As a Social Determinants Specialist for the Housecall Providers Advanced Illness Care (AIC) program, Phil Cleary is making a name for himself as someone that will stop at nothing to get his patients/clients everything they may need to support their health journey. Lately though, at least in the eyes of AIC patient Richard Crowley, he is entering into hero status.
“If Phil hadn’t stepped into the picture, I probably wouldn’t be here. I did the best I could to take care of myself, but I would likely be living in my car, and it would just go downhill from there,” Richard said.
Late December 2021, on the verge of unconsciousness, Richard made a last-second decision to call a friend instead of 911 to take him to the hospital because he was worried that emergency services wouldn’t get to him in time. “I was living in my RV on the outskirts of Beaverton and my friend knew right where I was and could get to me fast,” Richard said.
At the hospital Richard was diagnosed with COVID-19 and pneumonia. Those conditions coupled with a pulmonary embolism caused by blood clots forming throughout his body required that he be hospitalized for nearly three months. Upon release and needing to be on oxygen to manage his newly developed COPD, the same friend took him in so he could further convalesce. “I only stayed with her for a month before I was back living in my car in front of the autobody garage where I had been a night watchman,” he said.
The shop owner allowed Richard to plug his oxygen concentrator into an inside outlet which snaked through a window and into his car to help him while he slept. This, too, was going to be temporary though since the building was under contract to soon be sold.
A CareOregon member for years, Richard was assigned a respiratory therapist who quickly realized that more support was needed to help him manage his serious condition. Shortly thereafter the referral was made to the AIC program and nurse Sarah Vinopal and Phil visited Richard at the lot in front of the garage.
“Rick is a fighter and a survivor through and through,” says Phil. “He has adapted and found ways to keep going after he could no longer afford his last apartment, however many years ago.”
After speaking with Richard, the team learned that he was a honorably discharged Vietnam Veteran, so, with Richard’s blessing, Phil started to engage with Veteran Services with the goal of getting him a DD214 (the form needed to verify military service for benefits), a process that took upwards of three months. “I had been playing with the VA for a long period of time – trying to get some kind of help from them,” Richard said, “but when Phil got involved, things started happening.”
Even before the paperwork was completed, Phil had lined up an interview with staff from The Salvation Army Veterans and Family Center hoping to get Richard temporary housing while he also worked on obtaining the ultimate goal, a Veterans Affairs Supportive Housing voucher.
“We did a brief interview during their drop-in time and filled out the pre-intake paperwork,” says Phil. “He was then invited for a formal interview with eight people and the Major who runs the center. He really charmed them so they wanted to take him immediately, but they couldn’t until he proved he was enrolled in the VA.”
With the help of Sage Takayama, the Salvation Army’s Veterans Service Officer (VSO), Phil obtained Richard’s DD214 at the end of last August and he was able to move into the center just days before he needed to vacate the lot where he was parking at night. Eventually, he not only received the voucher enabling him to move into his own apartment last February, but discovered with the help of his case manager, that he qualified for a VA pension because of his service-related health conditions.
“I didn’t realize I was even eligible for a pension,” said Richard “but Sage did some research into my service record and told me that I was and that I should file some claims.”
Sarah and AIC Social Worker Karin Weaver have also been instrumental in Richard’s post hospital care this past year. They check in on him regularly and accompany him to medical appointments ensuring that he understands the information and orders put forth by his doctors. They also support him by providing disease and symptom management education so his plan of care can be followed.
“My doctor told me that it would be a long, long, road to recovery and I am so appreciative of Sarah, Karin and Phil’s support because they really get me,” said Richard. With the wraparound palliative care support that the AIC team delivers, Richard can rest assured knowing the team will be with him helping to ensure he experiences the best possible quality of life along the way.
“It makes me proud to do the work that I do,” said Phil. “I get some pretty tangible feedback that my working hours are often well spent on trying to lift people into better circumstances.”