HHS and Public Safety Committee

Remote HHS and Public Safety MEMBERS Meeting Agenda Councilor Anna Bullett, District 4, Chair Councilor April Fournier, At-Large March 11, 2025 at 5:30 PM Councilor Sarah Michniewicz, District 1 Remote Meeting Councilor Wesley Pelletier, District 2 To submit written public comment on an agenda item, email HHSPS@portlandmaine.gov. Submissions must be received by 12:00 pm the day before the Health & Human Services and Public Safety meeting to guarantee their inclusion in the agenda packet. All submissions must include the commenter's name and legal address. To help ensure your comment is submitted for the correct item, please include the name of the agenda item (see below). The Health & Human Services and Public Safety Committee will conduct this meeting remotely via Zoom pursuant to the Remote Meeting Policy adopted by the Portland City Council. Allow your computer to install the free Zoom app to get the best meeting experience. If you are not able to attend live either in person or via Zoom, a recording will be available in the Agenda Center following the meeting. You are invited to a Zoom webinar! When: Mar 11, 2025 05:30 PM Eastern Time (US and Canada) Topic: Remote HHS and Public Safety Meeting Join from PC, Mac, iPad, or Android: https://portlandmaine-gov.zoom.us/j/84411284189?pwd=B6eeOmdhEeGyfsnxFjBxygbZR0qvfx.1 Passcode:889505 Phone one-tap: +13052241968,,84411284189#,,,,*889505# US +13092053325,,84411284189#,,,,*889505# US Join via audio: +1 305 224 1968 US +1 309 205 3325 US +1 312 626 6799 US (Chicago) +1 646 931 3860 US +1 929 205 6099 US (New York) +1 301 715 8592 US (Washington DC) +1 719 359 4580 US +1 253 205 0468 US +1 253 215 8782 US (Tacoma) +1 346 248 7799 US (Houston) +1 360 209 5623 US +1 386 347 5053 US +1 507 473 4847 US +1 564 217 2000 US +1 669 444 9171 US +1 669 900 6833 US (San Jose) +1 689 278 1000 US Webinar ID: 844 1128 4189 Page 1 Passcode: 889505 International numbers available: https://portlandmaine-gov.zoom.us/u/ktNBFFNnx 1. Announcements 2. Review and Approval of Minutes from February 11, 2025 a. Draft Minutes 3. Pedestrian Safety (Mark Dubois, Police Chief) a. Staff Memo & Attachments 4. Policy Consideration Re: The State of Childcare (Councilor Anna Bullett, Chair) a. Starting Strong Policy Recommendations Staff Update re: Opioid Settlement Funds Request for Grant Applications (Maggie 5. McLoughlin, Health & Human Services Director) 6. Staff Update re: Syringe Services Program (Bridget Rauscher, Public Health Director) a. Staff Memo 7. Next Meeting: April 8, 2025 Page 2  Tuesday, February 11, 2025, 5:30pm, Remote Meeting Committee Attendance: Anna Bullett, Chair (District 4), April Fournier (At-large), Sarah Michniewicz (District 1), Wesley Pelletier (District 2). Councilor Attendance: Mayor Mark Dion City Staff: Adam Harr, Executive Assistant for Health and Human Services; Jason King, Police Major; Dena Libner, Assistant City Manager; Greg Jordan, Assistant City Manager ; Caity Hager, Emergency Management Coordinator; Maggie Mclaughlin, Director of Health and Human Services; Ethan Hipple, Director of Parks, Recreation, and Facilities. Guest Speakers: Executive Director of Youth & Family Outreach, Camelia Babson-Haley; Director of Starting Strong, Katie Soucy; Early Care and Education Associate Director in the DHHS Office of Child and Family Services, Tara Williams. Announcements Review and Approval of Minutes from January 14, 2025 ● Councilor Fournier moved to approve the minutes and Councilor Bullett seconded. The motion passed unanimously, 4-0. Youth and Family Outreach • YFO started in 1846 to always assess what is needed in the community and to provide any services they can to serve those needs • 1986 became a primarily childcare in response to a rise in teen pregnancy. • Today homeless and immigrant populations are focused on with wrap around services. o How are wrap around services funded (social workers are expensive)  Partnering with USM for 22 years to have a social work intern on site for the spring and fall semester with a volunteer supervisor. • What lies ahead given the precarity of federal funding. o People are already on the edge and a disruption in funding and related drop in services could heavily impact families. • Housing Project Update o Preparing to break ground in late July. Page 3  o It will double from 58 to about 110 slots, primarily focused on infants and toddlers  Primary demographic of the 300 child waitlist. o 60 unites the majority of which will be affordable housing. o Temporarily moving YFO during construction to a location where an existing childcare program is closing.  Attempting to absorb the families in the program closing.  In South Portland so transportation is an issue • Speaking with Metro board for increased frequency. Office of Child and Family Services: Early Care & Education Childcare Licensing • Maine DHHS Data page: Maine DHHS By the Numbers o Icon for each office in DHSS with tableau data. • Number of slots is the licenses capacity of childcare programs but does not tell the exact numbers of enrollees. o Not every program will enroll to licenses capacity. o Family childcare is enrolling at 88% of licensed capacity. o Childcare centers are enrolling at 70% of licensed capacity. • Providers enrollment data: o 8% of children enrolled in licensed programs are infants  Usually, a program will have a single infant class. o 24% are toddlers o 39% preschooler o 29% school age • 258 Childcare infrastructure grants awarded from July, 2022 to September, 2024. o $15 million o Closing out and is not granting new awards. • Child Care Affordability Program (CCAP) enrollment: o 4% infants o 22% are toddlers o 32% preschooler o 42% school age • Early Childhood Educator Workforce Salary Supplement Program o 3 tiers based on education. o Tier 1 has the most enrolled, receiving $240 per month. o Credentials and degrees lead to the higher tiers. o Year over year increase in workers despite workforce turnover. o The governor’s budget includes reductions. • Other helpful programs: o Infant and Early Childhood Mental Health Consultation (Maine ECCP®) Page 4  o Help Me Grow • Is there tuition support for this workforce or paid training? o Two contracts  Maine Roads to Quality Professional Development at USM • Groups of trainings that build into a credential o Infant toddler credential in development.  Maine AEYC scholarship for Bachelor’s degrees. o Need to see how many wants to access version how many can. • Many more teachers were at tier 3 than first planned. o Documenting education was never a priority before there was a financial incentive. o Now seeing movement on people attaining more education to move up tiers. • Are any centers doing exit interviews to identify problems with retention o YFO does exit interviews and anecdotally have seen the trauma of the pandemic. o It is a high stress job with inadequate pay. Starting Strong • Partnering with the Chamber of commerce since 2020 on their perspectives on childcare o 2023 survey  82% reported finding difficulty childcare.  94%  Last state • Without childcare, workers cannot get to work. • There are long waitlists at all childcare programs. • Providers are still struggling to recruit and retain teachers. • There is growing need. • Many licensed slots are for after school or before school and do not meet the need for infants and toddlers. • Childcare is a market failure o Families cannot afford to pay the true cost of quality care o Infant slots in Cumberland County costs $330 per week or 17,000 per year for one child and is 22% of the median income in Portland. o High quality infant care costs providers $544 per week  The low number of infant slots is how providers make up for this. o Techers make $37,000 per year (17.75 per hour). • Recommendations o Creating a local childcare scholarship program  Childcare voucher collaborative program used CDBG to fund scholarship opportunities for kids o Create a local stipend for early childhood educators. o Do a targeted needs assessment with city specific data. Page 5  o Other cities have done these programs  Burlington, VT pursued an early learning initiative in 2017. • What sort of funding models exist? o Can’t rely on federal dollars or state dollars.  CDBG o Vacancy fee tax or housing trust find type development money?  What else is out there? o Starting Strong offered to help the City research. o Potential workshop later in the year. ARPA funds: Bathroom Access Increase • $600,000 • Built 18 public bathrooms • Options o Make repairs to spring street garage bathroom  Serious plumbing issues: $118,000 to make operable again. • Would have $50,000 leftover to make an outdoor ADA bathroom for East End Beach as the bathhouse is only open while staffed by park rangers: until 6:00 PM.  Not currently ADA accessible: $400,000 to make accessible. o Add four outdoor restrooms on peninsula  All ADA accessible but are not heated.  Each has hand sanitizer, needle collection boxes, notice on how to access help.  Cleaned twice a day. Committee questions and discussion • Councilor Fournier o Making the city more ADA accessible is a goal. o Is spring street something that can be considered a CIP project rather than ARPA?  It can be but would compete with other City priority projects approved by Council.  It is not considered as part of the staff CIP process right now and would need an amendment at the committee or council level.  Parking is not involved and were spring street fixed, a downtown public works crew would clean it. • Councilor Michniewicz o How much were the spring street bathrooms used when they were functional.  They were used but get shutdown during Winter and would be open 8 to 9 months of the year. o Where would the 4 vault toilets go? Page 6   On Peninsula where there currently is no bathroom access, including but not limited to parks such as East End Beach. o What happened to OSS outdoor bathrooms?  Could be incorporated to other projects and may be on hold for them; if not earmarked, can be used. • Councilor Pelletier o Option 2 seems to make more sense. o What is the case for spring street?  The business community and Portland Downtown want additional bathrooms.  New brick and mortar bathrooms are cost prohibitive but restoring function to this bathroom was seen as a middle ground. • Chair Bullett is not interested in funding non-ADA compliant bathrooms • ARPA funds need to be spent by December of 2026; project would need to be in this CIP. • Consensus on option 2, 4 vault toilets. o Interested in bathroom locations. o Interested in changing tables. o Interested in exploring CIP for Spring street bathroom ADA retrofit. Public Safety Update • 10% increase in violent crime, 30% increase since 2020 largely due to gun violence. • 12 homicides sin the last three years. • 42% increase in property crime, back to pre-covid levels. • Some increase attributed to better crime tracking through online reporting. • Calls for Service logged for response o Reactive: initiated by member of the public through 911 o Proactive initiated by officer. • Beats 1-6 are on the peninsula. • Reduced staffing has led to a decrease in proactive calls for service. • Strategic Priorities & Department Initiatives o Pursuing a grant for Crime Analyst in Residence for real time data tracking. o Monthly Lieutenant Reports o Calls for Service Analysis o Special Deployments o Additional Data Sets/Analytics under development.  911 call volumes  Case clearance rate • 29 sworn officer vacancies. • Allowing volunteer overtime traffic enforcement. Page 7  • Integrating a cadre and board membership with the academy to guarantee a seat for every officer we need to send. • Also working on data sets with the Fire Department. • Schedule brought by unions. o Before had 6 teams with 11 beats per shift o Now 5 teams with 10 officers per shift which evens out staffing.  Add overtime for uncovered beats. • People are volunteering to take necessary shift and only using forced overtime to enforce parking bans. • Pursuing the CAR grant to make reports prophoenix cannot do Warming Shelter • Ask staff to research three options to manage weather emergencies (cooling and warming) shelter, excluding city-run options. o No fiscal impact option with coordination from emergency management. o Fiscal impact options  Day space? • First parish is not always available. • Physical space is the greatest barrier. o What options for next year are for warming and cooing centers? • Where to place in the workplan? o Keep in line with the budget process. o Late Spring/ Early Summer o Have it for April. • Explore regional collaboration. o Connect with Mayor over GPCOG. • Late Spring to early summer timeline. Committee Work Plan • Confirmed prioritization Councilor Michniewicz moved to adjourn the meeting; Councilor Pelletier seconded. The committee passed the motion 3 - 0 with Councilor Fournier absent. Meeting adjourned at 7:32 PM. Page 8 City of Portland | Executive Department Danielle P. West, City Manager To: Health-Human Services and Public Safety Committee Councilor Anna Bullett, Chair MEETING DATE March 11, 2025 AGENDA ITEM Agenda Item 3 - Pedestrian Safety PURPOSE Review data and information provided by the Police Department on traffic crashes and provide input on a draft City Council resolution on Vision Zero to be considered by the Sustainability and Transportation Committee. COMMITTEE WORK PLAN/CITY COUNCIL GOAL ALIGNMENT This item aligns with the Safe Streets priority included on the Committee’s 2025 workplan. BACKGROUND/ANALYSIS This item is in close alignment with work being done at the Sustainability and Transportation Committee on Vision Zero, and also follows the City Council’s March 3, 2025 adoption of Council Resolution #6, A Resolution to Immediately Address Pedestrian Safety Crisis in Portland. Police Chief Mark Dubois will present information and data on traffic crashes and pedestrian impacts over the last several years. Also, staff will seek Committee member’s input on a draft resolution that will be considered by the Sustainability and Transportation (ST) Committee for recommendation to the City Council. If approved by City Council as currently written, the draft resolution would build on Council Resolution #6, adopt the Greater Portland Council of Government’s (GPCOG) Vision Zero plan, and call upon the ST Committee and staff to advance appropriate Vision Zero actions specifically suited to Portland’s unique circumstances and needs. GPCOG’s Vision Zero Action Plan was adopted on May 23, 2023. Vision Zero is a traffic safety initiative aimed at eliminating traffic-related fatalities and serious injuries by prioritizing human life in transportation planning. Originating in Sweden in the 1990s, it is based on the principle that people make mistakes, but streets should be designed to prevent those mistakes from causing death or serious harm. The approach relies on data-driven policies, safe street design, speed management, enforcement, and public education, with a focus on protecting vulnerable road users such as pedestrians and cyclists. Vision Zero emphasizes shared responsibility among 1 Page 9 government agencies, engineers, law enforcement, and the public, promoting equity by ensuring that safety improvements benefit all communities. FISCAL IMPACT Adopting GPCOG’s plan does not by itself commit the City to allocate funding or expend resources. However, the plan would serve as a foundation for selecting and implementing various measures and/or design solutions which may increase costs or create new costs. The plan would serve as a foundation for advancing new programs and projects aimed at improving transportation safety. City Council approval would be needed for such initiatives as with any new program or project for which new funding appropriations are requested. CONCLUSION(S) This item is for information and discussion. Staff will report Committee member input to the Sustainability and Transportation Committee for consideration in drafting the final resolution to be recommended to the City Council. PRIOR COUNCIL/COMMITTEE REVIEW N/A PREPARED BY Mark Dubois Greg Jordan Police Chief Assistant City Manager Police Department Executive Department ATTACHMENTS Attachment A - Traffic Safety Slide Deck Attachment B - Draft Resolution 2 Page 10 Health and Human Service / Public Safety Committee Public Safety Update Portland Police Department March 11, 2025 Page 11 Pedestrian Accidents ● From Jan 2022 to YTD 2025, Portland has had 146 accidents involving Total Pedestrian Accidents pedestrians. 39% resulted in minor 146 injuries, 34.2% in possible injures, 12.3% in serious injuries, 8.9% in no Minor Injuries injuries, and 5.5% resulted in fatalities. 57 02 ● Three of the eight fatalities have Possible Injuries happened in the first two months of 2025. 03 50 Serious Injuries ● Of the 146 pedestrian involved accidents, 52 were the result of a 04 18 pedestrian violation and 93 were a result of a vehicle operator violation. No Injuries One was designated as no violation. 05 13 ● 18 Citations have been given as a result Fatalities of a pedestrian accident. 14 traffic 06 8 citations and 4 criminal. Page 12 Pedestrian Accidents - Violations Vehicle Operator Violations Pedestrian Violations ● Although pedestrians involved in accidents are rarely issued citations as a result of being hit, the following are common factors in the most serious incidents. 1. Dark Clothing 2. Improperly in Roadway 3. Failure to Obey Traffic Signal 4. Jaywalking Page 13 Pedestrian Accidents - Weather Conditions ● 81% of pedestrians accidents happened during clear weather conditions, while 8.2% happened during rain, fog, or snowy conditions. ● While Portland PD receives more accident related calls for service during inclement weather, the vast majority of pedestrian-involved accidents occur in clear conditions. ● Clear weather conditions lead to increased traffic volume, a higher number of pedestrians, and often, more distractions. Page 14 Pedestrian Accidents - Time of Day ● The majority of pedestrian accidents occurred during daylight hours, accounting for approximately 60.3%, while around 37.4% happened when it was dark. ● While most pedestrian accidents happened during daytime hours, six out of the eight fatalities over the last three years occurred at night. ● An important observation is that every fatality, except one, took place during the winter months, between November and early March. Page 15 Locations of Fatalities ● As you can see, pedestrian fatalities are not concentrated in one specific area but are instead spread throughout the city along major roadways. 1. Riverside St @ Manuel Dr 2. Brighton Ave @ Taft Ave 3. 1128 Westbrook St (Private lot) 4. Franklin St @ Congress St 5. 1396 Forest Ave 6. Fore St @ India St 7. 654 Riverside St 8. Forest Ave @ Walton St Page 16 Total Traffic Accidents (Pedestrian and Vehicle) ● Total traffic accidents have gradually decreased over the past ten years, with a sharp decline in 2020 due to the pandemic and fewer cars on the road. ● Within the first two months of 2025, we have already surpassed our yearly average for traffic fatalities, which is typically three per year. We have had four fatalities in 2025. Page 17 Traffic Accidents ● There is no definitive day with the highest number of traffic accidents, though they tend to occur slightly more frequently on weekdays than on weekends. ● During the week, commuting is at its peak meaning more cars and pedestrians are on the road. ● Multitasking and stress are also higher during the work week and could contribute to increasing the risk of accidents. Page 18 Traffic Accidents ● The majority of motor vehicle accidents occur during the workday, primarily between 8 AM and 6 PM, with the peak hours being 3 PM to 5 PM. ● The high volume of vehicles on the road during peak commuting hours, along with driver fatigue can impair reaction times. ● Depending on the time of year, 3pm-5pm is a transition from daylight to dusk, which can affect visibility. Page 19 Stops and Citations ● Traffic stops and citations have significantly declined over the past decade, largely due to reduced staffing and limited resources for proactive policing initiatives. ● Accident rates have remained relatively consistent, except for a sharp decline in 2020 when overall activity decreased. Since then, those numbers are gradually rising back to pre-pandemic levels. Page 20 Stops and Citations - 2025 ● In December 2024, Portland PD implemented an overtime traffic detail. ● Portland PD has made 659 traffic stops in 2025 - resulting in 229 citations and 452 warnings. ● The top five reasons for citations 1. Speeding 2. Failure to Stop at Red Light 3. Insurance Violations 4. Registration Violations 5. Inspection Violations Page 21 Health and Human Service / Public Safety Committee Public Safety Update Portland Police Department March 11, 2025 Page 22  DRAFT RESOLUTION CALLING FOR THE CITY OF PORTLAND TO ADOPT GPCOG’S REGIONAL VISION ZERO ACTION PLAN WHEREAS, the safety and well-being of all residents and visitors are urgent and paramount concerns for the City of Portland; and, WHEREAS, the Centers for Disease Control and Prevention reports traffic crashes are among the leading causes of deaths nationally, and in Maine, due to the convergence of dangerous driving behavior and human error with legacy transportation systems that inadequately prioritize and protect pedestrians and bicyclists; and, T WHEREAS, traffic fatalities and serious injuries are preventable occurrences that necessitate proactive and comprehensive measures; and AF WHEREAS, children, older adults, people of color, individuals with disabilities, those experiencing homelessness, and people with low incomes are disproportionately affected by the risk of serious traffic injuries and fatalities; and, WHEREAS, the Vision Zero approach emphasizes a Safe System framework, recognizing that human errors and misjudgments are inevitable and that transportation systems can and should be designed to ensure such errors do not result in severe injuries or fatalities; and, WHEREAS, the Greater Portland Council of Governments (GPCOG) has developed a R Vision Zero Plan aiming to eliminate all fatalities and serious injuries resulting from traffic crashes in the Greater Portland region by 2045; and, WHEREAS, successful Vision Zero programs result from strong community support, D effective partnerships across public, private and non-profit sectors, and alignment with related municipal ordinances, policies, and plans; and, WHEREAS, the Portland Area Comprehensive Transportation System (PACTS), which is the region’s federally designated Metropolitan Planning Organization (MPO), and of which the City of Portland is a member, adopted the regional Vision Zero Plan in 2023; and, WHEREAS, the City of Portland recognizes its obligation to work with the Maine Department of Transportation on roads under the State’s jurisdiction; and, Page 23  NOW, THEREFORE, BE IT RESOLVED, that the City Council of the City of Portland adopts the goal of eliminating all traffic fatalities and serious injuries by the year 2045; and, BE IF FURTHER RESOLVED, that the City endorses and adopts GPCOG’s Vision Zero Plan as the guiding framework for achieving this goal; and, BE IF FURTHER RESOLVED, that the Council Committee on Sustainability and Transportation will oversee development of a Vision Zero Quick Action Plan for the City of Portland, which shall be completed no later than June 30, 2025; include steps that can be implemented in the short-term in general alignment with City Council Resolution #6, A Resolution to Immediately Address Pedestrian Safety Crisis in Portland; and may be subject to City Council approval if budget appropriations are required; and, T BE IF FURTHER RESOLVED, that the Sustainability and Transportation Committee will oversee update of the City’s Complete Streets Policy based on the Vision Zero guiding framework, which shall be completed no later than September 30, 2025 and shall be subject to AF approval by the City Council; and, BE IF FURTHER RESOLVED, that the City Manager is encouraged to direct staff to update the City’s Technical Manual based on the Vision Zero guiding framework and updated Complete Streets policy, subject to approval by the Planning Board; and BE IF FURTHER RESOLVED, that the City’s Comprehensive Transportation Plan, subject to funding as part of the FY 2026 Capital Improvement Plan, will be grounded in the Vision Zero guiding framework and Complete Streets Policy; and shall serve as the principle R vehicle through which long-term changes are implemented to the City’s transportation systems and infrastructure, subject to all required concurrences from external public agencies; and, BE IF FURTHER RESOLVED, that these efforts are to be implemented in close D coordination and consultation with diverse communities across the City including those populations most at risk, as well as relevant public, private and non-profit stakeholders and partners; and, BE IF FURTHER RESOLVED, that the City Manager is encouraged to provide an annual report to the City Council detailing progress toward the Vision Zero goal, including metrics on traffic fatalities and serious injuries, implementation status of action items, and recommendations for adjustments to strategies as necessary. Page 24  Policy Recommendations for the City of Portland - Improving Access to Quality Child Care February 11, 2025 Develop a child care scholarship program A child care scholarship program supports families access to child care by offering financial assistance. When parents and caregivers have access to affordable child care, they are more likely to remain employed - contributing to a stable workforce which in turn boosts the local economy. A city with robust childcare opportunities and support is more attractive to businesses. Providing child care assistance can help bridge the gap for lower income families and contributes significantly to a child’s early development, and better educational outcomes later in life. The following is an abbreviated version of a process outlined in “Let’s Grow Kids Community Child Care Scholarship Handbook” Phase 1: Research and Community Engagement Conduct a Community Needs Assessment A community needs assessment for child care involves evaluating the demand and supply of services, including whether the current supply meets the needs across different age groups and neighborhoods. Affordability is another key factor, examining the cost of high-quality child care, existing funding sources, and who may be excluded from access. Barriers to expanding and accessing quality care, including affordability and funding limitations, are explored to understand the challenges in meeting needs. Establish a Scholarship Design Committee Establishing a scholarship design committee ensures the program has broad community support and is informed by the needs of key stakeholders. The committee should represent important sectors of the community including health care, public education, early childhood education, parents, business, and local government. It is also important to engage individuals with expertise in evaluation to ensure appropriate inclusion of evaluation of impact in the program design. Phase 2: Design Scholarship Program Establish guiding principles, target populations, scholarship eligibility, program costs and financing, and delivery model. Potential program designs include direct support to families and/or contracting with child care providers. Phase 3: Pilot Implementation Implementing a scholarship program requires a pilot phase to test all aspects of the program. A one-year pilot will allow the opportunity to examine and refine the design, and determine any changes needed to 1 Page 25  bring the program to scale. Specifically, the pilot year will allow for testing the delivery model, the program partnerships, the family experience, and the enrollment and payment processes. The evaluation plan developed in the design phase will provide guidance for collecting stakeholder input and design revisions, as well as being one basis for making iterations to the model before implementing beyond a pilot phase. Phase 4: Evaluation and Continuous Improvement During the program design phase, the advisory committee should create an evaluation plan for the scholarship program. Focusing on evaluation from the beginning of the project helps establish a culture of continuous improvement for the scholarship program and ensure that data guides every step of the program design and implementation. The evaluation will yield results that could continue to inform and improve the scholarship program while also setting the stage for a larger and longer-term impact evaluation. Develop a salary supplement program for early childhood educators A childcare employee salary supplement supports employees by offering financial assistance. Salary supplement programs have been shown to increase employee retention and attract more qualified new teachers. Phase 1: Program Planning & Design Identify the program's objectives - this includes determining the specific purpose of the stipend. The next step is to define the eligibility criteria. This involves establishing who qualifies for the stipend, whether it’s based on factors such as tenure, full-time status, or financial need, and setting clear guidelines for eligibility. Additionally, the stipend structure must be determined, including how much the stipend will be, how often it will be awarded, and whether it will be a fixed sum or tiered based on need. Phase 2: Funding & Application Process The second phase focuses on securing funding and developing the application process. It’s important to identify the program’s funding source, which could come from the city’s budget, external partnerships, or other financial resources. Ensuring long-term sustainability is key to the program's success. Additionally, decisions need to be made about whether childcare workers will need to apply for the stipend and how the review process will work. Phase 3: Communication & Pilot Implementation Clear communication is critical for the success of the program. In this phase, the stipend program should be communicated including details on eligibility, the application process, and important deadlines. It's essential to ensure that all potential applicants understand the program’s purpose, how to apply, and what they need to do to qualify. Phase 4: Monitoring, Evaluation & Continuous Improvement 2 Page 26  Once the program is launched, it’s important to monitor its impact and effectiveness. This involves tracking the stipend’s results, collecting feedback from recipients, and making necessary adjustments to improve the program. Evaluation will help ensure that the program continues to meet the needs of the childcare workforce and align with organizational goals. Adapting the program over time will help address evolving employee needs and keep the program relevant. Additional no-cost/low-cost opportunities to further support access to child care Eliminate or minimize barriers to opening new child care businesses in the city: ○​ Update this step-by-step guide (located here) to opening family-based child care businesses; identify and address potential barriers. Orient existing business assistance and microenterprise services to address the unique needs of child care businesses. ○​ Make operating a family-/home-based child care permitted as-of-right in all zones (including zones where it is currently conditional). ○​ Connect the City’s business assistance and microenterprise programs with the Child Care Incubator run by Portland ConnectED/Starting Strong, United Way of Southern Maine, Coastal Enterprises, Inc., and Southern Maine Workforce Initiative. This will leverage existing resources to support more entrepreneurs to open child care businesses in Portland. ○​ Identify any city-owned spaces that might be available to locate a child care business. Use existing contact points with low-to-moderate income families to inform and support families in applying for the state Child Care Affordability Program. Expand Portland Recreation Before & After the Bell Program to include Pre-Kindergarten students (self-funding). Ensure future comprehensive plans address child care as key economic infrastructure. City of Portland’s past efforts to improve access to child care ●​ Portland Growing Child Care Grants for start-up or expansion of child care businesses, funded with ARPA dollars, expiring end of year ●​ Community Development Block Grants: Childcare vouchers identified as “High Priority” under Economic Opportunity goal. (Most recent funding: Childcare Voucher Collaborative, $81,295 in 2023-24, no funding 2024-25) ●​ Office of Economic Opportunity created this resource to help families navigate finding child care. For more information, please contact Katie Soucy, Director, Starting Strong ksoucy@portlandconnected.org 3 Page 27 City of Portland | Health and Human Services Maggie McLoughlin, Director To: Health and Human Services & Public Safety Committee Councilor Anna Bullett, Chair From: Bridget Rauscher, Director of Public Health Date: March 11, 2025 Re: Progress on Sterile Syringe Program Evaluation MEETING DATE March 11, 2025 AGENDA ITEM 6. Staff Update re: Syringe Services Program PURPOSE To update the Health and Human Services and Public Safety (HHS & PS) Committee on progress made by Health and Human Services (HHS) and other Departments on addressing needle waste in the City of Portland and provide an update on the operations of the Portland Syringe Services Program (the Exchange). COMMITTEE WORK PLAN/CITY COUNCIL GOAL ALIGNMENT The HHS & PS Committee 2025 workplan includes the topic of “addressing the opioid epidemic” as its top priority for the year. BACKGROUND/ANALYSIS An increase in syringe litter, particularly in the neighborhoods of Bayside, East Bayside, and Parkside as well as many concerned citizens reporting syringe waste in different and varying locations in those neighborhoods led to a syringe services operational improvement plan implemented in fall, 2024. In previous meetings, the HHS Department presented a plan aimed at: decreasing the number of improperly discarded syringes, improving the efforts to collect data and the quality of data to improve the accuracy of our information, and responding to community concerns regarding safety. An update on progress was provided at the HHS & PS Committee meeting November 12th, 2024. This memo serves as the second update on the implementation of the SSP operational improvement plan. We have seen progress in each of the objectives. The salient benchmarks achieved as of the publication of this memo are summarized below: 1 Page 28  SSP Operational Improvement Plan Objective 1 Decrease the number of improperly discarded syringes Strategy 1 Strengthen client education about proper syringe disposal and incentivize clients to return their used syringes 1.1 Progress: Completed/Ongoing ●​ Implemented SSP client education aimed at increasing safe syringe disposal ●​ Implemented a syringe redemption pilot project modeled after successful programs in Boston and New York City, approved by Portland City Council - detailed later in this memo ●​ Launched Harm Reduction Ambassador Program ●​ Improved ratio of safely returned/disposed syringes Strategy 2 Develop a multi-pronged approach to syringe pick-up operations 1.2 Progress: Completed/Ongoing ●​ Increased syringe clean-up by Public Health staff from 5-7 to approximately 12 hours/week. In addition to building in an extra hour each weekday, staff are also increasing syringe cleanup during scheduled harm reduction outreach and other community-based work. Staff pay special attention to areas indicated by GIS mapping of improperly disposed syringes. ●​ Harm reduction ambassadors provide additional cleanup efforts 3-5 hours/week, as available ●​ The Public Works Department has increased the number of staff trained to properly collect and dispose of syringes. ●​ Added five community sharps containers, with four additional containers planned, in locations identified both as areas of need and within previously planned vault bathrooms, and replaced three community sharps containers in disrepair ●​ Distributed 1,083 sharps containers to clients from August 1, 2024 - March 4, 2025 Strategy 3 Hold community conversations with Harm Reduction Program clients 1.3 Progress: Completed ●​ Held 3 focus groups with 27 SSP unique clients regarding barriers to usage of community and/or personal sharps containers, as well as alternative solutions to reducing syringe litter that would be more manageable for clients. o​ While a range of feedback was received, there was a common theme related to individual fear, shame, and stigma related to their substance use, resulting in quick disposal of syringes, regardless of access to sharps containers. As such, the harm reduction team will work to create educational opportunities for members of the public addressing SUD-related shame and stigma. These may take the form of online training, community meetings, social media campaigns, etc. Additionally, harm reduction staff will continue to seek client feedback on service provision, access to safe disposal, and referrals for substance use and/or mental health disorder treatment. Objective 2 Improve data systems to provide more accurate information and evaluate program efficacy Strategy 1 Standardize information on syringes collected on City property by City personnel 2.1 Progress: Completed ●​ Held initial interdepartmental leadership meeting on 8/14 to discuss collaborative efforts to improve consistency in data collection and reporting related to syringe litter cleanup. ●​ Met with frontline Parks, Rec & Facilities and Public Works staff directly involved with syringe litter cleanup. Received feedback on experience, suggestions for improved collection and collaboration, and requests for additional safety equipment. ●​ Identified and addressed inconsistencies in reporting and use of ArcGIS across relevant departments. Strategy 2 Improve client data collection efforts 2.2 Progress: Ongoing 2 Page 29  ●​ Incorporated municipality and/or zip code of residence into the data collection tool used for each exchange. ○​ From 8/1/24 - 3/4/25, 97% of respondents (4,804 unique clients) reported living in a zip code within Portland. Of that, 90% of respondents (4,321 unique clients) report their zip code as 04101. ○​ The remaining 3% (126 unique clients) report living in either Westbrook or South Portland. ●​ Analyzing data comparing frequent exchange users reporting Portland zip codes and volume of syringes distributed to and collected from these clients in an effort to identify disposal trends. ●​ Determined that exchanges made during outreach yielded, on average, fewer returned syringes per exchange than on site exchanges. ●​ Began tracking the outcomes of referrals for clients working with patient navigators. A related report is forthcoming from our contracted evaluation team at the Catherine Cutler Institute. Strategy 3 Improve documentation, training, and management practices to create and transform collected information into a live dashboard. 2.3 Progress: Ongoing ●​ Harm Reduction and data management staff continue to meet regularly to collect and analyze data to improve coordinated service delivery, identify areas of need (“hotspots”), target outreach services (syringe cleanup, overdose prevention/naloxone distribution, syringe exchange as allowed, patient navigation services, etc.). ●​ Improved data collection to meet minimum standards adopted by HHS. Objective 3 Respond to community concerns re: safety Strategy 1 Attend neighborhood association meetings in areas with increased reports of improperly disposed syringes to solicit feedback, share improvement plans, and present information on residential and business reporting and pick-up options. 3.1 Progress: Completed/Ongoing ●​ Attended the Bayside Neighborhood Association meeting on 9/3, to address the problem at hand, provide education and safety strategies, answer relevant questions and concerns, and receive feedback from community members. Members of BNA inquired about scheduling an overdose recognition and response training. Training has been scheduled. Strategy 2 Promote syringe reporting resources to Portland businesses and residents. 3.2 Progress: Ongoing ●​ Updated promotional materials to include access to education on safe collection of sharps on private property. ●​ Working to create social media campaigns and website updates for businesses to obtain safe collection education and equipment from Portland Public Health. SYRINGE REDEMPTION PILOT PROJECT UPDATE January 14 - February 21, 2025 Syringe Redemption Program The Syringe Redemption Pilot Project, as outlined in the improvement plan, was implemented as a result of opioid settlement funds allocated by the City Council on September 9, 2024. Results The syringe redemption program has demonstrated a substantial increase in the number of syringes returned to the Exchange. In the four weeks prior to the program, 47,520 syringes were returned across all exchanges, compared to 91,185 syringes in the four weeks after. Similarly, in the six weeks prior to the program, 76,554 syringes were returned, whereas 120,793 were collected in the six weeks following the program. 3 Page 30 The median number of syringes returned per program participant was 200 (SD = 49.5), with 73% (162/221) of participants returning 200 syringes, 20% (44/221) returning 100-199, and 6% (15/221) returning 1-99 syringes. There are additional indications of reductions in improperly disposed syringes. During the same hours of operation, staff collected 76% fewer improperly disposed needles in the six weeks after program start up as compared to the six weeks before program start up (1,677 to 387), indicating a marked decrease in improper disposal. These findings suggest that the program effectively increased syringe returns while reducing environmental contamination. Operational Constraints Impacting Results The program faces structural constraints that limit participation, as the current enrollment represents only a fraction of the NEP and is further restricted by weekly and individual maximums. Due to demand compared to availability of funds, operations have been limited to six hours per week across three days. Individuals who cannot attend within these windows may be turned away, and access is further constrained by holiday closures, inclement weather, and the seasonal decline in January exchanges. Metrics ●​ 156 unique clients enrolled in the program. ●​ 38,252 syringes have been collected between January 14 and February 21, with $3,852 paid out to participants. ●​ 58% increase in syringes collected at the exchange overall in the six weeks following the program start (76,554 pre-program vs. 120,793 post-program). ●​ 19% (42 encounters) returned more than 200 syringes, exceeding the maximum weekly redemption amount. ●​ 34% (76 encounters) involved clients collecting syringes from the ground, with 56 specifying a location. ●​ 15% (32 encounters) received Narcan during the redemption exchange. ●​ 9 encounters resulted in referrals to HIV and/or HEP-C testing following a redemption encounter. ●​ 5 encounters led to recovery-related service referrals, and 16 clients were referred to patient navigator services for general additional support. ●​ All 156 newly enrolled clients received training on safe syringe collection. ●​ Average compensation per participant: $20, aligning with the median number of syringes returned. ●​ 76% reduction in observed improperly disposed syringes by exchange staff. 1,677 improperly discarded syringes were collected by city staff in the six weeks before the program, decreasing to 387 improperly discarded syringes in the six weeks after the program. ●​ The majority of program participants are unhoused (48% N=105) or have unstable housing (27%, N=56) 4 Page 31 * Syringe return presented in average per day to adjust for frequent exchange closures due to holidays and weather events in the weeks pre/post program’ 2024 SYRINGE SERVICES PROGRAM ANNUAL REPORT November 1, 2023 - October 31, 2024 All clients served 5,055 Total enrolled 4,705 Total syringe exchanges 8,620 # Syringes distributed 952,411 # Syringes collected 577,517 Total Referrals 6,034 FISCAL IMPACT N/A 5 Page 32 CONCLUSION(S) At this time, Public Health staff are confident that the objectives detailed in the SSP Action Plan are contributing to an overall reduction in the improper disposal of syringes in Portland. Most of the identified strategies have been implemented and results are yielding improvement. However, there are factors that require additional time and more robust data to provide an accurate reflection of the efficacy of the SSP Action Plan. An example of this includes seasonality. PRIOR COMMITTEE REVIEW HHS & PS Committee - October, 2024 PREPARED BY Bridget Rauscher Public Health Director Health and Human Services 6 Page 33