On our fifth episode of Vibrant, we are getting to know a bit more about one of Our House's core client programs: the Neighborhood Housing & Care Program (NHCP). Joseph Caver, Manager of NHCP, joins us today to give us the inside scoop on the work the NHCP team does to meet clients where they live to continue to provide the wrap-around compassionate affirming care that ensures their continued health, wellbeing, and sense of community! Listen to the full episode below or on your favorite podcast app. We also have the full episode transcript below the player!

Episode Transcript

Intro: Welcome to Vibrant, an affirming healthcare podcast from CAP, Our House and Prism Health. I'm your host, Dustin Vance, and I'll be here sitting down with folks across our agency to get the inside scoop on the work they do to provide provide compassionate, affirming care to all those in our community. Let's get the show started.

Dustin: Hey folks, welcome to the show. Today we're diving into the Neighborhood Housing and Care Program (NHCP), which is one of the many outreach programs of Our House. So joining us today is Joseph Caver, manager of NHCP. Let's get started just by having you briefly introduce yourself and tell us a bit more about your background and how you came to be at Our House.

Joseph: So my name is Joseph Caver and I am born and raised here in Portland. I really enjoy that. I think Portland is a beautiful place and I've always just loved it. Let's see, my background is rooted in an interest in psychology and counseling. I've always had a strong passion for helping folks in mental health. And I love the fact that the current culture, not only here in Portland, but really nationally and globally, mental health awareness is growing. And that makes me really happy because it's so neat, it's so important. So before working here, I was working at a place called St. Mary's Home for Boys. It's out in Beaverton. It's a tier five residential treatment center for teenage boys, and I was a residential counselor there. It was a beautiful experience. It was very fulfilling, very challenging, but it was really kind of my first experience working professionally in the field that I've always wanted to be in. And so I really enjoyed that experience. Unfortunately, there were some situations that had come up in my department and I could no longer continue that position just because of situational issues. And so I ended up looking around and seeing where could I continue providing this type of service, the treatment approach to clientele and helping with mental health and overall quality of life? And so in my searches, I had found a place called Our House, and it was really interesting because working at St. Mary's, I was working with a much younger population. They’re specifically teenage boys. And then when I was looking at the position with Our House, it was case management position, working with older adults who struggle with, obviously are diagnosed with HIV, and also have dementia and substance use. And I just know from education and psychology and mental health that there are particularly a lot of populations that struggle in this area. It seems like an excellent opportunity for me to continue, I guess, this therapeutic approach and maintain a therapeutic role, but with a different population. And I'm always interested to see how can I help these folks or this population. And so changing that scenery was really attractive to me. And because of the complications that I had had in some of my previous work, I was really cautious to see or to move into or with an organization that might not be in line with my values. And so I had done a lot of research on our House, and what I found was that Our House has historically and currently has a culture of what a lot of people referred to as like, a “family feel”. When you think about what the culture of Our House is and how it was developed, historically, Our House was hospice care, right? And so we're working with people who are actively dying. And if you think about it, that really facilitates an environment of human care. And so this is a huge aspect of the culture of Our House and that bleeds into the culture of NHCP, because NHCP is with Our House. And this is what you would continuously see when reading reviews of staff who have worked with Our House or other organizations who have worked with Our House, or family members of clients who lived in Our House and received the care. And so that quality human connection, like a family feel, that's really the root of therapy, right? Like, our brains are designed for human connection, and that is like nature's therapy in a way. So I was extremely excited to have an opportunity to work with this organization. And after going through the process of interviewing and establishing my role, it really did feel like that when I was in the organization. So that's why I kind of came upon Our House.

Dustin: Wow, it's really cool just to hear the personal journey you've been on and how you ultimately arrived at Our House. And we're super glad to have you here! You briefly mentioned it, but for those who are not super familiar with Our House’s programming, can you tell us a bit more about NHCP and the services that provides to our clients and residents?

Joseph: Okay, so NHCP is an outreach program that's associated with Our House. We are focused on assisting the HIV population and our team provides wrap-around support because the NHCP team is composed of different types of clinicians that work with clients in different domains of their life. Neighborhood Housing and Care Program is what the actual program is called. NHCP is our acronym, and we consist of case workers, peer recovery mentors, and registered nurses. And so we connect our clients with each clinician based on their need. So if an individual is struggling with engaging in their medical care or struggling with adhering to complex medication regimens, then obviously we would connect them with our Nurse Care Coordinator. If somebody is struggling with substance use and this is a barrier to helping them obtain, like, a higher quality of life, we'll connect them with our peer recovery mentors. And then, pretty much everything in between, our case workers will kind of help manage. And so it's really client centered. The work that we do it's really based on each individual's need, and that is what kind of constitutes how we approach each client and who we connect them with.

Dustin: Got you. That makes sense. All right, so how does NHCP help provide greater accessibility to healthcare for your program participants?

Joseph: Yeah, so with a lot of folks that are in the HIV community and who are older, there is a large population of the clientele of NHCP that is older. Folks with HIV, they tend to struggle with engaging in their care, especially with other barriers such as drug use or complex familial issues or trauma. And so it can be really hard to manage these things in life in general, let alone to adhere to complex regimens, to help or to manage a very destructive disease like HIV. And so with all of that, it can be really hard for someone to engage in their care or to even understand what they need to do. And so a big focus of NHCP is to ensure that folks are engaging in their care and to help monitor their symptoms, to help monitor their viral loads, and to assess is what is happening. Is this working for the individual? A lot of times clients, they feel like they don't know that much about their own disease, and this kind of inhibits their ability to advocate for themselves. Because typically people always think that the doctors know best and that is very true. Doctors knows a lot, but they're not always there with you. They don't necessarily always get to see what is your day to day function, what are the things that you're struggling with, especially if someone struggles with communicating and advocating for themselves. Right? So we help, not only folks engage in care, but we help monitor and communicate with their medical professionals to explain what is going on and make recommendations and really help their providers get a whole and full picture of what our clientele is working with.

Dustin: Wow! So it sounds like there's just so many different individualized touch points to ensure that these participants are getting the wrap-around care they really need, which is really amazing. Who is part of NHCP? Like, who makes the work happen on your team?

Joseph: So, NHCP is two case workers. We actually just hired a third case worker, an outreach case worker, which is going to be really beneficial to our program and just helping people know about our program. The thing about our program is that we're relatively small as far as an outreach program. And so we have a clientele of about 40 folks. So people oftentimes don't know about NHCP and the services that we provide. So we'll be bringing on an outreach case worker, and we have two other case workers. And we also have two Peer Recovery Mentors, and we have one Registered Care Coordinator Nurse. And I guess just for clarification, a lot of people hear RN, and they think that we are providing direct care and wound care and things like that. But specifically what our Care Coordinator Nurse does is coordinate care. So it's much more around the focus of advocacy and connecting with people that we see that they need to be connected with. And I just have to say this with pride, our NHCP team, each of our clinicians, are wonderful people. We really focus on bringing in folks who are in line with the mission of CAP and Our House in NHCP. And the hearts of the people who work in NHCP are very full, and it's a blessing to have .

Dustin: Wow, it sounds like you have just a really great team of folks caring for our NHCP clients. So I'm curious, how does NHCP fit into the broader Our House picture? Like, how do NHCP clients interact with Our House residents, and how do you build community between the two?

Joseph: Yeah, 100%. What's really cool is that HIV care has progressively been getting better, and our medications have been getting more and more effective. And so historically, with Our House, the residential care facility, it has been focused on hospice care. Right? Because in the past, if you were diagnosed with HIV, you were essentially told that you are going to be dying soon. And that was very real. And that happened for a lot of people. As the care for HIV has improved, what we're seeing is that people are not dying right? The medications are working and the care, as long as it's done right and wholeheartedly, is improving people's lives. And so folks who will come into our residential care facility and they get intensive treatment and they are strict on their regimens, they're getting better and they're no longer dying at Our House. And so what we see now is folks will come into the facility, get better, and go back out into the community. Now, when they go back into the community, it's not like everything is perfect. So sometimes they do continue to need some assistance and that's when NHCP can kick in. And so folks will come into Our House, get better, go back into the community, and go out into the community, live independently with the assistance of NHCP, so we can continue to provide that care and make sure that their health does not decline again. Right? Yeah, it's actually a little bit of a two way street as well because we've had plenty of folks who started an NHCP and for whatever reason, their health has declined and they needed something more intensive, something that is more along the lines of residential care. And we have had folks move into the RCS, get better, and then move back into NHCP. So it's like we kind of give and take based on what is needed.

Dustin: Well, that's great. It sounds like you really provide that wrap-around care experience, where no matter where you are, the services are available to you, and someone's there to help you. A lot of listeners at home typically want to find ways to get involved and directly help out programs. I'm wondering what opportunities exist for people to help with NHCP? Like, are there volunteer opportunities or do you rely on donations? How can people best help you?

Joseph: Yeah, so at this point, we do not have any volunteer engagement with NHCP specifically. Historically, Our House, the residential facility, has had a huge volunteer population who over years have contributed and helped out. But unfortunately, NHCP has not gotten to that point. So right now, the volunteer, I guess, opportunities are nonexistent. But I do foresee this to change in the near future. I think that there is a lot of opportunities that we can utilize volunteer populations, and while it's not established, I absolutely see that it will. So at this point, it's mainly funding for NHCP.

Dustin: Very cool. Well, we'll keep our eyes out for those volunteer opportunities in the future, but until then, we'll get some donations coming in, hopefully! As we get ready to close out, what is something you would like to leave our listeners with with regards to NHCP, Our House, or anything else on your mind?

Joseph: The only thing that I would say that I think is really important to note about NHCP is that I think that when you look around at social services in Portland, or even in general, you often see that case management and outreach tends to be a little bit removed from the individual. And what's really unique about NHCP is that our approach is really hands on. I mentioned earlier that NHCP is relatively small compared to other outreach programs. We have a total clientele of around 40 right now, and we have five now coming, six clinicians. Right? And so our client to clinician ratio is relatively small. But what that means is that we're able to be much more involved with our clients. And similar to the idea of, like, if you have a child and you're looking for a great school, one of the first questions you ask about the classroom is the student to teacher ratio. And the reason it's important is because you're able to really dive into the clientele and be with them wholeheartedly. It allows a larger focus on each individual, and in turn, what that gives is a lot more product, a lot more progress. So this is a unique feature of NHCP relative to other kind of outreach programs, and there's a lot of pride in that.

Dustin: Well, thank you so much for all your time today, Joseph. It's been such a pleasure to hear about the work you and your team at NHCP do to provide such critical services to our clients, and we can't wait to talk again soon!

Joseph: Thank you so much!

Outro: Well, that's our show for today, folks. Thanks so much for tuning in for another episode, and we can't wait to share a new one with you really soon. In the meantime, if you have questions or comments, feel free to reach out to us at comsat nw.org. Until then, stay vibrant.

About Cascade AIDS Project

CAP is a non-profit organization that was founded in 1985 as a grassroots response to the AIDS crisis. As the oldest and largest community-based HIV services provider in Oregon and southwest Washington, we seek to support and empower all people with or affected by HIV, reduce stigma, and provide the LGBTQ+ community with compassionate healthcare. We do so by helping to ensure the health and well-being of our program participants each year through health, housing, and other social services. When the need for affordable, accessible, and culturally affirming primary care services was identified as a community need, we responded by opening Prism Health in 2017.  More information can be found at www.capnw.org.

About Our House

Started as Juniper House in 1988 to provide housing and care needs of people with AIDS, the organizers soon formed a nonprofit corporation and opened Our House, a five-bed foster care facility. In March of 1990, Our House moved to its present location. Over the next 3 decades, Our House grew it’s service offerings to include the Residential Care Facility, the Neighborhood Housing and Care Program, Esther’s Pantry, and Tod’s Corner. In 2022, Our House officially merged with Cascade AIDS Project, bringing over 30 years of experience providing healthcare and housing for people with HIV to the regions oldest and largest HIV services provider. Together, CAP & Our House are looking into ways our combined expertise can help people living with other chronic conditions and hope we can continue to inspire more people to live well.