Supporting continuing care and jail diversion for behavioral health patients. by Pat Farr

 

I presented this resolution to my fellow members of the National Association of Counties (NACo) Health Steering Committee.  It was supported unanimously (with slight amendment) and will be considered to be part of NACo’s federal policy.

My vantage point as I proposed a resolution amending Code of Federal Regulations #42

Proposed Resolution to Support Interagency Coordination to Assist “High Utilizers”

Issue: Interagency coordination to assist “high utilizers”

Proposed Policy:

NACo supports an amendment to 42 Code of Federal Regulations (CFR) Part 2 privacy provisions to explicitly allow information sharing between behavioral health and law enforcement in order to best serve individuals with substance issues.

Background: There is a need to support the development of protocols and systems among law enforcement, mental health, substance abuse, housing, corrections, and emergency medical service operations to provide coordinated assistance to high utilizers. A high utilizer: (a) manifests obvious signs of substance abuse, mental illness, or has been diagnosed by a qualified mental health professional as having a mental illness; and (b) consumes a significantly disproportionate quantity of public resources, such as emergency, housing, judicial, corrections, and law enforcement services.

The privacy provisions in 42 CFR were motivated by the understanding that stigma and fear of prosecution might dissuade persons with substance use disorders from seeking treatment.  42 CFR laws protect substance abusers’ rights and, in cases where it is more stringent, overrule HIPAA regulations.

HIPAA laws were passed to protect personal health information from being disclosed electronically on an unsecured site and without consent.  As a result, confidentiality is two-fold:  1) all information identifying a person as a substance abuser is confidential and may not be released without a consent by the client or legal guardian (42 CFR, Part 2), and 2) all personal health information, including demographic data, that is created by the provider and relates to the person’s medical or mental health, services provided, and payment falls under the protection of HIPAA and may not be released without consent by the client or legal guardian.

In most cases, addiction treatment providers fall under the more stringent laws of 42 CFR, Part 2, but there is still confusion about the two sets of laws that define who and what is to be protected. Under 42 CFR, when a person is identified as a substance abuser no information, even confirmation of the person being in treatment, may be released without a written authorization by the client or guardian. In contrast, the HIPAA privacy rule is balanced so that it permits the disclosure of health information needed for patient care and other important purposes (i.e., coordination of care, consultation between providers and referrals).

To develop and support multidisciplinary teams that coordinate, implement, and administer community-based crisis responses and long-term plans for high utilizers, a uniform set of privacy rules for the proper dissemination of information between agencies needs to exist. Information sharing is essential to the coordination of care across service providers. The confusion caused by the differences between HIPAA and 42 CFR often result in reduced information sharing and coordination, even when it is permissible.

Fiscal/Urban/Rural Impact: Individuals with mental illnesses are overrepresented at every stage of the criminal justice process.  In response, many jurisdictions have developed a range of policy and programmatic responses that depend on collaboration among the criminal justice, mental health, and substance abuse treatment systems. A critical component of this cross-system collaboration is information sharing, particularly information about the health and treatment of people with mental illnesses who are the focus of these responses. At the program level, this information can be used to identify target populations for interventions, evaluate program effectiveness, and determine whether programs are cost-efficient. However, legal and technical barriers, both real and perceived, often prevent a smooth exchange of information among these systems and impede identifying individuals with mental illness or substance abuse issues and developing effective plans for appropriate diversion, treatment, and transition from a criminal justice setting back into the community.

 

Sponsor(s): Pat Farr, Chairman, Board of County Commissioners, Lane County, Ore.

 

 

 

Better Housing Together. by Pat Farr

Innovative housing approaches will be critical in addressing our housing crisis.

BETTER HOUSING TOGETHER…I’m standing with Clackamas County Commissioner Paul Savas in front of one of their prefab tiny homes for Clackamas County’s Veterans’ Village, patterned after projects in Lane County.

The vision to end homelessness in Lane County gained traction in our Poverty and Homelessness Board’s strategic plan, goals and tactics when hundreds of people gathered at the University of Oregon to discuss the crisis level shortage of housing in Lane County on February 20. I saw many of my long-time partners in the work as well as a lot of new faces talking about innovative approaches to our local housing crisis.

At my table, along with Mel Bankoff, Dylan Lamar, Mike Eister and others we talked about solutions to provide transitional and permanent solutions to the specific needs of households looking for a place to live.

Link here to our Poverty and Homelessness Board website

State of the County Address January 2018. by Pat Farr

Following is the full text of the State of the County Address I delivered in Harris Hall on January 8 2018.  Thank you to the Shasta Middle School Jazz Band directed by Mike Reetz for the interlude and musical numbers.

 

2017 has been a year of stabilization and progress for Lane County.

But 2017 has also been a year of challenges for the county. 

Facing the largest housing crisis, perhaps ever in the history of Oregon and Lane County, counties and cities throughout this state have struggled to find adequate numbers of decent places for men and women and families to live, leaving many suffering from grossly inadequate living conditions or for the first time in their lives living in homelessness.

Throughout the nation certain factions who have long been silent either through fear of being exposed for their views or through simple cowardice found themselves emboldened to openly in our streets and buildings threaten underrepresented populations, people of color or people who had felt safe with their gender identity or sexual orientation.  Threats of violence, retribution, oppression and suppression have become tragically more common than any time in recent history.

The physical and mental health of our county and people living here have been severely challenged by inadequate resources, facilities or planning and by illness and diseases that have shortened lives and drastically changed living conditions for the people suffering from preventable or chronic disorders.

Safety in our communities and on our roads and highways, always at the top of our list of concerns, has been challenged by increasing crime and the highest highway death toll of any of Oregon’s 36 counties.

Natural disasters ranging from historically devastating ice storms that paralyzed parts of the county and a long, dry fire season that found Oregonians and Lane County residents with no respite from mind-boggling smoke incursion.

Along with the other timber-producing counties in Oregon, Lane County has seen its federal revenue from timber harvest reduced to a trickle of its promised, former stream that raised the specter of reduced services, layoffs and closing facilities.  Lane County’s budget had become a bleeding wound that threatened even the basic services a county is required to deliver.

But despite the challenges that we encountered during 2017, this has been a year of stabilization and progress for Lane County. We have celebrated the beginning of new efforts to improve the health and safety of our communities across Lane County. And we continue to work hard to protect the financial stability we have achieved through careful planning.

The heart of stability and progress for any organization is its abiity to develop, communicate and execute a strategic plan that defines goals and tactics that every member of the organization understands and more importantly understands his or her role in the success of the plan.

Lane County is completing its third year of a three-year plan that aggressively aimed high with its goals and strategies.  Lane County’s dynamic plan has been bolstered by tactics at the department and team levels that have driven us to new levels of organization, production and accountability.

Our strategic plan has three goal areas: A safe and healthy county; vibrant communities and infrastructure.  Implementing the strategies under these three goal areas while working with an ever-more challenging budget has required controlling internal costs while structurally balancing revenue and expenses.  During my first four years as commissioner and during the decade prior to that the county struggled with layoffs, service cuts continuing decimation of needed reserves.

For the first time in seven years, this fiscal year has seen the county balance its General Fund and Road Fund without using reserves and without laying off valuable, talented staff or reducing services to residents.

We continue to control internal costs by implementing financial strategies such as refinancing old and ongoing debt and saving taxpayers over three million dollars.  Through self-insurance and reduction of administrative overhead our health insurance rates saw zero growth for the third consecutive year.  I challenge you to find another government body, nonprofit or private industry that can report that.

These and other such efforts produce cost savings that allow us to place more resources into direct services that people expect.  As a result of this exemplary financial stewardship, Moody’s Financial Services has upgraded Lane County’s credit rating to the highest level it has ever been—Aa2.

Lane County government was recognized this year by the Portland Business Journal as the third heathiest large employer in Oregon.  No other government agency in Oregon placed within the top 5 in any category.

Four years ago, during my previous term as board chair, we hired a new administrator, Steve Mokrohisky.  When he called me to accept the job, I was literally standing on the tarmac adjacent to an airport runway.  He accepted the job and the challenges of it and moved his family to Lane County.

During our first meeting together we talked at length about strategic planning and how essential a strong plan would be to meet the seemingly crippling challenges ahead.  Today, as we complete the final half-year of our first strategic plan we are embarking on our next three-year plan that will build on the successes and use our momentum and our solid staff to continue to make Lane County the best place to live.

I will cover the work of our three goal areas, the work that helped us to address the challenges that we encountered this past year in ways that would not have been possible five years ago.

A safe and healthy county.

Lane County has a Poverty and Homelessness Board that is unequalled in any Oregon County.  The PHB is comprised of elected officials, service providers, law enforcement, private industry and served individuals.

While the board has been successful in a broad spectrum of areas, I will talk about the work of one single subcommittee.  In 2015, the committee that is now the Shelter and Supportive Housing Committee formulated and executed Operation 365, housing homeless veterans.  The work plan housed 404 homeless veterans during that year, culminating in an invitation to a White House celebration in late 2016.  Through 2017, programs implemented through the plan have housed over four hundred more veterans.

The next challenge of the Shelter and Supportive Housing Committee is to enhance all levels of housing and shelter in our community.  Our winter emergency housing strategies, in its second year, is delivering overnight shelter, every night through this winter for hundreds of men, women and children.

Our current goal is called Operation 600:  planning and siting 600 supportive housing units by 2021.  Units that will house vulnerable individuals who are suffering from behavioral health disorders and active substance use.  It’s a lofty goal, but we are on our way.  When my former comrade-in-arms Major Tom Egan froze to death on our city streets it raised a hue-and-cry to make sure others were not suffering that same fate.  Adding safe, supported residential facilities, wet bed housing, we can help ensure that our most vulnerable neighbors will not suffer Tom Egan’s fate.

And we are on our way. Recently, e celebrated the opening of the Oaks at 14th, a facility that we were proud to partner with Sponsors, HACSA and others on. The Oaks at 14th provides affordable, permanent housing for individuals with criminal histories, including veterans, seniors, and people with disabilities.

Additionally, we have embarked on a frequent user system engagement plan, FUSE, that identifies the most frequent users of emergency services and provides them with immediate targeted help, including residential and medical.  The first year of the plan has produced incredible results and has garnered support for the ongoing program.

Our first county-operated supportive housing unit, on county property at MLK Boulevard, is in the planning stages and will ultimately house with wrap-around care, 50 individuals in safe and healing residence.

We adopted Lane County’s first-ever transportation safety action plan which is designed to help reduce the high number of fatalities on Lane County road through education, engineering and enforcement.

The removal of tobacco from our 70 County-operated parks, the increase in the tobacco purchase and consumption age to 21 years old, and the approval of a policy that will make County-owned properties tobacco-free.

In May of 2017 we sought to renew our Public Safety Levy for an additional five years.  We had received another successful audit of the use of levy funds in January of 2017 and anticipate a fourth audit later this month showing that we are keeping our promises to voters.  By actually reducing the amount levied by over 30% we garnered the trust of taxpayers during the first levy and they approved the renewal with a 72% yes vote.

The levy has ensured greater funding for youth services, added mental health specialists to jail staff and is a cornerstone of the Sheriff’s Department partnering with Lane County Behavioral Health to help first responders provide assistance needed in the best and safest way to our community members with mental illness.

In 2017, the Board adopted five Community Health Improvement Plan priorities for Lane County. The priorities were developed after vigorous community outreach and work with our partners. They are focused on economic development, housing and rural care, which we know are a foundation to a safe and healthy county.

Vibrant Communities

I am committed and all of Lane County Government is committed to ensuring that our county and our cities are a safe, nurturing and welcoming place to live.  We will not tolerate inequities waged on our the people who live with us and beside us in our community.  In 2017, our newly formed Equity and Access Advisory Board began meeting. This is a group of community members committed to helping Lane County place equity at the heart of its decisions – both internally and in our communities. Members have already helped to craft provisions regarding foreign citizenship that were adopted into Lane Manual by commissioners in July.

Our two-year vegetation management program study was completed in 2017 and the citizen committee unanimously presented a program to the board of commissioners that provided for effective preservation of our transportation infrastructure while minimizing roadside spray and overspray.

Additionally, our Parks Advisory Committee, fresh off its two-year large events task force work is embarking on a multi-year multi-disciplinary Parks and Open Space Master Plan.

Finally, I will talk about our ongoing work in cooperation with the city of Eugene and state government to site and build a new Lane County Justice Center to replace our aging courthouse, a new and vibrant Eugene City Hall and significantly a year-round permanently sited Lane County Farmers’ Market.  This work is ongoing and I expect plan finalization early in 2018.

Infrastructure.

Our third county-wide priority is infrastructure, which provides the backbone that supports our work in the first two priority areas.  Our infrastructure encompasses both physical and policy-based elements.

In 2017 Lane County’s office of Performance Auditor completed audits and forwarded recommendations in a number of areas, significantly our Behavioral Health and Road Maintenance divisions underwent performance auditing and the results were largely positive and will help us plan better for the future.

Lane County’s Performance Auditor reports to the Board of County Commissioners and is charged with identifying ways to improve the efficiency, transparency and effectiveness of county government.

Working with our legislators we helped craft and pass a transportation package that will provide and expected 8 million dollars per year for improvements in our roads and highways and helping us maintain our 1440 miles of county roads, hundreds of bridges and bike paths.

The most vital aspect of our infrastructure is the staff of talented and dedicated men and women who have chosen Lane County as their place to work.  I want to thank them for their commitment to their work, their drive to make Lane County a better place to live and to work and on behalf of the 360,000 people whose lives they affect every day offer my deep gratitude for their service.

I want to call out the names of four individuals who have had a profound and positive influence on the work I do here.

First, is Deeni Leeke, the face of Lane County to thousands of people who visit or call here annually. You know her voice and her face, she works in our front office on the third floor.  Her nature and her talent make every day I spend in my office more pleasant and productive.

Next is Diana Alldredge.  You may not know her face or her voice, but Diana is the flawless historian for just about every committee and public meeting in our Human Services Department.  Before I became a commissioner I would often chat with Diana in her office while waiting for Steve Manela.  She keeps the most flawless minutes record not only that I have ever seen, but that is possible.

Third is Lise Stuart, who helps administer numerous programs in human services, but significantly is the data reporter for our veterans housing programs, Operation 365 and its children.

Last on my short list is Diana Jones.  She is my voice in the sky.  Her work is unnoticed by the public, but if she did not do it to the level she customarily does, even on vacations and days off, the public would certainly notice.

Only four names, but representative of the hundreds of people who have dedicated their work and their lives to serving the people of Lane County.

Thank you to the men and women of AFSCME General, AFSCME Nurses, Admin-Pro, Public Works Local 626,  Lane County Federation of Oregon Parole and Probation Officers Association, Lane County Peace Officers Association, Prosecuting Attorneys  and non-represented staff.  You make my life better and you mean the world to the people who live here.

2018 will see a continued focus on providing short- and long-term solutions to homelessness. Our overnight parking program pilot in the River Road area will begin and pair interested businesses and religious institutions with people in need of a safe place to sleep.

We will also work to update our strategic plan so that we are focused and prepared for the opportunities and challenges over the next three years.

PLAY VIDEO

While we still face the obstacle of limited resources, we are creating the solid foundation we need to continue offering vital services to our community.

Working closely with our partner and overlapping jurisdictions is essential to effectively and efficiently providing services and infrastructure to the people we serve.  Finding new and innovative ways to both complement and enhance each other’s work is an ongoing process.

 

My term as board chair is about to expire, but my ongoing work will be more vigorous than ever.  Seeking innovative ways to leverage our resources into making Lane County the best place to live in Oregon and in the United States will consume me.  We had a great year—a banner year.  My work starting tomorrow sitting at the end of the bench will keep me very busy.  Until every child has food and shelter, until no man woman or child suffers from lack of medical care, until no man woman or child is homeless, the work goes on.

Please join me in celebrating our achievements in 2017 and looking forward to our work in 2018.

And now, to symbolize the magnitude of the work completed, planned and started this year, a site most people have never seen before, to recognize the brightness of the work ahead of us, Ms. Ashbridge, can you please shed light on our work in Harris Hall?

CURTAINS OPEN revealing the panoramic view of trees and sky outside Harris Hall

Continuing to house homeless veterans in Lane County. by Pat Farr

I took this photo of Mrs. Obama from my seat in the White House East Room as she delivered a powerful speech supporting creating and maintaining housing for our nation’s veterans

A year ago I was called to the White House by First Lady Michelle Obama in recognition of Lane County housing 404 homeless veterans in the year ending in March 2016.  Former Eugene Mayor Kitty Piercy was also invited.  I took as my guest Jon Ruiz, Eugene’s City Manager and Terry McDonald of St. Vincent DePaul of Lane County joined us as Kitty’s guest.

Revealing the number of veterans housed during Operation 365 with Terry McDonald and Kitty Piercy

Since then the work of finding housing for veterans here continues.  436 veterans have been housed since that date in 2016.
Each month Lise Stuart from Lane County Human Services compiles the record of the continuing services and forwards a copy to me and to the people and agencies who are tirelessly working to place men, women and families in housing.
Here is the list distributed by Lise on December 8.
Lane County Highlights:
·            436 Homeless Veterans on the By-Name List have been housed (temporary or permanent) since 03/2016 (20 months) 
CoC-HUD APR Veteran Destinations (This is an unduplicated count, therefore this number may go down because veterans return to homelessness)
·            159 Veterans currently on the By-Name Active List
·              97 Number Veterans had a Coordinated Entry Assessment to get on the homeless housing wait list since 03/2016
·                0 Number Veterans had a Coordinated Entry Assessment to get on the homeless housing wait list in the past week 
         (0 in past 30 days)
·          1418 Individuals have been assessed for the Homeless Veteran By-Name List since 03/2016
·              20 New Homeless Veteran By-Name assessments in the past week
·              36 Unscreened homeless Veterans on the list
·                6 New Homeless Veterans (unscreened) added to ServicePoint CMIS/HMIS in the week
The agencies and staffs involved in this effort include:  Lane County, Cities of Eugene and Springfield, Catholic Community Services of Lane County, FOOD for Lane County, St. Vincent DePaul of Lane County, Community Supported Shelters, Lane County ShelterCare.

Safe and legal camping in Lane County. by Pat Farr

 

Lane County Commissioners acted Tuesday to help local homeless people who are living in their cars. The commissioners have faced reality.

Commissioners voted 4-1 to allow overnight car camping on private property in the Santa Clara area, north of Randy Papé Beltline.

While this would be a pilot project, a similar car camping program, called the Overnight Parking Program, already exists in Eugene. The Eugene program, a partnership between the city and the nonprofit St. Vincent de Paul of Lane County, has been operating smoothly since the late 1990s. Last year, OPP helped 81 individuals, and 27 families with 41 children, at a cost to the city of $89,000.

The sad reality is that these are people who will be living out of their vehicles regardless of how the commissioners voted. They just wouldn’t be as safe or as stable — which is particularly hard on families with children. Nor would they have minimal provisions for sanitation.

Eugene’s program, in contrast, provides screening and placement of campers, sanitation, trash pick-up and parking site management at no cost to the host. It also reduces the amount of time police have to spend responding to reports of illegal camping, allowing them to focus on more important law enforcement needs.

Living in a vehicle isn’t a lifestyle people generally choose if they have other options, but it’s a better than living on the streets, often the only other alternative for car campers. St. Vincent de Paul has found that providing a safe, legal place to camp in a vehicle helps families and individual in crisis stabilize their lives and gain better access to services that can help them get back on their feet and into employment.
Eugene is far from the only city that has approved legal places for car camping. For example, Ashland, which has been struggling with soaring housing costs, began a vehicle camping program this year when a Unitarian church stepped forward and offered space.

The number of police citations for illegal camping in Ashland plummeted — from 146 in 2016 to 29 in the first half of this year, the Medford Mail Tribune reported. (Citations carry fines of around $100, and failure to pay or appear can result in an arrest warrant — a heavy price to pay for being unable to afford housing.)

An effort earlier this year to open a homeless camp in a part of Santa Clara that is within Eugene’s city limits, on an undeveloped city park site near the Fred Meyer store, fizzled in the face of neighborhood opposition.

The reality is that whether some Santa Clara residents like it or not, there are already homeless people camping in their area — they just don’t have a high profile.

What a legal homeless camp will do is bring them out of the shadows, improving their safety and making sure they have access to basic needs.

Santa Clara residents will deal with homelessness one way or the other — by paying for law enforcement, trash pickups and other byproducts of illegal camping, or by allowing adults and children to park their vehicles in a legal, safe and sanitary place, making it easier for them to get back on their feet. The latter option makes more sense.

Thank you Register-Guard for this article:  Facing car-camping facts, printed in the November 29, 2017 Register-Guard.

Clackamas County Housing Panel Discussion. by Pat Farr

Eclipse in Lane County: tips for your safety on August 21 2017. by Pat Farr

The eclipse in Lane County will look something like this

Eclipse tips for Lane County residents

Lane County is gearing up to help residents and visitors make the most of the 2017 solar eclipse on August 21st!
With much of Lane County at or close to ninety-nine percent totality we have a great opportunity to view the eclipse without fighting traffic and the risk of being stuck on the road during the event,” said Lane County Emergency Manager Linda Cook. “We encourage residents to enjoy the eclipse from a location near them – a backyard, balcony or similar place can provide a great and convenient view.”

Tips for Lane County residents during the eclipse:

• Consider the eclipse a multi-day event with increased traffic and visitors between August 16 and August 23.
• We are on the “path to the path” of totality. Roads on and off major highways might be busier than usual August 16–23 so be sure to pack your patience!
• Keep your cool and be kind in crowds and traffic. It’s sort of like a busy holiday that only comes once every 100 years or so. (The next total solar eclipse to cross Oregon will happen in 2169!)
• Don’t get stuck! Bypass the lines by filling up your gas tank and grocery shopping early in the week before the eclipse.
• Be patient with the internet, the ATM and your cell phone. With the increased number of visitors, internet and cellular service may become slow or overwhelmed (especially on Monday).
• Don’t fall for a fake: wear certified glasses made to protect your eyes from an eclipse. Learn more from NASA at https://eclipse2017.nasa.gov/safety.
Reminders for visitors during the eclipse:
• Pack ahead. Skip the lines and make food, beverage and other purchases before you leave.
• Remember cellular service is limited in much of Lane County and Oregon.
• Bring a printed map in case cellular service is slow or unavailable.
• Help keep Lane County green: If you packed it in, pack it out.
• Be water wise and carry plenty with you.
Know the tides if you visit the beach during the eclipse. Tidal changes affect rivers too.
• Know where your safety areas are & be familiar with tsunami evacuation routes on the coast.
• Be aware of beach hazards: keep an eye on the waves & don’t play on logs as they can shift and injure climbers.

 

Thanks Sergeant Carrie Carver, Lane County Sheriff’s Department, for these tips and text…

Lane County Commissioners will interview candidates to replace Faye Stewart on April 12 2017. by Pat Farr

Commissioners will interview candidates to replace Faye Stewart, seated on the left.

I will join Board of County Commissioners vice-chair Jay Bozievich and Commissioners Sid Leiken and Pete Sorenson on Thursday April 12 to determine who will replace Faye Stewart as East Lane County Commissioner.  26 candidates will participate.

Interviews for the District 5, East Lane commissioner seat will be divided into morning and afternoon sessions.

Beginning at 9:00 a.m. in Harris Hall (125 E. 8th Avenue, Eugene), the 26 candidates who met minimum qualifications and were available for the interview will each be asked to “Tell us why you applied for this position.”

Each candidate will have three minutes to speak. The order will be determined by having candidates draw numbers prior to the start of the meeting. Commissioners will not comment or ask additional questions of the candidates at this time.

After all 26 candidates have spoken, commissioners will deliberate and each commissioner will choose no more than three candidates to move forward to the afternoon session. We anticipate those deliberations will begin around 11:00 a.m.

The Board will break for lunch while staff from the Human Resources Department notifies candidates of the selection.

The second round of interviews will begin at 1:00 p.m. The candidates who were chosen to move forward to this round will each have 15 minutes to answer three questions from commissioners. The order will again be established by drawing numbers.

The questions will be selected from a list provided by the Human Resources director. The Board chair will direct questioning with the three remaining commissioners each asking one question.

After the second round of interviews is complete, commissioners will rank their top three choices. Each commissioner’s first choice will receive three points, second choice will receive two points and third choice will receive one point.

The three candidates who receive the highest number of points will move forward to answer a final question.

After the three top candidates are given three minutes to answer the final question, the Board will deliberate toward a decision.

In order to be appointed, a candidate must receive a minimum of three votes from commissioners. The Board of County Commissioners may recess for the evening and resume the process on Thursday morning if it is unable to come to a decision in a timely manner on Wednesday evening.

The meeting is open to the public and all deliberations will be conducted in public session. The meeting is also available at Comcast Channel 21 (Metro TV) to Eugene/Springfield-area Comcast subscribers.

The meeting is also available as a live webcast at http://lanecounty.ompnetwork.org.

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