This episode offers a rare, candid look at how humane leadership can drive real systems change. In a powerful conversation with Dr. Andy Mendenhall, CEO of City Central Concern, you’ll hear how a physician-turned-executive is tackling some of Oregon’s most complex challenges—behavioral health, homelessness, and workforce burnout by leading with data, dignity, and courage. If you’re a leader navigating complexity, scarcity, or mission-driven work, this conversation will challenge how you think about impact, accountability, and what it truly means to hire for good.
I see human beings, and I see their intrinsic and inherent value. I bring a strength‑based, humanistic approach to leadership—because people do their best work in safe, not fear‑based, cultures.” – Andy Mendenhall
Suzanne Hanifin: President at Acumen Executive Search. LinkedIn: https://www.linkedin.com/in/suzannehanifin/
Tanis Morris: Director of Business Development at Acumen Executive Search. LinkedIn: https://www.linkedin.com/in/tanis-morris-75a113266/
Andy Mendenhall M.D: President & CEO of Central City Concern. LinkedIn: https://www.linkedin.com/in/andy-mendenhall-m-d-8803b3114/
Acumen Executive Search Website: https://www.acumenexecutivesearch.com
Central City Concern Website: https://centralcityconcern.org/
Hiring for Good Transcript:
Suzanne Hanifin: Well, hi, this is Suzanne Hanifin with Acumen Executive Search, and I’m sad to say my lovely co-host Tanis Morris is not here today, but for those who are new at joining Hiring for Good podcast. It is a podcast of best in practices in leadership, and we are so excited today to have Dr Andy Mendenhall. Andy is the current CEO of City Central Concern and has really this incredible background, not only an MD but a co-founder of your own practice, moved on through, you know, working within substance use disorder and other expertise, to now today being the CEO of one of Oregon’s largest nonprofits and probably. And I’m not sure, Andy, you can correct me on this, but also Oregon’s largest nonprofit on substance use disorder and mental health.
Dr Andy Mendenhall: That’s correct.
Suzanne: Yeah. That’s what I thought. Yeah, so, so again, I can walk through your background, but it’s better to hear it from you. So share with us your journey and how did you get where you are today.
Andy: Thank you, Suzanne, such an honor to be here, um, and, and look forward to our dialogue together. My journey has been um blessed by a ton of different mentors. I knew very early on that I wanted to be a physician, um, courtesy of Alan Alda Hawkeye Pierce and MASH, um, and I went to college at the University of Portland. Was able to matriculate to medical school at Oregon Health and Sciences University. This is back in the mid 90s. Completed my training there and then was able to stay as a family medicine physician. And the folks that I resonated most with in medical training were the family the family docs. Um, they were humanists, they were generalists, they were interested in knowing people as well as, um, medical diagnosis, as well as Behavioral Health diagnosis. And, um, I always just felt at home in the presence of people that thought the same way that I did. So I found my medical home as a family medicine specialist and then made my way out to, um, Newberg, Oregon, which is a bedroom community of Portland, um, and went to work for a large health system out there as, as a family doc.
And during that time period, we kind of did it all. Um, I attended in the hospital, I occasionally moonlit in the emergency room. We admitted our own patients, and we admitted patients from what we would call City Call, meaning you were just up and you got to admit that person. And one day in 2005, I had the opportunity to admit a person from a well-known, um, uh, residential treatment facility. Um, this facility was owned and operated, still is, by the Hazelden, now the Hazelden Betty Ford Foundation, and, um, the ER called me. This person needed to be admitted to the hospital for complicated alcohol withdrawal. I didn’t think twice about it. I’d learned how to do that in residency, and, um, admitted the person. They had an unremarkable course, and then the next day, the medical director of that center called me and said I was the first physician in the community of Newberg in the eight years they had been operating there that had ever admitted one of their patients to the local hospital.
Every other patient had been sent 20-plus miles down the road to a different hospital. Which meant that there was disconnection from the treatment center, and actually, a large number of the folks that were referred there actually wouldn’t go back to the treatment center because of that lack of connection. And I thought to myself in that moment, which was a pivotal moment for me, gosh, here is a person suffering from substance use disorder. Ten to eleven percent of Americans have a lifetime probability of developing a moderate to severe substance use disorder. One in four American families, as we’re speaking today, are impacted by substance use disorder, and nobody seems to want to take care of these folks. And that became a pivotal moment for me to become an addiction medicine specialist in 2008, open up a private practice in partnership with, um, my very close friend and colleague Dr. Paul Conti, who is a published author, podcast, uh, uh guest, and, um, founder of Pacific Premier Group, which is based here in Portland, Oregon.
We, we really heeded the call from the general population of individuals that were suffering from substance use disorder. Also had pain management challenges, psychiatric challenges, and we found a niche and were very successful over a couple-year period of time. Founding that. Hazelden Betty Ford ended up acquiring that practice, and I’ve took a couple of different leadership steps over the last 10 years, including my tenure at Central City Concern over the last seven, two as the president and CEO.
Suzanne: Well, and it’s interesting because a lot of people would never say that, well, I shouldn’t say never, but it’s not typical for an MD to ra…be raised up into leadership position, and the transition from, you know, practicing in one-on-one relationship to then look strategically, how is that transition for you?
Andy: So, it’s a it’s, a great point. Um, as Healthcare in America has transformed and in many ways, um, consolidated into large agencies, there has been a need for the development of leaders of clinicians and clinician groups. And as we start to think more about the health of populations, um, there has been the opportunity for individuals to differentiate from, um, working in a clinic or working in a hospital and delivering clinical care, um, all day every day, if you will.
I did a fellowship between 2003 and 2004 in clinical leadership, and I had no idea where that was going to, uh, lead me to, but I’ve always had a natural proclivity and enjoyed helping develop other people, and I see that as a core competency of any supervisor, any manager, any leader.
And for me, what happened ultimately was I saw the opportunity to influence how Healthcare was delivered for individuals with substance use disorder, and that ultimately led me in the direction of, um, working, um, 10 years ago, um. After my tenure with Hazelden Betty Ford, I worked for a venture capital-backed company, um, based out of Northampton, Massachusetts, for a couple of years, where we were, um, rapidly growing and rapidly deploying brick and mortar centers to expand access to treatment of substance use disorders.
So, I realized at that point in my career that I could influence the health of much larger populations by choosing to be in leadership, and, um. And I’ve, I’ve, I think if there’s a natural gift anywhere, it’s the fact that I love human beings number one, and I want to see people grow and develop and be happy. Um, and I also want to see our populations, meaning society as a whole, get healthier, and what I recognized is that my individual contributions made a difference. For example, when I was a family physician in the little town of, of Newberg, right, and I couldn’t walk down the aisle of a grocery store without people saying hello, and, and sometimes, like turning my ear longer than I wanted them to. Um, but you know that was one chapter of my career.
Now, my chapter, the chapter of my career that I feel so blessed about, is helping really amazing teams of really amazing human beings influence the health of literally thousands of individuals in our community on a day-to-day, week-to-week, year-to-year basis, with the goal of growing and closing the gaps in service that exist here in Portland, Oregon, in particular. Um, so much so that, unfortunately, we make the news frequently about a lot of the challenges in our community.
Suzanne: Oh, absolutely, and as a recruiter who brings people to Portland a lot, it’s an interesting conversation, and I always say what makes this area so unique is that we’re able to have those conversations. And, and we don’t push it aside, and you, with your leadership at CCC, again you’re, you’re changing the conversation.
So today you talk about this gap, what are some of the initiatives your organization is taking on, and what’s the long-term impact of that?
Andy: Very good, yes, thank you, Suzanne. Um, first, I’ll ground the listeners and viewers in who we are and what we do.
Suzanne: Perfect.
Andy: So we’re a 45-year-old community nonprofit organization that provides services in healthcare to low-income individuals under what’s referred to as a federally qualified health center umbrella.
We have one of the most complex and broad portfolios of Health Care services of any healthcare for the homeless federally qualified Health Center in the United States, and we, we marry that up with a large portfolio of owned housing that is deeply affordable, transitional, 2800 units housing 4,500 people per year. We served 11,000 people in our health centers last year, and then we also combined that with the ability for folks to have supportive employment services.
So, we help people navigate this journey from basically being houseless with an active substance use disorder or severe mental illness through to being in recovery, housed, employed, paying their own rent under a lease agreement.
And, um, last year we touched the lives of, um, just, just shy of 17,000 people. So our organization has grown over time, um, in our community right now, and in our state, we are living in a, in a time where we have a housing gap. We also have a shelter gap, and, um, while things objectively look a little bit better, unfortunately, we know that, um, the number of unsheltered individuals in Multnomah County, um, has grown year-over-year, um, since the beginning of the pandemic and actually a little bit before that.
And in January of 2024, there were 5,400 individuals living in Multnomah County who were unsheltered. Um, what that means is they’re living outside, or they’re living in a car. Um, we have the highest per capita rate of unsheltered homelessness in the United States, and it’s unacceptable, right?
I’m happy that there are some good plans to build to scale some shelter, um, and also build housing. Our role in that is to provide mobile Health Services to shelter and shelter sites, and also to work on helping build some of the housing capacity, um, that the region needs.
All of that if you will is sort of the foundation of the challenges that are decades in the making in Oregon in that we are consistently in the bottom five in terms of, uh, per capita access nationally to psychiatric Residential Services, substance use disorder residential services, and broader Behavioral Health Services that are not residential to meet the needs of individuals with substance use disorder with severe pervasive mental illness.
Our state disinvested, um, three to four decades ago in, um, the behavioral health system of care, and we are going to have to spend the next five or six years invest a ton of dollars in investing in the workforce, investing in the brick and mortar, um, facilities and programs that are required both within the Tri-County’s area but across the state in order to close those gaps.
Because unfortunately, we have an aging population that’s aging into poverty, aging with a higher risk of homelessness than ever before, and we also have this issue of the opioid epidemic and the methamphetamine epidemic that’s driving acuity among the substance use in severe mentally ill populations.
Suzanne: Yeah, I did not realize we were in the bottom, which is very disappointing because I think most people feel vested into our community and believe in our community.
Well, and, and we’re kind of going a little bit out of order of my questions, but I want to bring this up that, you know, City Central Concern, CCC, cannot do it alone. You have to get different Community Partners involved, the state, the, the counties. What’s kind of the road map that you’re taking and are part of?
Andy: Thanks, Suzanne. We see ourselves as, uh, trusted advisors as well as service providers, and so, um, under my leadership and I’ve, I’ve been really proud to bring forward a population health strategy that, um, one of our regional Coordinated Care organizations, Health Share of Oregon. And one of the member organizations, um, are very important Medicaid funding partner, Care Oregon, have said, yes, that was a pretty good idea. Let’s find out the size, scope, and scale of populations of individuals with severe mental illness. Meaning specifically psychosis, substance use disorder, specifically stimulant use disorder, or opioid use disorder. So think meth and Fentanyl, and nobody had ever asked that question before, and literally, how big were the populations, what’s the growth trends?
It’s pretty simple data, like on, on I’m really not a rocket scientist, far from it, right. Just simple questions we can anchor that in paid claims data, meaning if somebody had a paid health care service for a particular diagnosis, we can see it. We also know very specifically it’s a very accurate data set and, um, this data was pulled over the last year.
What we know, unfortunately, is that in this region, about 10% of the Medicaid population, so less fortunate individuals, were driving about 40% of the total Healthcare cost. And that’s not sustainable, right? There’s a, a really important storyline there because most of that expense is not driving outcome, it’s paying to treat the complications of untreated homelessness, untreated behavioral health conditions. Specifically in this case, more substance use disordered as well as, um, other types of severe, um, mental illness.
So, the good news is, now that we’ve got our head wrapped around how big the challenges are, we can benchmark against those numbers to see how is our system doing, are we gaining ground, are we improving access to services and engagement of those clients or not.
And once you have a data set that gives you a common language, right, um, then you can start to ensure through, you know, advocacy work, through education work, that our government officials receive the right briefing and can create a sense of alignment in terms of what are the necessary strategies at the city, the county, the state, even the federal level.
As we think about ear, you know, pulling down earmark dollars and the need for that as well, um. All of those things can be aligned in a way that, um, I think previously the data didn’t necessarily support, and as a result, because the data wasn’t there. And as a result, folks just sort of took a bit more of a scattershot or a less aligned approach to solving the problems of the region and the state.
Suzanne: Absolutely, and I think it’s interesting listening to this. I can hear all these leadership qualities. Because, whether it’s with CCC or nonprofit or government involvement, numbers measuring where are we, where are we going, how are we doing, and always checking that in.
And also, as a leader, I’m listening to you, you know, I’m hearing this sense of oh, I’m trying to think of the right word, that you obviously bring in a lot of your personal values into what you do every day. Talk about some of those values and how you’ve been able to operationalize that at CCC.
Andy: Thanks, Suzanne. Um, I think I, I consider myself a humanist, right? What does that mean? I see human beings, and I see their intrinsic and inherent value. Um, I can’t tell you where that comes from, but I feel like that’s a central part of, of my being.
Suzanne: We can thank M.A.S.H.
Andy: Yeah. Um. And, and a lot of mentors and seeing good role modeling and all that, um. And so I, I like to bring a strength-based humanistic approach to my leadership, and what that means at Central City Concern is creating, um, a safe and emotional just work culture, not a gotcha culture, not a fear-based culture.
Um, because trust me, there’s plenty of things in homeless services and working with folks that are at the deep end of the pool that can be pretty fearful, especially when folks aren’t doing well. The last thing people need is that from their supervisors or their managers or certainly their executive team.
Um, I also think that part of creating that safety is a willingness to talk about the things that aren’t going well. A willingness to lean into those things because it’s easy to celebrate the good stuff right, and, and everybody wants to do that. And you have to do a certain amount of that to create, um, that if you will lineage and cultural engagement. But I’ve found that there is been the most important conversations happen when you’re talking and create a safe frame, talking about the things that didn’t go well or aren’t going well, and need help and support, because now we’re having real conversations.
And I fundamentally believe that everybody gets out of bed, certainly in my organization, but I think in life, like most people, are getting out of bed trying to do their very best. And if we start from that platform and can create a frame of safety, then we can say what’s needed to help someone or help a team be successful as opposed to that team has failed.
I would say you know where are we as leaders? Where did we set them up to not be successful? It’s our accountability to help the people that, that we are offered the privilege to lead, the opportunity to be and function and serve at their very best.
Suzanne: Yeah, and we were very fortunate to have both a state person in this podcast and somebody from Multnomah County on this podcast, and we talked about burnout and especially post-COVID. And in your business, I would imagine the burnout and the turnover would be incredibly high. How are you as a leader dealing with that?
Andy: It’s a challenged area first and foremost. So I won’t say that the words I’m about to offer mean that we’ve, you know.
Suzanne: Solved the problem.
Andy: Crack this. Right. Exactly. It’s true that it’s very hard both in the health care space and the housing space, even in the employment space. It’s very hard for people serving the least fortunate, most vulnerable members of our community and society to come to work every day and to know that eight out of 10 times that they have somebody who needs something they’re not going to be able to get them that which they need today or possibly even in the next couple of months right.
The first is just shelter beds, shelter space, or shelter alternative space. The second is housing, and a lot of the people that we’re working with are today, and tonight, and tomorrow, they will be sleeping outside. Um, and many of those individuals and also people that are housed but are struggling with active substance use are struggling with active severe mental illness that needs to be restabilized or treated; they’re on long wait lists to get treatment.
So, so the fact that we live in the wealthiest country on the planet, and, and there are basic needs for treatment access, service access, housing, food, food instability, all the things that folks, um, don’t have access to. It’s really hard for a workforce to show up every day, be their best, knowing that 20% of the time they’re going to be able to close the big gaps in a way that, that is meaningful.
And then they also, it’s smart folks, right? They see the complications of those unmet needs, and, um, so how we mitigate that is we talk about it, we talk about it actively. Um, my staff know that we are working very hard to drive strategy in a positive and forward way.
Um, and we’re hoping that, um, in Multnomah County, um, our colleagues at, uh, city and county government are going to succeed in the deployment of the Homelessness Response Action Plan – the HRAP. The final version of that was just brought forward this week.
We’re really proud to have offered, um, our expertise in the development of that content. We believe in the content; now the key is execution.
Suzanne: Yeah.
Andy: Right.
Suzanne: Well, and it’s not just, again, what I’ve loved about your, you know, your background and your approach is you’re not working individually, but you’re bringing the community together, saying we can help this. But we need all of us on the same page, with all these different initiatives that you’ve either sponsored or part of. So in the next five years, let’s kind of have a crystal ball. What do you see, and how is that going to change our community that we live in?
Andy: I’m really hopeful for our community, Suzanne and I say that sincerely. It it’s, uh, it, I’m hopeful because we have the data now. We have alignment. We have health systems partners around the table, um, really leaning in and saying, yeah, we agree this isn’t sustainable. We have our, um, health care funding partners saying, saying the same thing.
And what I believe we’re going to see over the next 5 years is we’re going to see a significant closure in the gap for unsheltered members of our community. And along with that, it’s not just the shelter, it’s shelter plus supportive services to help people stabilize enough to then be able to benefit from a housing intervention.
And there’s a ton of inventory out there right now that’s not fully deployed in terms of housing inventory out in the community, um, low-income housing. There’s, there’s some vacancies out there in the rental market in particular, and when people get healthy enough, and, and, that’s an important narrative, we see people get healthy every single day.
We take people, and, and I can talk about outcomes here in a minute, but we wouldn’t be doing this work if we weren’t seeing more than 50% of the folks that started with us have success with, with, success with, you know, very few sort of steps off the track, right, at the end of a six or nine-month, um, intervention.
What I like to say is we know what to do, we just need to do more of it.
So with respect to shelter and housing and supportive services, that’s one big tranche of what’s needed in the region.
The other big tranche of what’s needed in the region is inpatient psychiatric bed capacity. Our region lost access to the Oregon State Hospital for civil committed people, meaning people who haven’t committed a crime. They’re just really unwell psychiatrically, and they need a period of three to six, possibly longer months, um, to get stabilized, get medicated, and then to be re, have the opportunity to re-enter the community in environments that are secure residential treatment facilities.
And, um, we certainly, and I do not believe in long-term institutionalization, with rare exceptions, and, and, for those people, unfortunately, that’s a necessity. But the vast majority of individuals are very successful with that continuum. But the problem for our community has been the lack of access to the Oregon State Hospital and that means about 500 to 550 people that live in this region per year have not been served on an annual basis.
And those individuals get pressed back out into the community. They occupy hospital beds. They struggle to succeed. Those folks need, um, access to inpatient psychiatric services and then also secure residential treatment facility beds, all of which are on the docket to potentially be funded in the next long session.
And, um, we’re really optimistic to see that coming out as, uh, published in the Oregon Health Authorities report, Director Clark, recently, a couple months ago, um, you know, was very specific about the need for residential beds across the state, recognizing that one third of the Medicaid population of our state live in the Tri-County areas of Portland.
Suzanne: Yeah, very hopeful because we cannot, I think, most Oregonians feel we can’t continue doing what we’re doing. We need to change that story and change that narrative, and it does start with, with leaders like you, but then it’s the next gen, and talk to me about how you’re building the next leadership. Because this is a long-term play. This is not going to happen next year or five years. It, it, the conversation needs to continue.
Andy: That’s exactly right. So, um, couple layers to that at Central City Concern. We highly prioritize learning and development and, and ensuring that we are consciously thinking about succession planning. So, you know, how does that show up on a day-to-day basis? That’s everything from having managers and supervisors, you know, ensure that they have a place to facilitate meetings, right. Um, ensure that they are getting the type of facilitation training, training on data and analytics, um, and being brought into the discussions around strategic thinking. Those are very important parts of how we cascade the internal conversations within the organization.
Um. A big pillar of that is communication, right? Um, and have we gotten that correct over the last 5 years in particular? No. But I think we were very successful in communicating our internal strategy around our pandemic response, and that laid the groundwork to allow us to then start to fold in a deeper level of awareness of where we’re going, where we’re headed, the steps that we need to take as an organization to get there.
And, um, our, our current focus this year is on being a strong and strategic organization. We’ve actually really needed to strengthen and stabilize our operations, um, which at times means just ensuring that we’re addressing vacancy rates or we’re addressing turnover. So it’s very simple, um, very simple actions, um, but we have to be brave and say, you know, why do we have, why do we have a lot of turnover in a particular, uh, part of our workforce? What do we need to know about that? And, um, and that, that’s, that, that brings us back to that topic around, um, burnout and some of those drivers.
Suzanne: Well, and it’s interesting because, again, I think what’s happened from the outside perspective, truly outside perspective, is that a lot of health care providers and nonprofits have been very tactical, got emergency, solve the emergency. And it’s interesting to see as a citizen that now it’s becoming more strategic and saying again, this triage, you know, is not just working. We need to look bigger and broader.
And again, it comes down to the leadership of the leaders to come up with that strategy and things. So, looking back, Andy, your 20-year-old self, what advice would you give yourself?
Andy: I’m going to take a moment on that, Suzanne, just for a second. The thing that I would tell myself is as follows.
The number one thing is trust your gut. Go with your gut. Um, that’s not let me down. And when I’ve not followed my gut, I’ve usually regretted it.
Um, number two is, um, don’t settle for less or compromise. And I think for me, there have been times in my life, both professionally and personally, when I have downgraded my expectation, and, um, and that has led to, um, disappointment. Um, and I think on another level reflects, um, how I either have or have not, um, valued myself, prioritized my wants and needs in the context of especially I’ll just be transparent interpersonal relationship.
Suzanne: Yeah, it’s funny how sometime, especially with your background, I could see how you put others first.
Andy: Absolutely yes, Dr Gabormate would say, if you want to see the quintessential example of a codependent human being, uh, just picture a family physician.
Suzanne: Yeah, because it’s…
Andy: And it’s true
Suzanne: About them, not you.
Andy: That’s exactly.
Suzanne: Absolutely. So the podcast Hiring for Good has a lot of different connotations. What does it mean to you?
Andy: To me, hiring for good is a phrase that makes me think about social impact, positive social impact. And, um, that’s why I’m so privileged to be here, Suzanne, and, and have this podcast interview with you today, um.
I think that regardless of whether folks are working in the nonprofit sector or folks are working in the for-profit sector, um, uh, a mentor of mine, Mark Van Ness and, uh, Julie Van Ness, who are the publishers of Real Leaders Magazine, say you know people can do well while, while also doing good.
Um, I think that there’s a resonance for me in terms of how do we make the world a better place, um? How do we and, and we can do that through so many different lenses. From my perspective, it’s about human determinance of health, making sure that the world becomes a softer, less harsh, less dangerous place to be, um.
Because I think the art of being human is challenging enough as it is, so how can we be a little softer? How can we look after each other a little bit more? And I think the narrative that I’m going to continue to bring forward is, is a really important one, and it is that, um, doing the right thing for people typically costs less.
There are a lot of Neo-Calvinists out there that might, you know, push back on that, but we’re going to prove that. We’ve already got early data that’s reflecting that meeting the human determinance of health, housing, food security, um, health care, helping people who are less fortunate, um, who are struggling with challenges, do better, saves everybody money, and makes society a, a better, safer, warmer place to be.
Suzanne: Boy, I think on that note we should end it because that was beautiful and again such hope.
Andy: Truly.
Suzanne: And, and, I am so excited again to see the next, you know, couple years how this conversation, and I would love to have you back in a few years, and we can kind of then look at of saying, “Wow, look at what we’ve done.”
So Andy, thank you so much again. Dr Andy Mendenhall from City Central Concern. I don’t know why I just stammered on that one, um, but thank you very much for being here.
Andy: My honor, Suzanne. Thanks so much for your feedback and the opportunity.
Suzanne: Wonderful
Outro: Thanks for joining us today at Hiring for Good. If you were inspired by our conversation, don’t forget to like, follow, and subscribe wherever you get your podcast, and if you want to learn more about our executive search services, check us out at www.hiringforgood.net or our company website, Acumen Executive Search. Thanks so much, and don’t forget to join us next time for another in-depth conversation about transformational leadership. Till then, have fun.