On the streets: A new kind of food cart

Staff reports

Central City Concern, the city’s largest low-income housing and social service organization, has partnered with My Street Grocery, a new mobile grocer, to bring affordable, healthy food directly to Central City Concern’s tenants.

The program launched Sept. 24, with its cart open for business at Northwest Broadway and Couch, near the majority of Central City Concern’s buildings.

Three Boxes: Revisiting David P. Hooper

By Kathy Pape

A few years ago, working for Central City Concern, I was asked to “sort through those three Hooper boxes” in the basement. Just keep the important stuff. “Hooper” is of course David P. Hooper and many people in Portland know Hooper as the city’s Sobering Station and Detox Center where thousands of people have begun their recovery.

The Sobering Station is on a nondescript corner of Northeast Portland and it’s where police bring unruly, intoxicated people – a place to sober up, stay out of trouble, not hurt anyone and not hurt themselves. It’s no picnic. When I first started my job here, I went to tour Hooper imagining neat cots lined up and covered with fresh white sheets. Maybe little vomit containers near each cot. Not so. We are talking a near jail-like environment with concrete floors and drain holes for easy clean-up. But the Sobering Station is no jail and jail is where David P. Hooper died. The Sobering Station has a sophisticated intake system with 24-hour medical oversight to ensure that people do not die of alcohol poisoning or drug overdoses. It’s a far cry from what David P. Hooper had.

Just what the legislature ordered: Oregon races the clock to restructure its low-income health care system

By Amanda Waldroupe, Staff Writer

Autumn Bolds begins the day’s huddle by telling Dr. Rachel Solotaroff, the medical director of Central City Concern’s Old Town Clinic, that her patient schedule that afternoon has changed dramatically.

Solotaroff will see eight patients that afternoon. Bolds, a panel manager on Solotaroff’s patient team, is responsible for coordinating Solotaroff’s patients, and she quickly launches into briefing Solotaroff and Magadalena Juan, a medical assistant, on each patient and their health.

She goes through each patient chart, quickly saying why he or she is coming for a visit, what medications the patient is on, and whether pap smears, blood tests and other routine check-ups are up to date.

Juan scribbles notes, and Solotaroff asks some clarifying questions. The rapid pace pauses briefly as the three discuss, in the case of a couple patients, whether they have or need mental health providers, and if a particular concern the team has might be discussed with the patient at that time.

Ending with a high five, the day’s huddle is over after a short 20 minutes.

Solotaroff says these daily meetings are hugely beneficial in helping her and the team prepare for each patient visit, knowing what to expect, and also what to anticipate in terms of providing the best possible health care to the Old Town Clinic’s low-income and homeless patients.

“The idea is that your work of the day is not your schedule, but the population of patients you serve,” Solotaroff says.

Across town at southeast Portland’s Richmond Clinic, Dr. Nick Gideonse has similar daily meetings with his patient team, a group made up of doctors, nurses, medical assistants, and a behavioral health specialist.

Both clinics, and a handful of others around the state, are blazing the trail in providing this type of care to patients — health care in which a variety of providers addressing a spectrum of health needs communicate and work together. Care that is coordinated.

Oregon is adopting this model of care for its state Medicaid program, the Oregon Health Plan, in what are the most ambitious changes to the program since it began providing health care to Oregon’s poor in 1994.

By July, it is expected that the physical, mental and dental health care provided to 600,000 Oregonians on OHP will be restructured in this new coordinated system, with all providers — including doctors, nurses, mental health counselors, dentists, and other medical professionals — communicating and working in tandem. Its goals are to increase access and quality of health care — and create savings, $239 million worth, by the legislature’s budget.

All in their head: Traumatic brain injuries often go undiagnosed, especially on the streets

By Kate Cox, Contributing Writer

Readers note: This article is the first part in an investigative series by Street Roots on Traumatic Brain Injury and homelessness. Pick up the June 10, edition for the next in-depth article on the topic. Read Part II here.

You might say Nick Patton was born to fish.

Literally born on a boat, Nick spent his earliest years living in orphanages along the Alaskan coastline.  He ran away at the age of eight and quickly learned how to take care of himself and to rely on others — traveling in groups around the Pacific Northwest, picking apples and doing day labor.

He was only 11 years old when he started working the boats and canneries of the Alaskan fishing industry. With a community of other fisherman, Nick followed the seasonal work, living on boats and in tents, even during the cold Anchorage winters.

It all ended with the smack of a crowbar.

Canada and the U.S. are making significant strides toward mainstreaming harm reduction, but there are still walls to knock down

By Katie Hyslop with Devan Schwartz, Contributing Writers

Hundreds of doctors, politicians, researchers and frontline workers will get together with drug users and ex-users in Austin, Texas, this month to openly talk about drug use. But instead of reaffirming their commitment to the decades-long war on drugs, the eighth National Harm Reduction Conference will feature discussions on opening needle exchanges, legalizing and regulating the drug trade, and overdose prevention methods.

“What we do in (the United States) is make drugs as unsafe as they possibly can be, and we do that through laws, which means that, if you get busted with drugs, you go to prison for a long time. And that’s designed as a deterrent to make people stop using drugs, which obviously it isn’t,” said Allan Clear, executive director of the Harm Reduction Coalition, which runs the national conference. “We do things like take syringes out of circulation, which has caused epidemics of hepatitis and HIV. So harm reduction is a way of trying to make drug use safer for people who use drugs, without demanding that they stop using drugs.”

Harm reduction can include a range of services from needle exchanges and condom distribution to safe consumption sites and access to addiction services such as methadone and buprenorphine treatments and detox facilities.

Supported by the United Nations and over 93 countries worldwide, harm reduction remains controversial. More than half of the 158 countries where drug use has been reported say they support harm reduction, and 82 countries have needle exchanges, but only 73 provide opiate substitution therapies such methadone, and only eight countries have safe drug consumption facilities. There are only two safe consumption facilities in North America, both in Vancouver, British Columbia, Canada.

Progress in Portland: In the late 1980s Portland, Oregon became one of the first U.S. cities to establish Syringe Exchange Programs, or SEPs. The city was dealing with rampant drug abuse that continued through the 1990s, and reached 250 reported heroin-related deaths in 1999.

Portland now offers three fixed sites for syringe exchange, along with the mobile Multnomah County Exchange Van. A drug paraphernalia law remains on the books in Oregon, though the possession of needles and syringes is exempted.

Outside In provides a majority of local needle exchanges. The organization offer one-for-one exchanges of up to 30 syringes along with HIV and hepatitis C counseling. Kelly Anderson of Outside In observes a clear need for their services in the community, their needle exchange clients alone having doubled in recent years. Nevertheless, she says that their funding “has not increased in over five years.”

Despite the relative availability of services, drug-related deaths themselves have returned to alarming levels in Portland — the state’s main site for overdoses. Oregon’s Alcohol & Drug Policy Commission delivered a report to Governor Ted Kulongoski identifying 229 overdose deaths in Oregon is 2008. The Associated Press reports that in 2009, 127 Oregonians’ lives were claimed by heroin alone.

Dr. Rachel Solotaroff is the medical director at Central City Concern, one of Portland’s oldest service providers. She acknowledges the city’s heroin problems but then expands the purview onto the ubiquity of prescription opiates. Oxycotin, suboxone, and methadone — the latter two prescribed as anti-addictives — can lead to their own addictions, black market street distribution, and even deaths.

“Not many of the prescription opiates on the streets come from people breaking into pharmacies,” Dr. Solotaroff says. “That’s the onus on us as prescribers.  Not having sufficient regulation around prescription opiates is a huge contributor to drug-related death in Oregon.”

Solotaroff also identifies structural strains on providers. “With the unemployment and rising uninsurance in the country as well as in the state we just can’t see everybody. We just couldn’t keep our doors open. One issue is the rising uninsurance rate and the other is the increasing complexity of the individuals.”

Often cited social determinants of health include poverty, homelessness, addiction, social isolation, criminal history, and a lack of employment.

But Solotaroff doesn’t believe the issue is strictly a monetary one.  “We need the flexibility to give better care to our patients.  We need to support them in so many ways.  We need to have supportive housing for individuals.  And we need to have supportive housing for people still in their addiction. That’s often the first step to getting them out of their addiction. It’s something that may not take a lot of money, just an act of will and understanding and compassion.”

Central City Concern’s own Community Engagement Program (CEP) utilizes aspects of such a multidisciplinary approach. They attempt to address issues of drug addiction simultaneously with issues of chronic homelessness. “Housing is the really critical thing,” says Sara Goforth, Director of Addictions and Chemical Dependencies and Mental Health Services.

Times up at the West with less than a month left to find housing

West Hotel on NW 6th between Davis and Couch

By Amanda Waldroupe, Staff Writer

All is quiet in the West Hotel.

The two-dozen residents of the Old Town single resident occupancy (SRO) hotel are, for the first time in 27 years, no longer kept awake until one in the morning by the cacophonic punk rock sounds that would drift upwards from the iconic rock nightclub Satyricon two floors below.

The building is quiet to the point of eeriness. Entering the West through a black painted door on Northwest 6th Avenue, walking across the small lobby crowded by two recycling bins stored along one wall and up the steep stairs to a heavy wooden door opening to the first floor, a tenant hears nothing but the sounds of his own footsteps.

But there is something else now keeping the West’s residents awake at night: the possibility that they will become homeless if they don’t find new housing and move to it by Dec. 1.

The Macdonald Center, a Catholic-inspired assisted living facility and social-service agency, gave 60-day eviction-without-cause notices to the tenants on Oct. 1.
The MacDonald Center is nationally recognized for its innovative assisted-living facility, the Maybelle Clark Macdonald Residence, which provides assisted living and nursing care for 54 low-income or homeless people with chronic medical illnesses, physical impairments or disabilities.

The Macdonald Center has owned the West Hotel since October 2008. Executive director Pat Janik says the plan was originally to renovate the West. Built in 1905 and in need of extensive repairs, the West is, to use the words of Northwest Pilot Project’s housing consultant Bobby Weinstock, an “old, tired hotel that has outlived its usefulness.”

New background checks hurt experienced recovery workers

By Amanda Waldroupe, Staff Writer

Unforeseen consequences of a state law designed to protect vulnerable citizens dependent on residential care is impacting people’s abilities to find a job in social work. The negative impact is spurring the SEIU and social service advocates to have the law changed.

House Bill 2442 makes it illegal for organizations that provide residential care treatment to the elderly, disabled, adults in foster care, and the mentally ill to employ people who have committed certain crimes. The organizations affected by the law are limited to those that receive state funding.

Benefits specialist takes training statewide

By Joanne Zuhl, Staff Writer

Mellani Calvin remembers vividly the day Oregon did away with its General Assistance program. She was working as a paralegal for a disabilities attorney, and the program helped disabled clients survive while they waited, often years, for Social Security benefits.

Then one day in April 2004, it all went away.

“One client fell to her knees in the office, bawling,” Calvin says. “It was a black day in Oregon’s history.”

Central City Concern celebrates exhibit at the Golden West Building

On Thursday, October 22^nd, Central City Concern will host an “unveiling” celebration for a newly installed permanent exterior exhibit on two sides of the Golden West Building, former center of Portland’s African-American social and business life in the first decades of the twentieth century. The celebration will be free and open to the public, from 5:00 – 6:30 pm, at Carleton Hart Architects, 322 NW 8^th Avenue. The event will feature timeless music from “Sweet Baby James,” a song from the Portland Center Stage production “Ragtime” performed by actors Gavin Gregory  and Rachael Ferrera, and remarks at 5:30 by City of Portland Commissioner Randy Leonard and members of the project advisory committee.

The exhibit tells a social and ethnic story of the vibrant African-American community in Portland in the early 1900s and the successes and challenges of its residents.  “In that early generation of the Black community here…you could find the very powerful strains of what you might call pursuit of the American dream,” said Dr. Darrell Millner, Professor in the Black Studies Department at Portland State University and a consultant on the exhibit.

Veterans arriving on the streets not who you think

(Rick Stoller, who directs the Harbor Lights shelter, says it’s becoming increasingly difficult to find appropriate affordable housing for veterans.)

Shock Waves from the May 29 edition of Street Roots

It’s a warm, still May afternoon as people mill around the curb outside a downtown shelter, and Tyrone Brown, a fiery Vietnam veteran with a baseball cap and greying goatee, is pissed off.
“We got this country free,” he says, gesturing toward other veterans who are staying in the Glisan Street Shelter or, like him, waiting for a space in it. “What are we doing being homeless?”

Veterans have long been a large segment of the U.S. homeless population. There are no perfect estimates of how many veterans are on the streets, but by several accounts, the number is on the rise — especially for older veterans like Brown.

The Department of Veteran’s Affairs estimates that there are 2,042 veterans experiencing homelessness on any given night in the Portland service area, which includes Vancouver. That’s up from 1,790 in 2006.

Portland’s One Night Street Count, which surveys people who were homeless on a given night in January, found 192 veterans this year compared with 108 in 2007. The jump far outpaces the increase in the overall street count, which only grew by about 10 percent.

Though some of those new to the streets are younger veterans recently returned from Iraq or Afghanistan, the vast majority are 45 and older. Roughly a quarter said they’d been homeless for less than one year. Older veterans were becoming new to the streets.

John Means of Central City Concern’s Homeless Veterans Reintegration Project says their employment program is seeing more and more clients who are new to the streets. Two years ago, Means says, most of their clients were veterans considered chronically homeless, and they’d see the same people come back multiple times.

“Over the last year, maybe year and a half, newer people have come in,” Means says. “Now we’re getting a lot of people (who are) six months, seven months, eight months homeless.”

For Larry, a 48-year-old Marine Corps veteran who didn’t want his last name used, construction work dried up. Then he was laid off from a factory job. He recently found work picking up trash at the waterfront for the Rose Festival, but he was fired when his employer ran a background check and found a 20-year-old felony assault conviction.

“Evidently there’s a problem picking up trash at the Rose Festival for felons,” Larry said. “It’s never gotten in my way at all, but now with the economy the way it is, people are pickier.”

Thursday: Central City Concern shows off Depression workers’ art

At this week’s First Thursday gallery crawl in the Pearl District, Central City Concern will have its own show: “The Art of Working” showcases Depression-era Oregon artists who were funded by President Roosevelt’s Works Progress Administration. Featured artists include Douglas Lynch, Martina Gangle, Arthur Rundquist and Albert Rundquist.

CCC’s own workforce development program, recently renamed the Employment Access Center, has seen a deluge of job-seekers in recent months. Last year they helped 2,400 people; this March alone, they had 4,456 visits. You can learn more about the program at the reception accompanying the art exhibit.

What: Exhibit and reception showcasing Oregon WPA artists.

Where: CCC’s Employment Access Center, 2 NW 2nd Avenue in Portland

When: Thursday, May 7, 5-8 p.m.

Entrance: Free.

Richard Harris takes on Oregon’s mental health and addictions division

Post Oct. 24, 2008

By Amanda Waldroupe
Contributing Writer

The Oregon office of Addictions and Mental Health Division is moving and shaking.
On September 12, it was announced that Richard Harris, 68, the retiring executive director of Central City Concern, would replace Bob Nikkel and serve as interim director of the division.

Tapping Harris to head the Addictions and Mental Health office, which is a division within the state’s Department of Human Services, is nothing short of bold: His admirers say Harris is perhaps the only person in the state who has the integrity and experience to tackle the challenges facing Oregon’s mental health and drug treatment systems.

Some of those challenges include a dilapidated state hospital that was taken through the wringer by an investigation conducted by the Department of Justice released in January of this year, determining the future of Cascadia after its April financial implosion, bolstering the state’s community health systems, and all in times of scarce financial resources.

Harris has a solution, one that he has found working for Central City Concern for 29 years.  The social service agency’s nationally recognized way of providing alcohol, addiction and mental health services—combining supportive services with housing in a supportive community—is a model he hopes to begin replicating at the state level.

Harris started the job on Monday, September 29.  In an interview with Street Roots, Harris talked about his plans for being interim director and some of the challenges he faces.

More after the jump.