Portland city council prepares to vote on new sobering beds
KGW.com – May 2023
Council members are set to vote on Wednesday to add nine new sobering beds at the Unity Center’s Psychiatric Hospital. This would cost the city over $330K.
City of Portland Proposes Paying for Nine New Sobering Beds at Psychiatric Hospital
The city lost its last drunk tank back in 2019.
Willamette Week – May 2023
Since Portland’s only sobering center closed in late 2019, city and county leaders have contemplated its replacement. Now, those plans are coming into focus.
A proposal set to go before the City Council on Wednesday would have the city pay $335,000 to Legacy Health to retrofit an underused “living room” at its psychiatric hospital in the Lloyd District to provide “sobering services,” which would include nine beds and access to a nurse, a social worker and a peer counselor.
Portland’s now-closed sobering center was a place cops could drop off people in crisis who needed a place to sleep off drugs or alcohol. It shut down in 2019 after a whistleblower reported patients were routinely hurting themselves in the center’s isolation cells.
Officials at Central City Concern, the nonprofit that had run the facility since 1985, said they were unequipped to deal with the rise in methamphetamine use that was causing patients to lash out at staff and each other. Local emergency rooms, already crowded, have had to pick up the slack.
Jason Renaud of the Mental Health Association of Portland says it’s a good start. But, he added, “we need about 50 beds, not eight.”
The need for additional substance disorder treatment facilities in Portland is acute. In February, one of Portland’s two major detox centers, the Hooper Detoxification Stabilization Center run by Central City Concern, told the city it had turned away 2,000 people last year who were seeking help, nearly as many people as it let in its doors. WW talked to one of those rejected patients last week, a 22-year-old living on the streets who was desperate for help kicking his fentanyl addiction.
This year, both the city and county appear to be moving to address the public health crisis that has accompanied the drugs flooding Portland’s streets. The two governments have been collaborating for years on a “Behavioral Health Emergency Coordination Network” that was created in part “to examine ways to stand up a new sobering center,” according to a long-standing memorandum.
Portland’s investment would soon be joined by a much larger infusion from the county, which plans to allocate $2 million from its opioid settlement fund this year to the BHECN.
But it’s not yet clear how the money would be spent. A budget announcement by Multnomah County Chair Jessica Vega Pederson in April said it would go, at least partially, to “projects slated to come online in the next fiscal year.”
Two Portland hospitals plan to add a total of 17 beds for people suffering from alcohol intoxication or acute drug addiction.
Unity Center for Behavioral Health will add nine stabilization beds and Providence Portland Medical Center will add eight beds for people experiencing methamphetamine-induced psychosis or other alcohol or drug-related intoxication.
The additional beds represent a sliver of what’s needed following a slow-going, years-long effort to try to replace Central City Concern’s Sobering Station that abruptly closed in December 2019 following dozens of accounts of people harming themselves in isolation cells. The closure came amid a growing need to help those struggling from a mix of alcohol, drug and mental health issues.
The city of Portland and Multnomah County each will pay $335,000 to help support the new beds at Unity Center for Behavioral Health. Care Oregon, a nonprofit that provides health insurance services for low-income people, is expected to allot about $4 million for the capital costs and ongoing operations.
Providence Portland Medical Center’s additional beds will be covered by Care Oregon and funds received from Measure 110, which voters passed to decriminalize possession of small amounts of drugs, such as methamphetamine and heroin, and divert marijuana tax dollars to pay for treatment and recovery services in the state.
While past discussions centered on making Unity Center, the emergency and short-term psychiatric hospital in Portland, the hub for all services, officials from the city, Multnomah County and social service providers now are veering away from that model and looking at supporting multiple sites to cater to those attempting to recover from their alcohol or drug use.
Due to the high acuity of patients at Unity and its struggle to retain staff, the idea of it serving as a “one-stop shop” for different treatment services has been put aside for now, officials said.
Both Unity and Providence will renovate their facilities and hire staff to provide the extra beds.
Construction at Unity Center will begin in early fall and officials anticipate opening the new beds next March, but that could change depending on permit approvals and availability of construction materials, according to Ryan Frank, Legacy Health’s communications director.
Unity’s beds will be geared to people who’ve used methamphetamine and may be experiencing psychosis. Each bed could be available for up to an average of five days. That compares to traditional alcohol intoxication sobering beds that had been available for a three- to eight-hour stay, said Julie Dodge, former interim director of Multnomah County’s Behavioral Health division who is now consulting for the county.
“We are redesigning an area of the emergency department and repurposing eight beds,” said Gary B. Walker, a Providence Portland spokesperson. “This area will provide a calmer environment than a typical emergency department setting and increase safety for our caregivers.’’
Jason Renaud, of the Mental Health Association of Portland, said detox services should be a gateway to further treatment and sobriety. But the city needs “a lot more” beds, more like 50 to 100, he said.
“And when people are discharged they need a place to go, both for housing (which isn’t available) and for outpatient or inpatient addiction treatment (which isn’t available). Without these next necessary steps, the first step will too often end in frustration, and discouragement and continued addiction by those you seek to help,” he wrote in written testimony submitted to Portland’s City Council.
Dodge acknowledged the additional beds planned won’t meet the need.
“This is one piece of a broader plan,” Dodge said. ”We kind of look at these as first initial steps focused on highest acuity.”
The former sobering station and van service operated by Central City Concern since 1985 was meant to provide a safe space for people to recover from alcohol or drug use. The city of Portland largely paid for its operations. At the time it closed, the agency said they received more and more patients in the midst of a mental crisis, agitated from opioid or meth use or a combination of both, leading to increased safety risks.
In 2020, the city issued a request for proposals for a new agency interested in offering sobering services and received no applications. The city of Portland and CareOregon late that year hired project manager Aaron Lones to help propose a design and payment plan after coordinating with stakeholders. Lones, who worked with Bob Day, a retired Portland police deputy chief, had talked about a “one-stop site” for people in crisis, but they weren’t able to wrangle funding for such a project, Dodge said.
“It’s unfortunate because we’d all like to open something tomorrow, but it takes time,” Dodge said. “A lot of our providers are still struggling to get their workforces up.’’
State mental health and substance abuse providers have lost about 20% of their staff since the pandemic, leaving them struggling just to maintain the level of services they did in the past, Dodge said.
In September, Multnomah County and the city entered into a collaboration with providers under what’s called a Behavioral Health Emergency Coordination Network.
This summer, the county will issue a request for proposals for three other potential substance abuse, addiction and mental health services. Based on the responses, the county and city will likely move forward with at least one or two of the three by December, Dodge said.
The options: a 16-bed residential, subacute facility to stabilize people with both substance abuse and mental health needs that will provide beds for at least two weeks, sometimes longer; a crisis triage and urgent walk-in center where first responders can bring people suffering from substance abuse addiction or mental health issues and can be stabilized for up to 5 days with medical support; and a substance abuse stabilization center, which would provide intensive outpatient services.
“When we look at what we don’t have, all three of those are big needs,” Dodge said.
The county anticipates using its $2 million a year share of the state’s opiate litigation settlement to support one or two of those projects, with added funding from the city.
Oregon ranks first in the nation for percent of population needing but not receiving treatment for substance use disorders, with about one in five people in the state suffering from a substance use disorder, according to a 2022 OHSU-PSU School of Public Health study and survey of providers.
Hooper Detox, a subacute center that admits patients voluntarily for medical treatment of their withdrawal symptoms, turned away about 2,000 people last year, almost as many as the approximately 2,500 people it did serve, according to Dodge.