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News Releases
Report to physicians: 'Engage in the practice of medicine' when recommending medical marijuana - 02/15/17

February 15, 2017



*Report to physicians: 'Engage in the practice of medicine' when recommending medical marijuana*

*New clinical guidelines say it should be done 'within the context of a bona-fide physician-patient relationship'*

PORTLAND, Ore.--Physicians should provide medical marijuana patients a level of care that, at minimum, includes a full evaluation, treatment and follow-up plan, with documentation in the patient's medical record, when recommending the drug's use, according to a new Oregon Health Authority report.

A report presented this month to the Oregon Legislature, HB 4014 Clinical Guidelines Work Group: Guidelines for Attending Physicians When Recommending the Medical Use of Marijuana, provides recommendations to physicians on appropriate care of a patient diagnosed with one or more debilitating conditions for which the physician is recommending the medical use of marijuana.

Qualifying debilitating conditions include cancer; glaucoma; a degenerative or pervasive neurological condition; positive HIV or AIDS status; or a side effect related to treating these conditions. Also qualifying are a medical condition or treatment for a condition that produces cachexia; severe pain; severe nausea; seizures; persistent muscle spasms; or post-traumatic stress disorder.

The Clinical Guidelines Work Group, created when the Legislature passed House Bill 4014 in 2016, developed the guidelines with the principals that physicians who recommend medical marijuana to a patient engage in the practice of medicine and do so within the context of a bona-fide physician-patient relationship.

"What this report is saying is that patients for whom medical use of marijuana is recommended deserve the same minimum level of care as those prescribed any medication to treat a debilitating condition," said Andre Ourso, manager of the Oregon Medical Marijuana Program at the OHA Public Health Division.

The work group consisted of 10 allopathic and osteopathic physicians and a patient advocate, as well as Ourso and state health officer Katrina Hedberg, MD, as ex-officio members.

Patient evaluation includes obtaining a comprehensive medical history, and performing a complete physical examination appropriate to the patient's debilitating medical condition and medical history, the report states. The physician should develop a written treatment plan, including documentation of informed consent, and discuss risks and benefits. The physician should follow up with the treatment plan, conduct ongoing evaluation and treatment, and properly maintain and document health records.

The report also notes that the work group "strongly opposes the smoking of marijuana as a means of therapeutic delivery" because of harms associated with inhaling any kind of smoke, and that several other delivery options are available that pose less risk to patient health.

"Marijuana smoke, like smoke from a cigarette or a wood-burning stove, contains particulate matter, much of which is potentially bad for the lungs, so we do not recommend a patient consume marijuana by smoking it," Hedberg said.

In addition, physicians should advise patients to consume the lowest possible amount of marijuana to achieve discussed treatment goals, according to the guidelines. They also recommend physicians consider the potential negative health effects of using marijuana while also using opioids, and it refers physicians to Oregon's Opioid Prescribing Guidelines.

The report is available at http://healthoregon.org/marijuana under "Publications."

# # #

Direct link to the report: http://public.health.oregon.gov/PreventionWellness/marijuana/Documents/OHA-9262-Attending-Physician-Guidelines.pdf

Conference of Local Health Officials meets February 16 in Salem - 02/09/17

February 8, 2017

What: The monthly public meeting of the Conference of Local Health Officials

Agenda: Oregon epidemiologists upcoming conference; 2017 Public Health Week planning; crisis care guidance update; preparation for 2017-19 financial assistance agreements; upcoming request for 2017 annual plan information; public health National Center for Innovation grant opportunity

When: Thursday, February 16, 9:30 a.m. to noon. The meeting is open to the public. No conference call option is available for the public.

Where: Local Government Center, 1201 Court Street NE, Suite 300, Salem

The Conference of Local Health Officials provides recommendations to the Oregon Health Authority on the foundational capabilities and programs and any other public health program or activity under ORS 431.147. (ORS 431.340)

Program contact: Danna Drum, 503-957-8869, danna.k.drum@state.or.us

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Oregon State Hospital Advisory Board to meet February 16 in Salem - 02/09/17

February 9, 2017

Program contact: Jacee Vangestel, 503-945-2852, jacee.m.vangestel@state.or.us

What: Public meeting of the Oregon State Hospital Advisory Board

When: Thursday, Feb. 16, 1-5 p.m.

Where: Oregon State Hospital, 2600 Center Street NE, Salem, in the Callen Conference Room. The public also can attend via toll-free conference line at 1-888-278-0296, participant code 4294893.

Agenda: Topics will include admissions, recruitment for the new superintendent, the policy related to pregnancy, Patient Advisory Council update, public comment, retreat follow-up, the proposed closure of the Junction City campus in 2018, orientation manuals and Social Security Benefits.

Details: The Oregon State Hospital Advisory Board advises the superintendent, Oregon Health Authority Director and legislators on issues related to the safety, security and care of patients. Members include consumers, providers, advocates, legislators, community members, consumer families and OSH union members.

The meeting site is accessible to people with disabilities. To request alternate formats, sign language interpreters, physical accessibility, or other reasonable accommodations, call the Oregon Health Authority at 503-947-2340 at least 48 hours before the meeting.

For more information, see the board's website at http://www.oregon.gov/oha/osh/Pages/advisory-board.aspx.

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OHA releases community benefit report on Oregon hospital spending - 02/08/17

February 7, 2017

*$67 million spent in fiscal 2015 on direct community improvements and benefits*

SALEM--Oregon hospitals provided $1.9 billion in community benefits in fiscal 2015, a 1 percent increase from the previous year, according to a new Community Benefit Report from the Oregon Health Authority (OHA).

Whether paying for research, sponsoring local Little League teams or building new facilities, hospitals in Oregon spend money each year to benefit their communities. Since 2007 the Oregon Health Authority has been tasked with gathering and publishing data on how Oregon hospitals are providing their community benefit.

"This report provides insight for the public and Legislature on how Oregon's hospitals are using community benefit dollars and this is a great tool to showcase the assistance that Oregon hospitals are providing to local communities," said Lynne Saxton, Oregon Health Authority Director. "This report also demonstrates that the proportion of total community benefit is steadily increasing in the unreimbursed costs of Medicare and Medicaid."

Key information in the report released today includes:
-- The majority of the $1.9 billion in community benefits in fiscal year 2015 came from large urban hospitals, which account for $1.7 billion.
-- $67 million was spent on direct community improvements and benefits (e.g., community health improvement, in-kind cash, and community building) which accounts for 4 percent of total community benefit.
-- Over 70 percent ($1.3 billion) of total community benefit was provided through unreimbursed costs for Medicaid and Medicare.
-- Charity care has dropped 37 percent since 2014 to $157 million.

Oregon's 60 acute care hospitals are subject to the reporting requirements for community benefit. However, McKenzie-Willamette Medical Center in Springfield and Willamette Valley Medical Center in McMinnville are for-profit hospitals and therefore have no obligation to provide community benefit because they are subject to property and income taxes.

Hospitals report the data used to compile the annual community benefit document directly to OHA.

# # #

Link to Community Benefit Report: https://www.oregon.gov/oha/analytics/HospitalReporting/Community-Benefit-Report-FY-2015.pdf

Public Health Advisory Board Incentives and Funding Subcommittee meets February 14 by webinar - 02/07/17

February 7, 2017

What: A public meeting of the Incentives and Funding Subcommittee of the Public Health Advisory Board

Agenda: Review information on how existing tax revenue is allocated and discuss potential future funding sources for public health modernization; determine whether there is an ongoing need for the PHAB Incentives and Funding subcommittee to meet.

When: Tuesday, Feb. 14, 1-2 p.m. A five-minute public comment period is scheduled at 1:55 p.m.; comments are limited to two minutes.

Where: Join the webinar at https://attendee.gotowebinar.com/register/2359933864019205891. A conference call line is also provided at 1-877-873-8017, access code 767068#.

Background: Oregon's Public Health Advisory Board provides guidance for Oregon's governmental public health system and oversees the implementation of public health modernization and Oregon's State Health Improvement Plan. The Incentives and Funding Subcommittee develops recommendations for the board's consideration.

Program contact: Sara Beaudrault, 971-673-0432; sara.beaudrault@state.or.us

# # #

Public Health Advisory Board website: http://public.health.oregon.gov/PROVIDERPARTNERRESOURCES/LOCALHEALTHDEPARTMENTRESOURCES/Pages/ophab.aspx

Get immunizations updated before School Exclusion Day February 15 - 02/06/17

February 6, 2017

*Parents must provide schools, child care facilities with kids' vaccine records*

February 15 is School Exclusion Day, and the Oregon Immunization Program is reminding parents that children will not be able to attend school or child care starting that day if their records on file show missing immunizations.

Under state law, all children in public and private schools, preschools, Head Start and certified child care facilities must have up-to-date documentation on their immunizations, or have an exemption.

"Immunization is the best way to protect children against vaccine-preventable diseases such as whooping cough and measles," said Stacy de Assis Matthews, school law coordinator in the Oregon Health Authority Public Health Division. "It helps keep schools and the entire community safe and healthy."

If school and child care vaccination records are not up-to-date on Feb. 15, the child will be sent home. In 2016, local health departments sent 41,045 letters to parents and guardians informing them that their children needed immunizations to stay in school or child care. A total of 6,995 children were kept out of school or child care until the necessary immunization information was turned in to the schools or child care facilities. Letters to parents were mailed on or before Feb. 1.

Parents seeking immunizations for their children should contact their health care provider or local health department, or call 211Info--just dial 211 or go to 211info.org. No one can be turned away from a local health department because of the inability to pay for required vaccines. Many pharmacists can immunize children age 7 and older. Parents should contact their neighborhood pharmacy for details.

Additional information on school immunizations can be found at the Immunization Program website at http://www.healthoregon.org/imm. Follow the Oregon Immunization Program on Facebook. View a YouTube video featuring Matthews discussing Exclusion Day at https://youtu.be/8NVbDEIPZgI.

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Oregon Immunization Program on Facebook: http://www.facebook.com/OregonImmunize

Oregon Health Policy Board to meet February 7 in Portland at OHSU - 02/02/17

February 2, 2017

Contact: Jeff Scroggin, 541-999-6983, jeffrey.scroggin@state.or.us (meeting information or accommodations)

What: The monthly meeting of the Oregon Health Policy Board

When: Tuesday, February 7, 8:30 a.m. to noon

Where: OHSU Center for Health & Healing, 3303 SW Bond Ave., third floor, room 4. The meeting will also be available via live web-stream. A link to the live-stream and a recording of the meeting will be posted on the board's meeting page at http://www.oregon.gov/oha/OHPB/Pages/2017-OHPB-Meetings.aspx. Members of the public also can call in to listen at 1-888-808-6929, participant code 915042#.

Agenda: Welcome; public testimony; director's report; 2017 Legislative Session update; Action Plan for Health continued discussion

For more information on the meeting, visit the board's meeting page at http://www.oregon.gov/oha/OHPB/Pages/2017-OHPB-Meetings.aspx.

The meeting site is accessible to people with disabilities. To request alternate formats, sign language interpreters, physical accessibility, or other reasonable accommodations, call the Oregon Health Authority at 1-800-282-8096 at least 48 hours before the meeting.

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New OHA public health plan tackles climate change in Oregon - 02/02/17

February 2, 2017

*Resilience strategy builds on 2014 findings, outlines recommendations*

The Oregon Health Authority today released a new 2016 Climate and Health Resilience Plan to guide the state's public health workforce in taking action on climate change.

The plan builds on the findings of the 2014 Oregon Climate and Health Profile Report, which warned of increased risk of injury, illness and death associated with rising temperatures, more extreme weather events, changes in precipitation patterns, and disruptions in our local economies and social safety net systems.

Since the first report was published, Oregon has seen its hottest year on record. It also has experienced its lowest snowpack on record, followed by heavy snows this year. The state had one of the most severe fire seasons in modern history and most counties declared drought emergencies. The third Oregon Climate Assessment Report published by the Oregon Climate Change Research Institute last week shows Oregon continuing to experience more extreme weather events and confirmed that the health of Oregonians is threatened.

"The changes we are all seeing in Oregon include more extreme weather events along with conditions that could affect our access to clean air, clean water, and healthy food," said Lillian Shirley, Oregon Public Health Division director.

The Climate and Health Resilience Plan released today outlines a set of recommendations for the state's Public Health Division, local and tribal health departments, and community partners. The recommendations were developed with the help of local health departments, partner state agencies, academic institutions, and other community partners. Collaboration with state agencies is emphasized as a key way to advance strategies in other sectors.

A recent assessment of Oregon's public health system found that Oregon is not equipped to handle the emerging environmental risks. The vast majority of local health departments report only partial to minimal ability to identify and prevent environmental health hazards.

While the challenges are complex and far-reaching, Shirley said, work is already being done to prepare.

"Together with partners, the Public Health Division is building resilience to multiple climate hazards and stressors, while also doubling down on public health efforts that reduce greenhouse gas emissions," she said.

For example, interventions that strengthen local food systems and promote more walkable communities not only benefit human health by improving access to healthy food and places for physical activity, but they also improve air quality and benefit the atmosphere.

Although the plan is geared toward people working in public health, everyone in Oregon can take action on the recommended strategies. Community members can learn to be "change agents" in their respective workplaces, neighborhoods and communities. The plan emphasizes the importance of strengthening partnerships and prioritizing strategies that benefit multiple partners or advance multiple goals.

Oregon's Climate and Health Program, which is part of the Public Health Division's Environmental Public Health Section, has started leading a collaborative of health departments across the state to take action.

Charlie Fautin, chairman of the Conference of Local Health Officials and public health director at the Benton County Health Department, says the collaborations encouraged in the Climate and Health Resilience Plan are key to ensuring communities are ready to prepare for and respond to climate change.

"Working with our public and private sector partners to prevent and prepare for climate change will further enable us to address some of the root causes of health inequities and preventable diseases in Oregon," he said.

For more information visit the division's climate change website at http://www.healthoregon.org/climatechange.

# # #

Links:
-- 2016 Climate and Health Resilience Plan: https://public.health.oregon.gov/HealthyEnvironments/climatechange/Pages/resilience-plan.aspx

-- 2014 Oregon Climate and Health Profile Report: https://public.health.oregon.gov/HealthyEnvironments/climatechange/Documents/oregon-climate-and-health-profile-report.pdf

-- Third Oregon Climate Assessment Report: http://www.occri.net/media/1042/ocar3_final_125_web.pdf

Reminder: OHA launches Climate and Health Resilience Plan today - 02/02/17

February 2, 2017

What: State and local health officials will present the Climate and Health Resilience Plan that will guide Oregon's public health workforce in taking action on climate change.

When: Today, Thursday, Feb. 2, 10 a.m.

Where: Portland State Office Building, 800 NE Oregon St., Room 1A (first floor)
Live-stream: https://www.youtube.com/watch?v=Qy_a5QvscyE
Conference line: 888-240-3210, access code 8286605

Who:
-- Lillian Shirley, director, OHA Public Health Division
-- Emily York, Climate and Health Program coordinator, OHA Public Health Division
-- Muriel DeLavergne-Brown, director, Crook County Health Department (on phone)
-- Charlie Fautin, director, Benton County Public Health Department; chairman, Conference of Local Health Officials, Oregon (on phone)

Visuals: Videos describing climate change resilience efforts in Crook and Benton counties; infographic showing climate and health risks; posters featuring portraits and quotes from Climate and Health Resilience Plan partners and stakeholders.

Background: The Climate and Health Resilience Plan builds on the findings of the 2014 Oregon Climate and Health Profile Report, which warned of increased risk of injury, illness and death associated with rising temperatures, more extreme weather events, changes in precipitation patterns and disruptions in our local economies and social safety net systems.

# # #

Media alert: OHA launches new Climate and Health Resilience Plan - 02/01/17

What: State and local health officials will present the Climate and Health Resilience Plan that will guide Oregon's public health workforce in taking action on climate change.

When: TOMORROW, Thursday, Feb. 2, 10 a.m.

Where: Portland State Office Building, 800 NE Oregon St., Room 1A (first floor).
Live-stream: https://www.youtube.com/watch?v=Qy_a5QvscyE.
Conference line: 888-240-3210, access code 8286605.

Who:
Lillian Shirley, director, OHA Public Health Division
Emily York, Climate and Health Program coordinator, OHA Public Health Division
Muriel DeLavergne-Brown, director, Crook County Health Department (on phone)
Charlie Fautin, director, Benton County Public Health Department; chairman, Conference of Local Health Officials, Oregon (by phone)

Visuals: Videos describing climate change resilience efforts in Crook and Benton counties; infographic showing climate and health risks; posters featuring portraits and quotes from Climate and Health Resilience Plan partners and stakeholders.

Background: The Climate and Health Resilience Plan builds on the findings of the 2014 Oregon Climate and Health Profile Report, which warned of increased risk of injury, illness and death associated with rising temperatures, more extreme weather events, changes in precipitation patterns and disruptions in our local economies and social safety net systems.

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Public Health Advisory Board Accountability Metrics Subcommittee meets February 14 by webinar - 02/01/17

February 1, 2017

What: A public meeting of the Accountability Metrics Subcommittee of the Public Health Advisory Board

Agenda: Approve December and January meeting minutes; review and provide feedback on draft proposal for developing accountability metrics; plan for subcommittee meetings in 2017

When: Tuesday, February 14, 9-10 a.m. A 10-minute public comment period is scheduled at 9:50 a.m.; comments may be limited to three minutes.

Where: By webinar at https://attendee.gotowebinar.com/register/3197970631728372481; the public also can join by conference call at 888-251-2909, access code 8975738#.

Oregon's Public Health Advisory Board provides guidance for Oregon's governmental public health system and oversees the implementation of public health modernization and Oregon's State Health Improvement Plan. The Accountability Metrics Subcommittee develops recommendations about public health quality measures for the board's consideration.

Program contact: Sara Beaudrault, 971-673-0432, sara.beaudrault@state.or.us

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OHA releases quarterly legislative report on Oregon's health system transformation - 01/31/17

January 31, 2017

*Additional report released on CCO 2016 mid-year metrics*

SALEM--Oregon's health system transformation continues to pay dividends for Oregonians. Even as uncertainty about health care continues at the federal level, Oregon is seeing improved health outcomes, increased health coverage and lower costs to the state.

That's the message of the quarterly legislative report released today by the Oregon Health Authority (OHA). The report provides the Legislature with results and data on the progress of Oregon's health transformation and the vital health care coverage for children and families struggling to make ends meet, including low-income working families.

"Oregon has a long history of bipartisan health care reform that has improved access to affordable, high-quality health care," said OHA Director Lynne Saxton. "We don't yet know the impact on the state of the national health care debate, but from this report we know that the progress we are making here in Oregon is real and measurable."

The Oregon Health Plan (OHP) provides needed health coverage to approximately 1 million people, or more than one in four Oregonians and more than one in three residents in many rural counties. It is the largest health plan in the state and the engine for the health system transformation that has improved health outcomes and saved the federal and state governments $1.4 billion since 2012.

*One in three Medicaid recipients has coverage through the Affordable Care Act*

The quarterly report released today highlights that in September 2016, more than 378,000 Oregonians and one in three Medicaid recipients were receiving health care coverage through new income eligibility criteria allowed by the Affordable Care Act (ACA). The report also reveals that statewide, nearly 40 percent of working-age OHP members enrolled in a coordinated care organization (CCO) are employed and 8 percent are working more than full time.

*CCOs maintain financial health as operating margins begin to stabilize*

The increased membership resulting from the ACA expansion generally led to an increase in both the net assets and restricted reserves for Oregon's CCOs. On a statewide basis, CCO operating and total margins have been trending downward from their peak in 2014. This stabilization is to be expected and the report includes financial data for Oregon's 16 CCOs for 2014, 2015 and the first two quarters of 2016.

The quarterly legislative report also highlights financial pressures facing the Medicaid program and CCOs, including the impact on the OHP budget of increasing pharmacy costs. In 2015, pharmacy expenditures reached $674 million compared to $533 million in 2014. Hepatitis C drug expenditures continue to significantly increase, with $38 million spent on hepatitis C drugs in 2015 compared to $16.6 million in 2014.

The 2016 mid-year CCO metrics report also was released today. It lays out the progress of Oregon's CCOs on quality measures as of June 2016. Measuring quality and access to care are key to moving health system transformation forward, to ensure high-quality care for Oregon Health Plan members.

# # #

Health System Transformation Quarterly Legislative Report: http://www.oregon.gov/oha/analytics/Documents/LegislativeReport_Q2-Q3_2016.pdf

2016 mid-year CCO metrics report: http://www.oregon.gov/oha/Metrics/Documents/2016_Mid-Year_Report.pdf

Youth marijuana use prevention campaign reaching target audiences - 01/27/17

January 27, 2017

*Independent evaluation of OHA pilot campaign finds young people correctly identify social norms, understand legal consequences of underage marijuana use*

PORTLAND, Ore.--An Oregon Health Authority media campaign aimed at youth and young adults is raising awareness among its target audience of the risks associated with marijuana use, an independent evaluation has found.

"Stay True to You," the OHA's youth marijuana use prevention campaign, was launched in July 2016 in two pilot communities--the Portland metro area (Washington, Multnomah and Clackamas counties) and Southern Oregon (Josephine and Jackson counties). RMC Research Corp., contracted by OHA to evaluate the campaign, found that, at mid-campaign, a statistically significant higher proportion of youth and young adults in the pilot areas correctly identified that only one in five Oregon high school juniors use marijuana.

The evaluation also showed that a significantly higher proportion of youth and young adults in the pilot areas also correctly identified that possession of marijuana by persons under age 21 can result in a steep fine, community service, or court-ordered drug treatment.

Social norms, intent to use and perceived risk of use are known predictors of substance use behavior.

"Our focus group research showed youth and young adults wanted more information on marijuana use and its effects," said Kati Moseley, OHA policy specialist at the OHA Public Health Division. "This campaign provided those facts and our research shows the audience was receptive to them."

The mid-campaign evaluation was contained in a report OHA submitted this month to the Oregon Legislature. The full report is available at http://healthoregon.org/marijuana under "Publications."

The ability to measure long-term effects of the youth marijuana use prevention pilot campaign is limited given the short five-month duration between campaign launch and mid-campaign assessment. However, the campaign is reaching its intended youth and young adult audience, the evaluation concluded.

OHA launched the pilot campaign last summer in the midst of increased marijuana advertising and access to retail marijuana--recent changes that may promote underage marijuana use. Although the magnitude of marijuana advertising in Oregon is unknown, marijuana retail locations are almost twice as common as Starbucks or McDonald's. In eight of the 12 youth and parent focus groups conducted in pilot campaign areas, participants reported an increase in the visibility of dispensaries, marijuana advertising, and marijuana-related products in the past year.

Youth and young adult attitudes--including intent to delay marijuana use until age 21--have held steady in this environment. Despite that, the mid-campaign evaluation results indicate that a standalone media campaign may not be sufficient by itself to counteract Oregon's growing advertising of and access to retail marijuana. Because media campaigns are most effective when implemented in the context of community-wide support for youth, parents and families, this campaign's effects on youth marijuana use will grow with increased collaboration among the Oregon Health Authority's Public Health Division, counties, tribes and schools in Oregon.

*Background on Stay True to You Campaign and evaluation*

After the legalization and ongoing rollout of recreational marijuana, the Oregon Legislature passed HB 4014 and SB 1597, which provided OHA with $3.97 million to develop, pilot and evaluate a youth marijuana use prevention campaign in a rural and urban area of the state. Legislative intent guided OHA in choosing the Portland metro area and southern Oregon as the locations for the pilot campaign.

OHA developed the campaign using extensive audience research and focus groups. OHA conducted 28 focus groups in Portland, Bend, Medford and Pendleton featuring 260 youth and young adults ages 14 through 20. Participants from the African American, Asian and Pacific Islander, white, American Indian/Alaska native and Latino communities were included. RMC Research Corporation conducted groups in English and Spanish between October 2015 and March 2016.

The Oregon Legislature directed OHA to conduct an evaluation of the "Stay True to You" campaign and provide a report on the findings to the Legislature by Jan. 1, 2017. The evaluation has collected survey data from the target audiences at two time points: in June 2016 (baseline) before the Stay True to You campaign launch and in November 2016 at mid-campaign. A final survey will occur toward the end of the campaign in April 2017. RMC Research supplemented the survey data with qualitative data collected via focus groups conducted with youth groups, English-and Spanish-speaking parent groups in the Portland metro area, and Jackson and Josephine counties.

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