When Too Much Is Not Enough
Dear Friends and Neighbors,
As Multnomah County approaches adoption of its FY 2027 budget tomorrow, it is worth asking a basic question:
What is the point of the billions of dollars being spent?
A budget should answer that question. It should reveal an organization's priorities, explain how it intends to achieve them, and show how success will be measured.
From a functional budget, you should be able to reverse-engineer a plan for the organization, answering a few simple questions:
What are we trying to accomplish?
How will we know if it worked?
Are we getting what we pay for?
Can we justify the costs?
Those questions are virtually impossible to answer in Multnomah County.
Why is the Multnomah County budget so hard to decipher?
On paper, the budget appears detailed: hundreds of pages, dozens of categories, countless metrics, and lengthy narratives. But volume is not substance. In fact, the sheer volume of the County budget obscures the sheer depth of its lack of substance.
Programs are wrapped in layers of jargon - "navigation," "outreach," "engagement," "support," “capacity building” - words that may sound good, but make it nearly impossible to determine what programs actually do, let alone whether they are complementary, duplicative, or even worthwhile.
“Performance Measures” do not measure meaningful outcomes relating to whether people’s lives actually improve, but instead measure activities: meetings held, referrals made, contracts executed, money spent. The County routinely meets targets, even as homelessness worsens, hundreds die on our streets, and the County itself has recently thrown up its hands to say things are only going to get worse.
But the problem goes deeper than vague uncoordinated programs or performance measures that do not measure performance. The fundamental problem with the County budget is that running to stand still is embedded in the budget process itself.
The County Budget starts with the status quo and adjusts as little as necessary.
Each year, the County starts with last year's budget and adjusts around the margins. In good times, money is sprinkled like fairy dust across hundreds of existing programs. In lean times, reductions are driven largely by arbitrary decisions untethered to performance, function, goals, or impacts on real people.
As an example, you needn't look further than what will surely be a headline from tomorrow's budget adoption: the closure of hundreds of shelter beds, with no plan for the people who will be forced back onto our streets.
As a moral document, this budget stands as a profound moral failure.
And beyond the human toll, this decision will drive increased use of emergency rooms, crisis services, jails, and other costly interventions, making it far more expensive to cause harm to these individuals than getting them the help they need.
Meanwhile, ineffective structures, redundant contracts and performative initiatives remain embedded throughout the County’s system, consuming resources that could be used elsewhere.
You can’t follow the money.
Tens of millions of dollars allocated to specific programs remain unspent and roll over from year to year, with little ability for policymakers or the public to determine exactly where the money went, what it was used for, or what results it achieved.
Consider the Homeless Management Information System (HMIS). For the past three years, County leaders have highlighted plans to implement a new HMIS. On paper, more than $20 million has been budgeted for the effort since 2023. Yet year after year, substantial portions of the funds have simply rolled forward because the County has not spent them. The proposed FY 2027 budget includes another $9 million for the project, with no explanation for why this year's allocation is any more likely to succeed than those that preceded it.
I challenge anyone to trace Supportive Housing Services funds across fiscal years and explain how rollover dollars were allocated, what programs they ultimately supported, what outcomes they achieved, and how much remains unspent today.
If that exercise cannot be done, commissioners have no way of knowing whether scarce resources are being directed where they will do the most good. Nor can they know whether additional cuts are necessary before first identifying and redeploying resources that already exist.
Over time, spending accumulates without clear purpose, new initiatives are layered on top of old ones, and funding becomes increasingly disconnected from measurable results. The result is a sprawling, fragmented system so convoluted that meaningful oversight becomes nearly impossible.
To move beyond the inertia, the County needs to do three things:
Adopt zero-based budgeting. Every program should justify its existence, cost, and role in achieving County goals.
Without that reset and forced clarity, the County will continue funding yesterday’s assumptions indefinitely, and programs will continue because they’ve existed, not because they work.
Invest in results. Aligning funding with outcomes should be the minimum standard for stewardship of public resources. County residents deserve to know what success looks like, whether it was achieved, and what it cost.
Rather than emphasizing referrals, meetings, contracts, beds, or services offered, the County should focus on outcomes that matter: fewer evictions, fewer people living unsheltered, fewer people cycling through emergency rooms and jails, more people achieving long-term stability.
Contracts should include clear performance expectations. Results should be independently evaluated, publicly reported, and regularly reviewed. Underperforming programs should be required to improve or lose funding.
Fund integrated, high-performing systems that support people rather than programs, eliminate redundancy, and allow funding and outcomes to be tracked from beginning to end.
Today, the County finances a patchwork of hundreds of disconnected programs, administered by hundreds of nonprofits, overseen by multiple County departments operating largely independently of one another.
Last year, the County spent over $400 million on homelessness-related services, but much of that spending was scattered across behavioral health, public health, emergency medical response, emergency management, community justice, information technology, capital projects, and other departments. Each came with separate narratives, contracts, funding streams, and performance measures.
Our County has created a system where neither policymakers, the media, nor the public can determine costs or tie total spending to results.
A Case Study in Budget Obfuscation: Deflection.
At its core, “deflection” is a simple and worthwhile concept: Divert people with addiction away from jail and into treatment, recovery, housing, and stability.
Yet the County does not systematically measure transitions into treatment, treatment completion, sustained recovery, or long-term stability. It is impossible to know whether deflection achieved its intended purpose for even a single person.
Even the true cost is difficult to determine. While County leaders regularly cite a figure of roughly $8 million, a full accounting that includes facilities, capital improvements, security, transportation, staffing, and contracted services places the actual cost od deflection at substantially higher (upwards of $15 million its first year).
Commissioners have had repeated opportunities - and a fiscal responsibility - to understand the program's actual costs, structure, and results before approving additional funding. Accountability concerns were neither new nor hidden, yet commissioners repeatedly voted to fund the program.
Action came only after deflection's failures made the headlines, and even then the proposed remedies focused more on responding to the fallout than addressing the underlying causes of the failure.
Deflection is emblematic of a budgeting system that makes it extraordinarily difficult to understand where money goes, what it buys, and whether it works. And it illustrates how easy it is for commissioners to allow ineffective and costly programs to continue, when what is needed is the courage to call out the things that aren’t working.
A summary of our current state.
Multnomah County increasingly funds programs based on politics rather than performance, defines success through narrative rather than evidence, measures activities rather than outcomes, and then calls the result a budget.
The Chair develops the baseline budget over months, working with department heads reporting exclusively to her. Her office gatekeeps information through a tightly controlled process. Commissioners are largely presented with a finished product, subsequently being offered small opportunities for symbolic wins so long as they do not challenge the budget structure itself.
I know because I was part of that process.
It took time to recognize that the problem was not insufficient resources or flawed programs, but the architecture of the budget itself. Once I reached that conclusion, I said so publicly, voted accordingly (the only commissioner to vote against a budget since records became accessible), and laid out alternatives.
At this point, the evidence is virtually impossible to ignore.
“Leadership” requires more than accepting carefully curated presentations, repeating institutional talking points, and complaining about lack of resources. It requires asking hard questions, following the money, and being willing to challenge systems that are not working.
Actions speak louder than words. Commissioners who criticize the current process, only to ultimately support the current budget under the current system, are merely using the language of change to perpetuate the status quo.
But real change is possible.
The way forward.
A detailed implementation plan for transitioning Multnomah County to zero-based budgeting, results-driven contracting, integrated service systems, and measurable public accountability is laid out in my Comprehensive County Turnaround Plan.
The plan is a roadmap for building systems that actually work for the people they are meant to serve. It preserves essential services while ensuring that resources are aligned with results.
Multnomah County has no shortage of compassion or resources. What it lacks are accountability, structure, and courage. Until the County changes how it budgets, contracts, measures, and governs, it will continue pouring enormous sums into fragmentation and dysfunction while our communities - and the people most in need of County services - continue to suffer amidst plenty.
The real choice is whether we are willing to keep funding systems that produce excuses, or build systems that produce results.
In good health,
Sharon Meieran, M.D., J.D.
Photo: Ryan Aanderud | 1studio7.com