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White Bird Clinic opened a street medicine clinic at Community Supported Shelters’ office on West 11th Avenue to bring health care closer to the people who need it.
White Bird Clinic launched a new mobile medical clinic in partnership with a local homeless services provider on Tuesday, May 19, expanding a street-level model designed to bring health care directly to unhoused patients.
The mobile clinic will operate at Community Supported Shelters’ street outreach office on West 11th Avenue every Tuesday from 1 to 4 p.m., offering primary care, wound treatment, lab work and medication management for people who rely on Community Supported Shelters.
It builds on White Bird’s first mobile operation at St. Vincent de Paul’s Schlies Resource Center along Highway 99, which operates on Fridays and recently hit its one-year anniversary. The model helps patients overcome the obstacles that prevent them from receiving vital care, staff said.
“A lot of these people haven’t seen a doctor for 10 to 15 years, and there’s a lot of barriers with trauma to go into a clinic,” Sarah Austin, White Bird’s medical clinic manager, told Lookout Eugene-Springfield. “We can bring the medical out to them and not require them to come in.”
Moving toward answers
It’s a lean operation. A team of three or four White Bird employees — a nurse practitioner, one or two medical assistants, and a medical receptionist — work out of a van outfitted with medical equipment parked in a gravel lot.
Patients filled out paperwork under a nearby white tent next to tables lined with snacks, water and to-go bags of basic hygiene items and supplies, part of White Bird’s efforts to build trust and visibility with potential new patients.
On top of “point of care” testing like nasal swabs and basic urine screens, the clinic will draw blood on site, speeding up lab work that previously required patients to schedule and travel to separate appointments, nurse practitioner Justin Styles said.
“Not only will I have actionable data coming up faster, but I think for the patients, it’s a huge thing to know that they’re actually moving towards answers, more than just a plan for answers,” Styles said.
New patients often initially seek help for wounds, medication refills and doctor’s notes to register their pets as emotional support animals, Styles said. In the summer, staff often see foot wounds, because patients are being more active and removing their shoes. In the winter, injuries from exposure to cold and wet conditions are more common, he said.
But many patients’ medical needs quickly “balloon in complexity” as doctors learn more about their history, like substance use and unmanaged diagnoses, and when basic tests come back with abnormal results, Styles added.
“A lot of people who are living on the streets or are only partially sheltered are living with the amount of disease burden that you would expect to find a person in an assisted living facility,” said Styles, who also helps run the mobile clinic at St. Vincent de Paul.
Community Supported Shelters staff observed clients struggling with unfulfilled medical needs in the nonprofit’s day-to-day work, and White Bird had the equipment and staff to meet that demand, Styles said.
Meeting people where they are
The new clinic is primarily intended for the existing client base at Community Supported Shelters, but anyone nearby in need of care can stop by, said White Bird executive director Amèe Markwardt. Patients tend to interact with mobile clinics more than White Bird’s brick-and-mortar clinic on Mill Street, Styles added.
“It was a nice alignment of a need of a community agency and availability of services,” Styles said. “Without a doubt, coming out to where the people are, I will often have more patient contacts at our mobile clinic sites than I do in-clinic, even if I have a fully scheduled day.”
Staff aren’t discouraged when patients refuse services, as those conversations still offer them an opportunity to inform a patient about their medical needs and make a plan for the future, he said. If he needs to send a patient to an emergency room, he walks patients through what to expect when they arrive, Styles said.
A young man named Sean, who declined to provide his last name to Lookout, was among the new patients who stopped by the mobile clinic on Tuesday. He said he’s often in the area due to its proximity to Community Supported Shelters’ street outreach office and the Eugene BottleDrop Redemption Center.
Sean said he has been looking for a new primary care provider for years. His battle with addiction, which began at age 16, has “taken its toll” on his health, he said. He spoke of others who have gotten “fingers chopped off” because they lacked proper and timely wound care.
“It will be a game changer for a lot of people,” Sean said. “It really will.”
From a budget perspective, the mobile clinic breaks even after seeing roughly three patients, staff said. Many patients have Oregon Health Plan, the state’s Medicaid expansion program for low-income residents that reimburses the clinic, and White Bird is a Federally Qualified Health Center, meaning it receives federal grant funding to offer services on a sliding-fee scale.
“Most of the folks that we’re going to see won’t have to pay anything, because they don’t have an income,” Markwardt said.
The mobile clinic soon hopes to expand its hours to provide follow-up appointments between 9 a.m. and noon on Tuesday. Markwardt said she also hopes the mobile clinic can one day expand to operate daily.
White Bird is working to hire a new medical director with a background in epidemiology and informatics who can examine all of the nonprofit’s services from a high level, she added.
Staff plan to measure the mobile clinic’s performance, based on quantitative data and patient feedback, to help chart its future, Styles said.
“We’re doing stuff, but is this leading to more patients having consistent follow-ups, be it in the clinic or outside of the clinic?” Styles said. “Stepping beyond that, that’s just a number. How do the patients feel?”
Lookout photojournalist Isaac Wasserman contributed reporting.
