Multnomah County Behavioral Health Resource Center Reopens

Multnomah County’s Behavioral Health Resource Center reopened at 10 a.m. today after an intensive two-week effort to replace the facility’s on-site security provider; to ensure contracted staff were fully trained and appropriately conducting the day center’s operations; and to upgrade the building at 333 S.W. Park.

The closure also allowed leadership to conduct and begin resolving internal personnel investigations into allegations of inappropriate behavior at the Center among contracted security staff and other contracted employees.

None of those investigations involved clients or any services received by clients. Nor were any County employees involved. As the investigations continue, the County is satisfied the Center’s contractors can reopen starting today.

“Closing the Resource Center was a difficult, but necessary step to get to the heart of this complaint, resolve any issues, and set expectations for the high level of service we expect from our contractors going forward,’’ said Chair Jessica Vega Pederson. 

Multnomah County contracts with the Mental Health & Addiction Association of Oregon (MHAAO) to operate the day center. DPI Security had been hired to provide safety services, with Northwest Success contracted to provide custodial services. 

Late in the evening on March 29, a Health Department manager received a complaint raising several issues at the Center, including that staff from each of the three contractors was involved in inappropriate relationships with other staff.  

The complaint also indicated that contracted staff — without indicating which contractor — may have used “powder” — an illicit drug — on site.

No clients were reported to be involved in any of the allegations. 

The next morning, the County contacted contractors to address the allegations. MHAAO immediately began its own investigation with an outside contractor, launching that day, and worked to identify training gaps and provide training. The County also requested investigations from the other two contractors.

Because of the nature of the allegations, the County did not disclose the details of the March 29 complaint publicly to preserve the integrity of the investigations and to ensure the allegations could be credibly reviewed. As stated above, clients were not reported to be part of the allegations, and the subsequent investigations have also not found any evidence of that. 

After the closure, Multnomah County’s Workplace Security team reviewed security camera footage and conducted a floor-by-floor search of the premises. No drugs or drug paraphernalia were found. 

On April 7, DPI Security officials notified the County that a DPI employee who provided security at the Center admitted to using cocaine and marijuana onsite, outside of the presence of clients. The person was immediately fired after making the admission.

Due to the allegations of inappropriate relations and the admission of drug use at the site, the County directed DPI Security to replace all its staff at the Center. After the contractor said it did not have enough available staff to do that, the County replaced DPI staff with Northwest Enforcement Inc., which will provide security going forward.

“It’s critical that this Center has the security partners we need to ensure the BHRC is a safe and welcoming environment for participants and staff,’’ said Chief Operating Officer Serena Cruz. 

County and Contractors examine allegations

The Behavioral Health Resource Center is a first-of-its kind peer-led model, with a day center that employs a workforce with lived experience to connect with people who are experiencing chronic homelessness along with severe and persistent mental illness and substance use. The goal is to offer immediate assistance through hygiene services and other resources, and build relationships to help stabilize and eventually house people who currently fall outside most systems.

The Peer Support Specialists who run day-to-day operations are part of a professional service that is founded on lived experience, uses trauma-informed practices and has professional standards and certification requirements.

The Center in downtown Portland is typically open daily from 8 a.m. to 8 p.m, and receives an average of 1,200 visits a week. A total of 17,208 visits have been recorded since Dec. 5, 2022. The County plans to add additional behavioral-health-focused services later this spring, including opening 33 shelter beds and 19 beds for bridge housing. The temporary, short-term closure is not expected to result in any delay to opening this new, needed aspect of the program but will instead enhance the Center’s readiness to expand operations. 

Working at the Center, and empathetically meeting the needs of the clients who need it most, is complex and challenging. This is generally true for all “low-barrier” programs in which clients can directly access services without referrals or requiring sobriety to begin receiving services. MHAAO has reported 252 incidents since the Center opened — ranging from mild when staff had to redirect a client’s behavior, to extreme when someone was acting in a way that violated the code of care. In March, for instance, contracted staff managed 25 calls to 911, 14 times when someone was experiencing an acute mental health crisis and 62 instances in which a participant was asked to leave because of behavior. Incident response has improved through increased triage, contracted provider collaboration and communication to ensure participant and staff safety. 

The two-week closure allowed the MHAAO to further enhance its standard operating procedures and train employees to those policies. Although extensive staff training had taken place before the Center’s December 2022 opening, and in-service training had occurred regularly since, the two-week closure allowed MHAAO to offer additional concentrated coursework all at once.

This included a 90-hour training regimen on Peer Services specifically at the BHRC, including ethics, training to MHAAO’s Code of Conduct and attesting that they agree to, and understand expectations, and lessons on when to call law enforcement, administer Narcan, de-escalation, trauma-informed approaches, and instruction on how to manage queuing, among other topics. 

“The nonprofit MHAAO is one of Oregon’s oldest and largest peer-run agencies with over a decade of experience providing trauma-informed, culturally responsive peer support services across the tri-county area,” said Janie Gullickson, Executive Director at MHAAO.

“MHAAO leaders immediately responded to the County’s concerns and launched an internal investigation led by an outside contractor. While the investigation is ongoing, our staff has fully cooperated with the investigation, fully participated in the training and have willingly signed attestations of professional codes of conduct,’’ Gullickson said.

“While this is a new undertaking in our community, we are up to this task and are committed to continued learning and course correction. We appreciate our collaboration with the County and will continue to strive for excellence in our service to the community.”

“With their lived experience, professional training, certification and values, peer support specialists are the heart and strength of this model,’’ said Valdez Bravo, interim director of the Health Department. “And we need to ensure they’re receiving the support and security they need to be as effective as possible.’’

Site and operational improvements 

Over the past two weeks, the County has also made immediate physical security improvements in the five-story Center. The County installed additional security cameras inside the building and replaced others, added window protection, made upgrades to the nurse’s examination room, improved Americans with Disabilities Act access on the first floor, removed graffiti and removed doors on the third-floor dorms per operator request for safety. Additional work is also now underway to install new motion detection technology to prevent potentially fatal overdoses in restrooms and showers. 

The pause also allowed the County’s Behavioral Health leadership team to adjust services based on lessons learned from the Center’s first four months. The day center reopens today at a reduced capacity, centering peer delivered services and hygiene services for 25 people at a time. 

While more people will be allowed in for hygiene services, to limit queuing, participants will be required to reserve a time slot to use the shower and laundry facilities.

The County is also adding much-needed medical care to the Center, bringing a Multnomah County community health nurse to the Center and, beginning in May, hosting a mobile medical clinic once a day per week. Community providers will continue to have a significant presence on-site to engage participants to create connections to longer term services for housing, employment, and behavioral health treatment.

“Knowing you are not alone; connecting to a community of support; and having someone with lived experience who can build on conversations about recovery, eventually leading to goals and plans, are some of the most powerful aspects of low-barrier, peer-driven models,” said Thomas Bialozor, director of the Behavioral Health Division.

Source: Multnomah County

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