Occupy Medical Meeting 6/12/13
Present: Andrea, Karen Adkins, Carla, Jason, Intake Donna, Becca
Posters: We need to get the posters up around town. Donna will check with T, and Sue to get them. Andrea suggested Sean from Occupy might be willing to distribute some of them. Suggested places were the library, Capellas, Sundance, Kiva, Friendly Market, Frontier Market, Red Barn, Voodoo donuts, 5th St. Donna will check with the WOW hall re: distribution also.
PSAs: We need to get some to KLCC, KRVM, Eugene Weekly. Donna will check with T.
Raffle tickets: Karen has raffle tickets for distribution. $130 worth of raffle tickets have already been sold. We need someone to set up a table and sell them at Saturday Market. Donna will contact Graham to get the gift certificate and display he has about the SeaRose Guest House.
There was some discussion about other raffle tickets or perhaps getting bottle of wine to sell or have as door prizes. Becca will check with her contact about wine donations, and check with Cosmic Pizza to make sure it would be o.k.
Bus Cleaning Saturday June 15th 10am-2pm SVDP on Chad Drive:
Becca has an all day workshop but she will make the food Friday night and Andrea will pick it up and bring it out. Karen sent out an e-mail about the clean-up asking for RSVPs so that Becca will have some idea about how much food to prepare.
At least one representative from each station needs to be there to have a voice in organizing the new CLEAN LEAN MACHINE/Occupy Medical Bus.
If people have non-toxic cleaning supplies, bring them. There was also some discussion about using Simple Green on some surfaces, and bleach on the foot soaking tubs. More discussion was made about pressure washing the bus, washing windows, etc. Andrea may buy some tubs for storage.
Martin is working on getting some Spanish translators for the Clinic. Carla got some Spanish forms from Lane County Mental Health. It was noted that most Spanish speakers bring someone to translate and the telephone translation did work.
Meeting Notes – 5/29/13
Attendees: Elliott, Bill, Andrea, Jason, Karen, Arline, Sue, Benjamin, Donna R., T., Jerry, Becca, Ambrose, Donna G, Ali, Debra, Cindy, Dr. Bruce, Carla
Dr Willy has a line on lower-cost labs: he says his pal who owns AnyLabNow will give us “doctor prices” for any labs we order. We need to verify that patients (or the clinic) will only be charged client fees if the order is written on an OM lab form. The Charnelton Clinic now only has 1 month waiting list and the lab fees are free.
From Dr. Leigh: Dr. Willy also had a patient who needs her old records obtained from California to evaluate a serious issue. I will make a Release of Records form on our letterhead, and practitioners can either write their own contact info (e.g. fax number) on them, or allow the records to be sent to the office and brought to the next clinic if non-urgent. This highlights the fact that WE NEED A DEDICATED MEDICAL RECORDS TEAM. If we are going to do labs and handle lab results, ditto imaging, as well as request and store old records, not to mention handling records for people’s disability claims thus we need a dedicated person/team.
We are providing urgent care, street care. We don’t have the facility or the volunteers for this service. We provide longitudinal urgent care. (Urgent care plus)
Bill proposed that we go through HIPAA training together.
cargo hold feedback and remodeling next step – the cargo hold was solid and easy to use. Remodeling – label and color code the boxes to make set and break down easier. Andrea proposed having a clean up day and bus remodel planning.
prescriptions – pads, current protocol feedback
grievance policy – we need the structure for handling and addressing grievances and incident reports. Emergency suspension from service. We agreed to temporarily suspend a volunteer that violates the basic rules. Patient endangerment, volunteer endangerment, HIPAA violations (if it causes harm), discrimination or clinic endangerment are grounds for immediate suspension by the team leader. The volunteers involved must write an incident report. The next meeting, the volunteer will have the opportunity to address the incident.
Notes approval – 4/15/13 notes approved, 4/22/13 to be approved next meeting
Meeting notes 5/22/13
Attendees – Donna G., Vickie, Donna R., Elliott, Jerry, Andrea, Cindy, Dr. Willy, T., Karen, Arline, Sue
data – Vickie passed out a sheet for record keeping. This was a sample sheet for data collection that we can use for grant writing. Suggestions were made for adding and subtracting to make this from user friendly.
Heber – June 30 Tamale making and selling at Church of theResurrection. His wounds are getting worse. He has run out of supplies. Sue and Karen and Donna will bring by supplies.
BP cuffs are still missing – Elliott said that he put all the supplies in one clear tote in the area under the triage counter. We have 2 new cuffs that we had approved funding for coming this Sunday. We will do a more thorough search this Sunday before clinic. We consensed to buying the adult and pediatric cuffs.
Cahooots – If there is a suicide threat, we must take this seriously and call CAHOOTS. Mental health won’t talk to them until they sober up though.
Fundraiser – Donna volunteered to help T with the fundraiser.
grant – Donna R and T are working with WhiteBird Dental clinic. Sue, Donna and T met with Kim from WBD to set up the requirements for dental access to their clinic for free patient care.
Andrea – will be leaving the 19th of June
Insurance – We still don’t have break down insurance for the bus. Neither Good Neighbor Sam or AAA will cover.
We will continue to have only 2 people as the webmasters manage the site. Leigh and Sue are the current webmasters.
Storage – Polk site is possible site for storage. Security is a concern.
Treatment – We have limited space in treatment. Triage agreed to get the BP before going to herbal treatment.
volunteer concern – Discussion of how to deal with unacceptable or dangerous behaviors by volunteers. Proper policy guidelines. When and how to report a grievance. forms/instructions . Statistics and incident report forms taken off of website. Discussion of sexual harassment policy and procedures. Inappropriate postings to the OM website. Decisions re: new protocols, by-laws were read for clarification, prior mediation through SUGAR re: volunteer concerns, some discourse regarding decisions made at last week’s meeting, clarification re HIPAA discrimination pt endangerment volunteer endangerment clinic endangerment, unlawful activity, operating out of scope of practice,
policy changes, rules re: suspension of volunteers, proposed changes in
New proposal for by-laws, what is an “urgent/emergent” problem, protocol for removing a volunteer, possibility for team leaders to have a meeting once a month.
All Voting for new policy put on hold, 1) proposal once a month for policy, 2) proposals for changes to by-laws 3) how to bring closure for current volunteer problem
stress of ground rules getting solidly set, discussion of how to find an appropriate mediator
work on the wording, is listserve appropriate for this discussion
can we agree that suspending volunteer wasn’t following by-laws, clarification of what is an emergency suspension. (The last agenda item was revisited by the OM. See notes for 4/27/13 for updated information on this topic)
Next meeting:approving or amending by-laws, respectful communication via listserve
Attendees – Donna, Elliott, Brooke, T., Arline, Jerry, Andrea, Ali, Jason, Cindy, Leigh, Sue
growth plan – Elliott and Brooke gave a thorough presentation of our clinics growth. They passed out handouts and posted more notes on the wall to make it easier to see. Our patient load has quadrupled in the last 6 months. According to the growth rate which Elliott and Brooke tracked, our projected growth is between 25-40%. This means that by October we will be seeing between 155-300 patients per clinic. We are currently utilizing between 21-24 volunteers per shift. See the information in our Documents section of the website for more information on this presentation. Perhaps we need to break up our patients into acute and chronic care. 3 hour shifts for doctors to plan for overlap. Scarce resources are doctors and real estate.
mission statement – 501c3 paperwork has mission statement. Sue will send it to the email group. Siletz Tribe grant has money available. They will accept applications for under $15,000. To do lab tests, we need a CLIA waiver. This is a federal certification.
list serve – Volunteers that are vetted are on the list serve.
Sue’s job description – We need to agree to basic communication skills. Presentations in the community. Managing. 1st contacts. Taking to the press. If others can think of things they would like to add to her job description, please send her an email. Sue does not want to over or under step any boundaries. Clarity helps her do her job better.
U of O Students for Global Health – We have 2 students from this organization. We can draft volunteers from this group.
Fundraising – Steel Wool fundraiser is arranged for Cozmic Pizza. The Sugar Beets fundraiser is on the back burner for next year.
Coburg clinic – $1/month for rental of the space
Bus remodel – Dave will do an estimate of the remodel
Bus cleaning – We need to clean the bus. It is yucky.
Flow managing with treatment and docs will be discussed at a later date.
New intake form – Dr. Leigh brought in the new intake form. Some of the information has been eliminated on the form. Some information has been added.
Covering hospitality – Terra and Martin?
Trillium presentation – Sue 8:30am- Wednesday, May 12th
Larissa from Triage is applying for med school. Those that work with her could write a reference. This is one way to say thank you for all her hard work.
Attendees – Donna, Allie, Jerry, Wendy, T., Becca, Dr. Willy, Cindy, Brooke, Cindy K., Donna G., Elliott
Intake – Donna/Brooke We need to keep better track of our charts. Dr. Willy was trapped last Sunday and needs to have a runner to contain patient flow. Triage will work up a list of protocols to establish better patient flow. Take out pink chart to be served first. We will be cutting off patients at 3pm. Intake does not need to track treatment any more. Brooke will take care of this later.
May Day – Rally at Kesey Square. Sue has been invited to speak about OM. Consensus achieved.
MAP – Cindy will not be working at Peacehealth any more. Her new job allows her to directly access MAP for our patients at Occupy Medical. She will bring her laptop and enroll patients on Sunday. The behavior meds will not be on her list of meds to fill.
Kickstarter – Kids from UofO are close to finishing the kickstarter video
Calling a meeting to reenforce our allies -
fundraiser – T is getting the run around with connections on starting the band fundraiser. Becca will call her contact to get the number of the go to person to make this project go faster.
Trauma Center workshop – Tuesday 4/30/13 at Trauma Healing 1-3:30 – Workshop on dealing with patients with trauma 222 Coburg RD.
Cindy – announcement Trillium may be interested in funding us. Chiropractor/PT volunteer potential. He is invited to pop by and see how the clinic runs to see how he would fit in to the program.
Coop program LCC – Arlene discussed using our program as a destination for LCC students. Elliott and Sue will meet Peter to get more details.
Med students – Jerry met with the head of the OSU Pharmacy school to reinforce our relationship with their program. Consensus on moving forward with pursuing this project.
4 month camping ban – July 1
Cahoots – T suggested that we ask a rep from Cahoots to share the aspects of their program
Churches – T would like to see more churches to share food through out the month.
Retreat – Come one, come all. Bring food, bring liquids. Email Becca to let her know what time you will be arriving.
Vaccine Clinic – May 5th as planned. Allie sent a notice to Eugene Weekly already.
OM meeting April 3, 7-9pm Campus Glenwood,
Attendees – T, Brooke, Cindy, Elliot, Nurse Karen, Jerry, Andrea, Donna R., Benjamin, Karen M., Leigh, Donna G.
2nd tent – We have not heard back from Costco yet about the free or reduced price tent. Elliot and Jerry will go down to Costco tomorrow to find out for certain. We need the tent no matter what. If we can not get a reduction in price, we consensed to buy the tent no matter what the price by Sunday. It will rain and our patients are overflowing the existing space.
We will be getting a cot via Donna as a temporary outdoor exam table.
The water issue is partially solved. We have a donation from McKenzie Mist (Thanks to Patti Leahy) for 3 free 3 gallon containers of water with a pump per week. We just need to bring back the containers to be refilled.
Hot water – Sue hopes that our hot water worries are worked out. She wants to set up more water heating stations so we don’t get caught without an adequate source of hot water next time.
Volunteer log – We have more stats coming. We need to log our volunteer hours for future grants.
Mental health – Karen has been invited to sit on a board for community mental health. They are addressing the inadequacy of the system and amend it. It is a agency wide collection board.
Eliott talked about a clandestine meeting with a judge and 2 county workers who have no place to send their mental health clients. Is that us?
We need to find out how to manage our growth. How much money will it take to serve the increased population? How many staff? Where do we put them? Elliot and Brooke will work on this topic. We consensed that Karen will be our ambassador for the Mental Health Summit.
Dalia Lama – Both Karen and Sue invited the Dalai Lama to tour the bus. Those of us with tickets will flyer the inside of the Dalai Lama speaking event.
Friday Clinic will start again in June after Karen’s knee has healed.
501c3 – OM Bylaws were officially adopted. We consensed that Brooke is our Secretary. She agreed. Her first order of business is to sign the adopted bylaws.
Jerry contacted Good Neighbor Sam to get a quote on road service.
Meeting notes - 4/10/13 Attendees - Donna R., Sue, Karen, T., Elliot, Ben, Becca, Jerry, Alison, Andrea, Mark, Brooke, Cindy Agenda - Sean has gray scaled our brochures for print - 5,000 for free School board report - 4J school board is considering eliminating the in-school health and mental health clinics. Sue made a request to the school board to reconsider this austerity measure. Abusive Occupier - Sue would like to provide a safe place for women that have been victimized by the person. We can collect their stories and find a place bring them to light to protect the women that have been suffering alone. Donations - herbs - T suggested we need to get donations from larger companies. The herbalists have a list of potential donors that they are splitting up to beg for funds. Clinic flow - Karen noted that since we have 2 tents, we can divvy up the patients more effectively. We need 2 doctors at the beginning. We need 1 more Braun ear thermometer (White Bird) for triage and nurse station. Insect reports go to nurses first to determine whether the patient goes on the bus or not. Signs are needed for the tent - No smoking 1 free item per person 1st come 1st serve but some patients may need to be pulled to the front of your line. Thank you for your understanding. No photography without express consent of Occupy Medical. Permission forms are available at the intake desk retreat - Saturday, April 27th is a proposal for retreat. Call Karen for directions. Potluck and bring your own liquids. fundraising ideas - Garage sales, pints for a cause. Check in about mental health - is it working? - We feel supported by mental health. Vaccine clinic update - Heather proposed May 5th for the Lane County Public Health Tdap vaccines like we did last time. Allison is handling this event. Brooke notes - refills for pharmaceuticals, Google Voice Mail will have information about our refill system, Both refills from the VA and from the prison system can not be refilled. they must be treated as new patients. Volunteer time - We have an online form for logging volunteer time for grants. We will print out a version of the forms for hard copies to put in a folder. Hospitality can keep the hard copies and the name tags to distribute and remind people of their hour logging obligation.
Being asked to do things beyond our scope of practice
-Each team will handle things around scope of practice
Brooke reported back and there is a triage -> doctor choke point.
Maybe the Mission can treat lice.
Maybe the medication is over the counter.
People who say they have lice should not be on the bus.
Patients do not hold their own chart.
We need runners to get people to help with various things, including getting people for the different stations (doctor, triage, etc..).
Volunteer application has been put together.
There are some changes that Brooke will make to the form.
Martin rocks! We LOVE Martin!!!
Policies need to be made about treatment of animals and children.
Mental health team should feel free to intervene when this mistreatment is happening.
We need to learn about how to handle these situations: Agenda for retreat?
We need to remember we are mandatory reporters. Can we get mandatory reporting training?
On Sunday reports of child abuse go to 911.
Last weeks clinic:
We saw 28 people.
We would like to have people not playing and smoking right outside the bus.
We are seeing who have dealt with police brutality.
What about contacting lawyers in town that would be willing to help our patients.
Donna has applications for people to get $500/year dental care, but they have to have a lot of qualifications which our people probably won’t meet. Donna will keep the applications on time.
-Cindy has some dental resources.
OHP is opening slots and section 8 is opening slots.
Jerry will follow up with Lena about Dental
Do we want to take the bus?
We should have a table. We need some kind of presence.
We’ll look into tabling.
501(c)3 is almost done! Whoo whoo!!!
Larissa and Cindy got twinkle fingered into the group.
Do Karen and Martin want to work on this? Yes – Karen does! So does Martin!
Karen is taking an inventory of what we need and keeping an eye on it.
Karen and Martin are going to help people with boundary issues.
Do we need plastic shelving?
Water: we do have some in the back of the bus. It is being given out at a little of a time.
Patients need vitamin A.
Jerry and Elliot went to Costco to get a tent donation.
They have not gotten back to us. What about BiMart?
Should we park in BiMart on Sunday?
The brochure needs to be updated, Leigh will do that.
We need a printer.
Jerry will call a potential printer.
Can we get them to translate them into spanish.
We need to document the number of volunteer hours that we are putting in. Brooke will make a form for us to document.
Leigh will put together a protocol for when labs are needed by the doctors.
When a patient needs labs: a doctor will fill out a triplicate form that the patient needs labs, etc..
then lab sends the results to the doctor.
Eugene urgent care.
Sarah M is going to look into matching funds from Legacy Labs. Hopefully we’ll have money for labs.
Patients need to be somewhat reliable in order to run labs. How to determine that? Cindy can help follow up too.
We have 2 new pastors.
Pastor Tom has helped out.
Can the pastors come in civvy clothing? Brent and Tom.
Vistors will be asked to wear visitor tags at our discretion: name tags with occupy medical visitor.
Discussion ensues about helping Cindy’s patient with the wound care situation.
Susan is going to explore the potentials of a wound vac.
Medgift.com is a website resource.
In April the Oregon Medical Association is having their statewide meeting and the focus is on poverty.
Road trip to PDX April 19.
April Road trip: recruiting at medical schools.
Permission for capsule purchase.
Sue has a bunch of groovy herbs she needs to put in capsules. We’re going to buy capsules.
We need a different person to take notes and to facilitate.
To set agenda: pass around agenda on a piece of paper.
The day we have people coming. They are bringing lunch, and money for prescriptions. 11:30 – 12, and then 12-2.
OM meeting attendees: Donna R., Allison, Sue, Carol, Larissa, Carol, Jerry, Andrea, Eliot, Brooke, Benjamin, Donna G.
Last Sundays Clinic:
Good food, 32 patients, 2 doctors at one time made it easier to serve more patients, prescription service will be easier with Cindy’s connection for free bus passes, urine strips for blood glucose levels,
Conference update – Conference went well, we had many things to brag about, Occupy Newport and another group definitely want to start their own clinic
Palm Springs – National Mobile Clinic organization has been in contact with Jerry about speaking at their convention. We consensed about communicating with them.
2nd tent – Buy a new tent or a used tent. Ask Costco for a donated tent.
Vetting volunteers – process for vetting volunteers, volunteer application – Allison and Brooke will work on this, references and ID.
Patient H.update – The tamale fundraiser was successful in helping him get money for the lawyer to work out his immigration status. He had his backpack stolen this week so he lost his medical supplies.
New cards – We agreed to get another set of cards and it will be paid for by OM funds
Cottage Grove Health Fair – sue will send information about this event to the list.
White Bird wish list -
blood glucose strips
triple antibiotic cream
Occupy Medical Meeting
Attending: Andrea, Jerry, Elliot, Sue, Benjamin, Arlene (New! Yeah!), Donna R., Brooke, T, Leigh, Donna G.
• Trauma Healing Project: for acupuncture. It is free, it can be free.
• Patient(s) in the tent with electronics: They need to sit some place else besides by the coffee pot. Elliot will bring an extension cord. We may need to set up a separate electronics.
• Jennifer F-K and Scotty Perey are trying to get us a separate tent for a quiet waiting spot which can be used by mental health for peaceful retreats. The tent needs walls.
• Resource nurse?: we weren’t able to do this because we were short staffed. We will try again next week.
• Karen: Looking into putting Friday clinic at Springfield. Donna has given Karen the application and guidelines. Difficulty: finding space for the bus that has electrical hook ups. We will need some one to reserve us 2 parking spots.
• Triage team: Did they get together? Not yet.
• Jerry: next dental clinic? Lina is possibly organizing this in conjunction with her organization OCA.
• Incident form? done! Looks great. Might need a place for follow up actions.
• Benjamin got reimbursed!
• Policies and procedures will be on the website.
• Doctors that have been recruited: Dr. Mark? Dr. Mark? There are 2! One of them wants to work with the Friday clinic. Peter is Dr. Mark’s entry. Matthew McClain: Pac
• Recruiting: Jerry is going to go around to schools to recruit medical people.
Mental Health Team: met right before clinic.
• Becca is the point person for Mental Health
• The primary purpose is to make things easier for people on the bus
• No one will be there as a “Mental Health person” to offer professional counseling.
• Becca and Benjamin will give training on rephrasing.
• More information on scheduled drugs and those that aren’t prescribed to be put up around the clinic.
• Will they put together information on when to call Cahoots / the police?
• Sue: Safety of the clinic, volunteers and other patients is more important than the immediate concerns of a single patient. in other words, we can not allow a disruptive patient to endanger others.
• Sue’s policy about being seen on the bus:
- If the patient is a danger to volunteers or patients, they can’t be seen on the bus. (example: physically or sexually threatening)
- If a patient escalates in enclosed situations then they are seen off the bus.
- Patients that have highly communicable diseases they need to be seen off the bus. This is always a danger but some patients come with a diagnosis ahead of time. (ie. TB)
• At intake: If you see a pink clipboard, that patient should be seen off the bus.
• We have a safe word now: if you hear the phrase you are to drop everything and go assist. Ask what it is.
• People seen off the bus: they should be seen with more than one person.
• The mental health team will accompany someone who could be a problem on to the bus.
• Leigh has created a triage form for mental health.
We reviewed our drug schedule policy and decided to keep it as is.
Labs: we have funding for labs and are looking for funding for labs.
One complication: do we draw blood on the lab or do we send them?
We do have a number of people who can draw blood.
• Discussion about what the purpose of the form is, and how to format it.
• Do we need to figure out protocols for dealing with some incidents?
- We do have some protocols in place for some of them. They are on the bus. Ask someone on the medical team.
System flow data was briefly reviewed. Brooke, with Elliot’s input, will continue data collection the next two Sundays. Looking for clocks or watches to make the time checking easier. Brooke thanks everyone for being so helpful with this!
Send Mayor Piercy and the the City Council an email to thank them for the port-a-potty (email@example.com) We do not pay anything for this.
FYI: Our safety net clinics are gone, thus Occupy Medical is increasing in numbers.Whitebird, Charnelton Clinic, Riverstone (County Clinic) are closed to new patients or have a 3 month waiting list. That is one of the reasons why our numbers have gone up.