First, some recent context!

New, and sad -> Email from Derald Walker, CEO of Cascadia to all staff, June 5 2008 – Subject: Status Update

From the Portland Mercury, May 30, 2008 – County Fucks Up Mental Health, Asks People With Mental Illness, “How Does it Feeeeel?”

Email from Mary Monnat, CEO of LifeWorks to all staff, May 29, 2008 – Subject: Update on Lifeworks NW Response to Community Needs

Email “memo” from Washington County Heath and Human Services, May 28 2008 – To Washington County Behavioral Health System Partners

Email from Derald Walker, CEO of Cascadia to all staff, May 27 2008 – Subject: Washington and Multnomah Counties

Web site posting from Joanne Fuller, DHS chief, May 9 2008 – news about $2.5 million dollar “loan” – PDF

Questions and answers about Mental Health Services in Multnomah County and Cascadia Behavioral Healthcare, posted May 9 2008 – PDF

Email from Derald Walker, CEO of Cascadia to all staff, May 6 2008 – Subject: Still more progress

Email from Derald Walker, CEO of Cascadia to all staff, May 5 2008 – Subject: We’re making progress

From the Oregonian, May 30, 2008

Officials fear the health provider’s financial problems could put county clients at risk

Washington County is canceling its $2 million annual contract with Cascadia Behavioral Healthcare over concerns that the health provider’s financial troubles put county clients at risk.

A month ago, the county got word twice within about 10 days that Cascadia might have to quickly close its two centers in the county, a move that would have serious consequences for its vulnerable patients.

“The bottom line is they’re experiencing some pretty significant financial instability,” said Rod Branyan, director of Health and Human Services for Washington County.

Branyan notified Cascadia officials a week ago that the county would not renew the contract at the end of the fiscal year. Beginning July 1, two other health providers now operating on contract with Washington County are expected to assume Cascadia’s leases and patient loads.

LifeWorks Northwest, which is based in Cedar Mill, will oversee the center on Millikan Way in Beaverton, and Portland-based Coda will take over the downtown Hillsboro center.

The hope is that LifeWorks and Coda will hire Cascadia staff, who will continue to provide mental health and addiction counseling to the same clients.

“Our goal — I think everyone’s — is to have the least disruption possible,” said Mary Monnat, president and CEO of LifeWorks.

Jim Clay, communications director for Cascadia, said patients’ needs are the nonprofit’s top priority. During a briefing Wednesday of Cascadia staff, that concern was uppermost even among those worried about losing their jobs, he said.

Cascadia intends to send a letter to all clients, urging them to contact their current counselor or clinician and set up an appointment to discuss the transition, Clay said.

The Forest Grove School District is expected to take over Cascadia programs in the school district and hire their employees, according to a letter sent Tuesday to Cascadia staff from Chief Executive Officer Derald Walker.

Cascadia provides treatment, housing and emergency services to more than 20,000 clients statewide and operates 90 facilities in Multnomah, Washington, Clackamas, Lane and Marion counties.

After years of rapid growth, the company has increasingly struggled to cover costs. In recent months, it ousted its entire executive team, cut the ranks of upper management by 40 percent and staff by 20 percent to regain stable financial footing.

Earlier this month, state and Multnomah County officials agreed to provide as much as $2.5 million in loans to keep Cascadia operating for two months.

Although Cascadia is the dominant mental-health provider in Multnomah County, it has a much smaller presence in Washington County. The nonprofit provides mental-health services to about 400 people, or 8 percent of those served through Washington County. It offers addiction counseling to about 300 people, or 13 percent of those served through the county government. At least seven other agencies provide mental health or addiction services, Branyan said.

Washington County is Cascadia’s second-largest client after Multnomah County, but a far distant second, accounting for less than 5 percent of the nonprofit’s business, Clay said.

In 1999, in the wake of the shuttering of Garlington Center, several public deaths of people with mental illness, and a distressing countywide site review by the state mental health division, a wide-open, concerted, public conversation about Portland’s mental health system was launched by County Chair Beverly Stein.

The conversation became more complex as the County Mental Health Division was unable to provide basic data for an initial survey by a blue ribbon task force, chaired by Elsa Porter, a systems engineer. The media became alert.

Read – Mental Health Care Needs Overhaul, Panel Says, from The Oregonian, March 2000

Read – County Department Offers Mental Health Ideas, from The Oregonian, April 2000

Consumer and family members, invited into the discussion for the first time, insisted the system be overhauled, that the system be redesigned to suit the needs of people with mental illness instead of County bureaucrats and vendor agencies. Ed Blackburn from Central City Concern wrangled ten or more committees over the summer of 2000, with over 100 participants, to spell out how services should work.

Once services were redesigned, a third committee was formed, led initially by County Chair Diane Linn, to implement the changes to the mental health system. Large government contracts were at stake and both the direction and the leadership of this committee veered through the Spring and Summer of 2001. The final controversial solution, offered by proxy from the State mental health division and by the County was Cascadia.

Read – Mental Health HMO Proposed for Multnomah County, from The Oregonian, May 2001

Read – Radical Shrink, from Willamette Week, May 2001

Largely designed by Kim Burgess, now with Washington County, Peter Davidson, now with the State Mental Health Division, Cascadia offered a managed care proposal where risk for hospitalization would be shared with a single large provider. This potent incentive for change caused the immediate creation of psychiatric outreach teams, and a drop in hospitalization. The saved costs were to be invested in infrastructure and services.

Read – Turnaround Against Odds Earns Support, high praise from Bob Landauer, May 2003

Read – Give County Credit That Is Overdue, again from Bob Landauer, December 2003

In 2004 or 2005 Multnomah County, under Derald Walker, now Cascadia CEO, shifted the financial model of Cascadia from managed care to fee-for-service leaving Cascadia with no incentive to manage hospitalization risk, and the most service-needy clients. Acute care suffered and hospitalization began to increase. Public oversight was limited at this point – the community trusted a fix had been made.

Because no outcome data is made public by the County or Cascadia – anecdotal information is all we know. This inferior data about the quality and quantity of mental health services is scattered, but uniformly critical. From every perspective, system witnesses remark access is limited, treatment services are poor, ancillary services such as housing and employment assistance are limited, staff turnover is high and moral is low. Homeless shelters, jails, hospitals, and public health clinics are overflowing with people seeking services which should be readily available from County-funded mental health clinics.

Below is a mish mash and incomplete collection of useful documents from 1999 to 2003 from the redesign process. Bookmark this page – the documents will remain here as an archive.

Read – Network Behavioral Healthcare’s 1999 contract with Multnomah County. Note the added language requiring and defining consumer and family participation.

Read – Treatment of the Mentally Ill in the Criminal Justice System – written in August 2000 by Bill Toomey, probably for the Design Team Criminal Justice group. A nice snapshot of that moment.

Read – Options for Persons with Mental Illness in Multnomah County’s Criminal Justice System – probably from Summer of 2000.

Read – DCJ mental health resources, Summer 2000

Read – Overview of DCJ Case Management for Mentally Ill Offenders, October 2000

Read – the charge for the Design Team, Spring 2000

Read – the charge for the Persons With Mental Illness in the Criminal Justice System Work Group, Spring of 2000

Read – the charge for the Client Transportation Workgroup, Spring of 2000

Read – the charge for the Community-Based Intervention Services Workgroup, Spring of 2000

Read – the charge for the Transportation Group, Spring 2000

Read – the charge for the Inpatient Services Workgroup, Spring 2000

Read – the charge for the Data Collection Workgroup, Spring 2000

Read – the charge for the Crisis Workgroup, Spring 2000

Read – the charge for the Best Community Mental Health Services Model Workgroup, Spring 2000

Read – the minutes for the Best Community Mental Health Services Model Workgroup, July 13, 2000

Read – the minutes for the Best Community Mental Health Services Model Workgroup, August 10, 2000

Read – the minutes for the Best Community Mental Health Services Model Workgroup, September 14, 2000

Read – the charge for the Best Community Mental Health Services Model Workgroup, October, 2000

Read – Interdepartmental Communications Workgroup Minutes, October 24, 2000

Read – Mental Health Design Team Coordinating Team Agenda, September 11, 2000

Read – Mental Health Design Team Coordinating Team Agenda, September 26, 2000

Read – Mental Health Design Team Coordinating Team Agenda, October 2000

Read – Mental Health Design Team Coordinating Team Agenda, November 2000

Read – Memo from Design Team Child and Adolescent Work Group, Summary of Priorities for Work Group Recommendations, September 2000

Read – Summary of Recommendations from Design Team Child and Adolescent Work Group, October 2000

Read – Recommendations from Design Team Child and Adolescent Work Group, September 2000

Read – governance structure for community mental health system, 2000?

Read – Multnomah County Behavioral Heath Division policy manual, 2001

Read – Memo on Administrative Changes and Support, November 2000

Read – Report of the Alcohol and Drug Systems Workgroup, August 2000

Read – Proposal for the Atypical Anti-psychotic Medication Project, Spring 2000

Read – system description of the Case Management for Offenders with Mental Illness, Spring 2000

Read – Evaluating the Health Of Multnomah County’s Mental Health System, by Elinor Hall, MPH, May 2000

Read – Introduction: Recovery-Oriented Mental Services, by Ed Blackburn, Summer of 2000

Read – letter from Pat Cosgrove to Lolenzo Poe, one of the many reasons the CTC was closed, Summer 2000

Read – What Do I Want? (consumer / survivor focused mental health services), by Scott Snedecor, Summer of 2000

MORE TO COME

From the Portland Mercury, May 22, 2008

That was mental health advocate Marian Drake, addressing County Chair Ted Wheeler yesterday afternoon during a two-hour meeting to talk about the financial collapse of the county’s giant mental health-care provider, Cascadia.

WHEELER: Met with mental health advocates yesterday…

Since the financial problems hit, many of Cascadia’s clients have been worried about the future of their housing and psychiatric services. Wheeler’s director of County Human Services Joanne Fuller said there’s still no firm plan for what to do with Cascadia next, but she said it’s likely Cascadia will be “a much smaller organization” once the county’s plan is put into effect—it’s likely, too, that Cascadia’s services will be farmed out to other providers across the county, she said. However, “the clients are our top priority,” she said. “We don’t want to destabilize things by moving quickly to make changes that then have negative impacts and hurt consumers.”

“Because of all the instability around services, there’s angst around that,” said Beckie Child of the Mental Health Association of America. “My concern is that people will go into crisis because of all this angst.” “It’s very difficult for Cascadia to build trust with a client if they see a doctor and don’t know if they’re going to see them again,” Child continued.

“I’m less concerned about myself but more for the less capable clients,” said Ryan Hamit, also a Cascadia client and Client Counsel President of the Garlington Center, one of Cascadia’s centers. “One person was yelling about things, another person was yelling and screaming, and shouting, ‘my house, my house, my house’,” he said, bursting into tears. “They don’t want to transition out of where they are now. And then I walked into a meeting and they made an announcement about a new CEO on May 1st, and it’s been quite shocking…” he trailed off.

“If I went to a new provider I’d feel like I was in a strange land, because there’s people I’ve known at Cascadia for many years,” said Duane Hadtaja, one of three Cascadia clients at the meeting, who writes a newsletter for the nonprofit.

There’ll be a public meeting to discuss Cascadia’s future on May 29th at 6pm, in the cafeteria at Benson High school. Earlier this month, the state and county bailed Cascadia out by accelerating $1.5m in payments due to the group for work already performed. Cascadia had taken a $2m line of credit from its bank without informing the county, and thanks to the lack of proper oversight and accountability there, it was able to conceal the problems until the bank froze Cascadia’s accounts at the end of April, and it had to ask for help. Cascadia’s CEO, Leslie Ford, resigned, and has since been replaced by Derald Walker, who was also at the meeting with Wheeler yesterday.

Wheeler, who was conciliatory yesterday, said “this is no longer a dollar and cents issue, it’s a moral imperative…” to come up with a solution to Cascadia’s problems. Until a solution is offered, however, this situation puts a great deal of pressure on Wheeler to prove his mettle as County Chair in a crisis.

“We need to make sure we’re not just setting the system up for failure again,” said John Holmes, director of the Portland chapter of the National Alliance on Mental Illness.

“This is what happened in 2002-3, when the county set out to redesign the mental health system,” said Roy Silberstein, director of the Mental Health Association of Portland. “Although the difference is that they’re making an attempt this time to include consumers in the planning process. It’s encouraging because there’s a chance that consumers won’t be trampled.”

From the Portland Mercury, May 21, 2008

City’s Hazy Drug-Free Zone Replacement Program

After several weeks researching the city’s $1.3 million per year replacement program for the now defunct Drug-Free Zones (DFZs), the [Portland] Mercury has been unable to find a clear and consistent written policy on the new program anywhere in Portland.

The DFZs sunset last September, after independent statistical analysis showed African Americans were more likely to be excluded from the zones than white people when they were arrested for drug offenses. To fill a perceived gap left by the DFZs, City Commissioner Randy Leonard secured $840,709 in the fall to expand the city’s five-year-old Service Coordination Team (SCT). Plans are afoot to top that with an additional $1.3 million of taxpayers’ money next year, if the proposed budget is approved.

The SCT relies on a list of offenders—known as the Neighborhood Livability Crime Enforcement Program (NLCEP) list—who are then targeted for housing and drug treatment. The NLCEP list first came to this newspaper’s attention in April, when an analysis by local attorney Chris O’Connor showed that 214 of the 408 people on the list at the time, or 52 percent, were African American ["Blacklisted," News, April 24]. Following the publication of that story, Portland Police Officer Jeff Myers, along with the NLCEP’s new manager at the police bureau, Bill Sinnott, explained the program in detail to the Mercury in an interview on May 6.

Myers and Sinnott said the list is assembled by conducting blind data runs to find the top 30 arrestees in downtown, inner Northeast, and inner Southeast Portland for the past three months, for crimes typically associated with drug addiction: larcenies, motor vehicle thefts, frauds and forgeries, drugs, disorderly conduct, and probation violations. Those people are then discussed in private Monday meetings at Central Precinct between SCT members, including the cops, probation and parole officers, and service and treatment providers like Central City Concern and Volunteers of America, all of whom have to sign confidentiality agreements. People in the program also typically sign a release saying their information can be exchanged between the SCT parties, according to Central City Concern’s Ed Blackburn.

“We all work together and basically come up with get-well plans for each of the people on our list,” says Sinnott. “And we meet every Monday and discuss what’s been going on with our top offenders each week. If they’ve been showing up for treatment, if they’ve been staying in their room, if they’ve been behaving themselves, if someone’s seen them out using drugs again. And based on what we find out there, the group roundtables, ‘what are we going to do about them this week?’”

Yet despite the effort and considerable amount of money invested in the program, the criteria for getting on and off the NLCEP list doesn’t appear to be written down anywhere—nor is the program’s policy to be found anywhere on the city’s website or in city council legislative files. When asked for a written policy, Myers and Sinnott referred the Mercury to Deputy District Attorney David Hannon, who referred us in turn to Deputy City Attorney David Woboril, who in turn referred us back to Myers and Sinnott. Woboril, however, resisted a characterization of the program as “hazy.”

“Because people are not perhaps cooperating with you or giving you information in the form you want, don’t characterize it as they don’t have any good thinking on the subject,” Woboril said last Friday, May 16. “It’s a complex program. People see it differently. And yet there’s been a lot of thought put into it, a lot of good-hearted, smart thinking has gone into the program.”

Sinnott eventually admitted on Monday, May 19, that the policy isn’t written down in any official document.

“This program has been officially in effect for about five months,” he said. “And we do know what the policy is, it’s very clear to everyone, but we don’t have it written in a directive or in [standard operating procedure] format because we’re currently in the process of doing that. One of the reasons it’s taking a while is we’re not only trying to get consensus, but we’ve just been so busy that we’ve not had a chance to put it in an official form like that yet. But it is something that we’re working on.”

Sinnott set a target date to have a written policy by July 1. It’s a step in the right direction, to increase the program’s transparency and accountability.

“It’s sort of a smaller version of the larger issue our society is facing, which is what happens when you have secret laws made up by people who aren’t responsible to any public oversight,” says attorney O’Connor, with Metropolitan Public Defenders, who has been an outspoken critic of the new program from its inception.

“What’s important for the city is transparency, and having the procedures, the practices, and the scope of the program written down so that everyone can understand it is a really important thing for the government to do,” says Andrea Meyer, legislative director for the American Civil Liberties Union of Oregon. “And to the degree that the city is moving forward on that quickly, we are pleased.”

Meyer adds that she would like individuals who are on the list to be given notice about the fact and its implications, and said ongoing training is important to ensure confidential information isn’t exposed.

The SCT has also appointed a six-member advisory board to oversee the enforcement of the policy. The board had an introductory meeting on Wednesday, May 7, and will be meeting twice a year, Sinnott says. (It’s unclear if the meeting will be open.) Sinnott also plans to invite Jo Ann Bowman of Oregon Action to join the committee, after she expressed concern to the Mercury last week that the oversight board did not have anyone from the mayor’s racial profiling committee on it.

The SCT will also employ an independent consultant to look at why the numbers on the list appear weighted toward African Americans, Sinnott says.

O’Connor describes the new advisory board as a “rubber stamp,” and says true oversight needs to be public and established by city council, independently of the police bureau, to be truly effective. “But then, if you’re overseeing a policy that doesn’t actually exist,” he adds, “I guess it’s debatable whether it’s even worth doing in the first place.”

The future of Cascadia Behavioral Healthcare may be decided next Tuesday at a meeting between the State Addictions and Mental Health Services Division, the Multnomah County Mental Health and Addiction Services Division, Cascadia and Multnomah County Chair Ted Wheeler.

The Tuesday meeting is not open to the public. No public information about what’s happening with the County’s largest mental health and addiction treatment service provider has been distributed since May 1. No information about the content of these meetings have been made available to the public by any of the organizations involved.

An open and public meeting will take place Wednesday at 3 PM at the Chair’s office to brief people with a mental illness, consumers of mental health services, about the Tuesday decision.

The meeting will take place at 501 SE Hawthorne Blvd., in room 635, between 3 and 5 PM. All are invited to attend.

From the Oregonian, May 14, 2008

Heroin-related deaths spiked last year, while casualties from methamphetamine and cocaine dropped from year-earlier totals, Oregon State medical examiner Karen Gunson said Tuesday.

Overall, the number of 2007 drug-related deaths in Oregon was higher than in any year since 1999.

“The jump in heroin-related deaths is very alarming and the highest in that category for the last seven years,” Gunson said. “There is nothing in these statistics to celebrate.”

Last year, 231 people died in the state from heroin, cocaine, methamphetamine or a combination of drugs. That was up 8 percent from 2006.

Heroin accounted for 115 of the deaths, a 29 percent increase from the year before. The deaths of several high school and college students from heroin in recent months have attracted headlines.

Meth accounted for 71 deaths, a decrease of 21 percent. Cocaine was blamed for 55 of the deaths, a drop of 14 percent.

Multnomah, Clackamas and Washington counties all showed significant increases in drug deaths during the year.

See – Drug-related Death Report for 2007

From Joanne Zuhl of Street Roots, May 11, 2008

Portland filmmakers set out to document the life and death of James P. Chasse Jr.

On Sept. 17, 2006, in a tony Pearl District neighborhood, in the sights of police officers who saw something they viewed as “odd,” James P. Chasse Jr. stepped out of time. He was no longer in the Portland of his youth, and he wouldn’t live to see the city that might someday come to understand him.

In that moment, this odd-looking 42-year-old was chased by police, tackled to the ground, Tasered, hogtied, taken to jail, and placed in a holding cell. Less than half an hour later, he was shuttled to a hospital — by the arresting officers — after a jail nurse determined he needed medical care. He arrived dead at Providence Hospital with 16 broken ribs, a punctured lung and massive internal bleeding.

He was not a transient, nor was he violent or an illegal drug user, as was first suggested. He had a home, immense artistic talent, an active spiritual life and schizophrenia.

The story of Chasse’s life, and the circumstances surrounding his death, are the subject of a new feature-length documentary, “Alien Boy,” which is set to begin filming in mid-May. At the helm is director Brian Lindstrom, a Portland native whose film “Finding Normal” is receiving critical acclaim for its portrayal of recovering drug addicts in Central City Concern’s mentor program. In its initial showings across the country, Lindstrom says “Finding Normal” is striking a common chord among audiences about humanity in the misunderstood world of addiction and recovery. It is a chord he hopes to strike again with “Alien Boy,” this time about mental illness.

“I was fascinated by Jim’s earlier life, and I was also extremely interested in the onset of his mental illness, and the kind of gradual isolation that that seemed to create,” said Lindstrom. “I think that if people can understand Jim as a young person, with his incredible energy and creativity and artistic talent, they can see the kind of isolation that he had to deal with later in his life, and I just think it will be a very poignant story and help us explain how we deal with the mentally ill.”

Collaborating with Lindstrom on the project is Portland Mercury reporter Matt Davis, who has doggedly covered the Chasse case in print and blog reports. Davis also has become a student of Chasse’s life, following his career in Portland’s counterculture music scene of the 1980s. Chasse sang in a punk band and created his own punk zine, Organizm, covering the local music scene. The title of the documentary is taken from the punk classic of the same name written about Chasse by the Portland band the Wipers.

“We want to show what happened to him, we want to show why Jim was an important person and not just a nobody,” Davis said. “He was sophisticated, he had a lot of impact on a lot of people. And that’s not just ‘Alien Boy.’ He had friends, he was a poet, he made magazines, he was a significant person. The kind of person that if I knew in college or high school, I would have found really inspiring. He would have had a real impact on me, a person. I would have liked to have hung out with.”

Davis continues to monitor the case now as it waits the outcome of a civil lawsuit filed against the city by the Chasse family. In October 2006, a Multnomah County grand jury found the officers involved, Portland Police officers Christopher Humphreys, Sgt. Kyle Nice and Sheriff Deputy Brett Burton not criminally liable for Chasse’s death. Davis has been unabashed in his contempt for police union protectionism and his desire to see the police officers involved with the Chasse arrest fired.

“I want people to be aware of the silencing that goes on around issues like this, and the way that they’re played and manipulated to avoid the attention on what’s really important, which is firing the individual officers who were involved.”

As much as the documentary will focus on Chasse, it is also about the changes Portland has experienced in his lifetime, according to Lindstrom, who thinks that it is more than incidental that Chasse’s end begins in the Pearl District.

“The gentrification plays a role in all of this,” says Lindstrom. “He was first spotted by the police on the corner of 18th and Everett, and then, in pursuit, he ended up near Blue Hour in the Pearl District, and it seems like this is a collision between the Pearl District and Old Town. What does it mean when an industrial neighborhood becomes an upscale Soho of Portland? I don’t think this would have happened 10 years ago. I think if you take gentrification out of this story, Jim is not even arrested that day and his life goes on.”

Jason Renaud, a mental health advocate and founding member of the Mental Health Association of Portland, went to high school with Chasse. Within days after Chasse’s death, Renaud’s organization was speaking with the mayor’s office about how to proceed: apologize to the family; create a committee with the community to make sure it doesn’t happen again; make crisis intervention training mandatory for all patrol officers; and fire the officers involved. All but the last request was fulfilled within a month, said Renaud said, who is working as a consultant on the film.

As Chasse’s illness progressed, Renaud saw how he lost friends and became more isolated. But Chasse maintained his independence, living in a one-room apartment and staying on medications to manage his illness. It was an existence that a man in his condition wouldn’t have had only a few decades ago, Renaud said. For Renaud, the responsibility lies squarely on the three officers involved in Chasse’s arrest, not the mental health system.

“James was an example of how the mental health system worked really well,” says Renaud. “James was really sick. And 20 or 30 years ago, James would have spent his life in an institution, heavily drugged, often restrained, away from his friends and family, away from the library he loved, the music he loved, the people he enjoyed being around. Because of our outpatient mental health system and better medication, and because of our generous housing system, Jim was able to live independently, live alone, and care for himself, which he was able to do for the most part. That would have all been gone 20 years ago without this mental health system. He was a big success. Even though he had really bad times, and when people look at the way he looked or the way he acted, they’d see someone who was very ill, he would have been much more ill without this system.”

Ultimately, Renaud thinks the movie will have an upbeat message; one that shows the response of the city to date, and what still needs to be done, including creating a sub-acute care facility that could take people in crisis.

“It’s Jim’s legacy that these things occurred. I don’t think Jim was a mental health advocate, he was not a person who spoke out about anything except his undying love of the Velvet Underground. He was a very shy, very frightened person who had a strange gift and had a hard time sharing it with people.

“Everybody in Portland knows the story of what happened to Jim,” Renaud says. “And a lot of people know, who care to know, the things that the city and the county did to make sure that what happened to Jim doesn’t happen to anybody else. Who doesn’t know is the city of Phoenix, Chicago, New York, Paris and London. We need to make this film to tell the rest of the world what happened to Jim, and what the city of Portland did to address concerns.”

Lindstrom hopes the film goes beyond words and images and prompts action.

“It can be a model of how a city reacted to this terrible tragedy,” Lindstrom says. “And also make sure that, God willing, nothing like this will happen again.”

The Mental Health Association of Portland, pursuing it’s mission to help people with mental illness and addictions speak up and speak out, has created a web site for the Homeless Liberation Front.

The web site is at http://homelessliberation.wordpress.com

The Homeless Liberation Front is a political action by homeless individuals protesting the City of Portland’s Camping Ordinance and the Sit / Lie Law. The protest has been in operation on the East sidewalk of Portland’s City Hall for the month of May.

Members of the Homeless Liberation Front have full access to authorship of this site. The site is permanent, free and was created by volunteers.

From the Oregonian, May 7, 2008

Mental health – The $2.5 million buys the service provider some time, but it faces an “uncertain future”

State and Multnomah County officials agreed Tuesday to provide up to $2.5 million in loans to keep Oregon’s largest mental health care provider operating for the next two months.

The loans will keep Cascadia Behavioral Healthcare open long enough to complete planning the future of the local mental health system, including decisions about whether to break up the nonprofit company, said county Chairman Ted Wheeler.

Without the loans, Cascadia would have had to close its doors by the end of the week, putting clients in jeopardy and costing the county millions of dollars to rebuild the system, Wheeler said.

“A lot of people would find themselves on the street, some people would probably die,” he said.

Dr. Derald Walker, now in his second week as Cascadia’s CEO, praised the county and state for providing the money.

“It takes us out of the imminent financial crisis, but no one in their right mind would say it takes us out of crisis,” Walker said. “We have a huge uncertain future ahead of us.”

Cascadia provides treatment, housing and emergency services to more than 20,000 clients statewide and operates 90 facilities in Multnomah, Washington, Clackamas, Lane and Marion counties.

After years of rapid growth to become the dominant provider in the state’s most populous county, the company has increasingly struggled to cover costs. In recent months, it ousted its entire executive team, cut upper management ranks by 40 percent and staff by 20 percent to get back on stable financial footing.

Last week, Capital Pacific Bank took most of Cascadia’s available cash to pay off an outstanding debt. The state and county agreed to speed up $1.5 million in payments owed to Cascadia so it could pay its 1,000 employees.

But the infusion didn’t help Cascadia catch up on lease and mortgage payments, including for its clinics and administrative headquarters. Vendors, including those providing crucial food and pharmaceutical services, started demanding cash payments upfront for all transactions, further aggravating the crunch.

Wheeler said Tuesday’s loan — $1.5 million from Multnomah County and $1 million from the state Department of Human Services — buys “time for a thoughtful transition of services.”

Jim Scherzinger, deputy finance director for state Human Services, recommended the state and county carefully track spending. “We fully expect to get the money back,” he said.

Some in Cascadia wondered why the county and state hadn’t acted sooner to provide financial support, a move they believed would have kept the bank from declaring the company in default last week.

Jana McLellan, deputy chief operating officer for Wheeler, said the county needed more time to conduct its own financial analysis of Cascadia.

Across town at Woodland Park Medical Plaza, Cascadia executives spoke to a group of clients, assuring them of their commitment to continue services, but making few promises.

Several clients feared their treatment could be cut at any time, one declaring that she was already suffering “feelings of abandonment.”

Nonprofit – Multnomah County officials hold meetings to keep services going
From The Oregonian – May 01, 2008

Multnomah County leaders were scrambling Wednesday to craft a last-minute plan to keep mental health services operating as the state’s largest provider moved closer to collapse.

Cascadia Behavioral Healthcare learned in the late afternoon that its bank was collecting on a long-standing $2 million debt due this week, a development that the nonprofit company previously warned would likely force it to declare bankruptcy.

County officials held a series of tense emergency meetings from early morning into the night to come up with a plan to keep the system going. Participants said they couldn’t disclose details of the discussions, which included officials from the state, Cascadia and other mental health service providers.

“We’re going to do everything we can to keep the services alive for clients,” said Joanne Fuller, head of Multnomah County’s Department of Human Services. Spokesman Jim Clay said Cascadia’s 90 facilities in Multnomah, Clackamas, Washington, Lane and Marion counties would “absolutely” be open for business this morning.

With a $58 million budget, Cascadia provides housing, treatment and crisis response services to 23,000 people each year for ailments ranging from depression to alcohol abuse to schizophrenia.

Multnomah County urged current clients to attend scheduled treatment today and to call its mental health information line at 503-988-4888 with any questions.

Employees will still be paid, Clay said. “If that changes at any time, we would let employees know,” he said.

County officials first learned the scope of Cascadia’s financial problems about a month ago, when the company approached them with a request to guarantee millions in loans. County Chairman Ted Wheeler denied that request — as did the state Department of Human Services — but launched an ongoing audit of Cascadia’s finances and began planning to stabilize the mental health system in case the company failed.

Cascadia executives have said the company lost millions switching to a new billing system, worsening an already shaky bottom line.

Wheeler hoped that Capital Pacific Bank would provide Cascadia more time to allow that work to continue. Capital Pacific CEO Mark Stevenson said the bank has spent “enormous amounts of time” trying to reach a solution, without success, but remains open to negotiating.

Clay said Cascadia managers were busy working on survival plans. “They spent more time talking about the clients than they did about their own paychecks,” he said. “Everyone knows the consequences here.”