Rooted in Community: Old Town Clinic

Monday, August 05, 2019

For 40 years, Central City Concern (CCC) has been caring for people in Portland who are impacted by homelessness. In the late 1970s, we offered recovery treatment with housing, which was a new but logical approach: it’s easier for people to get better if they have a place to live. This was the beginning of CCC’s deep roots in the Portland community that expanded through the decades with new ideas and innovations in response to evolving patient needs.

By the early 80s, Old Town was only a few years removed from the height of living up to its “Skid Row” reputation. Thankfully, agencies were beginning to make headway toward helping people into better, more stable situations. For example, Burnside Consortium (as CCC was then known) sprouted up a few years earlier to save and increase the safety and maintenance of the single room occupancy (SRO) housing stock in the neighborhood and to fund local alcohol treatment providers. In 1983, Old Town Clinic (OTC), a small medical but sorely needed facility run by the Burnside Community Council, opened in neighborhood fixture Baloney Joe’s, a shelter serving homeless people located at the east end of the Burnside Bridge.

OTC moved to W Burnside and Third Ave in 1985; the next year Ecumenical Ministries took over management and continued to run the facility, providing primary care to the neighborhood’s homeless population for the next 15 years.

In 1983, Old Town Clinic (OTC), a small medical but sorely needed facility run by the Burnside Community Council, opened in neighborhood fixture Baloney Joe’s, a shelter serving homeless people located at the east end of the Burnside Bridge.

By 2001, CCC had recognized just how important health care is for helping people to realize their full potential; we took over management of the clinic. A decade of running CCC’s Portland Addictions Acupuncture Clinic (later renamed the Portland Alternative Health Center), which provided acupuncture, naturopathic and light primary care services to those living in and around Old Town, demonstrated the importance of comprehensive care to the success of long-term recovery. Assuming OTC’s operations solidified our commitment to providing holistic care. We quickly expanded the clinic’s services while continuing to operate in a low-cost setting. OTC began to offer both primary and naturopathic care, preventive exams, injury treatment, and connections to mental health and substance use disorder services. The clinic became a crucial starting point to help many patients end their homelessness and began a path to better health. 

Gary Cobb, CCC community outreach coordinator who has been with the agency since 2001, remembers how things fell in to place for the Old Town Clinic, as if it was all meant to be. “Sometimes you can’t sit and wait for opportunities to arise,” he said. “You need to jump and make things happen.”

At first, OTC operated under Multnomah County’s Federally Qualified Health Center (FQHC) status. But in 2003, CCC became its own FQHC site. This new designation allowed CCC to receive federal reimbursement for uninsured and underinsured poverty-level clients, opening up opportunities to bring much-needed medical services to our other programs like Hooper Detoxification Stabilization Center, Letty Owings Center and the Community Engagement Program. (CCC now has 13 FQHC sites.)

“Sometimes you can’t sit and wait for opportunities to arise. You need to jump and make things happen.”

In 2003, OTC moved temporarily to NW 5th Ave. and Everett for about a year. But in 2004, CCC opened a shiny new building on W Burnside and Broadway where OTC and PAHC essentially consolidated into a single program to offer both primary care and complementary medicine services under the same roof. Old Town Clinic and our pharmacy continue to thrive there today. “We had leadership who had been community organizers, so their expertise in building relationships made the clinic into the national model it is today,” said Cobb.

OTC began a partnership with Oregon Health & Science University (OHSU) in 2006. This partnership placed volunteer OHSU resident physicians in safety net clinics where they are trained by CCC staff to meet the medical needs of Portland’s homeless and low-income community. This “social medicine” partnership was a mutually beneficial one that allowed CCC to expand its medical services while training a future physician workforce to be familiar with and responsive to the needs of safety net clinics’ patient populations.

When Oregon began its statewide health system transformation to coordinated care organizations (CCOs) and expanded Medicaid coverage, CCC jumped on board to help achieve the triple aim of better care, better health and lower costs for all Oregonians. In 2012, CCC joined 10 other local health care and social service organizations to become a founding member of Health Share of Oregon CCO, which serves Medicaid members in Multnomah, Clackamas and Washington counties.

In 2013, OTC was one of a handful of clinics nationwide singled out by the Robert Wood Johnson Foundation as an “exemplar practice” for our innovative work making health care more accessible to patients. The clinic hosts many innovative teams and programs, such as the Summit team that treats medically complex and fragile patients with integrated flexible care.

Being part of an organization that also provides affordable, supportive housing also gives OTC an unprecedented opportunity to serve its surrounding community. With some ingenuity, CCC’s Housed and Healthy program breaks down walls to lower barriers to quality care for hundreds of area residents.

Being part of an organization that also provides affordable, supportive housing also gives OTC an unprecedented opportunity to serve its surrounding community.

OTC and its pharmacy recently began using highly effective drugs to treat hepatitis C, a serious chronic liver disease that can lead to cirrhosis, cancer and even death. Oregon’s rate of hepatitis C is one of the highest in the country, and people with substance use disorders experience higher rates of hepatitis C. In 2018, OTC treated and cured 107 people who were infected with the hepatitis C virus, giving them a much healthier and brighter future. This treatment program continues to save lives.

Through OTC has hopped around the neighborhood and changed management over the past 36 years, one thing has always been constant: caring for the community that needs us the most. We respond to challenges with new ideas, and grow stronger with change. And we welcome and honor the people who entrust us with their health; they are the reason we’re here.