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OHSU and Central City Concern Partner to Improve Health Care Access for Homeless

Program introduces “social medicine” curriculum that relies on frontline community service to train future safety net physician work force

Oregon Health & Science University (OHSU) and Central City Concern (CCC) have joined forces in an innovative “social medicine” partnership that places volunteer OHSU resident physicians in safety net clinics where they are trained by CCC staff to meet the medical needs of people who are homeless or recovering from addictions.

“This new strategic partnership will benefit both organizations for years to come as we learn from each other, but ultimately it is our hope that the community benefits the most,” said Richard Harris, executive director of CCC.

Founded in 1979, CCC is a nonprofit agency serving adults and families in Portland who are impacted by homelessness, poverty and addictions. The School of Medicine’s Division of General Internal Medicine and Geriatrics is leading the partnership on behalf of OHSU.

“Access to health care has become progressively more difficult for the very poor and homeless in Oregon,” said Peter Kohler, M.D., president of OHSU. “A goal of this partnership is to help CCC expand these types of medical services while training a future physician work force sensitive to the needs of safety net clinics.”

As part of the partnership, OHSU will support a medical director for CCC’s Old Town Clinic as a joint OHSU/CCC faculty appointment. Further, the two organizations will work together to identify grant and/or research opportunities in the areas of health care disparities, integrated care models and improved access for the underserved.

“Social and economic conditions profoundly affect health, disease and the practice of medicine. This partnership provides new avenues for OHSU providers to become involved with community health care needs,” said Rachel Solotaroff, M.D., general medicine fellow at OHSU. Solotaroff was recently appointed to the new medical director position created by the partnership for the Old Town Clinic.

“The partnership gives CCC access to the knowledge base and resources of an academic health center and OHSU gains access to our unique integrated model of services to end homelessness and care for the underserved members of our community,” said Ted Amann, R.N., director of health care and improvement at CCC.

The program requires OHSU medical residents to ride in the CHIERS (Central City Concern Hooper Inebriate Emergency Response) Van, to volunteer in the Hooper Detox Center, and to provide primary care services at the Old Town Clinic and alcohol and drug treatments at the Portland Alternative Health Center. Medical residents also accompany CCC providers on intensive care site visits.
The influence of these experiences is already evident after only six weeks of the program. A medical resident reflected that the clinical experience “had changed the way I think about patients. If I see a patient in the hospital, I make certain assumptions about how he could care for himself given that he was being discharged to a home environment. Now I know not to make such assumptions about what ‘home’ really means.”

“Through this collaboration, there will be better health care today as we improve our skills and better health care tomorrow from physicians who have a deeper understanding of how to serve the community,” said Amann.

“We are striving to make this a win-win situation for everyone involved,” said Solotaroff.

Jessica Gregg, M.D., assistant professor of medicine, and Judith Bowen, M.D., professor of medicine and section chief, Division of General Internal Medicine and Geriatrics in the OHSU School of Medicine were also instrumental in the program development, in collaboration with Amann and Ed Blackburn, director of health and recovery services at CCC.

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