Positive response: Central City Concern’s Crisis Team

Oct 27, 2016

About five years ago, Central City Concern leadership wanted to provide the best assistance to clients in need, but was equally concerned about the emotional toll on staff members responding to crisis. Our mission is based on finding the positive in every person and situation. But because we are a large organization serving many people, things happen. Our staff—often alone and unprepared—had to deal with intense situations involving distressed, and sometimes traumatized, people.

In 2012, CCC’s Director of Equity and Inclusion Sonja Ervin looked for a better way to respond to incidents that protected clients and staff. “How do you support people and make them feel safe?” she wondered. She proposed a new Crisis Team model, which consists of “primary” contacts who carry the crisis phone for a week at a time, 24/7. There is also a “secondary” supervisor to support the primary contact and go on scene with them in cases of physical and emotional trauma. Crisis Team responders, usually six to eight people rotating through a year, come from across the agency’s housing, employment and health care programs. It is a paid on-call position that is above and beyond their regular jobs.

“It’s really meaningful work,” says Freda Ceaser, CCC’s Employment Access Center director, who has been on the Crisis Team close to three years. “It can be hard, but I feel completely supported by CCC.” Most of the crises, such as elevator problems, water issues and minor disturbances, can be handled over the phone. But sadly, physical and emotional traumas, including deaths, are among the crises that the team responds to in person. But the crisis responders always arrive together to support each other and everyone else who has been affected by the event.

Since it began, the Crisis Team responders, now led by Dana Brandon, CCC’s director of Supportive Housing, have answered the call to hundreds of incidents, large and small, at all hours of the day and night. Their only goal is to help people get through it. “The Crisis Team is peer support, peer driven, and they have no other agenda than to be there,” Sonja says. “They really do it from the heart.”



Monthly Volunteer Spotlight: October 2016 Edition

Oct 25, 2016

In breaking the mold from our typical Q&A-style monthly volunteer spotlights, this October we wanted to bring a narrative regarding the transformational, sustainable, and invaluable work of Central City Concern's longest-tenured volunteer, Annette. Read below to hear from current and former staff members, and Annette herself, about the amazing impact her time has had on Old Town Clinic and those they serve.

• • •

Central City Concern serves individuals who suffer from homelessness or low incomes through diverse programming focused on housing, health care and employment. Within one of our Federally Qualified Health Center sites, Old Town Clinic, lies the CCC Pharmacy which serves “the uninsured as well as those who have a hard time negotiating the outside world,” as put by CCC’s former Head Pharmacist, Sandy Anderson. It is here that CCC has benefited from the amazing service of Annette Moreau, a volunteer whose time and commitment to Old Town Clinic predates the pharmacy itself.

Annette began her time at OTC as a volunteer registered nurse in 1992 and soon shifted her focus from rooming patients and drawing blood to organizing the in-house medicine closet that was “just a mess” as she recalls. Creating a sustainable organization to the med closet, Annette inserted herself as the initial point-person for tracking any donated incoming medications, medication expiration dates, patient prescriptions and use, and a script system implementation. Thanks to Annette’s diligence the prescribing physicians at OTC were able to more efficiently track and access needed medications, allowing them to spend more time with their patients and less time digging around the med closet.

“Basically, my portion was to help out in any way I could as a volunteer,” describes Annette. “I just see myself as a cog in the big wheel that is giving the patients what they need as far as medications because many of these patients would not be able to afford them at an outside pharmacy.”

When one has a mental illness diagnosis, suffers from chronic back or joint pain, or needs assistance dealing with an ongoing condition such as diabetes, even the simplest of responsibilities may seem daunting. The most basic interactions can take an extraordinary amount of effort and regular tasks, such as visiting the doctor or pharmacy, can quickly overwhelm.

It is in these situations that Annette’s professional background as a registered nurse shines through. Kristine Palo, a CCC pharmacy technician, states that Annette’s earnest nature “just creates a lot of trust between the pharmacy and the patients; she’s definitely helped out with that.”

And adds Sandy, “A lot of [our patients] she knows either by name or by face.” In a clinic where the patient-practitioner relationship is truly vital for positive outcomes, Annette’s openness and encouragement oftentimes serve as a conduit for client success.

Annette’s 24-year impact at Old Town Clinic also extends to CCC’s staff members. “For the first time I was able to really learn about relating nursing with pharmacy,” expands Sandy. Annette’s time, composure, and consummate professionalism “really strengthened the inter-professional relationships between RNs and pharmacists and technicians. She taught us how to relate to RNs.”

In a clinic where more than 5,700 unduplicated patients are seen on an annual basis, strong staff cohesion across departments is tantamount to successful health outcomes. By exemplifying how healthily and productively RNs can partner with pharmacy professionals, Annette’s knowledge base, compassion, and charisma, in their own way, have led to better care for those OTC serves no matter the diagnosis, pain level, or condition.

In August 2012, after Annette had been volunteering with Old Town Clinic for 20 years, she had a minor setback. As Sandy Anderson describes:

“Annette was volunteering one day and I thought she had a heart attack! She just went to the floor and I thought, ‘Oh my gosh she’s had a heart attack!’ So I went and got Todd [a clinic physician] and we were asking her ‘Can you move? Can you move?’ and Annette is saying, ‘No! I can’t move, I can’t move! I hurt, I hurt!’”

As it turns out, Annette had been taking a medication that had slowly dissolved the bone tissue in her femur. On that fateful day Annette had actually shattered her femur while performing her regular volunteer duties.

But little could a broken femur and two surgeries keep Annette away from her volunteer shifts at Old Town Clinic. “She was using a walker for a little bit but she came right back as soon as she could,” says Kristine.

“Her dedication to us is just amazing,” reiterates Sandy, as Annette was back in the pharmacy by December of that same fall to help with whatever administrative tasks she could.

The CCC Pharmacy fills over 14,000 prescriptions each month for those who are either homeless or living on low incomes. There are now eight full time pharmacists and a bevy of pharmacy technicians, interns, and volunteers ensuring that those prescriptions are organized, handled, and distributed so that their patients don’t have to live in chronic pain and suffering while also navigating an oftentimes intimidating world to those who may be down on their luck. Before any of this growth—including a new state-of-the-art bubble-wrapping machine, insurance billing, and the current modern building—there was Annette.

Annette’s realization of the potential for growth and change at Old Town Clinic and within the pharmacy has made a true community impact that continues each day. What was once an afterthought—the medicine closet that Annette first began organizing and managing 24 years ago—now allows Old Town Clinic, and Central City Concern as a whole, to provide better services to more individuals in need. Without Annette, it is difficult to think such an impact would have been made.

• • •

If you are interested in learning more about volunteer positions in at Central City Concern’s health and recovery, housing, or employment programs contact Eric Reynolds, CCC’s Volunteer Manager, at eric.reynolds@ccconcern.org or visit our volunteer webpage.



CCC Outreach Workers Fill Gaps in Health Care

Oct 21, 2016

On Monday, PBS Newhour aired a fascinating and insightful segment on the rise of utilizing community health workers—already popular in other parts of the world like Sub-Saharan Africa—to better serve vulnerable and hard-to-reach patients. (You can watch the video above or on the PBS website.) As the segment makes clear, community health workers play a vital role in helping patients improve their health.

At Central City Concern, a number of our specialized health care programs rely on Outreach Workers to engage those we serve in direct, meaningful ways that truly exemplify our commitment to meeting patients where they are.

The Community Health Outreach Workers (CHOW) team works to bring individuals who are newly enrolled in the Oregon Health Plan (Oregon’s state Medicaid program) into our Primary Care Home, where patients can find barrier-free access, team-based care, integrated mental health and addiction treatment, and additional wellness resources. They’ve also been working with the care teams at Old Town Recovery Center, CCC’s mental health clinic, to help their clients get connected with primary care.

CHOW team members may meet people on the street, at shelters or hospitals, or in their own homes, and often check in with patients to ensure that they are engaged comfortably into the care available to them.

Members of the CCC Health Improvement Projects (CHIPs) team, also known as our Health Resilience Specialists, are embedded in the four main care teams at CCC’s Old Town Clinic (OTC). CHIPs team member work closely with OTC patients (what we call “high touch” support) who have shown a high rate of hospital emergency utilization, helping them decrease unnecessary hospital use by providing intensive case management and addressing social determinants of health. CHIPs team members meet patients at home, on the street, in the hospital, or wherever else the patient needs engagement to happen most.

For those already living in our housing, CCC’s Housed + Healthy team provides a direct pipeline from housing to CCC health care. By performing a needs assessment with new residents as they move into their CCC home, the Housed + Healthy team can identify high needs residents who have gaps in their health care support. The Housed + Healthy team can streamline the referral processes to connect residents to care and even increase coordination between service providers. Further, our Housed + Healthy team provides on-site wellness education programming to encourage healthy living.

The work and impact of Outreach Workers are so important that they can be found beyond the three teams we highlighted here; programs like CCC's Bud Clark Clinic, among others, also lean on Outreach Workers to build relationships with those who are vulnerable in order to connect them with basic health care and services.

The flexibility of CCC’s Outreach Workers allows them to bring care and compassion to our patients. Maintaining and improving health outcomes takes work outside clinic walls, and our Outreach Workers are there to walk that journey with those we serve!



Six health care organizations partner with CCC

Oct 11, 2016

We are so excited about our new collaboration with six Oregon healthcare organizations that was announced on September 23. Adventist Health, CareOregon, Kaiser Permanente, Legacy Health, OHSU and Providence Health & Services are joining together to invest $21.5 million in a unique partnership to respond to Portland’s urgent challenges in affordable housing, homelessness and healthcare. This unprecedented collaboration has gained national attention.

The investment will support 382 new housing units across three locations, including one with an integrated health center in Southeast Portland.

Governor Kate Brown said, "This project reflects what we've known for a long time -- health begins where we live, learn, work, and play. Stable, affordable housing and health care access are so often intertwined, and I’m gratified to see collaborative solutions coming from some of our state’s leading organizations. I applaud the efforts of all those involved and am grateful for the partnership in moving Oregon forward and making ours a home where each Oregonian thrives."

"It’s exciting that health care providers recognize the deep connection between housing and health care," said Multnomah County Chair Deborah Kafoury. "This is exactly the kind of collaboration that our community needs during this housing crisis. None of us can solve homelessness alone. But this collaboration will change hundreds of lives at a critical time of need."

Eastside Health Center will serve medically fragile people and people in recovery from addictions and mental illness with a first-floor clinic and housing for 176 people. The center will also become the new home for an existing Central City Concern program, Eastside Concern, and will offer 24-hour medical staffing on one floor.

Stark Street Apartments in East Portland will provide 155 units of workforce housing.

Interstate Apartments in North Portland will provide 51 units designed for families. It is part of Portland’s North/Northeast Neighborhood Housing Strategy to help displaced residents return to their neighborhood.

This significant contribution is an excellent example of healthcare organizations coming together for the common good of our community. It also represents a transformational recognition that housing for lower income working people, including those that have experienced homelessness, is critical to the improvement of health outcomes. This housing will remain affordable for generations and it couldn’t come at a better time.

"Health and home go hand-in-hand," said Nan Roman, President and CEO of the National Alliance to End Homelessness. "This is a breakthrough collaboration with the health care community and a partnership that has the potential to change the landscape of how we can end homelessness in this country."

Though the health care organizations' contributions are significant, CCC will finance the remainder of the costs, about $37 million, through tax credits, loans and fundraising. Our upcoming capital campaign is an opportunity for everyone to contribute to this project.

• • •

About Housing is Health: The Housing is Health network supports innovative approaches to housing and healthcare in the Portland region.

Learn more at www.centralcityconcern.org/announcement and join the conversation on social media at #HousingisHealth.

See photos from the press conference.

News articles:

- New York Times (AP)
- The Oregonian
- KGW
- OPB