Keep 100 uninsured Portlanders out of the ER

Congratulations to Sharetta Butcher, Habiba Addo and Jimi Hardin! They recently completed a two-week training to become state-certified Community Health Workers (CHWs). Over the past year, we worked in partnership with the Community Capacitation Center, Urban League of Portland and other community-based organizations to develop and implement this 80-hour CHW training. With a focus on the African American and African communities in Portland, the training provided in-depth sessions on topics such as chronic diseases, nutrition and exercise, cross-cultural communication, leadership and care coordination. Since we opened seven years ago, we have seen great improvements in the health of our patients, especially those with high blood pressure and diabetes. We know we can do even better by using CHWs to assist patients in following their health care plan and to address some of the social issues underlying poor health. Sharetta, Jimi and Habiba are born leaders and perfectly suited for this work. We are excited to watch them grow and to support them in this new role!

The three generations of women pictured here have deep connections to our community and to North by Northeast. We met Skylar in the fall of 2011 when she joined our mentorship program as a junior at Jefferson High School. We immediately loved Skylar’s cheerful personality and got to know her well during her yearlong internship. A quick learner and eager to put her new knowledge to use, Skylar talked with her family and friends about the risks of high blood pressure. When her grandmother, Sue Price, needed help, Skylar’s knowledge and familiarity with North by Northeast’s services was invaluable. Sue had lost her job eight months’ prior and been unable to refill her blood pressure medicine. Skylar encouraged Sue to come to our walk-in clinic, where volunteer Dr. Tom Syltebo got her back on her blood pressure medication. Her pressure was soon down to normal but a month later Sue began experiencing pain in her left arm. She called us, and our staff talked her through the warning signs of stroke and heart attack and advised her to go to the emergency room. Sue credits this advice with saving her life. Though she is no longer a patient at North by Northeast – she now has Medicare – Sue is an active member of our Patient Wellness Council, coordinating quarterly potlucks for the group and injecting her humor and great spirit into the Council’s monthly meetings.

For the past year we’ve also gotten to know Shawn Price: Skylar’s mom and Sue’s daughter. Shawn also came to North by Northeast concerned about high blood pressure. Over the past year, with medication, lifestyle coaching and lab monitoring, Shawn has seen her blood pressure come under control. Shawn believes North by Northeast has been life-changing for her and her mom: “I’m so thankful for the care given to me this year,” says Shawn. “I am convinced I would have had a stroke without this clinic. Please know this place is essential to our community’s survival. Even though small in size, the clinic excels in treating the patient as a whole and creating a personal relationship. This should be the standard in healthcare.”

Thank you, Shawn. We couldn’t agree more!

2012 was a great year for North by Northeast, which means it was a great year for our patients. We often share patients' stories as a way to tell the North by Northeast story, but at least once a year we like to tell the story in numbers, because the numbers are so telling and inspiring. Special thanks to our Physician Quality Assurance Lead, Dr. Louise Clark, whose tireless efforts and "fire in the belly" to improve health outcomes and reduce health disparities make North by Northeast a better place to get care every day.
 

What kind of care are we providing?

• In 2012 we provided 1,594 visits-an increase of 10% from 2011.
• We provided over 1,840 prescriptions at no cost to our patients, helping prevent serious complications of untreated medical conditions, an increase of 5% compared to 2011.
• Our prescription program saved our patients over $190,000 in medication costs alone in 2012.
• With the generous support of Legacy Health Systems, we provided over 800 lab tests to our patients, saving them almost $20,000.
• 93% of our hypertensive patients have reached blood pressure control targets on at least one clinic visit. We are very proud of this, since on average only 50% of all patients in the US achieve blood pressure control; the rates are even worse for African Americans.
• 78% of our diabetics have good or excellent blood sugar control with HbA1c (a standard measure of diabetes control) below 8. Over 35% started care with HbA1c above 10.
• We've achieved a 94% vaccination recommendation rate for our diabetics for pneumonia and hepatitis B vaccinations and are encouraging all smokers to get the pneumonia vaccination. 
• Our newly formed Patient Wellness Council has been instrumental in guiding our future plans for further improving community health.

Who are we seeing? 

• All of our patients are uninsured. 
• Almost all have household incomes below 150% of the federal poverty level. 
• 53% of visits in 2012 were with African American patients and 27% were with Caucasian patients. 
• 67% of the patients on our Chronic Disease Registry with diabetes and/or hypertension are African American.

How do the patients feel about our service? 

• Most of our new patients come to us after a recommendation by a friend or neighbor. 
• We receive thanks and blessings from grateful patients every week.

What are our plans for 2013?

• The need for care continues to increase during these difficult economic times. 
• Our goal for 2013 is to increase visits by 10%, serve 15% more people with high blood pressure and be an even better resource for improved health for the entire community we serve. 
• We will begin a Community Health Worker program to provide more care to those whose blood pressure and diabetes remain uncontrolled.

Thank you for your ongoing support. Together, we are building a stronger community.

"What's different about North by Northeast is that it's personal, one-on-one. You really matter to everyone and it shows. I have the utmost respect for these doctors and nurses and administrative people who give of their precious time. They are people helping people and that's what keeps our community together." - a note from a grateful patient

Abigail L. has a dream: to open her own theater company and help build local youth theater opportunities. Pursuing her dream meant leaving a steady job at a state university – and the health insurance she relied on – and moving back to Portland and a variety of jobs that didn’t provide health coverage. When she came to us for her first visit in mid-September, it was for follow-up of a leg wound that she worried could turn into something serious. She didn’t know there was a far bigger threat to her health. Our volunteers discovered that Abigail’s blood pressure was 209/143. With a family history of hypertension but no obvious symptoms, Abigail knew she might have problems with her blood pressure someday but didn’t imagine it would happen until she was older. By the end of her first visit, Abigail had a prescription for free blood pressure medication from volunteer Dr. Debbie Murphy, an order for lab tests donated by Legacy Health System and a follow-up appointment. With frequent visits and medication adjustments, Abigail’s pressure came down from dangerously high levels to near normal within six weeks. Her decision, as she says, “to get busy living,” has also been critical to her success. The theater company is putting on their first production in the summer of 2013. When they make it big, says Abigail, she plans to give back to North by Northeast for the care and dedication of our volunteers and staff and all we have given her. We’ll be right there, cheering her on!

On July 6 our Board of Directors and staff spent the day at Kennedy School for our annual Strategic Planning session. We got to know each other a bit better (including what everyone would choose for a superpower!) and shared our vision for how we can provide great care to our neighbors in North and Northeast Portland by continuing to do what we do well and expanding to do even more.

We kicked off the day with a presentation from Dr. Ann Curry-Stevens. Ann has been working with us for the past 10 months on a Community Value Assessment that included patient and volunteer focus groups, a survey of our patients, interviews with community leaders and a conversation with board members and staff. Ann set the stage with a demographic overview of North and Northeast Portland and the changes these neighborhoods have gone through over the past twenty years as well as an explanation of the serious health disparities experienced by our community. She shared the overwhelming gratitude that our patients feel for the services they receive and for our commitment to their health, and then she proposed recommendations for us to consider as we think about how to expand and how to react to healthcare reform on the national and state level. 

From there we were given the opportunity to do some "Blue Sky Visioning," of areas North by Northeast could strategically move into over the next 5-7 years. We thought big and got lots of incredible ideas out for all to see! This session was led by North by Northeast board member Richard Howells, to whom we're incredibly grateful for donating his expertise and skill in facilitating the entire day. Thank you Richard! 

We also had the opportunity to thank and commend two of our founding board members - Dr. Jill Ginsberg and Ray Robertson - who are leaving the North by Northeast board after six years of board service! They have both contributed great time, energy and, most of all, love to us over the past six years. Dr. Jill will continue to serve as North by Northeast's Medical Director, and we know Ray won't stray too far either.