PORTLAND, Ore. – Health care doesn't stop after a person leaves the doctor's office. Factors outside of the traditional care setting such as housing play a pivotal role in a person's overall health.

Michael Mellick, a housing case manager with CareOregon, says anybody who has experienced chronic homelessness most likely experiences other issues as well.

"It's safe to assume they're going to have substance-use dependence issues, which we try to help them with,” says Mellick. “There's mental-health issues that often come into play. There are criminal background involvement issues that have to be remedied."

Addressing social determinants such as adequate housing are mandates for coordinated care organizations, which manage the Oregon Health Plan in local communities.

In Portland, six health organizations, including CareOregon and Kaiser Permanente, launched the "Housing is Health" initiative in 2016. Funding from it has supported two developments for low-income tenants, and another project is scheduled to open this summer.

Housing is Health is one part of CareOregon's response to housing issues. Case managers such as Mellick help non-residential clients look for solutions to their unique needs.

He describes a client who had lived on the streets for two years with a chronic lung disease. After helping to clear up his legal issues, Mellick found housing for the client.

He says the man is older and in a vulnerable position, and housing is helping to extend his life.

"He continues to engage in behaviors that aren't necessarily the healthiest for him but his utilization and the cost of his care drastically decreased for the simple fact that he was now sleeping inside in a warm, safe place,” says Mellick.

Mellick says one common thread among clients is a feeling of isolation. It can come from a variety of sources, such as trauma at an early age or the effects of racism or poverty.

He says addressing this could make for a better society.

"You're not just ending with the individual,” says Mellick. “You're looking at the individual's relationship with community. Healing, recovery, renewal. It goes back to the notion of relationships and the person's place in the community."

Construction will begin early next year on new affordable housing dedicated to low-income Oregon farmworkers. This project is the latest by the Farmworker Housing Development Corporation, a nonprofit that is partnering with Energy Trust of Oregon to make their housing more energy efficient. This year, the FHDC hosted workshops teaching more than 200 families how to save energy at home.

Ramon Martinez, communications and advocacy coordinator with the FHDC, said the payoffs are significant. Along with receiving more than $20,000 in incentives to help reduce energy use across their properties, residents' bills are down.

"During the cold months, some people are afraid to turn on the heater, right? But its been great because I've heard successful stories about residents seeing $200, $300 bills, lowering it down to the $100 range," he explained.

Research shows that most farmworkers in Oregon do not have access to affordable housing and often live in over-crowded conditions.

In Oregon and Washington, 32% of farmworker households live in poverty, which is more than twice as much as the general U.S. population. The Farmworker Housing Development Corporation manages 460 units across the central Willamette Valley, providing affordable housing to more than 2,000 people. Along with rental housing, it also helps farmworkers who are interested in becoming homeowners.

Christian Meneses-Zurita, senior asset manager with the FHDC, said it has hosted homebuyer resource fairs and recently started a fund to help farmworkers find housing and pay for education.

"Our affordable housing options can be a stepping stone," Meneses-Zurita said.

More information about the Ramon Ramirez Fund is at www.FHDC.org.

In early 2025, construction will begin on new affordable housing dedicated to low-income Oregon farmworkers.


get more stories like this via email

One life-altering situation turned a North Carolina woman's stability into homelessness and now, she is sharing her journey to humanize homelessness and advocate for solutions to affordable housing.

Tonya Adams-Ruffin, 54, never imagined she would end up on the streets. A combination of domestic violence and a work accident left her without a home, a situation from which she is still recovering as she transitions into new housing.

"That was one of the hardest things that I had to do," Adams-Ruffin explained. "Not knowing if someone is going to try and hurt you, not feeling safe."

With support from the Interfaith Council for Social Services, Adams-Ruffin is using her experience to lead and advocate for change. After receiving leadership training from the council, she has taken on roles such as working the polls in her community and raising awareness about the realities of being unhoused.

Another way Adams-Ruffin is raising her voice to dispel myths about homelessness involves creating signs to raise awareness, with messages like "We may be homeless, but we're not helpless." The signs are part of her larger effort to spotlight the struggles faced by homeless individuals, challenges extending beyond appearances to include barriers in accessing essential resources such as safety, food and shelter, even from organizations designed to provide them.

"Just because you're homeless, you don't want to have to be in a situation where you can't bathe, eat, lie down when you need to and feel safe," Adams-Ruffin pointed out. "What I would do is say, 'Look, we need to do more with affordable housing.'"

Adams-Ruffin stressed her advocacy thrives through partnership with the council, which helps her amplify her vision for community impact. She is also raising awareness about a national grant to support those facing homelessness.

Alyssa Hinton, voter engagement project lead for the council, said the organization is providing the resources and support Adams-Ruffin needs to make a difference.

"There is a national grant that is up for $25,000 for anyone who has faced or is facing homelessness right now," Hinton noted. "We are priming and prepping our members to be able to apply for that grant. We have ideas. We can get this money. We have a place to do this. Let's do it together."

In 2023, nearly 10,000 people in North Carolina were homeless on any given night.


get more stories like this via email

Low-income Montana residents are getting help accessing legal aid online.

In some cases, updates to automated legal forms could help residents facing eviction stay in their homes, and also assist people who need help with family law issues.

Montana Legal Services Association will use the $275,000 technology assistance grant to overhaul and redesign its most-used automated, online legal forms.

MLSA's Community Legal Education Coordinator Linden Howard-Murphy said the information from those forms will be integrated into the state's court systems.

"We know that not everyone can afford a lawyer, and we also know that navigating the court system on your own can be extremely overwhelming," said Howard-Murphy. "One of the cornerstones of our work here at MLSA is empowering Montanans with the tools they need to handle their civil legal problems pro se. Pro se means without a lawyer."

MLSA data show there is only one legal aid attorney for every 8,900 Montanans who need civil legal help. Howard-Murphy said upgrading the online forms will help improve those numbers.

Ron Flagg - president of the Washington, D.C.-based Legal Services Corporation, which awarded the grant - said streamlining the online help low-income Montanans can access could be the difference between staying in their home and being evicted.

"And if you're living on the edge, that means you're one medical expense, one fender-bender from not being able to pay your rent," said Flagg. "And having legal assistance available in those cases is a game changer."

The Legal Services Corporation funds 130 nonprofit legal aid programs nationwide.