The Cahaba Newsletter: January 2023
CAHABA MEDICAL CARE NEWS
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CAHABA MEDICAL CARE NEWS 〰️
CAHABA RECEIVES GRANT FOR SHINGLES SHOTS
Cahaba Medical Care was awarded $10,294.08 from the Lucille Beeson Trust for the purchase and administration of 60 doses of the Shingrix vaccines to patients in Jefferson County age 55+ who fall in the coverage gap without medical insurance, as well as patients with insurance that have a large out-of-pocket deductible and cannot afford the vaccine. With this funding, Cahaba will have a Shingle Vaccine Day at the West End clinic in March 2023.
DEPARTMENT SPOTLIGHT: BEHAVIORAL HEALTH / SOCIAL WORK
Increasing access to mental health services is a universal problem. Statistics show that 1 in 5 people experience some form of mental illness. According to Mental Health America, Alabama ranks 48th in the nation for overall mental health which indicates a higher prevalence of mental illness and lower rates of access to care. Statistics also note there are 120.8 mental health providers per 100,000 people. With the continuing influx of mental health patients and the ever-growing shortage of mental health providers, researchers noted almost a decade ago that primary care providers are in the ideal position to help in addressing mental health concerns. Yet, there are limitations on what primary care providers can provide due to limited training in primary care residency training programs in mental health.
Since 2012, Cahaba Medical Care has strived to incorporate social work and behavioral health services into the multidisciplinary services offered to patients, understanding the importance of a holistic and well-rounded approach to patient wellness. Over the past decade, we have expanded our behavioral health department so that every clinic has a social worker and a behavioral health counselor. Cahaba’s behavioral health providers have partnered with the medical team to provide innovative behavioral health treatments for many primary care patients who otherwise might not have been identified as needing behavioral health interventions. All patients at Cahaba Medical Care are universally screened for substance use disorders, depression, and at-risk behaviors, and integrated behavioral care is provided as indicated.
Our behavioral health department consists of three levels of social support:
Counselors: Counselors provide 30-60 minute individual, group, and family therapeutic sessions in our primary care clinics, as well as our school-based health center.
Behavioral Health Consultants (BHCs): Behavioral Health Consultants act as embedded members of the primary care team to provide brief, targeted, real-time (ad hoc) assessments and interventions to address patients’ psychosocial and behavioral health needs.
Social Work Case Managers: Our social work case managers assist with our patients' tangible needs. Some of the duties of our case managers include home visits, sliding fee applications, dental vouchers, patient assistance applications, transportation assistance, clothes and food assistance.
COUNSELING SERVICES
Through 30-60 minute face-to-face behavioral health sessions, our counselors assess and address mental health and problematic behaviors, and promote resilience for overall wellness. Cahaba’s counselors provide treatment to children, adolescents, and adults struggling with the following:
Trauma
Behavior problems
Coping skills
Anger management
Social skills
ADHD
Identity confusion
Crisis incident / situation
Anxiety
Depression
Emotion regulation
Stress
Relationship issues
Academic / school difficulties
Grief
Attachment
Substance use disorders
TARGETING INTEGRATED COUNSELING
Much like our Behavioral Health Consultations, which are fully integrated visits, Cahaba has targeted certain populations for specialized integrated care:
Integrated Perinatal Behavioral Healthcare
Integrated Trauma Informed Care Groups
Integrated Alternative to Opioids Pain Management Groups
Integrated Diabetes Management Clinics
Integrated Substance Use Disorders
CASE MANAGEMENT SERVICES
Transportation assistance
Medication assistance
Clothing, food, housing, & utility assistance
Dental vouchers for emergency dental needs
Insurance outreach and enrollment assistance
Sliding fee program enrollment
Coordination of specialty care
BEHAVIORAL HEALTH SERVICES
Health Behavior / Disease Management
Medication adherence
Weight management
Chronic pain management
Smoking cessation
Insomnia / sleep hygiene
Psychosocial and behavioral aspects of chronic disease management
Any health behavior change
Management of high medical utilization
Mental Health / Behavioral Issues
Diagnostic clarification (Depression vs. Bipolar Disorder) and intervention planning
Facilitation of consultation with psychiatry regarding psychotropic medications
Behavior management
Suicidal / homicidal risk assessment
Substance abuse assessment and intervention
Panic / anxiety / mood management
Interim checks of psychotropic medication response between scheduled PCP visits
Parenting skills
Stress management
Anger management
PATIENT STORIES
*The Cahaba stories that follow are real. However, the names have been changed to maintain patient confidentiality.
Jennifer and Robert Sims are a married couple with a 10-year-old daughter, Laura. Jennifer and Robert came to Cahaba for behavioral health and substance use treatment after losing custody of Laura due to drug-related charges. Jennifer and Robert had been using opioids (pain killers) for over 10 years when the Department of Human Resources stepped in to temporarily take custody of Laura. After losing custody of Laura, the Sims were determined to attempt counseling and substance use treatment with the hope of reuniting their family.
Today, the Sims have been in treatment at Cahaba for two years and their daughter has been reunited with the family. Services that Jenifer and Robert received during their two year treatment were as follows: integrated primary and behavioral healthcare, medication assisted treatment, weekly group counseling, individual counseling, brief behavioral health interventions, and social services. Laura now credits Cahaba Medical Care with returning her parents to her. Robert and Jennifer also acknowledge that they are defying the odds by being a couple who successfully maintained sobriety together while reuniting with their daughter.
Similar to the Sims, other couples and families such as the Robinson family come to Cahaba after suffering traumatic life events. Mrs. Robinson was pregnant with her seventh child after suffering a recent stillbirth when she and her husband became patients in 2020. The family of seven was homeless and living with relatives in the midst of the pandemic. Mr. Robinson was without work, addicted to opioids, and diagnosed with depression. After obtaining integrated care (behavioral, medical, substance use treatment, and OB care for Mrs. Robinson) through Cahaba Medical Care, the family succeeded in weathering the emotional anxieties related to the pregnancy. Mr. and Mrs. Robinson received medication assisted treatment for opioid use disorder; Mrs. Robinson safely delivered their seventh child, and Mr. Robinson successfully obtained employment. The family of eight now have their own home and are living a healthy life as a result of Cahaba Medical Care’s interventions as their medical home.
The Sims and the Robinsons are just a couple of the many families reaching their mental health, sobriety, and pain management goals through the assistance of Cahaba’s Behavioral Health and Primary Care Team.
RESIDENCY NEWS
WELCOME, DR. JARED BROCKINGTON!
Cahaba Medical Care - West End welcomes Dr. Jared Brockington, a board certified Pediatrician.
Dr. Brockington attended Kansas City University where he earned his Doctorate of Osteopathic Medicine. He completed his training in Pediatrics at the University of Texas Medical Branch at Galveston and is Board Certified by the American Board of Pediatrics.
Dr. Brockington has served in rural areas overseas including Uganda, Zambia, Guatemala, Indonesia and Africa. His heart of service is tied to his Christian faith and a commitment to provide quality care to all.
SCHOLARLY ACTIVITY
A Delay in care due to COVID 19 pandemic: Findings from the National Health Interview Survey presented by Daniel Fijabi, MD, MSc (Urban PGY-3 Resident); Oluwaseyi Isehunwa MBCHB, MPH, PHD; Philip Ojeabulu, MD (Emergency Medicine Fellow); Adam Ross, MD (Assistant Residency Director - Urban Track) at the American Public Health Association (APHA) 2022 Conference.
INTERNATIONAL ROTATIONS: NICARAGUA
Submitted by: Dr. Clay Rice (PGY-2 Urban Resident)
I spent my missions month in Diriomo, Nicaragua working with Los Rayos de Esperanza. LRdE is an incredible organization that staffs a clinic, trains local health promoters, has a school for children, has a business school, and several programs including those for pregnant teens and children with special needs. I got to go on home visits in rural areas without access to health care, run a traditional clinic, and give training on several topics. All of this was done while providing culturally sensitive care. I especially enjoyed being able to provide wound care, praying with patients, taking care of children, and listening to the stories of the elders. I found it a little frustrating to navigate the lack of availability of many medicines (even insulin!!) and resources that are so prevalent in the U.S., but I found that I actually enjoyed paper charting and felt the care I delivered was more patient-focused and simple. I averaged seeing about 15-20 patients a day. All in all, I’m very grateful for the opportunity to have gone to Nicaragua.
We are a community-based non-profit healthcare organization that aims to follow Christ in becoming an incarnation of love, peace, and justice for our patients on their journey towards physical, mental, social, and spiritual well-being