Why I'm running for Multnomah County Commission

By Rob Milesnick of Portland, Oregon. Rob is a candidate for Multnomah County Commission, District 3. (Currently held by Commissioner Lisa Naito.) More information at RobForCounty.org

RobmilesnickNow that the November 6th election results are known, one thing is certain: we still have a lot of work to do.

And that’s why I’m running for Multnomah County Commissioner in District 3, in Southeast Portland.

There are few places outside Multnomah County where people are so passionately committed to living the progressive values in which they believe. I believe that these values should guide the work of the County Commission.

One of those values is that everyone in Multnomah County should have access to high quality, affordable health care no matter where they live or how much money they make. Unfortunately, because of a lack of federal leadership, too many families still live without adequate health coverage. County Government can do a lot of good here. The Multnomah County Health Department already operates seven health clinics, an HIV center, and 12 health centers in local schools to keep kids and the county as healthy as possible. We need a Commissioner that can strongly advocate for state and federal funds and ensure our health programs don’t suffer funding cuts. Working with ODS Health Plans, I’ve gained valuable insight and experience into how to get things done in Salem and I want to put this experience to work for the County.

County government also has an important role in education. SUN (Schools Uniting Neighborhoods) Community Schools coordinate and provide educational, recreational, social, and health services at neighborhood schools that help kids and families succeed. Despite the success of SUN Schools, funding for this program has been used as a political football to advance short-term political agendas. I want to ensure a permanent funding source and find ways to let more local kids participate.

Leadership starts at the top, and Multnomah County needs a sheriff’s department in which the public has faith. Appointed by the City of Portland to the Citizen Review Committee, I have asked law enforcement professionals tough questions and I intend to keep asking tough questions about Wapato jail, our aging courthouse, and our sheriff.

But we can’t address these challenges until Multnomah County has a commission that can truly work together and solve problems. As a graduate of the Syracuse College of Law and its Conflict Resolution program, I’ve built and maintained bridges of support and respect between public officials, community leaders, and local citizens. I have the training and experience to focus on solutions, not more political bickering.

It may seem early to begin discussing these issues so soon after a big election. But it’s important that we start doing that work today. Small changes in County government can have an immediate impact, and big changes have the potential to change lives.

That’s why I got up early this morning to work on my campaign for the County Commission.

Please contact me at any time for more information and to offer your ideas, at [email protected], or visit us online at www.robforcounty.org to learn more about my campaign.

Our campaign kick-off event is November 15th at the Teamsters Local 223 Hall at 1230 NE 106th Ave., Portland, OR 97220. I hope you can make it.

Rob

Comments

  • Carla Todenhagen (unverified)
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    Rob’s commitment to a viable and efficient local government that truly benefits the Portland community is commendable. It’s exciting to think of the improvements and dedication he will bring to the Multnomah County Commission, and I look forward to hearing more from him at the kick-off event.

  • Janet Grayson (unverified)
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    Rob will bring a fresh face and new ideas to the Multnomah County Commission. His enthusiasm and sincere concern for Multnomah County and its residents will enable him to bring about much needed change in schools, healthcare and law enforcement.

  • Peter Toll (unverified)
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    I've known Rob for several years and have immense respect for his judgment and ability to work with other folks to actually get things done. He has the youth, the vigor and the vision so badly needed in Multnomah County. At last, a meaningful and exciting breath of fresh air. He clearly deserves our wholehearted support.

  • Jefferson Smith (unverified)
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    Rob -- methinks we should do something about the Max out to East County.

    I'm thinking about rounding up some peope, wearing red vests, and riding the max as volunteers. Wanna help? I figure we invite any opponents as well (there are some good people running in your race), so it's not a campaign thing as much as a service thing. Might raise awareness too.

    What's going on is ridiculous, and citizen paticipation (in addition tot he added police presence) might make a bit of difference.

    (Forgive me using this as email...I lost your address, but I think it's an issue relevant to the campaign and to anyone concerned about East Portland / Mid-County / East County -- the area that's really getting the short end these days.)

    And if you got ideas, I'm happy to hear 'em.

  • Rachel McCarthy (unverified)
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    I've had the pleasure of knowing Rob for several years. He has a ton of enthusiasm and drive for improving the lives of Multnomah County residents. I shared an office with Rob and got to watch him work one on one with criminal defendants to achieve the goals of community safety and lifelong sobriety. His problem solving skills are superior. I am very excited that he is running for Multnomah County Commission, District 3.

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    I've reported on Police Citizens Review Committee meetings when Robert was present in his official capacity. He never voted against the bureau's findings and sometimes drew startled looks, even from his fellow committee members, for some of his positions.

    His election would do nothing to further the cause of police accountability in Portland. Plus, he's kind of a douche.

  • OddsyGirl (unverified)
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    I am wondering why you don't see promotion of the health care that is available through all of these county health clinics as an option for those who do not have health insurance. My family used them before we had health insurance and we received good care.

  • Tim (unverified)
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    A "douche"?

    Seeing as we're not on the playground at recess, I'm more comfortable interpreting the comment above not so much as unsubstantiated and puerile name-calling, but more as an awkwardly prosaic attempt to indicate that Rob's election will freshen up the County Commission -- in which case I'm in full agreement with Mr. Davis.

    I've known Rob personally for a couple of years now and unhesitatingly vouch for his sincerity and integrity, as well as for the eagerness with which he is pursuing the position as County Commish. I've had the opportunity to talk politics with him several times on an informal basis, and I'm constantly impressed by his depth of knowledge, completeness of analysis, and ability to objectively consider and decide among several different possible approaches to an issue.

    Rob, I'm confident that your contributions to county government will precipitate positive changes on personal and community levels, and I'm excited for you as you undertake this course. Congratulations and good luck, man.

  • TJ Romano (unverified)
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    I have known Rob for several years, and I am excited for the residents of Multnomah County to get to know him as well as I do. What you will discovery is that Rob is a great person, intelligent, and the best listener I know. His passion and commitment to public service are going make our County even better. Don’t talk my word for it, contact him or attend an event, and you will find out for yourself that Rob will make a great Multnomah County Commissioner. I am already looking forward to next Election Day – good luck Rob!

  • Rob Milesnick (unverified)
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    Jefferson,

    That's a great idea. I served on the Board of Directors of the Northeast Coalition of Neighborhoods. One of the programs they operate with Tri-Met and County funds is the Rider Advocate Program. It's an extension of Tri-Met's Customer Service Division. Advocates provide service to the ridership by providing a sense of security, answer route questions, and act as eyes and ears for security crews. Funding has been an issue for the program, and there are only 7 advocates who patrol a very large area.

    Let's coordinate with them too!

    Thanks, Rob

  • Mike Langer (unverified)
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    Rob is a thoughtful, vibrant person with a real interest in improving our community.

    I have gotten to know Rob on a personal level, and have repeatedly observed him donating his time an energy to benefit others. What has most impressed me about this is that he has done so without an interest in personal gain, but rather with a sincere interest in helping others. I believe this quality makes Rob a superb candidate for County Commissioner.

    I've also had in-depth discussions with Rob regarding education and healthcare. He has consistently impressed me with his knowledge of the issues and ability to consider various solutions to the problems inherent in those issues. I am confidant that if he is elected County Commissioner, he would improve our educational and healthcare systems for everyone.

    Rob's election would bring new and positive energy to the position, and he deserves our support.

  • Ginny Goldberg (unverified)
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    Having worked with the SUN Community Schools at several neighborhood schools, I am happy to see Rob take an active interest in keeping this valuable program intact. Keep it up, Rob!

  • Sherrelle Owens (unverified)
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    I sit on the Citizen's Review Committee with Robert Milesnick. I am a strong advocate of police accountability. While serving on the committee, I, at different times, have contributed to some startled looks in Robert's direction based on his vote...And then, I got to know the man.

    I became aware of his sincere concern for women's issues, for issues related to people of impoverished backgrounds, for issues related to race relations, and for his concern about equal access to healthcare. It became apparent to me that this is a guy who is passionate about what he believes in and because of that, when tested, will stand his ground at all costs, even in the face of opposition. And this is who sits with me as a member of the Citizen's Review Committee.

    Here's a guy who is more than an image, more than a candidate, more than a front man, more than flowery phrases, and more than a stiff in a suit. He may not always see things how you or I see them. And he may not always vote like you or I vote. But he will make himself available. He will allow you to be heard. He will weigh the information in front of him. He will reflect on what you've given him. He will do his own research. And then, he'll make his decision. You can't ask for more than that.

  • Rob Milesnick (unverified)
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    Thank you for sharing that experience, OddsyGirl.

    In 2006, more than 62,000 people received county health care services. 45 percent of those served had no health insurance. And that was up from 41 percent in 2005. It's great that the county can help so many people without insurance. But county clinics can only serve up to their capacity, and they have limited resources. I would like to increase that capacity, and fund at a level proportionate to demand for health services.

    And you're right, the county should be doing what it can to make people aware of these services.

    Thanks, Rob

  • Dan Mattock (unverified)
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    I'll be interested to see how things turn out in this election and intend to follow it closely.

    I've been reading quite a bit about Rob lately and have been impressed by his dedication to improving the local area of Portland.

    It is rare to find a candidate who is extremely current on the issues the community is facing, coupled with the drive to inspire change.

    It is my opinion that Rob will be the candidate to watch. You can't teach the ability to inspire, and Rob truly has that gift. Portland is crying out for inspiration more than ever right now.

  • Jessica (unverified)
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    As a good friend of Rob's, I know how much he cares about others, and how much he cares about making a difference in his community. I believe that the best government starts not just at a local level, but on a personal level, and Rob truely cares about others. He is one of the most compasionate, caring, best listeners I've known and he would bring energy, passion, compassion and a desire to serve others to this office.

  • Rosemarie Cordello (unverified)
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    I have known Rob well for about six years. In that time, I have become more and more impressed with him. He has a huge capacity to care, not just about individuals but about the whole community. This is demonstrated by his exceptional ability to listen carefully, ask thoughtful questions and extend a hand to help. In the entire time I've known him, he has been fully engaged in public service. Not just feel-good service, but the hard work most of us won't do, for example, his service on the Police Review Commission, his work with ex-offenders recovering from abuse abuse, and his neighborhood work healing community conflict. I can't imagine a better choice for county commissioner.

  • Brantley (unverified)
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    In getting to know Rob over the last year-and-a-half, what has impressed me the most about him is his ability to listen. Paraphrasing dialog from a movie (the title of which I cannot remember), Rob doesn't just listen so that he knows when it is his turn to talk. He listens because he cares about what you're saying. This quality, above all else, makes me believe that Rob would make a great county commissioner.

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    Jefferson,

    That's a fantastic idea (though it smacks of mob rule). I would be there with a bat and a flashlight if I weren't stuck in Eugene. We don't have light rail trains to patrol. Oh, well.

    And I had the opportunity to meet Rob at the Labor Day picnic at Oak's Park. An obviously bright and motivated guy who genuinely wants to make a difference (although I've never lived in Multnomah County, so I suppose I should stay out of their politics).

  • Cindy (unverified)
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    I had the pleasure of meeting and getting to know Rob when he first moved to Oregon. For as long as I have known him, his dedication to the community around his has been evident. He is committed to change, and helping others. His sincerity and depth of knowledge is obvious to all who know him. If you don't already know him, his kickoff event will be an excellent opportunity to learn more about him and his beliefs. I only wished I lived in southeast so that I would have the opportunity to vote for him myself.

  • Katie Walker (unverified)
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    I have known Rob for many years, and have been impressed by his commitment to public service and to the communities of Portland. I work as a speech-language pathologist in a public school system and experience daily how the lack of funding, large class sizes, and minimal resources negatively impacts students. Particularly those students who have special needs. I have no doubt that with Rob's dedication to making positive changes and his immense compassion towards children and education, he is the change that Multnomah County needs to move the education system in the right direction.

  • Steve Buel (unverified)
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    Rob, your advocacy for the SUN schools, certainly a positive program, is admirable. But the lower economic neighborhood middle schools in Portland need serious after school and in-school sports, music and the like which connect directly to the school. SUN schools don't do that in the same way.

    A look at Evergreen in Vancouver shows you a district that does both. Are you prepared to fight for the schools in parts of this city that are now heavily neglected by the Portland Schools Foundation and Stand for Children, the two groups which control PPS? If that is not the case then as a county commissioner you will not be one iota better than the commissioners we have now as far as schools are concerned. And therefore as an advocate for neighborhoods who are not advocating well for their own schools while many of their children end up in jail, on drugs, prematurely pregnant, in gangs, alcoholics, and/or dropouts because of our poor schools, you won't be very much of an improvement, if any. Good luck.

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    Sorry, the douche thing was "unsubstantiated and puerile name-calling." But Sherelle...

    His concern for women's issues, for issues related to people of impoverished backgrounds, for issues related to race relations, and for his concern about equal access to healthcare. It became apparent to me that this is a guy who is passionate about what he believes in and because of that, when tested, will stand his ground at all costs, even in the face of opposition. And this is who sits with me as a member of the Citizen's Review Committee.

    Here's a guy who is more than an image, more than a candidate, more than a front man, more than flowery phrases, and more than a stiff in a suit. He may not always see things how you or I see them. And he may not always vote like you or I vote. But he will make himself available. He will allow you to be heard. He will weigh the information in front of him. He will reflect on what you've given him. He will do his own research. And then, he'll make his decision. You can't ask for more than that.

    How does "getting to know" Bob make up for his voting record on the CRC? Name me one tough question he has ever asked of the police as a member of the CRC, and I'll withdraw my remarks.

    It was Churchill said "if you've never made any enemies, you've never stood up for anything," and I find it hard to believe Milesnick is more than any of the flowery phrases or stiff in a suit stuff you mentioned, judging from the nature of his support here. I don't see leadership. I don't see conviction. I see politics, and way too much of it.

    "Healthcare for all." Give me a break.

  • Rob Milesnick (unverified)
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    Steve,

    Fighting to close the education gap is a top priority for me, and should be for every elected official in Oregon.

    I'll be sure to research how Evergreen High School in Vancouver administers their programs and receives funds.

    I do know that Franklin High School, for example, has received a little over $110,000 in New Vision and Community grant money from the Equity Fund of the Portland Schools Foundation, and that the Foundation is trying to help.

    I also recently met with the director of Stand for Children in the Portland area, and must say that their commitment to helping kids with through a host of programs is evident, and very encouraging.

    Thanks for your comment. Rob

  • Rob Milesnick (unverified)
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    Matt,

    Healthcare for all is a very attainable goal. Public and political pressure has been building for some time, and it will occur. I have no doubt of that.

    As to your comments about my voting record on the CRC, I’ll let my votes stand for themselves. Because of the confidential nature of CRC files that are not discussed at our hearings, I won’t talk about specifics on a public blog. But what I will do is offer to sit down with you over a cup of coffee to discuss my votes and my questions of both the Portland Police and the complainants involved. Our past interaction has been limited to a brief handshake and name introduction.

    It is possible to have conviction, listen, and display leadership, without making enemies. Our community has seen too many County Commissioners make enemies too quickly in the recent past, and I intend to be the kind of Commissioner who builds bridges rather than burns them.

    I look forward to meeting with you soon.

    Rob (or Robert)

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    Jefferson:

    What a great idea. You're right that the MAX is one of the biggest issues out here right now. The fact that Gresham's having to use its meager police force (we only have enough funding to have 7 officers on at any given time) to patrol the MAX just goes to show how bad it is.

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    Whoops, hit post before I meant to.

    We should put something together. I bet I could get the Neighborhood Associations involved. I'm president of the NE Gresham one, and although MAX stops just before our neighborhood, we have the second highest percent of households without a car. So many catch the bus on Kane or Stark and head to the MAX.

    Plus we have a coalition of neighborhood associations meeting next week, and I could bring it up there.

    Our neighborhood associations are pretty big into the Neighborhood Watch, and I'd say this would definitely fall under that.

  • Rob Milesnick (unverified)
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    Jenni,

    Thank you for the enthusiasm. Ron Laster, President of the Northease Coalition of Neighborhoods, has devoted years to this issue and the programs that support it. It would be great to get his thoughts on the Rider Advocates, MAX, and how we can help.

    Thank you for sharing this with your Gresham Coalition.

    Rob

  • John Dieter (unverified)
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    I have known Rob for a couple of years now. His support for, and understanding of, the necessity of unglamorous projects such as a new courthouse, healthcare, opening the new jail and spending money to treat alcohol and drug abuse are vital to making Portland a better place. Rob has a passion for social justice and the energy and drive to follow through with his convictions. His election would be a boost to our great community.

  • Zach (unverified)
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    Very impressed with Rob's statements and how he appears to handle conflict. Look forward to hearing more from him in the future.

    Best of luck, Zach

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    Rob:

    Not a problem. I'll bring up the idea and see who wants to get involved with something. I'll also post it to our e-mail list so that everyone gets to hear about it.

    Maybe then some of us can get together Ron Laster and see what he says. Maybe include people like Gresham's police chief (who is also running for the county commission, but for Lonnie Roberts' seat).

    I think that ideas like this are perfect examples of how governmental entities within the county can work together. It's something I advocated for in my attempt to be appointed to the city council, and will be a part of my run for city council next year. If our city council members (for all the cities within the county), county commission members, state legislators, etc. could work together more on the issues that affect the county, we could get a lot done.

  • Rob Milesnick (unverified)
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    Jenni,

    I wholeheartedly agree. It's amazing what can be accomplished if people don't mind who gets the credit.

    You and Jefferson highlight such an important concern for East County, and I'm looking forward to working together on this.

    Rob

  • Michael Wexler (unverified)
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    As a political enthusiast on many levels, it's enjoyable for me to read everyones responses thus far. Rob's committment toward his community is undoubtadly apparent and I look forward to seeing good things in the future. Always remember, "if you can find a path with no obstacles, it probably doesn't lead anywhere." (Frank A. Clark)

    Best, Michael

  • Jason Wax (unverified)
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    Rob did a helluva good job in getting so many of his supporters to post comments! Very well organized.

    And Jefferson's MAX idea is brilliant.

  • Jud (unverified)
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    Jason Wax, Rob didn't need to do a helluva good job in getting his supporters to post comments. What happened is that people came on to post favorable comments because they saw a likeable, intelligent, hard-working candidate being mocked by someone whose most-insightful analysis consisted of dropping a junior high playground taunt. I'm curious to know if Mr. Davis accepts the offer of a coffee and a chat. The chat might get in the way of his preconceived notions.

  • Morgan Allen (unverified)
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    "One of those values is that everyone in Multnomah County should have access to high quality, affordable health care no matter where they live or how much money they make. Unfortunately, because of a lack of federal leadership, too many families still live without adequate health coverage."

    I don't know you Rob, so I ask this question in the gentlest way possible...How can you place the blame on the feds for the health care crisis? Especially when you work as a lobbyist for one of the largest private health insurance companies in the Northwest?

    I think most BlueOregon readers would agree that Congress and the President have not adequately addressed the health care crisis in this country. But at least this BlueOregon reader would assert that the profit motive for hospitals and health insurers is the root cause of a problem that the feds haven't fixed, rather than the problem being one of the feds making.

    Your statement on healthcare and your job seem to be at odds.

  • Rob Milesnick (unverified)
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    Thanks for your comment, Morgan.

    I want to be sure my position is clear. In the statement you quoted, I am certainly not blaming federal government for creating our nation’s healthcare crisis. But I believe that federal leadership, and federal regulation, as to hospitals, private insurance companies, drug companies, and other entities, can help us out of the crisis, and toward getting families the coverage they lack. Oregon’s efforts to reform the healthcare system, including The Archimedes Movement and Senate Bill 329, may also play a vital role. And the County should be doing its part as well.

    Although I work in Government Affairs at ODS, I am not a lobbyist. They use a small business in Salem for their lobby work. I have kept informed about the healthcare debate in Salem, consulted with ODS about these matters, and am now working to help implement, on an institutional level, the coverage-related law coming out of the Legislature earlier this year.

    ODS is a provider that was founded in Oregon, and employs more than 850 Oregonians, the vast majority in Multnomah County. It was also the first provider in the state to provide coverage to domestic partners, and it is a big contributor to environmental and other socially progressive causes. I don’t see how working for this company should reduce my strong belief that universal coverage is both possible and necessary. I’ve also worked in the Multnomah County Courthouse as a Drug and Alcohol Case Manager, working side-by-side people without insurance, without medical or dental care, doing everything possible just to stay afloat. Over 50 percent of all personal bankruptcies occur in this country after a major medical procedure, and I believe that needs to stop.

    I’ve worked with probationers, judges, doctors, dentists, presidents of the Oregon Medical Association and Oregon Dental Association, legislators, and members of the public on the issue of health care. It’s those relationships that have led me to understand that healthcare reform is complicated, but absolutely possible. And I intend to put this perspective to work for Multnomah County.

    Thanks, Morgan. I hope to meet and discuss this further with you some day.

    Rob

    [email protected]

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    Please attend to Jeff's plea re cops. This week we got this from our House District 26 leader Susan Gates:

    LAURIE CHILCOTE – As you know, one of our dear members, Laurie Chilcote, was beaten last Saturday night near the Gresham MAX station. He is in fair condition but remains in OHSU. There has been a fund set up to help Laurie with his medical expenses. Donations can be made at any Wells Fargo Bank. Caren Topliff, Laurie’s sister, is also a member of our group, and has been kind enough to keep us updated on Laurie’s condition. She plans to attend our meeting Saturday and give us more information. We encourage get well cards, donations, and will also make a contribution from our group as well. This was a terrible thing to happen to a kind man. Please keep Laurie and his family in your thoughts and prayers, and him help financially if you are able.

    Laurie is a diabetic and so disabled that he can barely get around. He uses public transportation exclusively. In addition to the personal heartbreak, this is a huge embarassment for the (allegedly) most progressive county in Oregon!!!!!!!!!!!!!!!!

    Did I forget to add?-!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

  • Rob Milesnick (unverified)
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    Pat,

    Thank you for sharing Laurie's current condition. Do you know of any contact information for Laurie and his family?

    I don't think there was a person in the state not sickend by this attack. I will do everything in my power to coordinate with the cities of Gresham, Portland, and Tri-Met to improve passenger safety. You're right. This shouldn't happen to a progressive county.

    Thanks, Pat.

    Rob

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    As to your comments about my voting record on the CRC, I’ll let my votes stand for themselves. Because of the confidential nature of CRC files that are not discussed at our hearings, I won’t talk about specifics on a public blog. But what I will do is offer to sit down with you over a cup of coffee to discuss my votes and my questions of both the Portland Police and the complainants involved. Our past interaction has been limited to a brief handshake and name introduction. It is possible to have conviction, listen, and display leadership, without making enemies. Our community has seen too many County Commissioners make enemies too quickly in the recent past, and I intend to be the kind of Commissioner who builds bridges rather than burns them. I look forward to meeting with you soon.

    I'll trust Churchill for the time being, thank you, Robert, but my phone number is 503 294 0840. Please call me and let's set up that coffee, and perhaps you can change my mind.

    Any candidate running for county office without police accountability as a top priority needs to be held to account and I am quite happy to fulfil that function over at the Mercury. I always wondered whether you were using the CRC as a leapfrog to run for office, but I'm afraid simply showing up and keeping your head down didn't do it for me.

  • David McDonald (unverified)
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    This post feels more like an awards ceremony than anything else.

    Rob, I don't know you from Adam and I have a question (not a pat on the back) for you. In light of the recent revelations about abuse and neglect toward people with developmental disabilities in our county and state, what steps would you take to turn things around? Thanks

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    I apologize for calling Rob a "douche." He's just phoned and we're having coffee on Monday.

    But I want to talk to him about two things: 1.His voting record on CRC, and his perspective on its effectiveness as a committee and 2.Ted Wheeler's funding priorities when it comes to funding a crisis triage center for the mentally ill, so that cops have somewhere to take people in crisis. Wheeler voted against a plan by Lisa Naito to fund that in September.

    Here are the two stories on that:

    http://portlandmercury.com/portland/Content?oid=457263&category=22101

    http://portlandmercury.com/portland/Content?oid=462695&category=22101

  • Steve Buel (unverified)
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    Rob, thanks for commenting back on my post. Stand for Children, while being a great organization at lobbying the legislature and getting more money for schools, is one of the two main organizations creating major roadblocks for lower economic neighborhood schools being improved. (The other is the Portland School Foundation.)

    While there is an Evergreen High School, the district on the east side of Vancouver is the Evergreen District. Their middle schools are better, as far as programs go, than probably any middle school in the state of Oregon. A good place to see what can be done.

    Hopefully every political person in the state of Oregon will not care one whit about the achievement gap. What they need to care about is the quality of education which each child receives. There is a huge, huge difference between the two things.

    Thanks for sticking your neck out and running for public office. Seems like you have some good ideas.

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    Rob,

    The question I would have for you about the healthcare big picture is whether your ties to ODS cause you to oppose public provision of universal health insurance in principle?

    This is not terribly relevant to a county commissioner position in some ways. However, insofar as local & regional officials should act as advocates and "tribunes of the people" to officials at higher levels of government, an idea you seem to embrace around healthcare, it is of a bit of interest to me as an public health professional & healthcare improvement activist.

    Clearly you are not opposed to public provision of services by local entities, esp. counties, which is good. Payment may be organized in a more efficient public manner, or in a less efficient private manner characterized by system fragmentation, excessive duplication of private bureaucracies and profit rake-offs.

    Either way, part of improving service delivery, prevention and early diagnosis, as well less expensive treatment for certain types of services, surely is going to occur through expansion of the types of local access points you identify.

    One question I would have for you is whether you think, in addition to services to the uninsured, should use of public clinics, school based programs etc. also be encouraged for the insured, whether public or private insurance? Have you thought about insurance-based revenues as part of a stream to expand personnel and improve facilities & thus also support improved services to the uninsured as well? This might go along with negotiating contributions from hospitals that are overburdened by misuse of emergency departments as primary care facilities in the absence of other options, if provision of better, more appropriate, less expensive access points can be shown to reduce the ED burdens.

    It is here however that the potential for conflicts of interest in the for-profit primary system come to be of concern. How could we make sure that costs which currently get passed along as part of overhead charges, and differentially to different payers and group plans, if saved, actually get passed along as savings to insurance purchasers in an equitable manner, given that the current system makes true costs opaque and distributes them inequitably among consumers and plans?

  • Rob Milesnick (unverified)
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    Thanks for your question, David.

    The abuse and neglect of the developmentally disabled is a grave problem facing the state and county. As an editorial in today’s Oregonian highlighted, following a related article over the weekend, one in five developmentally disabled Oregon residents have been mistreated since 2000, the year that budget cuts following Measure 5 forced the closure of the state-run Fairview Training Center.

    Multnomah County’s Developmental Disabilities Services Division offers a range of services to the developmentally disabled, including intake and eligibility assessments to help place individuals in reputable programs providing the appropriate level of assistance, coordinating with service providers to develop employment and residential plans, and, importantly, monitoring the administration of those services. The County’s Crisis Services program helps developmentally disabled children and adults find different placements when crises arise, including those stemming from abuse and neglect. It is vital for these programs to be amply funded, to increase capacity and reduce employee turnover.

    I am continuing to learn about this issue, and am committed to improving this situation. I support proposals to maintain a computerized registry that identifies abusive caregivers, or, at a minimum, creating a public forum for family members to report and record instances of abuse.

    Also, the Sheriff's department must carefully train deputies to better identify individuals with disabilities. Specifically for law enforcement professions, it is imperative to understand that developmentally disabled individuals may respond differently to, and may be unable to comply with, sheriff’s deputies’ commands. Without proper training, this situation can escalate quickly, and even become life threatening, for a person with a developmental disability.

    The responsibility is ours.

    Thanks,

    Rob

  • David McDonald (unverified)
    (Show?)

    Rob,

    If only the system really did what you described for developmentally disabled people...

    The truth is that the system is badly broken at both the County and State levels. Increased funding is only a small part of the answer. There is virtually no accountability, transparency, or logic involved in the system. That's one of the reasons as much abuse and neglect happens as the Oregonian reported.

    In reality it's more like a secret society with the same people being recycled and playing musical chairs. Career paths take precidence over the best interest of the folks being served.

    As someone who has worked in and against this broken system for over 23 years, I know this to be true. I hope that if you are elected you will think back on these words when they start telling you all is well. It aint.

    David

  • Rob Milesnick (unverified)
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    David,

    I really appreciate your concern and input here. I'll be sure to look with a critical eye at the County programs that provide care and services to developmentally disabled people.

    I hope you'll continue to share your perspective with me.

    [email protected]

    Thanks, Rob

  • Rob Milesnick (unverified)
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    Thanks for your question, Chris.

    You make a lot of intricate points and it’s clear that healthcare is very important to you, as it is to me.

    First, from a national perspective, I support universal coverage for every man, woman, and child in America. A person can’t learn or work at their full potential if they’re sick. I’m not opposed to a single payer system. The result we want is a healthy country. As an aside, though it’s not single payer system, Ron Wyden’s plan includes some good ideas.

    At the local and county level, three standards must be constantly weighed and evaluated as we work to improve services. They are the cost, the quality, and the coverage of our healthcare system. Ed Rendell (D) Governor of Pennsylvania told the New York Times, “If we’re ever going to have accessible health insurance for all Americans, we have to begin by containing costs. If costs continue to spiral out of control, there is no way government can afford to pay for it.” I quote him because those are my feelings too.

    The insurance industry shares blame in our broken system, transparency is vital, and emergency room care is too unbelievably cost prohibitive to be an effective delivery tool for basic health needs. Despite this, I believe cost is the most dangerous variable in our healthcare system.

    This post could go on forever, but a very real example of where we could dramatically reduce cost at the local level is with our end-of-life care. We spend about 25 percent of our healthcare dollar for people in their last year of life. The county, and all government for that matter, needs to be doing a better job of engaging the public in a discussion about the benefits of end-of-life planning. Forms should be provided with instructions, and people should feel comfortable talking about end-of-life care with doctors, nurses, and even lawyers. End-of-life-planning is a very tough subject for Americans to discuss, but not talking about it makes the process more difficult and costly.

    The U.S. Centers for Disease Control states that four big factors influence our health: our personal behavior, the environment, access to health care, and our genetic predisposition. Of these, personal behavior is the most influential. Yet we spend 88 percent of our healthcare dollar on treatment, and only 4 percent on changing personal behavior. The single best act government took to reduce the cost of healthcare in America in the past 20 years was the anti-smoking campaign.

    Let’s sit down and talk, Chris. I suspect we could spend a long, long time on this one issue, and my time on BlueOregon is almost up, and I’m not sure I was able to address all your points.

    Please feel free to send me an email.

    Thanks,

    Rob [email protected]

  • (Show?)

    Thanks for the thoughtful response Rob. I agree with you about the intricacy of the issues & that Wyden's plan has a number of virtues though I don't think it can get at large elements of cost issues.

    Also there are more and less progressive vs. punitive ways to approach both cost and behavior/ prevention, as I now suspect you would recognize. Costs due to inefficiencies, misallocation of resources, excessive profits, fragmentation and so on are one thing. Cost containment strategies that work by discouraging or denying coverage for contact with the system or delivery of needed services in the long run work against prevention/ pro-health behavior change. And it is funny that the same folks most insistent that the system be "market-based" are those most unwilling to treat increased demand as neutral in market terms -- I'vew never been quite sure why is it o.k. if Americans want to buy more S.U.V.s (e.g.) or gas, and thus drive prices up, but it is inherently bad if they want more health services and to spend a larger part of either individual or public budgets on them.

    Anyway, don't answer here, I'll get in touch and look forward to learning more of your take on things, since you seem to be thoughtful, open-minded and informed, so maybe I can learn something.

  • David McDonald (unverified)
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    Rob,

    You can't take editorials at face value. That 1 in 5 number reflects SERIOUS neglect and/or abuse numbers. The reality is that 50% of the people who were deinstitutionalized when Fairview closed have had abuse and/or neglect charges substantiated. DHS also says on their website that most abuse and/or neglect incidents go unreported. If you let your mind explore those facts, you see just how horrid the situation really is.

  • Robbie (unverified)
    (Show?)

    Rob -

    It seems you have taken an open view toward the office you are running for. Looking at the entries above, you’ll need to. Is the system you are running for perfect? Nope. Does it need work? Sure does. As a voter, I need to ask myself are YOU going to make "IT" work? Sir, I think you can. I have just moved to the area and am becoming increasingly aware of issues challenging the Portland Area. So far, you seem to have it together and I look forward to following you until the election.

  • Gena Frassinello (unverified)
    (Show?)
    <h2>Rob and I have been friends for many years. During this time he has proven himself to be one of the most genuine, thoughtful, dedicated, and enthusiastic people I know. He's helped me through difficult personal times and guided my professional career. I wouldn't have made Portland home without his generosity and support. I can vouch for Rob's passion for his community. I can vouch for his talent at connecting to, and working successfully with, people from all walks of life. And above all else, I can vouch for his character. A good politician has high integrity, good judgement, and a clear vision. Rob is one of the good ones. I'm proud to endorse him for Multnomah County Commission, District 3.</h2>
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