From the Portland Tribune, May 29 2009

One-night count could be skewed by weather and agency improvements

Oregon’s sagging economy could be behind a large increase in the number of homeless people across the state.

Information released Friday by the Oregon Housing and Community Services found a 37 percent jump from a year ago in the number of homeless people counted during a January one-night statewide census.

The count found 17,122 people who were homeless, up from 12,529 people in January 2008.

Skyrocketing unemployment numbers and some wage reductions during the recession could have contributed to the number of people who live on the streets.

“The numbers confirm what we already knew, families and individuals can’t afford to pay for one of their most basic needs – a place to live,” said Rick Crager, Oregon Housing and Community Services deputy director.

“It’s a new face of homelessness that we’ve not seen before,” said Corky Senecal, director of Housing and Emergency Services at Neighbor Impact in Central Oregon, an area hard hit by unemployment and resulting homelessness. “Last year these people would have read the stories in the paper, watched them on the evening news – and very possibly would have written a check to an organization that helps the homeless. Today, they are homeless.”

Among the state’s most dramatic differences discovered from last year:

• A doubling in the number of homeless veterans.
• A 100 percent increase in the number of childless couples who are homeless.
• A 150 percent increase in the number of people tallied in the street count.
• More than four times the number of households living in doubled-up situations with friends or family.
• An additional 1,150 people who said they were camping.
• A 32 percent increase in the number of unaccompanied youth who were living on the streets.

In the most recent count, 9,890 individuals – nearly 60 percent of the people identified as homeless – did not receive services or shelter, according to the state information. People in more than 2,000 households are on the streets or living with friends or family. And close to half of households counted had a member with an emotional, mental or substance abuse issue.

Crager said the one-night census numbers, while dramatic, could have seen big increases because local agencies have improved the way they find and track homeless folks. “There are more homeless on the streets, and we’re better at finding them,” he said, citing homeless numbers rising from 3,294 on the street in 2008 to 8,561 in 2009.

Weather can be another factor, Crager said. In snow in 2008 hindered efforts in some rural Oregon towns to count homeless people. “In urban areas, cold weather can attract people to warming centers and other services, making them easier to find,” he said.

From the Salem Statesman Journal, May 29 2009

Contract management likely will ‘protect state’s investment,’ report says

A new state audit gives high marks to the Oregon State Hospital replacement team for its handling of the early stages of the $458 million project.

READ – Oregon State Hospital Replacement: Good Construction Management Practices Help Protect State Investment (PDF)

The state is moving forward with a seven-year plan to build two new psychiatric facilities to replace the obsolete and unsafe 126-year hospital in Salem.

Multilayered checks and balances are keeping project costs in line with objectives, according to the audit, released today by the Secretary of State’s Audits Division.

The audit links effective management of the project to three key factors: assembling an experienced project team; establishing clear expectations with project contractors; and managing contracts to control costs.

The project team assembled by the state Department of Human Services “has implemented good contract management practices that should help protect the state’s investment,” the report says.

Linda Hammond, state hospital replacement administrator, said she was pleased with the audit.

“I think it reflects the direction from leadership and the ability of the team that is working on this project,” she said. “This is a monumental project, and we take those responsibilities seriously, as it shows in the audit.”

Plans call for building a 620-bed facility on the existing hospital campus in central Salem, scheduled to partially open late next year and fully open in 2011, and a 360-bed hospital in Junction City, scheduled to open in 2013.

Brown said management of the initial stages of the hospital project has far exceeded prior state construction projects, including a prison-construction project that drew fire from state auditors in 1999.

“Previous audits showed real problems with how state agencies managed construction contracts,” Brown said. “This is an example of good practices that will help control the project’s costs and risks.”

The 1999 audit of prison construction turned up numerous management flaws and resulted in several recommended improvements.

A consultant on the prison project, now working on the state hospital project, used the earlier audit report to help guide construction management practices for the hospital project, according to the Secretary of State’s office.

The new audit partly links the smooth start of the hospital replacement project to the experience of the DHS team formed to work on it.

Human Services officials “recognized the project’s large size and significance, and assembled a team of department employees and consultants with a wide range of experience in construction contracting, project management, and psychiatric treatment,” the report says.

The audit also commends the agency for clearly defining each team member’s role and responsibilities.

Financial controls on the project include sharp scrutiny of contractor invoices, amendments and change orders, reports the audit.

“Specifically, we noted that project staff had reviewed contractor invoices and timesheets in detail, recalculated changes and corresponded with contractors regarding questioned costs,” it says.

Auditors spotlighted one area for change. They recommended that the hospital project team negotiate the prices for equipment rented from the general contractor in advance, as well as carefully track total rental charges to ensure prices are not exceeded.

The hospital replacement team signaled its intent to heed the recommendation, the report says.

Oregon Secretary of State Kate Brown issued this audit report, Oregon State Hospital Replacement: Good Construction Management Practices Help Protect State Investment, in May of 2009.

EXECUTIVE SUMMARY

The Oregon Department of Human Services is in the early stages of constructing two new state psychiatric facilities to replace the outdated Oregon State Hospital. The Oregon State Hospital Replacement Project (OSHRP) is expected to cost approximately $458 million.

Given the large size of this state investment, we performed this audit to provide early feedback on how well the department is controlling project costs and risks. Specifically, we reviewed whether the department has processes to ensure contract payments, amendments and change orders are in line with applicable rules, contract terms and best practices. We also reviewed whether contractor selections were in accordance with public improvement contract laws.

We found the department has implemented good contract management practices that should help protect the state’s investment by controlling costs and risks. The department performed three main actions that led to its success to date:

1. Assembled an experienced project team
2. Established clear expectations with project contractors
3. Managed contracts to control project costs and risks. We also found that the department selected its contractors in accordance with public improvement contract laws.

AGENCY’S RESPONSE

The Department of Human Services generally agrees with the audit conclusions included in the report.

READ – Oregon State Hospital Replacement – Good Construction Management Practices Help Protect State Investment

Substance abuse and addiction cost federal, state and local governments at least $467.7 billion in 2005, according to Shoveling Up II: The Impact of Substance Abuse on Federal, State and Local Budgets, a new 287-page report released May 28 by The National Center on Addiction and Substance Abuse (CASA).

The CASA report found that of $373.9 billion in federal and state spending, 95.6 percent ($357.4 billion) went to shovel up the consequences and human wreckage of substance abuse and addiction; only 1.9 percent went to prevention and treatment, 0.4 percent to research, 1.4 percent to taxation and regulation, and 0.7 percent to interdiction.

The report, based on three years of research and analysis, is the first ever to assess the costs of tobacco, alcohol and illegal and prescription drug abuse to all levels of government.  Using the most conservative assumptions, the study concluded that the federal government spent $238.2 billion; states, $135.8 billion; and local governments, $93.8 billion, in 2005 (the most recent year for which data were available over the course of the study).

Multnomah County was one of the handful of municipalities which participated in this survey.

OREGON STATISTICS FOR 2005

The burden of addiction was 9.5% of the total Oregon state budget in 2005 – $1.4 billion dollars
Oregon spent $96 million on addiction prevention, treatment and research- $26 per person
Liquor store revenue total $309,649,000; $83.67 per capita
Tobacco and alcohol tax revenue total $257,301,000; $69.53 per capita

MULTNOMAH COUNTY STATISTICS FOR 2005

The burden of addiction was 15.5% of the total Multnomah County budget in 2005 – $116 million dollars
Multnomah County spent $6.4 million on addiction prevention, treatment and research- $9 per person, 0.9% of the county budget

EXTRA – download the CASA report Shoveling Up II: The Impact of Substance Abuse on Federal, State and Local Budgets

Dorothea Carroll holds a picture of her son, Andrew Hanlon, who was fatally shot by a police officer in Silverton, Oregon in 2008. Hanlon was showing signs of paranoia and possible schizophrenia when he was shot.

Run on Morning Edition, May 21 2009
LISTEN – Training Police To Handle Mental Illness Cases

In 1987, a Memphis, Tenn., police officer shot and killed a mentally ill man who was cutting himself and threatening others. The incident inspired training programs to help police handle these tricky situations. Those programs are catching on.

Confronting The Mentally Ill

It’s a situation no one wants to see: An armed police officer is called because someone is in the throes of a psychotic episode. “How the officer handles that situation can have a significant impact,” says Russell Laine, head of the International Association of Chiefs of Police.

The IACP held a two-day meeting recently to discuss how officers should respond. On the first morning of the meeting, there was a silent period for attendees to write the names of officers or people with mental illness who had lost their lives in an encounter. There were about 75 people in the room, and about four dozen names went up on the board. National statistics, though, are hard to come by.

Feeling Threatened

Police officer Darek Ardoin of the Calcasieu Parish Sheriff’s Office in Lake Charles, La., was at the conference. About three or four of the calls he’s sent out on each week involve people with mental illnesses. Ardoin says they’re disturbing the peace, scaring their families or threatening to hurt themselves.

He says he’s rarely felt directly threatened. But last year, a man called and asked for the police to come to his home. The man’s wife was in the bedroom, talking back to the television, and was quite agitated. The man himself wouldn’t get near the bedroom.

“I talked to her from the front door at first, and then I made it to the bedroom door,” Ardoin says. “I could see the knife was there, lying next to her on the bed.”

He followed his training, talked to her quietly and reassured her that he didn’t want to take her to jail. After about 20 minutes, the woman agreed to go to the hospital. “At that point, we had established a relationship,” he says.

The Use Of Deadly Force

Old-style policing calls for subduing the person, usually by force. That approach is upsetting to the person in the throes of a psychotic episode. It’s upsetting to the family, who are often the ones who called the police in the first place. And it’s upsetting to police officers, says Laine.

“Any time an officer has to use deadly force, it takes a significant toll,” he says.

Ardoin has trained three officers who came to training because they had shot and killed a mentally ill man. It was their way of dealing with their post-traumatic stress disorder.

“This is not a magical program, where 100 percent of the incidents will end up well,” Ardoin says. But he says it’s dramatically decreased officer injuries as well as injuries to people with psychoses, and the number of call outs to SWAT teams in Calcasieu Parish.

It’s not just an issue for police. It’s tough from the point of view of the person with psychosis and his or her family members. Sandra Spencer, executive director of the National Federation of Families for Children’s Mental Health, felt that firsthand when her son, who has bipolar disorder, was stopped by police officers when he was walking home from a friend’s house.

“He was manic, shaking,” she says. “He wasn’t coherent.” The police officers told him to be quiet and stay absolutely still. Instead, he reached into his pocket for his cell phone to call her.

“Guns were drawn,” says Spencer.

No shots were fired, but when the officers got her son home, says Spencer, she could see he was a wreck. “He had completely come apart,” she says.

Understanding Mental Illness

She began to talk to other families around the country, and heard a lot of stories about problems with police encounters. She talked to police officers, too, and realized there were lots of misunderstandings. So her organization put out a booklet for families, with advice like always telling the police dispatcher that mental illness is an issue, and not rushing out to greet the police, who might think they were being attacked.

The city of Memphis created a model program for training police officers after that shooting incident in 1987. It was started by Samuel Cochran, who now says officers tend to reflect the views of society.

“When I, in my career in law enforcement, came across a person with mental illness, the reaction I had was, this is just another crazy person that I’ve got to deal with. I was learning that from the community.” Cochran says.

But when the Memphis police chief told him to deal with the public reaction to the shooting, Cochran started talking to mental health experts and families. And he realized that most situations could be defused if police officers were trained to approach mentally ill people differently from common criminals — slowly, calmly and recognizing that the person may not be seeing the situation clearly.

According to the Bazelon Center for Mental Health Law, an advocacy group for people with mental illness, there are now about 200 or 300 police departments around the country with active training programs. The center’s position is that what’s really needed are community services where people with mental illness can get treatment and support, so that crises can be avoided in the first place.

That’s in line with Russell Laine, the head of the police chiefs’ organization. He says one of the challenges facing trained police officers is that there’s often nowhere to take people in need of immediate help other than the county jail.

Oregon State Hospital is in need of volunteers from the community to serve on its Seclusion and Restraint Committee. Oregon law mandates that the committee must have at least three community members.

Committee members support the hospital’s goal to reduce and eliminate the use of seclusion or restraints. Community volunteers should have some knowledge of the state’s mental health system. For example, mental health care providers, mental health professionals or former consumers of mental health services would be considered.

Volunteers will be asked to sign a confidentiality statement because committee members review data that includes patient names and other identifying information. Members must also be comfortable with reviewing and discussing data reports, including tables and graphs, to analyze the hospital’s use of seclusion or restraints.

Interested individuals will be interviewed by the OSH director of quality improvement and appointed by the OSH superintendent. The committee meets on a monthly basis, usually the third Friday of the month, from 10 a.m. to noon.

If interested in volunteering, please contact Ted Ficken, director of quality improvement, at 503-945-0916.

EXTRA – Download Seclusion & Restraint Committee flyer (PDF)

Guest opinion by Mecelle Stone, published in the Eugene Register Guard, May 21 2009

“George W. Bush is the second anti-Christ,” I thought to myself as I entered the Oakway Spa, where only men were allowed on this hot sunny day in 2005.

I had just gone shopping and had bought a new outfit. They let me use the women’s facility to get dressed. I put on a rainbow-colored bathing suit under my new skintight flagger-girl Capri pants and white tank top.

As I was about to leave the spa, I spotted the cards lined up belonging to all the men who were there to work out. I thought it was a secret society. I lunged toward the undercover cop dressed in the neatly pressed suit. I shoved him and said angrily, “I know what you’re up to and you’re not going to get away with this!”

I stripped down to my bikini. I was barefoot, running around the parking lot and threatening to douse myself with gasoline and burn myself to death if anyone touched me.

I now thought I was in a video game. I ran across the street and jumped into a koi pond. The cops were called, and they made their arrest. In the back of the patrol car I was sticking out my tongue and saying “neener, neener, neener,” as if I were 6 years old.

Bipolar disorder was revealing its nasty self once again.

It would be the second of eight hospitalizations in a year and a half. By the end, tranquilizers and restraints often were too well-known. They just reinforced my delusion that George W. Bush was the new Adolf Hitler, and that I was one of his experiments.

Delusions and paranoia controlled my very existence. I had stopped taking my medication because I became suicidal and I was gaining weight.

What a big mistake on my part: I should have worked with my psychiatrist to make adjustments. Instead, I was led to homelessness, unprotected sex and a new love for crack cocaine.

I was hospitalized three times in Eugene. Unfortunately they turned me away the fourth time, which was the night I became homeless. I went missing for two months, hitchhiking to Utah and Colorado. That was right after I told one of my best friends that she was the devil, and that I needed to kill the devil. To this very day, I’ll never know why they didn’t commit me.

During most of my hospitalizations, I would have benefited from a lengthier stay. Instead of a day to a week-and-a-half of treatment, a monthlong stay, minimum, would have been sufficient.

That would have allowed me to get adjusted to my medication and stabilized. Instead, it was as if they bandaged a compound fracture and sent me home as soon as possible.

I believe that I had too many rights as a mentally ill person. In most cases, I threatened to sue the hospital if they didn’t release me. Even though I was out of my mind, legally they couldn’t contain me because I was not “a danger to myself or others.” I actually was quite a danger to myself.

I believe doctors need more power to place individuals on holds, especially if there is a psychologist involved. Due to the system, my therapist did not have the “right” to be part of my treatment. This is someone who had known me for 13 years. She of all people would have been the mastermind of my wellness. Instead, in most cases I was released within a week or so and sent back to society to cope on my own.

I now know that one can appoint a medical power of attorney to overcome the obstacles with one’s medical treatment. The advanced directive form can be found at http://www.nrc-pad.org/content/view/349/5/, or ask your psychiatrist. It will allow people who are incapable of making decisions to have a representative make medical decisions on their behalf.

Although a medical power of attorney is a great measure to have, during the peak of my illness I was in deep denial that anything was wrong. The last thing I would have done was sign an advanced directive form. I believed I had control of the entire universe. The worse my symptoms became, the more in control I thought I was.

Mental illness is a serious biological disease. Funding is low for programs, and they are cutting 30 percent of mental health care services in Oregon. It will take all of us as a community to come together and fight for what’s right, bringing relief to these vulnerable people.

There are many ways one can get involved. Donate clothing, blankets, backpacks and toiletries, and fund the National Alliance of the Mentally Ill/Lane County.

NAMI offers support groups, information and an abundance of resources. Its offices are located at Lane County Mental Health, on the second floor.

Get involved in legislation that supports mental health programs. Also, St. Vincent de Paul has a program called “Lift” and “Vet Lift” that assists people with dual diagnosis. They offer permanent housing for these individuals. You may provide supplies directly to them.

Mechelle Stone of Eugene (www.mechellestone.com) is a student who is writing a book about her experiences with bipolar disorder.

EXTRA – Possible changes in Oregon’s Psychiatric Advance Directive Laws, Mental Health Association of Oregon, May 19 2009
EXTRA – Declaration for Mental Health Treatment (Oregon). Comment – this is not a legally binding document.

Please Help Save Our Multnomah County Human Services!

A hearing for Multnomah County Commissioners will be held Tuesday, May 26th, 6 – 8 PM
501 SE Hawthorne, Multnomah County Building, 1st Floor. The public will be allowed to comment.

It will be a major catastrophe for Oregon’s most vulnerable citizens if critical human services are cut. State and county budget shortfalls are placing essential mental health and addiction services programs on the chopping block.

Come share your story and make a difference:

• Educate the commission and the public about how critical these services are to the health of our communities.

• Thank the commission for protecting human services in their proposed budget.

• Urge the commission to continue to fund human services as the economic crisis continues.

To RSVP contact Joe Cartino at 503-408-4090 ext 405

SEIU Local 503 will be partnering with NAMI Multnomah to turn out advocates for quality mental health and addiction services to this hearing.

Together we can find a long term solution that achieves adequate funding for human services throughout Oregon.

Accessible by Tri-Met bus lines # 4, 6, 10, 14, 33.
Street parking available. Parking garage across street locked up at 6pm

This location is accessible for people with disabilities.