Monthly Volunteer Spotlight: January 2017 Edition

Jan 31, 2017

Our first Volunteer Spotlight of 2017 highlights the unique role of Dr. John Bishop, a clinician who has chosen to spend time in Old Town Clinic’s Wound Care Clinic. As the Wound Care Clinic program is in its relative infancy, our lead practitioner, Pat Buckley, had this to say about Dr. Bishop’s contributions:

“Having his expertise as we were developing the program was extremely beneficial because it really helped us ramp up the quality of care more quickly than we otherwise would have been able to… He’s the bomb.”

If you’d like to learn more about Old Town Clinic’s Wound Care program we recommend you check out the National Health Care for the Homeless’s Healing Hands newsletter, where they highlight this young, yet valuable, Old Town Clinic service. In the meantime, take a look below to find out both what distinctive challenges Dr. Bishop encounters while at Old Town Clinic, but also what makes the care process so rewarding to him.

• • •

Name and Volunteer Position: John Bishop, provider in the Wound Care Clinic of Old Town Clinic.

How long have you been volunteering with us?
About year and a half now; it’s been very positive. It’s a different kind of wound care than I was used to, a different kind of situation, but it’s been very positive. Good, nice, qualified people to work with... pleasant, friendly. I like the patients, too. The patients, for the most part, are very nice.

What made you want to volunteer at Central City Concern?
I decided to be retired. And moving to Oregon from Florida there was no real employment for me, financially, in a semi-retired level. I spent many years learning how to do wound care and I didn’t want to just give up that knowledge overnight. It took a long time to develop what I know and I didn’t want to just throw it away so I figured I could use what I know positively for a few more years. And since I don’t get paid, I’d rather take care of people who can’t pay [Note: All Old Town Clinic patients are on a sliding scale fee.] They need the care and there’s no reason why they shouldn’t get it.

Have there been any surprises at Old Town Clinic so far?
Well, the biggest problem I have here is with continuity of care and follow-up. Part of it is me as I only volunteer but two times a week, but part of it is the patients that don’t come back. That’s probably the biggest disappointment.

Then again, that’s the challenge from which we have to work. That’s what’s different from my civilian or private practice before I got here. That’s just one of those things in the practice of medicine.

Have you tried strategies to combat that?
Well it does direct how we administer our care. We have to prescribe a type of care with the assumption that maybe the patient won’t come back. That way, if they don’t, they’re not going to get themselves into more trouble from the care. My philosophy is to be positive, develop a little relationship with them, and have them feel like I’m expecting them so that they might feel more of an obligation from that. I make sure to say “I will see you next week!” and I hope they think, “If he cares enough to be there to look for me I ought to show up.” I don’t know if that’s how it works but that’s my goal.

I like doing wound care, I like taking care of people, and I like seeing wounds get well. It’s a very satisfying thing to start off with a mess and then see the patient eventually walk out and to tell them, “Don’t come back, you’re all done!" And along the way, since many wounds are chronic, there’s a big effort to teach the patient how to take care of it themselves so that they won’t have to come back. I don’t know how successful I am with that but it’s always been my guiding light in wound care. It’s  "Okay, this is what I want to do; if it happens again, this is what you can do for yourself.”

Having practiced medicine at Old Town Clinic, if somebody were on the fence about volunteering here is there anything you would want them to know?
Well I think the volunteering business is pretty nice. The state of Oregon has their physician emeritus program that kind of gives you liability coverage and allows you to practice and keep your skills alive. It lets you use the skills you already have and I think more physicians ought to consider that.

• • •

If you are a licensed practitioner interested in volunteering time with Portland’s vulnerable populations, we recommend checking out the Coalition for Community Health Clinics, a community and care-driven collaborative (of which Old Town Clinic is a partner).

For any other Central City Concern volunteer inquiries, please visit our volunteer webpage.



Medicaid Waiver Extension is Good News for Central City Concern

Jan 13, 2017

On Friday, Jan. 13, Governor Brown announced the federal government extended Oregon’s Medicaid Demonstration Waiver for another five years, effective immediately to run through June 2022.

“This is great news for Central City Concern,” said Executive Director Ed Blackburn. “As a health care provider serving people with very low incomes or experiencing homelessness, we have many patients who are highly dependent on Medicaid to access medical, mental health, and substance use disorder treatment.”

In 2013, the year before Medicaid expansion in Oregon, 47 percent of CCC’s patients were uninsured; two years later in 2015, only 11 percent of CCC’s patients lacked health insurance coverage. This expansion of Medicaid coverage improved CCC patients' access to needed care as well as enabling CCC to offer a more intensive care model that responds appropriately to the needs of these high-risk populations. Without Medicaid expansion, CCC could lose the capacity to serve as many as 2,000 homeless and very low-income patients.

“We treat every patient as an individual,” said Blackburn, “and many of those individuals rely on the Oregon Health Plan to access desperately needed services. Lisa G. is just one example of the many people who need this support and benefited from Oregon’s Medicaid expansion here at CCC.”

Lisa G. was terrified of losing her health insurance. Before Medicaid expansion, the Oregon Health Plan denied her coverage three times. “It’s something I think about all the time. Without the Oregon Health Plan,” Lisa said, “I just don’t know where I’d be.”

Lisa, 23, used drugs such as heroin and methamphetamine for five years. She also struggled with bipolar disorder, which further complicated her ability to stop using drugs. She tried quitting with no luck, until eight months ago when she accessed recovery support services through CCC. In Lisa’s case, medication assisted treatment helped her tackle her opioid addiction, so she could then focus on her severe bipolar disorder and other medical issues at CCC’s Old Town Clinic.

Lisa now lives in supportive alcohol and drug-free recovery housing and works in CCC’s On-Call Staffing program. She hopes one day to become a peer mentor and help others to overcome their opioid addiction. Without Medicaid expansion, Lisa wouldn’t have had access to critical recovery services that led to integrated health care, housing and employment services.

“Medicaid not only supports these individuals in their health and well-being,” said Blackburn, “but also leverages other resources such as housing and employment, further enhancing the health and well-being of our entire community. Though there are uncertainties about health care on the national scene, we’re tremendously relieved Oregon’s Medicaid Waiver will continue for five more years.”

CCC is a large non-profit organization, founded in 1979 in Portland, OR, that serves people experiencing or vulnerable to homelessness by providing health care and recovery services, housing, and employment services. In the last year, CCC helped more than 13,000 people, most through our 11 Federally Qualified Health Center (FQHC) sites that offer integrated behavioral health and primary care. For more information, visit centralcityconcern.org.