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On July 7, WW reported that the Multnomah County Health Department was planning to begin distributing tinfoil and pipes to fentanyl users as part of its harm reduction program. Such plans came as a surprise to many county officials and, three days later, County Chair Jessica Vega Pederson announced the suspension of the program.
News of the program was met with intense criticism, some of it from people appalled by street conditions downtown, where fentanyl is openly sold and consumed along Southwest 6th Avenue, often resulting in overdoses. Others acknowledged the utility of providing smoking supplies to drug users in order to build trust, but questioned whether the money shouldn’t instead be spent on increasing capacity at detox and rehab facilities.
Vega Pederson’s explanation of why she suspended the distribution focused on timing and communication, rather than the merits of the program.
“My decision to suspend Multnomah County’s distribution of smoking supplies was based on a lack of communication and poor due diligence by the Health Department,” she said in a statement. “Neither my office nor our chief operating officer were alerted that this program would begin on July 3. As a result, this process lacked robust community engagement, a communications plan, and a system to track outcomes. We are also expanding our legal review, as the legality of the program starting on that date is in question.”
WW then requested all of the communications about the program between the health department and Vega Pederson’s office. That request was fulfilled today. WW was provided with an undated “communications plan” as well as a series of emails between health department leaders.
A county spokesperson clarified to WW after publication of this story that Pederson’s dismay was due not to the lack of a communications plan, but the failure to execute that plan by “informing and educating the Board and public.”
Regardless, the documents do not contradict Vega Pederson’s assertion that she was unaware of the program’s July 3 start date. They do, however, show that the county had drafted a detailed communication plan that considered the legal ramifications of the program—and that Vega Pederson had signed off on the purchase of the supplies in May.
Here’s what we learned:
Feb. 14: Multnomah County’s harm reduction program authors a report recommending the distribution of smoking supplies, including tinfoil and straws, “as soon as possible.”
March 16: Vega Pederson’s chief of staff, Chris Fick, is copied on an email noting the discussion of “harm reduction changes” at a biweekly meeting.
April: County officials write up a list of “talking points” about the new program. “This is a necessary change in services that will reengage clients who have completely switched to smoking and engage new clients who may need our services,” it reads. It also notes some potential legal issues: “Providing smoking and snorting supplies is a complex legal issue. Although these supplies are considered drug paraphernalia, syringe service programs are able to distribute them due to local policy and laws that protect public health.” (House Bill 2395, which would protect the distribution of smoking supplies, has passed the Oregon Legislature but is still awaiting Gov. Tina Kotek’s signature.)
April 20: Interim health director Valdez Bravo emails Vega Pederson: “We want to confirm if we have your approval to move forward with purchasing these materials. As a reminder, this is time sensitive, as materials must be purchased by May 12.” Vega Pederson responds that she has questions and schedules a meeting for the next day.
April 27: Public health director Jessica Guernsey asks Bravo whether she should present a report recommending the distribution of “smoking supplies” to the chair’s office. Bravo tells her to “maybe socialize at the meeting that we have this.”
Week of May 1: The approximate deadline to communicate the “change in services” to county commissioners, according to the communication plan shared with WW.
May 3: Vega Pederson gives her go-ahead to purchase the supplies. “I’ll be interested in updates on how the new program is going and what we’re seeing in terms of engagement, both number of people engaged, type of engagement, and connection to other programs/services,” she writes.
May 9: A health department official tells Vega Pederson that the county has started receiving supplies but plans to temporarily close its harm reduction clinic. “We start up HRC service site again in June,” the officials says. Bravo alludes to the challenges facing the program in a separate email: “The limitations in staffing that we face at both of these sites are part of the broader issues in recruitment and retention across the health care and public health landscape.”
June 27: Harm reduction program supervisor Kelsi Junge describes the new program in an email to “internal/external harm reduction partners.”
“Our program will begin distributing additional supplies at both our field based (82nd) and HRC locations beginning in July,” she writes. “Participants can choose up to two of the following kits per day: Snorting Kit, Booty Bumping/ Boofing kit, Bubble Kits, Straight Pipe Kits, Hammer Pipe Kits, and Foil kits.”
Boofing, or “booty bumping,” is the practice of using drugs through the anus, which provides a stronger high than smoking. An invoice obtained by KATU earlier this month shows the health department spent $5 on an instructional ‘zine, which describes boofing as “the holy act of putting drugs up your butt.”
June 28: Guernsey says the chair’s office signs off on the “comms plan” and asks the health department’s board liaison, Maggie McEvoy, “for any guidance on more ‘officially’ sharing with the rest of the Board.”
(McEvoy’s response was not included in the documents shared with WW.)
County officials also debate whether to make a public statement about the finalized report recommending the distribution of smoking supplies. Junge recommends simply linking to the report on the county website.
“I lean away from any other broader public announcements, which I think would just draw unnecessary attention,” she writes in an email to health department leaders. “The report is long and there is always the risk that folks will pull data or statements out of context that we then need to spend significant energy contextualizing or responding to in the media.”
July 3: The county begins distributing smoking supplies.
July 7: WW reports the details of the program.
July 10: Two members of the Multnomah County Board of Commissioners, Sharon Meieran and Julia Brim-Edwards, demand the program be delayed in statements to WW. Vega Pederson announces the program’s suspension later that day.