital at a town hall meeting. Kitzhaber stresses his long-term commitment to community-based mental health care and to transforming the Junction City facility into a prison eventually.
• March 2012: New Salem hospital is set to be entirely completed.
• Spring-summer of 2012: Junction City site preparation scheduled to begin if Legislature provides funding.
• Summer of 2013 and 2014: Majority of construction work in Junction City scheduled to occur.
• Early 2015: Possible opening of Junction City hospital.

By Maxine Bernstein, The Oregonian, Friday, January 20, 2012

Portland police Chief Mike Reese wants the City Council to pay for nine new sergeants’ positions to help the bureau change how it investigates officer use of force.

The new policy, recommended by the U.S. Department of Justice during its ongoing inquiry into Portland police practices, requires sergeants to go out to scenes and start investigations into all police use of force that results in injuries or when a person complains an officer used inappropriate force that caused injury.

Reese said he’ll ask the Council for an additional sergeant per shift at each of the bureau’s three precincts, at a time when the bureau is considering holding 20 officer positions vacant and looking for up to $6 million in budget cuts next fiscal year.

“It’s complicating the budget discussion a little bit,” Reese told a bureau budget advisory council this month. “It will require more sergeants on patrol than we currently have.”

More: The Oregonian’s continuing coverage of the U.S. Department of Justice inquiry into the Portland Police Bureau.

The new directive was signed Jan. 1 and took effect Jan. 15. Supervisors received training the first two weeks of this month to learn how to secure or photograph evidence, obtain statements from officers and witnesses and document it all in a use of force after-action report that’s to be forwarded to an assistant chief.

Meanwhile, the Portland Police Association – the union that represents rank-and-file officers, sergeants, criminalists and detectives – filed a grievance with the city on Jan. 6, objecting to the new policy.

Officer Daryl Turner, union president, urged the city to vacate the new policy, arguing in the grievance that the city had to negotiate the impacts of the policy on sergeants’ wages, hours, workload and safety.

The union further urged the city to provide “no less than a 3 percent wage increase and 10 percent FTO (field training officer) pay” for all sergeants due to their increased workload.

Currently, a patrol sergeant makes $85,051 after four years in the rank. A sergeant working in the investigative branch or criminalist division now receives 3 percent higher pay.

The union said the additional pay should be granted, retroactive to the policy’s adoption.

The U.S. Department of Justice launched an investigation in June to determine if there was a pattern of excessive force used by Portland police, particularly involving people who suffer from mental illness. The investigation is continuing.

By Alan Gustafson, Statesman Journal, Jan. 19, 2012

A new two-tiered system for releasing criminally committed patients from the Oregon State Hospital is being launched at the Salem psychiatric facility, raising hopes that some patients will have shorter, less costly stints of care.

But even as some patients and mental health advocates welcome the new hybrid system, they also worry that it will function much like the previous one, long criticized for taking a cautious approach to releasing patients.

Effective Jan. 1, release authority for 114 forensic patients — sent to the hospital after being found guilty but insane of non-violent crimes — shifted from the state Psychiatric Security Review Board to a new state hospital review panel.

The five-member panel now has authority to decide when patients committed to OSH for non-Measure 11 crimes are fit to be released.

The PSRB retains release authority over 182 patients who committed violent crimes. The board also retains jurisdiction over former patients who have been conditionally released to live in group homes and other community-based settings.

Creation of the two-tiered release system was authorized by the 2011 Legislature, after complaints about the PSRB taking an overly strict approach to releasing patients, resulting in stays at the psychiatric facility that are too long and costly.

It costs taxpayers more than $200,000 a year to keep a patient at Oregon’s main mental hospital.

State Sen. Jackie Winters, R-Salem, a chief sponsor of Senate Bill 420, the legislation that created the two-tiered system, is hopeful that it will lead to timely discharges for non-violent patients “who are clinically ready to be released.”

Winters said the legislation was aimed at preventing patients from languishing at the hospital after therapists have determined they are fit to be released.

“It is trying to break open that logjam that exists at the hospital when individuals actually have been deemed ready to transition back,” she said. “We can’t afford from a budgetary standpoint just to continue this big logjam — from the humane side and the budgetary side.”

Patient Richard Laing complained this week in a phone call to the Statesman Journal that the hospital has failed to provide patients with detailed information about the two-tiered system.

“They don’t know nothing,” he said, referring to patients. “There’s total ignorance here.”

Laing, an outspoken critic of the PSRB, describes the new hospital review panel as a step in the right direction.

“Obviously, they’re holding too many people too long,” he said.

Officials said there is no guarantee that the retooled release system will produce speedier discharges.

In fact, the new panel is set up to operate much like the PSRB, said Arthur Tolan, director of the new Forensic and Legal Services Department at OSH.

During a Wednesday interview, Tolan gave this answer when asked to delineate how the new panel is different than the PSRB:

“Really, not much. If you look at it, the standards are the same. The criteria that patients have to meet in order to be considered for conditional release are exactly the same. The exhibits required for the hearings are the same. The clinical work that needs to take place and the types of assessments that we provide for these hearings are the same.”

Tolan said the hospital review panel is charged with taking an objective approach to release decisions.

Like the PSRB, its foremost consideration is public safety.

“The patients will have to demonstrate that they are no longer a risk to the community due to their mental illness,” he said. “They demonstrate that by being able to show skills to manage certain risks. Then we really have to look at what resources are in the community to manage that risk. So it’s hard to tell at this time how it will go.”

The panel is scheduled to hold its first full slate of hearings today at the state hospital. The four cases up for review aren’t release hearings, dealing with other matters, officials said.

Members of the new hospital review panel include a psychiatrist, a psychologist, a lawyer, a probation officer and one member from the general public.

In choosing panelists, Tolan said objectivity and “expertise in their fields” were primary considerations.

“What we wanted to do is ensure that the folks coming in on this panel don’t come in with any hidden agendas,” he said. “They’re not pro-patient, pro-release. They’re not pro-correctional approach, ‘let’s keep them locked up.’ They’re people that don’t have a bias towards patients that are mentally ill and have also committed crimes. So we wanted people that are pretty objective.”

The Legislature allocated more than $577,000 to establish the new system, covering start up costs and funding for two employees.

A key hire for the hospital came late last year, when Micky Logan became the first director of legal affairs at OSH.

Logan formerly was a senior state assistant attorney general, employed by the state Department of Justice for 20 years. She represented the state hospital on legal matters, including an ongoing five-year federal civil rights investigation of OSH.

New hospital duties for Logan include ensuring that the review-panel process works smoothly.

As a state lawyer, Logan represented about 15 agencies within the state Department of Human Services and the Oregon Health Authority.

“I was probably wearing about 15 different hats every day,” she said Wednesday. “Frankly, my favorite hat was the state hospital but it was a small part of my job before and now I can wear the hat all the time. I’m very happy to be doing that.”

OSH’s roll out of the new release system will benefit from having Logan on board, said Bob Joondeph, executive director of Disability Rights Oregon, which has represented hospital patients in lawsuits brought against the state.

“I think it’s really good for everybody concerned, actually, because she knows the area very well and gets along well with all the different parties,” he said. “In order to make something like this work effectively, you have to get along with a lot of different types of folks. She seems to do that, and she also knows her stuff.”

Joondeph is reserving judgment on whether the two-tiered release system is a positive development or bureaucratic duplication.

“The answer is, it depends on how it works. I think it’s good that it’s being given an opportunity to see if it can be successful. But we won’t know whether it is or not until it’s had an opportunity to do its thing.”

By Katherine Boyce, Portland State Vanguard, January 19, 2012

Vending machines with healthier alternatives are being installed at PSU

As you grow hungry on your way to class, you may begin to regret not bringing food with you. Thankfully, you spot a vending machine in the hall, which allows you to grab something quickly and be on your way.

But as you bite into your newly procured snack, you find that you are not provided with the feeling of satisfaction that one should get when hunger is no longer a problem. While the snack food commonly found in vending machines may fill you up temporarily, you are not getting the right nutrients.

If you, like many others, are tired of the usual junk that shows up in vending machines and stores, you need not be disappointed much longer. On Jan. 25, four new vending machines will be installed in the lobbies of the Portland State University residence halls. Instead of the usual chips and candy bars, these vending machines will contain healthier local food.

Usual junk food typically contains artificial coloring, additives and artificial flavors. While some additives have been ruled as safe, most of them have adverse effects. These can include behavioral disorders, hyperactivity and other mental problems. More importantly, however: these artificial flavors can also cause nutrient deficiencies and even cancer.

For example, Tartrazine, shown on any nutrition-facts label as “Yellow 5,” is a synthetic yellow dye made from coal tar and is commonly used in soap, shampoo, nail polish and crayons. Its consumption has been found to lead to cancer, as well as behavioral disorders such as ADHD. It is commonly found in Doritos, nachos, cotton candy, soft drinks, instant soups, various candies, gum and even pastries and cake mixes.

Quinoline yellow, another yellow food dye, is made from synthetic coal tar dye and can cause not only ADHD, but also asthma and rashes.

Erythrosine, better known as “Red 3,” is a cherry-pink synthetic food dye also made from coal tar and used to kill maggots and flies. It can cause light sensitivity, cancer and learning difficulties.

Allura red, otherwise known as “Red 40,” is more commonly used in the United States. Often found in tattoo ink and cosmetics, this food dye is also associated with behavioral disorders in children and is banned in Denmark, Belgium, France and Switzerland.

Obviously, artificial colors, as well as other additives, have no place in a healthy diet. The fact that these things are in so many foods which are made so widely available is, frankly, disturbing.

Luckily, junk food does not seem to be the typical diet for very many students at PSU. Some students have said that although a bag of chips or other junk food might look good, they know it is not very good for them. Others said that they try to find the healthiest food that they can find—not always an easy endeavor.

Students told about the new vending machines reacted with enthusiasm, saying that healthy snacks would be great. They were pleased to hear that local and healthy foods would be available. Even students who claim they do not typically get food out of vending machines say that they would be likely to buy the healthy alternatives these new vending machines will offer.

The students’ main concern regarding the new vending machines is the cost of the healthier food. Though the price of the food in the new vending machines remains to be determined, the assumption is that it may cost more simply because healthier food tends to be more expensive.

However, what students lose now monetarily when choosing healthy food, they make up for later. Eating cheap but unhealthy food can lead to more money spent on medical bills later when dealing with the consequences of their unhealthy diets. And those consequences may be closer than one would think.

Young people can develop health problems as easily as anyone, so save yourself the shock of being told that you have a health problem by preemptively eating healthy food.

When we eat chips and candy bars, what we are shoveling into our mouths is otherwise used for killing bugs or put into soap, cosmetics and nail polish.

Instead of eating cancer-causing products that barely fill us up, we should make sure that we get the proper nutrients that will help us in the long term. This will be even easier once the new vending machines are installed.

The presence of the new and healthy vending machine food may make the usual junk food pale in comparison and encourage everyone to get something healthy, even if they are only looking for a quick snack. If the new healthy vending machine food is successful enough in encouraging students to substitute their usual snacks, the new vending machines may turn up in other buildings on campus besides the residence halls.

Everyone should consider going to the new vending machines for snacks, whether they live in the residence halls or not. Instead of buying a bag of chips at the store or grabbing a candy bar from a machine just because it is cheap and quick, pay attention to the value of what you consume.

http://www.spokesman.com/stories/2012/jan/19/high-court-to-hear-burger-case/

The case of a Clark County sheriff’s deputy who in 2010 sued Burger King because an employee spit in his Whopper is heading to the Washington Supreme Court.

 

 

The issue: Whether the state’s Product Liability Act allows a plaintiff to collect damages for emotional distress without suffering any physical injuries.

Deputy Ed Bylsma’s lawsuit, filed in U.S. District Court in Portland, was dismissed in late 2010. Bylsma appealed to the United States Court of Appeals 9th Circuit.

Last week, the panel of judges asked the Supreme Court to take a look at the case to resolve the “emotional distress” question. The appellate court said the product liability law is unclear in whether plaintiffs can sue even if they aren’t physically injured.

The act is defined by causing harm by the manufacture or preparation of a product, but doesn’t outright define “harm,” the appeals court said.

“We have not been able to find any product liability case allowing emotional distress damages caused by a product in the absence of physical injury,” according to the appeals court’s written request.

The Court of Appeals decision is on hold until the Supreme Court addresses the question.

Bylsma received the contaminated burger at the drive-through of the restaurant at 5513 N.E. Gher Road on March 24, 2009. He was in full uniform and driving his patrol vehicle.

Bylsma said he inspected his Whopper because he could tell something was amiss when the employee avoided eye contact while handing him the food. He peeled away the patty and discovered a thick glob of saliva laced with phlegm, according to the lawsuit.

Fellow sheriff’s deputies responded and collected evidence from the burger. Later testing at a crime lab showed the saliva matched that of former employee Gary Herb.

Herb was arrested and received three months in jail after pleading guilty last year to third-degree assault against an officer.

Herb and another employee were terminated after the incident.

Bylsma said that he now suffers “ongoing emotional trauma from the incident, including vomiting, nausea, food anxiety and sleeplessness and has sought treatment by a mental health professional,” according to the appeals court.

The appellate court said the Supreme Court’s decision could set a precedent.

Shana Larsen is in front of her laptop in the dining room of her Beaverton townhouse. She’s been shopping for her own health insurance, armed with hard-won knowledge. Her husband, Greg fought a four-year battle with cancer.

Larsen says, “He was diagnosed in 2006, when he was 29. The big thing that tipped me off is we were training for Hood to Coast, and he was very athletic, and he couldn’t run a mile without running out of breath.”

As the illness took its course, Shana became more deeply immersed in dealing with the bills for Greg’s treatments, which she estimates at well over a $1 million.

“It was more confusing than anything, because you don’t think about where all the money’s going to come from at first. We ended up keeping an Excel spreadsheet of all of the bills, trying to keep track of them that way,” Larsen said.

Greg died in April. Now, Shana Larsen is re-entering the health care universe as a consumer and a voter. She says she takes a very different view of health care policy, because of her experience.

CD-1 (2010)

How CD-1 Residents Pay For Hospital Visits (by percentage):

Commercial Insurance: 44.05
Medicare: 37.31
Medicaid: 12.99
Self-Pay: 5.64

STATEWIDE (2010)

How Oregon Residents Pay For Hospital Visits (by percentage):

Commercial Insurance: 37.94 (down 1.29% from 2009)
Medicare: 41.35 (up 0.24% from 2009)
Medicaid: 13.82 (up 0.72% from 2009)
Self Pay: 6.88 (up 0.32% from 2009)

“Things you don’t think about when they’re choosing health care, is limits. Yearly coverage limits, life-time coverage limits. As I’m shopping now,. I’m noticing that a lot more, that a lot of plans have these limits to them,” Larsen said.

From coverage limits to drug coverage, Larsen’s much more aware of how different insurance plans can mean the difference between getting a key treatment or going without. As she looks over premium options, she’s thinking about access to health care in an entirely new way.

Access has been a focal point in the First District candidates’ discussions of health care policy. Democrat Suzanne Bonamici has addressed it in terms of her experience in the state legislature. She’s voted on bills that will re-tool Oregon’s insurance markets to meet federal mandates over the next three years.

“I know that health care needs are significant, and I know the most important thing is to make sure people are covered. Until we have universal access, we won’t be able to drive down costs. What happens now is that people who don’t have coverage get their health care needs met in the most expensive place. That’s the emergency room,” said Bonamici.

Bonamici also says she says she’ll focus on mental health care needs and support providers as they modernize their work with electronic records and telemedicine.

As a voter, Shana Larsen is certainly concerned with access. But as a self-employed personal chef, she also keeps an eye on costs. That’s the sensibility Republican Rob Cornilles tries to address.

“On the federal level, I believe it’s the responsibility Congress to pass legislation that will allow costs to go down,” said Cornilles.

Cornilles is a Tualitin businessman who has said he would not have voted for the Obama Administration’s Affordable Care Act, as it was presented. But he also does not favor the repeal some other Republicans tried to pass last year. He describes his approach to health care policy as cost conscious.

Cornilles said, “Every year I’ve been in business, my health premiums have gone up, for me and my employees. And we’re a pretty healthy group. There are a lot of ideas that have been out there for years that they don’t have enough political courage on either side of the aisle to enact.”

Cornilles says he thinks building greater portability into health care markets is a first step.

While the national health care debate has fallen out of the headlines, it’s apparent Congress’ work on the issue is far from done. When Gov. John Kitzhaber delivered his State of the State address last Friday at the City Club of Portland, he talked about Oregon’s efforts to overhaul Medicaid and other state-sponsored programs. The goal, he says, is to get ready for a big coverage expansion mandated by the Affordable Care Act – and, at the same, time, improve the quality of care.

Kitzhaber explained, “The business plan for our new coordinated care organizations shifts the focus and the financial incentives from the emergency room to wellness, prevention, and early intervention, and the community-based management of chronic conditions like diabetes and congestive heart failure.”

To do this, Kitzhaber and other state officials will need a series of waivers from the federal government, allowing Oregon to spend Medicaid money in different ways. Last week, he spent a few days in Washington DC, talking to officials about waivers. Assuming the Legislature acts next month to set the changes into motion, the Governor will seek help from the Congressional delegation to secure the waivers he says are critical to make Oregon’s health care system work.

Democrat Bonamici says she believes in what’s happening at the federal and state levels.

“If there’s anything I can do to be helpful with the implementation of the insurance exchange, I’ll be right there to do that. When you look at what’s happening in Oregon, our insurance exchange, our transformation, increasing access through community care, more primary care,” she said.

Those, Bonamici says, are the changes that will bring costs down across the system.

Republican Cornilles takes a sharply different view of the federal mandates.

“As I understand it, as a small business owner, I’ll be forced to pay for a more expensive program, or I’m going to have to turn my employees over to a public plan,” he said.

While Cornilles’ concerns about cost have been often repeated, federal and state officials say they believe the federally-mandated changes will keep costs under control in the long run.

But Cornilles says he supports Gov. Kitzhaber quest for waivers for Oregon. He says he hopes that, in doing so, the state can reduce the burgeoning cost of health care while improving access. He also says he can think of a better model than Medicaid for covering those with low incomes who are uninsured.

“What we do have in Oregon that’s a really good model is federally-qualified community health centers. There are six clinics in Washington County and Yamhill County combined. These are six clinics in Washington County and Yamhill County, combined. These are community-based entities that provide health care for people who are uninsured,” he said.

Cornilles says he believes this model would be less expensive than trying to buy monthly insurance for people who are not currently covered.

Both candidates rate access to care as one of the fundamental problems facing the health care system. They also say they’d be interested in attacking other problems specific to the First District – like a lack of access to primary and acute care. The federal government labels Columbia County, for example, as an area that has a shortage of health professionals.

Cornilles says he’s interested in increasing the number of doctors across the region.

Bonamici says she’d support boosting the number of professionals who can do primary care at a lower cost than doctors — like nurse practitioners.

Beaverton resident Shana Larsen knows she experienced the health care system at its most extreme. But Larsen points out that many people have anxieties around health care today.

“Most of my friends are having children and worrying about coverage on some of the normal stuff that happens – going to the pediatrician,” she says.

And, above all, she knows first hand how important it is to think about the tough issues that come up around health care policy.

Larsen says, “I’m glad people are talking about it. It’s incredibly important.”

From KTVZ.com, January 19, 2010

Gov. John Kitzhaber‘s proposed health care overhaul would save less than half of the nearly $240 million that Oregon lawmakers assumed when they wrote the state budget, projections released Tuesday showed.

The shortfall – $125 million under the most optimistic projection – could require reductions in Oregon Health Plan benefits or even steeper cuts in payments to doctors and hospitals. But state officials said they’re hopeful the federal government will provide an influx of money as a sort of down payment that would be recouped with future savings.

And the potential for future savings is significant. In the long run, Oregon could eventually save as much as 50 percent on health care by focusing more on preventative medicine and coordinating care, Doug Elwell, managing principal at Health Management Associates, told the Oregon Health Policy Board on Tuesday.

“It’s a tremendously exciting opportunity,” Elwell said. “I think it’s probably the best way to get to a permanently sustainable system.”

Kitzhaber hopes that the state can get a handle on rapidly rising health care costs by intensively managing chronic diseases to keep patients out of hospitals and by coordinating care between doctors, dentists and mental health providers.

The approach can allow the state to save between $58 million and $115 million from the General Fund in the first year, a net savings of 10 to 20 percent, Elwell said. In the two-year budget cycle beginning in 2013, the savings would climb to 40 to 50 percent.

Elwell acknowledged that the savings projections sound high, but he said they were conservative and realistic estimates. But he cautioned that the successful implementation will be a challenge. Historic competitors will have work together, he said, and mental and physical health providers will have to learn to cooperate.

Last year, state lawmakers balanced the two-year budget in part with an assumption that the Oregon Health Plan overhaul would save almost $240 million beginning in summer 2012. Some state lawmakers said from the beginning that they were skeptical the proposal could actually save that much money.

The Oregon Health Plan is the state’s version of Medicaid, a low-income health care program funded jointly by states and the federal government.

State officials said they’re hopeful federal money might help make up for the shortfall. Kitzhaber is in Washington this week to meet with senior health officials in the Obama administration, including Marilyn Tavenner, director of the Center for Medicare and Medicaid Services. Tavenner’s agency must waive some medical privacy and payment regulations if the proposal is to be fully implemented.

Congress contributes more than 60 percent of funding for Medicaid in Oregon, so federal coffers stand to save even more than the state’s from a successful health care overhaul. That’s the argument state officials are making to the federal government, said Mike Bonetto, Kitzhaber’s health policy adviser. He declined to say how much money the state is asking for.

“Any new federal dollars that we would be getting would be going toward transformation,” Bonetto said. “It’s not necessarily to backfill a budget hole and keep us entrenched in the status quo, and that’s the kind of thing that’s resonating at the federal level.”

If the federal government doesn’t chip in, the Legislature would probably have to reduce benefits or cut reimbursements to doctors and hospitals.

Skeptics of the health care overhaul have said it would be unworkable. The Legislature approved the concept last year, but lawmakers still must approve the more detailed implementation plan when they meet in February.

Under Kitzhaber’s proposal, community-based nonprofits called coordinated care organizations that would be responsible for patients in their region. The organization would provide community health workers to check in on patients with chronic illnesses to ensure they’re taking medications and following a doctor’s orders.

Kitzhaber aides said they’re encouraged that major health organizations in the Portland area have already started work on a coordinated care organization. The group of insurers, hospitals and three counties is trying to work out an organizational and financial structure, and organizations that have historically competed have been working together, said George Brown, Legacy Health System chief executive.

The state should ensure that privacy laws allow health care providers to share information, he said. It should allow public corporations or joint ventures to run a care organization, not just nonprofits, Brown said, pleading for flexibility.

“We have a lot of historical behaviors, stereotypes that have to be set aside because we’re not used to working with one another,” Brown said. “This requires time.”

By Emily E. Smith, The Oregonian, Tuesday, January 10, 2012

A repeat sex offender will spend the rest of his life in prison without the chance of parole because he can’t be rehabilitated, a Washington County judge decided Tuesday.

David Allen Baker, twice convicted of raping young girls, landed the life sentence under Oregon’s three-strikes law for sex offenders after his most recent pursuit of sex with a teen girl.

Baker, 48, met a 13-year-old Hillsboro girl through a phone chat line in 2009, and the two carried on conversations for months, according to court records.

At Baker’s Tuesday sentencing before Judge Gayle Nachtigal, Deputy District Attorney Dan Hesson said Baker groomed the girl through many phone calls before making sexual comments and expressing an interest in having sex with her.

After that, court records show, the girl stopped talking to Baker. He then began calling the girl’s home phone and calling and texting her mother’s cellphone, demanding to talk to the girl.

In December 2010, the girl’s mother reported the persistent phone calls and messages to police, who traced them to Baker through the name and phone numbers he gave the girl.

Earlier that month, the girl’s mother, family members and neighbors spotted an unfamiliar man prowling around the girl’s home. After police began investigating, witnesses recognized the man as Baker from prior a jail booking photo. He was arrested in January 2011.

At trial in September last year, jurors found Baker guilty of online sexual corruption of a child, unlawful contact with a child and attempted third-degree rape.

Baker is a twice-convicted child rapist, according to court records.

In 1985, he picked up a relative from elementary school and brought her back to his cold apartment, Hesson said. He told her to get in his bed to warm up, instructed her to take off her clothes and raped her. When the girl didn’t return home that day, her mother called police. Officers found the girl with Baker, both of them naked in his bed.

In 1998, Baker babysat a 6-year-old girl in Minnesota. He raped the girl twice while he had her alone, according to reports.

Baker served prison time for both of those incidents. The Minnesota Department of Corrections classified him as a predatory sex offender.

He returned to Oregon and was living in Multnomah County Community Corrections transitional housing when he committed his most recent crimes in Washington County.

In their investigation, Hillsboro police turned up online ads Baker posted looking for a “cute sex slave” as young as 14. They also found pages and pages of printed web searches that revealed an obsession with animals raping children, Hesson said.

Defense attorney Ethan Levi said Baker has multiple mental health issues that have contributed to his behavior. His mother beat him “viciously” as a child, Levi said. When one of the beatings sent him to the hospital at age 14, Levi said, he was removed from the home.

Baker is mentally ill and developmentally delayed, Levi said. He struggled with reading, writing and speech and eventually dropped out of school and started using drugs.

Over the years, Baker has been diagnosed with Tourette’s syndrome, psychosis, borderline intelligence, depression, anxiety and post-traumatic stress disorder, Levi said.

He suffered a severe head injury in a 1981 car crash, Levi said. In 1988, he attempted suicide. He’s been raped twice by inmates in prison, Levi said.

Levi argued that a life sentence didn’t fit the crime in Baker’s case both because of his diminished mental capacity and because he never had physical contact with the victim.

Nachtigal disagreed.

“He is not rehabilitable,” she said. “He will never change his behavior. He will be a predatory sex offender until the day he dies.”

There is no treatment or medication for a sex offender facing a combination of brain damage, mental illness and addiction, Nachtigal said.

“We know a lot about Mr. Baker,” she said. “Given who he is and what he can and cannot do, the only way to prevent this kind of behavior is … to keep Mr. Baker away from society.”

In faded orange jail scrubs, Baker whispered in his attorney’s ear before Levi told the judge he didn’t wish to make a statement. Pale and unshaven with shaggy graying hair, Baker showed no reaction to his sentence.