Department function is directly tied to the background, expertise and experience of directors. Currently, too many directors do not have a background in the departments they’re supposed to be leading, leading to departmental and institutional dysfunction.
Multnomah County used to be a centre of excellence. Leaders of county departments were respected leaders in their professions – medicine, public health, social services, and animal services. They had directed research, written books, and were on the cutting edge of their fields.
Amidst a toxic culture of fear at the County, there has been unprecedented turnover of department and division leaders. The core knowledge base of County department heads has diminished to an unacceptable level, yet it’s been accepted. This is illustrated by a plethora of recent examples and has occurred as the need for leadership and guidance has never been greater.
- The Health Department: The Health Department (HD) director plays one of the most crucial and influential roles in the County and, in fact, the state. The position touches on all core county functions – mental health and addiction, public health, corrections health, emergency response, homelessness, and public safety. In my eight years at the County, seven people rotated through the HD director job. The current director came to the role with no background in healthcare systems, behavioral health, Medicaid, or direct clinical services, and didn’t know key health systems players in the state.
- Behavioral Health Director: The County’s behavioral health (BH) director sets County policy and establishes operations around one of the County’s most crucial functions – ensuring a robust continuum of services exists to address mental illness and addictions. This position could not be more important to the community, and knowledge, background, relationships and expertise could not be more important to the position. In my eight years at the County, seven people rotated through the BH director job, and the most recent hire left last month. Only one former director had the background, skills, and vision to lead the division and left the County years ago; the others have not been qualified for the role, and the County’s approach to mental health and addictions has foundered.
- Corrections Health (CH) Director and Corrections Health Officer: Multiple individuals have been fired or left the division, and there has been poor integration with the Sheriff’s Correction Deputies, who have been doing clinical work with the same adults in custody. There was a report that one of the CH directors was not qualified for the position, but the standards were lowered so he could serve. An unprecedented number of people have died in custody. In my eight years at the County, four people rotated through the Corrections Health Director job and three rotated through the Corrections Officer job. Since I left the County, another CH officer (who had been hired despite complaints filed with the Oregon Medical Board) ultimately left the position.
- Public Health Director and County Health Officer: These core County functions rely on having consistent, expert leadership. In my eight years at the County, four people rotated through the Public Health director job and four rotated through the County Health Officer job.
- Integrated Clinical Services (Multnomah County Community Health Clinics): The federally qualified community health centres are the backbone of Multnomah County’s clinical services system. They are not integrated with other core County functions and services. Their providers have operated under extreme stress that has not been addressed by leadership. In my eight years at the County, five people rotated through the ICS director job.
- Youth and Family Services Director: Ensuring the adequacy of and overseeing a functioning system of services for youth and families is one of the most essential core functions of the County and one of the most complex. There are a number of specialized aspects of the work, including intersection with shelter and housing systems, physical and mental health systems, addictions, school-based health, dependency court, juvenile justice, social services and supports, and safety systems. People involved in this work spend years training, gaining the knowledge and skills needed to understand and interact with the systems involved, and getting to know youth and families by doing the actual work. Most recently, a sitting County Commissioner was selected for the position, even though she had no specific qualifications, background or training for the job.
- Animal Services: Ensuring the responsiveness and effectiveness of our Animal Services division is a core County responsibility, and the County has failed to provide adequate leadership, accountability and oversight. Three years ago, a person who had served in various mid-level management roles at the County was appointed to the position of Animal Services director, despite having no background, expertise or qualifications for the role. Per the report of volunteers who had served for years, Animal Services spiralled downward, and animals and the people adopting and serving them have been harmed.
- Homelessness Response System: The fact that there is both a Homeless Services Department (formerly “Joint Office of Homeless Services”) and a Homelessness Response System is a problem that will be discussed in future posts. For now, suffice to say that, in addition to the HSD/JOHS there is a HRS. The leader of the HRS is selected exclusively by the Chair, and the HRS is housed in the Chair’s office. In less than two years since its inception the HRS has had three directors. The first was the Chair’s former chief of staff, who left the County under a cloud. The second left the position after only a few months. And the current director selected by the Chair is a politicial consultant.
- County Homeless Services Department (formerly Joint Office of Homeless Services) Director: The utter failure of the HSD/JOHS will be addressed in future posts. This post will simply describe the qualifications of its leadership and how this has contributed to the failure of the County in addressing homelessness.
- The HSD/JOHS Director oversees a budget of hundreds of millions of dollars, is responsible for the intersecting systems of homelessness prevention, shelter, transitional housing, rent assistance, and permanent housing, oversees more than a hundred individual programs, and is responsible for allocation of hundreds of millions in Supportive Housing Services Measure funds.
- Four directors served as HSD/JOHS directors during my eight years at the County. One previous director had been serving in the JOHS for only a couple of years as an equity manager before he was promoted to be Deputy Director of the entire department, then, after a brief time, JOHS Director.
- After his departure, a government relations director for a healthcare organization was hired as JOHS Director. He spent his first year, including hundreds of thousands of dollars on consultants, learning the basics of homeless services and systems. During the most recent budget it was revealed that around $75 million from the SHS measure had been inappropriately budgeted. Meanwhile, there were ongoing challenges relating to getting money out the door, contracting organizations regularly expressed major challenges regarding relationships with the JOHS, and the number of people living and dying unsheltered reached unprecedented levels.
- He left after two years, and the Deputy Director – who had been a contracts administrator without a background in homeless services – is now leading the department on an interim basis.
The County Chair does not have to be a subject matter expert in the work of the County. But if not a subject matter expert herself, she should be surrounding herself with people who have the experience she lacks. Unfortunately, she has not done this and the vacuum of subject matter expertise and leadership at the County is palpable.
If any other business was facing the rate of turnover and depth of personnel challenges being seen at the County, it would have failed many times over.