PLUS NEW HORIZONS What Measure 110 funds are doing in Harney County THE HEALTH CARE ISSUE July/August 2024 | OregonBusiness.com UNPLANNED Reproductive health in post-Roe Oregon HEAD OF THE CLASS Dufur’s new school health clinic
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⁄Contents⁄ July/August 2024 FEATURES 26 Funding From Measure 110 Fuels a Transformation in Harney County Cover The most controversial part of Oregon’s drug-reform law was gutted this spring. But parts remain intact and are funding much-needed addiction services across Oregon. 36 Planned Parenthood’s New Plan How Dr. Sara Kennedy and Amy Handler plan to lead Planned Parenthood’s two Oregon affiliates REGULARS 06 Editor’s Letter 10 Newsfeed 12 Tactics Lindsey Norlander, executive director of Dress for Success Oregon, talks about inflation, COVID and why jobreadiness is about so much more than a good interview suit. 16 Spotlight How a state-funded program is getting high school graduates ready for careers in caring 20 Profile How Dufur’s new school clinic will care for Wasco County kids — and why stakeholders want more centers like it 42 Powerlist Financial planners 44 Downtime Chill out with Jarod Cogswell, general manager at Life Time, Inc. 46 Policy Brief Sussman Shank lawyer Hansary A. Laforest outlines how franchise owners can be liable for wrongful acts of franchisees in Oregon. Subscribe to our weekly e-newsletter featuring the best of OregonBusiness.com, plus articles from our print publication. To sign up, go to OregonBusiness.com. BRAND STORIES 24 Milestone Systems Video-technology software provider drives policies to protect people and innovation. 34 Willamette Valley Medical Center Quality care at the H.R. Hoover, MD, Cancer Center pairs patient-centric services with leading technologies. PLUS NEW HORIZONS What Measure 110 funds are doing in Harney County THE HEALTH CARE ISSUE July/August 2024 | OregonBusiness.com UNPLANNED Reproductive health in post-Roe Oregon HEAD OF THE CLASS Dufur’s new school health clinic COVER PHOTO: Jason E. Kaplan COURTESY OF MERCY FLIGHTS JASON E. KAPLAN CORRECTION The story “Fighting a Plastic Planet,” which ran in the June issue of Oregon Business, erroneously stated that litigation between Ridwell and Washington County is ongoing. In fact, Ridwell dropped its lawsuit in August 2023. Oregon Business regrets the error. CHECK OUT THESE EXCLUSIVES ON OREGONBUSINESS.COM n In Conversation: Margot, Owner of Fig Tree Studio — As business slows in Portland’s strip clubs, interest in pole dancing climbs. n Portland Fashion Institute Founder Sharon Blair Talks About Fashion, Education and How AI Could Make the Fashion Industry Greener —The PFI started as a series of sewing and pattern-making classes in Portland’s Hollywood neighborhood. Now more than 8,000 students have taken classes at the school — and many go on to full-time careers in the apparel industry. n Oregon Freight Forwarding Company Hit With Serious Penalty — USGoBuy was found out of compliance with exportcontrol law for shipping rifle scopes and other items to countries considered national security threats. n Insurer Files $9.5M Lawsuit Against City of Astoria, Contractors Over Buoy Brewery Collapse — The brewery, which partially collapsed in 2022 and experienced a second partial collapse in December, began demolition in June. Follow @OregonBusiness for breaking news, blogs and commentary. 16 4
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⁄From the Editor⁄ Checking In With Measure 110 AFTER OREGON VOTERS passed Measure 110 in 2020, two narratives quickly took hold. The piece that got the lion’s share of attention was decriminalization — whether decriminalizing small quantities of hard drugs was a good idea to begin with, and whether it worked in practice. Oregon legislators did away with that reform this spring, with many blaming M110 for the increased visibility of public drug use in communities throughout the state, though the law only decriminalized possession of certain drugs and public use remained illegal. (Public use also hasn’t appreciably waned since HB 4002 took effect in April — at least not in my neighborhood.) Bundled in with Measure 110’s groundbreaking decriminalization experiment was the promise of increased funding for addiction treatment services, which stakeholders on all sides of the issue say have been drastically underfunded for decades. By 2022 a second narrative on Measure 110 had taken hold. A series of news stories and a damning audit from the Secretary of State’s office underscored that the state was struggling to implement the law’s far less controversial reform: diverting cannabis taxes to the coffers of organizations that provide drug treatment. This spring I asked staff writer Garrett Andrews to get an update on what’s happening with that funding. He ended up zooming in on how funds set aside by the measure have affected one rural Oregon community. In Burns, where the increased prevalence of fentanyl has had a devastating effect, people seeking treatment have some access to clean and sober housing, and access to employment at the Fresh Start Café. The resulting story, “Funding From Measure 110 Fuels Transformation in Harney County” (p. 26), doesn’t comprehensively account for every dollar of funding promised to stakeholders. But it does show us what one community is doing with the funding — and it gives us a sense of what’s possible amid a drug epidemic whose effects have devastated communities throughout the state. VOLUME 47 ⁄ NUMBER 6 OREGON BUSINESS (ISSN 02798190) is published 8 times per year, monthly except Mar/Apr, Jul/Aug and Oct/Nov/Dec issues, by MEDIAmerica Inc. at 12570 S.W. 69th Ave., Suite 102, Portland OR 97223. Subscription inquiries should be directed to 503-445-8811. Subscription charge is $24.95 per year, $49.95 for two years in the USA. Single copies and back issues available at above address and at selected newsstands. The editor is not responsible for unsolicited manuscripts. Copyright © 2024 by MEDIAmerica Inc. All rights reserved. All material is protected by copyright and must not be reproduced without written permission from the publisher. Printed in Oregon. Periodicals Postage Paid at Portland, OR. POSTMASTER: Send address changes to Oregon Business, 12570 S.W. 69th Ave., Suite 102, Portland OR 97223 EDITORIAL EDITOR Christen McCurdy christenm@oregonbusiness.com ART DIRECTOR Joan McGuire joanm@oregonbusiness.com STAFF WRITER Garrett Andrews garretta@oregonbusiness.com STAFF PHOTOGRAPHER Jason E. Kaplan jasonk@oregonbusiness.com COPY EDITOR Morgan Stone CONTRIBUTING WRITERS Hansary A. Laforest, Amy Milshtein PUBLISHING PUBLISHER Courtney Kutzman courtneyk@oregonbusiness.com EVENTS MANAGER Craig Peebles craigp@oregonbusiness.com ACCOUNT EXECUTIVE Evan Morehouse evanm@mediamerica.net ADVERTISING AND PRODUCTION COORDINATOR Greta Hogenstad gretah@mediamerica.net DIGITAL PRODUCTION COORDINATOR Alison Kattleman alisonk@mediamerica.net PRESIDENT AND CEO Andrew A. Insinga CONTROLLER Bill Lee BOARD OF DIRECTORS CHAIRMAN André W. Iseli PRESIDENT Andrew A. Insinga SECRETARY William L. Mainwaring TREASURER Win McCormack 6
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ECONOMY & FINANCE ●Decreased motor function. Medford-based dealership group Lithia Motors became the latest Oregon-based Fortune 500 company to announce layoffs, after Dutch Bros did so earlier this year. Lithia hopes to save $150 million in a “targeted” staff reduction that will affect some underperforming general managers and sales managers. HEALTH CARE ●Surgical strike. More than 3,000 nurses from six hospitals in Providence’s Oregon network participated in a strike in late June. It was the largest nurses’ strike in the state’s history. When this issue went to press, the nurses had returned to work but still didn’t have a contract. TRANSPORTATION ●Backup alert. All lanes of Interstate 5 were closed at the Terwilliger curves south of Portland for three days while crews constructed a new bridge deck over SW 26th Ave. The bridge carries more than 100,000 vehicles per day. RESTAURANTS & RETAIL ●Food stall. A citizen review board recommended that the Oregon Health Authority deny a $24.6 million proposal by Kroger to acquire rival Albertsons. The board warned the proposed sale could reduce competition between pharmacies in the state and would not improve access to pharmacy services in Oregon. ●Wet bar. Portland’s women’s sports bar the Sports Bra made waves in June when it opened a poolside pop-up at the Cannes Lions International Festival of Creativity in southern France. B-ball phenom and rapper Flau’jae Johnson performed a song. Located on NE Broadway in Portland, the women-centric sports bar announced plans to franchise earlier this year. MANUFACTURING ●In the soup. Tualatin’s Pacific Foods plant, which employs 330 people, will close by 2026, the brand’s parent company, Campbell Soup Company, announced in May. ●Tire chains. Prinevillefounded Les Schwab Tires has acquired commercial tire manufacturer CMC Tire. Founded in 2014, CMC — based in Colorado, Utah and Nevada — employs around 200 people, while Les Schwab employs more than 8,000 people at 540 locations. POLITICS ●Dem changes. Oregon Senate Democrats elected Sen. Kathleen Taylor, D-Portland, as the next senate majority leader. The legislative body’s Republicans will also have a new leader in Sen. Daniel Bonham, R-The Dalles, who replaces Tim Knopp, R-Bend, who was barred from reelection by ballot Measure 113 for his participation in the 2023 Senate walkout. ●Sea change. A new scientific assessment found that rising oceans could threaten dozens of water-treatment plants, police stations, fire departments and other critical infrastructure along the Oregon Coast. Twenty-six sites could flood twice per year, according to a recent paper by the nonprofit Union of Concerned Scientists, which assumes the seas rise 3.2 feet by 2100. TOURISM & HOSPITALITY ●Hit the road. Travel Portland’s CEO, Jeff Miller, announced his retirement after 19 years leading the marketing and promotion organization, a period that saw record-breaking tourism numbers for Portland. He will leave in December. FARMS & FORESTS ●Hothouse growth. The state’s greenhouse and nursery industry retained the top spot on the state’s list of top agricultural commodities, followed by cattle and calves, hay, and milk. The greenhouse and nursery industry is valued at $1.22 billion. MISCELLANEOUS ●Hangin’ out. Twenty-eight people were trapped upside down on the AtmosFEAR ride at Oaks Park Amusement Park for around 20 minutes before firefighters rescued them. ●Good boy. A Halfway man was rescued with help from his dog after driving off a forest road and down an 85-foot ravine in remote Baker County. Blue, a whippet-pit bull mix, ran 4 miles back to a campsite where he and his owner had stayed recently. That led to the rescue of his owner, Brandon Garrett, and Garrett’s three other dogs. ●Dead to the world. Oregon politician Neil Goldschmidt, whose legacy includes major infrastructural changes and admitted sexual abuse of a teenage girl who babysat his children, died at 83. ENTERTAINMENT ●Red giant. NBA Hall of Famer and Trail Blazers legend Bill Walton died of colorectal cancer in May at age 71. Walton, the Finals MVP in the Blazers’ lone championship run in 1977, followed his NBA career with a decades-long turn as a sports broadcaster. ENERGY & ENVIRONMENT ●Fish out of water. Fish fans flocked to Gearhart Beach near Seaside to view a rare 7-foot-long, 2,000-pound mola tecta, or hoodwinker sunfish, that washed up. It’s thought to be the largest example of its species ever recorded. Discovered in 2017 near New Zealand, the species is typically found in the southern hemisphere. ⁄Newsfeed⁄ Jenny Nguyen is owner and founder of the Sports Bra, the first allwomen’s sports bar, which announced plans to franchise earlier this year. JASON E. KAPLAN 10
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⁄Tactics⁄ Lindsey Norlander Looks Beyond the Dress The executive director of Dress for Success Oregon talks about the organization’s commitment to supporting women and genderexpansive people in the workforce and beyond. INTERVIEW BY CHRISTEN MCCURDY DRESS FOR SUCCESS OREGON STARTED in 1999 in a Portland garage, becoming the seventh affiliate of an organization that started two years earlier in a church basement in New York City. As the name suggests, the organization provided — and continues to provide — donated clothing to women who need something to wear to a job interview or to a new job. But the scope of both the national and local organizations has grown well beyond that, to offer job training and upskilling, networking opportunities, financial education and access to other resources, including—at the onset of the COVID-19 pandemic—new laptops and access to the internet for clients who suddenly found themselves working from home but without the right technology to do their jobs. The organization has served more than 30,000 clients in 25 years. A spokesperson for DFSO says that in 2022, 73% of surveyed clients were on public assistance, but two years later, only 36% of the respondents were still on public assistance. Lindsey Norlander became the executive director of DFSO in February, after six years with the Oregon affiliate and 11 total with the organization. She started working at Dress for Success Houston as a volunteer manager in 2014. In 2023 Norlander moved to Oregon; she worked as DFSO’s volunteer and store manager, its director of programming and community engagement, and its interim executive director before stepping into the ED role permanently. Before working with Dress for Success, Norlander consulted with nonprofits on fundraising and grant writing. Norlander’s experience also includes a stint teaching English as a second language in Thailand and acting as a liaison for a Thai orphanage, working with prospective adoptive families. Oregon Business met with Norlander this spring to talk about the wide variety of clients DFSO serves, the varying needs they bring to the table and what’s next for the organization. This interview has been edited for length and clarity. 12
JASON E. KAPLAN How has the pandemic affected your work? You’ve mentioned that people still associate your organization with formal wear, but most so-called white-collar workers are working from home and can wear pajamas if we want to, as long as we look OK on a Zoom call. We were one of the first human-service agencies in the state to pivot to virtual in 2020. We knew women-dominated industries were really impacted [by COVID]: retail, hospitality, education. During that time, we were hearing from our clients things like, “I don’t need work clothes, I need access to the internet,” or “I need a computer,” or “I don’t know how to work Zoom,” or “How do I apply for a job over the internet?” Since then, things have evolved. We started to use a hybrid approach, much like other human-service agencies, so everything we do in person, we offer virtually as well. We’ve been able to support more women from different backgrounds. The amount of single parents that we’re able to support within our workforce-development program has increased because they could be making food at home for their kids while, for example, hearing from a financial adviser through our virtual programming. The cost of living in Portland — and inflation — have had a real impact on not only our clients but our donor base. We’ve had to be strategic in the ways in which we support our clients in terms of the programs we offer, and reprioritizing wraparound services. We’ve also had to be very strategic in the way we think of fundraising. To your point, often if I’m personal shopping — which I don’t get to do as much anymore — it’s like, “Can I get yoga pants and a blouse?” But we support all industries. The most interesting request I’ve had was about a year ago, and somebody was getting a job in human services. They were doing nonemergency work, where their supervisors were asking them to be dressed in business casual, but they had to be seasonal and they had to be able to run if needed. And so they were trying on business-casual clothes, flat shoes, and were literally running right here; that’s what they needed. We see a lot of clients who come in needing scrubs and nonslip shoes. It’s also really interesting seeing trends based on time of year. January through March, we see a lot of temp work going into financial institutions because of tax season. In spring we see an influx of clients going into trades and census work. Then at the end of the year, we see a lot of needs for retail seasonal work. That kind of helps us be able to pivot and think thoroughly, annually, of what donations are needed. Do you have storage space beyond this space? No. So you’ve got to be really mindful about what you bring in. That can be challenging because I think the way our building is set up, you don’t see the warehouse, you don’t see the back stock and that we’re at capacity. We aren’t set up like some other nonprofits like Goodwill, that have hundreds of employees processing clothing. The same people who are scheduling volunteer groups to process clothing are the individuals who are processing clothing for here, who are working with our corporate drives, who are working with our retail partners. And so we have a very full 40 hours, and we’re able to do that because of our incredible volunteer base. But we have to be very strategic about what we ask and what we can accept just based on capacity of time and space. You mentioned that inflation and increased cost of living in Portland really affected both your donors and your clients. How has that impacted what your clients are asking for? Some of the stories I’ll hear are like, “I’ve just gotten a new job, I make $24 an hour, my rent is $1,700 or $2,000. I have two kids. That leaves me with a very small pot of funds at the end of the month.” So it gets down to meeting the children’s basic needs, and then that gets down to the nitty gritty in terms of, does that parent have access to personal-care items? Are they prioritizing buying food for themselves? So we know it has a direct effect on our clients’ abilities to take care of themselves. That’s things from shampoo, conditioner, feminine care to transportation. You said that Dress for Success started in a garage in Tigard. Is that the whole organization or is that the Oregon affiliate? We were the seventh affiliate. The original Dress for Success started in New York in the basement of a church. A woman — her name is Nancy Lublin — received a $5,000 inheritance from her great-grandfather. She went to a local church and she asked the nuns who were working there what were the highest needs that they saw. It was really the economic disparities that women were facing. Getting a job is expensive, and you need to be able to show up to that interview and be taken seriously. We now know that it’s not just that. There are so many different avenues and social determinants to getting and sustaining work that are beyond just clothing. But it really is those determinants that hinder people from keeping their jobs. Continued on the next page. 13
What do you do when you’re not at work? I have a baby, so that’s all-consuming. I’m an hour from my door to Timberline, and I ski a lot. And I have a border collie, because having a baby isn’t busy enough. So I run around Mt. Tabor a lot with my stroller and my border collie. I like to be outside. What is on the horizon for Dress for Success, in terms of either needs that you anticipate or your plans? Our goal is that we can continue to be nimble to the needs of our clients and that we can continue to see the 1,000-plus women we do a year and the ways that are best going to support them as they’re looking for work, sustaining work and finding livable-wage jobs. One short-term goal that we have this year is, as a 501(c)3, we obviously can’t share our political views, but what we can do is empower people to vote, so in 2020 we registered 170 new voters. We know Multnomah County has that new ranking system. So we have scheduled for the summer both a voter-registration workshop and a demystifying of that new ranking system. So much of our work is self-defined success and autonomy. And so what success means to one of our clients may mean something totally different to someone else, so the question is, how do we help prioritize all the resources and information they need to be able to find the avenue that works best for them? PHOTOS BY JASON E. KAPLAN 14
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⁄Spotlight⁄ BY GARRETT ANDREWS SOMETHING IS HAPPENING in Medford practically unheard of in the field of emergency medicine, an experimental pilot program that officials hope can serve as a model around the country. It’s not driverless ambulances or medical-transport drones. It’s not AI-assisted 911 dispatch or an app that streamlines decision-making for first responders. It’s a paid internship. Inspired by the model of the building trades, a coalition of Southern Oregon organizations has started a novel “earn to learn” EMT apprentice program funded by $3 million in state grants. Without breaking any new technological ground, the program, which just wrapped its second year, takes aim at the emerging health care workforce crisis with the idea that if you bring young people into your industry and support them financially, they’re more likely to stick around. The country is in the midst of a health care workforce crisis that’s expected to deepen over the next decade. In essence, it’s a matter of demand growing faster than supply. In other words, health care workloads are increasing due to an aging population while fewer people are working in the medical field. The stress from higher workloads drives retirements and burnout, forcing many workers from the field in a vicious circle. These problems tend to be worse in rural areas. Today in the counties of Jackson and Josephine, there’s a need at nearly every skilled position from 911 operator to nurse to physician to medical-transport pilot (helicopter and fixed-wing). “We’re in a paradigm shift,” says Heather Stafford, director of the Rogue Workforce Partnership. “There are less humans being born, more options for work and rising inflation. And you’ve got a generation coming up that’s not that interested in just trading their time for dollars. They want to do something more interesting, something that has more purpose.” The Rogue Workforce Partnership is one of nine regional workforce-development boards in Oregon responsible for distributing federal workforce dollars. In rural Jackson and Josephine counties, the health care sector remains the largest employer and offers residents some of the best opportunities for career advancements, according to Stafford. But workforce needs are spreading across the health care landscape. It’s no longer just the region’s two big health employers, Asante Rogue Regional Medical Center and Providence Health & Services, who need lots of skilled professionals, namely RNs. The dust is still settling in health care employment since the pandemic, when one in five health care professionals quit their job. To fill gaps, traveling nurses, who can earn up to twice the wages of their full-time counterparts, have become ever-present, putting more pressure on large health employers. Bringing in contract workers who earn up to twice the wages of company staff is often bad for morale and can cause agencies to give out bonuses or other costly benefits to retain staff. In response to the dearth of doctors in Southern Oregon, a group of health systems and medical providers calling itself SOAPP, or the Southern Oregon Alliance of Physicians & Providers, has pooled its resources to recruit doctors by marketing the region as a great place to live that’s home to high-quality schools, wineries and health resources. Facing Workforce Crisis, Health Care Officials Push Apprentice Programs in Oregon Jackson County’s largest medical transport service hopes paying young people to learn the ropes draws talent to emergency services. “You’ve got a generation coming up that’s not that interested in just trading their time for dollars. They want to do something more interesting, something that has more purpose.” HEATHER STAFFORD, DIRECTOR OF THE ROGUE WORKFORCE PARTNERSHIP Mercy Flights ambulance fleet COURTESY OF MERCY FLIGHTS 16
“We think you will love it here,” reads SOAPP’s website. The Legislature made a major investment in workforce development in 2022 with the $200 million Future Ready Oregon funding package with a considerable setaside for expanding nursing-career pathways. One area that’s seen less focus, though, is emergency services. At the moment, most emergency agencies in Oregon have open positions, according to the Oregon State Ambulance Association. “We always knew there was a demographic cliff coming, but it seems like it just happened overnight,” says Sheila Clough, CEO of Mercy Flights, the region’s largest medical transporter. “There’s a combination of things happening: We’re struggling to have enough trained paramedics and nurses. At the same time, there’s been a 20% increase in demand for services.” Emergency service is increasingly difficult to staff, Clough says. Despite a considerable training requirement, the work is low-paying in addition to high-stress. And once trained, EMTs and paramedics are difficult for agencies to keep. They commonly move to other areas or are recruited to nursing pathways by large hospital systems. With a staff of around 200, Mercy Flights responds to around 26,000 calls for service each year. Those calls break down into three types: traditional ground transport, mobile integrated care (a fast-growing service area due to the shifting health care landscape) and, as the name suggests, critical care air transports to primarily Portland-area hospitals. As of this writing, Mercy Flights has 10 open positions with staff working regular overtime hours. These days, the service sees 50% to 70% fewer applications than prior to the pandemic, and recently had to bring in contract paramedics for the first time in its 75-year history. For decades, paramedic trainees in Jackson County had to work 40-plushour weeks unpaid for at least a year while they attended classes. Many students worked a separate full-time job to pay their tuition and other life expenses. Two years in the making, the new apprentice program, which Mercy Flights oversees on behalf of several other fire-service and EMS providers, provides a living wage for a 40-hour EMS internship and full tuition to attend EMS classes at Rogue Community College. Another key aspect of the apprentice program is K-12 support to inspire the next generation to join the health care profession. The Rogue apprentice program includes a $250,000 career technical-education component to fund an Introduction to EMS class at Phoenix-Talent School District’s Phoenix High School, where students can earn four credits toward an EMT degree plus CPR certification. One large-scale education trend could help health care employers in Southern Oregon: Young people are increasingly rethinking the value of a four-year college degree. Nearly three-quarters of high school seniors polled by the Higher Education Coordinating Committee felt vocational school was a better investment of time and resources than a four-year degree. So brain drain has been less of a problem lately, Stafford says. “In Jackson County, we retain more of our young people,” she says. “For us, that creates an opportunity to train up a vocational workforce.” The Mercy Flights apprentice program has already helped Dex Dumore, 19. An honor student in high school, Dumore seriously considered attending a four-year college to study mechanical engineering. But she’s also from a health care family, and thanks to an explorer program at her high school, she knew she was drawn to the fast pace and adrenaline rush of emergency services. In the end, she decided she was more interested in getting right to work. “Not sitting in college for four years was definitely an appeal to me,” Dumore says. Dumore wrapped her first year as an apprentice in June. When she wasn’t in class or studying, she restocked medical supplies around the station and occasionally rode on calls. Next year, as an Apprentice 2, she’ll ride on more calls and prepare. In all, Dumore is one of 50 people the Rogue apprentice program will support. A similar nursing apprentice program at Rogue, funded by Providence, is currently supporting 22 nursing apprentices. Considering the scale of the health care workforce crisis, these are drop-in-the-bucket figures, to be sure. But to apprentices like Dumore, these contributions have been massive. “I’ve had a lot of extra hours because of the apprenticeship program, which has really helped me get comfortable with patient contact and whether this job is right for me or not,” she says. “It helped me really connect with our crews and get a lot of good experience and advice from people who’ve been working there a long time. And I absolutely loved it.” “We’re struggling to have enough trained paramedics and nurses. At the same time, there’s been a 20% increase in demand for services.” SHEILA CLOUGH, CEO OF MERCY FLIGHTS A Mercy Flight medical transport aircraft COURTESY OF MERCY FLIGHTS 17
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⁄Profile⁄ Student Bodies and Minds BY AMY MILSHTEIN BACK-TO-SCHOOL NIGHT will look a little different in Dufur — a Wasco County town whose population was 635 as of the 2020 census — this year. Along with meeting teachers and reconnecting with classmates, its students, parents and the rest of the community will celebrate the grand opening of the district’s brand-new School-Based Health Center. The clinic represents a solid win for the town. Accessing health care in Oregon remains difficult, but it is especially challenging in rural and frontier areas. Desperately needed behavioral and mental health services are even harder to secure. But for kids in Dufur — there are 360 in grades pre-K through 12 — their immediate family and school staff will be able to address basic medical and mental health needs right on campus. The need for more physical and mental health services for youth is clear. Across the country, children are suffering from increased incidents of depression, anxiety and suicidal ideation. And they’re not the only ones struggling. The issue was even summed up in a “Saturday Night Live” sketch that aired in May this year, where a teacher, played by Maya Rudolph, laments working in a school filled with rampant behavior issues admits to the kids that “Y’all won.” “COVID broke something we can’t fix,” Rudolph says wearily. While the sketch is more focused on teachers’ burnout than kids’ School-based health clinics deliver muchneeded care to one of our most vulnerable populations. Why doesn’t Oregon have more of them? “The people in Dufur were grant-writing machines.” KRISTEN NICOLESCU, PROVIDER, ONE COMMUNITY HEALTH 20
PHOTOS BY JASON E. KAPLAN suffering, it’s not far from what advocates describe. “We work with school districts that are desperate for help with youth mental health,” says Maureen Hinman, executive director of the Oregon School-Based Health Alliance. “It’s impacting staff. We have teachers who are scared of the kids.” Clearly, this is a national phenomenon. But Oregon’s problem is particularly acute. The state has a dismal record for absenteeism, the fourth highest in the nation, and ranks dead last in the country for mental-illness prevalence and access to care. So why doesn’t Oregon invest more school-based health clinics? DUFUR’S NEW FACILITY brings the number of Oregon’s school-based health clinics to 89, meaning about 25% of school districts have one, according to Hinman. “That percentage may go up a bit now that Dufur’s clinic is online,” she says. But securing a school-based health clinic takes a lot of work and coordination. Dufur’s resource became a reality after years of assessing needs, building community trust and finding funds. Grants came from the Oregon Health Authority, various foundations and a $50,000 chunk from the deep pockets of Google, which operates a data center nearby. “The people in Dufur were grant-writing machines,” remembers Kristen Nicolescu, medical provider and physician assistant for One Community Health. (One Community Health will provide the staffing and supplies for the clinic.) So what will all of this work yield? Not intended to replace primary care, the clinic will offer vital supplemental services, designed to “increase seat time for students while keeping them focused and engaged,” according to Hinman. These services include providing sports physicals; offering preventive care; and diagnosing and treating illnesses and injuries like strep throat, sprained ankles, and ear infections. The clinic will be equipped with a small pharmacy and can administer free vaccines. That’s good news considering Oregon has the second highest nonmedical exemption rate for vaccines in the country at 9%. Dufur School’s new health clinic is set to open in August. Dufur school nurse Kamala Malcolm was the driving force behind creating the new facility. 21
These services promise to provide great relief for families where children are bused to school each day from points far and wide. “Our school district covers 500 square miles,” reports Dufur school nurse Kamala Malcolm, the driving force behind creating the new facility. She also speaks to the student population’s great economic diversity. “We have everything from wheat and cow farmers to populations without running water or electricity.” This combination means that most everyone in Dufur faces some kind of barrier to timely health care. Some families have no insurance, many are on Medicaid. But even the wealthiest, most-resourced families still need to drive at least 15 miles to The Dalles for higher levels of care, resulting in school absences and lost workdays. “Even if you have a primary care provider, it can take up to two months to get a doctor’s appointment,” laments Hinman. “This is an easy way to get a simple sports physical or quick appointment and not have to mess with getting seen by your primary care provider.” Hinman stresses that records will be seamlessly shared with those PCPs. Offering mental health supports will also be a big part of the clinic’s mandate. While logistics are still in the works, Malcolm is planning for one full-time behavioral-health consultant to be available one day a week. This counselor can provide talk therapy and coordinate with other providers and families to make sure kids, their families and staff have access to care. There will also be a nurse practitioner on staff who can prescribe anti-anxiety and anti-depression medication. It’s a big leap in the right direction. “We have strong evidence that students are more likely to go to a school-based health clinic for mental health care than any other kind of counselor,” reports Hinman, citing a 2018 study of Oregon schools. “It shows that adolescents are 10 to 21 times more likely to get mental health services at a schoolbased health center and youth that receive those services are 12% less likely report depressive episodes, 16% less likely to report suicidal ideation and 18% less likely to report a suicide attempt.” Dufur School superintendent Jack Henderson helped secure funding for the health center. Dufur School’s new health clinic will have an on-site lab. PHOTOS BY JASON E. KAPLAN 22
DUFUR’S STUDENTS are already ahead of the curve when it comes to important metrics for success. “Our graduation rate is 87%, and 64% of our students are present for 90% or more of the time,” reports Malcolm. “Both of these are above the Oregon average.” The school also has a history as a vital community hub, serving as a designated cooling center and providing a place for wildfire-smoke relief. Residents, whether they have kids or not, clearly value the school as a resource. But will students and their parents trust the clinic for their health care needs? “It takes a while to build that trust,” admits Nicolescu. “If you are not offering services consistently, it’s hard to gain traction. The need is there, but if you’re not consistent, the demand is not high. They are just not used to seeing you.” In answer, One Community Health has been operating a mobile medical unit at Dufur once a month to get students and parents used to the idea of accessing health care at school. “It’s been a great transition,” says Malcolm. “The parents have been welcoming and appreciative.” Nicolescu is hoping to steadily grow participation, starting with “maybe 15 patients the first month and then growing 5% to 10% a month after that.” Payment for this medical attention will come from private insurance providers, Medicaid or self-pay. “We use a sliding scale to determine the self-pay rate. If it’s an uninsured student, the visit is usually written off,” says Nicolescu. A $60,000 chunk of funding will also come from the state every year, a number that hasn’t changed since 2013. Efforts to pass Senate Bill 549A, allocating more money for these vital services, died during the last legislative session when Republican state legislators, including Dufur’s own representative, Bill Hansell, walked out on their jobs. House Bill 4070 — which would have invested some $18 million into school-based health clinics, $7.8 million for mental health and addiction programs, and another $10 million for new health centers — also failed in this year’s six-week short session. That draft bill would also make planning grants available to schools that want to create their An examination room in the new clinic Maureen Hinman, executive director of the Oregon SchoolBased Health Alliance own centers, as well as more funding for bonds to help with construction costs, according to Hinman in a November 2023 article from the Lund Report. Sad news for a state where kids are literally dying for lack of accessible health care. But Hinman and others remain hopeful that their next effort will be successful. She and others will push ahead with a similar bill that asks for more funding, including giving existing clinics a 10% bump and increases tied to inflation. Her goal is to keep the kids in Dufur and the rest of the state healthy, happ, and thriving in school. “In five years, I’d love to see a school-based health clinic in at least every high school or multilevel school,” she says. “Since we’ve seen them be successful in as small as a K-12 school of around 130 total students, I believe that is feasible.” 23
24 BRAND STORY PRODUCED BY THE OREGON BUSINESS MARKETING DEPARTMENT BY NATALIA HURT AI-driven video technology software represents just one way in which Milestone Systems makes society safer. Its policy work, however, takes that mission to the next level as it seeks to put privacy, accountability and responsible technology at the heart of all AI applications, protecting people and, consequently, innovation too. From healthcare to smart cities, AI technologies today are transforming every industry they touch. The video security sector is no different. AI-enabled capabilities, such as video data analytics and machine learning, have multiplied the potential applications of video security tools, which, according to Milestone Systems’ CEO Thomas Jensen, have outpaced legislation. “I absolutely do not believe that advanced technology development and use is adequately regulated today, especially with the capabilities of artificial intelligence,” he explains. “We already see this with our phones and how much data they track. The power of AI offers unprecedented opportunities that need to be properly managed.” According to Jensen, regulatory laxity can create an environment in which the improper use of facial recognition could potentially undermine public trust in the legitimacy and social benefit of video security. On a daily basis, Milestone Systems witnesses its solutions’ life-changing interventions firsthand. For example, a city in North America utilized Milestone Systems’ video analytics to adjust rush hour traffic light coordination thereby decreasing traffic congestion, saving time and money, and cutting pollution. In another city, the police stake out of a suspected (and later proven) drug house was conducted via video surveillance for the 36 hours required to obtain a search warrant, providing valuable evidence and freeing up officers for other tasks. In Denmark, video technology software, in conjunction with flood lights and alarms, warn passersby of a canal’s edge, reducing the number of accidents and drownings. For unfortunate individuals who still fall in, rescue teams can be alerted and deployed by the video system automatically. Milestone Systems’ solutions help improve lives and outcomes in hospitals as well, where video technology software plays a vital role in enabling over-extended nursing staff to do more with less through virtual rounding and alerts triggered by abnormal movements within rooms. Video technology even protects patient privacy by blurring their identities and activities while still identifying when they might be in distress. “Video surveillance can feel like an invasion of privacy if not used correctly, but it’s not the technology that’s a problem. It’s how it is used,” Jensen continues. “Video technology software can be focused to a very narrow space so that we can, for example, The Pursuit of Responsible, Human-Centric Technology Video-technology software provider Milestone Systems drives policies to protect people and innovation. Milestone Systems’ CEO Thomas Jensen
25 BRAND STORY protect citizens from acts of harm before they happen. But it can also be used in ways that result in a huge invasion of privacy and breach of human rights—and we must protect against this.” With the understanding that regulations are essential to both protecting human rights and advancing innovation, Milestone Systems has a long history of supporting responsible technology innovation. In 2024, Milestone became the first technology company to adopt the G7 AI Code of Conduct. Four years after coauthoring the Copenhagen Letter in 2017, a promise by firms to place humans at the heart of the tech movement, Milestone Systems adopted the UN Guiding Principles for Human Rights in 2021. It also integrated human rights clauses into its contracts and licensing agreements. Internally, Milestone Systems promotes responsible innovation by shining a spotlight on the unconscious bias that finds its way into generative AI. The company is currently building a training program for software developers on how to mitigate that bias. The team is also working to develop image enhancement capabilities that bolster video data accuracy, which would minimize the occurrence of false positives. While the technology is impressive, some of Milestone Systems’ most impactful work comes through conversations with policymakers and standards associations across the EU and US. “We engage with politicians and encourage them to yield some societal advantages in favor of safety, whilst still protecting human rights,” Jensen says. “I’m recommending they limit my ability to earn money by limiting the use of facial recognition to a predefined list. We remain ethically minded in our approach and encourage the entire tech industry to follow our approach.” Any aversion to increased regulation probably stems from a large misconception: that increased regulation lowers profits. On the contrary, Milestone Systems believes that comprehensive regulations enable the public safety and trust required for AI technology to reach its full potential as a driver of positive transformation. The EU’s AI Act and President Biden’s recent Executive Order on Safe, Secure, and Trustworthy Development and Use of Artificial Intelligence lay the groundwork for AI’s responsible use. Jensen emphasizes that regulations must stay as forward-looking as the technologies themselves. “This is a journey. What we plan for today and implement tomorrow will be different six months down the road,” he concludes. “We don’t know what it will look like two years from now. It’s a journey with a moving target. That is why we emphasize the need to regulate use rather than the technology itself.” What Milestone Systems does know, however, is that, regardless of what the future holds, it will continue advocating for legislation that embraces a human-centric approach to AI and protects the fundamental rights of every individual. n About Milestone Systems Milestone Systems’ video software and analytics solutions leverage AI and IoT technology to give clients centralized oversight and actionable insight across their footprints. The solution’s cloud-based, on-premises and hybrid options empower public and private entities with the data needed to alter strategies and prevent unwanted outcomes. Through its video surveillance solutions, Milestone Systems aims to shape safer, more proactive societies. “Video technology software can be focused to a very narrow space so that we can, for example, protect citizens from acts of harm before they happen. But it can also be used in ways that result in a huge invasion of privacy and breach of human rights—and we must protect against this.” THOMAS JENSEN, CEO, MILESTONE SYSTEMS
Thirty-four months after Oregon voters decriminalized hard drugs with Measure 110 (and three months after legislators rolled back major provisions of the unpopular law), money from Measure 110 is fueling a transformation in Harney County. More than one, in fact. “We think we have a really good idea with Late to arrive, money from the controversial law now funds a mix of recovery programs around the state including Burns’ Fresh Start Cafe. But progress remains slow and data and accountability lag. BY GARRETT ANDREWS | PHOTOS BY JASON E. KAPLAN Funding from Measure 110 Fuels a Transformation in Harney County this, and we think we’re going to be able to impact a lot of people,” says Chris Siegner, director of Symmetry Care, Harney County’s lone behavioral health clinic, which recently unveiled a novel client-based business in downtown Burns: the Fresh Start Cafe. Perhaps the most obvious change is to the building itself. Constructed in 1920 at 195 North Broadway Avenue, the space was originally a general store called Smith’s Market. Then in 1955, it became a family-owned Chinese restaurant, which is what it was for most of its history, though the family in question turned over several times. “They love their Chinese food here, which maybe you wouldn’t expect,” says Chelan Thissell-Armstrong, whose great-grandfather owned Smith’s Market. “For a lot of ranchers, it was a weekend treat.” In 2022 Ping and John Lei retired and 26
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