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37595

Resolution

Connect mental health and substance abuse recovery services to unhoused individuals

Adopted
Amended by Council

50% INCREASE IN UNSHELTERED HOMELESSNESS

WHEREAS, the unsheltered homeless population grew by 50% from 2,037 people in 2019 to 3,057 people in 2022[i]; and

700 OFTEN-MOVING CAMPS SCATTERED ACROSS PORTLAND’S 146 SQ MILES

WHEREAS, the Impact Reduction Program of the City of Portland has observed over 700 self-sited unsanctioned encampments across the City’s 146 square miles[ii]; and

SERVICES ARE OUT OF REACH

WHEREAS, sprawl of self-sited unsanctioned encampments makes outreach and charitable/service distribution difficult, uneven, and inequitable; and

WHEREAS, in early 2022, 95% of homeless individuals surveyed said they were not offered temporary shelter, transitional or permanent housing or other services to meet their immediate needs prior to the removal of their self-sited encampment (Feb. 2, 2022)[iii]; and

LACK OF BASIC SANITATION

WHEREAS, those camping in self-sited unsanctioned encampments often lack access to reliable sources of food, water, and hygiene services; and

LACK OF SAFETY

WHEREAS, Street Roots found that homeless individuals were more likely to be victims of violent crime than perpetrators[iv]; and

WHEREAS, homeless people with mental illness are highly vulnerable to violence, with a reported lifetime incidence of 74% to 87% of violence being perpetrated against them[v]; and

ROOT CAUSES OF HOUSLESSNESS

WHEREAS, Dr. Solotaroff, the former President and CEO of Central City Concern, explained the essential root causes of homelessness as stemming from both individual factors (early childhood adverse experiences, serious mental illness, substance use disorder, personal history of violence, etc.) and structural factors (absence of affordable housing, absence of entry-level employment that can lead to meaningful wage employment, structural racism and discrimination, the criminal justice system and impediments to enable a person to thrive after incarceration, etc.)[vi]; and

BEST SOLUTION: AFFORDABLE HOUSING WITH NEEDED SERVICES

WHEREAS, the ultimate solution to homelessness is housing, including rapid re-housing an intervention designed to quickly connect people to housing and services[vii]; and

YEARS-LONG WAITING TO GET INTO AFFORDABLE HOUSING

WHEREAS, applicants for affordable housing units wait an average of five years, with some waits taking up to ten years, as they languish on the streets or in unstable housing (per data commissioned by Mayor Wheeler from Home Forward—Portland’s local housing authority)[viii]; and

WHEREAS, this wait turns deadly due to high rates of substance use disorder and the cheap, synthetic, and dangerously potent drugs on our streets (e.g., fentanyl and P2P meth)[ix]; and

LONG WAIT TIMES WITHOUT SERVICES EXACERBATESMENTAL ILLNESS, DRUG ABUSE

WHEREAS, people experiencing homelessness experience overdose rates up to 30-fold higher than the general population[x]; and

WHEREAS, people experiencing homelessness, as a sociodemographic group, are more vulnerable to unhealthy substance use than those who are housed[xi]; and

WHEREAS, those experiencing homelessness are more vulnerable to suffering mental health issues—locally, a 2021 Oregonian survey found that 63% of homeless Portlanders suffered from mental health issues[xii], and of those who reported suffering from mental health issues:

  • 66% reported suffering from depression
  • 65% from anxiety
  • 52% from post-traumatic stress disorder
  • 43% from bipolar disorder
  • 40% from substance use disorder
  • 27% from schizophrenia[xiii]; and  

WHEREAS, homelessness has been associated with poorer mental health outcomes, and; homelessness may even trigger or exacerbate certain disorders. For example, studies show that homelessness relates to increased psychiatric distress and lower perceived levels of recovery from serious mental illness[xiv]; and

WHEREAS, in 2020, Oregon jumped from having the ninth highest rate of meth use in the country to the highest, according to the most recent National Survey on Drug Use and Health data[xv]; and

WHEREAS, the price of meth has decreased, while the potency has increased, allowing users to purchase three days' worth of meth for $5[xvi]; and

WHEREAS, “[m]eth dependence gradually develops into not only meth psychosis but also persistent neurocognitive deficits” which impair daily living and working[xvii]; and “[m]ethamphetamine-induced psychosis is often times clinically indistinguishable from paranoid schizophrenia”[xviii]; and meth use can cause obsessive, hoarding behavior[xix]; and

WHEREAS, Oregonians voted overwhelmingly for Measure 110 in 2020, with the understanding that decriminalizing the personal possession of illegal drugs would be coupled with revenue (from marijuana sales and funds reallocated away from drug enforcement) to fund a new drug addiction treatment and recovery grant program[xx]; and

WHEREAS, Measure 110 is a public health approach and when implemented alongside treatment and recovery investment, is a laudable and more humane policy, but in the two years since the decriminalization of the personal use of drugs in Oregon, funds for drug abuse treatment and recovery have yet to be fully implemented[xxi]; and

WHEREAS, only 4.6% of people ticketed for a Measure 110 violation have called Lines for Life to be connected to services[xxii]; and

WHEREAS, there is a 49% gap in substance use disorder services needed by Oregonians[xxiii]; and

WHEREAS, among Oregon Health Plan members, rates of substance use disorder diagnoses suggest that less than half of those with a use disorder have been diagnosed or treated[xxiv]; and

WHEREAS, Oregon ranks second in the nation for percent of population with past year substance use disorder[xxv]; and

WHEREAS, Oregon ranks 50th in nation for percent of population needing but not receiving treatment for substance use disorders[xxvi]; and

DEADLY CONSEQUENCES OF SUBSTANCE ABUSE DISORDER

WHEREAS, drug overdoses in Multnomah County increased 94% between 2019 and 2021 (from 215 in 2019 to 417 in 2021)[xxvii], and fentanyl overdoses increased by 588% between 2019 and 2021 (from 25 in 2019 to 172 in 2021)[xxviii]; and

WHEREAS, drug overdoses (417) killed more people in Multnomah County in 2021 than gun violence (71) and automobile crashes (84) combined[xxix]; and

CAMP REMOVALS WITHOUT CAMPING BAN NOT EFFECTIVE

WHEREAS, in Spring of 2021, with the lifting of COVID pandemic restrictions, Mayor Ted Wheeler, issued an Emergency Declaration that created the Street Services Coordination Center (SSCC) that coordinates homelessness outreach efforts by the City of Portland and Multnomah County with the purpose of providing streamlined services to those experiencing unsheltered homelessness[xxx]; and

WHEREAS, the SSCC improved its assistance to unsheltered individuals, including:

  • An offer to reserve a shelter bed
  • Free transportation to that shelter, and storage of personal belongings exceeding what is allowed in a shelter space for up to 30 days[xxxi]; and

WHEREAS, unsanctioned encampment removals increased by 2844% from September 2020 to September 2022 (from 9 to 265) (from IRP)[xxxii]; and

WHEREAS, despite the substantial increase in removals, the number of encampments has risen to over 700[xxxiii]; and

WHEREAS, approximately 20% of those camping in self-sited unsanctioned encampments accept an offer for congregate shelter[xxxiv]; and

WHEREAS, even with the improved shelter referral process, of the thousands of people offered a shelter bed, only a total of 405 have accepted[xxxv]; and

WHEREAS, providers engaged in daily outreach around the city estimate that upwards of 60% of those living in self-sited unsanctioned encampments would accept an offer for a designated camping site[xxxvi]; and

WHERAS, qualitative evidence suggests that the majority of campers prefer to remain outdoors, rather than go into congregate shelter, and simply move to another unsanctioned camp location, putting them at risk of removal and continued lack of access to services; and

WHEREAS, Portland’s City Council extended the duration of a housing emergency and continued the current housing emergency for three additional years in Ordinance 190756 on March 30, 2022[xxxvii]; and

WHEREAS, stabilization of those living unsheltered in managed communities with peer support is trauma-informed and compassionate; and

WHEREAS, the campus model and phased approach is more effective for connecting individuals with services such as charitable, government, and healthcare, for example, Vancouver’s meal train for its Safe Stay program[xxxviii], Medford’s Urban Campground for up to 125 people, and Talent Gateway Transitional Housing Project for 159 people in 53 RVs[xxxix]; and

WHEREAS, the City of Portland will soon open all six Safe Rest Villages; and

WHEREAS the City is committed to serving the needs of unhoused individuals with disabilities and connecting them with appropriate services in City shelters and campsites [xli]; and

NOW, THEREFORE, BE IT RESOLVED, led by the Street Services Coordination Center (SSCC), the City Council directs City bureaus and Council offices to work together to develop a plan that identifies needed policy changes, investments, and public, nonprofit, and private partnerships to greatly expand the number of available shelter slots as quickly as possible; obtain all health and human services at key sites; as part of the annual budget process, the SSCC will provide an update to individual Council Offices by the end of each fiscal year regarding the total available beds and the safety of designated alternative camping sites; and, complete an operational plan to phase-in over 18 months, once funding has been secured, a citywide ban on self-sited unsanctioned encampments coupled with designated alternative camping sites with services, including:

  1. The City of Portland wants to partner with Multnomah County to:
    1. Facilitate the opening of remaining shelter beds that are currently funded but not available, including beds in new facilities that are currently under construction as well as beds in current facilities that are not operating at full capacity, and increase the shelter utilization rate to 100 percent.
      1. Designated camping sites will initially serve approximately 150 people per site, with the possibility of up to six campuses with a maximum of 250 each when divided up, managed 24/7, with hygiene, food, and access to services across the continuum of care and that are safe;
        1. City Council will need to approve each additional camp on each campus, with the first site opening within 18 months of securing funding. 
    2. Establish at least six designated camping sites that must be diversely spread across the City that will serve as an alternative to self-sited unsanctioned encampments.
    3. Offer mental health and substance abuse treatment services to people in Portland experiencing homelessness.
    4. Gain access to the Built for Zero unified database that facilitates a client-centered public health approach.
  2. The City of Portland commits to partnering with Multnomah County to:
    1. Support the Behavioral Health Emergency Coordination Network and the opening of a polysubstance/meth stabilization center[xl];
    2. Increase its scope of work to engage in navigation outreach and connection to shelter options that provide behavioral and mental health service connections across the City of Portland.
    3. Hire 50 additional navigation team members as City employees to engage in outreach and navigation to shelter and services in partnership with the County and JOHS navigators.
    4. The City Council will prioritize investments associated with this resolution and related resolutions in the 2022 Fall Budget Monitoring Process.

BE IT FURTHER RESOLVED, the City Council requests that staff return with implementation, operational and funding plans for its further consideration.


[v] Roy L, Crocker AG, Nicholls TL, et al. Criminal behavior and victimization among homeless individuals with severe mental illness: a systematic review. Psychiatr Serv. 2014;65:739-750. See: https://www.psychiatrictimes.co…

[x] Fine DR, Lewis E, Weinstock K, Wright J, Gaeta JM, Baggett TP. Office-Based Addiction Treatment Retention and Mortality Among People Experiencing Homelessness. JAMA Netw Open. 2021;4(3):e210477. doi:10.1001/jamanetworkopen.2021.0477

[xiv]  Castellow J KB, Townley G. Previous homelessness as a risk factor for recovery from serious mental illness. Community Ment Health J. 2015;51:674-684. See: https://www.psychiatrictimes.co…

[xix]Sam Quinones, The Least of Us, page 4.

[xxvii] Multnomah County Medical Examiner

[xxviii] Multnomah County Medical Examiner

[xxxi] Id.

[xxxiii] Per Impact Reduction Program’s latest observation.

[xxxiv] SSCC data average per quantitative (weekly reports) and qualitative (navigation and other outreach worker feedback) data.

[xxxvi] Two service providers engaged in this work daily across the city made this qualitative analysis after specifically asking people if they would say yes to a designated camping site if it were an option.

Impact Statement

Purpose of Proposed Legislation and Background Information

The purpose of this legislation is to declare the City Council's intent to change City’s outdoor camping protocols to better connect homeless individuals with available sanitary, mental health, and substance abuse recovery services and banning self-sited encampments with designated alternative locations (e.g., emergency shelter, Safe Rest Villages, designated sanctioned campsites).  

Financial and Budgetary Impacts

Additional details will be added when available.

Community Impacts and Community Involvement

Additional details will be added when available.

100% Renewable Goal

Additional details will be added when available.

Budget Office Financial Impact Analysis

The resolution itself does not mandate specific costs but does direct Council to prioritize investments associated with this and related resolutions in the FY 2022-23 Fall Budget Monitoring Process. The direct financial impacts of adopting this resolution would be staff time and capacity needed to conduct this work; it is unknown to CBO at this time if additional resources to support staff capacity is necessary.   

Although limited details have been provided to develop cost estimates, the resolution does direct the Council to prioritize investments associated with this resolution and related resolutions in the 2022 Fall Budget Monitoring Process. CBO notes the following potential fiscal impacts associated with discrete goals outlined in the ordinance, which could require multiple millions of one-time and ongoing resources.      

Street Services Coordination Center  

This resolution directs the Street Services Coordination Center (SSCC) to lead City bureaus and Council Offices to develop a plan that includes policy changes, investments, and partnerships. In addition to the likely costs resulting from this plan, the SSCC is funded with one-time resources in the current fiscal year. Based on current funding assumptions, continuing support for the SSCC for an additional 18 months would require approximately $1.6 million. There would be additional staff time costs for other bureau and Council staff.  

Designated Camping Sites  

This plan would create a new form of alternative shelter that does not currently exist locally, and no fiscal impact has been identified in the resolution. Based on estimates previously provided by the Streets to Stability program and Joint Office of Homeless Services, the ongoing cost of services and site operations for designated camping sites serving approximately 150 people per site could be between $3.0 and $6.8 million annually. The resolution discusses serving a maximum of 500 people with this new model; using these cost estimates, serving 500 people would cost between $10.0 million and $22.5 million annually. Given the intent to provide 24/7 management with hygiene, food, and access to service across the continuum care, it is reasonable to expect that the annual costs to support these sites would be closer to the higher end of this range – i.e. $6.8 million for a 150 person site or $22.5 million to serve 500 people. This cost estimate does not include the cost of tents or sleeping bags; if the City were to provide those materials, the annual cost would increase as those materials would likely need to be regularly replaced based on turnover.   

The one-time capital costs for these sites could vary greatly based on the size and condition of the lot, required environmental remediation, proximity to utilities and access points, and other factors. Information provided from the Safe Rest Villages program as part of budget development in FY 2022-23 shared that site development for villages (not including sleeping units/pods) meant to serve 30-60 villagers was between $350,000 to $500,000 per site, and communal service structures ranged from $130,000 to $200,000 per site. It is difficult to know the costs of siting this newly proposed model but should site development require similar space allocations and amenities as the Safe Rest Villages (again, not including the cost of sleeping pods), serving 150 people per site would translate to approximately $1.44 to $2.1 million per site. The resolution expresses a goal of establishing at least three sites; with three sites of this size using this costing methodology, the cost estimate would range from $4.3 to $6.3 million in one-time costs.    

Facilitate Opening of Remaining Shelter Beds and Increase Shelter Utilization Rate to 100%  

This action focuses on opening shelter beds that are already funded and increasing the shelter utilization rate. Given that the focus is on opening beds already funded, any direct financial impacts of this resolution would likely pertain to staff or capacity costs to increase the availability and utilization of currently funded beds. In terms of increasing utilization of currently opened beds, the 2021 Annual Homeless Assessment Report (AHAR) to Congress found that on the night of the Point-in-Time Count in January 2021, major cities had an occupancy rate of 84.8% in shelter programs. Occupancy rates do vary by shelter, and there may be opportunities to increase utilization at sites with more open beds.  

Hire 50 Additional Navigation Team Members as City Employees  

The resolution expresses a desire to have the directed implementation plan include the hiring an additional 50 Navigation Team members. The cost of this proposal would depend on the classification and compensation for these positions. The new Peer Support Specialist classification created for Portland Street Response costs out at approximately $100,000 annually, including benefits. (The salary range for this classification in the current year is approximately $49,000 to $73,000.) Using this figure, hiring 50 Navigation Team members would cost approximately $5.0 million annually. Additionally, there would likely need to be materials and services costs as well as supervisory positions added to this cost estimate. 

Support Opening of the Behavioral Health Emergency Coordination Network (BHECN) and Opening of a Polysubstance/Meth Stabilization Center  

The City has set aside $1.9 million in ongoing General Fund resources previously budgeted for the Sobering Center to support the development of the Behavioral Health Emergency Coordination Network (BHECN). CBO has not seen any updated cost estimates for BHECN nor cost estimates for the opening of a polysubstance/meth stabilization center, but costs could be significant.   

--  

As mentioned above, the direct costs of this resolution are predominantly in the form of staff time and capacity in developing an implementation plan for goals established in the resolution. Some of these goals are detailed in the resolution and are likely to result in multiple millions of dollars in one-time and ongoing costs. The most notable costs would likely be in the siting and operating of a new model of alternative shelter sites with services, and with hiring an additional 50 navigation team members.   

Document History

Item 901 Time Certain in October 21-27, 2022 Council Agenda

City Council

Continued

Continued to November 3, 2022 at 2:00 p.m. Time Certain.
Submit written testimony to cctestimony@portlandoregon.gov.

Item 929 Time Certain in November 2-3, 2022 Council Agenda

City Council

Adopted As Amended

Motion to remove under the NOW, THEREFORE, BE IT RESOLVED subsection 1.A.l., “a maximum of 500 people per campus when divided into quadrants” and replace with, “up to six campuses with a maximum of 250 each when divided up” and under subsection 1.B., remove “three” and replace with “six”: Moved by Rubio and seconded by Hardesty. (Y-Mapps, Rubio, Ryan, Hardesty; N-Wheeler)

Motion to include WHEREAS section, “WHEREAS, over 60% of the houseless population in Portland have self-identified disabilities we must ensure that sanctioned large scale campsites have sufficient facilities to address these varied needs[xli]; and” and reference link [xli].: Moved by Hardesty and seconded by Rubio. Motion withdrawn.

Motion to include WHEREAS section, “Whereas the City is committed to serving the needs of unhoused individuals with disabilities and connecting them with appropriate services in City shelters and campsites [xli]; and” and reference link [xli].: Moved by Hardesty and seconded by Wheeler. (Y-5)

Motion to remove under the NOW, THEREFORE, BE IT RESOLVED section, “complete an operational plan to phase-in over 18 months, once funding has been secured, a citywide ban on self-sited unsanctioned encampments coupled with designated alternative camping sites with services” and replace with, “develop a plan to limit self-sited unsanctioned encampments in consultation with experienced community partners once sufficient capacity exists to assist the City’s houseless population and meet the City’s legal requirements”: Moved by Hardesty and not seconded. Vote not called.

Motion to remove under the NOW, THEREFORE, BE IT RESOLVED subsection 1.A.l., “a maximum of 500 people per campus when divided into quadrants”: Moved by Hardesty and not seconded. Vote not called.

Motion to remove under the NOW, THEREFORE, BE IT RESOLVED subsection 1.A.l.a., ”on each campus” and replace “18” with “6” months.: Moved by Hardesty and not seconded. Vote not called.

Motion to include subsection 1.A.l.b. under the NOW, THEREFORE, BE IT RESOLVED section, “After the establishment of initial camps the City may consider creating a campus model where multiple camps are approved on a single large City controlled property.”: Moved by Hardesty and seconded by Rubio. Motion withdrawn.

Motion to include under the NOW, THEREFORE, BE IT RESOLVED subsection 1.B., “that that must be diversely spread across the City”: Moved by Hardesty and seconded by Rubio. (Y-Mapps, Rubio, Hardesty; N-Ryan, Wheeler)

Motion to include under the NOW, THEREFORE, BE IT RESOLVED section, “as part of the annual budget process, the SSCC will provide an update to individual Council Offices by the end of each fiscal year regarding the total available beds and the safety of designated alternative camping sites;”: Moved by Wheeler and seconded by Mapps. (Y-5)
  • Commissioner Mingus Mapps Yea
  • Commissioner Carmen Rubio Yea
  • Commissioner Dan Ryan Yea
  • Former Commissioner Jo Ann Hardesty Nay
  • Mayor Ted Wheeler Yea

Contact

Skyler Brocker-Knapp

Senior Policy Advisor

Requested Agenda Type

Time Certain

Date and Time Information

Requested Council Date
Requested Start Time
2:00 pm
Time Requested
3 hours (3 of 5)
Confirmed Time Certain