The Ousters of Tricia Tillman and Joanne Fuller

Tricia Tillman Dismissed as Public Health Director
The Skanner, September 12, 2017

Multnomah County accused of ‘systemic’ racism
Portland Tribune, September 12, 2017

Alleged racism in Multnomah County prompts Chair Deborah Kafoury to pledge action
Oregonian, September 15, 2017

Packed audience mulls county workforce equity
Hearing focuses on manager who is being forced out, but other employees complain about racism, too
Portland Tribune, September 21, 2017

Tillman’s Firing Ignites Plan for Systemic Racism in the County
The Skanner, September 21, 2017

County Settles with Tillman, Joanne Fuller Retires
The Skanner, September 26, 2017

Multnomah report finds no racism in ouster of Tricia Tillman
Documents released show staff complaints, but Tillman says she was blindsided.
Portland Tribune, September 26, 2017

READ – Multnomah County’s Workforce Equity Strategic Plan (PDF), August 2017


Top Multnomah county manager, Joanne Fuller, retires abruptly
Portland Tribune – updated to September 25, 2017

A longtime top Multnomah County manager, Joann Fuller, retired abruptly Monday following the controversial ouster of public health director Tricia Tillman.

Tillman last week was given a settlement worth more than a year’s pay after her letter accusing the county of institutional racism went public.

The sudden ouster sparked concerns in the community and among county employees, as Tillman has been prominent, has many allies, and, indeed, was considered by many to be Fuller’s likely successor.

Tillman’s Sept. 7 letter to the county board sparked the controversy when it went public in the Portland Tribune and The Skanner newspapers. The letter implicitly criticized Fuller, who until Monday headed the health department.

After news broke of Tillman’s situation, a group of community leaders sent the board a letter accusing Fuller’s department of “orchestrating” Tillman’s ouster, calling it “unacceptable.”

In an email to fellow county managers, county commissioners and staff Monday morning, Fuller gave no reason for her decision, saying, “As some of you know, I have been thinking about retiring for some time. I have decided that now is the time. I will be leaving my position as Multnomah County Health Department Director at close of business today. I am grateful that it is possible for me to step back from high-pressure, full-time work and pursue my many other passions.”

Fuller could not be reached for comment, and her email account sent an auto-reply saying she was out of the office Monday.

Her announcement, came shortly after Chair Deborah Kafoury launched an investigation of how Tillman’s situation was handled. It also came about one business day after the county reached a settlement with Tillman — one that was worth about three times what officials had offered her before the investigation launched by Kafoury.

In her letter to the Multnomah County board earlier this month, Tillman, who is African-American, said she was being forced out despite good performance evaluations and feedback from Fuller.

Tillman’s ouster sparked concerned testimony to the board, calls for an independent investigation, and a

Sept. 13 letter from a group of 14 local minority leaders to the board calling her treatment “unacceptable.”

Under Tillman’s settlement, the county agrees to provide her with administrative leave from Sept. 14, 2017, through Aug. 14, 2018. On top of that, it will pay her a $25,000 lump sum, and provide her an agreed-upon letter of reference.

“I have opted to put this situation behind me in order to focus on my family and move forward in my career,” said Tillman in a statement relayed by her attorney, Dana Sullivan, earlier this week. “Even though my dispute with the County has been resolved, I hope that people continue to hold the County’s feet to the fire to address the systemic issues illustrated by the courageous stories shared by so many during last week’s hearing.”

The terms of the settlement were a significant improvement for Tillman from where things stood as of Sept. 7, when she sent her letter the board. At that time, she’d been offered “slightly more than” four months severance, she wrote. Considering her salary of $149,221, that suggested a settlement of $50,000 or a little more.

Her new settlement is worth approximately three times the county’s earlier proposal.

Reasons for ouster unknown

Performance reviews released under Oregon’s records law show that Tillman was praised for her work at the six-month and 18-month marks of her tenure after leaving the state for the county in January 2015.

“This has been a great year for Tricia as she has dug into leadership of the new Public Health Division,” said the June 27, 2016, review signed by Fuller. Fuller credited Tillman’s leadership for a variety of successes by the department. “Tricia has a wonderful calming style that helps people focus on the work at hand. She is very supportive of her people and clear with them about expectations and results. I am very pleased with her work and the work of the public health division this year.”

In April 2017, Tillman took family leave to care for her mother, who suffers from Stage 4 lung cancer. Tillman returned to the county on July 5 and asked for her performance review, she wrote in her Sept. 7 letter. In response, Fuller, “told me that a review would not be necessary, as she said they are perfunctory and she would take care of it so that my increases could take effect,” Tillman wrote.

Fuller told Tillman to go

But in a meeting on Aug. 18, Tillman wrote, Fuller informed her she would be demoted and allowed a “graceful” exit after two to three months — but could not remain at the county. Two subordinates had said they could not work with her, according to Tillman.

The limited information available so far on Tillman’s treatment caused questions among those who worked for her and with her in her previous job at the Oregon Health Authority, as well as an earlier stint at Multnomah County.

“I’ve known Tricia for many years and found her to be an excellent leader,” said Dr. Ken Rosenberg, the recently-retired former chief science officer for the Oregon Health Authority’s public health division, who worked with Tillman there. “Her firing sounds fishy. I’ve never heard of someone legitimately fired because subordinates could not work with her.”

Fller’s email to staff that announced her retirement concluded, “It has been the highest honor for me to work with the wonderful employees of Multnomah County for 29 plus years. Multnomah County employees have an unusual combination of smarts, caring, skills and commitment that makes our local government special. All of you come to work every day ready to serve our whole community. This community needs you and you are always there. I will miss working with all of you and wish you the very best.”


READ – Letter from Tricia Tillman to the Multnomah County Board of Directors (PDF), September 2017

READ – Letter to Multnomah County Commissioners on behalf of Tricia Tillman (PDF), by Kali Thorne Ladd, Lolenzo Poe, Sen. Avel Gordly (Ret.), Ron Herndon, Tony Hopson, Joseph Santos-Lyons, Dr. T. Allen Bethel, Joyce Harris, Rukaiyah Adams, Kayse Jama, Sen. Margaret Carter (Ret.), Alberto Moreno, Cyreena Boston Ashby, Pastor W.G.Hardy Jr.

READ – Tillman Performance Review (PDF), 2016

READ – Tillman settlement agreement (PDF)


Multnomah County Health Department Director Joanne Fuller Abruptly Retires
Announcement follows county’s paying a hefty settlement to former director of public health.
Willamette Week, September 26, 2017

Multnomah County Health Director Joanne Fuller retires suddenly amid allegations of systemic racism
Oregonian, September 26, 2017

Multnomah health director, Joanne Fuller, retires abruptly following controversial ouster
Fuller forced out Tricia Tillman, leading to $165,000 settlement and criticism of Fuller.
September 25, 2016


Dear Colleagues,

As some of you know​,​ I have been thinking about retiring for some time. I have decided that now is the time. I will be leaving my position as Multnomah County Health Department Director at close of business today. I am grateful that it is possible for me to step back from ​high pressure ​full time work and pursue my many ​other ​passions.

​I​t has been the highest honor for me to work with the wonderful employees of Multnomah County for 29 plus years. Multnomah County employees have a ​unusual ​combination of smarts, caring, skills and commitment that makes our local government special. ​All of you come to work everyday ready to serve our whole community. This community needs you and you are always there. ​I will miss working with all of you​ and wish you the very best. ​

​Take care,​

Joanne​ Fuller – Multnomah County Health Department Director​


Dear colleagues,

I wanted you to know that Joanne Fuller is retiring as Health Department Director.

In an email to staff this morning, Joanne said she had been planning to retire for some time and had decided now is that time. I accepted her notification letter effective 5 p.m. today. I have asked Deputy Director Wendy Lear to step in as interim director in the short term while the I work with the Department to formulate a medium and long-range plan. Integrated Clinical Services will report directly to Multnomah County Chief Operating Officer Marissa Madrigal.

Joanne has overseen the Health Department’s $336 million budget and 1,400 employees since 2013. In 29 years at Multnomah County, she also served as Director of Department of County Human Services, Director of Department of Community Justice and the County’s Chief Operating Officer.

Throughout her tenure, Joanne has brought a social worker’s heart and a CEO’s mind to Multnomah County. She’s been a tireless champion for people with mental illness and disabilities, for working families and for those in the criminal justice system, especially juveniles. She brought that same steadiness and heart to to the Health Department and we are deeply grateful for her service.

In addition to leading the largest safety net health care provider in Oregon, Joanne steered the Health Department through some of its greatest challenges, including state and federal health reform, integration of Mental Health and the building of a new Gladys McCoy Health Department Headquarters.

We will miss her.

Deborah Kafoury – Multnomah County ​Chair​


Dear Health Department Colleagues,

As many of you know, Joanne Fuller announced yesterday that she’d be retiring from her position as Health Department Director after more than 29 years of service with the County. I will be acting as the Interim Director while we determine our next steps and Chair Deborah Kafoury initiates a national search for qualified candidates.

In my role as Interim Director, I’ll be overseeing Mental Health and Addiction Services, Public Health, the Health Officer, and Corrections Health. I’m also asking certain managers to take on some extra responsibilities to support Business Operations. Integrated Clinical Services will report to Marissa Madrigal, the County’s Chief Operations Officer.

The events of the past couple of weeks have been destabilizing for our organization. Concerns of systemic racism weigh heavily on us all, especially staff of color. As I begin to fill this new role, I am taking these challenges very seriously. That’s why I will be convening a series of meetings and informal brown bags to hear from you directly about your questions and concerns. The dates and times of these gatherings will be announced in a forthcoming email.

In the meantime, I’d like to assure you that we will move forward together. Our critical role and our services to our diverse communities will continue, despite any changes in leadership.

I want all of you to know that I value the unique experience and contributions that each of you brings to the Health Department. My priority is to build on these strengths and continue to preserve and foster an organization where everyone is treated with dignity and respect. I’m proud of our Department’s progress on becoming more trauma informed, and I’m pleased that work on hiring an Equity and Inclusion Manager is progressing. I also affirm the County’s commitment to implement its Workforce Equity Initiative.

Lastly, I want to thank you all for continuing to promote and protect the health of everyone in our county, even in the midst of challenging times. I look forward to partnering with you as we navigate a new chapter and work through these changes as a unified organization.

Sincerely,

Wendy Lear, Interim Director Multnomah County Health Department


Dear MHASD Team,

Yesterday Joanne Fuller announced her retirement as Health Director after more than 29 years with the County. While a search for a new Health Department director begins, Wendy Lear will act as Interim Director.

I understand many of you have questions about how Joanne’s retirement will affect our Division. I’m also aware that you may get questions from community partners or those we are serving. Even though our leadership has changed, we remain committed to reaching our vision and goal of ensuring all residents can access behavioral health services that meet each individual’s unique need. All our programs are continuing as usual, as are our relationships with our community partners.

As we begin this new chapter, I want to remind everyone that our county has experienced change before. And while the past couple weeks have been painful for many of us, our work together continues. It is also important for you to know that our commitment to an inclusive and respectful workplace for every single employee in MHASD will remain central to supporting you and those we serve.

For those who are still wondering about our work moving forward, there will be opportunities to share your questions and concerns in a series of brown bag meetings with Wendy and department leadership. I will share the details on those meetings as soon as they are available.

I’d like to thank you all for your excellent service to our community every day, especially amidst the confusion that recent events have caused. We will move forward together.

Sincerely,

David (Hidalgo, Multnomah County’s Mental Health and Addiction Services Division)

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Addiction sufferers need accessible treatment

By Brenton Gicker – for The Register-Guard – SEPT. 24, 2017

Brenton Gicker is a registered nurse and emergency medical technician who lives and works in Eugene – and a member of the Mental Health Association of Portland’s Advocacy Council.

Any day of the week, one can find news stories describing the plague of addiction that is ravaging the country.

According to a Sept. 2 story in The New York Times: “Drug overdoses killed roughly 64,000 people in the United States last year… Drug overdoses are expected to remain the leading cause of death for Americans under 50, as synthetic opioids — primarily fentanyl and its analogues — continue to push the death count higher.

“Drug deaths involving fentanyl more than doubled from 2015 to 2016, accompanied by an upturn in deaths involving cocaine and methamphetamine. Together they add up to an epidemic of drug overdoses that is killing people at a faster rate than the HIV epidemic at its peak.”

Much attention is being paid specifically to the opioid epidemic, which kills an estimated 100 Americans daily. Other substances — such as alcohol and methamphetamine — usually destroy bodies and minds over time.

Opioids are arguably more benign than alcohol or methamphetamine — which wreak havoc on people in ways opiates do not — but opioids are extremely addictive and easy to overdose on, which is why they kill so many people.

One might think that, considering the carnage caused by drug abuse that is all around us, and the constant media focus on the horrors of addiction — specifically opioid addiction — there would a concerted effort to enroll addicts in treatment. But that’s not happening.

Narcan — a drug that can potentially reverse an opioid overdose if given early enough — is becoming more readily available to professionals and the public (including addicts and their loved ones), which will potentially reduce the number of opioid overdose deaths.

Primary care providers are being scrutinized for prescribing opioids too liberally — a problem that many blame for the opioid epidemic — and pressured to wean their patients off of them.

Rightly or wrongly, many patients who have relied on opioids for chronic pain management are being tapered off of them.

In some cases, that process is not gradual but abrupt. Given that opioid withdrawal — which typically isn’t a medical emergency though it’s very uncomfortable — is a miserable process.

Patients are often left feeling as if they’re being punished for becoming dependent on drugs prescribers previously encouraged them to take.

But while the media are reporting horror stories and prescribers are changing their practices and medical professionals are educating the public on the use of Narcan, where’s the treatment?

Various local agencies (Emergence, Serenity Lane, White Bird Clinic, Willamette Family Treatment, etc) offer excellent outpatient treatment services.

But for a hardcore addict — you know, the kind of person who is found dead or half-dead in an alley or motel room with a needle in their arm; the kind of person we laugh at when we see their mugshot until we realize we went to high school with them or that they’re a coworker’s child — attending meetings isn’t likely to work.

What they need is inpatient treatment; intensive, holistic treatment — treatment they are highly unlikely to receive without a solid support network and financial resources (which, of course, most addicts don’t have).

Only two local agencies — Serenity Lane and Willamette Family Treatment — offer medical detoxification and residential treatment services.

They are both excellent, essential organizations. But inpatient services offered by Serenity Lane are inaccessible to many because of their insurance and payment requirements. Willamette Family detox and residential programs are more accessible (they accept Oregon Health Plan) but are often full or may have long wait lists and other barriers.

People stay in absolutely miserable situations — the people you see strung-out all over town aren’t having fun — because they don’t know what else to do with themselves.

Maybe they’ve never done anything else. Maybe they’ve never had the opportunity to do anything else. And — considering the barriers that exist to getting help, real help — why even try?

For emotionally and physically battered individuals, it’s just too daunting.

Narcan should be accessible, and doctors should be challenged for turning their patients into junkies. But what is painfully missing are low-barrier, easily accessible treatment facilities — facilities whose message to addicts should be loud and clear: Come to us. We want you to be here. We’ve been waiting for you.

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Portland police still can’t measure effectiveness of response to mental health calls, say police consultants

Oregonian, September 15, 2017

Portland police still lack the ability to track whether officers are using less force against people with mental health issues three years into a federal settlement that was supposed to improve their response, outside consultants say.

“We do not believe the PPB has the data systems in place to adequately measure the effectiveness of their unique system,” the Chicago-based consultants wrote in a report recently filed in federal court.

READ – COCL COMPLIANCE REPORT, Third and Fourth Quarters: July through December, 2016

The city-hired consultants, Rosenbaum & Associates, tried to evaluate the bureau’s Enhanced Crisis Intervention Team of officers who receive more than 40 hours of training to handle mental health crises. They work regular patrol, are scattered among the bureau’s three precincts and go to mental health-related emergency calls if they’re available.

A U.S. Justice Department investigation found in 2012 that Portland police used excessive force against people with mental illness. The negotiated settlement with the city, approved by a federal judge in 2014, calls for changes to Portland policies, training and oversight.

The agreement recommended a different method of crisis response modeled after a strategy Memphis police started that has a team of trained officers respond to mental health crisis calls as their full-time role. The team reports to one high-ranking supervisor.

“PPB continues to operate with a modified Memphis model but has yet to produce data to demonstrate its effectiveness and responsiveness to the Portland community,” the report said.

The consultants say they suggested that the Police Bureau track frequency of mental health calls, adequacy and availability of the specially trained officers by precinct and shift, outcomes of the calls and differences in outcomes when enhanced crisis intervention officer can’t respond.

The bureau had been using a special screen that pops up on an officer’s mobile computer to fill out information on all interactions with people who exhibit mental illness. But police halted the practice after the District Attorney’s Office advised them that the information must be shared with defense lawyers if the people faced criminal prosecution.

To address the district attorney’s concerns, the bureau switched to a different type of screen that an officer completes only if the call requires a written police report, to make the information more accessible for sharing with the defense at prosecution.

But that means the information no longer reflects all police contacts with people suffering from mental illness, consultants Dennis Rosenbaum and Amy Watson found.

Data the consultants reviewed from March 2016 through Jan. 31 showed that 10 percent, or 18,748, of Portland police calls had some type of mental health element involved. Of those, 6.3 percent, or 1,179, were considered of a type that should draw an enhanced crisis intervention officer. Of those 6.3 percent of calls, the officers with the extra training responded nearly 70 percent of the time.

The consultants asked the city Bureau of Emergency Communications, which dispatches police to 911 calls, for more detailed information on mental health calls, but the bureau said it didn’t have the staff to perform such data extraction or analysis. The consultants said the Police Bureau also has access to the information, but it also said it didn’t have the staff to provide a data review.

“This significantly limits (both bureaus’) capacity to analyze trends and assess the adequacy of their mental health response system,” the consultants said.

Mary Claire Buckley, principal management analyst who works on the Police Bureau’s Department of Justice compliance team, said the bureau is working to compare the outcomes of responses to mental health calls by enhanced crisis intervention officers versus other officers. She said she anticipates that analysis may be available next month.

Justice Department lawyers also noted in a report this summer, “Our team has repeatedly heard from officers, on ride-alongs and in the (enhanced crisis) training, that they are frustrated by repeated contacts with known individuals … who they take to the hospital only to be released, over and over without any answers from PPB about what they should do.”

The consultants also found that the bureau has failed to embrace computer tracking to identify at-risk officers or patterns of problems that would allow for early intervention, as required under the federal agreement.

The consultants said police supervisors who oversee the system have resisted their recommendations “time and again.”

Police supervisors have told the consultants that the system’s setup meets the settlement’s requirements. It does track supervisors’ performance reviews of officers under their command, and the rate that the officers use force as a ratio of their arrests and compared to that of other officers on their shifts.

The Justice Department expects more, the consultants said.

“We have seen little in the way of meaningful progress during this review period. … After two years, we believe more progress should have been made and urge PPB to make substantive changes,” the consultants wrote in their quarterly report, covering July through December 2016.

The Police Bureau says the Employee Information System is intended to allow a “comprehensive review” of an officer’s performance on the job, benefit the bureau and officers by “facilitating professional growth” through feedback from supervisors — but may not be used to make decisions about discipline, transfers or promotions.

The consultants said they’d like to see the tool used to ” help save officers’ careers and encourage good policing in general.”

The system flags officers in the computer database if they have used force in 20 percent of their arrests in the prior six months, if they have used force three times more than the average number compared with other officers on the same shift, if they receive two or more complaints with similar allegations or if they have received three or more complaints within the prior six months.

The consultants said the system should track much more information over a longer period, including complaints against officers, their total number of responses to 911 calls, their use of force overall and compared to force used by officers by shift and precinct, ratio of force to arrests and ratio of force used to suspect injuries and officers injuries.

They also recommended that the system track the type of complaints, sustained complaints, ratio of complaints to interactions on the job, tendency to engage in car or foot chases after suspects, their use of sick leave, how frequently they charge a suspect with resisting arrest and how that compares to officers by shift and precinct.

About 90 percent of the flags that arose from the current system aren’t forwarded to an officer’s direct supervisor, but reviewed by the system administrator, the report said.

Seattle police, in contrast, require a direct supervisor review to determine if an intervention, such as mentoring, is warranted.The Los Angeles County Sheriff’s Office has a performance review committee of three commanders that makes such decisions.

“The adequacy of the current review process is unknown because of a lack of documentation, but on its face, does not appear sufficient in light of best practices,” the report said. “Also, a system of intervention has not been established to our knowledge which is the primary goal of (such) systems. As such, we see no evidence that officers who truly would benefit from supplemental instruction and guidance are receiving it.”

Buckley said the bureau has made changes to the system since the consultants completed their report. For example, more is being shared with officers’ direct supervisors when a flag is triggered in the system, and the supervisors are now required to document if they took any action, such as a debriefing, extra counseling or training, Buckley said.

The bureau has met the settlement requirements governing what the system tracks and what would trigger an alert about an officer, Buckley said.

“Certainly we’re going to be looking at improvements to the system. But we first want to comply with the settlement agreement before we’re able to add things,” she said. She added that the bureau’s resources are limited, noting there’s one sergeant who is in charge of the Employee Information System, and the programmer is based in Denver.

The consultants expect to release an updated report next month.

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Announcement – Oregon Advocacy Award

Nominate a mental health or addiction advocate for the Oregon Advocacy Award here.

The Oregon Advocacy Award is given annually to a great advocate for people with mental illness and addiction in Oregon.

The Advocacy Award is given by the Mental Health Association of Portland at the Oregon Law & Mental Health Conference. The winner is announced prior to the annual conference, and given at the conference.

The Award represents the perspective of persons represented by advocacy – persons who have experienced mental illness and addiction.


Advocacy Award Committee Members for 2018

Lakeesha Dumas – Office of Consumer Engagement Coordinator, Multnomah County
Mike Hlebechuk – Oregon Health Authority, retired
Stephanie Matheson – Youth Without Borders, Klamath Basin
Lisa Naito – Naito Public Affairs
Bob Joondeph – Disability Rights Oregon
Brenton Gicker – White Bird Clinic, Eugene

Complete Award information is here.

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