Back in the 1970s, Portland’s Old TownChinatown neighborhood was a place people dismissed as “Skid Row.” Unemployed men drifting about aimlessly from one low-cost room to another, often struggling to deal with their alcohol-use issues. In 1979, the City of Portland and Multnomah County received a grant to jointly address the problem. Central City Concern (CCC) was soon born. Today, its main goal is providing housing, integrated health care and employment services to prevent homelessness. Since 60 to 80 percent of the people it serves have substance use disorder (SUD) issues, it’s also engaged in fighting addiction.
“Substance use disorder services are the foundational aspect of a nexus of the physical and behavioral health that direct the mission of the organization,” says Andrew Mendenhall, Central City Concern’s Chief Medical Officer. “Integrating housing and SUD services is the backbone of the ‘secret sauce’ of what we do.”
Being a federally qualified health center that serves more than 13,000 people every year, CCC offers services to those living in poverty. Some 2,100 housing units are made available and primary health care is provided to more than 8,000 patients annually. In 2018, 3,220 received SUD treatment, with 3,334 accessing the short-term sobering center.
When it comes to addiction services, a variety of special features are available. “We act as a hub for 20 to 25 partners across the tri-county area,” says Susan Wickstrom, director of communications and marketing. She notes culturally specific programs are available for African-American and Latinx patients. Additionally, Old Town Recovery Center serves people with severe mental illness. The Letty Owings Center provides help to pregnant women and their children. There’s also the Hooper Detoxification Stabilization Center, CCC Recovery Center, Recovery Peer Mentor Program, and a Sobering Station that serves more than 3,000 people a year.
Central City Concern has recently started using medication-supported recovery (MSR).
“We embrace the narrative of recovery, and MSR is the gold standard for opioid care,” Dr. Mendenhall explains.
In 2018, about half of CCC’s 1,200 patients with opioid use disorders chose buprenorphine MSR. Another 500-600 primary care patients receive care in the community. That has produced a 400 percent decline in ER visits by those on MSR, lowering the cost of treating them by $200 a month per patient. “The most efficient model provides patients with a chronic disease management model,” Dr. Mendenhall points out. “Some may struggle, but they aren’t immediately shown the door. We’re striving for progress, not perfection.”
That approach is producing positive results. Wickstrom points to Lisa Greenfield as one of many success stories. She arrived at CCC with mental health issues and addicted to heroin. Lisa received housing, recovery treatment, mental health services, and primary health care. She overcame addiction and became a peer educator. Now she works for Central City Concern. “For the first time in a very long time, I felt safe and supported,” Lisa says. Most touching, Lisa has reunited with her family. “They gave me a ring for my one-year clean date,” she says proudly. “It has all my siblings’ names and birthstones on it.”
There are countless other stories similar to Lisa’s. And as long as people in the Portland area need help, Central City Concern will continue providing it.
Central City Concern was a featured award winner in the 2019 Innovation Now project of the Addiction Policy Forum.