RRHC to become Patient Centered Medical Home; WISH house may close due to lack of funds

Virginia Graziani

Redwood Times

Redwoods Rural Health Center is gearing up to apply for designation as a Patient Centered Medical Home (PCMH), RRHC executive director Tina Tvedt told participants in Southern Humboldt Working Together's monthly open meeting last Wednesday, Feb. 6.

The PCMH program was created in 2011 by the National Committee for Quality Assurance, a Washington, DC-based non-profit organization dedicated to improving health care quality.

The PCMH program sets a standard of excellence and positions RRHC as a "responsive and compassionate provider," Tvedt said, as well as making "meaningful use" of the new electronic health records system and helping RRHC with funding opportunities.

RRHC has received grants from the federal Health Resources and Services Administration as well as support from the Centers for Medicare and Medicaid Services to help the health center make changes needed to qualify for the PCMH program.

To qualify, RRHC must meet a menu of standards in the areas of patient access and continuity of care, identifying and managing specific patient populations, planning and managing care for each patient, helping patients with self-care and developing community support, tracking and coordinating care, and measuring and improving the health center's performance.

RRHC has already made strides toward meeting these goals, Tvedt said. For example, the health center now blocks out a certain amount of time each day for same-day or urgent care appointments. One RRHC provider is on call 24/7 to address urgent issues that come up when the health center is closed. Patients are scheduled to see the same provider and medical assistant every time they come in, to provide continuity.

One RRHC staffer has been assigned to do all referrals for outside testing and visits to specialists, and she also makes sure that patients and their primary providers receive the results of the tests and consultations as soon as possible.

Electronic health records have made many innovations possible. For example, if a patient calls RRHC with an urgent issue after-hours, the message service contacts the provider on call. The provider can then look at the patient's records online from wherever he or she is at the time so that the provider already knows the patient's health history, including test results and medications, before contacting the patient.

Patients also receive specific, individualized reminders when it's time to schedule a visit or come in for a lab test. Test results and histories from other providers will eventually be integrated into each patient's records.

Providers and their medical assistants will work with patients to develop programs to help them improve their health. Recommendations will be geared to each patient's individual needs; for example, daily workouts at the gym will not be suggested as a good exercise program for a patient who lives in Alderpoint.

Eventually, when electronic health records are fully up and running, patients with high-speed internet access will be able to make appointments, look at their records, pay their bills, and contact their providers directly online.

Tvedt expects that RRHC will be ready to submit its application for PCMH status to the National Committee for Quality Assurance this spring. The health center's goal is to reach "90 percent recognition" of all the standards by the fall of 2014.

The health center has already made the switch to electronic health records and will soon be testing the patient interactive online system. Online services will be introduced incrementally, starting with giving patients the ability to communicate with their providers via secure messaging on a dedicated website, as well as being able to make appointments online.

Asked about the security of patient records and messages, Tvedt explained that the website operates like online banking.

She encourages all interested patients to come to RRHC to sign up. They will receive a "security token" and instructions on how to access the service.

The new system should be launched in April, she said.

Tvedt also reminded everyone that children enrolled in the state Healthy Families program will have to enroll in Medi-Cal by this September. The Healthy Families program currently provides children in lower income families with a wide spectrum of care including wellness checks, immunization, and dental care.

For more information and to enroll in Medi-Cal and other programs to help meet medical expenses, call Linda at RRHC, 923-2783, extension 318.

During the time for announcements from other participants, Gail Eastwood, the coordinator of the Youth Alive! program, described her recent work with seventh and eighth graders at Redway Elementary on anti-bullying and non-violent conflict resolution techniques.

This is Eastwood's first time working inside the school system. "I'm very impressed with the commitment of the teaching staff and their knowledge of the students as full human beings.... We've got some real treasures," she said, noting the tough conditions teachers work under, especially with classes now as large as 36 students.

Eastwood is particularly concerned about the high anxiety level among the boys, and what she described as "the high level of sex harassment language" that boys use toward girls.

"It's hard to explain to 12-year-old boys why certain words are so offensive," she said.

During discussion it was generally agreed that kids that young don't really understand the meaning and implications of such language but are responding to peer pressure to appear "cool." But the group also agreed that even if kids don't understand the exact meaning of the words, they understand how hurtful and insulting such words are.

Barb Truitt, newly elected president of the board of the Southern Humboldt Healthcare District, said that her goal is to increase cooperation and coordination with other healthcare providers and the entire community.

Truitt recently attended a health fair in Eureka sponsored by St. Joseph Hospital, and said she wanted to see the Garberville health fair continued and expanded. All of the health care providers she spoke to in Eureka were enthusiastic about participating in a Southern Humboldt event.

One of the highlights in Eureka was a walk-through colon, Truitt said, accompanied by a display of tools and techniques used during a colonoscopy. She also observed the absence of Planned Parenthood, which was not allowed to participate, even to talk about their cancer-screening services.

Past health fairs, which have been during the summer in the Garberville Town Square, were sponsored by the Southern Humboldt Health Alternatives Association, an organization that Eastwood also coordinates. Eastwood said she'd be glad to work with SHCHD, RRHC, and others to put on an expanded fair this summer.

There was no health fair last summer because of the construction going on in the Town Square, Eastwood added.

Amie McClelland reported that WISH, the local shelter for women and children who are victims of domestic abuse, is once again nearly out of funds. WISH has applied for a new grant, but if this does not come through, the shelter will have to close its doors within the next few weeks.

The Humboldt County Domestic Violence Services (HCDVS), a non-profit based in the Eureka area that provides support and services to victims of domestic violence, may be able to take over the WISH house or provide other help, McClelland noted.

For more information, or to make a donation, call WISH's business office at 923-4100.

"The street scene is pretty quiet right now," observed SHWT secretary Kathy Epling, a longtime community activist, "but it seems that more people stayed here through the winter than usual, including women and families."

On the positive side, although there are no shelters for homeless and transient persons in SoHum, as far as Epling knows no one has died from exposure so far this winter.

"We are bracing ourselves for the summer influx," she said. People looking for work in the marijuana industry begin coming into the area in mid-spring, and the numbers usually increase as the warm weather continues until harvest season in the fall.

Epling expects more people than before to come to the area this year. She noted that she has been seeing more older people arriving recently, people who have lost their homes and jobs, and who are looking for any kind of work.

SWHT holds a monthly meeting open to anyone who is interested on the first Wednesday of every month. The next meeting is scheduled for March 6 from noon to 1:30 p.m. at the Civic Club on Maple Lane in Garberville.