For the past 40 years, CCC has worked hand in hand with the Portland community by providing critical housing, health care, recovery treatment and employment services for people affected by homelessness. In 1985, CCC assumed operational responsibility for the Sobering Station. Over the past decade, we saw an increase of clients acutely intoxicated by methamphetamines and with co-occurring severe mental health challenges.

CCC recognizes that instances of self-harm occurred in the Sobering Station. It became increasingly difficult to manage the needs of clients in crisis in a facility based not on health care design, but on a correctional design, even with timely transfer out to the Emergency Department. As the needs of clients changed and risks of self-harm increased, we took several actions, including: 1) performing a comprehensive safety review of the program; 2) revising admissions criteria; 3) restricting the use of isolation rooms to only stable patients with hygiene needs, and; 4) enhancing de-escalation training for Sobering Staff.

Even with these changes, we knew the current model for the Sobering Station was not meeting Portland’s need for effective behavioral health crisis intervention. Grounded in a correctional model, the design of the program did not meet the emerging standard to provide a safe, comfortable, voluntary space for intoxicated individuals to shelter when they need support. Last September, we had already made the decision to close this program at the end of our contract in June 2020.

Evolving problems call for evolving solutions. Beginning in September 2019, CCC shared a vision, based on the work of the National Sobering Collaborative, for how Portland can meet its need for effective behavioral health crisis intervention. We connected with multiple stakeholders including the City, County, Portland Police Bureau and local area hospitals. We suggested the Sobering Station be replaced by a Voluntary Sobering Center combined with a Crisis Stabilization Unit, independent of the Portland Police Bureau.

Sobering Centers are designed to address the needs of people who are acutely affected by substances and who need a safe space to rest and recuperate. These are not detoxification facilities and do not provide the level of care of a hospital. Sobering Centers utilize trained healthcare, peer support and lay staff in a supportive shelter setting to assess and monitor the wellness of individuals. Most Sobering Centers admit voluntary clients and will take referrals from a variety of community partners. CCC’s Sobering Station was unique, as it utilized a police involuntary hold on clients during admission.

Crisis Stabilization Units (CSUs) are designed to provide specialty behavioral health crisis stabilization requiring a more immediate response than a regularly scheduled behavioral health visit. Often thought of as an alternative to psychiatric emergency services, CSUs provide participants a secure environment, less restrictive than a hospital, but equipped to meet the medical needs of individuals who may be in a mental health or substance induced crisis, or a combination of both. People experiencing this level of crisis can present erratic behavior towards others or themselves. Individuals experiencing a behavioral health crisis require a safe and therapeutic environment ideally supported with highly trained behavioral health professionals and staff skilled at complex care coordination.

It should not take getting arrested to gain access to quality healthcare programs. Just as Portland and our nation are considering changes to interventions for people in need, the closure of the Sobering Station and the review of what replaces it should contemplate both the program model and how people gain access to its services.

There is significant national research and models supporting voluntary Sobering Centers combined with a Crisis Stabilization Unit, focusing on the health needs of the clients. We hope the community can learn from our experience and leave behind what is no longer working for today’s needs, develop services that center people most impacted, and take a healthcare approach to health needs.

In July 2019, Blackburn Center opened its doors to patients and job-seekers — weeks after welcoming nearly 100 residents to their new, affordable homes. This moment was the culmination of years of dreaming, planning and designing a first-of-its-kind, deeply integrated care model. Finally, CCC's signature services, from housing to health care to employment assistance, would all be available under one roof.

The hard work didn't end with opening the doors to Blackburn Center, and it continues each day as we connect with clients and deepen our roots in the East Portland community.

Since opening, Blackburn has served:

• 214 residents
• 1,956 health patients
• 68 job-seekers

As we celebrate one year of Blackburn Center, we also celebrate every individual who has walked through our doors seeking housing, health care, recovery support, employment, or any combination of our services. One of those individuals is Charlette, who came to Blackburn Center as soon as it opened seeking a new path. Today, we're celebrating two anniversaries: one year of recovery for Charlette and one year of services at Blackburn Center.

Charlette was homeless and addicted to heroin for six years — living in cars, sleeping in bus stops or just walking around all night. Then, six friends died of overdoses in one week. That was when she knew she had to turn her life around.

Charlette was one of the first people to walk into CCC’s new Blackburn Center. Within a single day, Charlette:

• Saw a primary care provider, who treated her for her chronic thyroid condition 
• Saw a psychiatric nurse practitioner, who started her on buprenorphine (also known as Suboxone) for acute opioid withdrawal 
• Immediately filled her buprenorphine prescription via the Blackburn Pharmacy 

Over the next few weeks, Charlette saw a drug counselor and became active in groups and one-on-one counseling. She was also one of the first residents of Blackburn’s alcohol- and drugfree transitional housing.

“Having my housing and health care together in one building is a big thing!” Charlette says. “I can just go right downstairs and get my Suboxone at the pharmacy, or go to a group meeting, without ever leaving the building. That’s huge.”

Within less than six months, Charlette graduated from her outpatient program and, guided by Blackburn’s on-site employment specialist, began training as an on-call employee in CCC buildings.

“Having my housing and health care together in one building is a big thing!”

One year later and Charlette has stable housing, is working at CCC's Letty Owings Center, and has one full year of recovery under her belt.

Clearly, the full slate of services available at Blackburn Center is working well for Charlette. She says, “I’m paying back everything that CCC has given me by being a success. That’s exactly what I want to be.”

June 19 marks Juneteenth (also known as Freedom Day), a holiday commemorating the abolishment of slavery in 1865 in Texas and the Confederate South, two and a half years after Abraham Lincoln issued the Emancipation Proclamation on January 1, 1863.

These events eventually resulted in the ratification of the 13th Amendment, which states:

“Neither slavery nor involuntary servitude, except as a punishment for crime whereof the party shall have been duly convicted, shall exist within the United States, or any place subject to their jurisdiction.”

What followed Emancipation was the disproportionate impact of mass incarceration, discriminatory housing policies and a lack of economic investment in Black communities. Although Juneteenth is a day to celebrate freedom and equality, African Americans have experienced hundreds of years of racial discrimination and injustices, and have yet to enjoy full freedom from slavery.

The events of the past several weeks have only amplified these disparities. The murder of George Floyd is another example of racist violence stemming from the roots of our country. This violence takes its form not only in the killing of Black lives and other people of color by police, but in the deep injustices we see across our systems of criminal justice, public safety, housing, education, health care and our public health systems. The protests taking place across the nation and globally, often with violent response by police, are an expression of centuries of that injustice.

Central City Concern (CCC) is dedicated to serving single adults and families in the Portland metro area who are impacted by homelessness, poverty and addictions; and to support them in achieving their dreams of stable housing, health and economic opportunities. We cannot achieve our mission under systems that perpetuate racialized violence and systematic oppression.

• Imani Center—Provides comprehensive approaches to mental health and addictions treatment for and by African Americans. The Center’s services empower clients to build community with other African Americans working toward recovery, with the support of staff members who have lived knowledge of Black culture and the African American experience.
• Flip the Script (FTS)—CCC’s reentry program links individuals exiting incarceration to housing, employment services, peer connections and advocacy opportunities.

From a public policy framework, CCC works to center the voices of our Black, Indigenous and people of color (BIPOC) clients and those who have experience with the criminal justice system. Additionally, CCC proactively works on issues related to housing, integrated health care and social and economic opportunity.

From higher rates of poverty and food insecurity to unemployment and mass incarceration, recent events have highlighted deeply rooted issues in America: the continued existence of two histories, black and white, separate and unequal, and the stark, persisting impacts of discrimination.

Juneteenth is a holiday that should be recognized and honored by all in the United States. In our work of providing comprehensive solutions to ending homelessness, we are raising awareness and working towards uprooting policies, practices and behaviors that uphold systemic injustices and perpetuate conditions of poverty. We aim to build a society where everyone can thrive.