in the state’s most populous county, Multnomah, have drawn fire for a proposal to open a so-called “drop-off center” that wouldn’t include a health screening or follow-up services. “I think Measure 110 was an important concept, but it was doomed to fail,” says Andy Mendenhall, president and CEO of Central City Concern, a Portland nonprofit that manages addiction-treatment centers, affordable-housing buildings and other programs. “We have not been able to meet the demand for people seeking treatment for substance-use disorder for years. Demand has always exceeded supply.” “It’s easy to say, ‘These problems are all Measure 110’s fault.’ But the truth of the matter is Measure 110 took a broken system and threw it over a cliff,” Mendenhall tells Oregon Business. It probably wouldn’t have been successful even in ideal circumstances because of the gaps in shelters and housing in our region and around the state.” Oregon has struggled for decades to adequately fund behavioral health and provide shelters and housing. Compounding matters, for the past four years, the state mental hospital in Salem has been unable to accept civil commitments, pushing people with severe mental illness back into their communities. Mendenhall, a physician, says much of the behavior people witness on the streets of Portland and assume is related to substance abuse is, in reality, untreated severe mental illness. “I would say, unequivocally, that a very progressive population in Portland has reached its threshold of compassion fatigue,” he says. “We live in the wealthiest country on the planet, and people are tired of seeing individuals who need to be stabilized and institutionalized and medicated, wandering the streets in a confused, disoriented state.” There’s ample debate in the recovery community about approach. Some media outlets have focused on “harm reduction” programs that distribute clean needles and other safe drug-use supplies. The operator of Medford’s provocatively named nonprofit Stabbin’ Wagon, which received $1.5 million from Measure 110, has been especially outspoken with her views on police abolition and support for the homeless. Tony Vezina, executive director of 4D Recovery in Portland, which specializes in harm reduction and peer services for adolescents and young adults, was personally opposed to Measure 110 because he feels some form of intervention is typically needed to spur a person into recovery. A $5 million grant from Measure 110 allowed 4D to open new services for young adults and offer new housing vouchers to people in recovery. One-time grant money allows 4D to somewhat bypass bureaucracy when prescribing treatment, which is often when people in recovery fall back into old ways. “In general, people agree addiction is a disease and there are different strategies about how to deal with it,” Vezina says. “Each strategy works, in my opinion, and it’s usually a combination that’s going to be effective.” A JobLike This Where Measure 110 was effective was in creating a pool of resources that have funded some important projects in an already catastrophically under-resourced system, though the distribution of those resources was significantly delayed. It’s increased access to detox in Southeast Portland. In Eugene it funded a drug-addiction treatment center geared to the Latino population. To disperse Measure 110 grants, the state established a network of Behavioral Health Resource Networks (or BHRNs, pronounced “burns”). Symmetry Care is one of 12 certified community-behavioral health clinics in Oregon and also the BHRN for Harney County. Harney is a county small in population (7,500) but enormous in area (10,000 square miles — roughly the size of Belgium). On one hand, the need there looks the same as in the metro area; fentanyl poses the same risk in Harney County as in Portland. But Symmetry doesn’t have multiple agencies to refer people to, like other BHRNs. Symmetry enrolls between 250 and 300 adults and children in services ranging from addiction treatment to care for developmental disabilities, mental health diagnosis and treatment, and even couples counseling. The Fresh Start Cafe is the brainchild of Andy Mendenhall, president and CEO of Central City Concern, in Portland’s North Park Blocks Fresh Start manager Stacey Radinovich 28
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