A View from the Edge of the Mat

Apr 28, 2017

As you’ve seen by this week’s previous pieces, Living Yoga has truly ingrained themselves in Central City Concern programming. Luckily, it sounds like our class participants have endeared themselves to their teachers, as well.

“This was my first real experience of volunteering and I am so grateful for the opportunity that Living Yoga and CCC gave me to teach yoga to some of the most engaging and committed class participants,” shared a volunteer instructor, Diane, who teaches classes at Old Town Clinic. On several occasions, she’s shared that her “weekly yoga volunteer hour is the best hour of my whole week.”

With that warmth and positivity, and in the spirit of collaboration, volunteerism, and serving those who have so much to share, we wanted to finish our National Volunteer Week celebration with a piece from Laura Walsh. One of the very first Living Yoga volunteer instructors to give her time to Central City Concern—she started at Old Town Clinic some nine years ago!—Laura’s experience, wisdom, and beautiful writing seemed like the perfect way to conclude an amazing week.

Thank you, volunteers, for helping Central City Concern do more and do better with compassion, kindness, and an inspirational sense of service.

• • •

There’s a little story about some yogis sitting at the edge of a lake in meditation. All of a sudden, one of them jumps up and runs across the lake and comes back with a shawl, puts it on, and resumes a sitting posture. A little while later, another one of the group runs across the lake and whispers she needed to check on the soup for dinner. Well, after a bit more time goes by, a more recent member stands up and says, “Ahem… seems I forgot my mala beads.” He heads out to edge of the lake, takes a running start, and quickly becomes completely wet—splashing and struggling for footing before making his way to shore again. This scenario was repeated a couple of more times before the first yogi turns to the second and asks, “Do you suppose we might tell him where the rocks are in the lake?”

A chuckle, maybe? Some recognition of one time or another continuing to use the same unskillful ways to “reach” or gain solid ground—getting a proverbial “soaking” in the process? While there are several images or metaphors to illustrate “the way” or “path,” it essentially does come back to “the journey,” yes?

In this little vignette there is the sense that each person’s intention is to travel to the other side. The teaching rests in each person finding his or her own way. For one, it may mean paying attention to how others negotiate an obstacle and what skills are needed; another may ask questions and explore the conditions of the lake; someone might walk around while another could build a raft; one possibly could find a friend with a boat or even begin an active swimming regimen. Could a map, compass, or even a guide be of help?

The yoga of “IT” is in discovering how to honor one’s circumstances and nature with a practice to live in the “ground” of life’s circumstances—the union of all in and around “the lake.” A quote from Carl Rogers, “The curious paradox is that when I accept myself just as I am, then I can change,” brings us again to the image of the lake.

What I have experienced in my years sharing yoga at Old Town Clinic is that there is a readiness of participants to begin the sitting and the process of travel. There is a place for each person to symbolically look into the surface of the water for a reflection of how things are at that present time. There is a quality of movement within a contained landscape. Old Town Clinic continues to provide the opportunity for offering an environment where people are supported to engage in their proverbial lakeside experience—yoga is one of the elements that assist in safe and also challenging passage.

That there is a willingness to roll out the mat and take one’s seat is one of the most courageous and affirming acts in yoga. When we begin class, yogis are reminded of the principle, ahimsa, which translates as “non-harming.” One is reminded to offer kindness and respect and to bring a gentleness to the current state of body and mind. When we link breath awareness to movement or into stillness there is a space to notice what may be present and alive and asking for attention in that moment—to do or not do…. to sit at the edge of the “lake” or to enter into the “flow” of movement.

I am ever so grateful to be a part of this community and value the time spent with the ever-positive, present, and insightful Old Town Clinic staff ally, Moira. Over the years there have been people coming to yoga as part of a treatment program or a wellness regimen, to explore calming and regulating practices, or even for a place to rest. There has been a consistent member of our yoga collective who I offer deep gratitude for his brilliance, wisdom, discernment, and generosity of spirit. He gives expression to how yoga aligns one in well-being off the mat and into the world.

To those new to the practice, to those who are curious, and to some who find it not useful or of interest… thanks for showing up and for “getting the toes wet.” Maybe some will come back or may find interest in another discipline which offers healthful benefits… or maybe not, too. All who have come to my classes, however, have been such good sports!

For your trust and good-natured spirits to try, to modify, to be patient or curious, to stay with, to be with, and to allow for or to witness—I celebrate you. I thank you. I feel touched by the quality of intimate space created by sharing breath, time, and effort together.

So, at the edge of the lake… sharing a few lines from a noted author and activist, Wendell Berry, and then “jumping” in!

Expect the end of the world. Laugh.
Laughter is immeasurable. Be joyful though
you have considered all the facts.

Namaste



"Let all beings everywhere be happy and free"

Apr 26, 2017

Moira Ryan, Central City Concern Old Town Clinic’s Wellness Services Coordinator, works with a number of volunteers, and she witnesses firsthand what Living Yoga volunteer instructors bring to the patients of our community health clinic. In this latest National Volunteer Week blog post, Moira reflects on the many ways our Living Yoga volunteers meet our diverse patients where they are and embody the compassion, empathy, and kindness that we see across all CCC volunteers.

• • •

Starting any movement or exercise practice can be so intimidating, especially for folks dealing with limited mobility, social anxiety, chronic pain, body shame, or an institutionalized mind-set. Walking into a practice like yoga can be even more stressful—“I don’t know the right words, I’ve seen yogis on TV and I know I can’t do yoga the right way,” etc.

One of the many things that I love about Living Yoga (LY) instructors is their gentle encouragement. The teachers don’t single folks out or shame modifications, but instead take the temperature of the room and offer safe options for every body. Just as important, LY teachers don’t assume that people in wheelchairs can’t test themselves, and don’t fragilize folks out of trying new postures. This mix of gentleness and encouragement the volunteers practice allows our clients to feel they have permission to try as well as permission to let themselves guide their practice. Having permission to practice being yourself in this way, and in a room full of people, is so important.

After Gentle Yoga groups, people report feeling stronger, clearer, and better about themselves. Some do leave frustrated with themselves, but many come back to try again. I’ve seen one client practice twice a week for the last year move gradually out of her wheelchair and onto the mat. She uses a chair when she needs one, and more and more, she doesn’t. Two months ago, she successfully worked her body into a beautiful Downward Dog and held that pose for over a minute. She was so happy, so pleased with herself. When new people come in and talk about “not doing it right,” she often interrupts the instructor to let the new person know that that’s ok: “We do what we can. And we’re doing it. You’re doing great.”

LY teachers typically let our classes know how yoga has worked for themselves. They talk about their own anxiety, injuries, or recovery stories, and I think this transparency makes our groups feel less didactic and more individualized and exploratory. Group members often tell me how much they enjoy the different kinds of yoga practice they learn from various teachers. One brings in harmoniums and teaches us chants ("Let all beings everywhere be happy and free" is a favorite). One offers a quieter, more internal practice. One laughs a lot, and makes us work our hamstrings like crazy. One focuses more on balance and talks about aging. One always helps us with some really yummy neck stretches. All are unique models of some different ways to practice, helping clients move away from “shoulds" and toward finding their own yoga.

Aside from the physical practice, I know that offering folks a safe, routine, short practice of meditation has been hugely helpful. It can be really tough to walk into a 30-90 minute meditation group, but not so hard to try meditation for a few minutes at the end of a yoga group. People talk about feeling more open and more peaceful because of the minutes we spend in our final relaxation pose.

Gentle Yoga has been for years one of our most successful offerings. We’ve tried other movement modalities—gentle dance, walking, etc.—but none have caught on like the classes Living Yoga offers.

I really want to thank the behinds-the-scenes team for supporting the instructors and managing the schedules and coordinating with all the programs you serve. This includes Eric Reynolds, CCC's fabulous volunteer manager, who's been instrumental in connecting Living Yoga with the Wellness Program and continues to offer ongoing support. I’d also like to thank those who donate to Living Yoga on behalf of OTC clients, for helping us provide yoga to folks who can’t afford or access studio classes.



Seva: The Act of Selfless Service

Apr 25, 2017

As Central City Concern celebrates National Volunteer Week by highlighting our volunteer partnership with Living Yoga, we thought it imperative to hear from them directly. Avery Lewis, Living Yoga’s Events and Communications Manager, was gracious enough to write a guest blog post on the organization’s behalf in which she shares how trauma-informed yoga aligns with the needs of those CCC serves, how Living Yoga’s own volunteers are transformed by their service, and much more.

• • •

In honor of volunteer week, we want to recognize the 130+ volunteers who selflessly dedicate their time and energy to teach trauma-informed yoga at our partner sites every year, including Central City Concern’s Letty Owing Center, Hooper Detox, and Old Town Clinic. At these sites alone, 24 Living Yoga volunteers have practiced yoga with more than 900 students in the past twelve months.

In yoga, some refer to this act of selfless service as seva. Seva is the Sanskrit word used to describe an action in which we selflessly give of ourselves to promote the well-being of others. Perhaps the most beautiful thing about seva is that, more often than not, the one serving and the one served both benefit. This is something Living Yoga volunteers experience time and time again when working with students at our partner sites.

Greg, who teaches weekly at Hooper Detox, says, “My experience at Hooper has helped me grow and connect not only as a yoga teacher, but also as a human. I am always impressed by the attitudes of the students and staff—I love their authenticity and gratitude. I feel invited to causally express myself in my teaching, just as I invite the students to do so through their breath and movement. I have fun when I teach yoga at Hooper, and the students appear to enjoy themselves as well. Their occasional contributions of light-hearted banter, sighs of relief, and brief anecdotes help create a relaxed and comfortable atmosphere.”

Living Yoga’s partnership with Central City Concern over the past nine years has played an integral role in the healing process and resiliency of our students. By offering trauma-informed yoga classes, students learn to create positive change from the inside out. Trauma-informed yoga acknowledges that trauma can cause individuals to feel unsafe and disconnected from their bodies. Practicing trauma-informed yoga allows the individual to reconnect with their body, increase self-knowledge, and create a safe place within themselves. It’s a powerful tool for recovery and for life in general.

Through the practice of yoga, students gain valuable skills that support their ability to realize their full potential. Students find themselves using these skills outside the classroom, contributing to their own long term well-being and to the health and well-being of the communities in which they live. Jillian, a Living Yoga volunteer teacher at Letty Owings Center, reported, “Another great class! Again these women are so open and ready for yoga. We talked a little about the classes they’ve done so far—one woman said she couldn’t sleep the other night so she got out of bed and did yoga to relax! It’s like textbook Living Yoga—awesome! It is really landing with them, and it feels so great to be part of their yoga journey.” 

Yoga is such a deeply transformational practice to share with someone. It promotes self-love, self-respect, forgiveness, healing, confidence, and growth. It teaches us compassion and how to communicate with heart and intention. And it has a ripple effect! When we realize the inherent goodness inside of ourselves, we learn to act and interact from that place with others. We learn that we are more than our worst behaviors.

For the volunteer teachers at Living Yoga, it is clear that the sharing of this experience through yoga is as satisfying, if not more so, as the practice of yoga itself.



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.



Monthly Volunteer Spotlight: December 2016 Edition

Dec 22, 2016

Old Town Clinic’s Wellness Program offers a variety of classes and activities to further patient care, healing, and connectedness within the Central City Concern community. This month we wanted to emphasize the outstanding work of Jeff Beers, an art therapy volunteer who Program Manager Moira Ryan refers to as “a co-conspirator toward the Wellness Program’s aim of encouraging self-acceptance while building community.”

In fact, when approached about Jeff’s wonderful service being the spotlight for December, Moira jumped at the opportunity to provide a glance into her work and experience with Jeff:

San Francisco-based artist Jeff Beers has years of experience working with diverse populations as an arts educator. Jeff joined us in July and has been a fantastic peer volunteer and co-facilitator of several Wellness groups. In our Art for Everybody and Art Journaling groups, he’s brought a more tactile experience of art-making as we practice trying out working with oils, inks, powder tempera, collage, collagraphy, and even found items! He draws upon his experience as a self-taught artist and encourages mistake-making, regularly reminding folks that we have permission to practice not being perfect here. Additionally, drawing from his experience as a certified instructor of Thai Massage, he’s developed curricula for a group we’re calling Eastern Techniques for Health and Longevity. In that group, we draw on trauma-informed somatic experiencing precepts as we explore tapping, brushing, acupressure, stretching, and other acts of gentle self-love.

With Moira’s enlightening recap of Jeff’s involvement, read below to hear his own words about how he utilizes personal experience with a desire to help others through one of his greatest passions—art!

• • •

Name and Volunteer Position: My name is Jeff Beers and my volunteer positions are for Art for Everybody on Mondays, and then on Wednesdays we do table-top Games and then I lead a group in Eastern Techniques for Health. On Thursdays I do ceramics and the art journaling as well.

So a pretty wide array of activities. What’s your background?
My background is in art for the most part; that’s what I do. Every year I choose an organization I want to volunteer for. Money comes very low on my priorities so I feel like it’s a way I can give back since I can’t give back monetarily. So I just find places that I really believe in and then volunteer. I get to pay it back and do what I love.

How have you been able to use those skill sets to connect specifically with those that CCC serves?
Well, I really like the clients. I have a lot of admiration for them because I know that they’re struggling with one thing or another and I just admire their efforts to reach out for help and be there. A lot of the groups, they vary in sizes, but it’s just cool to see the people regularly and to be a part of their lives. And just to contribute whatever I can, which would be a positive attitude, and some skill sets, but mostly just showing these people my admiration for what they’re doing.

And I want to make it worth their time too. I always feel conscious that if people make the effort to be in the class or in the group it should be worth their while. I keep that in mind and try to get a lot of feedback from the people and just tune-in to what they’re interested in; that’s been a lot of fun.

Have you had any cool projects that have been more successful or well-received that stick out?
Yeah! In Art for Everybody on Mondays I’ve been having a lot of fun introducing different techniques to the clients and they’re usually always interested in at least trying it out which is great. They find their voice and the right materials they want to work with. Then all of a sudden they become artists. Before they were always saying, “I’m not an artist, I’m not an artist,” and that’s hard for me to hear, so I like to bring them forward and show them what they can find in themselves.

And then the Eastern Techniques Class, that’s been a blast. Although it takes more preparation for me to package and present all of these techniques I’ve learned through the years, it’s been a lot of fun. I ask the clients for a lot of feedback and they’re usually pretty forthright about just coming up with critiques so it’s been fun to constantly let that group grow in that way.

Do you feel like the activities are a good fit for CCC and the Wellness Program?
Oh, very much so. Your guys’ program is just fantastic. When I was a client I just was blown away by all of the services that were provided under one roof so people didn’t have to go to different parts of the city to receive different services. I thought that was great. Of all of the private insurances I’ve had in the past this was easily, no contest, the most fantastic clinic I’ve ever seen. And so, it was an easy choice to volunteer.

I mean you even have volunteers who work at Old Town Clinic cleaning up things, setting up different things, I think it’s great. I think your program should be like a model for most of the clinics in the United States. It’s a great example of what you can do.

And lastly Jeff: if somebody were on the fence about volunteering with Central City Concern or about getting involved, would you have any advice or words of wisdom for them?
For me, I’ve always had a respect for people no matter what their situation is and I want them to know that. I think it’s a good thing for volunteers to show their genuine respect or admiration and not feel that it’s something out of obligatory need. I’m blown away by some of the people CCC serves and what their stories are that they share. So I think for volunteers in general that would be the most important thing.

And I think that anybody that would find interest or have the time to volunteer at CCC should never have to have any doubt about the value of what they’re bringing.

• • •

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.



Following the Recipe for Health and Community

Dec 20, 2016

''The frittata and the carrot muffins were the favorite thing we made.'' -Stykhead (in red)''I feel more confident that I can leave here with what I learned as we cooked every week.'' -Josh''My favorite thing we made was shepherd's pie. Instead of using a recipe they gave me, I kinda put my own spin on it.'' -Tom (in green)
''The best part was learning, especially how to budget. And you know what? The volunteers… they really, really care. I didn’t think theyd be so personable, but they are. It really touched me.'' -Kristina
Next

Cooking Matters, a partnership between Central City Concern and the Oregon Food Bank, teaches clients the skills and knowledge required for healthy cooking and eating habits. Click on a photo to begin the slideshow.

• • •

On a sunny Wednesday afternoon in November, the kitchen of Central City Concern’s (CCC) Living Room community space filled with sounds most could recognize as busy food preparation. The rhythmic rocking and knocking of a knife, the hollow echo of water falling on aluminum, the unmistakable crinkling of plastic packaging being opened and emptied, and even the overriding din of playful banter—all there.

Behind that noise? Eight people, all participants and soon-to-be graduates of the six-week Cooking Matters program, a partnership between CCC and the Oregon Food Bank. This was their final session as a group, so they were reveling in the chance to put what they’d learned in the weeks prior to good use. And based on that kitchen banter, they were having a blast doing it—together.

Since their first session, participants had gained a soup-to-nuts education on the skills and knowledge required for healthy cooking and eating habits, including following recipes and meal planning, shopping healthily on a budget and maximizing resources, understanding food labels, and even knife skills and food safety. At the end of each class, they received a grocery bag of food with which they could replicate the course they made that day.

According to CCC Health Educator Kerith Hartmann and Population Health Coordinator Linda Nguyen, the Cooking Matters curriculum can help address a number of issues common among Old Town Clinic (OTC) patients: food insecurity, weight gain, hypertension, coronary issues, and diabetes or pre-diabetes.

In fact, OTC primary care providers had been clamoring for a nutritional guidance program for patients for years and Kerith had often recommended Cooking Matters classes hosted by Oregon Food Bank elsewhere in the community. But the idea to bring the class to patients instead of referring patients out became more and more appealing, and soon enough the need was undeniable. “You wouldn’t necessarily think that there would be a cooking class based out of a medical clinic, but it makes so much sense, especially for the people we’re working with,” says Kerith.

With Oregon Food Bank on board to pilot a Cooking Matters class at CCC starting in late spring 2016, it was off to the races to find participants.

Approximately half of the Cooking Matters participants were identified and referred by their OTC primary care providers based on their medical histories and the level of engagement with their care. Because Cooking Matters builds on each week of curriculum, patients who showed an active engagement in their own care would benefit most.

Other participants were recruited through CCC’s Housed+Healthy initiative, which coordinates services between CCC supportive housing services and CCC’s health care programs. The work Housed+Healthy staff members do within the walls of CCC housing allows them to show clients that Cooking Matters is well worth attending, even if that means showing up at their doors prior to a session and walking with them to the Living Room.

“People living in our housing are inherently good candidates to benefit from Cooking Matters,” says Permanent Housing Manager, Dana Schultz. “They’re living in low-income housing, so they have budget restrictions and limited cooking resources. On average, people living in our housing are about 59 years old, which is when you see a prevalence of chronic conditions that can be managed through diet.”

Dana adds, “Plus, people who live in low-income housing have to be proactive about combating social isolation daily.”

Knowing that, the sounds heard in the Living Room kitchen take on a slightly different meaning. Those aren’t just the clatterings of making a meal. It’s the sound of people—all some combination of vulnerable, unwell, or isolated—coming together as the ingredients of community. Over the course of six weeks, they’ve encountered unfamiliar ingredients, learned new skills, grown in confidence, and broken bread—literally—together. They’re not shy about talking of this community aspect, either.

Tom, a Cooking Matters participant, says, “My favorite thing was being around these people and being able to cook something with different people around and eating together.”

Another participant, Stykhead, says, “The camaraderie here is great. Getting together and thinking of how we can cook better for ourselves. It gives a whole new outlook on how to cook.”

For Josh, Cooking Matters helped her extend community to her home. “I was able to share the food I made with my housemates.”

Though Cooking Matters at CCC has only completed two cohorts, stories of the program’s impact can start filling up a small cookbook. One patient lost enough weight to get a surgery she needed. Another participant loved learning how to make burritos so much that he not only stacked his freezer with them, but also gave them out to friends. Yet another made a lasagna for her neighbors. A few participants who lived in the same building developed a friendship during the program and held potlucks after they graduated.

Kristina, a participant in this latest cohort, says, “I can actually do a prepared meal on a regular basis. Before this preparing meals felt so tedious and hard to do. But now I have a plan in my head and it happens.” She pauses and lifts her chin up proudly. “And my son likes it.”

“I learned a lot as far as being able to buy healthy,” Stykhead shares. “It’s nowhere near as hard as I thought it was.”

Based on the popularity of Cooking Matters, Oregon Food Bank has committed to bringing the program to CCC for three more sessions through 2017. Their partnership, which includes providing additional volunteers, the curriculum, and all of the food used during each class, has been extraordinary, says Kerith.

Incorporating Cooking Matters into CCC helps send clients and patients on a trajectory to a better quality of life, Linda says. Participants have secured housing; with Cooking Matters, they are working their way toward securing health and moving toward overall wellness.

“It’s a joy to watch people’s faces light up when they try a new vegetable they love or even hate. At the end of the day, they get to enjoy a meal with people they like. And having that group of people to do this with compels them to believe that they can make all these skills a part of their daily life.”



Celebrating Transgender Awareness Week

Nov 18, 2016

Nov. 14 – Nov. 20 is Transgender Awareness Week! GLAAD describes this week as a time to “help raise the visibility of transgender and gender non-conforming people, and address the issues the community faces.”

The transgender patients and clients we serve at Central City Concern are a valued part of our vibrant community, but they also face a number of unique barriers. According to CCC Associate Medical Director of Primary Care, Dr. Eowyn Rieke, people who identify as transgender are more likely to have difficulty finding employment and accessing housing. This, of course, increases the chances they become homeless and live in poverty, which is often how they end up as CCC patients.

Roran Everheart, an urgent care medical assistant at our Old Town Clinic, adds, “There is an overriding fear of being outed and ending up on the street. There’s a fear of violence.”

Our mental health providers also see a relationship between people who struggle with questions about their gender identity in isolation, and mental illness and substance use disorders. “Oftentimes we see that someone’s gender identity struggles play such a role in their mental illness that we actually see a relief of symptoms when people can make steps toward living the life that they believe is rightfully theirs,” says Erika Armsbury, Director of Clinical Services at our Old Town Recovery Center. “And the same goes with substance use—we see people who use substances as a means to manage whatever it is they are struggling with around who they are with respect to gender.”

Roran, who identifies as trans, understands some of this firsthand. “I wasn’t able to transition until I got into recovery,” he shares. “Gender identity is so complex. When you’re trying to figure out what your gender identity is, it’s a strain on your mental state. From my own experience, it’s hard for me to imagine how hard it must be for someone who is also homeless, addicted, and also trying to transition.”

These are the very real issues that affect the transgender community we serve; they matter profoundly to us. We also know CCC must continue working to extend the values of equity and inclusion to more and more people. In fact, increasing equity is an explicit part of our organization’s strategic plan.

In that spirit, CCC—particularly our health services—has taken steps over the last year to make our agency is more trans affirming, trans inclusive, and responsive to the experiences of transgender individuals. Staff members formed working groups. They held meetings, brainstormed, and prioritized. They consulted with our own health care consumers and colleagues.

Since that call to action, CCC’s health services have made significant advances to address the unique issues our trans patients and clients experience.

Trainings
Within the past few months, every single CCC staff member across our primary care, mental health care, and substance use disorder programs has gone through a “Trans 101” training to provide an understanding of the basics. The information covered in these trainings was intended to demystify trans issues, as well as to learn how to be an ally and interact with transgender patients in appropriate, sensitive ways.

However, Eowyn emphasizes that this is not about cultural competence; instead, it’s about humility. “Competence implies that we who don’t identify as trans ‘get it.’ Instead, 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.”

Old Town Clinic primary care providers received additional training on the basic medical care of transgender patients. In a separate two-session training, mental health providers at Old Town Recovery Center learned about working with transgender patients during the transition process, as well as their responsibilities related to writing assessment and approval letters for patients hoping to transition.

“We want to be sure out providers are on the same page,” Erika says. “[Providing letters] is something we want to offer our patients consistently, but it’s important for us to improve our larger understanding of trans issues because, for us and our patients, the letter isn’t the ultimate goal, nor is it the end of their journey.”

Providing CCC health staff with information doesn’t just benefit them. It’s also a way to take a common burden off our trans patients. As Roran says, “Having to train your doctor to be trans aware can be so exhausting.” Staff members who are aware of trans patients’ experiences drastically reduces the chances of retraumatizing patients with insensitivity and judgment. Instead, calling back to CCC’s goal of cultural humility, Erika says, “Even if we aren’t experts, we know enough to be open and accepting. We honor their experiences and all the things they come to us with. We can show that we want to work with them to tease out the severe mental health hardships while also supporting them around their gender identity.”

Transgender Support Group
Patients of Old Town Clinic and the Old Town Recovery Center can now find a community of support, thanks to a new group co-facilitated by Roran and Shanako DeVoll. Though in its early stages, Roran sees great potential for the group, named “Chrysalis.”

“A lot of our clients are pretty isolated in their lives,” Roran says. “When you start to navigate your gender identity without supportive family or friends, it can be lonely to not have that sounding board. This group gives them a chance to meet other people who identify as trans.”

The hour-long support groups make room for organic conversation to talk about struggles and victories, resources, and relevant topics. Roran and Shanako co-facilitate, but the group itself is largely client-led. It begins open for anyone for two meetings, then closed for the following three months to give the group time to develop a sense of community and trust. After, the group open up again. That sense of trust, Roran says, is imperative to our clients.

“Many of our clients face mental health and addiction challenges. There are already lots of groups out there for trans people, the feeling is that many of them feel cliquish. Clients with mental health challenges may not be able to navigate the social cues at larger, more established groups, so having someone like Shanako, a mental health professional, on board is great.”

Roran hopes to see the support group thrive. Early signs show interest is high, and people appreciate this opportunity to find an accepting community. “I hope that people want to come back all the time and that this first group will invite their friends to this awesome group they’ve discovered.”

Adapting Electronic Health Records
In a health care setting, it’s easy to forget infrastructure and technology can carry the same biases and blind spots that we seek to mitigate. Thankfully, CCC health services didn’t forget, and instead spearheaded substantive changes to our Electronic Health Records (EHR) system to, as Eowyn says, “reflect this culture change of becoming more trans affirming and inclusive that we’re working to embed within the organization.”

The most immediate and noticeable change is the banner when one pulls up a patient’s record. There, at the very top, is now an area that shows the patient’s pronoun and preferred name. Though small, this change will help staff interact much more appropriately in the way that the patient identifies.

The EHR system will also help health care staff ask appropriate questions related to gender identity and sexual orientation, in both content and word choice. Staff members performed hours of research to learn about best practices for asking these questions, then adapted it to CCC’s culture to be even more inclusive than what the current body of research suggests. The goal, according to Eowyn, is to structure these questions in a way so “as many people as possible have a place to feel like they belong.”

Better, more inclusive questions means gathering better, more inclusive responses. This, ultimately, will help CCC health services track how we are serving our transgender patients as a whole. In that vein, an OHSU Doctorate of Nursing student is planning a period of focus groups and one-on-one interviews during which trans patients and clients can provide direct feedback about how CCC is doing and how we can continue to improve.

Keeping the Trans Community Visible
Finally, CCC will continue to be intentional about talking about trans issues, whether internally within the CCC community, or externally with partners and constituents. (Even this blog post is part of that effort!)

According to Erika, “The more we talk about [trans issues], the more we see it, and the more we work with people who identify as trans in a safe, open, and aware way, it will have a ripple effect in the public.”

Knowing that, CCC will continue to bring stories of our trans patients, as well as the work we do to, as Erika says, “give people an opportunity for people to live as they see themselves.”

 



The Impact of Never Giving Up

Nov 14, 2016

The road has been long. It’s been bumpy. It’s been forked. And sometimes, it’s even been closed. But when Keva S. makes up her mind to start something… she finishes. A 2016 graduate of Oregon Health & Science University, Keva is now employed as a Physician Assistant at Central City Concern’s Old Town Clinic. She’s come a long way since getting clean and sober ten years ago.

As a child, bouncing between an alcoholic mother, a cocaine-addicted father, and foster care in Michigan, Keva couldn’t count on where she and her two younger brothers would be sleeping next. As a young adult, she moved to Portland, where an unstable and unhealthy lifestyle continued. After enduring years of addiction, illness, violence, and eventually homelessness, Keva checked into Central City Concern’s Hooper Detox. Soon after, she received a key to a tiny Central City Concern apartment and entered Central City Concern’s Recovery Mentor program. There, “the world just flipped,” Keva says.

With new confidence and hope for the future, Keva engaged in Central City Concern’s Employment Access Center. An employment specialist helped her put together a résumé and look for a job. Soon Keva found a program that allowed her to earn certification as a phlebotomist. For the next seven years, she worked at a hospital, drawing blood. But Keva wanted to go further.

Watching resident medical students do rounds in the hospital where she worked inspired Keva to enroll in a pre- med program at Portland State University. A presentation she saw on homelessness and the need for Physician Assistants piqued her interest. So she set her sights on OHSU.

In 2014, Keva was one of 1,300 applicants for 42 spots in OHSU’s Physician Assistant program. Not only did she get in, she was a unanimous choice and received a scholarship.

In August, Keva graduated from OHSU and applied to work at Central City Concern’s Old Town Clinic. Explaining her motivation for wanting to work at Old Town Clinic, Keva shares, “When you’re a homeless addict, not many people are nice to you. And I had had lots of health problems, so I got to see lots of doctors at lots of hospitals and clinics. The people at Old Town Clinic were the only ones that treated me with respect. They were nice to me. They were willing to see me when I didn’t have money, or insurance, or anything else—and just needed health care. That was huge to me.”

Keva’s first day was September 6, 2016. She started seeing patients in October. She believes her experience overcoming addiction and homelessness will give her unique insight into her new profession—working with people who may not have any money, or insurance, or anything else. “Despite all the resources that it takes, it pays off,” she says. “When you look at somebody like me, and the medical bills I would have had, and that eventually I would have ended up in jail … I would have needed public support forever, until my death. None of that happened. All of that money that would have been spent supporting me just to sustain my addiction didn’t happen because Central City Concern offered me help. And so instead, I’ve gotten to turn everything around. And make money, and donate money, and be productive, and give back.

“Central City Concern on an urgent level, stabilized me. They provided me with a home, so that I could go to treatment every day, and so that I could get that process started. They gave me a mentor. They gave me a whole team of people who told me I could do things when I didn’t think I could. They gave me back dignity. They gave me a life. They gave me the opportunity to hope for a life.

“Now I’m going to try and give that opportunity to other people.”



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.