Thank you to the patients who told their La Clinica stories for this newsletter.
A warm welcome
La Clinica is nationally recognized for taking a fair and equitable approach to patient care
"When I was sick, my friends and family gave me plants. Now, looking after them brings peace. Through my plants, I find life and hope."
Maria Trujillo struggled to get her health concerns across clearly when she relied on doctors who used phone interpreters to understand her Spanish. Like many people, she had difficulty getting care because something fundamental—in her case, language—was in the way.
“Before coming to La Clinica,” she says through an interpreter, “I was in a lot of physical pain and couldn’t walk. I felt like I was going to die.”
She shed tears of gratitude when Michelle Maestro, one of La Clinica’s staff of 58 on-site interpreters, joined her at West Medford Health Center and she was finally understood.
A movement in health care aims to address barriers like Maria’s and make care more accessible and equitable to everyone, no matter the hurdles they face at the door to the doctor’s office. La Clinica this fall earned national recognition for its work in this area when it received the National Committee for Quality Assurance’s new health equity accreditation. It is the first healthcare organization in Oregon to earn the honor.
This recognition shows that La Clinica meets certain high standards for its patients. It acknowledges that the organization has built systems over the years to understand diverse backgrounds, respect genders and orientations, provide language help, and more. It is a step toward making health care more equitable for all.
NCQA acknowledged La Clinica's use of in-house interpreters and translators instead of relying on external language services. It recognized the organization's commitment to equity, diversity, and inclusion. Transparent salary ranges in job postings, a staff EDI council, and collecting and using staff demographic data to shape recruiting, retention, and pay decisions were among the noted practices.
“La Clinica is committed to equity. Receiving this accreditation reinforces our core values. We believe no one should be left behind when it comes to healthcare access,” says Equity, Diversity, and Inclusion Director Bryon Lambert, who documented practices for the accreditation. The National Association of Community Health Centers helped La Clinica cover costs of research related to the application for accreditation.
“If we don’t understand structural health inequities, the gap will get bigger, and patients will not receive the care they deserve when all other factors are equal,” says Bryon. "The incredible team at La Clinica made this happen. But it's our patients and community who get the benefit of this work.”
Luis Figueroa, a behavioral health support specialist involved closely in Maria's care, noticed her gratitude for receiving care in her native language.
“It's a basic human right to be understood without barriers in health care,” he says.
Maria’s healing journey with La Clinica’s support led to her physical and emotional recovery. La Clinica’s team referred her to a specialist who helped her walk again. She says she feels much better and has found joy in caring for houseplants.
"When I was sick, my friends and family gave me plants. Now, looking after them brings peace," she says, smiling.
The health equity accreditation, lasting three years, requires regular maintenance, much like Maria’s houseplants.
"Through my plants, I find life and hope," says Maria.
Call the residents
La Clinica's new training program is creating additional space for patients and building skills among new graduates
“I knew that by doing this residency, I would be learning from really amazing, seasoned providers and having support as I start to take care of patients."
The setting is like any doctor’s office you’ve ever visited. The healthcare provider knocks on the door, enters the exam room, and begins working through the patient’s visit. She listens closely and then considers how to proceed.
La Clinica’s new training program for nurse practitioners and physician assistants gives her one important tool she otherwise wouldn’t have as a newly graduated primary care provider: the backing of a team of highly experienced peers dedicated to providing guidance and support in a lively and collaborative setting.
This is La Clinica’s new Advanced Practitioner Residency Program, an initiative aimed at helping address the Rogue Valley’s healthcare provider shortage while improving La Clinica’s ability to serve a growing number of patients who need care. Although new nurse practitioner and physician assistant graduates are not required to complete training programs such as residencies before they begin practice, a growing number do so, recognizing that classroom preparation sometimes doesn’t give them all they need to do the job well.
In its first year, the program has helped the organization create new access for patients waiting for care while providing support and training to three new nurse practitioners and a physician assistant. In 2024, the program, funded for four years through a $700,000-a-year grant from the federal government, will have space for twice as many participants.
“I really wanted to be good in this role of helping people with their health, and I knew that by doing this residency, I would be learning from really amazing, seasoned providers and having support as I start to take care of patients,” said Liz Fairweather, a nurse practitioner resident. “It’s a big learning curve to be in this role, and this gives me a lot of support as I step into it.”
In addition to seeing patients, residents take part in weekly educational sessions, honing their technical skills while also learning on topics such as leadership; equity, diversity, and inclusion; and resilience. They work with La Clinica employees who focus on a variety of topics outside of general primary care training, including gender-affirming and substance use disorder care. Because of La Clinica’s strong relationships with healthcare partners, they get exposure to even more types of care by spending time with specialists in the community.
“We are grateful for the way other organizations are stepping into this,” said La Clinica Chief Medical Officer Chris Alftine. “It shows our community’s great support for learning, and the bottom line here is that we’re working together to improve our community’s access to care.”
Connected to care
Life outside can be rough. New technological paths are ensuring care for people living along the Greenway and elsewhere
La Clinica's partners on the Bear Creek Greenway and other areas where people are "living rough" can now connect with healthcare providers including Patty Schein by phone and view patient medical records online to quickly determine how best to help.
Oregon Health and Sciences University nursing student Stephanie Spatz bandages Shawn, a man living along the greenway whose burned finger had blistered. She and fellow nursing students including Saima Shah visit the path each week to deliver supplies, connect people with essential community resources, and get them the medical care the need. The team's ability to hook up directly to La Clinica medical records speeds up the process and helps the team understand what people need.
Stephanie and Saima pause along the path to arrange for a cell phone for a community member who needed access to one.
Heading down the Bear Creek Greenway with a wagon filled with snacks, handwarmers, socks, Gatorade, and information about community resources, a street team of Oregon Health & Science University nursing students are prepared to deliver more than just comfort items to the people living in scattered campsites. They are equipped with encrypted cell phones and connections to La Clinica’s electronic health records and video visit platform — ready to connect people to care at La Clinica.
Connecting patients to virtual visits and coordinating information between La Clinica and the street nurses is the latest step in an evolving partnership to weave a stronger safety net of care for people living without homes across the community. That’s about 1,250 people in Jackson County on any given day in 2022, with about half those people in shelters, says a report from a collaboration of agencies working to address homelessness.
The partnership between La Clinica and nursing students from Southern Oregon University’s campus acknowledges the unmet need beyond the shelter sites La Clinica already serves. It also is a good fit for La Clinica’s field-based team relying on virtual visits while it awaits the next Mobile Health Center.
“This is literally meeting people where they are,” said Patty Schein, medical director of La Clinica’s field-based team and a family nurse practitioner likely to be waiting on the other side of the screen to provide care.
La Clinica’s team can triage, consult, and treat patients virtually alongside the nursing students, while also forging connections to resources for behavioral health and basic needs.
“This partnership can move us forward to meet needs in a way we never have before,” Patty said.
Recently a man who had been hospitalized for diabetic complications was released onto the street without housing. He had his prescribed insulin, but no glasses to see well enough to prepare the correct dosage. The nursing students gave him reading glasses and set up a virtual visit with Patty. With shared access to medical records, Patty and the street team could get a clearer picture of the complex care the patient needed and collaborate more effectively.
Patty envisions this type of story repeating itself as street nurses checking blood pressure and tending wounds along the greenway can see what has been prescribed and easily and securely report back to her whether medications are working or if another visit is needed.
People living in shelters are more than twice as likely to have a disability compared to the general population. Conditions such as diabetes, heart disease, and HIV/AIDS are found at high rates among people who don’t have homes, sometimes three to six times higher than that of the general population, the Alliance to End Homelessness reports.
“We’re trying to create a pathway to build trust and provide care for the most vulnerable people living in the rough, in tents along the creek,” said Ed Smith-Burns, La Clinica’s community partnership director. “Serving people in great need speaks to the very nature of why La Clinica was founded.”