A team approach for better health care

MEDFORD, Ore. — Jackson Care Connect member Jean Fitch has found a new health care team, and she’s the star member. With the help of the La Clinica Wellness Center, she is using new approaches to improve her health.

Because 70 percent of primary health care visits have a psychosocial driver, Jackson Care Connect provides financial and technical support to help primary care clinics, including La Clinica, integrate behavioral health into their practices. Jackson Care Connect is a coordinated care organization providing care for Oregon Health Plan (Medicaid) members in Jackson County.

Fitch has a history of complex health issues­—trauma, chronic depression and seizures—as well as a history of injuries, including a major car accident. Because she was deemed uninsurable in another state, she spent 8-10 years without any medical care, before she learned about the Oregon Health Plan (OHP).

Once she was enrolled in OHP, Fitch connected with Dr. Justin Adams as her primary care provider. Adams is also the chief medical officer for La Clinica.

La Clinica’s Wellness Center houses primary care, mental health counseling and wellness services like movement and nutrition classes under one roof. Being able to call the Wellness Center her medical home has been “massively” life changing for Fitch.

“I can literally say this place has kept me alive. It really has,” she says.

Kim Oveson, integrated behavioral health coordinator at La Clinica, says the integrated team approach starts from the very first visit with a patient, if needed. “The medical provider will ask the patient’s permission to introduce them to a team member who can help,” she says.

Fitch has welcomed this approach, and in addition to regular visits with Dr. Adams, Fitch also sees a licensed clinical social worker and a wellness coach. “They work really hard at helping me stay out of the hospital,” she says.

Fitch credits La Clinica with the way they addressed her seizures, which she has suffered from for much of her adult life. Jackson Care Connect covered seizure studies, and the team at La Clinica discovered a psychogenic component to her seizures. Fitch credits their honest, caring approach with helping her address them. The tools she learned, as well as the quality of care she is receiving, helped her decrease the number of seizures from 40-50 seizures a day to about 5 a week.

“It’s kind of a collaboration that gets me involved. I have stakes in this. It’s my life. It’s my health. I should have a stake in it,” Fitch says.

With multiple care providers involved, open communication is key. Oveson says the design of the La Clinica offices allows for plenty of face-to-face conversation between providers, which, along with chart notes and secure emails, helps ensure the whole team is up to date on a patient’s progress.

“When a group conversation is needed, the medical provider and behaviorist might meet with the patient together,” says Oveson. “That happens quite frequently.”

In addition to physical health and counseling visits, Fitch has taken advantage of La Clinica’s classes in yoga, mindfulness, nutrition and stress release and says the approach “has given me a way to think about health in a different way.”

Through the nutrition classes, Fitch has discovered ways to eat better and reduce inflammation, and she is now able to walk without pain for the first time in years. She has also lost 50 pounds. Her blood sugar, blood pressure and cholesterol numbers have all improved. 

“So, the goal for everybody is overall general health, but [also] to get to the point where you can manage whatever chronic issues you have,” she says.

Through the wellness classes, Fitch has discovered mindfulness as a means of coping with pain, depression and anxiety.

She says, “I’m actually getting to where I can use specific tools that I’ve learned…I can work through it more from a behavioral standpoint.”

Another important piece of the puzzle is having a diagnosis of post-traumatic stress disorder. Fitch says that diagnosis gave her a new perspective on her health.

“It feels less like I’m the crazy person…it's more like your life experiences are what has opened you up to this,” she says.

Through the improvements she has made over the past couple of years, Fitch has also learned, with the help of her team, that she is a survivor.

“I had gotten to the point before I started coming here of… I didn’t think I could do that anymore. I had lost hope. I had lost energy. I had lost everything. And now I have the energy to work on it. I have tools to work on it.” Fitch says.

“I am grateful that OHP exists. I am grateful that Jackson Care Connect and CareOregon put it together in the way that they do.”