CenterPiece December 2013
Graduate Medical Education Program a win-win Residents like Center, provide fresh approach, extra hands Learning and teaching have always been integral components of the Center for Family Health. Now that combination has been taken up a notch with the Center’s role in Allegiance Health’s Graduate Medical Education Program. Since July 2013, the Center has been working with numerous residents who are specializing in or rotating through Women’s Health, Family Medicine and Pediatrics. It’s a win-win situation for the Center and the residents. “Our patients have a lot to teach them,” said Dr. Sharon Rouse, pediatrician and primary-care medical director. “They have some interesting medical histories and some challenges.” The Center benefits from its participation in the residency program by having more doctors available to see patients, Dr. Rouse said. At first, they see one patient an hour; by the end of their three-year residencies, they will be seeing a patient every 15 minutes. And, every July, a new crop of residents will come on board, upping the number in the system In addition, some of the residents may decide that Jackson is an interesting place to practice. “Several area physicians will retire in the next 5-10 years,” said Dr. Sangeeta Sinha, Ob/Gyn and the Center’s chief medical officer. “We need to make sure we have physicians to replace them.” In the short run, resident training
Above, Dr. Tuyen Nguyen consults with preceptor, Dr. Promita Roychoudbury, at the Center for Family Health. At top right, Dr. Shawn Lazoff discusses a treatment plan with patient Herman Pollock. At bottom right, three Family Medicine residents take a moment out of their clinical schedule. From left are Dr. Tuyen Nguyen, Dr. Shawn Lazoff and Dr. Dorothy Brown.
improves patient care, Dr. Sinha said, and having about 35 residents move into the community improves the economy. “It makes us better physicians. We read more, think through the process because we have to explain it,” she said. Through the Family Medicine Continuity Clinic, six residents are spending time at the Center. They are assigned patients to see during their three-year residency program, and they are supervised by a group of experienced physicians, called preceptors. Of the Family Medicine residents, usually two or three are at the Center for part of the day. Five are
CFH is supported by ongoing donors, including:
Inside... Thank you for Medicaid expansion page 2 Patient Kym Scouten speaks out page 2 News in Brief page 2
graduates of the Michigan State University Osteopathic Medical School. “Next year, there will be residents here every day, all day,” Dr. Rouse said. In addition, other residents spend a month rotating through Women’s Health, Family Medicine and Pediatrics at the Center. Not all of Allegiance Health’s residents spend time at the Center; some rotate through other practices in Jackson. The residents hail from all parts of the country, not just from Michigan, Dr. Sinha said. Some are second-year residents, after transferring from another program.
A look at CenteringPregnancy group page 3 F our new providers profiled page 3 J ennifer White a committed volunteer page 4
“Our patients have a lot to teach them. They have some interesting medical histories and some challenges.” —Dr. Sharon Rouse, pediatrician and primary-care medical director Looking for more information? Check out our website!
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Executive Staff Molly Kaser President & CEO Sara Benedetto Vice President & COO E. Dale Ernst, Jr. Vice President & CFO Sangeeta Sinha, MD, FACOG Chief Medical Officer Sharon Rouse, DO Primary Care Medical Director Kim Hinkle QI Director
Board of Directors Ted Hilleary Board Chair Allan Padbury DDS, MS, Board Vice-Chair Betty Toll Board Secretary Jeanne Wickens Board Treasurer Jerry Grannan Immediate Past Board Chair Suzi Finch Lee Hampton Lori Heiler Steven Hogwood
R. Dale Moretz William Patterson Brenda Pilgrim Jennifer White
Providers Chiquita Berg, MD Jerry Booth, DDS, MS Mohammad Ghali, MD, MPH Elliot Hardy, DDS Monica Hill, MD Rose Johnson, MD Samira Haque, DDS Sarah Malinda, DDS Edward Mathein, DDS Miraflor Reyes-Ganzon, MD Navira Rizwan, MD Sharon Rouse, DO Promita Roychoudbury, MD Shahzad Shaikh, MD Sangeeta Sinha, MD Gloria Smith, DDS Gregory Trompeter, DDS Dana Virgo, MD James Williams, MD Amy Anglin, FNP Mollie Bailey, PA-C Travis Brown, PA-C Shawn Heiler, PA Patrick Hite, PA Liz Findley, NP Theresa Nestorak, ARPN-MSN Jaquetta Reeves, FNP Bridget Thomas, FNP Margaret Wolfram, PNP
MESSAGE FROM THE CEO
Medicaid expansion to help thousands in Jackson County What a fall! Health care has been a hot topic during this latter half of 2013. The Affordable Care Act, commonly called “Obamacare,” kicked off its insurance-exchange program Oct.1, the same day the 16-day federal government shutdown began. But health-care news in Michigan began earlier than that. On Aug. 27, our state Legislature passed – and, on Sept.16, Gov. Rick Snyder signed into law – expansion of eligibility for Medicaid. This will open the door to health care for approximately 470,000 low-income adults in Michigan. Dubbed Healthy Michigan, this expansion is scheduled to take effect on April 1, 2014. Here in Jackson, best estimates are 7,000 to 9,000 lowincome, uninsured residents will qualify. Adults who fall within 133 percent of the federal poverty level — $15,281 for a single person and $31,321 for a family of four — will be eligible for Medicaid coverage. What will this mean for those who will be newly eligible for Medicaid health-care coverage in
Jackson? Here are some common situations that they will no longer have to face: ■ Husbands and wives splitting their bloodpressure medication because they can’t afford to fill two prescriptions. With Medicaid eligibility, prescriptions are covered. If people take their blood-pressure medication, they can avoid costly and life-threatening events, such as heart attacks and strokes. ■ Adults who cannot work because they need a hip or a knee replaced. Imagine wanting to work and support yourself but being unable to do so due to advanced arthritis or other ills. Without health insurance, very few of us can afford to pay for a joint replacement. ■ Many people have chronic breathing or airway problems and require oxygen. Oxygen tanks and supplies for patients with breathing difficulties is covered by Medicaid; for those who are uninsured, that is an ongoing, high cost.
Kym Scouten looks upon the Center for Family Health as her sanity provider. As the 43-year-old mother of a special-needs daughter, Scouten often is under stress, worrying about her 20-year-old daughter, Shayna Miller. Shayna has spastic quadriplegic cerebral palsy and epilepsy. She uses a wheelchair, has seizures and cannot speak. Scouten and her daughter are patients at the Center. Scouten uses HealthPay, the Center’s sliding-discount scale; Shayna is covered through Medicaid and Children’s Special Health Care. As a child, Shayna saw Dr. Sharon Rouse, pediatrician. Today they both see Dr. Rose Johnson in Family Medicine. Shayna, a student at the Lyle Torrant Center, also sees a host of specialists at the University of Michigan. “Dr. Johnson had to learn Shayna’s issues quickly,” Scouten said, adding that she often speaks with Marie Yarbrough, a triage nurse. “Marie listens to me when I am giddy and happy because Shayna had a great day,” she said, adding that she talks her down when she is over-reacting
to something she read online or saw on television about Shayna’s condition. “She is professional but comforting.” Scouten, who lives in Rives Township with her husband and Shayna, also appreciates that the Center calls back quickly and intercedes with UM to get appointments faster and test results more quickly. “Dr. Johnson and Marie kick things into gear when issues” come up, she said. “Dr. Johnson is my center point.” Her latest concern is that Shayna is experiencing secretions that create a gurgling sound in her throat. It started after a routine surgery at UM to replace a belly pump. At first, normally cheerful Shayna was lethargic. Now she has more energy and is back in school. So far the UM doctors have not come up with a solution to the secretions. “The last five months have been the scariest I have ever been through,” Scouten said. Scouten, who devotes her energies to caring for Shayna, is mindful that she needs to stay healthy for her daughter. She works out and sees
News in Brief
Center for Family Health 505 N. Jackson St. 517/748-5500
Center a patient-centered medical home
Northeast Health Center 1024 Fleming St. 517/787-4361 Teen Health Center at Parkside 2400 Fourth St. 517/788-6812 Center for Family Health at LifeWays 1200 N. West Ave. 517/796-4550
■ Suffering from carpal tunnel limits use of one’s hands and ability to function; this requires seeing a specialist to correct, and without healthcare coverage, it means paying the specialist out of pocket. Being uninsured takes a toll on individuals, families, businesses and – ultimately – on our community. The Healthy Michigan program makes sense. Thank you to Jackson County’s state representatives, Mike Shirkey and Earl Poleski, for their leadership on this issue!
Patient Kym Scouten pleased with care
Jackson High Health Center 544 Wildwood Ave. 517/780-0838
Molly Kaser, President & CEO
The Center for Family Health has been recognized by the National Committee for Quality Assurance as a patient-centered medical home for 2013-16. The NCQA is a private, not-for-profit organization dedicated to “measuring quality and improving health care.” It is a proponent of patientcentered medical homes, which it calls “one of modern health care’s most important innovations.” This model of care focuses on creating a partnership between primary-care providers and their patients. Such a partnership increases health-care quality while lowering costs. Specifically, fragmentation of health care is eliminated because the primary-care provider coordinates care among all of a patient’s doctors. In addition, patients are involved in decisions about their care because their providers explain procedures and care options. “We learned a lot about coordination of care and our follow-up process while working on the submission to NCQA,” said Kimberly Hinkle, quality improvement director at the Center. “So even though it was a lot of work to put together this submission, I am glad we did it
Kym Scouten and her daughter, Shayna Miller, (in picture) are patients at the Center.
Dr. Monica Hill at the Center for her pap smears and mammograms. Scouten, who suffers from post traumatic stress syndrome, also has used the Center’s Behavioral Health services. “Sandra is wonderful. It’s wonderful to go in there,” she said. Thanks to the Center, “at no time do I feel I’m out here alone,” Scouten said.
“The Center for Family Health is a place where patients receive excellent care and now we have the recognition to prove it.” This is the second time the Center for Family Health has been recognized as a patient-centered medical home. In August, the Center earned the designation of Patient Centered Medical Home from Blue Cross Blue Shield of Michigan for 2013-14..
Marketplace helps residents with exchanges
The Health Insurance Marketplace, operated by the Center for Family Health at 407 N. Jackson St., is helping residents maneuver the federal health insurance maze – for free. In addition to answering questions and providing paper applications, lead navigator Dani Carpenter and her staff help people access HealthCare.gov. Carpenter also is making presentations in the community to make residents aware of the ins and outs of the insurance exchanges, mandated by the Affordable Care Act. The Marketplace is open 8 a.m. to 5 p.m. Monday through Friday.
Northwest Community Health Center 6700 Rives Junction Road 517/569-3200
Questions about any of our articles? Just call 517/748-5500 and ask for Molly Kaser.
Centering helps expectant moms focus on learning together One by one, the expectant moms enter the room. After checking in, they join the circle. As more women arrive, the noise level increases with chatting and laughing. They share a bond: All are due in December, and all are receiving their prenatal care through the CenteringPregnancy method at the Center for Family Health. Designed by the non-profit Centering Healthcare of Boston, CenteringPregnancy is a model of group prenatal care with a goal of promoting health, healthy lifestyles and patient participation in health care. The moms in Dr. Sangeeta Sinha’s Centering group have been together for months, meeting for two hours each session. On this Thursday, eight moms and one dad are in attendance. During the gathering time, the women take their own blood-pressure readings, weight and temperature. Each spends a few minutes in the corner with Dr. Sinha, listening to her baby’s heartbeat and asking Dr. Sinha questions. Healthy snacks and drinks are available on the counter. Meanwhile, the women seated in the circle are discussing a wide range of issues from food to methods they have heard can bring on contractions to comfortable sleeping techniques. Pillows, all agree, are the key. One woman laughingly says she sleeps surrounded by pillows, making her feel like, “There she is, the Queen of Sheba.” The group is diverse.Their baby bellies are various sizes, their ages vary, and their experience with pregnancy is divergent; some are first-time moms, others have one or more children at home. Today is session 7 and the discussion begins with Dr. Sinha, asking, “How is everyone doing?” Dr. Sinha, an Ob/Gyn and the Center’s chief medical officer, and Tracina Christiansen, an RN, are the group’s facilitators. Dr. Sinha mentions that Dr. Sharon Rouse, a pediatrician and primary-care medical director at the Center will be stopping by. “I have lots of questions,” one mom says emphatically. The conversation returns to today’s topics – selection of baby health-care providers, breastfeeding, baby supplies, child care, immunizations and circumcision. They are listed on a white board and the women are encouraged to put a check next to the ones they are prepared for. One mom says she is having trouble with Charlie horses and wonders what to do. Dr. Sinha throws the question out to the group: “What do you think? Do you know what to do?” One of the tenets of Centering is that the women are encouraged to offer solutions, advice and experiences; the sharing promotes trust, creating a supportive community for the participants, while disseminating important, useful information to the women. Several suggestions are offered about the leg cramps: Rub the area, stretch, eat bananas, drink water and get more rest. One woman says you can take a potassium pill, but “it’s a horse pill and you’d really get sick on it.”
The women line up to make their check marks on which items they have completed to prepare for their babies. After completing the task, the women return to their conversation circle.
The group turns its attention to the list with the check marks. Several moms have not indicated that they have selected a doctor for their babies. “Does anyone know how to find a doctor for baby?” Dr. Sinha asks. Again, the suggestions pour forth: Call your insurance company and ask who’s accepting new patients, check to see what pediatricians are located near your home. “What makes a good baby doctor?” Dr. Sinha interjects. One woman says how the doctor interacts with the baby is the most important criteria. “The doctors are really nice here. As the kids get older, they talk directly to them,” one says. The conversation moves to baby supplies. “What all do you need?” The mom who earlier said she has lots of questions says,“I don’t know how to bathe the baby. I don’t know anything. I’m overwhelmed.” The others quickly reassure her and note where she can get additional information. Bassinets, high chairs, baby tubs, diaper bags and car seats then are dissected, with numerous advice from the moms. On diaper bags: Yes, you need one with a good amount of diapers, an extra change of baby clothes, an extra shirt for mom, a pacifier and toys.
Mindy Shanks checks her blood pressure and takes her temperature.
Above, a woman gets checked in the room’s corner by Dr. Sangeeta Sinha, Ob/Gyn. At left, Dr. Sharon Rouse, pediatrician, answers questions during a Centering group.
About CenteringPregnancy The Center for Family Health implemented it this summer, but traditional prenatal care is still available. There are four Centering groups now. It encourages self-care, creates a support group and provides for more learning time. It strives to improve the well-being of pregnant women, improving their self image, increasing their self-care skills, and decreasing infant mortality and maternal morbidity. It also promotes the healthy growth and development of the fetus, reduces family violence, promotes family development and reduces unintended pregnancies. Research also shows an increase in breastfeeding among women in Centering groups, better attendance at the prenatal visits and more participating in post-partum visits.
Christa Moreno weighs herself during a Centering session.
On car seats: Call 211 and you can get a free one. When Dr. Rouse joins the group, she answers questions, including how often to bathe the baby (every few days), how to care for circumcision (Vaseline), burping (recommended after the baby drinks two or three ounces), and crib bumper pads (not recommended). She also addresses the schedule for pediatric visits and vaccinations, among a score of other topics. Dr. Rouse leaves, and the free-ranging conversation and questions continue while the women visit the nurse individually for a TDP shot. The group winds down, with Dr. Sinha reminding the women of their next meeting. As the women prepare to leave, the chatting and the laughter slow to a trickle – until the next Centering session.
Four employees added to Center’s professional staff Several new providers recently joined the Center for Family Health. Dr. Promita Roychoudbury, a board-certified family-medicine physician, is the associate director of the Center’s Family Medicine Continuity Clinic. She has a MBBS Bachelor’s and Medical Degree from Calcutta University and Calcutta National Medical College and Hospital. She completed her residency at St. Clare’s Hospital Family Medicine Residency in Schenectady, N.Y. Dr. Roychoudbury’s work experience includes positions as a teaching faculty member at Wayne State University Department of Family Medicine and University Family Physicians, and teaching faculty and family medicine attending physician with Providence Hospital Family Medicine Residence Program
Dr. Promita Roychoudbury, MD
Shawn Heiler, PA
At the Providence program, residents twice awarded her the Joseph A. Schwartzberg Award for Teaching Excellence in Family Medicine. Physician Assistant Shawn Heiler is the primarycare provider at the Northwest Community Health Center, which opened this fall at R.W. Kidder Middle School. He has a bachelor’s in Sports Medicine Athletic
Dr. Samira Haque, DDS Deborah Harshbarger
Training from Eastern Michigan University and a master’s in Physician Assistant Studies from Wayne State University. His previous positions included work in urgent care and emergency departments. Heiler is certified by the American Academy of Physician Assistants and Michigan Academy of Physician Assistants, and the National Athletic
Trainers Association Board of Certification and member of the Golden Key National Honors Society. Dr. Samira Haque, DDS, joined the Center’s dental staff. She has a bachelor’s degree granted with distinction from the University of Michigan in anthropology-zoology and classical anthropology. Her dental degree is from UM School of Dentistry. After completing her residency at Cherry Street Health Services in Grand Rapids, Dr. Haque worked at UM Emergency and Oral Surgery Clinic. Her most recent job was at the Family Health Center of Battle Creek. Deborah Harshbarger is a part-time pharmacist. She earned her bachelor’s in pharmacy from Ferris State University; she has worked as a pharmacist for years.
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505 N. Jackson Street Jackson, MI 49201
Jennifer White serves Center in multitude of ways Jennifer White is a woman who has taken multi-tasking to a new level. She grew up in Jackson, graduating from Jackson High School in 1995 and leaving a few records there as a sprinter. White went to Eastern Michigan University, graduated with a bachelor’s in Technology Management, and then worked in Lansing and Kalamazoo before returning to Jackson to be close to family in 2003. White, 36, is a single mother of two children – a 2-year-old daughter, Kendall, and an 8-year-old son Briston. She works full time for Jackson County as the mapping specialist, a job that dovetails with her degree. As an employee of the Equalization Department, she maintains the parcel boundary maps for all 19 townships within Jackson County. White is also involved in Briston’s school, Paragon Charter Academy. “They really encourage parent involvement. I love that.” She lives in Jackson with her 75-year-old grandmother, helping her out. She also is a member of Dominion Ministries International Church, is on the County Wellness Team and is a union steward for AFSCME Local 2098. She is working on her master’s degree from Eastern Michigan University in Technology Studies, continuing the Technology Management concentration. Now, add lots of volunteering to that busy schedule. When her son was in Early Head Start, she served on the Community Action Agency’s Policy Council and currently serves on its Jackson Advisory Council and Board of Directors. It was through CAA that she met Molly Kaser, president & CEO of the Center for Family Health. “She (Kaser) said I might be a good fit for this and that I shared some of the same interests,” White said, referring to the mission of the Center and explaining how she was recruited for the CFH Quality Improvement Committee. In early 2013, she joined the Center’s Board of Directors. White was familiar with the Center long before she met Kaser.
“When I moved back to Jackson, I was looking for a doctor for myself,” she said, adding that she had health insurance through the County. “The Women’s Health services offered by the Center had all of the qualities that I was looking for – particularly a female Ob/Gyn. “I have always been pleased with the care that I have received. As a working parent, I appreciate their evening hours.” Jennifer and her children receive their health care at the Center, and now her grandmother is a patient there. “People don’t realize that the Center for Family Health is a community center,” she said. “It’s a great resource, they have a knowledgeable staff, and provide great services for myself and my family. I have always felt respected.”
White is such a believer in the Center that she is going to give back in a unique way: She plans to complete her master’s degree capstone project at the Center, examining its past, present and future model combining technology and human resources. The capstone will examine some of the trends that have directed the path from where the Center started to where it may be headed. “The capstone is just a snapshot of my educational journey, and it is my privilege to highlight the Center during my experience,” White said. Such an analysis is priceless, and it is another way Jennifer White is making a difference in Jackson.
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