Hennepin Health Newsletter: October 2014


October 2014



Ross Owen
Deputy Director

Julie Bluhm
Clinical Program Manager

Lori Imsdahl
Operations Coordinator


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Hennepin Health is an innovative health care delivery program that was launched in January 2012.

The program is a collaboration between Hennepin County Medical Center (HCMC), NorthPoint Health and Wellness Center (NorthPoint), Metropolitan Health Plan (MHP), and Human Services and Public Health Department (HSPHD) of Hennepin County.

Hennepin Health members receive care from a multidisciplinary care coordination team. Other innovative features include a common electronic health record, and tiered care that is based upon a member’s identified needs.

Find eligibility and enrollment information at the MNsure website.


For more information about Hennepin Health visit www.hennepin.us/ healthcare

Hennepin Health’s Crisis Care Diversion

Reducing unnecessary crisis care (e.g., emergency department, inpatient hospitalization) is a Hennepin Health goal, and we have many initiatives to support it.

Hennepin Health’s ED In Reach Program with RESOURCE Chemical and Mental Health is one such initiative. TJ Redig, M.S., from RESOURCE, provides up to 16 weeks of targeted case management to Hennepin Health members who have visited the Hennepin County Medical Center Emergency Department or Acute Psychiatric Services three or more times in the past four months.


Another initiative involves embedding care coordinators in key locations. For instance, Hennepin County Medical Center hired five outreach community health workers via a 2014 Hennepin Health reinvestment initiative. Two of them were placed in the Emergency Department and Urgent Care. Hennepin County Medical Center also hired a social worker for its Acute Psychiatric Services

These care coordinators connect members to primary care and to other parts of the health care system, including social services.

Crisis Care Diversion Staff Spotlights:

TJ Redig, M.S., from RESOURCE Chemical and Mental Health


The beginning:

When Redig started working with Hennepin Health’s ED In Reach program in 2014, he got a crash course in homelessness from Joseph Desenclos, street outreach program manager at St. Stephen's Human Services. Desenclos took Redig on a tour of the metro’s homeless encampments, and Redig said it bowled him over; he was shocked by the number of camps and people who live “off the radar, just outside of view.”

Things he sees:

Behavioral health concerns, chemical dependency, domestic abuse, criminal history, and generational poverty (Redig met four generations of a family living under the I-394 bridge)

What works:

It’s important to talk to clients “like a ‘normal’ person,” Redig said. He explained that many people he works with held high-income jobs before falling on “bad times.” There’s the 46-year-old female veteran and the 43-year-old man who was a radio broadcaster. Another client, who has obsessive compulsive disorder, earned six figures as a computer programmer before his symptoms became too debilitating. Later, he had to foreclose his condo and was homeless when Redig met him. 

Above all, Redig said, it’s important to meet clients “where they’re at,” (i.e., work with them even if they’re not yet sober).  

Cerenity Petracek, MSW, CPRP, from Hennepin County Medical Center’s Acute Psychiatric Services


The beginning:

Petracek was hired via a 2014 Hennepin Health reinvestment initiative. She works closely with Hennepin Health, referring Acute Psychiatric Services clients to Redig if they meet ED In Reach eligibility criteria.

Things she sees:

Homelessness. “Housing is huge,” Petracek said, and a lack of it poses particular challenges for people with behavioral health concerns. It’s difficult for people to remain on a medication regiment when they’re homeless, Petrack said. One reason is that homelessness becomes a person’s “main stressor and number one priority.” Even though people may try to remain on a medication regiment while homeless, “it’s usually not their top priority.” In addition, homeless people find it difficult to store medication, and they often report that their medication gets stolen. That is why “safe, secure shelter where one can lock their door is a basic need for people, just like food and clothing,” Petracek said.

What works:

The ability to spend extra time with patients is key, Petracek said, and so is the “team approach.” She credits her success to working with an array of health care professionals including nurses, doctors, residents, and mental health workers. Two of these individuals are Amber Morgan, R.N., an R.N. clinical care coordinator from the Hennepin County Mental Health Center, and Redig.

DeeAnna Engebretson, community health worker from Hennepin County Medical Center‘s Emergency Department 


The beginning:

Engebretson was hired via a 2014 Hennepin Health reinvestment initiative along with four other outreach community health workers. A focus for Engebretson, who is embedded in Hennepin County Medical Center’s Emergency Department, are the patients who come with dental pain. Engebretson estimates that she works with five to 10 of them per day. She connects these patients to dental services at Hennepin County Medical Center’s Dental and Oral Surgery Clinic, NorthPoint Health and Wellness Center, and community dental providers. All Hennepin Health members have dental coverage, which is provided by Delta Dental.

Things she sees:

Many people come to the emergency department not because they are in a crisis, but because they can’t or don’t know how to navigate the health care system, Engebretson said. As a result, her job involves educating people about the system and empowering them to use it appropriately.

What works:

“Building trust.” If patients are able to build trust with just one care coordinator, then they are more likely to trust other providers who the care coordinator refers them to, Engebretson said.


Hennepin Health’s crisis care diversion staff have built “a good relationship over the months,” said Char Elioff (above), a social worker in Hennepin County Medical Center’s Emergency Department. Redig, Petracek, Engebretson, Elioff, and Denita Ngwu (a community health worker embedded in Hennepin County’s Dental and Oral Surgery Clinic) meet every other week to discuss patients that they are seeing simultaneously and to streamline their processes.

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Member Spotlight: Jerome

In February 2014, Jerome boarded a bus in Milwaukee and headed to Minneapolis.

Jerome has a criminal history and, on the day he left Milwaukee, he was also addicted to alcohol, cocaine, and marijuana. Jerome had decided to leave his hometown of 50 years in order to “make a change.” A local church paid for his ticket.

The father of three adult daughters arrived in the Twin Cities with two dollars in his pocket. After he bought food, he asked people on the street where he could find shelter. They directed him to the Salvation Army’s Harbor Light Center

Over the next months, Jerome's life got worse before it got better.


A few days after he arrived in Minneapolis, Jerome enrolled in an outpatient treatment program at the Recovery Resource Center. But the temptation to drink alcohol and take drugs was strong, and he continued to use them between classes. After twice confessing to using alcohol and cocaine, the staff told him that the program was not a fit, and suggested an inpatient setting.

After he left the Recovery Resource Center, Jerome said he “started thinking crazy.” He slept on park benches, and sometimes at St. Stephen’s Human Services or Harbor Light. He frequently felt suicidal, and in April 2014, he showed up at Hennepin County Medical Center’s Acute Psychiatric Services for the first time. That day, he met Cerenity Petracek, MSW, CPRP, and she gave him chemical dependency assessment information. 

That summer, Jerome also visited Hennepin County Medical Center’s Emergency Department for foot pain. He was surprised to learn that a bone in his foot was broken; he guessed that it broke from an injury he'd sustained months earlier. However, due to the drugs and alcohol in his system, it had taken a while to feel any pain.

Turning Point

June 29, 2014, was a turning point. That day, Jerome arrived at Acute Psychiatric Services in the early morning. He was under the influence of drugs and alcohol, and the staff let him sleep off the side effects. Later, Jerome admitted to Petracek that he was feeling suicidal, was hearing voices, and had slept on a bus the previous night.

TJ Redig, M.S., from RESOURCE Chemical and Mental Health, came to Acute Psychiatric Services, and he and Petracek worked together to get Jerome placed at the Salvation Army’s Adult Rehabilitation Center. Once he was admitted, Redig dropped Jerome off. For the next 30 days (phase one) of the program, Jerome was not allowed to leave the center.

The Adult Rehabilitation Center’s mission is to provide “spiritual, social and emotional assistance for men who have lost the ability to cope with their problems and provide for themselves.” A mainstay of the six-month, five-phase program is work therapy. From 7:30 a.m. to 4 p.m. each day, Jerome unloads trucks and sorts donations. As of October, he’s in phase two. After phase five, some clients get job offers and can stay at the Adult Rehabilitation Center for six more months, as long as they pay rent.

“When I’m in my program, I always think of Cerenity and TJ. I know I can’t let them down,” Jerome said.

A few weeks ago, Petracek  saw Jerome at Acute Psychiatric Services. He had come to thank her.

“When I walked out [into the waiting room] I didn’t even recognize him,” she said. “He was groomed, had a haircut, and was wearing nice clothes.”

That day, Jerome also told Petracek that he was experiencing tooth pain. In a show of care coordination, she brought him to see Engebretson, a community health worker in Hennepin County Medical Center’s Emergency Department. Engebretson scheduled a dental appointment for Jerome, and the dentists resolved his pain. 

Going forward

The Adult Rehabilitation Center is Jerome’s “ninth or tenth” chemical dependency treatment program. His first was at 21.

Sprinkled between the treatments were incarcerations. “It seemed like every time I relapsed, my addiction got worse,” he said. Still, he refers to his current treatment “as the end of the rainbow” and is making plans for the months ahead: complete treatment; get a job; go back to school; and make amends with his daughters.

Jerome also wants to get back in to motivational speaking. He once worked at Table of the Saints, a Milwaukee-based mentorship program. There he spoke to men about his incarceration and chemical dependency and encouraged them to get their lives on track. He said that motivational speaking helped him remain sober and is looking for a similar opportunity in the Twin Cities.  

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Event Spotlights

Bipartisan Informational Briefing


On September 24, Jennifer DeCubellis, Hennepin County Government's administrator of health, presented about Hennepin Health and other health care reform efforts at a bipartisan informational briefing in Washington D.C.

NorthPoint Farmer's Market


Every other Friday, beginning in May and running through mid-September, Hennepin Health’s partner, Northpoint Health and Wellness Center, works with Second Harvest Heartland to provide free produce to the general public. Items include peaches, bananas, tomatoes, cucumbers, zucchini, and more. On average, more than 300 families are served each week.


Hennepin Health Member Event


On October 21 and 22, Hennepin Health held a member event at the Grain Exchange Building in downtown Minneapolis. Members had the opportunity to meet care coordination staff, schedule a primary care appointment, and get a flu shot.                  


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Trauma Informed Care

In September, Julie Bluhm, LICSW, Hennepin Health clinical program manager, gave a seminar on trauma informed care. Want to learn more? Read this webinar presentation

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Subscribe to the Hennepin Health Newsletter with Your Phone

You can now subscribe to the Hennepin Health newsletter on your phone in two ways:

  • Text HENNEPIN HEALTH to 468311. Every time a newsletter is published, you’ll get a text message with a link to it.


  • If you prefer to receive future newsletters via email, then place your personal email address after HENNEPIN HEALTH (example: HENNEPIN HEALTH lori.imsdahl@hennepin.us) and text it to 468311. You will receive future newsletters via email.

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Recent Press

On September 15, this Health Affairs blog post about safety-net accountable care organizations mentioned Hennepin Health.

On October 6, this Star Tribune article featured Hennepin County Mental Health Center. Staff at the Mental Health Center provide top-notch care to Hennepin Health patients and many others. Read more about Hennepin Health’s involvement with the Mental Health Center.

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