Sharon Meieran
Meieran is an emergency medicine physician and Multnomah County commissioner for District 1. She lives in Portland.
There is a humanitarian crisis facing us in Multnomah County. Thousands of people are living outside in unsafe and unhealthy conditions, with inadequate shelter or medical care. Only weeks ago, a man in a makeshift shelter burned to death while trying to keep himself warm. Homeless encampments, which posed health and environmental risks prior to the COVID pandemic, have grown substantially in number, size and impact over the past year. The current situation is unacceptable from a health, safety and human decency standpoint.
It is clear that urgent solutions are needed. But in order to provide the right solutions, we need to be asking ourselves the right questions, and acknowledging up front that our region currently does not have the capacity to provide housing, or even indoor shelter, for everyone living on our streets. I think about the issue in terms of “harm reduction” - a public health approach used to mitigate the negative impacts of an underlying unhealthy condition or set of circumstances. Applying this lens, the question becomes, “How can we minimize the trauma, suffering, and public health and safety risks associated with unsheltered homelessness, while we are working toward longer term solutions?” That is a question that is both answerable and actionable.
There are many innovative approaches that could expand our system to better meet the needs of people living unsheltered. For example, I believe we should implement a coordinated network of small, publicly owned sites to provide people who are unsheltered with secure insulated structures, a place to keep their belongings and assurance that they would not be forced to leave. These sites would need to be accessible to transportation and services, but reasonably distanced from residences and businesses. They should have hygiene and sanitation services, along with mobile showers and laundry facilities. People would be assisted in getting to the sites, and they could stay – without fear of being uprooted – until more permanent housing became available.
The current policy of camp cleanups, or “sweeps,” wastes valuable resources and causes significant trauma to those who are displaced, while doing little to meaningfully, sustainably, or permanently address the larger public health and safety issues surrounding encampments. A network of healthy camping sites that meet people’s needs is a real solution that could be implemented in real time to reduce real harm.
Other models -- such as larger self-governed or publicly managed villages, hygiene hubs, parking lots where people could stay in their cars and RVs, and more -- can contribute to a broader network of safer, healthier, more stable options for people experiencing unsheltered homelessness in the near term. The Joint Office of Homeless Services is currently soliciting innovative proposals from the community for alternative shelter models that show an improvement for participants vs. sleeping unsheltered in unsanctioned public spaces. This is a step in the right direction, but we have much more room to grow in this space.
We don’t need to reinvent the wheel to create and act on effective short-term strategies. But we do need to improve the wheel we have. Local elected officials, people with lived experience of homelessness and leaders from faith, philanthropy, business, nonprofits and academia already collaborate on housing and homelessness strategies through our countywide initiative, A Home for Everyone. But the group hasn’t traditionally focused on a more expansive set of “harm reduction” strategies. Further, some partners that are fundamental to addressing homelessness, such as Multnomah County Behavioral Health and Public Health and the City of Portland’s Homelessness and Urban Camping Impact Reduction Program, have not been part of our collective
conversation. Rather than reinventing the wheel, we can improve it by bringing those who are missing to the table; by broadening our coalition’s priorities to more urgently address unsheltered homelessness; and by implementing strategies that reduce harm immediately.
We need a long-term plan for prevention and permanent housing if we are ever to truly end homelessness in our region. Fortunately, we are engaging in that work through the Metro Supportive Housing Services program. But striving for a better future should not keep us from better providing for the health, safety and dignity of those living in our community today. As we experience wildfires and ice storms, the COVID pandemic continues, and an unprecedented number of people potentially face eviction when their suspended rent payments become due, we must address unsheltered homelessness in new ways, with a strategic, action-oriented, harm reduction approach to the humanitarian crisis that continues to unfold on our streets. We need to act.