From the Portland Mercury, May 31, 2001

With her shoulders hunched and eyes narrowed, Mayor Vera Katz pounded her gavel. “I can clear this room,” she declared, addressing a murmuring crowd of approximately 80 people who gathered at City Hall last Wednesday afternoon to talk about pending changes to the city’s police oversight committee. Over the past year, a growing number of activists and ordinary citizens have embraced the mechanism of the police oversight committee as a means to tame a police department that many believe has become unruly, abusive, and arrogantly headstrong.

Wednesday’s meeting was a final opportunity for citizens to comment on proposed changes to Police Internal Investigations Auditing Committee (PIIAC), a city-ordained group of citizens that reviews allegations of police misconduct. In mid-June, City Council will vote on adopting a series of proposed changes to PIIAC.

In recent years, a chorus of critics has emerged, complaining that PIIAC is the toothless lap dog of the police. Last summer, with demands that PIIAC be deputized with real powers to investigate allegations of misconduct and to discipline wayward officers, a group of citizens set in motion a laborious process to overhaul the committee. Over the year, a wide variety of opinions and demands emerged–from requests that the number of PIIAC members be reconsidered to pleas that PIIAC be given power to ask questions. (Currently, PIIAC relies on Internal Investigation reports, a process that many believe is akin to asking a fraternity brother to squeal on his mates.) That process of considering changes and overhauling PIIAC is finally limping towards its conclusion, but many believe that the proposed changes fall far short of their expectations–and that nothing will change at all.

The first speaker–a 40-ish, balding man–pointed blame for the death of Jose Mejia-Poot, a Mexican immigrant who died while in custody, to the lack of substantial oversight of police procedures. He implied that the man’s death was the direct responsibility of the mayor, who oversees the police bureau. Mayor Katz instantly became agitated and pointed the gavel at the man. “That’s enough,” she shouted.

The man continued, saying he had no faith in her ability to reign in the police. When several members began to applaud, Katz again slammed down her gavel and confronted the man. “Do you know how many [police] officers I’ve dismissed?” she asked, intoning that she is a no-nonsense boss. When the man shook his head, Katz fired back that perhaps he should do more research before confronting her.

At that point, several members of the audience began jeering that she had only disciplined eight officers during her tenure. Again, Katz slammed her gavel down. “I will clear [the room],” she threatened.

Over the past several years, frustration over the lack of a substantive oversight committee has welled up behind a blockage of legalese, bureaucracy, and so-called policy issues. In 1984, Portland was a pioneer in setting up an independent oversight committee; but since then, the concept has failed to mature, say critics. They point out that while other cities like Minneapolis allow a citizen committee to fully and freely investigate allegations of police misconduct, PIIAC enjoys few real powers and largely defers to the investigations by Internal Affairs.

Disappointed that City Hall has failed to promise real fundamental changes, a ballot measure has emerged. Proposed by the members of the Police Accountability Campaign, the measure seeks much more dramatic changes, such as the power to subpoena testimony from officers. Many of the speakers on Wednesday urged City Council to reject the proposed changes, which, in turn, would set up an opportunity for the matter to be decided by voters in the next election.

Information about the proposed changes, the pending ballot measure, and a comprehensive review of PIIAC can be found at www.portlandcopwatch.org; to urge city council members to vote one way or the other, call (503) 823-4000.

From The Oregonian, May 18, 2001

The panel overseeing reform of the Multnomah County mental health system has asked its staff to rewrite a controversial draft proposal by June 6 with more detail and specific numbers.

“It’s a very sturdy skeleton, but it needs a lot of flesh,” acknowledged staff member James Gaynor, author of the draft. After pitching his “action plan” to the Mental Health Coordinating Committee on Wednesday, he readily agreed to come back next month with a much more specific version.

Gaynor called his draft a “rapid departure point” for discussion of “the acute care crisis that is the largest threat to the stability of the system.”

Much of the ensuing two-hour discussion focused on the need for more mobile crisis teams, safe drop-in centers and other services to help keep patients who are having a crisis from needing to stay in a hospital. Council members asked for more detail about how Gaynor’s plan would curb costs, reduce hospitalization and improve care — as it pledges to do.

“There are big questions in here that are not being addressed,” said council member Jim McConnell, the county’s director of Aging and Disability Services.

“I would like to express my disappointment in the lack of details in the plan,” said Marie Dahlstrom, representing the Latino Network of Portland. “How is this going to happen — so we’ll never have another tragedy like what happened with Senor Mejia?”

Jose Santos Victor Mejia Poot, a 29-year-old Mexican national, was fatally shot during an altercation with police last month at BHC-Pacific Gateway Hospital.

“This is the thinking, but this is not the details,” said Dr. Gene Borkan, a psychiatrist. The county’s shortage of services for acutely ill patients has reached “a phenomenal crisis,” he said.

“We have to turn this around — and turn it around quick,” Gaynor agreed.

During the public comment period, 13 people spoke up, many with experience as patients. Most pleaded for prompt action to improve outpatient care and for additional consumer and minority representation on the council.

The 20-member council includes county officials, mental health care providers and patients and family members.

“I’m not here to bash or point fingers, but our community felt excluded from this process,” said Rosemary Celaya-Alston, who chairs the Latino Network for Multnomah County.

“Somehow, systems broke down,” she said in reference to the Mejia case, “and a man died.”

From The Oregonian, May 16, 2001

This week, Multnomah County officials are getting their first look at a controversial plan to revamp the county’s beleaguered mental health care system.

The draft proposal is aimed at preventing what its authors call a “train wreck” in acute mental health care. It recommends, in effect, a county-run managed care plan to curb costs and help keep patients from needing hospital care.

The current system is “extremely fragmented and fraught with wasteful redundancies,” according to the draft, and fosters scapegoating more than good care.

“All too often,” the draft concludes, “it is the consumer caught in this dysfunctional crossfire.”

But in a meeting Tuesday to discuss the mental health plan and its budget, Multnomah County commissioners hammered both. The commissioners complained repeatedly that the new plan looked nothing like what they had requested.

The proposal caps a process that began two years ago, when former county board chairwoman Beverly Stein appointed a task force to look into mental health reform.

The draft will be presented to the Mental Health Coordinating Council at a public meeting 4:30 p.m. today in the Multnomah Building, 501 S.E. Hawthorne Blvd. The council — including the Multnomah County Board of Commissioners, care providers and mental health patients and family members — is overseeing reform of the county’s mental health system.

“Basically, we want to keep people out of the hospital,” said James Gaynor, director of redesign for the council and author of the draft.

Previous efforts to encourage hospitals to discharge patients more promptly failed, he said, because hospitals had no “step-down” place to send them. Nor were adequate community services available to keep patients out of the hospital in the first place.

“There’s this huge gap,” Gaynor said. “It’s a glaring hole in the system.”

To fill that gap, he said the county needs more mobile crisis teams and safe drop-in centers that can help patients who are having a crisis but do not need to stay in a hospital.

“We can’t keep looking to the police as the mental health ambulance system,” Gaynor said.

“There are people scared to death to have a crisis,” he said. “It usually means the cops picking you up and transporting you to the Crisis Triage Center (at Providence Portland Hospital) in handcuffs.”

Mental health HMO

Under Gaynor’s proposal, a newly formed entity called Verity Integrity Behavioral Healthcare Systems would become the county’s main mental health agency. Verity would be “a prepaid health plan for all intents and purposes,” much like Kaiser Permanente, he said.

Gaynor’s draft drew support from Jason Renaud, executive director of the National Alliance for the Mentally Ill of Multnomah County, an advocacy group.

“We don’t need to add any new money to this,” Renaud said. “We just need to stop flushing money down the toilet.”

He acknowledged that the draft was written in broad-brush generalities, leaving the specifics for later. “How you get from these homilies to real change is a fascinating problem,” he said.

Gaynor calls his draft a “lightning rod for discussion. If somebody has a better idea, I’d love to hear it.”

Commissioners’ concerns

He got his wish, sort of, on Tuesday. Interim Commissioner Pauline Anderson said the plan must look at other counties that are able to run programs within the appropriations from the state.

The redesign team was told to rework the plan to address the commissioners’ concerns and return for another discussion in early June.

It’s not that patients are being hospitalized when they don’t need care, said Dr. Jerald Block, a psychiatrist. It’s that community resources are not available to keep patients stable so they don’t go into crisis and require hospitalization.

“The key is in the details,” Block said. “If those facilities aren’t funded adequately, nothing is going to change.”