Starting June 5, Compass Health Network’s Children’s Center will open its doors to mid-Missourians.
Children will be able to go from their dental appointment to their doctor’s appointment and then to therapy — all under one roof. The Children’s Center, in eastern Columbia, will also offer limited vision care and psychiatric services.
The integrated health care model “reduces depressive symptoms, enhances access to services, improves quality of care” and “lowers overall health care costs,” according to the American Psychological Association.
Karen Cade, vice president of corporate services for Compass Health’s central region, said the organization researches how to best serve Missourians. Compass Health serves 42 counties with eight locations in Columbia, nine with the new center.
Cade is also a part of the Health Department’s steering committee, which produces community health assessments and holds conversations with Missourians to decide what services are most needed in the cities they serve. Compass Health uses these health assessments along with other types of surveys to decide how to best help Missourians.
Compass Health is seeking to make pediatric health care more convenient and accessible for people with children, Cade said.
“I think back to the days when I had children, and I think that it would have been great as a working parent to have one location that served all of those needs,” Cade said. “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 invites the community to tour the facility and enjoy bounce houses, a petting zoo, a Second Chance pet adoption event, food trucks and face painting, from 3 to 6 p.m. June 22 at the new center, 200 Portland St.
Integrated health care model
At the core of the integrated health care model is collaboration among health care 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 off at the organization as a pediatric dentist with just one chair for checkups and procedures. It quickly became two chairs, then 10 chairs, and now the Keene Street location is at 20 chairs.
Her role is to make sure the quality of oral health care remains high for all patients. One way to do that is by marrying different forms of health care.
“Integrating medical, dental and behavioral (health care) is so incredibly important because so many times, we separate medical and dental care out. And it’s all part of treating the entire body,” said Jacqueline Miller, Missouri state dental director.
Miller also said regular dental exams starting at age 1 give dentists the opportunity to look for indicators of future health problems, not only dental problems.
Michaela Muehlbach, Compass Health vice president of outpatient and psychological services, specialized in integrated health care for her doctorate degree.
“Integration is literally my favorite thing to do in my role,” Muehlbach said. “It is the magic that gets people better faster, better longer. And they have longer periods of health and wellness in between illness. It is a model that is truly beneficial for everybody.”
Muehlbach also said integrated care leads to increased patient and staff satisfaction and decreases burnout.
Some Compass Health locations have already implemented the integrated model to varying degrees.
Broadway East location
Nancy Howe is one of the central region medical directors and the statewide 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 Columbia medical contact for refugee medicine, which means she sees and takes care of refugee children living in Columbia.
In her daily appointments, she works with a behavioral health consultant who joins her in exam rooms and evaluates behavioral health needs while Howe focuses on medical health.
Muehlbach said it will take some effort to switch to the fully collaborative environment Compass Health is developing, but it will be worth it in the end.
“It’s literally like this seamless dance that everyone is doing when a patient arrives in a scene,” Muehlbach said.
In the new location, Howe will be just a hallway away from her patients’ complete health care team, which means they can address concerns together and find comprehensive solutions.
A typical appointment at the Children’s Center might go something like this: A child comes in and sees their medical doctor, who steps out of the examination room to give the behavioral health consultant an update on the child’s wellness. The behavioral health consultant will then go in and have a discussion with the child and possibly suggest some behavioral health interventions.
The contents of the conversation would be shared with the doctor and added to the patient’s chart for others in the care team to consult.
For example, if a child is struggling with dental issues — which may be a result of avoiding or fearing dental appointments — a behavioral health consultant could step in to offer emotional and psychological support to help get the child the dental care they need.
Such consultants can also help make appointments more comfortable for those with developmental disabilities.
“Behavioral health literally impacts everything,” Muehlbach said. “We have an obligation to provide whole person care to everybody.”
Preventive care and accessibility
In 1954, preventive medicine became recognized as a specialty in the U.S. It remains a work in progress partially due to inaccessibility.
Miller identified preventive measures and education on preventive measures as focuses for the next few years. She said tooth decay is a completely preventable disease that “causes over 51 million school hours annually to be lost.”
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 issues. They also provide fluoride varnish, which can prevent cavities in primary and permanent teeth.
The Children’s Center will be a Federally Qualified Health Center, which means it will receive government funding to help people get the care they need. Compass Health also gets money 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 lengthy and time-consuming, Compass Health also has staff available to help people apply for additional benefits. This includes but isn’t limited to Medicaid, food assistance and rent assistance.
Compass Health locations including the future Children’s Center accept Medicaid, some private insurance and self pay. There is also a sliding fee program. According to Compass Health’s website, the “sliding fee program is designed to reduce barriers to accessing health services by offering outpatient services at a discounted fee to those who qualify.”
The sliding fee is decided by real people who sit down with interested folks to discuss payment options.
“If you can get to us, we can help you,” Howe said.
On-site residency program
According to Cade, having integrated pediatric services is “a unique thing.” In addition to the Children’s Center having a pediatric dentist, pediatricians and at least one behavioral health consultant specializing in pediatrics, it will be a site 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 residency site for eight dental residents who work now at the Keene pediatrics location. They will move to the Children’s Center once it opens. The number of therapy and medical residency spots varies.
The new Children’s Center will occupy the upper level at 200 Portland St. McCambridge Center, a women’s treatment center for substance abuse disorders, will be on the lower level.
Since 1978, McCambridge has helped women in recovery, particularly pregnant women and mothers, address behavioral health needs and access community resources for themselves and their children.
The program at McCambridge also invites women to live on-site with their children, allowing children to avoid foster care while their parent gets sober.