Kids can go from their dentist appointment to their doctor’s appointment and then to therapy – all under one roof. The Children’s Center, in eastern Columbia, will also provide limited eye care and psychiatric services.
The integrated health care model “reduces depressive symptoms, improves access to services, improves the quality of care” and “reduces overall health care costs,” according to the American Psychological Association.
Karen Cade, vice president of business services for Compass Health’s central region, said the organization is exploring how to best serve Missouri residents. Compass Health serves 42 counties with eight locations in Columbia, nine with the new center.
Cade also serves on the health department’s steering committee, which conducts community health assessments and interviews with Missouri residents to decide which services are most needed in the cities they serve. Compass Health uses these health assessments along with other types of surveys to decide how best to help Missourians.
Compass Health is trying to make pediatric health care easier and more accessible for people with children, Cade said.
“I think back to when I had kids, and I think it would have been great as a working parent to have one location that met all of those needs,” said Cade. “I just felt like it would have made my life a little bit easier.”
Walk-in services will also be available.
To celebrate the new children’s center, Compass Health is inviting the community to visit the facility and enjoy bouncy castles, a petting zoo, a Second Chance pet adoption event, food trucks and face painting, from 3-6 p.m. on June 22 in the new center, Portlandstraat 200.
Integrated care model
At the heart of the integrated care model is the collaboration between healthcare providers and patients and their families. Providers can include a general pediatrician, dentist, behavioral health consultant, and others.
Sujatha Sivaraman is one of four board-certified pediatric dentists within 50 miles of Columbia and Compass Health’s director of pediatric dentistry. She started with the organization as a pediatric dentist with only one chair for checkups and procedures. It quickly became two seats, then 10 seats, and now the Keene Street location stands at 20 seats.
“Integrating medical, dental and behavioral (health care) is so incredibly important because we so often separate medical and dental care. And it’s all part of the whole-body treatment.”
Dr. Jacqueline Miller, Missouri dental director
Her role is to ensure that the quality of oral care remains high for all patients. One way to do that is to marry different forms of health care.
“Integrating medical, dental and behavioral (health care) is so incredibly important because we so often separate medical and dental care. And it’s all part of whole-body treatment,” said Jacqueline Miller, Missouri dental director.
Miller also said regular dental exams from age 1 give dentists the opportunity to look for indicators of future health problems, not just dental problems.
Michaela Muehlbach, Compass Health vice president of outpatient and psychological services specializing in integrated health care for her doctorate.
“Integration is literally my favorite thing to do in my role,” Muehlbach said. “It’s the magic that makes people better faster and longer. And between illnesses, they have longer periods of health and well-being. It is a model that really benefits everyone.”
Muehlbach also said that integrated care leads to greater patient and staff satisfaction and reduces burnout.
Some Compass Health locations have already implemented the integrated model to varying degrees.
Location Broadway East
Nancy Howe is one of the Central Region Medical Directors and the National Director of Pediatrics at Compass Health. Howe spends most of her time with patients as a general pediatrician at the Broadway East location. She also acts as the medical liaison for refugee medicine in Columbia, meaning she sees and cares for refugee children living in Columbia.
In her daily appointments, she works with a behavioral health consultant who accompanies her in exam rooms and evaluates behavioral health needs, while Howe focuses on medical health.
Muehlbach said it will take some effort to transition to the fully collaborative environment that Compass Health is developing, but it will be worth it in the end.
“It’s literally like this seamless dance that everyone does when a patient arrives in a scene,” Muehlbach said.
At the new location, Howe will be just a hallway away from her patients’ entire healthcare team, meaning they can discuss concerns together and find comprehensive solutions.
A typical pediatric center appointment might look something like this: A child comes in and sees their doctor, who leaves the exam room to give the behavioral health consultant an update on the child’s well-being. The behavioral health consultant will then go in and have a conversation with the child and possibly suggest some behavioral health interventions.
The content of the conversation would be shared with the doctor and added to the patient card for others on the care team to access.
For example, if a child is struggling with dental problems, which may be the result of avoiding or dreading dental appointments, a behavioral therapist can step in to provide emotional and psychological support to help the child get the dental care they need.
Such counselors can also help make appointments more comfortable for people with developmental disabilities.
“Behavioral health literally affects everything,” Muehlbach said. “We have a duty to provide whole person care to everyone.”
Preventive care and accessibility
In 1954, preventive medicine was recognized as a specialty in the US. It remains a work in progress, in part due to inaccessibility.
Miller identified preventive measures and prevention education as areas of focus for years to come. She said tooth decay is a completely preventable disease that “causes more than 51 million school hours to be lost each year.”
Miller said she hopes to expand the Preventive Services Program, which sends dentists and dental hygienists to schools to work with nurses and screen children for dental problems. They also offer fluoride varnish, which can prevent cavities in primary and permanent teeth.
She said tooth decay is a completely preventable disease that “causes more than 51 million school hours to be lost each year.”
The Children’s Center will become a Federally Qualified Health Center, meaning it will receive government funding to help people get the care they need. Compass Health also receives funding from Boone County Children’s Services Fund and The Heart of Missouri United Way for the counseling they provide in schools.
Because applications are often long and time-consuming, Compass Health also has employees available to help people apply for supplementary benefits. This includes, but is not limited to, Medicaid, food aid, and rent aid.
Compass Health locations, including the Future Children’s Center, accept Medicaid, some private insurance, and self-payment. There is also a sliding fee program. According to Compass Health’s website, the “sliding fee program aims to reduce barriers to accessing health services by providing outpatient services at a discounted rate to those who qualify.”
The sliding fee is determined by real people sitting down with interested people to discuss payment options.
“If you can reach us, we can help,” Howe said.
On-site residency program
According to Cade, having integrated pediatric services is “something unique.” In addition to the Children’s Center with a pediatric dentist, pediatricians, and at least one behavioral health consultant specializing in pediatrics, it will be a venue for a pediatric dentistry residency program.
First and second year residents will provide services and learn at the Children’s Center. The new location will be a residence for eight dental residents who now work at Keene’s pediatrics location. As soon as it opens, they move to the children’s center. The number of therapy and medical residences varies.
The new children’s center will occupy the top floor of 200 Portland St. McCambridge Center, a treatment center for women for substance abuse disorders, on the ground floor.
Since 1978, McCambridge has helped women in recovery, especially pregnant women and mothers, address behavioral health needs and access to community resources for themselves and their children.
The McCambridge program also invites women to live with their children on site, allowing children to avoid foster care while their parent sobers up.
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