Blue Cross Grant Leaves Lasting Effects in GR Safety Net Clinics
A pair of safety net health clinics in Grand Rapids tested out a new approach to helping patients address underlying behavioral health care needs with a Blue Cross Blue Shield of Michigan Foundation grant three years ago.
Even though the grant has ended, its impacts are still being felt today in the clinics’ daily operations.
A $96,250 grant in 2016 funded a social worker that split their time between two Grand Rapids nonprofit clinics: Exalta Health, formerly Health Intervention Services, and Catherine’s Health Center.
The grant was a part of a larger initiative to help Michigan’s safety net providers expand their treatment options, funded by the Blue Cross Blue Shield of Michigan Foundation, Blue Cross Blue Shield of Michigan, the Ethel and James Flinn Foundation and the Michigan Department of Health and Human Services.
Both Exalta and Catherine’s Health provide primary care services to those who are underinsured, uninsured or can’t otherwise afford health care. But providers there noticed that many patients were being diagnosed with behavioral health issues, including anxiety, depression and substance use disorder.
The addition of the grant-funded social worker changed the way the clinics approached behavioral health.
“We went from behavioral health really being something we tried to address piecemeal when a crisis arose to it being something that’s really addressed as a part of the whole person care that we give,” said Karen Kaashoek, executive director of Catherine’s Health Center.
Instead of having a primary care doctor talk to patients about their depression or anxiety and referring them out to another clinic, the doctor could call a social worker into the room to talk to the patient during the same appointment. It’s called integrated care.
“The social worker spends more time in the exam room than in their office,” said Bill Paxton, president of Exalta Health. “It’s been really remarkable the change that has occurred for providers and the total patient care experience.”
Depression and anxiety scores in patients have been changing for the better, Paxton said. But the biggest benefit has come from in the doctors’ behavior in the exam room with patients. Now, doctors are asking for social workers to be a part of certain appointments, when necessary – a major shift that is helping to normalize behavioral health for patients, Paxton said.
“People will listen to their primary care doctor,” Paxton said. “It kind of normalizes it (behavioral health) as a health issue rather than stigmatizes it.”
The grant has made a long-lasting impact in both clinics. Exalta and Catherine’s Health decided to hire a full-time social worker after the 18-month-long Blue Cross Blue Shield of Michigan Foundation grant concluded to continue the integrated behavioral health practice. And because Exalta serves a large population of Hispanic residents, that position is bi-lingual. Exalta also hired a part-time bilingual social worker to have a social worker present the entire time the clinic is open.
While each clinic serves a different neighborhood in Grand Rapids – Exalta is in Burton Heights and Catherine’s Health is in Creston – both clinics serve uninsured, unemployed and low-income residents in the city.
Sharing a social worker – as well as a medical director – between Exalta and Catherine’s Health has made the safety net clinics find ways to better work together and not as competitors, Paxton said.
“Each time we’ve worked together – even though we have somewhat different missions, different boards – we keep finding more and more things that are in common,” Kaashoek said. “The resources in the community have to be leveraged in order to provide as much as we can, and at times the best stewardship is to do things together.”
Blue Cross’ commitment to West Michigan clinics continues. Catherine’s Health Center will receive a $50,000 grant on Monday, Nov. 11 courtesy of the Blue Cross Blue Shield of Michigan Foundation. This funding will help improve access to care by integrating a community health worker as part of the clinic’s multidisciplinary care team.
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