which had already wreaked havoc in communities around the East Coast, arrived with a vengeance. Layoffs and evictions forced more people onto the street. It was a challenging time to work in behavioral health in Oregon. And it’s not like it was easy before. Since the 1940s, Oregon has tried to move away from a model that stockpiles patients at mental hospitals and toward one that treats patients in their communities. But treatment options have never kept pace with demand, and wait lists for local providers and the state hospital in Salem have only grown. The 2022 audit by then-Secretary of State Shemia Fagen found that the body convened by OHA to disperse the more than $100 million per year in grants had not been given the resources to be successful. That body, the Oversight and Accountability Council, was also unable to track the law’s impacts and effectiveness around the state due to a stark lack of data. Of particular note, the audit found $32 million in “Access to Care” grants was largely unaccounted for. (A later accounting by OHA found the money in question went to 66 organizations around the state, and that recordkeeping was hampered by limited OHA staff and a push to quickly get funds out the door.) In summer 2023, lawmakers addressed shortcomings with the law identified in the audit, but it might have been too little too late. Later that year, for the first time since the 1980s, more people moved away from Portland than to it, with some former residents citing crime, high taxes and increasingly visible homelessness as the reasons for their departure. The city’s problems haven’t gone unnoticed by outlets eager to paint the city as a liberal wasteland. When this year’s short legislative session arrived, lawmakers passed House Bill 4002, rolling back Measure 110’s decriminalization component with broad bipartisan support. But “recriminalizing” street drugs might not be so simple. As of press time, county-level officials around Oregon are drafting local policies that would “deflect” drug users from arrest, as called for in HB 4002. But officials sold the building to Symmetry Care, which planned to convert it to a coffee shop that teaches life skills and provides work experience to people with serious mental illness and addiction. Funding from Measure 110 enabled Symmetry to purchase not only the building but a nearby fourplex to house employees. Both the restaurant space and fourplex were stripped to the studs and remodeled. The apartments got new finishes, fixtures and appliances. The cafe is now hardly recognizable with modern appointments better suited for hip Portland than tiny, windswept Burns. While most projects funded by Measure 110 offer clean needles, counseling or methadone, the Fresh Start Cafe, which opened June 3, offers a full menu of coffee drinks and breakfast and lunch options. And despite locals who clamor about missing their Chinese food, the cafe is developing a passionate following of its own. When Siegner visited during a soft opening, after a patience-testing two-year development process (“Nothing happens fast in Harney County,” he says), he was moved by what he saw: workers buzzing dutifully, customers enjoying their food. “I tell you, I walked in and the reality of it just hit me in the face.” ‘Doomed to Fail’ Approved by a wide margin in 2020, Measure 110 is now widely regarded as a failure. Overdose deaths rose by 70%. Drug- treatment courts and other programs widely considered beneficial ground to a halt as public drug use soared. Portland became a punchline and a cautionary tale. Measure 110 has two parts. And while decriminalization is that piece that drew the most skepticism from pundits, the law also allocates around $100 million per year from cannabis revenue to expand addiction- treatment services, and as critics have noted, actually getting that money to treatment providers has been a serious challenge. A January 2023 audit from Oregon’s Secretary of State found that the Oregon Health Authority was slow to disperse funds to providers, in part because of a complex and inconsistent grant-application process. A year and a half later, programs like Fresh Start Cafe and dozens of others around the state are at long last putting to use more than $300 million from Measure 110. By the time cannabis tax dollars were finally rolled out, fentanyl — a highly potent and deadly synthetic opioid — and a form of meth health care providers described as far more dangerous than others were wreaking havoc around the state, notably in the Portland area, which was already struggling with rising rates of crime and homelessness. In fact, the timing of Measure 110 could hardly have been worse. The pandemic shuttered offices and service businesses that catered to them. George Floyd’s death fueled months of protest in downtown Portland. Fentanyl, Fresh Start Cafe’s location in historic downtown Burns Chris Siegner, director of Symmetry Care, at Fresh Start Cafe 27
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