This document discusses several organizations that provide charitable care in communities. It describes non-profit dental clinics, food banks, meals programs, and healthcare organizations that offer free or low-cost services to low-income and uninsured individuals. These services include dental cleanings and treatments, medical care, food assistance, and support for those with HIV/AIDS. The document emphasizes the importance of these charitable resources in improving health and reducing health disparities for vulnerable populations.

1. In order to provide charitable care to those in need we are in need of providers and others
to volunteer their time to help the community. But there are a lack of providers willing to
volunteer their time and sometimes their materials to do so. With the help of non-profit
organizations that are going out in to these communities it can encourage the providers to want to
volunteer their time, especially if the materials to do so are provided as well as the equipment
needed. There is also the challenge if more need than help in the community, that these non-
profits are flooded with people who are trying to receive care and they are not able to fulfill the
needs of everyone in one day. Today there are many organizations around not only the Portland
metro area but also organizations that travel nationwide and international to help those
communities that are poverty stricken.
Mission of Mercy also known as “MOM” is an organization which started in 2010, that is
known nationwide for providing free dental care. Since starting in 2010 they have provided $.47
million dollars in free dental care to 7,811 patients (facebook). They bring together doctors,
dental assistants, hygienist, dental lab technicians and also find others to volunteer time checking
these patients in. The importance of having an organization to provide this type of service is to
make sure that those who would not otherwise be able to afford dental care are able to receive it.
When people are seeking this care they are in need of dental cleanings, but they also need
treatment such as extractions and fillings. If a person’s oral hygiene is poor it can cause other
medical issues, it is a vital part of our health. By having this organization come and give their
time to help these community members it is rewarding knowing your heling them get on a path
to a healthier life. Their mission statement says it all and you know that this organization is
passionate about education to raise awareness of the importance of oral hygiene.

2. A successful MOM focuses on:
“Providing free access to critical dental care while placing a high priority on
patients suffering from dental infections or pain. Raising awareness of the
increasing difficulty low-income adults and children face in accessing critical
dental care. Challenging low-income and Medicaid patients, policymakers, and
dental professionals to work together to reduce the disease burden and improve
the oral health of Oregon residents, including those who have been promised care
by the state.”(facebook)
In the Portland metro area there is a local dental group Green Apple Dental, they have
multiple locations from Clackamas to Tualatin. The day after Thanksgiving they open for one
day to the general public on a first come first service basis for simple treatments such as
extractions and fillings. They give about an hour per patient and in that time get what they can
done. Every year there is a high turn-out and long lines for those seeking care, they have between
four and five doctors on hand and each one has an assistant to help them with the treatment
process. For those who are underinsured or uninsured it is a great way to take care of a filling
that either needs to be replaced or if there is a severely decayed tooth it can be extracted so it
does not cause further damage and lead to infection. The founder of Green Apple Dental Dr.
George Kang believes the importance of serving the community and giving time for those who
truly need it. Dr. Kang finds a rewarding feeling to be able to give his time for the needs that are
in the immediate community.
Medical Teams international is another organization that travels the Portland Metro area
on their dental bus. Started by a business man in 1979, Ron had a desire to help those in need.
Today they have offices in nine countries and five states. The mobile dental clinic was started in

3. 1989 and is still going strong today. Each day of each week they are in a different location
providing dental care to those who could otherwise not afford it. It is common to see those who
are homeless seeking the services. There are a group of dentist who volunteer their time to go to
these comminutes and help these people. They also look for dental assistants to volunteer to the
doctor on the procedures, and sterilizing instruments and getting ready for the next patient. The
other important aspect about medical teams international is that they have groups of people who
travel to other states that have declared a state of emergency and also international to volunteer
their time for immunization clinics and providing medical care.
Compassion Clinic is another non-profit organization that goes to different churches in
the community and set up to provide dental, and medical care. It can include chiropractic care,
foot and nail care as well as vision care. Currently there are four states that have set up these
clinics they include Oregon, Washington, Arizona and Idaho. Currently Oregon is number one
with 14 clinics in different communities. Pastor Gary from Clear Creek Church located in
Gresham, Oregon decided to start local medical, dental and vision screenings for those in his
community, after mission’s trips left him wondering if this could be done right here in our
backyard. It has since grown from the first clinic that started in April of 2006. 10 years, 4 states
and creating what is now called Compassion Clinic Connect they are able set up in multiple
church locations to serve the people in their community.
Nelson Pediatric Dentistry and Orthodontics in SW Portland is private duel specialty
office specifically for children and orthodontic needs (braces). Dr. Casey Nelson is the pediatric
dentist in the office and he provides care to children for their dental needs preventive and
treatment. Being one of the only offices in the Portland metro area that is specific to pediatrics
and is currently taking the state funded insurance plans. We do a vast amount of charitable care

4. for these children. Most need dental treatment for SECC also known as severe early childhood
caries, and most are too young to sit in the dental chair and not willing to let you do much in
their mouths. He provides dental treatment under general anesthesia and oral conscious sedation
for these children to treat the decay. Because these children are on state funded insurance the
fee’s that he charges are way above what is actually paid. He is also a mercury free office and
does not place amalgam fillings. Most insurance plans do not cover the composite material and
there for he again is writing off more than he is making in these cases. Dr. Casey believes that
these children are not to blame for their cavities and hopes that through education to parents
about more than just brushing and flossing that he can make a difference in these child’s lives
and their parents.
Dr. Casey Nelson also believes that working at the pace of the child is in all parties’
benefits. He does not hold children down for treatment or force them to do anything they are not
ready to do. Although sometimes he can get firm with a child and have to use behavioral
management including TSD also known as tell-show-do and the use of voice control. Both have
been known to really work when it comes to working with children who are a little nervous and
resistant during any treatment. Having had the pleasure of working alongside Casey Nelson for
the last two and half years as his chairside assistant I have seen him work and believe that he is
one of the best out there and has been able to get children gain his trust and have them do things
that they many have not otherwise done in any other case. Because we are a mercury free office
and most insurance companies do not pay at the composite filling rate he always writes off the
difference for the patients, he also will do small fillings and give reductions in co-payments to
families as he sees fit if they are a good child.

5. It has been recommended by the Institute of Medicine and the Commission of Dental
Accreditation (CODA) that dental schools incorporate community-based accredited program for
dental students. During this program these students will be able to learn the skills needed and
appropriate for that community that is vulnerable. This would teach them confidence in the skills
they have gained and motivation to want to work in these communities after graduation. Because
there is such a high population that does not have access to dental care or they are not educated
in oral hygiene, these students that went through community- based dental education (CBDE),
weather working in community clinics or they are working in a private practice that provides
charitable care. The importance of having dentist willing to go out into the underserved areas is
very serious, we see many different community outreaches. But having these dentists who went
through the CBDE, have further knowledge of how to best serve this population and to teach
them the skills needed to better their oral hygiene
(http://www.jdentaled.org/content/78/1/110.full).
Virginia Garcia Memorial Health Center is another non-profit organization located in
Washington and Yamhill county with 5 health centers and multiple school based health clinics,
as well as a mobile clinic. This organization was started in honor of a young six-year-old girl
who along the way traveling with her farm working family had cut her foot, her foot became to
infected and she sadly died. Because of the socioeconomic issues and language barriers they
were unable to seek help. This raised the community and Virginia Garcia was started in a three-
car garage, they were determined to prevent this from happening again. Today they serve nearly
42,000 people a year between the centers, school clinics, and mobile clinic. The clinics provide
other services such as dental care and pharmacy needs. They also provide outreach to schools,

6. community health fairs and to migrant and seasonal farmworkers at local camps and commercial
nurseries through our mobile clinic.
The school-based clinics are located on the school campus and there they provide many
services to aid in the needs of young teens. These clinics provide mental health services with a
licensed therapist, there is a doctor on hand to provide a range of test from pregnancy to sexually
transmitted diseases. They also provide birth control and condoms to the students as well to
encourage them to practice safe sex if they choose not to stay abstinent. During the month they
also have a hygienist come to the clinic to provide dental cleanings and other preventive services
such a fluoride treatment and sealants. These clinics have become a viable part of the school’s
community; teens can now go in confidence to these clinics without having to face their parents.
In most cases, kids will not go to their parents and ignore the signs and symptoms of an STD or
other medical issue. But also it is a great resource for those students who are in need of mental
health services.
Paramedics, EMT’s, and firefighters are very important part of our community, they
provide lifesaving skills every day to anyone and everyone who is in need. For those who are
homeless and without insurance but are in need of medical attention these men and women run to
their side and provide medical treatments and transportation to the hospital. This is another way
we see charitable care in our community, because these medical professionals without any
question or hesitation are required and responsible to provide the medical attention that is needed
or if they are unable to effectively take care of the medical emergency they will transport to a
facility that can. Because they are homeless and more than likely do not have any insurance, no
money is exchanged. It is their duty no matter what to provide care if they are requesting it.
Without these brave men and women, there would be more deaths, homes burned to the ground.

7. Every day they will wake up and go to work and risk their lives for the rest of the community
that is a not only a definition of charitable care, but also bravery and selflessness. These
professions under acknowledged and they all deserve the upmost respect from everyone in the
community.
In the community we also see a need for those who have or may have contracted hiv/aids.
Although we see it more common in the LGBQT community it is also in the hetero-sexual
community as well. The cascade aids project (CAP) located in downtown Portland, started in
1983 and then incorporated into CAP in 1985 started with just a two-person staff and a budget of
100,000 do a 60-person staff and nearly 6-million-dollar budget. CAP is an organization that
helps those who have been diagnosed with HIV/AIDS. The help comes in ways such as housing
and helping them find stable employment. They also help with finding the essential medical care
that is now required and just helping overall with the endless list of issues that come with a
diagnosis like this. They hold true to their mission statement “Our mission is to prevent HIV
infections, support and empower people living with or affected by HIV, and eliminate HIV-
related stigma and health disparities.” The importance of this organization is the educate
everyone in the community of the safety of not just safe sex but discussing with you partner and
telling them you are HIV/AIDS positive, not an easy task they give you the guidance and support
to help you process and the way to talk to your partner. It is also a great community resource for
those who are HIV/AIDS positive and where you can meet others in your community who are
dealing with the same issues.
This organization is there for them when they lose their family, friends, housing, and job
due to the side effects from the disease. They are left with nothing and when they turn to the
CAP for help, they are there to help and will do what they can to get you back on your feet. They

8. encourage these people when they are depressed and feel there is no hope. I truly feel that
without the help of this organization that the disease could be more wide-spread, more people
would die earlier from the disease or they would choose to end their life because of diagnosis.
CAP offers testing for HIV/AIDS and they also offer a medication called PrEP, Pre-Exposure
Prophylaxis. This medication called Truvada is taken daily and can help reduced the risk of
contracting HIV/AIDS, as well as open and honest commutation with you partner(s) of your
status and the use of condoms. CAP offers free and low cost testing for Gay, Bi men and trans at
Pivot, the test includes; STI’s, HIV and syphilis during the week each day they offer certain
testing and the doors open at different times each day. They also have Testing4All located at
their main clinic for anyone looking to get a rapid HIV test as well as an outreach program, CAP
brings the rapid testing to your area and events hosted in the metro area. CAP is planning to open
an LGBQT health care clinic in 2017, they will focus on wide range of primary care, mental
health, integrated pharmacy services for those in the community as well as specialized services
for the transgender, and of color community.
It is important that we understand that charitable care means more than medical and
health related services. In order to be a healthy community we need to have access to food and or
have food provided for us. The senior citizen community is a high concern of being able to have
meals prepared for them and even having access to get food. They live on strict budgets and most
are on high cost medications that they need to live. Most do not have ways to get around town to
even be able to go to the store, or they are unable to leave their home. Places like meals on wheel
is a great resource for those who are unable to leave their home and unable to prepare food. They
live true to their mission statement every day “We enrich the lives of seniors, and assist them in
maintaining independence, by providing nutritious food, human connections and social support.

9. We also use our expertise and capacity to serve other nutritionally at-risk populations.” Most
senior citizens are living along and in isolation, with no other contact with other people. By
being provided these meals they are able to not go hungry and get social interaction.
Meals on wheels also has dining centers that provide hot meals and lunches, but they also
provide art classes as well as outings throughout the community. These diners are for those who
are age 60 and older no matter income. They are asked to donate what they can but are not
required to pay the full amount. They offer a healthy balanced lunch with a salad, starch
vegetable, bread, desert and beverage. For those who are diabetic they offer a meal for them as
well called the DASH Diet, it focuses on low sodium and low cholesterol meals. While their
mission statement is geared towards seniors they also have a program for children as well, they
have meals delivered to them that are in a low income family and community as well as those of
color who do not have the ability to prepare a meal. Having these diners in the area promote
health and well-being for the senior citizens of our community and encourage them to come
together and meet and create friendships and bonds that continue outside the doors of the diner.
Throughout the community there are food banks locations set up for families in need,
donations are taken from stores in the area that has food that is near expiration date or past the
perishable date but is still safe to eat. It is picked up and sent to each facility where it is
organized and placed in boxes. Families are then able to come and pick up a box, or they are able
to pick out a certain number of items from each food group. Without these food banks there
would be a number of families that would be going without meals to eat. The Oregon food banks
mission is to “eliminate hunger and its root causes . . . .because no one should be hungry” Started
in 1975 they were created to eliminate hunger but also address the issue of food waste. There are
21 regional food banks and 950 relief agencies. Together they team up with farmers,

10. manufactures, wholesalers, retailers, individual and government agencies, that provide the food
that is distributed. They go to the 4 main regional banks where it is organized then delivered to
the nearly 300 food pantries in the area.
There are many reasons that food banks are important in our community and surrounding
areas. First they are there to provide food for those and their famines who otherwise could not be
able to, but also they are reducing the amount of food waste that is going into landfills. We are a
world filled with waste and anyway we can reduce our carbon foot print so to say, benefits us in
many ways including our health. The other reason food banks are important to the community is
by building a stronger more connected unit from those that graciously spend their time
organizing the food that comes in and getting it ready to place on shelves or in boxes for those
families. Food banks also can teach these families about starting their own garden and the best
way to utilize the food that they are given by offering classes on cooking and gardening. By
providing these classes those in the community come together to create a way to have constant
provided food for these families while also eating healthy fresh fruits and vegetables instead of
frozen, canned and processed foods that have other additives that are not the best for our bodies.
Heart 2 Heart farm located in Sherwood, Oregon is a family run farm by Tyler and Liz
Boggs that believes in raising organic, and hormone free live stock for butchering purposes, they
also provide different raw milks from goats, and sheep. They were concerned about the
pesticides, hormones and other chemicals that were in the foods that their daughters were eating.
They sell all their meats to the public, they include yak, chicken, quail, duck, beef, alpaca, pork,
and even rabbit. They also provide fresh quail, duck and chicken eggs as well for purchase. Heart
to heart understands that not everyone can afford the cost of fresh eggs and organic range meats
so they have barter, work-trade and other options to work with you. I feel this is great for

11. families in need and that are unable to afford to always buy meat even at the grocery store. They
are able to work on the farm, including feeding, bathing and cleaning stalls. They recently
announced expanding the southern Oregon and have great options for work for living. They will
let you live on the farm and work for your food and room and board.
The farmers of Heart to Heart also provide many classes and summer camps for children
teaching them about the farm and all the animals. They offer a wide range of classes from
butchering, upcycling, rain water collection, food preservation and fermentation as well as a few
others. These are all great classes for those families who are looking to stretch the food that they
have and how to otherwise create food of their own. These classes are wonderful for anyone
interested in what Liz calls “living off the grid”, because your able to use what comes from the
earth and use otherwise products that would be thrown away and create something useable in the
home and in your garden. I believe this in charitable care because they are willing to help you
get on your feet and provide fresh foods and education to do this on your own at home. Tyler and
Liz are always looking for help around their farm, but warn that it is not for the faint of heart, for
those who are not big animal fans, and are ok with getting a little dirty while on the property.
Old McDonald farm located in Corbett, Oregon is the only nonprofit farm in Oregon,
they started in 1994 and offer many different classes and lessons for children. Old McDonald
farm partners with Saturday Academy and created many different programs, classes and groups
for children. During these classes children are taught about agriculture and animals, and are
immersed in activates that include lives animals. This is specifically for children and they are
always looking for help, encouraging parents and other adults in the community it volunteers
their time to help during the summer programs. Having this farm and these programs for children
encourage them to love animals and become educated in agriculture and the needs of animals.

12. Although it does cost money for some of the classes and programs other people are donating
time and money to make sure these children are given the opportunity to learn and it gives them
something to do that is educational.
The Red Cross is another example of charitable care in our community, they provide
housing to those who are displaced during fires and natural disasters. But they are also in need of
people to be a apart of the charitable care, by donating blood to the blood bank or hosting a blood
drive you can be part of charitable care. There is always a need for blood donations for hospitals
in our area and all around the world. They provide different classes about live saving techniques
for anyone who wants to become certified. By becoming certified you are not able to respond to
medical emergencies big and small that you may come across, you can volunteer your time in the
community during natural disasters or go to where there is a need for able bodied people to help
during a crisis. Having more organizations out there that are known nation-wide and even
internationally for providing care and assistance to those in need, means there is a higher need
for people to volunteer. By being a volunteer your apart of the group of people who provides any
form of care without expecting payment of any kind.
Hospitals that are non-profit are expected to provide charitable care to their patients if
they expect to have tax exemptions. This can encourage and detour these non-profit hospitals
that want to participate. Most are located in urban and rural areas, where the population is less,
and also in most cases most do not have a job with benefits. There is always a need for these
types of hospitals even in the city limits. But the down falls can out way the benefits, you take
pay cuts for services and in most cases the tax exemption is not comparable to the loss they
gained. The reward of providing care to these patients that otherwise would have not been able to
receive care, and the appreciation that most the patients will show. When you’re looking at what

13. it means to be not-for-profit hospital, the employees must all have the same set of morals and
ethics and they must believe the same mission statement that their company has created.
More and more physicians are seeking bigger tax breaks for providing charitable care,
they are wanting more write offs on their yearly taxes. It a since some are still out for money and
yet they want to make a good impression in the community. The main point is that they are there
to help those in need and ultimate cannot expect much payment in return, they only have the
feeling of gratification of doing good in the community. It is hard to find providers who are
willing to accept the Medicaid and Medicare funded insurances because the reimbursement rate
is very low and in most cases they end up losing money over making profit for the services
provided. It discourages them and in the case where they only want profit and gain, they will
more than likely turn away these patients and not be contracted with their state or government
funded insurance plan.
If these state and government funded insurance companies and plans would raise the
reimbursement rate, I feel that more providers would be willing to become contracted and start
seeing the patients. Some of these insurance companies are desperate to find more providers
willing to become contracted, there are too many people on the state funded insurance and not
enough providers. This means there is a longer wait to see a provider and longer wait to see a
specialist if that is what is needed. The hurry up and wait game is played and in some cases that
could be detrimental to the patient if they are in need of immediate care or surgery. If they do
accept the insurance there are times where patients may feel that they are treated differently
because they are on the state funded insurance plan. Sadly, there are providers out there that do
in fact treat these patients differently and that is discrimination, but most of these patients know
that this is the only place they have to go and don’t file a complaint.

14. Having worked for a provider who is contracted with state funded insurance we see many
of those patients, strictly children. They come from low-income, impoverished families, most are
undereducated and very young. These children come in and they have decay from being put to
bed with a bottle, and poor oral hygiene. If they were given better materials on ways to prevent
decay in children and ways beyond just brushing their teeth. When you see children come in with
recurrent decay, and we had treated that decay before we know that these parents have not taken
the skills and tools that were given to them. Parents are quick to blame their child for the reason
they have more decay, when in fact it is the parents fault for not caring for their child and taking
control of their child’s poor behavior. It is also common to see children that have never seen a
dentist and they are age 6 or older, and their younger siblings will also have rampant decay. This
is largely due to the parents continuing the poor habits with the additional children, maybe
because they do not know what should be done, or maybe they just really are selfish and want to
sleep and give their child a bottle.
There are a few simple ways that we could encourage them to be better and oral hygiene
with their child. We as providers should be allowed to charge the patient if they continue to bring
their child in with decay. The state funded insurance plans should also allow us to charge them if
they miss appointments for either preventive services such as cleanings, as well as scheduled
treatment appointments. Currently we are unable to charge them because they are under a state
funded insurance plan. Thus there is no accountability on the parent’s part, this shows disrespect
to the provider who blocked out this time to care for the child. If fee’s were to be charged to the
parents, the hopes it that it would encourage them to show up to their appointment or otherwise
face fines for not doing so. The other option is to send a bill to the insurance company that is

15. covering the patient, ether way we are getting paid. As providers who accept these insurance
plans we are doing them a favor for being contracted and treating their subscribers.
Medical schools should encourage their students to become more involved in the
community-related care and provide incentives for those that choose to volunteer their time
during residency and also after graduation. Incentives could range from reduced charges for
room and board during their residency, the cost of books for the classes would be at no cost to
the student, and after graduation the students would see a reduction in student loans. Because
there is such a need for more providers to accommodate the need for charitable care, it needs to
start at the beginning when they are in school. Creating more programs and classes that pertain to
charitable community-based care, from how to handle that population and what to expect while
in the field. Because must students are not prepared mentally or emotionally for what they will
see. In these cases, I feel that there should be a counselor on hand to help them cope with the
trauma that it may cause them.
More importantly there needs to be more education for the community on importance of
staying healthy and active to percent the need for health care related services. For those on state
and government insurance plans should be required in order to obtain insurance to take classes
on healthy eating, oral hygiene and staying active. I also feel that during these classes the
instructors should press the importance of showing up to appointments and what the cost of the
services are. If they understood the cost and what a provider might lose if they do not show up
and what the cost difference it could hopefully encourage them to want to show up to their
appointments. For those that are also on food benefits they should place restrictions on what can
be purchased such as sodas, cookies, ice creams and heavily processed foods. By placing caps on

16. what can be purchased, it can force them to by healthier alternatives, doing so could reduce the
amount of food related health issues in our community.
All and all, charitable care is more than just physicians volunteering at an event over the
weekend, it is more than them being contracted with state and government funded insurance
plans. It is about the overall health of the community and that starts at home. But lack of
education and living in an impoverished area are big factors for the need of more charitable care.
If the reimbursement rate was higher, if more students had become education in medical school,
and the community had a better understanding of what these providers sacrifice on a daily basis
we could build a better, healthy, longer living community and have that continue for the next
generations. Charitable care is always going to be needed in every part of this country and the
need is going to get higher as the senior generation becomes larger and the funds start to
dwindle. The future starts now, and we are the ones responsible for making that future a better
place for the generations to come.