A look back at 2017 to get us dreaming bigger in 2018

Dec 29, 2017

In 2017, Central City Concern (CCC) made significant headway toward increasing the number of affordable homes in Portland, bridged service gaps with new programs, further cemented our reputation as leaders in the national conversation about how to end homelessness, and much more. But most importantly, thanks to you, CCC helped thousands of our neighbors find housing, wellness, and opportunity through our compassionate and comprehensive model of care.

Below are some highlights from the year at CCC. As you read through this snapshot of what we accomplished, we hope you will feel good about all the things you made possible.

July: Hill Park Apartments became home to 39 households in Southwest Portland.

August: Charlotte B. Rutherford Place, a 51-unit apartment building for families, broke ground.

September: Stark Street Apartments, which will provide 153 homes, broke ground.

November: The Blackburn Building—combining a clinic, pharmacy, transitional and permanent housing—broke ground.

February: Multnomah County, the City of Portland, and CCC launched the Law Enforcement Assisted Diversion (LEAD) program to help low-level drug offenders work toward recovery, find stability and avoid reoffending.

February: CCC, Multnomah County’s Department of Community Justice, the Joint Office of Homeless Services and Meyer Memorial Trust together launched Flip the Script, a culturally specific reentry program that aims to reduce recidivism.

March: CCC joined forces with Health Share of Oregon and CODA, Inc. to form Wheelhouse, a program to expand Medication Supported Recovery services throughout the Tri-county area.

May: CCC Clean Start trains formerly homeless workers to help keep neighborhoods clean by removing trash and graffiti. The program works with the City of Portland’s One Point of Contact.

May: Ed Blackburn, Portland Business Alliance Community Partner of the Year

July: Town Center Courtyards family housing community, Gold Nugget Merit Award

October: Ed Blackburn and Central City Concern, National Alliance to End Homelessness Pioneers in Innovation and Excellence Award

November: Housing is Health Collaboration, Portland Business Journal Innovations in Corporate Philanthropy Award

January: After a fire displaced 98 residents of CCC's Hotel Alder building, community members rallied to send a flood of donations to meet the needs of our tenants.

August: Close to 300 runners and walkers attended Portland's first Heroes in Recovery 6K. Proceeds of the race benefited CCC and Hooper Detox.

March: The United States Interagency Council on Homelessness highlighted CCC Recovery housing.

April: CCC hosted Kimberly Johnson, director of SAMHSA’s Center for Substance Abuse Treatment, for a visit that included a Recovery Housing “fish bowl” dialogue.

June: CCC staff members and a health care consumer hosted six informative and well-received presentations at the National Health Care for the Homeless Council’s annual conference in Washington, D.C.

January: Ed Blackburn, CCC's executive director since 2008, announced that he would retire later in 2017. A national search began in the spring for his successor.

August: Rachel Solotaroff, M.D., was announced as the new President & CEO for CCC. She had been with CCC since 2006, first as CCC’s Medical Director, then as Chief Medical Officer since 2014

September: Freda Ceaser was named CCC's director of Equity and Inclusion. She was previously the Director of Employment Services at CCC's Employment Access Center.

April: CCC highlighted our robust volunteer program and partnerships during National Volunteer Week.

August: CCC celebrated National Health Center Week by sharing the many ways we extend our health care work past clinic walls and directly to where people live.

The Imani Center program increased the number of people they serve with culturally responsive Afrocentric approaches to mental health and addictions treatment by 50 percent. They also held the first two graduations in the program's history.

CCC's social enterprises—Central City Coffee, the Central City Bed, On-call Staffing and CCC Clean Start—employed 80 formerly homeless clients over the year.

CCC's Recycling and Reuse Operations Center, a program that gives abandoned property a second life, processed more than 44,000 pounds of items (91% of which was kept out of the landfill) and provided nearly 700 clients with much-needed household items and clothing.



The 2017 Sandy Anderson Award Winner: Way More than "just an enforcer"

Dec 20, 2017

During the Old Town Clinic (OTC) all-staff meeting on Wednesday, Dec. 6, Billie Kay Stafford, OTC's operations manager, was recognized with the Health Services Advisory Council’s (HSAC) 2017 Sandy Anderson Award.

Billie Kay, or BK as she's affectionately known across Central City Concern, was an exemplary choice to be this year's awardee. For the last three years, the Sandy Anderson Award has been given by HSAC to a staff person who:

- Is always person-centered in their interactions with consumers.
- Puts the needs and goals of consumers first.
- Listens deeply and sees and hears beyond how people might seem on the surface.
- Is collaborative and solves problems with us instead of for us.
- Keeps long-term care goals in mind while also meeting people where they are.
- Can instill hope, no matter what.

Billie Kay is well-known and much-admired for the excellent job she does keeping OTC a calm and safe environment. If a patient is upset, she deftly intervenes in a way that makes them feel heard and de-escalates them, but also makes it clear what the clinic rules are around behavior to keep OTC a welcoming environment for everyone.

As our Old Town Clinic has grown in the number of patients we serve, the staff we employ, and the services we offer, Billie Kay has been an essential part of improving patient access and the patient experience. Despite the countless moving parts that make OTC what it is, Billie Kay makes sure that the clinic operates as efficiently as possible.

Upon the announcement of her recognition, Billie Kay received a standing ovation from OTC staff. Clearly touched, she said through tears and, as always in her trademark Texas accent, that the award was especially meaningful for her in light of its namesake and past honorees.

"I look at the people that have gotten this and the person it's named after as being people with huge hearts, that everybody respects and loves. I see myself as just the people think of as just the enforcer."

Billie Kay's commitment to centering our clinic's work on the people we serve, her ability to collaborate to solve problems big and small, and her obvious love of our patients ensure that her colleagues certainly see Billie Kay as more than that. "I love my job and I love y'all," she said.

Congratulations, Billie Kay!

Past winners of the Sandy Anderson Award include OTC Care Team Manager Carol Weber in 2015 and Old Town Recovery Center psychiatrist Phil Shapiro in 2016.



Monthly Volunteer Spotlight: November 2017 Edition

Nov 30, 2017

This month’s spotlight features a volunteer who came aptly qualified for our Cooking Matters program, which is a partnership between Central City Concern and the Oregon Food Bank that teaches clients the skills and knowledge required for healthy cooking and eating habits. Having previously volunteered with a different Cooking Matters session and given her experience in the health care industry, she couldn’t have been a better fit to volunteer with the program! Linda Nguyen, who supervised Nickie in the program, said about her work, “The Cooking Matters team at Old Town Clinic was honored to have Nickie share her time and knowledge with our program. Nickie’s kind, calm, and compassionate spirit helped create a friendly environment where our clients felt safe and supported throughout the 6-weeks program.”

Read on to see why Nickie has continued to volunteer with the Cooking Matters program, and what was so special about the classes at CCC.

• • •

Peter: What is your name and volunteer position?

Nickie: My name is Nickie Dane and I am the Cooking Matters lead assistant.

P: And you had done the Cooking Matters program before coming to CCC, right?

N: Yes, I was a grocery store tour coordinator [with a Cooking Matters program] in North Carolina. People would be referred to this day of tours through the health department or WIC [the Special Supplemental Nutrition Program for Women, Infants, and Children], and we’d put on like six in one day, so people would come in and go through the grocery store and get a “10 dollar challenge” where they got to practice buying things from the different food groups.

P: And how is this class different than the one you had done before?

N: It’s different in that it’s over a six-week period, while those other ones it was just an afternoon, so they come in and get an hour or two hour tour and that was it. With this there would be follow up and participants would come in and talk about the recipes and what they’d done at home that was a little healthier. It was exciting seeing people make the commitment and keep coming. There were a good eleven people who did the whole class. I just enjoyed people being excited about cooking and health.

"It was exciting seeing people make the commitment and keep coming.... I just enjoyed people being excited about cooking and health."
-Nickie, CCC Volunteer

P: What is it about Cooking Matters that is meaningful for you and kept you coming back to it?

N: I work in the health care industry and seeing the lack of information given to people by traditional primary care providers about what people can do to improve their health as far lifestyle and food choice goes has been a big driver. I think that prevention needs a little more attention and if they haven't gotten it from their doctor then they can get it from other sources, like Cooking Matters.

P: What were the common questions or misconceptions that folks had?

N: So, some of the things that come up are like, “Why do we have to look at saturated fat?” So, we’ll have a conversation about heart disease and they’ll go, “Oh well, I have some heart problems,” or high blood pressure and that will lead us down the conversation of sodium intake and reading food labels. And they never knew they should look at that part of the food label and they didn’t know that sodium affected their blood pressure significantly. Because their doctor might have said, “Oh, try to cut back on salt,” but they didn’t really understand why or get into a conversation any deeper than that.

P: I think we do hear that a lot, just sort of, “You should eat better.”

N: Yeah, just really generic instructions and there’s not a how you should do that, or why you should do that.

P: Is that something that is part of the Cooking Matters program, more than just “you should,” but this is how this affects your body?

N: Yes! And not just that, but understanding how a recipe works and if you don’t have a recipe, how to take the foods you’re getting at the food pantry or what you’re able to purchase at a low price and how to make that into something healthy and also looking at things like leaving the peels on fruits and vegetables, because that gives you more fiber. And fiber is better for you because it helps prevent cancer and lowers you cholesterol, so these are things we all talk about in the class over the six weeks. Lots of questions, lots of “Oh, I didn’t know that!”

P: Were there any common reasons that folks weren’t always able to access healthy food?

N: I think one of the barriers living in this area is access to healthy food, so purposefully going out of your way to go to the bigger grocery stores to buy fresh produce. That is a big barrier, because it’s easy to just go down to that little convenience store that’s right there.

P: I think that’s something we can all relate to, if it’s hard to fit that time in to your week or you don’t have a car or reliable transit, just valuing food enough to make that time to make that trip and that effort.

N: Yes. And seeing that it’s not a huge hurdle. It can be a hurdle, but we took the bus to Fred Meyer so they got to see that it just took a few minutes.

Another thing that would come up is the kitchens that they have available to them. They would say, “Oh, I don’t have this, I don’t have an oven, I only have a microwave or a hotplate.” So we’d talk about different ways to get around that so you could still have the healthy food and the good options and kind of overcoming not having measuring cups, little things that we take for granted.

P: Were there any stand out moments from the class?

N: I loved the last day when everyone got to come together and talk about what they learned and the recipes that they liked and just got to hang out. I think a bunch of people stayed later and we all took pictures and everyone got a little award and an apron and they just talked about how much they loved it and how they want to take more classes.

The last day we also played food jeopardy. Alison [the lead chef for Cooking Matters] set up this Jeopardy board and prizes, like mixing spoons and things like that they could use, and everyone did so well remembering things like what temperature you need to cook chicken to and what’s the biggest way you can prevent disease or foodborne illness, which was “wash your hands,” which everyone knew.

I got to know some people and the hard things they’ve gone through and what they’ve overcome. And now that they’re getting back in to a stable lifestyle this is something where they can meet people and learn a new skill and take their health into their own hands. I think having something to stick with and to get out and meet people and interact with them was really good for several participants. There was a couple in there too and they used it as their date night. And one of them didn’t like vegetables at all, or only certain vegetables, so it kind of pushed him outside of his comfort zone. And that was cool to see.

P: And what was important about this experience for you?

N: Seeing how resilient people are. It was so neat to get to know people over these six weeks and hearing what they’re going through with their health and illness, rough backgrounds, and the social isolation and they’re just putting themselves out there and working to get better. When I work as a paramedic, I talk to someone for about 15 to 30 minutes, and that’s about it, and I leave them at the hospital, so I don’t really get beyond, “What are you feeling right now?” Working with this population, which I don’t get to do very often, it kind of pushed me beyond my comfort zone in effective communications and how to talk about things that are hard without being biased or offending anyone.

P: And what keeps you coming back to volunteer?

N: It feels so good, people thank you, and hopefully I’ll get to see people on the street now walking around in this area and say hi and catch up and make connections.

P: It’s a great reminder that we’re all in this space together and you can make a connection like that.

"It’s nice to just break it down and just understand that while they have a completely different life from what I have, they are valuable, they are human, and want interactions. We’re all people in this community."

N: Just even walking over here, I try to smile at people on the street when I’m walking by and maybe they don’t get attention or noticed or whatever, so just smiling and saying hi and just watching them be like, “Oh, Hi!” It’s nice to just break it down and just understand that while they have a completely different life from what I have, they are valuable, they are human, and want interactions. We’re all people in this community.

P: And for our traditional last questions, if you met someone who was on the fence about volunteering with CCC, other than that wonderful pitch you just gave to me, what would you tell them?

N: Oh, I mean, even if you just do a little bit I think that seeing other ways of life or confronting things that you have a bias toward or against, it just makes you feel more connected to humanity. It makes you feel more human. And more empathetic. That’s a big, big part of why I’m doing this. It’s so important to interact with people that you don’t normally and do something for another person.

• • •

If reading about Nickie and Cooking Matters inspires you to make a donation of items, we are in need of kitchen supplies to help keep the class going at Central City Concern. Our Cooking Matter Amazon Wish List makes it easy for you donate, or you can contact our Donor Relations Manager, Catharine Hunter at catharine.hunter@ccconcern.org if you have quality used materials from the list that you would like to donate.

And if you are interested in learning more about volunteer positions in at Central City Concern’s health and recovery, housing, or employment programs, contact Peter Russell, CCC’s Volunteer Manager, at peter.russell@ccconcern.org or visit our volunteer webpage.



Continuing to listen to trans voices

Nov 16, 2017


Happy Transgender Awareness Week 2017! According to GLAAD, this special week, Nov. 13 to Nov. 17, is set aside to “help raise the visibility of transgender and gender non-conforming people, and address the issues the community faces.”

In this space last year, we shared about the numerous steps Central City Concern was taking to ensure that our programs and services, as well as the staff members providing them, were as affirming and inclusive of our transgender patients and clients as possible. This year, we want to provide an update on our efforts to do so!

Trainings: CCC continues to offer trainings year-round to our staff members about working with trans and gender non-binary patients and clients. Several lead staff members have also made it a point to attend trainings hosted by community organizations so they can share what they learn with our program staff.

We continue to encourage our training attendees to approach the sessions from a place of humility. What Eowyn Rieke, CCC’s Associate Medical Director of Primary Care, said last year continues to apply to our approach: “We’re working toward a culture of humility as it relates to gender identity—recognizing that there are great differences at play here and that we need to be humble about our assumptions.”

"We’re working toward a culture of humility as it relates to gender identity—recognizing that there are great differences at play here and that we need to be humble about our assumptions.”
- Eowyn Rieke, Associate Medical Director of Primary Care

CCC Director of Equity and Inclusion Freda Ceaser says that this posture has provided the organization with a blueprint to fully operationalize trans affirming program services across the agency. She says that in the coming year, her goal is to work with every CCC program to begin an initial assessment of procedures and policies to become more trans affirming and inclusive.

“It’s so rewarding to see how the work of health services intentionally recognizes and affirms the identity of each of our patients. I want every person we serve, no matter their gender identity, to feel accepted, valued, and respected.” 

Trans Support Group: Chrysalis, the trans and gender non-binary support group that formed last year in response to what we heard from our patients, has been thriving. Open to patients of Old Town Clinic (OTC) and Old Town Recovery Center (OTRC), Chrysalis is a safe place where, according to facilitator Shanako Devoll, “people can talk about the difficulties of navigating everyday life and strategies used to address safety, mental health, and substance use.”

Group members say that Chrysalis helps them counteract the isolation they can feel by being part of a group that understands each other’s struggles and triumphs. At each session, attendees share their experiences, bring information about resources they’ve come across, and slowly build a community of shared experiences together.

The group meets bi-weekly. While the make-up of each meeting can differ, Chrysalis averages about five attendees each time the group comes together. Chrysalis is currently open to new members; in mid-December, the group will close for six weeks to allow the group members build trust and create the safe space they need.

"I want every person we serve, no matter their gender identity, to feel accepted, valued, and respected.”
- Freda Ceaser, Director of Equity and Inclusion

Electronic Health Records: Thanks to CCC’s amazing EHR implementation team, our health services can now make changes to patients’ gender identification information faster and easier than ever.  

Responding to the Needs of the Trans Community: As we continue to listen to our trans patients, we’re making changes that we believe are positive for them and the larger community.

All our multi-stall bathrooms inside OTC and OTRC now have signs that emphasize our support for individuals using the bathroom that best fits with their gender identity.

To better support trans patients and clients in substance use disorder treatment programs, our services are working toward making our urinalysis collection process more trans affirming.  

And finally, Margot Presley, an OHSU Doctorate of Nursing Practice candidate, used her doctorate project as a way to seek out and listen to trans voices at our Old Town Clinic. Margot’s project, “Patient Engagement in Quality Improvement: Raising the Voice of Transgender Patients Experiencing Homelessness” used patient engagement and qualitative inquiry techniques to interview people about their experiences as trans patients of OTC. Their feedback was used to recommend changes to our clinic operations with the goal of better meeting their needs.

Her manuscript is in process of being published in Transgender Health, “the first peer-reviewed, open access journal dedicated to addressing the healthcare needs of transgender individual;” Margot also presented a poster showing her work at several conferences. 

• • •

Each year, Trans Awareness Week leads up to the Trans Day of Remembrance on Nov. 20, an observance to honor and remember those whose lives were lost to acts of anti-trans violence. There are a number of events in the Portland metro area to participate in that day. All descriptions are from the event hosts: 

Thursday, Nov. 16
Keynote featuring Jennicet Gutiérrez: How to Get Involved, Hosted by Portland State Temprr Month and PSU Queer Resource Center
: Join us for our TEMPRR keynote panel event with activist Jennicet Gutiérrez! As a founding member of La Familia: Trans Queer Liberation Movement, Gutiérrez's activist experience with transgender rights and immigrant rights has given her great knowledge on how to get involved with various types of activism. This panel will also have local activists who will answer questions and share more about their activism. (Link) 

Friday, Nov. 17
5th Ave. Presents: ReAgitator, hosted at Fifth Avenue Cinema
: Join us in honoring Trans Day of Remembrance a few days early with an incredibly inventive film from independent trans-filmmaker Dylan Greenberg. Her film Re-Agitator: Revenge of The Parody, tells the bizarre story of a mad scientist using a cynical serum to revive a beautiful woman back from the dead leading to complete and total chaos. Using an arsenal of homages and spins off of classic and modern horror, Re-Agitator is bound to satisfy a weird and experimental itch. The film will feature an introduction from Dylan herself, including discussion of her experience with being an indie filmmaker and multi-media artist in NYC. This event will be donation-based instead of our regular ticketing prices, all proceeds will go to the artists. (Link) 

Sunday, Nov. 19
Trans Day of Remembrance March & Interfaith Vigil
: Please all Transgender folk and Cisgender allies join us in reverence and solidarity to honor the fallen and make a stand against Transphobia. We will gather at Terry Schrunk plaza for a staging and a brief program whereupon we will process to the First United Methodist Church for a candle lighting ceremony for the fallen and a message of hope and renewal from local area spiritual leaders followed by a reception where light refreshments will be served. (Link)

Monday, Nov. 20
Transgender Day of Remembrance 2017, hosted at Portland Community College
: This event is being planned by the Portland Transgender community, with the support of Portland Transgender organizations, Portland LGBTQIA2+ organizations, and allies, and is being led by Portland Transgender People of Color. (Link)

Transgender Day of Remembrance Memorial Meeting, hosted at Multnomah Friends Meeting House: We welcome you to join us on this day to mourn and honor the lives of those who have been murdered in the previous year because of anti-transgender hatred.

We gather to remember. We also gather to pray for, and to dedicate ourselves to work for, a world where transgender people are safe from hatred and violence. (Link)



Making Suicide Prevention a Routine Part of Care

Sep 11, 2017

national suicide prevention week ribbon and logoSuicide Prevention Week is Sept. 10-16, but preventing suicide is something Central City Concern (CCC) thinks about every day of the year. “Zero Suicide” is the national model of treatment that CCC’s Old Town Clinic (OTC) has adopted and integrated into all aspects of the primary care it provides to more than 5,000 individuals it serves annually. It’s a commitment to the idea that every suicide can be prevented with the right kind of care.

“No matter what your position, we’re all responsible for suicide prevention,” says Brian Barnes, Associate Director for Behavioral Health in Primary Care at OTC. Barnes explains that making suicide prevention a system-wide priority and a routine part of care is the key to ensuring that no one falls through the cracks. Having clear, established procedures is better for patients and better for staff because it normalizes prevention and helps everyone know how to get the right kind of help.

“Suicide prevention starts way back so that when we see a patient we are looking at the whole picture."

At Old Town Clinic, this has meant incorporating questions about suicide into regular patient visits, establishing new protocols to ensure that clinicians are aware of patients who have a plan to harm themselves and designating a suicide "clinician of the day" who can respond to help, usually within five minutes. An intervention by the clinician of the day can last several hours—enough time to really engage someone in a moment of crisis, gain new perspective on a situation that may seem hopeless and come up with a concrete safety plan for the day, which clinic staff follow up on. Implementing these changes entailed a team-effort at the clinic, with leadership for designing and operationalizing the new procedures from Susan Marie, Senior Medical Consultant for Behavioral Health in Primary Care, and Lydia Bartholow, Associate Medical Director for Outpatient Substance Abuse Disorder Services.

“This type of work is more typical in a specialty mental health setting,” says Barbara Martin, Senior Director of Primary Care at CCC. But in serving some of Portland’s most vulnerable residents, OTC aims for a comprehensive approach. Many of the clinic’s patients face struggles that make primary care especially challenging: finding housing, getting and keeping regular access to health care, or dealing with addiction and other severe mental illness. At the same time, health care providers can lean on CCC’s extended network of wraparound services in housing, addiction treatment, employment services and social support.

“Suicide prevention starts way back,” Barnes says, “so that when we see a patient we are looking at the whole picture.” It requires going beyond crisis-intervention and stabilization to address long-term needs that support overall health and well being. Recalling how the clinic staff helped one person who recently attempted suicide, Barnes notes: “We were able to get her treatment here, at Old Town Clinic, change some things with her mental health medications, and get her housed in CCC housing with programming specifically designed for people recovering from addiction. We consider all of that primary care, because it’s primary to the person, to their overall care.”

Having clear, established procedures is better for patients and better for staff because it normalizes prevention and helps everyone know how to get the right kind of help.

Barnes and Martin both emphasize that everyone can help make zero suicide a reality. Go with your gut, they say, and reach out to a hotline or many of the other resources available if it seems that someone is at risk of harming themselves. “The most important thing is to listen,” Martin says, “because the evidence shows that if someone is getting close to a point of despair, thinking about hurting themselves, they often talk to people.” And Barnes adds: “Every person’s behavior can be explained if you understand the context, but if you don’t have time to understand the context, then get someone who can.”

• • •

The Multnomah County Crisis Line is available 24/7: 503-988-4888. 
The National Suicide Prevention Lifeline is also available 24/7: 1-800-273-8255
The David Romprey Oregon Warmline offers confidential peer support from 9:00 a.m. to 11:00 p.m. every day: 1-800-698-2392



NHCW 2017: Serving a population where they live

Aug 18, 2017

On September 23, 2016, leaders from six Portland health organization gathered at Central City Concern’s Old Town Recovery Center to announce an unprecedented $21.5 million dollar investment in the Housing is Health initiative that will fund three new CCC buildings in Portland. The crown jewel of this shining trio is the Eastside Campus, which will serve medically fragile people and people recovering from substance use disorders and mental illness with a health care clinic and 172 housing units.

“This significant contribution is an excellent example of health organizations coming together for the common good of our community,” said Ed Blackburn, CCC president and CEO. “It also represents a transformational recognition that housing for lower income working people, including those who have experienced homelessness, is critical to the improvement of health outcomes."

Each floor is designed to foster healthy peer relationships, with vibrant common spaces where residents, supported by CCC staff, can build community.

CCC will break ground on the Eastside Campus in late October 2017. The center will build on CCC’s existing Eastside Concern program, and will offer integrated housing and clinical services, including substance use disorder treatment, primary care and urgent care. More than 3,000 CCC patients each year will access care in a unique and welcoming health home environment.

The housing portion of the Eastside Campus will have about 172 units of housing, including short-term medical stabilization and palliative beds as well as transitional housing for people in recovery from behavioral health disorders. Each floor is designed to foster healthy peer relationships, with vibrant common spaces where residents, supported by CCC staff, can build community.

“It’s important to serve people where they live."

“It’s important to serve people where they live,” said Blackburn. “This project will replicate the integrated care we give at our Old Town campus to help people get back on their feet and achieve health and self-sufficiency.”

The Housing is Health initiative is supported by Adventist Heath Portland, CareOregon, Kaiser Permanente Northwest, Legacy Health, OHSU and Providence Health & Services. The new construction includes the Eastside Campus, Stark Street Apartments and Charlotte B. Rutherford Place apartments on N Interstate.

The CCC Eastside Campus is scheduled to open in Winter 2019.



NHCW 2017: Adapting the system to work for our most complex patients

Aug 17, 2017

Central City Concern's Summit team takes care of our Old Town Clinic's most complex and medically fragile patients. Instead of expecting patients to fit into a health care system, the Summit team adapts the system to work for them by offering flexible scheduling, around-the-clock availability, and even home visits. Like many of the programs we've featured during National Health Center Week so far, the Summit team goes above and beyond to break barriers and narrow the gaps that keep vulnerable individuals from becoming as well and healthy as they can be.

We're so excited to share this video about Summit with you, which features Summit team staff and several Summit patients talking about what sets this program apart and how it impacts the lives of those it serves. A version of this video was originally shown at the National Health Care for the Homeless Conference in June.




NHCW 2017: Starting primary care engagement outside clinic walls

Aug 16, 2017

There are few professions in the world that call on you to do your job in an RV, but that’s where Catherine Hull found herself a few weeks ago, helping the person who lived inside fill out intake paperwork. If she minds the odd working environment, she certainly doesn’t show it. After all, her role as Central City Concern’s Community Health Outreach Worker (CHOW) has also taken her under bridges and overpasses, into day centers and shelters, and onto most of the streets that form downtown Portland.

“My days are almost always pretty uncertain. A lot of the time, I get a phone call or an email and I’m off to respond at the drop of a hat,” she says. “Once I get to where I’m needed, I can help people figure out the different needs they have.”

CCC’s CHOW program was originally created partly in response to the difficulty of phone outreach to individuals who, though insured, weren’t engaging with our Old Town Clinic or any other primary care clinic, often leaving chronic health conditions unmanaged. Rather, these folks were utilizing the emergency room or acute care services at high rates for needs that could have been taken care of, and even avoided, with a primary care provider.

These potential patients—most unhoused or low-income—didn’t need reminders; they needed relationships to enter into and navigate a health care world that was as confusing as it was untrustworthy.

Calling people wasn’t enough. These potential patients—most unhoused or low-income—didn’t need reminders; they needed relationships to enter into and navigate a health care world that was as confusing as it was untrustworthy. So Catherine started hitting the pavement.

Hospitals contact Catherine when an emergency room patient who they had previously referred to the Old Town Clinic for primary care shows up again and again. Community members phone get in touch when they feel compelled to help someone on the street they see every day. CCC programs like Hooper Detox call her when a patient needs to establish a primary care provider in order to be referred to other programs. As long as there’s someone to meet, she goes.

Through it all, Catherine practices profound empathy. While following through on a primary care appointment may seem like a small task to many, she understands—and hears firsthand—what stands in the way.

“Patients typically have to wait a few weeks after their initial intake to see a provider, and that can clearly be frustrating when we’re asking them to take charge of their health,” Catherine says. “A lot of the time their primary concern isn’t primary care at all; it’s their substance use disorder or mental health or the simple fact that they don’t have a home.”

Lack of transportation, sleep deprivation, fear of being judged by a doctor, and a feeling of stuck in their situation place additional barriers to engaging with primary care. Catherine listens and then does what she can to help each person inch closer to primary care. She performs intakes on the spot, ensuring that the individual can see a provider even sooner. She hands out bus tickets, offers assurances that our care providers truly have heard it all before and are not in the business of judging, and true to her self-given title of “the queen of resources,” offers information that can be of any further help.

“It’s understandable that if someone doesn’t know where they’re sleeping each night, a clinic appointment two weeks from now won’t be at the top of their mind. So we’ll make a plan to look for each other on 4th Ave. every day to check in until the day of the appointment,” she says. “I’m hoping to bring what little bit of the clinic I can take with me to where they are.”

In addition to responding to calls and emails, Catherine holds hours twice a week at CCC’s Bud Clark Acute Care Clinic, which treats acute issues as a bridge until patients feel ready to engage with a primary care home. When a patient feels ready, Catherine is there to seize the moment.

“The ability of our patients to access care has improved markedly by having Catherine do her outreach,” says Pat Buckley, a provider who splits her time between Bud Clark Clinic and Old Town Clinic. “She facilitates people who desperately need to get into a primary care environment very quickly. CHOW’s been an amazing adjunct to CCC’s practice.”

“I’m hoping to bring what little bit of the clinic I can take with me to where they are.”

Catherine is aware that the CHOW program won’t result in every person she sees engaging with primary care, but she remains hopeful for each person she meets.

“Of course my goal is to get them excited about primary care, but if I can at least get them to start thinking about it, I’ll take it. I’ll keep trying as hard as I can to help them understand that primary care is a good thing to do, but I’ll always be understanding that there are so many things in the way.”

Until then, Catherine will continue going to where the people who don’t think they’re quite ready for primary care are. An RV one day, an underpass the next, and maybe an ER bed later. All of it is worthwhile as long as the people she meets get closer to setting foot inside Old Town Clinic.



NHCW 2017: Breaking down the walls between housing & health

Aug 15, 2017

While he waited for his name to rise to the top of the Central City Concern housing wait list, Glenn O. lived out of his van in northwest Portland. As he walked back to where he had last parked, he found his van stolen. Gone. And with it, all his possessions, including his dentures.

Not long after, he moved into CCC housing. But even with a roof over his head, his troubles weren’t over. The doctor he had begun seeing wanted him to eat healthier, but without dentures, the list of foods he could eat was short. What he could eat, and how he ate them, led to intestinal problems and months of feeling sick and uncomfortable.

He called his insurance to see if they would cover new dentures. After all, they were stolen, not carelessly lost. They said that they could only cover new dentures once every 10 years. He’d only had his dentures for three.

Glenn went back to gumming his food, feeling unhealthy, and going against his doctor’s orders.

• • •

Moving into Central City Concern permanent housing is often reason enough for our new residents to feel good about their trajectory. The assurance of having a roof over one’s head feels like a giant step forward toward something better. Indeed, we know that having housing is one of the most significant determinants of health, so becoming a resident of CCC housing is definitely an occasion to cheer.

However, being housed isn’t a guarantee that better health is on the horizon. Even for residents of CCC housing, especially those with more complex health care needs, successfully engaging with CCC’s health care services—or any health care services, for that matter—can feel like a world away. The connection between housing and health care is crucial: how well a resident's health needs are met is tied closely to a resident’s likelihood of successfully staying in housing, says Dana Schultz, Central City Concern’s Permanent Supportive Housing Manager.

Though CCC provides both housing and health care, the nature of the programs, as well as privacy considerations, have traditionally made it difficult to share information between the two areas of service. But where Dana saw walls, she also saw an opportunity. The situation called for a way to put teeth behind a core belief that housing is health. That way? A program called Housed and Healthy (H+H).

"Our supportive housing program realized that we can’t distance ourselves from our residents’ health—it’s everything to them and it’s everything to us."

“We started Housed and Healthy as an initiative to better support our residents’ health by engaging with them where they are: in our housing,” Dana says. “Our supportive housing program realized that we can’t distance ourselves from our residents’ health—it’s everything to them and it’s everything to us.”

The Housed and Healthy program serves to improve the connection between health clinics—be it CCC’s own Old Town Clinic and Old Town Recovery Center or other community providers—and CCC’s supportive housing program, and vice versa. Since H+H started, all new residents of CCC’s permanent housing are given a health assessment so that staff can gain a fuller picture of the new tenant. They are asked about their health insurance status, any chronic health conditions they may be dealing with, and who, if anyone, their primary care provider is.

Perhaps most importantly, new residents are asked to sign a release of information, which unlocks the line of communication between CCC’s housing and health service programs.

“Once the two program areas can start talking, we can immediately map out a web of support,” says Dana. “Our clinic can flag the resident’s electronic health record to show that they live in our housing and note who their resident service coordinator is in case they need their help reaching out to a patient. In turn, our resident service coordinators can know which providers and clinics their tenants are connected to in case health issues arise.”

Housed and Healthy represents a big shift in the way supportive housing sees its role in the well-being of its residents. Housing staff are integral to extending health care out from the clinic setting into where their patients live.

The health assessment can also help H+H coordinators identify potential issues—related to their physical or mental health, or to substance use disorder—that, if unaddressed, could result in a resident losing their housing because of violations that put the safety and peace of the rest of the housing community at risk.

“In the past, we’ve seen people not succeed in our housing for reasons that, in retrospect, were preventable,” she says. “If we know what to look out for and the team of support people we can coordinate with, we can put out fires before they really burn down a person’s entire life.”

Housed and Healthy represents a big shift in the way supportive housing sees its role in the well-being of its residents. Housing staff are integral to extending health care out from the clinic setting into where their patients live. H+H even brings opportunities for health education, such as chronic pain workshops and classes like Cooking Matters, straight to residents. In doing so, the chances that patients continue to have a place to live increase.

Glenn, who had seen Dana in his building frequently as part of her work as the H+H Coordinator, approached her about his denture problem. His issues didn’t put him at high risk of losing his housing yet, but he wanted to follow his doctor’s eating advice. He was, after all, nearly three years sober, and he wanted to continue feeling healthier.

She promised him that she’d look into it. She consulted with Glenn’s Old Town Clinic care team. She researched resources and made countless phone calls. Several weeks later, she gave Glenn the best news he’d received since learning that he had his own CCC apartment: she found a city program that would cover nearly the entire cost of new dentures.

“Dana did all the work I didn’t know how to do. The questions she asked me sounded like she knew a lot about what I needed,” Glenn says. “Now that I have dentures again, oh yeah, I feel healthier now. I’m so grateful to her.”

While Housed and Healthy is ostensibly a housing program, it functions as a way to not only expose residents to the many ways to better health, but as a de facto arm of health services that can reach into where their patients live. Gaps in care get caught and filled; residents are supported in better utilizing health care services; and people like Glenn find trustworthy faces to bring health-related concerns.

“Our housing staff want to see our residents healthier; health care providers want to see their patients housed,” Dana says. “It just makes sense.”



NHCW 2017: A clean safe resting place with a dedicated staff

Aug 14, 2017

Central City Concern’s Sobering Station for people incapacitated by alcohol or drugs might not sound like an uplifting place, but there is plenty to love about it. “My favorite part is getting to know people and hearing their stories,” says Amanda Guevara, program director. She has worked for CCC for 11 years and is dedicated to helping people in the community.

“We have return visitors,” she says, “and when they decide to make a change, we can be a part of it.”

Sobering visitors range from repeat visitors to weekend warriors.... Last year, the CHIERS van conducted 1,128 street assessments, and 3,757 people were admitted into sobering.

The Sobering Station in inner-southeast Portland takes people who need a safe place to come down from drinking too much alcohol or taking too many drugs. The Portland Police Bureau or community members refer people in need. The Central City Concern Hooper Inebriate Emergency Response Service (CHIERS) van picks people up and transports them to the Sobering Station where they receive an assessment from a medical professional. Anyone can call for the CHIERS van (503-238-8132, 1:45-11:45 pm) to pick up someone on the street who is incapacitated, and the van also roams the streets looking for people who may need help.

Sobering visitors range from repeat visitors to weekend warriors. PDX airport often calls for travelers who have had too much to drink, and Portland police refer people who have not done anything illegal, but need a safe place to sober up. Last year, the CHIERS van conducted 1,128 street assessments, and 3,757 people were admitted into sobering. 

Once someone is admitted into sobering, they get a medical assessment, a clean place to rest and referral to additional resources. But mostly, they receive a level of caring that only a dedicated staff can provide.

“I like knowing there is a population we help and know best,” says Kevin Smith, Sobering Station supervisor. “They know us—these are our people.” Kevin says he likes being able to offer resources and problem solve for people. The Sobering Station staff sometimes washes visitors’ clothes, provide hygiene kits and shoes, and even cut hair and apply lice treatments. “We see some people regularly,” says Kevin, who has worked for CCC for seven years. “We know what they need.”

“We’re here for people who may have burned bridges. We’re here for people who have nowhere else to go.”

The Sobering Station also does anything it can to serve the community at the street level. In the summer, the CHIERS van staff passes out water and sunscreen; in winter, hats, gloves and hot soup. On extremely bitter nights, volunteer crews make the rounds after hours and give people rides to shelters. The Sobering Station building sometimes opens as a warming shelter. In Sept. 2017, CCC will unveil a new CHIERS van with updated features that will ensure safe and comfortable transport for people going to the Sobering Station.

“We’re here for people who may have burned bridges,” says Amanda. “We’re here for people who have nowhere else to go.”

• • •

Download a card as a handy reminder of how to contact the CHIERS van in case you see someone in need.