Former Multnomah County Commissioner
Fixing Multnomah County
January 2026
Oregon’s largest county is spending billions yet failing to deliver crucial health, homeless and human services because it is rudderless. I am sharing a detailed plan to meet community needs – for less.
The plan re-organizes the County’s collection of siloed, unfocused programs to a results-driven system. It brings 11 fragmented departments together into five integrated hubs; coordinates, streamlines and advances successful approaches; builds a zero-based budget where every dollar is accounted for and tied to a specific outcome; and reengineers revolving door programs into pathways to stability.
The plan draws on my experience while on the County commission (Jan. 2017 – Jan. 2025) and in emergency and street medicine, with insights from health care colleagues, provider experts, and people on the front lines. It also incorporates proven strategies from comparable counties.
The deeper I’ve gone, the more optimistic I’ve become. Because turning around the County – for the people who most need our help and for all who long for a thriving community – is eminently doable.
OVERVIEW | FULL PLAN | HOMELESS SERVICES
CURRENT ORG CHART | FUTURE ORG CHART
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