Driven by care and compassion: Billi Odegaard's vision helps Multnomah County Health Department flourish

Friday, 11/16/12 - 2:02 pm

No headlines announced when Billi Odegaard retired as the Multnomah County Health Department director in 1999.

And that’s just how she liked it.

For nearly 30 years, the public health nurse quietly propelled the department from a small entity into a nationally recognized public health agency on the leading edge of adolescent, oral and primary health care.

When she first arrived at the county in 1969 wearing a crisp blue cap and uniform, Odegaard was one of about 120 employees whose efforts were newly merged with the city of Portland’s health department.

By the time she retired, Multnomah County was the largest primary and dental care safety net provider in state with nearly 1,200 employees working across the county and in nearly 20 primary care, dental and school-based health centers.

Today, Multnomah County operates 25 health centers including the first downtown safety net clinic that opened on Friday, Nov. 9.

“She was an amazing woman who always had the vision and could see what was coming around the corner before the rest of us,’’ said Mary Lou Hennrich, executive director of the Oregon Public Health Institute. “We didn’t use the word ‘strategic’ then, but she was strategic and driven by care, compassion and worry about the most vulnerable people. That was always at her core.’’

Still, few outside government realized how Odegaard seized opportunity after opportunity to serve the public.


The eldest daughter of a county extension agent, Odegaard grew up in Jamestown, N. D., devouring the “Cherry Ames Nurse Stories,” the popular series of an adventurous mystery-solving nurse.

Inspired, Odegaard earned her nursing degree at Jamestown College then went onto the University of Washington to earn a master’s degree in public health.

She was fresh out of graduate school when she was hired as a Multnomah County public health nurse. Within two months, she was supervising colleagues who visited new moms and their babies at home and conducted clinics in schools and church basements.

By 28, Odegaard was director of nursing. She went on to head the health division, then under the Department of County Human Services, and as it evolved, the Multnomah County Health Department.

Odegaard believed that unless her department was sensitive to the broad range of health needs in the community, it could never meet its prevention goals.

“If you have an aching tooth its hard to talk about the importance of brushing your teeth,’’ Odegaard said.

Still, it was an uphill road. After budget cuts in 1974, Odegaard told staff they could no longer rely solely on the county general fund.

She set a goal to capture more than $250,000 in grants the next year - and did. That first grant became the nucleus of the Northeast Health Center. From there, every few years, the department extended services to meet the community’s needs. Among the most innovative: school-based health centers to reach families with children.

Odegaard tackled the HIV/AIDS epidemic with non-traditional outreach and prevention. She recognized the health department needed to develop a workforce as culturally and linguistically diverse as the community. And she helped establish the community health council to ensure clients helped drive policy.

“We are standing on the shoulders of these public health nurses who started out in Old Town and built the forward-looking health department you see today,’’ said Loreen Nichols, division director.

Tom Higgins, former Department of County Human Services director, said Odegaard was also ahead of her time as a manager in building teams and consensus.

“People in the private sector underestimate what it takes to be successful in administering public programs. They don’t appreciate how complex it is and how important it is to serve stakeholders, not just shareholders.”

Odegaard enjoyed remarkably good relations with county commissioners, working with them to take over health care in the county jails. The board sponsored the first public health nurse to become a nurse practitioner.

Before the Oregon Health Plan was created in 1993, Odegaard teamed with Oregon Health & Science University president, Dr. Peter O. Kohler, to set up a managed care organization to serve that population. The collaboration eventually formed CareOregon.

Even as she retired, Odegaard realized a final dream: creating a foundation to promote a workforce and public policies around good health. Friends of Public Health evolved into the Oregon Public Health Institute, which has granted hundreds of thousands of dollars in scholarships and education grants.

In naming the new dental clinic, Lillian Shirley, director of the Multnomah County Health Department, said it was “fitting, and thrilling… to honor one woman who has done so much to make the Multnomah County Health Department a vital link in the safety net: Billi Odegaard.”

“She promoted the core values we embrace today.’’