Hennepin Health Newsletter: November 2014

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November 2014


IN THIS ISSUE


CONTACT US

Ross Owen
Deputy Director
612-543-1324

Julie Bluhm
Clinical Program Manager
612-348-8400

Lori Imsdahl
Operations Coordinator
612-543-0055

 

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ABOUT US

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.


MORE INFO

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


Member Spotlight: Jon

Fifty-three-year-old Jon hit rock bottom on Wednesday, February 6, 2013.

That day, Jon was an alcoholic with depression and bipolar disorder who worked and lived out of the side room of a car wash. The owners of the car wash had taken Jon in and were paying him $25 per day under the table.

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Prior to living at the car wash, Jon had been homeless for 13 months. During that time, he’d slept on the streets and at the Salvation Army’s Harbor Light Center. When the car wash owners offered Jon a job and a place to stay, he was grateful and thought they were his friends. Eventually, he realized that they were taking advantage of him. He also realized that he didn’t know where else to go or what else to do.

Feeling hopeless, Jon crafted a plan to commit suicide by hanging himself from a rope under the Hennepin Avenue Bridge.

On February 6, Jon set the wheels of his plan in motion. He left the car wash with a rope. Then he hit several bars in downtown Minneapolis. He ordered one screwdriver after another. “I didn’t want to feel any pain while I was hanging myself,” he explained.

Jon was drinking at a pub on Nicollet Avenue, when he finally felt ready. He left the pub with his rope and began trudging toward the bridge. “Suddenly, it was like a flash,” Jon said. In his head he heard these words: “Don’t do it. Get help.”

Jon returned to the pub and called the Nancy Page Crisis Residence. They sent a cab to pick him up.

Over the next week, Jon experienced horrendous detox symptoms, including intense flashes of heat and cold. The symptoms became so debilitating that the staff sent him to Hennepin County Medical Center. When he was released a few days later, Jon stopped by the same pub on the way back to Nancy Page and drank eight more screwdrivers.

“When I came back intoxicated, the staff chewed me out,” Jon recalls, but that was the turning point. “I’m just killing myself,” he realized. After that, he resolved to “stay put” and let the experts dictate his next step — a 90-day stay at the Huss Center for Recovery.

Like Nancy Page, Huss is owned by People Incorporated. Located at 2120 Park Avenue, in Minneapolis’ Ventura Village neighborhood, the center serves adult men and women with co-occurring chemical dependency and mental illness. The program offers an array of services, including inpatient, intensive outpatient, and continuing care.

Huss was not Jon’s first inpatient chemical dependency treatment — in 1996, he completed a 21-day program in Pine County, Minnesota — but the difference was that the treatment at Huss was tailored to people with co-occurring disorders. “[Before Huss], I didn’t realize the link between chemical dependency and mental illness,” Jon said. In fact, prior to Nancy Page, Jon didn't even know that he had depression and bipolar disorder. Incorporating chemical dependency and mental illness treatment changed everything.  

Mission Lodge   

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Although parts of his past are blurry, Jon can recall dates with startling precision. “I was at Huss from Friday, February 15, 2013 to Thursday, May 16, 2013,” he says, pulling a certificate of completion out of a folder.

It’s a Friday in late October, and Jon is seated in the dining room of Mission Lodge, a residential center in Plymouth for men and women with chronic chemical dependency. The dining room is adorned with Halloween decorations and out the window Medicine Lake is visible through the foliage.

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Jon has lived at Mission Lodge since he graduated from Huss.

“[People Incorporated and Hennepin Health] have got my back every which way,” Jon says. Opening his wallet, he extracts a pile of business cards and spreads them on the table. Etched on the cards are the names of people who’ve contributed to his recovery. They include staff from Nancy Page, Huss, People Incorporated’s Assertive Community Treatment Team, and Hennepin County Medical Center’s Adult Psychiatry Clinic and Downtown Medicine Clinics.

Hennepin Health's care coordination services have helped Jon navigate the health care system and integrate his medical, behavioral health, and social service needs. Destiny Powell, a community health worker at Hennepin County Medical Center, serves as Jon's care coordinator. 

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Clearly, Jon's recovery has been a team effort.   

But it couldn’t have happened without his resolve.

“I’ve made my recovery what it is by getting involved with it and taking it a day at a time,” Jon says.

One thing that’s helped immensely is working out of the Mission Lodge maintenance bay, where he does tasks like mow grass and plow snow. 

Jon leaves the dining room and visits the bay to talk to his supervisor, who is retiring that day. He calls the man a role model and someone who has taught him about perseverence.

After Jon exits the bay, he ambles across the grounds of Mission Lodge, passing a gaggle of geese, a garden, and a gazebo covered in vines.

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Near Medicine Lake, he points out a small boat that he likes to row in his free time.

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“[Mission Lodge] is a stepping stone,” Jon says. After he gets out, he hopes to get his high school diploma, get his driver’s license back, and find a job. He’s also interested in becoming a certified peer specialist, a role that someone at People Incorporated told him to consider.

There’s also the issue of family. Jon has three children — a 20-year-old daughter and two sons, ages 22 and 34 — and he hasn’t seen or spoken to them in a few years. Recently, though, the children reached out via email. They’re proud of him and want to reconnect. Jon is just about ready.

“I think I’ll write them a letter,” he says.

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Article in Health Affairs

Hennepin Health is featured in the November issue of Health Affairs. The 10-page article, “Hennepin Health: A Safety-Net Accountable Care Organization for the Medicaid Population,” was authored by people from Hennepin County Government, Hennepin County Medical Center, NorthPoint Health and Wellness Center, and the Association of American Medical College’s Center for Workforce Studies.

Here’s the abstract.

On November 5, Ross Owen, Hennepin Health deputy director, gave a presentation and fielded questions about this article at the National Press Club in Washington D.C.  

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Provider Spotlight: Joseph Desenclos

In 2010, Joseph Desenclos quit his job in the private sector to become a street outreach worker at St. Stephen’s Human Services. Two years later, he was promoted to street outreach program manager.

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Joseph (left) with Jerry, St. Stephen's volunteer outreach worker

The career change was a long time coming.

“Up until the 1990’s, I believed that if I had certain material things, I’d be happy and successful,” Desenclos said, from his office at Central Lutheran Church. But after years of accruing possessions, he realized that “I hadn’t had joy in my life for a long time.”

One day Desenclos went to a Caribou Coffee in St. Paul to “soul search.” He borrowed a pen from a customer and started scrawling things that might make him happy on a napkin. After six hours, he’d winnowed the list to four. “Get involved in social work” was at the top.

Several months later, Desenclos began working as a homeless advocate with Catholic Charities' Dorothy Day Center. He was employed there from 1999 to 2003.

In October 2010, after seven years back in the private sector, Desenclos realized that he needed to return to social work. He identified the organizations he wanted to work for by walking in off the streets and applying for their services. “I wanted to see first-hand how an organization treated its clients and if they provided accurate referrals,” he explained. From this process, he selected St. Stephens as a potential employer. In his cover letter, Desenclos detailed his philosophy for dealing with people in poverty: “Despite my education and experience, I will never consider myself the expert in anyone’s life because that would be one more hurdle they would have to overcome to achieve self-sufficiency.”

That philosophy — that people intuitively know what is best for them — continues to shape his work.

In October 2014, Desenclos and Renee Nyman, St. Stephen’s lead outreach street worker, gave Hennepin Health care coordinators a training on street outreach, where they offered tips for navigating the job safely and effectively.

Desenclos advised street outreach workers to be conscious of “power dynamics” in their encounters, explaining that when he interacts with people on the streets he positions his body at or lower than his clients’ and sits or crouches beside them, not in front. His goal in every encounter is to “get the person to talk more than me.” It’s also important to stay up-to-date on available community resources, so that when someone reveals their needs and motivations, the street outreach worker can readily connect them to ones that are most appropriate.

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Breanna, St. Stephen's outreach worker

Another point he raised was the importance of social connectedness. “We can place people in housing, but we need to do a better job of integrating people into their community,” he said. A big part of this integration is identifying a client’s purpose. “I’ve learned that everyone wants a purpose in life and that most people had a purpose before they started living on the streets,” he said. Therefore, Desenclos’ job “is literally finding out what are their hobbies, what did they like to do in their free time before they were homeless.”

He mentioned a 55-year-old woman he worked with who would panhandle and crochet scarves on Nicollet Mall to pass the time. On one of his outreach shifts, Desenclos caught her crying. She explained that someone had stolen her backpack full of crocheting materials. 

Desenclos realized that, in addition to locating the client stable housing, it was important to consider her hobbies. He located a community member who was willing to donate crocheting materials. Then he found a community center in the neighborhood that the client was moving into that offered a sewing, knitting, and crocheting group for seniors. The woman’s health improved as a result of her involvement there. “She ended up developing friends with similar interests,” he said.

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A homeless client's artwork hangs on the walls of Central Lutheran Church

Finally, Desenclos believes that observation and flexibility are integral to his work. “Really good outreach is just being in an area and looking around without an agenda,” he explained.

St. Stephen’s currently has 130 people on its “unsheltered list” and is collaborating with Hennepin County on a plan to end homelessness by 2025. Desenclos believes the goal is feasible, and is excited by the rollout of a “coordinated assessment” that street outreach workers will administer to clients upon intake to ascertain their needs and motivations and to determine what types of services are appropriate for them.

Going forward, many of Desenclos’ ideas for how to improve street outreach come from seeing how it’s done in other parts of the country. While in Arizona in January 2014, he visited the Central Area Shelter System and brought back ideas about how to integrate paramedics into Minneapolis shelters in order to reduce ambulance calls and triage clients for health care services. Similarly, while in New Orleans for the 2014 National Health Care for the Homeless Conference, Desenclos roved the street near his hotel to talk to individuals experiencing homelessness.

“I learn more on the streets,” he said.

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Hennepin Health Reinvestment Initiatives

In October, Hennepin Health received 20 reinvestment initiative proposals from across its partnership. Hennepin Health’s Operations Committee spent much of October and November evaluating these proposals to determine which to fund. We’re now is the process of presenting our recommendations to the Hennepin Health Finance Committee and the Hennepin Health Policy Steering Committee (including the county commissioners). Pending their approval, we expect to notify sponsors of our decisions in early December. We’ll announce the list of funded proposals in the January newsletter.

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Trauma Informed Care

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On November 13, Hennepin Health held a care coordination training on Trauma Informed Care (our second training on this subject). To learn more about this subject, read this webinar presentation

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Adult Mental Health Local Advisory Council

Hennepin County is looking for volunteers to serve on its Adult Mental Health Local Advisory Council (LAC) in 2015. Hennepin Health members, family members, providers, and others are encouraged to apply. Applications are due by December 31, 2014. Details are listed here. Questions? Contact Martin Marty at martin.marty@hennepin.us

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